6,570 results
Search Results
352. Birth history, age structure, and post World War II fertility in ten developed countries: an exploratory empirical analysis.
- Author
-
Artzrouni MA and Easterlin RA
- Subjects
- Age Factors, Cohort Studies, Europe, Population, Population Characteristics, Population Dynamics, Research, Scandinavian and Nordic Countries, Statistics as Topic, Age Distribution, Birth Rate, Demography, Developed Countries, Economics, Fertility, Forecasting, Fourier Analysis, Models, Theoretical, Population Growth
- Published
- 1982
353. [Demographic knowledge and family planning in Colombia].
- Author
-
Ojeda G and Ordonez M
- Subjects
- Americas, Colombia, Demography, Developed Countries, Developing Countries, Europe, Fertility, Latin America, Longevity, Mortality, Population, Population Characteristics, Research, South America, Statistics as Topic, Age Distribution, Age Factors, Birth Rate, Forecasting, Life Expectancy, Philosophy, Population Density, Population Dynamics
- Published
- 1989
354. Population size and growth in Pakistan based on early reports of 1972 census.
- Author
-
Krotki KJ and Parveen K
- Subjects
- Asia, Asia, Southeastern, Developing Countries, Pakistan, Population, Population Characteristics, Population Dynamics, Sex Factors, Social Sciences, Age Distribution, Age Factors, Demography, Population Growth, Sex Distribution
- Published
- 1976
355. Patterns of net migration by age for U.S. counties 1950-1980: the impact of increasing spatial differentiation by life cycle.
- Author
-
Mueser PR, White MJ, and Tierney JP
- Subjects
- Americas, Developed Countries, Family, Family Characteristics, North America, Population, Population Characteristics, United States, Age Distribution, Age Factors, Demography, Emigration and Immigration, Geography, Life Cycle Stages, Population Dynamics, Suburban Population, Time Factors, Urban Population
- Published
- 1988
356. Demographic trends and saving propensities: "a revisit with life cycle theory"..
- Author
-
Owens EW
- Subjects
- Americas, Demography, Developed Countries, Developing Countries, North America, Social Sciences, United States, Age Distribution, Age Factors, Economics, Family, Family Characteristics, Financial Management, Income, Life Cycle Stages, Population, Population Characteristics, Population Dynamics, Socioeconomic Factors, Taxes
- Published
- 1986
- Full Text
- View/download PDF
357. Demographic study of Khasis.
- Author
-
Marbaniang SL
- Subjects
- Age Factors, Asia, Culture, Demography, Developing Countries, Educational Status, India, Marital Status, Marriage, Population, Population Dynamics, Religion, Rural Population, Sex Factors, Urban Population, Age Distribution, Ethnicity, Population Characteristics, Population Density, Population Growth, Sex Distribution
- Published
- 1982
358. Outcome of carpal tunnel decompression: the influence of age, gender, and occupation
- Author
-
Talal Ibrahim, C. J. Kershaw, I. Majid, and M. Clarke
- Subjects
Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,Age categories ,Severity of Illness Index ,Carpal tunnel decompression ,Age Distribution ,Postoperative Complications ,Sex Factors ,Surveys and Questionnaires ,medicine ,Humans ,Orthopedics and Sports Medicine ,Carpal tunnel ,Prospective Studies ,Sex Distribution ,Aged ,Aged, 80 and over ,Original Paper ,business.industry ,Significant difference ,Age Factors ,Mean age ,Recovery of Function ,Middle Aged ,Decompression, Surgical ,Carpal Tunnel Syndrome ,Surgery ,Occupational Diseases ,Treatment Outcome ,medicine.anatomical_structure ,Orthopedic surgery ,Physical therapy ,Female ,business - Abstract
The aim of this study was to investigate the effect of age, gender, and occupation on the outcome of carpal tunnel decompression. A total of 479 patients (342 females, 137 males) with a mean age of 56 years undergoing 608 carpal tunnel decompressions were prospectively studied. Outcome was assessed using the Brigham Hospital carpal tunnel questionnaire at two weeks pre-operatively and six months post-operatively. Cases were divided into four age categories (less than 40 years of age, 40-59, 60-79, and over 80 years of age) and two occupation (repetitive and non-repetitive) groups. The mean differences for both the symptom-severity and functional-status scores amongst the four age categories were similar and no significant difference was found. The mean differences for both the symptom-severity and functional-status scores between females and males and the two occupation groups were similar and no significant differences were found. The majority of the patient's symptoms improved following carpal tunnel decompression. However, we found no influence of age, gender, or occupation on the outcome of carpal tunnel decompression in our series of patients.
- Published
- 2008
359. Women's Perceptions about the Etiology of Urinary Incontinence
- Author
-
Jennifer L. Melville, Wayne Katon, Lauren E. Wagner, Ming Yu Fan, and Katherine M. Newton
- Subjects
Adult ,Washington ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Cross-sectional study ,media_common.quotation_subject ,MEDLINE ,Urinary incontinence ,Age Distribution ,Quality of life ,Risk Factors ,Perception ,Prevalence ,medicine ,Humans ,Women ,Aged ,media_common ,Aged, 80 and over ,Pelvic floor ,Urinary symptoms ,business.industry ,General Medicine ,Middle Aged ,Original Papers ,Cross-Sectional Studies ,Urinary Incontinence ,medicine.anatomical_structure ,Quality of Life ,Physical therapy ,Etiology ,Women's Health ,Female ,medicine.symptom ,business ,Clinical psychology - Abstract
Incontinent women have low rates of care seeking and treatment, some of which may be explained by their beliefs about the causes of their own urine loss. As little is known about these beliefs, our aim was to qualitatively assess what women perceive as the etiology of their urinary incontinence (UI).In a written survey on urinary symptoms administered to female HMO enrollees aged 30-90 years, incontinent women were asked the open-ended question: "Why do you think you lose urine?" Qualitative analyses of the responses identified themes, which were quantified and organized into major categories. Subjects were assigned multiple themes/categories as indicated. Relationships between major categories and subject/incontinence characteristics were explored.Of the 1458 women with incontinence who completed the survey, 1192 (82%) responded to the open-ended question. Qualitative analyses identified 23 themes, with 5 themes cited byor=10% of subjects: pelvic floor/bladder muscles (31%), pregnancy/childbirth (18%), age (14%), exertional triggers (12%), and waiting too long to void (10%). The 23 themes were organized into 5 major categories: pelvic floor/bladder related (53%), uncontrollable factors (23%), part of being female (21%), personal/lifestyle attributes (21%), and don't know (12%). Subjects expressed a range of 1-4 themes/categories. Major categories differed by age, and significant associations were seen between major categories and incontinence severity.Women attribute their UI to a number of causes, which can be condensed into workable themes and categories. By understanding women's beliefs about the etiology of incontinence, clinicians may improve their ability to educate, counsel, and treat women with incontinence.
- Published
- 2008
360. The epidemiology of traumatic humeral shaft fractures in Taiwan
- Author
-
Horng-Chaung Hsu, Yi-Chin Fong, Chun-Hao Tsai, Ying-Hao Chen, Chin-Jung Hsu, and Chia-Hao Chang
- Subjects
Adult ,Male ,Humeral Fractures ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Taiwan ,Fractures, Open ,Young Adult ,Closed Fracture ,Age Distribution ,Injury Severity Score ,Epidemiology ,Odds Ratio ,medicine ,Humans ,Orthopedics and Sports Medicine ,Humerus ,Fractures, Closed ,Sex Distribution ,Child ,Aged ,Retrospective Studies ,Aged, 80 and over ,Fracture Healing ,Original Paper ,Multiple Trauma ,business.industry ,Incidence ,Incidence (epidemiology) ,Retrospective cohort study ,Odds ratio ,Middle Aged ,Surgery ,Radiography ,Logistic Models ,medicine.anatomical_structure ,Multivariate Analysis ,Orthopedic surgery ,Female ,business - Abstract
We retrospectively analysed 106 consecutive traumatic humeral shaft fractures over a five-year period. The mechanism of injury, age, gender, fracture types, associated injury and the presence of injury to the radial nerve were reviewed. The incidence was about 10 per 100,000 per year; most were closed fractures in young males which had been sustained as a result of traffic accidents. The age–gender distribution was characterised by gradually increased incidence from the fifth decade in women, while it reached a peak at the third decade and decreased after the fifth decade in men. The results revealed different epidemiological features from previous studies. The epidemiology differs between ethnicity and country, and updating the epidemiological features of humeral shaft fractures may provide information for appropriate treatment programmes. This study documents the epidemiology of humeral shaft fracture in Taiwan, probably for the first time in this Asian community.
- Published
- 2008
361. Congenital talipes equinovarus in Papua New Guinea: a difficult yet potentially manageable situation
- Author
-
C. R. Tapping and A. D. Culverwell
- Subjects
Male ,Clubfoot ,Pediatrics ,medicine.medical_specialty ,Risk Assessment ,Papua New Guinea ,Age Distribution ,Humans ,Medicine ,Orthopedic Procedures ,Orthopedics and Sports Medicine ,Congenital talipes equinovarus ,Significant risk ,Sex Distribution ,Developing Countries ,Physical Therapy Modalities ,Retrospective Studies ,Original Paper ,Cultural Characteristics ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Infant ,New guinea ,Retrospective cohort study ,Prognosis ,medicine.disease ,Ponseti method ,Early Diagnosis ,Treatment Outcome ,Socioeconomic Factors ,Child, Preschool ,Female ,Surgery ,Risk assessment ,business ,Attitude to Health - Abstract
Reports in the literature have suggested a high incidence of congenital deformities, including congenital talipes equinovarus (CTEV), in many Pacific Islands. This study performed a retrospective analysis of cases of CTEV in an isolated region of Papua New Guinea over a 2-year period. Data was collected on the incidence of CTEV, together with an analysis of initial treatment and outcome. The incidence of CTEV was 2.7 per 1,000 live births per year. A peak incidence of CTEV births in September suggested that maternal anaemia secondary to malaria was a significant risk factor. Good functional outcome was confirmed in only 20% of cases following initial treatment. The authors suggest the Ponseti method as a realistic option for treating CTEV in this region and that it could be instigated with minimal resources and training.
- Published
- 2008
362. Antimicrobial Resistance of Bacterial Agents of the Upper Respiratory Tract of School Children in Buea, Cameroon
- Author
-
Nkuo Akenji T, E A Ntiege, Lucy M. Ndip, Jane-Francis Tatah Kihla Akoachere, Gerald Nkwelang, and Roland N. Ndip
- Subjects
Male ,Staphylococcus aureus ,Microbial susceptibility tests ,Adolescent ,medicine.drug_class ,Antibiotic resistance ,Health, Toxicology and Mutagenesis ,Antibiotics ,Respiratory System ,Drug resistance ,Biology ,Respiratory tract infections ,medicine.disease_cause ,Haemophilus influenzae ,Microbiology ,Young Adult ,Age Distribution ,Streptococcus pneumoniae ,Drug Resistance, Bacterial ,medicine ,Humans ,Cameroon ,Sex Distribution ,Child ,Schools ,Bacteria ,Public Health, Environmental and Occupational Health ,Drug resistance, Microbial ,Pneumonia ,Original Papers ,Influenza ,Klebsiella pneumoniae ,Gentamicin ,Female ,Cefuroxime ,Food Science ,medicine.drug - Abstract
The study was aimed at determining bacterial agents of the upper respiratory tract and the susceptibility patterns of isolates to antibiotics. In total, 200 throat swabs were obtained from students attending different boarding schools within the Buea Municipality and screened to obtain the prevalence of respiratory pathogens and to understand the antibiotic susceptibility patterns of isolates using standard microbiological procedure and the disc-diffusion test. Of the 200 samples screened, 112 (56%) had positive cultures with the dominant bacterial pathogens being Haemophilus influenzae (20%), followed by Streptococcus pneumoniae (15%), Klebsiella pneumoniae (11%), and Staphylococcus aureus (10%). Although 56% of the isolates were recovered from females compared to 44% from males, the difference was not statistically significant (p>0.05). Sixty-seven percent of the pathogens were isolated from the age-group of 10-13 years, 19.6% from the age-group of 14-17 years, and 12.5% from the age-group of 18-21 years. Antibiotic susceptibility testing revealed that gentamicin (92%) and cefuroxime (88.4%) were the most effective antibiotics against the isolates. Generally, susceptibility ranged from 0% to 92% depending on the antibiotic and the species of microorganism. Penicillin had the highest (100%) resistance to all the isolates. The findings revealed that students living in boarding schools in the Buea Municipality were at risk of acquiring upper respiratory tract infections from their peers since the upper respiratory tract of more than 50% of the students was colonized with respiratory pathogens. Although multidrug-resistant strains of organisms were identified, gentamicin and cefuroxime are recommended as the first-line antibiotics of choice against the pathogens. There is, therefore, a need for surveillance of nasopharyngeal carriage of resistant strains of these organisms, especially H. influenzae in unhealthy school children since the vaccine is yet to be introduced in Cameroon. The findings have clinical and epidemiological significance.
- Published
- 2008
363. Does eGFR improve the diagnostic capability of S-Creatinine concentration results? A retrospective population based study
- Author
-
Zahra Khatami, Anders Kallner, and Peter A Ayling
- Subjects
Male ,Contrast Media ,urologic and male genital diseases ,inpatients ,Cohort Studies ,chemistry.chemical_compound ,Reference Values ,Diagnosis ,Outpatients ,Aged, 80 and over ,General Medicine ,Middle Aged ,female genital diseases and pregnancy complications ,Creatinine ,Female ,Algorithms ,Research Paper ,Glomerular Filtration Rate ,Cohort study ,medicine.drug ,Adult ,medicine.medical_specialty ,Metabolic Clearance Rate ,Iohexol ,Renal function ,Sensitivity and Specificity ,Age Distribution ,Internal medicine ,CKD ,medicine ,Humans ,Sex Distribution ,Aged ,Retrospective Studies ,Sweden ,algorithm ,business.industry ,Drug administration ,Retrospective cohort study ,medicine.disease ,United Kingdom ,Surgery ,Population based study ,ROC Curve ,chemistry ,Kidney Failure, Chronic ,business ,Kidney disease - Abstract
The use of MDRD-eGFR to diagnose Chronic Kidney Disease (CKD) is based on the assumption that the algorithm will minimize the influence of age, gender and ethnicity that is observed in S-Creatinine concentration and thus allow a single cut-off at which further diagnostic and therapeutic actions should be considered. This hypothesis is tested in a retrospective analysis of outpatients (N=93,404) and hospitalised (N=35,572) patients in UK and Sweden, respectively. An algorithm based on the same model as the MDRD-eGFR algorithm was derived from simultaneously measured S-Creatinine concentrations and Iohexol GFR in a subset of 565 patients. The combined uncertainty of using this algorithm was estimated to about 15 % which is about three times that of the S-Creatinine concentration results. The diagnostic performance of S-Creatinine concentration was evaluated using the Iohexol clearance as the reference procedure. It was shown that the diagnostic capacity of MDRD-eGFR, as it stands, has no added value compared to S-Creatinine. The gender and age differences of the S-Creatinine concentrations in the dataset persist after applying the MDRD-eGFR algorithm. Thus, a general use of the MDRD-eGFR does not seem justified. Furthermore the claim that the eGFR is adjusted for body area is misleading; the algorithm does not include any body size marker. It is thus a dangerous marker for guiding drug administration.
- Published
- 2008
364. The data and the dynamics of the Chinese populations.
- Author
-
Taeuber IB
- Subjects
- Age Factors, Asia, China, Developed Countries, Developing Countries, Asia, Eastern, Fertility, Japan, Population, Population Growth, Sex Factors, Social Sciences, Taiwan, Age Distribution, Birth Rate, Demography, Population Characteristics, Population Dynamics, Sex Distribution, Sex Ratio
- Published
- 1973
365. Research on Knowledge Learning of COVID-19 Video Viewers: Based on Cognitive Mediation Model.
- Author
-
Liu, Jingfang, Lu, Caiying, and Cai, Jingxian
- Subjects
PUBLIC health surveillance ,LEISURE ,STRUCTURAL equation modeling ,COVID-19 ,ATTITUDE (Psychology) ,MOTIVATION (Psychology) ,AGE distribution ,COGNITION ,HEALTH literacy ,LEARNING strategies ,RISK perception ,SEX distribution ,SURVEYS ,PHILOSOPHY of education ,HEALTH ,INFORMATION resources ,ATTENTION ,NEWSPAPERS ,PATH analysis (Statistics) ,VIDEO recording ,MEDICAL research ,EDUCATIONAL attainment - Abstract
During the COVID-19 epidemic, social media has become the main channel for people to learn information related to the epidemic, among which information in the form of videos has played a significant role in the prevention and control of COVID-19. However, few studies have analyzed the process of knowledge learning of individuals through watching COVID-19 videos. Therefore, to explore the process of COVID-19 video viewers' knowledge acquisition, this paper constructs a knowledge learning path model based on the cognitive mediation model and dual coding theory. A sample of 255 valid questionnaires was collected to validate this model. The results of this study show that an individual's perceived risk of COVID-19 affects their surveillance motivation positively, while surveillance motivation further stimulates the attention and elaboration about the information in COVID-19 videos. Among them, attention positively influences the elaboration about the information. Ultimately, both an individual's attention and elaboration positively influence the knowledge he or she acquires from the COVID-19 videos. This paper not only verifies the hypothesized relationships in the original cognitive mediation model, but also extends the model to the context of video knowledge learning. Analyzing the knowledge learning process of COVID-19 video viewers, this paper can provide suggestions for government propaganda departments and relevant media to improve public knowledge of COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
366. Suicide risk and suicide risk factors among immigrants in Italy: A bi-center matched sample study.
- Author
-
Berardelli, Isabella, Tarsitani, Lorenzo, Sarubbi, Salvatore, Pinucci, Irene, Rogante, Elena, Cifrodelli, Mariarosaria, Erbuto, Denise, Lester, David, Innamorati, Marco, and Pompili, Maurizio
- Subjects
- *
SUICIDE risk factors , *IMMIGRANTS , *LENGTH of stay in hospitals , *PSYCHOTHERAPY patients , *SUBSTANCE abuse , *ALCOHOLISM , *AGE distribution , *HEALTH status indicators , *RISK assessment , *SUICIDAL ideation , *SEX distribution , *PSYCHOSOCIAL factors , *HOSPITAL care , *AGE factors in disease , *DISEASE duration , *SOCIODEMOGRAPHIC factors , *MENTAL illness - Abstract
Italy has the third-largest immigrant population of European Union countries, but only a few research papers have examined suicide risk in immigrant psychiatric patients in Italy. The main aim of this paper was to compare suicidal ideation and suicide attempts in a sample of 304 psychiatric patients. We included 152 immigrant patients matched with 152 Italian patients admitted to the same wards during the same time period by age, gender, and diagnosis. We also investigated sociodemographic and clinical characteristics of the two samples including psychiatric diagnosis, age of illness onset, duration of illness, previous hospitalizations, length of hospitalization, previous suicide attempts, and substance and alcohol abuse. There were no differences between immigrant and Italian patients in either suicidal ideation (previous or current) or suicide attempts (previous or current). Immigrant patients were more likely to have a shorter duration of illness than the Italian patients and Italian patients were more likely to report substance abuse than were immigrant patients. Despite similar suicide rates between immigrants and Italian psychiatric inpatients, appropriate assessment of suicide risk in these patients is essential in implementing therapeutic suicide prevention strategies. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
367. Self‐efficacy, uncertainty and anxiety among nursing graduates in response to licensing test postponement due to the COVID‐19 pandemic: A mixed‐methods study.
- Author
-
Zilber, Rama, Hazan Hazoref, Rivka, and Kagan, Ilya
- Subjects
- *
NURSING licensure , *STATISTICS , *RESEARCH methodology , *MULTIPLE regression analysis , *AGE distribution , *UNCERTAINTY , *SELF-efficacy , *GRADUATES , *QUALITATIVE research , *CRONBACH'S alpha , *SURVEYS , *T-test (Statistics) , *PEARSON correlation (Statistics) , *SEX distribution , *FAMILY attitudes , *DESCRIPTIVE statistics , *QUESTIONNAIRES , *ANXIETY , *DATA analysis software , *THEMATIC analysis , *COVID-19 pandemic , *EDUCATIONAL attainment - Abstract
Aim: To examine the relationships between self‐efficacy, uncertainty and anxiety among nursing graduates waiting for a mandatory nursing licensing test that was postponed due to the COVID‐19 pandemic. Methods: A total of 352 graduates of nursing education programs participated in this mixed‐methods study. The data were collected using an online questionnaire in June 2020. Results: The participants demonstrated high uncertainty and anxiety and low self‐efficacy towards the ability to succeed in the licensing exam. Graduates, who started working, reported lower uncertainty. Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of 24% of the variance of the anxiety. The qualitative analysis revealed three themes: (a) emotional distress, cognitive challenge and social implications, (b) consequences for significant others and (c) strengthening of professional values and norms. Conclusions: A significant crisis like a pandemic is accompanied by acute cognitive burden and stressful emotional experiences and creates an unconventional situation that requires unusual solutions. Granting a temporary permit for employment as a nurse following the postponement of a licensing test contributed to the ability of nursing graduates to cope with the situation. Policies to deal with similar situations in the future emergencies should be developed and implemented. Summary statement: What is already known about this topic? The COVID‐19 pandemic changed all the rules when the licensing examination was postponed at relatively short notice.The graduates found themselves without a work permit and also outside the education system.Many graduates reported economic challenges and feelings of uncertainty and fear of the future. What this paper adds? The participants demonstrated high levels of uncertainty and anxiety, with low self‐efficacy.Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of the anxietyQualitative analysis supported these findings through examples that paint the whole picture in vivid colours. The implications of this paper: The study emphasizes the importance of providing emotional support and information to the students in times of crisis, while communicating policy decisions.Granting a temporary permit for employment as a registered nurse following the postponement of the licensing test contributed to the ability of nursing graduates to contend with the situation.There is a need to formulate policies to deal with similar situations in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
368. Building the speech-language pathology workforce in Cambodia through the lens of the Sustainable Development Goals.
- Author
-
Bryce, Ruth, Easton, Catherine, Bong, Debbie, Net, Chenda, Chan, Samnang, and Knight, Jennifer
- Subjects
TREATMENT of communicative disorders ,THERAPEUTICS ,SPEECH therapy ,HEALTH services accessibility ,DEGLUTITION ,AGE distribution ,DEGLUTITION disorders ,INTERVIEWING ,POPULATION geography ,QUANTITATIVE research ,EMPLOYEE recruitment ,LABOR supply ,ORGANIZATIONAL goals ,QUALITATIVE research ,DESCRIPTIVE statistics ,RESEARCH funding ,PEOPLE with disabilities ,HEALTH equity ,METROPOLITAN areas - Abstract
Current speech-language pathology (SLP) services in Cambodia are limited in scope, service accessibility and integration into government systems. However, momentum is growing to develop an internationally recognised profession. This paper examines the depth and breadth of SLP support available to people with communication and/or swallowing difficulties in relation the Sustainable Development Goals (SDGs). Qualitative interview data collected from service facilities (n = 13) and speech therapy practitioners (n = 27) were mapped and analysed for accessibility and scope of SLP services. Data revealed a workforce density of 0.16:100 000. Disparity in service accessibility was identified between provincial and urban locations, adult and paediatric populations and range of practice areas. The findings demonstrate the importance of partnerships (SDG 17) among government departments, non-government organisations and private sector entities to establish a sustainable and culturally responsive SLP profession in Cambodia. Although there is no Cambodian university training program, there is a growing momentum and local commitment to establishing a workforce to support Cambodians with communication and/or swallowing difficulties. This commentary paper focuses on good health and well-being (SDG 3), decent work and economic growth (SDG 8), reduced inequalities (SDG 10), and also addresses no poverty (SDG 1), quality education (SDG 4) and partnerships for the goals (SDG 17). [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
369. Alcohol and Skeletal Muscle in Health and Disease.
- Author
-
Simon, Liz, Bourgeois, Brianna L., and Molina, Patricia E.
- Subjects
- *
COMPLICATIONS of alcoholism , *MUSCLE protein metabolism , *MUSCLE diseases , *MUSCULAR atrophy , *GRIP strength , *SKELETAL muscle , *RHABDOMYOLYSIS , *MYALGIA , *AGE distribution , *CELLULAR signal transduction , *MITOCHONDRIA , *ALCOHOL drinking , *QUALITY of life , *EXTRACELLULAR matrix , *CACHEXIA , *TUMORS , *COMORBIDITY , *EPIGENOMICS , *DISEASE risk factors , *DISEASE complications - Abstract
PURPOSE: Alcohol-related myopathy is one of the earliest alcohol-associated pathological tissue changes that is progressively exacerbated by cumulative long-term alcohol misuse. Acute and chronic alcohol use leads to changes in skeletal muscle mass and function. As discussed in this evidence-based review, alcohol-mediated mechanisms are multifactorial with effects on anabolic and catabolic signaling, mitochondrial bioenergetics, extracellular matrix remodeling, and epigenomic alterations. However, systematic studies are limited, especially regarding the acute effects of alcohol on skeletal muscle. SEARCH METHODS: This review focuses on peer-reviewed manuscripts published between January 2012 and November 2022 using the search terms "alcohol" or "ethanol" and "skeletal muscle" in MEDLINE, PubMed, and Web of Science using EndNote reference management software. SEARCH RESULTS: Eligible manuscripts included full-length research papers that discussed acute and chronic effects of alcohol on skeletal muscle mass and function in both clinical and preclinical studies. The review also includes alcohol-mediated skeletal muscle effects in the context of comorbidities. The three databases together yielded 708 manuscripts. Of these, the authors excluded from this review 548 papers that did not have "alcohol" or "muscle" in the title and 64 papers that were duplicates or did not discuss skeletal muscle. Thus, of all the manuscripts considered for this review, 96 are included and 612 are excluded. Additionally, relevant papers published earlier than 2012 are included to provide context to the review. DISCUSSION AND CONCLUSIONS: Both acute and chronic alcohol use decrease protein synthesis and increase protein degradation. Alcohol also impairs mitochondrial function and extracellular matrix remodeling. However, there is a gap in the literature on the known alcohol-mediated mechanisms, including senescence, role of immune activation, and interorgan communication, on the development of alcohol-related myopathy. With increased life expectancy, changing alcohol use patterns, and increasing frequency of alcohol use among females, current observational studies are needed on the prevalence of alcohol-related myopathy. Additionally, the compounding effects of acute and chronic alcohol use on skeletal muscle with aging or exercise, in response to injury or disuse, and in the context of comorbidities including diabetes and human immunodeficiency virus (HIV), call for further investigation. Though evidence suggests that abstinence or reducing alcohol use can improve muscle mass and function, they are not restored to normal levels. Hence, understanding the pathophysiological mechanisms can help in the design of therapeutic strategies to improve skeletal muscle health. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
370. Stability of language difficulties among a clinical sample of preschoolers.
- Author
-
Breault, Chantale, Béliveau, Marie‐Julie, Labelle, Fannie, Valade, Florence, and Trudeau, Natacha
- Subjects
- *
LANGUAGE disorder diagnosis , *SPEECH therapy , *AGE distribution , *SPEECH evaluation , *FISHER exact test , *SEVERITY of illness index , *COMPARATIVE studies , *RESEARCH funding , *DESCRIPTIVE statistics , *QUESTIONNAIRES , *CHI-squared test , *DATA analysis , *CHILDREN ,DIAGNOSIS of child development deviations - Abstract
Background: Some data call into question the persistence of developmental language disorders (DLDs) identified during the preschool period. For this reason, speech–language pathologists (SLPs) often reassess children. However, it is unclear if the instability of the profiles documented in community sample studies is present in children referred to specialized clinics. Given the scarcity of SLP resources, is re‐evaluating the language skills of these children a good use of clinical time? Aim: To examine the stability of the findings from two SLP assessments in a sample of Canadian preschool children referred to a tertiary clinic between the ages of 2 and 6 years. It was hypothesized that children under the age of 4 years at first assessment and children with less severe initial deficits would show less stability of DLD diagnosis. Methods & Procedures: The clinical files of children referred to an early childhood psychiatric clinic in Canada were reviewed. For 149 children with two SLPs assessment reports, persistence of language deficits was documented and tested with McNemar's statistics. Differences between preschoolers under the age of 4 versus 4 years and over, as well as between mildly and severely impaired children, were examined. Outcomes & Results: High level of agreement (94%) and McNemar's test (p = 0.180) supported the stability of initial diagnosis. The stability for children assessed before the age of 4 (n = 64) was 100%, and was significantly different from older children's (n = 85) stability of 89% (Fisher's exact test, p = 0.01; bilateral). The stability for children with mild impairments (n = 18) was 78%, which was significantly lower than the stability (97%) in children with severe impairments (n = 114) (Fisher's exact test, p = 0.007; bilateral). Conclusions & Implications: No instability of language status was observed in children assessed before 4 years of age, which could be related to the significant severity of the difficulties that children in this age group presented and be specific to this type of clinical sample. The great stability of language status observed in preschoolers referred to a specialized clinic suggests that clinicians should limit reassessments to devote available resources to intervention efforts. What this paper adds: What is already known on this subject?: Previous research that has demonstrated important instability in the classification of language impairment before 4 years of age gathered data mainly by screening the general population or was not based on a comprehensive clinical assessment. What this paper adds to existing knowledge?: This study investigated the classification stability of DLD between two comprehensive SLP assessments in a clinical sample of Canadian preschoolers. The results indicate great stability of language status assessed before 4 years old in this population, suggesting that severity of impairments may trump the age factor in this group. What are the potential or actual clinical implications of this work?: In the case of children referred to a specialized clinic, clinicians and policymakers should be aware that DLD diagnosis made before 4 years of age remains stable during preschool age, and that a best practice with this population would be to abandon unnecessary testing in favour of early intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
371. A Study on the Variations in Menarcheal Age Among the Meitei, Muslim and Kabui populations of Manipur Valley.
- Author
-
Devi, Ningombam Shanta
- Subjects
- *
MUSLIMS , *TRIBES , *AGE distribution , *AGE , *MENARCHE - Abstract
This paper attempts to analyse the variation of Menarcheal age among the Meitei, Muslim and Kabui populations of Manipur Valley. The sample of each population consists of 300 women. In women's life, menarche marks the beginning of sexual maturation and is influenced by various factors like - biological and genetic factors, socio-economic, environmental, and nutritional factors. In general menarcheal age varies from one population to another. Thus, this paper also aims to compare the mean age of menarche available from different ethnic groups of Manipur. The present study reports that mean age at menarche among the Meitei women is 14.11 ± 0.10 years, 13.81 ± 0.09 years among the Muslim and 14.71 ± 0.09 among the Kabui women. The findings of the present study revealed that mean age at menarche occur earliest among the Muslims and latest among the Kabuis, while that of the Meitei, lies in the middle. As per 't' tests, significant differences have been observed in all the three populations at 5% level. Significantly, it may be noted that a homogenous distribution of menarcheal age has been noted among the Meitei, the Aimol and the Kom tribes, whereas the Muslims show significant differences from all the three populations. [ABSTRACT FROM AUTHOR]
- Published
- 2023
372. Exploring the potential causes of HIV prevalence among young women in South Africa: a critical literature review.
- Author
-
Zakeyo, Karin and Nyashanu, Mathew
- Subjects
HIV infections ,CAUSES of death ,HUMAN sexuality ,SYSTEMATIC reviews ,AGE distribution ,DISEASE incidence ,HIV seroconversion ,SOCIAL factors ,SEX distribution ,HUMAN services programs ,SOCIAL isolation ,SEXUALLY transmitted diseases ,PRE-exposure prophylaxis ,SEX customs ,EPIDEMICS ,DESCRIPTIVE statistics ,CAUSALITY (Physics) ,WOMEN'S health ,HIV - Abstract
Purpose: The purpose of this study is to explore the potential causes of HIV prevalence among young women in South Africa. Human immunodeficiency virus (HIV) is one of the leading causes of death in sub-Saharan Africa. South Africa (SA) has the largest HIV pandemic in the world with approximately 7.2 million people living with HIV as of 2017. There is a disproportionate incidence of HIV between women and men, particularly affecting young women 15–24 years of age. This paper reviewed 10 articles on the impact of HIV in SA among young women. Design/methodology/approach: A total of 10 articles on HIV in SA were selected for review using academic databases including Library One Search Pro, Google Scholar, the British Medical Journal and Elsevier. The search generated 11,095 articles, which were narrowed down to 10 by the criteria of being specific to gender and age and publication period. Findings: Five themes were identified from the findings as to the potential causes of HIV prevalence among young women these included age-disparate relationships, social factors and sexual behaviour. Impact of HIV on communities and individuals, gender and patriarchy including poverty and social isolation. Originality/value: The paper shows the impact of inequalities between men and women leading to HIV infection among young women. It also shows some gaps that require further research with regards to HIV infections among young women. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
373. ASL Developmental Trends Among Deaf Children, Ages Birth to Five.
- Author
-
Hernandez, Brianna, Allen, Thomas E, and Morere, Donna A
- Subjects
DEAFNESS in children ,AGE distribution ,SIGN language ,FETAL development ,LANGUAGE acquisition ,PEOPLE with disabilities - Abstract
Language development is an important facet of early life. Deaf children may have exposure to various languages and communication modalities, including spoken and visual. Previous research has documented the rate of growth of English skills among young deaf children, but no studies have investigated the rate of ASL acquisition. The current paper examines young deaf children's acquisition of ASL skills, the rate of growth over time, and factors impacting levels and growth rates. Seventy-three children ages birth to 5 were rated three times using the Visual Communication and Sign Language Checklist and given a scaled score at each rating. An average monthly gain score was calculated for each participant. The presence of a deaf parent, use of ASL at home, use of cochlear implant(s), whether the child was born deaf, and age of initial diagnosis were analyzed for their impact on the level of ASL skill and rate of growth. Results indicated that the use of ASL in the home has a significant positive effect on deaf children's ASL skill level. Additionally, children with lower initial ratings showed higher rates of growth than those with higher initial ratings, especially among school-aged children. The paper discusses implications and directions for future studies. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
374. Estimated life expectancy of Parkinson's patients compared with the UK population
- Author
-
Anette Schrag, Carol Brayne, Lianna Ishihara, and Anne Cheesbrough
- Subjects
Adult ,Male ,Paper ,Gerontology ,Young onset ,Population ,Levodopa ,Age Distribution ,Life Expectancy ,Predictive Value of Tests ,Humans ,Medicine ,In patient ,Age of Onset ,Sex Distribution ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,Parkinson Disease ,Middle Aged ,Age specific ,United Kingdom ,Time of death ,Psychiatry and Mental health ,Predictive value of tests ,Dopamine Agonists ,Life expectancy ,Female ,Surgery ,Neurology (clinical) ,Age of onset ,business ,Demography - Abstract
Objective: To calculate the best possible estimates for age specific life expectancy (LE) and anticipated age at the time of death (AAD) in patients with Parkinson’s disease (PD) compared with the general population in the UK. These may be of greater value to patients than standardised mortality ratios (SMRs), which are usually reported in studies on mortality in PD. Methods: A literature review identified articles with data on age stratified life expectancy or SMRs to calculate estimations of LE using the Gompertz function and data on mortality and LE in the UK from the Office of National Statistics and Actuarial Department for the year 2003. Results: Two UK studies and four from Western Europe were used to estimate LE and AAD for patients with PD from SMRs. The mean LEs of patients with PD compared with the general population were: 38 (SD 5) years for onset between 25 and 39 years compared with 49 (SD 5) years; 21 (SD 5) years for onset between 40 and 64 years compared with 31 (SD 7) years; and 5 (SD 4) years for onset age ⩾65 years compared with 9 (SD 5) years. The average AAD of patients with PD with onset between 25 and 39 years was 71 (SD 3) years and considerably lower than that of the general population (82 (SD 2) years). The difference between average AAD for older individuals with PD (onset ⩾65 years) and the general population was smaller, with an AAD of approximately 88 (SD 7) years compared with 91 (SD 5) years. Conclusions: The calculations showed that LE and AAD in PD are reduced for all onset ages but this reduction is greatest in individuals with a young onset. While the results are average estimates, these can provide useful indications of LE and AAD.
- Published
- 2007
375. Idiopathic chronic inflammatory demyelinating polyneuropathy: an epidemiological study in Italy
- Author
-
C. Buffa, Adriano Chiò, Federica Plano, Edo Bottacchi, Andrea Calvo, Roberto Mutani, Dario Cocito, and Maurizio Leone
- Subjects
Male ,Paper ,medicine.medical_specialty ,Pediatrics ,Biopsy ,chronic inflammatory demyelinating polyneuropathy ,CIDP ,epidemiology ,Population ,Prevalence ,Chronic inflammatory demyelinating polyneuropathy ,Severity of Illness Index ,Disability Evaluation ,Age Distribution ,Catchment Area, Health ,Sural Nerve ,Severity of illness ,Epidemiology ,medicine ,Humans ,Sex Distribution ,education ,Aged ,education.field_of_study ,business.industry ,Incidence ,Incidence (epidemiology) ,Polyradiculoneuropathy ,Middle Aged ,medicine.disease ,Surgery ,Psychiatry and Mental health ,Italy ,Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ,Disease Progression ,Female ,Neurology (clinical) ,business ,Polyneuropathy - Abstract
Aim: The clinical and epidemiological characteristics of chronic inflammatory demyelinating polyneuropathy (CIDP) in an Italian population were assessed. Subjects and methods: All subjects with a diagnosis of demyelinating neuropathy after 1990 in Piemonte and Valle d’Aosta (4 334 225 inhabitants) were considered. The diagnosis of CIDP was based on the research criteria of the American Academy of Neurology. 165 of 294 patients met the diagnostic criteria. Results: The crude prevalence rate was 3.58/100 000 population (95% CI 3.02 to 4.20). At the prevalence day, 76 (49.0%) cases had definite, 67 (43.2%) probable and 12 (7.7%) possible CIDP; disability was mild in 105 (67.7%) cases, moderate in 32 (20.6%) and severe in 18 (11.6%). The course was remitting–relapsing in 40 cases (25.8%), chronic progressive in 96 (61.9%) and monophasic in 19 (12.3%). Considering the 95 patients whose disorder presented in the period 1995–2001, the mean annual crude incidence rate was 0.36/100 000 population (95% CI 0.29 to 0.44), with a male to female ratio of 2.3:1. 14 cases were affected by diabetes mellitus. In multivariate analysis, factors related to severe disability at the prevalence day were: age>60 years; failure of immunomodulating therapies at the time of diagnosis; worse disability at nadir; and chronic course. Conclusion: Incidence and prevalence rates of CIDP in Italy were higher than those observed in most previous studies. At the prevalence day, more than 80% of cases had a mild or moderate disability, indicating either a good response to immunomodulating therapy or a tendency of CIDP to have a mild course in most cases.
- Published
- 2007
376. Incidence of subarachnoid haemorrhage
- Author
-
N. K. de Rooij, J. Van der Plas, Gabriel J.E. Rinkel, F. H. H. Linn, A. Algra, and University of Groningen
- Subjects
Adult ,Male ,Paper ,HORMONAL FACTORS ,medicine.medical_specialty ,Subarachnoid hemorrhage ,NEW-ZEALAND ,Poison control ,INTRACRANIAL ANEURYSMS ,Aneurysm, Ruptured ,STROKE INCIDENCE ,symbols.namesake ,Age Distribution ,30-DAY CASE-FATALITY ,Injury prevention ,medicine ,Humans ,COMMUNITY STROKE ,COMPUTED-TOMOGRAPHY ,Poisson regression ,Sex Distribution ,Stroke ,IZUMO CITY ,Aged ,Demography ,Aged, 80 and over ,business.industry ,Incidence (epidemiology) ,Incidence ,Intracranial Aneurysm ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Confidence interval ,Surgery ,Psychiatry and Mental health ,symbols ,RISK-FACTORS ,Subarachnoid haemorrhage ,Female ,Neurology (clinical) ,Seasons ,TRANSIENT ISCHEMIC ATTACKS ,business - Abstract
Background and aim: To update our 1996 review on the incidence of subarachnoid haemorrhage (SAH) and assess the relation of incidence with region, age, gender and time period.Methods: We searched for studies on the incidence of SAH published until October 2005. The overall incidences with corresponding 95% confidence intervals were calculated. We determined the relationship between the incidence of SAH and determinants by means of univariate Poisson regression.Results: We included 51 studies (33 new), describing 58 study populations in 21 countries, observing 45 821 896 person-years. Incidences per 100 000 person-years were 22.7 (95% CI 21.9 to 23.5) in Japan, 19.7 (18.1 to 21.3) in Finland, 4.2 (3.1 to 5.7) in South and Central America, and 9.1 (8.8 to 9.5) in the other regions. With age category 45-55 years as the reference, incidence ratios increased from 0.10 (0.08 to 0.14) for age groups younger than 25 years to 1.61 (1.24 to 2.07) for age groups older than 85 years. The incidence in women was 1.24 (1.09 to 1.42) times higher than in men; this gender difference started at age 55 years and increased thereafter. Between 1950 and 2005, the incidence decreased by 0.6% (1.3% decrease to 0.1% increase) per year.Conclusions: The overall incidence of SAH is approximately 9 per 100 000 person-years. Rates are higher in Japan and Finland and increase with age. The preponderance of women starts only in the sixth decade. The decline in incidence of SAH over the past 45 years is relatively moderate compared with that for stroke in general.
- Published
- 2007
377. Mental health nurses' measured attitudes to people and practice: Systematic review of UK empirical research 2000–2019.
- Author
-
Dickens, Geoffrey L., Schoultz, Mariyana, and Hallett, Nutmeg
- Subjects
- *
PSYCHIATRIC nursing , *ATTITUDES toward mental illness , *CINAHL database , *PSYCHOLOGY information storage & retrieval systems , *NURSES' attitudes , *SUBSTANCE abuse , *PSYCHOTHERAPY patients , *WORK , *AGE distribution , *ATTITUDES of medical personnel , *SYSTEMATIC reviews , *EFFECT sizes (Statistics) , *BORDERLINE personality disorder , *SEX distribution , *NURSE-patient relationships , *EXPERIENTIAL learning , *RESTRAINT of patients , *HOSPITAL nursing staff , *DESCRIPTIVE statistics , *PSYCHOSOCIAL factors , *SECLUSION of psychiatric hospital patients , *MEDLINE , *EDUCATIONAL outcomes - Abstract
Accessible Summary: What is known on the subject?: Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or restraint).It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. What the paper adds to existing knowledge?: To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory‐informed approaches to attitudinal research.By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets—indicated by large proportions of respondents who appraise negatively—concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. What are the implications for practice?: Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice.There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments.Training programmes that focus on attitudinal change need to be more rigorously evaluated. Introduction: Attitudes are considered integral to mental health nursing practice. Aims: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. Methods: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK‐based mental health nurses' attitudes with multi‐item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. Results: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude‐practice links. Discussion: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. Implications for Practice: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co‐morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude‐practice links. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
378. Machine Learning Techniques Outperform Conventional Statistical Methods in the Prediction of High Risk QTc Prolongation Related to a Drug-Drug Interaction.
- Author
-
Van Laere, Sven, Muylle, Katoo M., Dupont, Alain G., and Cornu, Pieter
- Subjects
- *
C-reactive protein , *DECISION trees , *PREDICTIVE tests , *KIDNEY function tests , *AGE distribution , *LONG QT syndrome , *MACHINE learning , *POTASSIUM , *ATRIAL fibrillation , *RETROSPECTIVE studies , *RISK assessment , *DRUG interactions , *HEART beat , *ELECTROCARDIOGRAPHY , *DESCRIPTIVE statistics , *RESEARCH funding , *PREDICTION models , *STATISTICAL models , *SENSITIVITY & specificity (Statistics) , *CALCIUM , *LOGISTIC regression analysis , *DATA analysis software , *LONGITUDINAL method , *DISEASE risk factors , *EVALUATION ,RESEARCH evaluation - Abstract
In clinical practice, many drug therapies are associated with prolongation of the QT interval. In literature, estimation of the risk of prescribing drug-induced QT prolongation is mainly executed by means of logistic regression; only one paper reported the use of machine learning techniques. In this paper, we compare the performance of both techniques on the same dataset. High risk for QT prolongation was defined as having a corrected QT interval (QTc) ≥ 450 ms or ≥ 470 ms for respectively male and female patients. Both conventional statistical methods (CSM) and machine learning techniques (MLT) were used. All algorithms were validated internally and with a hold-out dataset of respectively 512 and 102 drug-drug interactions with possible drug-induced QTc prolongation. MLT outperformed the best CSM in both internal and hold-out validation. Random forest and Adaboost classification performed best in the hold-out set with an equal harmonic mean of sensitivity and specificity (HMSS) of 81.2% and an equal accuracy of 82.4% in a hold-out dataset. Sensitivity and specificity were both high (respectively 75.6% and 87.7%). The most important features were baseline QTc value, C-reactive protein level, heart rate at baseline, age, calcium level, renal function, serum potassium level and the atrial fibrillation status. All CSM performed similarly with HMSS varying between 60.3% and 66.3%. The overall performance of logistic regression was 62.0%. MLT (bagging and boosting) outperform CSM in predicting drug-induced QTc prolongation. Additionally, 19.2% was gained in terms of performance by random forest and Adaboost classification compared to logistic regression (the most used technique in literature in estimating the risk for QTc prolongation). Future research should focus on testing the classification on fully external data, further exploring potential of other (new) machine and deep learning models and on generating data pipelines to automatically feed the data to the classifier used. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
379. Prevalence and high-risk behaviors associated with non-fatal overdose among people who use illicit opioids: A systematic review and meta-analysis.
- Author
-
Armoon, Bahram, Bayani, Azadeh, Griffiths, Mark D., Bayat, Amir-Hossein, Mohammadi, Rasool, Fattah Moghaddam, Ladan, and Ahounbar, Elahe
- Subjects
DRUG overdose risk factors ,RISK-taking behavior ,NARCOTICS ,ONLINE information services ,MEDICAL databases ,META-analysis ,CONFIDENCE intervals ,DRUG overdose ,SYSTEMATIC reviews ,AGE distribution ,SEX work ,RISK assessment ,SEX distribution ,METHAMPHETAMINE ,DISEASE prevalence ,PUBLIC spaces ,DESCRIPTIVE statistics ,DRUGS of abuse ,MEDLINE ,HOMELESSNESS ,ODDS ratio ,OPIOID abuse - Abstract
The aim of the present study was to determine the prevalence of non-fatal overdose among people who use illicit opioids (PWUIOs) and determine the demographic and behavioral characteristics associated with non-fatal overdose among this population. Studies in English published before February 1, 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with non-fatal overdose among PWUIOs. After reviewing for study duplicates, the full-texts of selected papers were assessed for eligibility using PICOs criteria. After a detailed assessment of over 13,845 papers, a total of 67 studies met the eligibility criteria. The findings showed a past-year pooled prevalence rate of non-fatal overdose among PWUIOs of 26% (95% CI, 23% −29%). Greater odds of non-fatal overdose among PWUIOs was associated with (i) being younger, (ii) being female, (iii) being homeless, (iv) individuals who received money, goods, or drugs in exchange for sex, (v) individuals who had witnessed somebody else have an overdose, (vi) individuals who had used public spaces as primary injection locations, (vii) individuals who reported polydrug use, (vii) use of non-injection methamphetamine, and (viii) high injecting frequency (more than two daily drug injections). Harm-reduction programs should consider the provision of education concerning overdose-related risk factors to the vulnerable and hard-to-reach PWUIOs. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
380. Cataract Surgery in Low-Income Countries: A Good Deal!
- Author
-
Flessa, Steffen
- Subjects
TREATMENT of cataracts ,CATARACT ,SERVICES for caregivers ,MIDDLE-income countries ,EYEGLASSES ,AGE distribution ,MEDICAL care costs ,COST control ,CATARACT surgery ,COST analysis ,QUALITY of life ,LOW-income countries ,COST effectiveness ,AGE factors in disease ,ECONOMIC aspects of diseases ,QUALITY-adjusted life years - Abstract
Cataract is a major cause of blindness worldwide. In particular, in low-income countries, the burden of disease as well as its direct and indirect economic cost are a major challenge for the population and economy. In many cases, it would be possible to prevent or cure blindness with a comparably simple cataract surgery, but many countries lack the resources to strengthen healthcare systems and implement broad cataract surgery programs reaching, in particular, the rural poor. In this paper, we analyse whether such an intervention could be cost-effective or even cost-saving for the respective health systems. We calculate the net value of the lifelong costs of cataract with and without surgery. This calculation includes direct costs (e.g., treatment, glasses, surgery) as well as indirect cost of the caregiver and the patient. We total all costs from the year of onset of cataract until death and discount the respective values to the year of onset. We define the surgery as cost-saving if the net-value of costs with surgery is lower than without surgery. If the cost per quality adjusted life year is lower than one gross national product per capita, we define the intervention as highly cost-effective. We find that the cost-effectiveness of cataract surgery depends on the age of onset of the disease and the age of surgery. If the surgery is performed with the beginning of severe impairment, even surgery of a 78-year-old patient is still cost-saving. Almost all possible constellations are highly cost-effective, only for the very old it is questionable whether the surgery should be performed. The simulations show that cataract surgery is one of the most cost-effective interventions. However, millions of people in low-income countries still have no chance to prevent or cure blindness due to limited resources. The findings of this paper clearly call for a stronger effort to reach poor and rural populations with this cost-effective service. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
381. Intermediate-Term Results of Laparoscopic Repair of Giant Paraesophageal Hernia: Lack of Follow-up Esophagogram Leads to Detection Bias
- Author
-
Rathore, Munir A., Andrabi, Imran, Nambi, El, and McMurray, Arthur H.
- Subjects
Aged, 80 and over ,Male ,Hernia ,Paraesophageal ,Fundoplication ,Middle Aged ,Laparoscopic ,Age Distribution ,Hernia, Hiatal ,Treatment Outcome ,Recurrence ,Scientific Papers ,Quality of Life ,Humans ,Female ,Laparoscopy ,Aged ,Retrospective Studies - Abstract
Introduction: This retrospective study was performed to review the intermediate-term results of the laparoscopic repair of giant paraesophageal hernia (PEH) in the unit. Methods: This retrospective 8-year case series involved 42 patients. The clinical records were retrieved, reviewed individually, and data were collected regarding symptoms, investigation, operative details, and follow-up. Results: M:F ratio was 1:1.8 and median age was 64 years.Symptoms included epigastric/chest pain (69%), heart-burn (42.8%), dysphagia (38%), vomiting (23.8%), gastric volvulus (19%), and upper GI bleed (16.6%). The repair included reduction, sac excision, esophageal mobilization, and cruroplasty. Fundoplication (anterior partial) was done in 18 (42.8%) patients with radiologically documented reflux. Median hospital stay was 3 days. The complications included esophageal perforation in 1 (2.3%), gas-forming mediastinal abscess in 1 (2.3%), small bowel obstruction in 1 (2.3%), and bilateral basal atelectasis in 3 (7.1%). One patient (2.3%) died due to duodenal perforation and myocardial infarction. Of the 38 (90.4%) patients followed up (median 18m), 20 (52.6%) had a follow-up investigation. One patient (2.6%) had postoperative dysphagia, and 3 (7.8%) had postoperative heart-burn. Five (11.9%) had recurrence. Symptom outcome was Visick grades I/II (86.8%), III (10.5%), and IV (2.6%). Conclusion: Laparoscopic repair of PEH resulted in a short length of stay, excellent outcome in almost 87% of patients, and an overall recurrence rate of 11.9%.
- Published
- 2007
382. Suicide and older adults in postdisaster northeastern Japan
- Author
-
John W. Traphagan
- Subjects
Adult ,Male ,Rural Population ,medicine.medical_specialty ,Population ,Social issues ,Suicide prevention ,Disasters ,White paper ,Age Distribution ,Sex Factors ,Japan ,medicine ,Earthquakes ,Humans ,Sex Distribution ,Psychiatry ,education ,Cause of death ,Aged ,Aged, 80 and over ,education.field_of_study ,Government ,Descriptive statistics ,Health Policy ,Incidence ,Age Factors ,Middle Aged ,Mental health ,Suicide ,Female ,Psychology ,Demography - Abstract
Following the Tohoku Daishinsai or Great Tohoku Earthquake, one of the widely reported concerns was the potential for a significant increase in suicides among those leftto deal with the disaster. The Los Angeles Times, for example, reported the worries of Naoko Sugimoto-based on the "grapevine" of Japan's mental health system-that a trickle of suicides might turn into a "river" exemplified bythe farmer who hanged himself, distressed about a cabbage harvest ruined by radioactive fallout from the Fukushima Daiichi nuclear power plant; the overworked government worker near the complex who took his life; the father who killed himself after a fruitless search for his child after the tsunami. (Glionna, 2011)These fears seem quite reasonable given the fact that Japan has shown among the highest suicide rates in the world and experienced a significant increase in suicides in the late 1990s that has yet to return to earlier levels (Traphagan, 2010).Although there is much research to be done concerning suicide in general following the disaster, in this article, I explore the more specific issue of elder suicide in Tohoku since March of 2011. Throughout this article, the basis for my research is the following hypothesis:(a) Older adults in Tohoku were disproportionately affected by the disaster in March of 2011. (b) Elders in the Tohoku region show high rates of suicide when compared to other parts of Japan. Therefore, (c) given the levels of stress experienced, suicide rates among the older adults are likely to have increased following the disaster.I begin by discussing some of the general trends in recent years concerning suicide in Japan and specifically within the Tohoku region. Following this, I will explore some of the data related to suicide and the postdisaster situation in Tohoku. This article relies on qualitative data and will emphasize the use of descriptive statistics because the samples involved are not sufficiently large to employ more complex statistical methods.SUICIDE IN JAPANOver the past decade, suicide has grown to be viewed as one of the more pressing social problems in Japan. In 2007, the Japanese government published a White Paper on countersuicide that discusses methods for reducing the suicide rate and stresses the importance of developing systems of addressing the needs of suicide survivors, potential suicide victims, and the families of suicide survivors and those who have attempted suicide (Cabinet Office, Government of Japan, 2007). The government is also spending significant funds ($220 million by 2017) to develop programs for suicide prevention and support. Indeed, suicide is a leading cause of death in Japan, having raised as high as sixth among causes of death (Yamamura, Kinoshita, Nishiguchi, & Hishida, 2006:575), and the suicide rate for Japan has typically hovered around 25 per 100,000 for the past several years (Traphagan, 2010); by comparison, the suicide rate in the United States is normally around 11 or 12 per 100,000; and in 2000, the world suicide rate was estimated to be roughly 16 per 100,000 (Hasegawa et al., 2011:276). Japanese men are considerably more likely to commit suicide than women are; and particular age groups, such as teens and middle-aged men, are particularly prone to suicidal behavior (Yamamura et al., 2006:576-578). Yamamura et al. (2006) note that there is a correlation between population den- sity and suicide in Japan, with lower density population areas exhibiting higher suicide rates than more densely populated urban areas.Among the more troubling aspects of Japanese suicide over the past 15 years has been a sharp increase in the suicide rate since the late 1990s. Figure 11 shows suicide rates in Japan from 1970 to 2010. Although it is not clear where the cause in the increase during the late 1990s may lie-there were some changes made in how suicides are reported as well as ongoing problems with the Japanese economy- the suicide rates have hovered around 25 for more than a decade, a rate that represents an annual number of suicides that typically exceeds 30,000, which is higher than for the United States despite the much larger U. …
- Published
- 2013
383. Factors Influencing Childhood Immunization in Uganda
- Author
-
Edward Bbaale
- Subjects
Adult ,Employment ,Male ,Rural Population ,Health Knowledge, Attitudes, Practice ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Urban Population ,Health, Toxicology and Mutagenesis ,Bivariate analysis ,Measles ,Health Services Accessibility ,Young Adult ,Polio vaccine ,Age Distribution ,medicine ,Humans ,Uganda ,DPT vaccine ,Sex Distribution ,Developing Countries ,BCG vaccine ,Measles vaccine ,Vaccines ,Tetanus ,business.industry ,Public Health, Environmental and Occupational Health ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Original Papers ,Full immunization ,Poliomyelitis ,Religion ,Vaccination ,Socioeconomic Factors ,Population Surveillance ,Educational Status ,Female ,Immunization ,business ,Food Science ,Demography - Abstract
This paper investigates the factors associated with childhood immunization in Uganda. We used nationally-representative data from Uganda Demographic and Health Survey (UDHS) of 2006. Both bivariate and multivariate approaches were employed in the analysis. The bivariate approach involved generating average percentages of children who were immunized, with analysis of pertinent background characteristics. The multivariate approach involved employing maximum likelihood probit technique and generating marginal effects to ascertain the probability of being immunized, given the same background characteristics. It revealed that slightly over 50% of children in Uganda were fully immunized. Additionally, 89%, 24%, 52%, and 64% received BCG, DPT, polio and measles vaccines respectively. Factors which have a significant association with childhood immunization are: maternal education (especially at post-secondary level), exposure to media, maternal healthcare utilization, maternal age, occupation type, immunization plan, and regional and local peculiarities. Children whose mothers had post-secondary education were twice as likely to be fully immunized compared to their counterparts whose mothers had only primary education (p < 0.01). Thus, gender parity in education enhancement efforts is crucial. There is also a need to increase media penetration, maternal healthcare utilization, and to ensure parity across localities and regions.
- Published
- 2013
384. Data from a nationwide registry on sports-related sudden cardiac deaths in Germany
- Author
-
Jürgen Scharhag, Tim Meyer, and Philipp Bohm
- Subjects
Adult ,Male ,medicine.medical_specialty ,Competitive Behavior ,Epidemiology ,Population ,Poison control ,sudden death ,Context (language use) ,030204 cardiovascular system & hematology ,Sudden death ,Occupational safety and health ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Age Distribution ,prevention ,Risk Factors ,Germany ,Injury prevention ,Sports Cardiology ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Registries ,Sex Distribution ,education ,Original Scientific Papers ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Middle Aged ,medicine.disease ,Death, Sudden, Cardiac ,Athletes ,Emergency medicine ,cardiac screening ,Female ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Sports - Abstract
Background Prospective national registries examining the incidence and aetiology of sports-related sudden cardiac death (SrSCD) not only in competitive athletes but also in recreational sports participants are uncommon. In May 2012, a prospective registry on SrSCD was installed to examine the incidence and particularly the aetiology of such events in the general population in Germany. Methods The registry consists of a web-based platform to record SrSCD cases. Media-monitoring and cooperation with 15 institutes of forensic medicine complemented the search. SrSCD was defined as death occurring during sports activity or up to 1 hour after its cessation, regardless of successful resuscitation. We included subjects at all levels of competition as well as recreational athletes. Results After 30 months of observation, 144 SrSCDs were recorded (mean age 46.8 ± 16.2 years). The overall incidence was 1.2–1.5/million/year, with 97% being male. Most of the cases occurred in the context of non-elite competitive or recreational sports. Football and running were the most common disciplines. In subjects ≤35 years, myocarditis prevailed, whereas in athletes ≥35 years, CAD predominated by far. Few cardiomyopathies were observed. Conclusions In Germany, the largest proportion of SrSCDs occurs in middle-aged men during recreational sports or non-elite competitive sports. The distribution of cardiac diseases responsible for SrSCD seems to vary among European countries. Our findings may indicate the need for a larger focus on myocarditis prevention in the young as well as widening the screening scope to younger athletes below the ‘elite’ level and to senior athletes.
- Published
- 2015
385. The role of temperature in reported chickenpox cases from 2000 to 2011 in Japan
- Author
-
Nobumichi Kobayashi, Keiji Mise, Ayako Sumi, and K. Harigane
- Subjects
Surveillance data ,Time Factors ,Epidemiology ,Rain ,Maximum entropy method ,Age Distribution ,Chickenpox ,Japan ,medicine ,Humans ,Spectral analysis ,Relative humidity ,Least-Squares Analysis ,Child ,Incidence ,Infant, Newborn ,Temperature ,Infant ,Humidity ,Seasonality ,medicine.disease ,Annual cycle ,Original Papers ,Infectious Diseases ,Climatology ,Child, Preschool ,Environmental science ,Seasons - Abstract
SUMMARYAnnual periodicities of reported chickenpox cases have been observed in several countries. Of these, Japan has reported a two-peaked, bimodal annual cycle of reported chickenpox cases. This study investigated the possible underlying association of the bimodal cycle observed in the surveillance data of reported chickenpox cases with the meteorological factors of temperature, relative humidity and rainfall. A time-series analysis consisting of the maximum entropy method spectral analysis and the least squares method was applied to the chickenpox data and meteorological data of 47 prefectures in Japan. In all of the power spectral densities for the 47 prefectures, the spectral lines were observed at the frequency positions corresponding to the 1-year and 6-month cycles. The optimum least squares fitting (LSF) curves calculated with the 1-year and 6-month cycles explained the underlying variation of the chickenpox data. The LSF curves reproduced the bimodal and unimodal cycles that were clearly observed in northern and southern Japan, respectively. The data suggest that the second peaks in the bimodal cycles in the reported chickenpox cases in Japan occurred at a temperature of approximately 8·5 °C.
- Published
- 2015
386. Malignant lymphomas in the head and neck region : a retrospective, single-center study over 41 years
- Author
-
Walter, Christian, Ziebart, Thomas, Sagheb, Keyvan, Rahimi-Nedjat, Roman Kia, Manz, Asina, and Hess, Georg
- Subjects
Male ,Lymphoma ,non-Hodgkin lymphoma ,610 Medizin ,Middle Aged ,head and neck ,oral ,Age Distribution ,immune system diseases ,Head and Neck Neoplasms ,hemic and lymphatic diseases ,610 Medical sciences ,Humans ,Female ,Sex Distribution ,Research Paper ,Aged ,Retrospective Studies - Abstract
Objectives: Non-Hodgkin lymphomas are malignant neoplastic proliferations of the immune system that can manifest as nodal or extranodal lymphomas. The aim of this study was to retrospectively investigate the site of occurrence of lymphomas in the head and neck area and to analyze the typical symptoms of patients who presented at an oral and maxillofacial surgical department. Material and Methods: All patient files from1971 until 2012 from an Oral and Maxillofacial Surgery of a University were analyzed for the diagnosis non-Hodgkin lymphoma. Epidemiologic data and data regarding the localization of the malignant lymphoma were evaluated. Results: 62 patients, 34 women and 28 men with a non-Hodgkin lymphoma in the head and neck area were treated in the 41 years analyzed. In 87% of the cases the lymphoma belonged to B-cell and in 12% to the T-cell lineage. The average age at the time of diagnosis was 67 years for women (n=34) and 56 years for men. With 22 patients each, the non-Hodgkin lymphoma was localized in either the soft tissues or osseous structures. In the remaining 18 cases, multiple structures were affected. In 33 patients no accompanying nodal manifestation was noticed. In 33 cases the lymphoma was located in the oral cavity. The most common symptoms were swelling (97%), pain (40%) and the existence of an ulcer (11%). Conclusion: In the present study more than 50% of the lymphomas were located in the oral cavity. Due to the unspecific symptoms, a histopathological verification of the diagnosis is crucial.
- Published
- 2015
- Full Text
- View/download PDF
387. Characteristics and Help-Seeking Behaviors of Internet Gamblers Based on Most Problematic Mode of Gambling
- Author
-
Sally M. Gainsbury, Nerilee Hing, Alex Blaszczynski, and Alex M. T. Russell
- Subjects
Adult ,Male ,Demographics ,Health Informatics ,Sample (statistics) ,Mode (music) ,Age Distribution ,Humans ,Sex Distribution ,Original Paper ,Internet ,treatment ,business.industry ,pathological gambling ,Australia ,Psychological distress ,Internet gambling ,Patient Acceptance of Health Care ,Help-seeking ,gambling ,The Internet ,Female ,Optimal alignment ,business ,Psychology ,Social psychology - Abstract
Background Previous studies of problem Internet gamblers have failed to distinguish whether their problem gambling relates to Internet or land-based gambling modes. Therefore, characteristics and help-seeking behaviors of people whose gambling problems relate specifically to Internet gambling are unknown, but could inform the optimal alignment of treatment and support services with the needs and preferences of problem gamblers. Objective This study aimed to compare (1) characteristics of problem Internet gamblers and problem land-based gamblers and (2) uptake of different types and modes of help between problem Internet gamblers and problem land-based gamblers. Hypothesis 1 was that problem Internet gamblers are less likely to seek help. Hypothesis 2 was that problem Internet gamblers are more likely to use online modes of help. Methods A sample of 620 respondents meeting criteria for problem gambling was drawn from an online survey of 4594 Australian gamblers. Respondents were recruited through advertisements on gambling and gambling help websites, Facebook, and Google. Measures consisted of gambling participation; proportion of gambling on the Internet; most problematic mode of gambling; help seeking from 11 different sources of formal help, informal help, and self-help for gambling problems; psychological distress (Kessler 6); problem gambling severity (Problem Gambling Severity Index, PGSI); and demographics. Results Problem Internet gamblers were significantly more likely than problem land-based gamblers to be male (χ2 1=28.3, P
- Published
- 2015
388. Microhardness evaluation of non enzymatically glycated bovine femur cortical bone
- Author
-
Fındıkoğlu, Gülin and Evis, Z.
- Subjects
collagen ,Aging ,Conference Paper ,age distribution ,collagen metabolism ,cortical bone ,bone tissue ,microindentation technique ,bone strength ,incubation time ,biomechanics ,collagen fiber ,animal tissue ,image analysis ,oxidative stress ,controlled study ,microfracture ,protein structure ,response time ,Microindentation ,load carrying capacity ,bone age ,analytic method ,nonhuman ,bovine ,protein processing ,risk assessment ,dehydration ,scanning electron microscope ,ultrastructure ,hardness ,structure analysis ,Fracture ,laboratory test ,microhardness test ,SEM ,glycation ,microhardness ,femur ,Toughness ,femur fracture ,scanning electron microscopy - Abstract
Purpose: The aim of this study is to investigate deterioration in mechanical integrity of the collagen network of bovine bone formed by non-enzymatic glycation (NEG), a process that mimics aging by microindentation technique. Methods: Young and old bovine cortical bone specimens were rested in solutions for four weeks for the process of NEG and were grouped as ribosylated and non-ribosylated. A series of indentations were made on bone specimens weekly for each of 3-masses of 50 g, 100 g and 200 g for 10 s to detect the effect of indentation load and for each of five durations of 5 s, 10 s, 20 s, 30 s for 100 g to study the effect of indentation duration. The applied load was increased to 300 g, 500 g, 1000 g and 2000 g for 10 s to be able to make microcracks. Specimens were tested in the wet and dry state to study the effects of hydration on microhardness measurement. Results: Loads of 50 g, 100 g and 200 g for 10 s were able to differ ribosylated bone from non-ribosylated bone for the young and old bovine bones. Microhardness values increased with increasing incubation period. Microhardness of dry specimens were found to be statistically higher than that of wet specimens. Presence of extrinsic toughening mechanisms including crack bridging due to uncracked ligaments and collagen fibers were directly observed by scanning electron microscope (SEM). Ribosylated bone was found to have lower number of collagen bridging compared to non-ribosylated bovine bone. Conclusion: Microhardness test by these are able to discriminate non-modified collagen structure from modified collagen. On the other hand, it is found that microindentation was not able to discriminate the degree of NEG. © 2015 World Scientific Publishing Company.
- Published
- 2015
389. Role of snus in initiation and cessation of tobacco smoking in Sweden
- Author
-
Lars Ramström and Jonathan Foulds
- Subjects
Adult ,Male ,Tobacco, Smokeless ,Health (social science) ,Adolescent ,medicine.medical_treatment ,Nicotine patch ,Smoking Prevention ,Nicotine ,Age Distribution ,Prevalence ,medicine ,Humans ,Sex Distribution ,Aged ,Retrospective Studies ,Sweden ,business.industry ,Smoking ,Public Health, Environmental and Occupational Health ,Advertising ,Tobacco Use Disorder ,Odds ratio ,Middle Aged ,Nicotine replacement therapy ,Confidence interval ,Nicotine gum ,Snus ,Smoking cessation ,Female ,Smoking Cessation ,business ,Research Paper ,Demography ,medicine.drug - Abstract
Objective: To examine patterns of smoking and snus use and identify individual pathways of Swedish tobacco users in order to clarify whether snus use is associated with increased or decreased smoking. Methods: Retrospective analysis of data from a cross-sectional survey completed by 6752 adult Swedes in 2001–2 focusing on identifying tobacco use history by survey items on current and prior tobacco use and smoking initiation and cessation procedures. Results: 15% of the men and 19% of the women completing the survey were daily smokers. 21% of the men and 2% of the women were daily snus users. Almost all (91%) male daily smoking began before the age of 23 years, whereas initiation of daily snus use continued throughout the age range (33% of initiation after age 22). 20% of male primary snus users started daily smoking compared to 47% of non-primary snus users. Thus, the odds of initiating daily smoking were significantly lower for men who had started using snus than for those who had not (odds ratio (OR) 0.28, 95% confidence interval (CI) 0.22 to 0.36). Among male primary smokers, 28% started secondary daily snus use and 73% did not. 88% of those secondary snus users had ceased daily smoking completely by the time of the survey as compared with 56% of those primary daily smokers who never became daily snus users (OR 5.7, 95% CI 4.9 to 8.1). Among men who made attempts to quit smoking, snus was the most commonly used cessation aid, being used by 24% on their latest quit attempt. Of those men who had used one single cessation aid 58% had used snus, as compared with 38% for all nicotine replacement therapy products together. Among men who used snus as a single aid, 66% succeeded in quitting completely, as compared with 47% of those using nicotine gum (OR 2.2, 95% CI 1.3 to 3.7) or 32% for those using the nicotine patch (OR 4.2, 95% CI 2.1 to 8.6). Women using snus as an aid were also significantly more likely to quit smoking successfully than those using nicotine patches or gum. Conclusion: Use of snus in Sweden is associated with a reduced risk of becoming a daily smoker and an increased likelihood of stopping smoking.
- Published
- 2006
390. Simultaneous versus sequential one-stage combined anterior and posterior spinal surgery for spinal infections (outcomes and complications)
- Author
-
Muren Mutlu, Ali Sehirlioglu, Cagatay Ozturk, Recep Vural, Ufuk Aydinli, Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı., Öztürk, Çağatay, Aydınlı, Ufuk, Vural, Recep, and Mutlu, Muren
- Subjects
Male ,Blood transfusion ,medicine.medical_treatment ,Surgical approach ,Kyphosis ,Postoperative Complications ,Anesthesia ,Orthopedics and Sports Medicine ,Priority journal ,Vertebra ,Osteomyelitis ,Middle Aged ,Management ,Spondylitis ,Epidural Abscess ,Operation duration ,Statistical analysis ,Spinal fusion ,Spine stabilization ,Female ,Sex ratio ,Age distribution ,Human ,Adult ,medicine.medical_specialty ,Major clinical study ,Article ,Spinal cord decompression ,Spine surgery ,medicine ,Paralysis ,Humans ,Blood Transfusion ,Fusion ,Aged ,Retrospective Studies ,Original Paper ,Intermethod comparison ,business.industry ,Bleeding ,One stage ,Surgical technique ,Retrospective cohort study ,Follow up ,Pyogenic vertebral osteomyelitis ,medicine.disease ,Spinal cord infection ,Spinal surgery ,Postoperative complication ,Surgery ,Outcome assessment ,Orthopedics ,Spinal Fusion ,Debridement ,Orthopedic surgery ,business ,Controlled study - Abstract
To compare simultaneous with sequential one-stage (same anaesthesia) combined anterior and posterior spinal surgery in the treatment of spinal infections in terms of the operation time, blood loss and complication rate. Fifty-six patients who underwent one-stage (same anaesthesia) simultaneous or sequential anterior decompression and posterior stabilisation of the involved vertebrae for spinal infection from January 1994 to December 2002 were reviewed. In group I (n=29), sequential anterior and posterior surgery was performed. In group II (n=27), simultaneous anterior and posterior spinal surgery was performed. With regard to age and gender, there was no statistical difference between both groups (P=0.05). The analysed and compared data between the two groups included the age, gender, blood loss, operation time and postoperative complications. There was a statistically significant difference between the two groups in terms of the duration of surgery, amount of blood transfusion needed and occurrence of major postoperative complications (P < 0.05). The mean correction of the kyphotic deformity was similar in both groups (P > 0.05) without a subsequent loss of correction on follow-up radiographic films at a mean follow-up of 6.5 years (range, 3 to 11 years). Simultaneous anterior and posterior surgery is a good alternative procedure. It provides the ability to manipulate both anterior and posterior aspects of the spine at the same time and appears to result in less blood loss, a shorter operative time and fewer complications. However, gaining experience and the availability of two surgical teams are important factors in the success of the procedure.
- Published
- 2006
391. Changes in smoking prevalence in Russia, 1996-2004
- Author
-
Anna Gilmore, Richard Rose, Martin McKee, Martin Bobak, and Michael Marmot
- Subjects
Adult ,Male ,Health (social science) ,Adolescent ,Rural Health ,Smoking prevalence ,Russia ,Age Distribution ,Residence Characteristics ,Prevalence ,Humans ,Medicine ,University education ,Sex Distribution ,Aged ,business.industry ,Maternal Deprivation ,Rural health ,Smoking ,Urban Health ,Public Health, Environmental and Occupational Health ,Outcome measures ,Middle Aged ,Smoking epidemiology ,Population Surveillance ,Long term monitoring ,Educational Status ,Female ,Age distribution ,Rural area ,business ,Research Paper ,Demography - Abstract
Objectives: In Russia, smoking prevalence has historically been high in men and relatively low in women. Female smoking prevalence is predicted to rise but assessment of changes has been limited by the lack of comparable data. Changes in the prevalence of smoking in Russia between 1996 and 2004, and whether theses changes differed by sociodemographic groups, were investigated. Design: Repeated national interview surveys in 1996 (731 men and 868 women) and 2004 (727 men and 864 women) aged 18 years or more. Main outcome measure: Prevalence of current smoking. Results: The age standardised prevalence of smoking in 1996 and 2004 was 61% and 63%, respectively in men and 15% and 16%, respectively in women (both p values > 0.4). In men, the prevalence of smoking seemed to decline in those with university education (from 51% to 40%, p = 0.085). Among women, smoking appeared to increase in those with university education (from 10% to 17%, p = 0.071) and low levels of self-reported material deprivation (from 11% to 18%, p = 0.053). There was a pronounced increase in prevalence among women living in villages (from 8% to 14%, p = 0.049); the strong urban/rural gradient seen in 1996 became considerably weaker by 2004. Conclusions: Overall smoking prevalence in both men and women in Russia remained stable between 1996 and 2004 but, given the sample size, a moderate increase in female smoking cannot be ruled out. In men, smoking increased among the least educated and declined in the most educated. In women the opposite appeared to occur, in addition to an increase in smoking in rural areas. More long term monitoring of smoking patterns in Russia, especially among women, using sufficiently large surveys, is required.
- Published
- 2006
392. Are comprehensive environmental changes as effective as health education for smoking cessation?
- Author
-
Y. Kita, Naomi Miyamatsu, Takehito Hayakawa, Akira Okayama, Hirotsugu Ueshima, Kayoko Hishida, Takashi Kadowaki, Hideyuki Kanda, Tomonori Okamura, and Makoto Watanabe
- Subjects
Adult ,Male ,Health (social science) ,Adolescent ,Outcome measurements ,medicine.medical_treatment ,Age adjustment ,Social Environment ,Quit smoking ,Age Distribution ,Japan ,Occupational Exposure ,Environmental health ,Humans ,Industry ,Medicine ,Workplace ,Health Education ,business.industry ,Smoking ,Public Health, Environmental and Occupational Health ,Social environment ,Middle Aged ,Social Control, Formal ,Smoking cessation ,Smoking Cessation ,Health education ,Age distribution ,Occupational exposure ,business ,Research Paper - Abstract
Objectives: To compare the effectiveness of health education on smoking cessation for all smokers regardless of their willingness to quit smoking and cumulative environmental changes including designation of smoking places, legislation, and price rise. Design: Comparison of smoking cessation rates over two time periods: the period of health education on smoking cessation (1997–1999), and the period of cumulative environmental changes (2002–2004). Setting: An occupational setting in a radiator manufacturing factory in Japan. Subjects: All habitual male smokers who remained in the worksite through the pertinent time period (n = 202 in the period of health education and n = 170 in the period of environmental changes). Main outcome measurements: Smoking cessation rates at the end of each time period. Results: The smoking cessation rates over the periods of health education and environmental changes were 8.9% and 7.1%, respectively. There was no difference between these two proportions in a χ 2 test (p = 0.513). The age adjustment did not significantly alter the cessation rate. Conclusions: Cumulative environmental changes are fairly effective in promoting smoking cessation, and may yield similar smoking cessation rates as a health education intervention reaching all smokers regardless of their willingness to quit smoking.
- Published
- 2006
393. Progressively increasing operative risk among patients referred for Coronary Artery Bypass Surgery
- Author
-
Horan, Paul G, Leonard, Niall, and Herity, Niall A
- Subjects
Paper ,Male ,Medical Audit ,Age Distribution ,Humans ,Female ,Coronary Artery Bypass ,Middle Aged ,Ireland ,Referral and Consultation ,Risk Assessment ,Aged - Abstract
Objective Advances in surgical, anaesthetic and percutaneous interventional techniques may have led to higher risk patients being referred for coronary artery bypass graft surgery (CABG). The purpose of this study was to compare the predicted mortality risk (EuroSCORE) of a contemporary cohort of patients referred for isolated elective CABG (2002) with that of a cohort referred five years previously (1997) and to examine temporal trends in patient demographics. Methods Records (n = 2873) of weekly cardiac surgical referral meetings were examined and the age, sex, type of operation and surgical decision for every patient referred from 1997 to 2002 inclusive were recorded. Furthermore samples of patients referred in 1997 (n = 111) and in 2002 (n = 110) were chosen, and a complete EuroSCORE was calculated for each patient and compared between groups. Results In both 1997 and 2002 the median EuroSCORE among patients not accepted for surgery was significantly higher than those accepted (1997; 3 vs 2, p
- Published
- 2006
394. Modelling predictions of cancer deaths in Northern Ireland
- Author
-
French, D., Catney, Denise, and Gavin, Anna
- Subjects
Medicine(all) ,Adult ,Aged, 80 and over ,Male ,Paper ,Adolescent ,Infant, Newborn ,Infant ,Middle Aged ,Age Distribution ,Editorial ,Child, Preschool ,Neoplasms ,Linear Models ,Humans ,Female ,Registries ,Sex Distribution ,Child ,Ireland ,Aged - Abstract
Background An ageing population has service planners concerned about future levels of disease which are age dependent. Predictions of mortality for colorectal, lung and breast cancers, which account for 30% of cancer cases and 40% of cancers deaths, were calculated for 2010 and 2015, based on trends in death rates and the predicted change in the demography of the Northern Ireland population. Methods The US National Cancer Institute's “Joinpoint” program was used to check for structural breaks in the time series of cancer death rates from 1984 to 2004. The prediction models applied to the data allowed variations in trends across age groups to be taken into account. A linear model was used for increasing or constant trends and a log linear model was used where the trend was decreasing. The models assume the number of deaths in each stratum, defined by age-sex and time-period, is Poisson distributed, with the average value determined by a log or linear function. Results Recent trends in rates of cancers studied were downwards except for female lung. Predictions include decreased colorectal cancer deaths in females and lung cancer deaths in males. In females, lung cancer deaths are predicted to more than double by the year 2015 (473 deaths), based on the 1984 level. Colorectal death rates in males are predicted to drop, but the number of deaths will increase by more than 10%, due to demographic change. Numbers of breast cancer deaths are likely to rise slightly, despite falling age standardised death rates, due to an ageing population. Conclusions This work has provided estimates of early future trends, useful to service planners, and highlights the need for tobacco control, to reduce numbers of lung cancer deaths in females. The recently announced control of environmental tobacco legislation is one welcome development which should reduce lung cancer mortality in Northern Ireland.
- Published
- 2006
395. Evaluations of dentists on a German physician rating Website: an analysis of the ratings
- Author
-
Martin, Emmert, Frank, Halling, and Florian, Meier
- Subjects
Adult ,Male ,Internet ,Original Paper ,patient experience ,dentist ,Dentists ,Middle Aged ,Age Distribution ,quality of care ,Germany ,Physicians ,physician rating website ,Humans ,Female ,Social Media - Abstract
Background Physician rating websites have been gaining in importance in both practice and research. However, no evidence is available concerning patients’ ratings of dentists on physician rating websites. Objective The aim of this study is to present a comprehensive analysis of the ratings of dentists on a German physician rating website over a 2-year period. Methods All dentist ratings on a German physician rating website (Jameda) from 2012 and 2013 were analyzed. The available dataset contained 76,456 ratings of 23,902 dentists from 72,758 patients. Additional information included the overall score and subscores for 5 mandatory questions, the medical specialty and gender of the dentists, and the age, gender, and health insurance status of the patients. Statistical analysis was conducted using the median test and the Kendall tau-b test. Results During the study period, 44.57% (23,902/53,626) of all dentists in Germany were evaluated on the physician rating website, Jameda. The number of ratings rose from 28,843 in 2012 to 47,613 in 2013, representing an increase of 65.08%. In detail, 45.37% (10,845/23,902) of dentists were rated once, 43.41% (10,376/23,902) between 2 and 5 times, and 11.21% (2681/23,902) more than 6 times (mean 3.16, SD 5.57). Approximately 90% (21,324/23,902, 89.21%) of dentists received a very good or good overall rating, whereas only 3.02% (721/23,902) were rated with the lowest scores. Better ratings were given either by female or older patients, or by those covered by private health insurance. The best-rated specialty was pediatric dentistry; the lowest ratings were given to orthodontists. Finally, dentists were rated slightly lower in 2013 compared to 2012 (P=.01). Conclusions The rise in the number of ratings for dentists demonstrates the increasing popularity of physician rating websites and the need for information about health care providers. Future research should assess whether social media, especially Web-based ratings, are suitable in practice for patients and other stakeholders in health care (eg, insurance providers) to reflect the clinical quality of care.
- Published
- 2014
396. Incidence of amyotrophic lateral sclerosis in southern Italy: a population based study
- Author
-
R. Palagano, Stefano Zoccolella, Vito Lepore, Paolo Lamberti, Angela Fraddosio, Isabella Laura Simone, Giancarlo Logroscino, L. Serlenga, and Ettore Beghi
- Subjects
Adult ,Male ,Paper ,medicine.medical_specialty ,Neuromuscular disease ,Adolescent ,Climate ,Latitude ,Age Distribution ,Catchment Area, Health ,Humans ,Medicine ,Sex Distribution ,Amyotrophic lateral sclerosis ,Child ,Aged ,Aged, 80 and over ,Electromyography ,business.industry ,Incidence ,Incidence (epidemiology) ,Amyotrophic Lateral Sclerosis ,Infant ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Population based study ,Psychiatry and Mental health ,Italy ,Population Surveillance ,Female ,Neurology (clinical) ,business ,Motor neurone disease ,Cohort study ,Demography - Abstract
Background: While the incidence of amyotrophic lateral sclerosis (ALS) is similar across the world (range, 1.0 to 2.5/100 000), a latitude gradient from north to south has been observed. Objective: To determine the incidence of ALS in Puglia, a region of south eastern Italy, and to test the latitude gradient hypothesis comparing the present study with findings in studies conducted with the same design in a northern latitude. Methods: Puglia (4 086 613 residents in 2001) is the site of a multicentre-multisource prospective population based registry established in 1997. All incident ALS cases during the period 1998–99 were enrolled and followed up. Cases were classified using the first and the revised El Escorial criteria. Results: During the study period 130 cases were enrolled. The annual crude incidence for ALS in Puglia for the two year period 1998–99 was 1.6/100 000 (95% confidence interval, 1.3 to 1.9). The incidence was higher for men (incidence rate (IR) = 2.1 (1.7 to 2.7) than for women (IR = 1.2 (0.9 to 1.5)) in all age groups, with a male to female ratio of 1.6. For both men and women, the incidence increased through age 75 and declined rapidly afterwards. The mean annual incidence adjusted by age and sex to the 2001 Italian population was 1.7/100 000 (1.4 to 2.0). Conclusions: ALS incidence is within a narrow range across countries, with a peak between 65 and 75 years and a higher incidence in men . A north to south latitude gradient of ALS incidence is not supported by the results of cohort studies.
- Published
- 2005
397. Smoking behaviour in Taiwan, 2001
- Author
-
C C Hsu, C P Wen, Shan Pou Tsai, David T. Levy, and T. Yuan Cheng
- Subjects
Adult ,Male ,Low income ,Health (social science) ,Adolescent ,Taiwan ,Tobacco smoke ,Cohort Studies ,Age Distribution ,Environmental health ,Prevalence ,Humans ,Medicine ,National Health Interview Survey ,Sex Distribution ,Socioeconomic status ,Aged ,business.industry ,Smoking ,Tobacco control ,Public Health, Environmental and Occupational Health ,Middle Aged ,Socioeconomic Factors ,Population Surveillance ,Childbearing age ,Educational Status ,Female ,Tobacco Smoke Pollution ,business ,Sex ratio ,Research Paper ,Cohort study - Abstract
Purpose: To examine smoking behaviours in Taiwan and compare those behaviours to those in the USA. Methods: Using the National Health Interview Survey (NHIS) of Taiwan (2001), a survey of over 20 000 participants, frequencies were calculated for smoking, ex-smoking, quantity smoked, and exposure to environmental tobacco smoke (ETS). Breakdowns by age, sex, and socioeconomic status were also calculated. Results: The ratio of male to female smoking rates was 10.9 to 1 among adults (46.8%/4.3%), but 3.6 to 1 among underage teenagers (14.3%/4.0%). The proportion of underage to adult smokers was three times higher for girls than for boys. Smoking prevalence substantially increased during and after high school years, and peaked in those aged 30–39 years. Smoking rates of high school age adolescents increased more than threefold if they did not attend school or if they finished their education after high school. Low income and less educated smokers smoked at nearly twice the rate of high income and better educated smokers. The smoker/ex-smoker ratio was close to 7. Male daily smokers smoked on average 17 cigarettes/day, and females, 11. Half of the total population, especially infants and women of childbearing age, were exposed to ETS at home. Conclusions: Taiwan has particularly high male smoking prevalence and much lower female prevalence. The low female prevalence is likely to increase if the current sex ratio of smoking by underage youth continues. The low quit rate among males, the high ETS exposure of females and young children at home, and the sharp increase in smoking rates when students leave school, are of particular concern. These observations on smoking behaviour can provide valuable insights to assist policymakers and health educators in formulating strategies and allocating resources in tobacco control.
- Published
- 2005
398. Uncovering the relation between betel quid chewing and cigarette smoking in Taiwan
- Author
-
Michael P. Eriksen, Shan Pou Tsai, T Y Cheng, Chi Pang Wen, H. J. Yang, Chien-Jen Chen, and David T. Levy
- Subjects
Adult ,Employment ,Male ,Health (social science) ,Adolescent ,Taiwan ,Dentistry ,Betel quid chewing ,Age Distribution ,stomatognathic system ,Cigarette smoking ,Environmental health ,Prevalence ,otorhinolaryngologic diseases ,Humans ,National Health Interview Survey ,Medicine ,Sex Distribution ,Child ,Areca ,biology ,business.industry ,Smoking ,digestive, oral, and skin physiology ,Tobacco control ,Public Health, Environmental and Occupational Health ,Middle Aged ,biology.organism_classification ,stomatognathic diseases ,Socioeconomic Factors ,Relative risk ,Cohort ,Female ,Smoking status ,business ,Research Paper - Abstract
Objective: To describe the characteristics of betel quid chewers and to investigate the behavioural and mortality relations between betel quid chewing and cigarette smoking. Method: Prevalence and mortality risks of betel quid chewers by smoking status were calculated, based on the National Health Interview Survey in 2001 and a community based cohort, respectively. Cox's proportional hazards model was used to adjust mortality risks for age, alcohol use, and education. Results: Almost all betel quid chewers were smokers, and most started chewing after smoking. Chewers were predominantly male, mostly in their 30s and 40s, more likely being among the lowest educational or income group, and residing in the eastern regions of Taiwan. On average, betel quid chewers who smoked consumed 18 pieces of betel quid a day, and smoked more cigarettes per day. Far more smokers use betel quid than non-smokers (27.5% v 2.5%), but ex-smokers quit betel quid more than smokers (15.1% v 6.8%). The significantly increased mortality of betel quid users who also smoked, for all causes, all cancer, oral cancer, and cancer of the nasopharynx, lung, and liver, was the result of the combined effects of chewing and smoking. Smokers who chewed betel quid nearly tripled their oral cancer risks from a relative risk of 2.1 to 5.9. Increasing the number of cigarettes smoked among betel quid chewers was associated with a synergistic effect, reflective of the significant interaction between the two. Conclusion: To a large extent, the serious health consequences suffered by betel quid chewers were the result of the combined effects of smoking and chewing. Betel quid chewing should not be considered as an isolated issue, but should be viewed conjointly with cigarette smoking. Reducing cigarette smoking serves as an important first step in reducing betel quid chewing, and incorporating betel quid control into tobacco control may provide a new paradigm to attenuate the explosive increase in betel quid use in Taiwan.
- Published
- 2005
399. Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries
- Author
-
Martijn Huisman, Anton E. Kunst, Johan P. Mackenbach, Public Health, and Other departments
- Subjects
Adult ,Male ,Health (social science) ,Tobacco use ,Inequality ,Adolescent ,Cross-sectional study ,media_common.quotation_subject ,Prevalence ,Age Distribution ,Risk Factors ,Odds Ratio ,media_common.cataloged_instance ,Medicine ,Humans ,European Union ,European union ,Sex Distribution ,Disadvantage ,media_common ,business.industry ,Smoking ,Public Health, Environmental and Occupational Health ,Odds ratio ,Middle Aged ,Europe ,General Social Survey ,Cross-Sectional Studies ,Educational Status ,Female ,business ,Demography ,Research Paper - Abstract
Objective: To determine those groups who are at increased risk of smoking related diseases, we assessed in which male and female generations smoking was more prevalent among lower educated groups than among the higher educated, in 11 European countries. Design: Cross sectional analysis of data on smoking, covering the year 1998, from a social survey designed for all member states of the European Union. Subjects: Higher and lower educated men and women aged 16 years and older from 11 member states of the European Union. Outcome measures: Age standardised prevalence rates by education and prevalence odds ratios of current and ever daily smoking comparing lower educated groups with higher educated groups. Results: A north–south gradient in educational inequalities in current and ever daily smoking was observed for women older than 24 years, showing larger inequalities in the northern countries. Such a gradient was not observed for men. A disadvantage for the lower educated in terms of smoking generally occurred later among women than among men. Indications of inequalities in smoking in the age group 16–24 years were observed for all countries, with the exception of women from Greece and Portugal. Conclusions: Preventing and reducing smoking among lower educated subgroups should be a priority of policies aiming to reduce inequalities in health in Europe. If steps are not taken to control tobacco use among the lower educated groups specifically, inequalities in lung cancer and other smoking related diseases should be anticipated in all populations of the European Union, and both sexes.
- Published
- 2005
400. Regional, disease specific patterns of smoking-attributable mortality in 2000
- Author
-
Majid Ezzati and Alan D. Lopez
- Subjects
Adult ,Male ,medicine.medical_specialty ,Lung Neoplasms ,Health (social science) ,Respiratory Tract Diseases ,Developing country ,Digestive System Neoplasms ,Age Distribution ,Cost of Illness ,Cause of Death ,Neoplasms ,Epidemiology ,medicine ,Humans ,Lung Diseases, Obstructive ,Sex Distribution ,Intensive care medicine ,Lung cancer ,Developing Countries ,Aged ,Cause of death ,COPD ,business.industry ,Developed Countries ,Smoking ,Public Health, Environmental and Occupational Health ,Cancer ,Respiratory tract neoplasm ,Middle Aged ,medicine.disease ,Respiratory Tract Neoplasms ,Cardiovascular Diseases ,Female ,business ,Developed country ,Research Paper ,Demography - Abstract
Background: Smoking has been causally associated with increased mortality from several diseases, and has increased considerably in many developing countries in the past few decades. Mortality attributable to smoking in the year 2000 was estimated for adult males and females, including estimates by age and for specific diseases in 14 epidemiological subregions of the world. Methods: Lung cancer mortality was used as an indirect marker of the accumulated hazard of smoking. Never-smoker lung cancer mortality was estimated based on the household use of coal with poor ventilation. Estimates of mortality caused by smoking were made for lung cancer, upper aerodigestive cancer, all other cancers, chronic obstructive pulmonary disease (COPD), other respiratory diseases, cardiovascular diseases, and selected other medical causes. Estimates were limited to ages 30 years and above. Results: In 2000, an estimated 4.83 million premature deaths in the world were attributable to smoking, 2.41 million in developing countries and 2.43 million in industrialised countries. There were 3.84 million male deaths and 1.00 million female deaths attributable to smoking. 2.69 million smoking attributable deaths were between the ages of 30–69 years, and 2.14 million were 70 years of age and above. The leading causes of death from smoking in industrialised regions were cardiovascular diseases (1.02 million deaths), lung cancer (0.52 million deaths), and COPD (0.31 million deaths), and in the developing world cardiovascular diseases (0.67 million deaths), COPD (0.65 million deaths), and lung cancer (0.33 million deaths). The share of male and female deaths and younger and older adult deaths, and of various diseases in total smoking attributable deaths exhibited large inter-regional heterogeneity, especially in the developing world. Conclusions: Smoking was an important cause of global mortality in 2000, affecting a large number of diseases. Age, sex, and disease patterns of smoking-caused mortality varied greatly across regions, due to both historical and current smoking patterns, and the presence of other risk factors that affect background mortality from specific diseases.
- Published
- 2004
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.