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BackgroundEthnic disparities have been associated with injury and mortality. The impact of ethnicity on head and neck injury (HNI), traumatic brain injury (TBI), in-hospital mortality and resource utilization following a motorcycle crash (MCC) is undetermined. This study explored the influence of ethnicity in these aspects and the effect of helmet use on HNI and TBI following a MCC.MethodsThe National Trauma Registry provided hospitalization data on motorcycle riders and passengers between 2008 and 2017. Ethnicity was classified as Jews or Arabs, the two major ethnic groups in Israel. Univariate followed by multivariable logistic models were applied to examine ethnic disparities. Mediation effect was tested by structural equation modeling.ResultsAmong 6073 MCC casualties, Arabs had increased odds of HNI (OR = 1.37,95% CI = 1.12–1.65) and TBI (OR = 1.51,95%CI = 1.12–1.99), and a six-fold decreased odds of helmet use (OR = 0.16,95%CI = 0.12–0.22). The HNI and TBI associations with ethnicity were mediated by helmet use. Arabs had significantly higher odds for admission to intensive care unit (OR = 1.36,95%CI = 1.00–1.83), and lower odds for ambulance evacuation (OR = 0.73,95%CI = 0.61–0.89) and discharge to rehabilitation (OR = 0.55,95%CI = 0.39–0.7). In-hospital mortality was not associated with ethnicity.ConclusionsHelmet non-use is an important etiologic factor associated with motorcycle-related HNI and TBI among Arabs. While in Israel, ethnic equality exists in in-hospital health care, disparities in ambulance and rehabilitation utilization was found. Intervention programs should target the Arab population and focus on helmet compliance.

Dog bites are a substantial public health concern. Rarely has hospitalizations resulting from dog bites been examined. We examined, at a national level, demographic and injury characteristics of dog-bites injuries requiring hospitalization to target prevention programs and policies for those who are at higher risk.Data on hospitalizations due to dog-bite injuries with an ICD9-CM E906.0 coding were extracted from the Israeli National Trauma Registry between 2009-2016. We calculated the annual incidence of hospitalized dog-bite injuries and compared rates by Chi-squared test. Mantel Haenszel chi-squared test and Dickey-Fuller time-series analysis were used to test linear age and temporal trends, respectively.Overall 986 persons were hospitalized for dog-bite injuries between 2009-2016. An increasing significant trend over the 8-year-period in the proportion of hospitalized dog-bite injuries among all trauma hospitalizations was revealed among children between 0 and 14 years old (p = 0.01). Children had also approximately twice the risk for dog-bite injuries compared to persons aged between 15 and 94 years old (relative risk [RR] = 1.89, 95% confidence interval [CI] = 1.35-2.66, p 0.0001); the 2016 (latest year) rate per 100,000 was significantly higher for boys than for girls (RR = 2.85, 95%CI = 1.57-5.19, p 0.0001); no gender differences were detected in the other age groups. Injury in the face/head/neck was most common in children between 0 and 14 years old (49.7%), specifically among the youngers (1, 1-3 and 4-5 year olds) compared with the 6-11 and 12-14 age groups (p 0.0001), with 4-fold-risk compared with persons aged between 15 and 94 years old (RR = 3.78, 95%CI, 3.01-4.75). There was no overall significant temporal trend in the annual incidence rates (from 1.84 (95%CI = 1.54-2.15) in 2009 to 1.54 (95%CI = 1.28-1.81) in 2016 per 100,000 population.Children younger than 15 years, with greater extent in boys than girls, represent the high-risk demographic group for dog bites. Prevention programs targeting at this group should be implemented and translated into an actual reduction in the incidence of dog-bites. In addition, an ongoing monitoring and reporting system specific for all dog-bites should be established in Israel, in order to better understand how to minimize the incidence of dog-bites and evaluate prevention efforts.

Background Evidence for an association of fasting plasma glucose (FPG) with cognitive function in adults free of diabetes is scarce and based on middle-aged and older adults. We examined the association of FPG, measured at age 30, and of change in FPG from age 30 to 43, with cognitive function at age 50. Methods 505 nondiabetic participants of the population-based Jerusalem Lipid Research Clinic (LRC) cohort study had baseline FPG, 2-h post-oral challenge plasma glucose (OGTT) and insulin determined at ages 28-32, and FPG and OGTT again at ages 41-46. Subsequently at ages 48-52, global cognitive function and its five specific component domains were assessed with a NeuroTrax computerized test battery, using multiple linear regression and multivariable logistic models. Results Hyperglycemia (FPG ≥ 5.6 mmol/l vs.

BACKGROUND Whether life course anthropometric indices relate to cognitive function in midlife remains insufficiently explored. Rarely was socioeconomic position (SEP) adequately accounted for. OBJECTIVE To examine the association of the cumulative life course burden of high-ranked body mass index (BMI), its trajectory, and stature with cognitive function in midlife. METHODS Weight and height were measured from age 17 across a 33-year follow-up. 507 individuals completed a NeuroTrax computerized cognitive assessment at ages 48-52. Life course SEP was assessed by multiple methods. Using mixed models we calculated the area under the curve (AUC), representing both the life-course burden of BMI (total AUC) and trends in BMI (incremental AUC) from age 17 to midlife. The associations of BMI and height with global cognition and its five component domains were assessed by multiple regression. RESULTS Higher BMI in late adolescence and total AUC over the life course were associated with poorer global cognition (Standardized beta (Beta) = -0.111, p = 0.005 and Beta = -0.105, p = 0.018, respectively), adjusted for childhood and adulthood SEP, and demographic characteristics. The associations with higher adolescent and midlife BMI were both restricted to those with low childhood SEP (p

Background Inflammatory markers are elevated in patients with dementia. Evidence for an association between inflammation and cognitive function in dementia-free individuals is sparse, inconsistent, and predominantly restricted to the elderly. Assessment of inflammatory markers in young adults as predictors of cognitive function in midlife, well before the onset of overt dementia, is lacking. Furthermore, rarely has the relation with longitudinal change in inflammatory markers been examined. Objective To examine the association of the inflammatory markers C-reactive protein (CRP), fibrinogen, white blood cell count (WBC) and GlycA, a novel NMR-determined biomarker of systemic inflammation, measured in young adulthood and of GlycA change over 13 years follow-up with cognitive function in midlife. Methods 507 participants of the Jerusalem Lipid Research Clinic (LRC) study were assessed at 3 time points over 18–22 years. First, the inflammatory variables GlycA, CRP, fibrinogen, and WBC were measured in blood samples drawn at ages 28–32. Then, in blood samples drawn a mean 13 years later (range, 12–16 years) at ages 41–46, GlycA was again measured (in 484 individuals). Subsequently at ages 48–52, on average 7 years later, global cognitive function and its five specific component domains were assessed with a NeuroTrax computerized test battery. Multiple regression and multivariable logistic models were applied. Results Inverse unadjusted associations were shown for baseline levels and longitudinal change in inflammatory markers and measures of cognition. Multiple regression models were adjusted for age at cognitive assessment, sex, socio-demographic characteristics, baseline measures of leisure-time vigorous activity, smoking status and body mass index (BMI) at ages 28–32, change in smoking status and BMI between ages 28–32 and 41–46, and depression assessed at the time of cognitive testing. The highest quintile of GlycA change, but not the baseline inflammation measures, was inversely related to global cognition (standardized β = -.109, p = .011) as well as to the information processing speed and memory domains (standardized β = -.124, p = .008 and-.117, p = .014, respectively). The multivariable-adjusted odds ratio for low ranked global cognitive function (lowest fifth) comparing the extreme quintiles of GlycA change was 4.8 (95%CI, 1.7–13.5, p = .003; p for trend = .031). Conclusions In this longitudinal study of a novel systemic inflammatory marker in a population-based cohort of young adults, GlycA increase over 13 years, but not baseline measures of inflammation, was associated with poorer cognitive function in midlife.

Evidence for an association of leukocyte telomere length (LTL) with cognitive function, predominantly in older adults, is inconsistent. No report has examined the association of LTL dynamics (age-specific LTL and its attrition rate) with cognitive function. We aimed to examine the association of LTL dynamics over 13 years in young adulthood with cognitive function in midlife. 497 individuals who had LTL measured at ages 28–32 and 41–46 years were assessed at ages 48–52 for global cognitive function and its five specific component domains with a NeuroTrax computerized test battery. Multivariable regression and logistic models were applied for cognition treated as a continuous and categorical variable, respectively. We found that LTL attrition (adjusted for sex, baseline LTL and potential confounders including socioeconomic variables) was inversely associated with global cognition (standardized β = −.119, p = .004) and its component domains: information processing speed (β = −.102, p = .024), visual-spatial function (β = −.102, p = .017) and memory (β = −.093, p = .045), but less so for the attention and executive domains. The multivariable-adjusted odds ratio for low global cognition comparing the upper versus lower thirds of LTL attrition was 2.12 (95 % CI 1.11–4.08, p for trend = .023). There was no association of baseline or follow-up LTL with cognition. No effect modification was evident for sex, smoking or inflammatory markers. In conclusion, faster LTL attrition in young adulthood was associated with poorer global and domain-specific cognitive function in midlife, suggesting that more rapid LTL attrition may be predictive of cognitive aging in healthy young adults. Electronic supplementary material The online version of this article (doi:10.1007/s10654-015-0051-4) contains supplementary material, which is available to authorized users.

Despite the controversy regarding the risks and benefits of hormone replacement therapy, studies in various countries report a two- to threefold increase in the use of HRT during the last decade.To estimate the prevalence of HRT use among post-menopausal Jewish women in Israel and to determine the variables predicting current HRT use.A cross-sectional telephone survey was conducted in 1998 on a random sample of Jewish women aged 45-74. Of 935 women who were located and eligible, 704 (75%) were interviewed by means of a structured questionnaire.A total of 589 women (85%) were peri-menopausal or post-menopausal. Ninety-nine of them (16.8%) were currently using HRT and 78 (13.2%) were past users. Higher rates of current use were found among women who had undergone hysterectomy and/or oophorectomy (38%) than among all other women (13.5%). Among naturally menopausal women the highest rate of current use (25.6%) was found in those aged 55-59. A multiple logistic regression showed that the variables associated with current HRT use among naturally menopausal women were: having a regular gynecologist (odds ratio 3.6, 95% confidence interval 1.7-7.5), visiting a gynecologist during the past year (OR 2.9, 95% CI 1.4-6.0), experiencing symptoms of menopause (OR 2.0, 95% CI 1.01-3.8), having more than a high-school education (OR 1.9, 95% CI 1.04-3.6), and a lower body mass index (OR 0.91, 95% CI 0.85-0.99).The factors associated with HRT use may be markers for other socioeconomic or psychological characteristics. The disparities noted between population subgroups may be indicative of differences in awareness or in the delivery of preventive healthcare services to women in Israel, and as such need to be addressed by the health system.