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Santos LRCS, Assunção AÁ, Lima EDP. Back pain in adults living in quilombola territories of Bahia, Northeastern Brazil. Rev Saude Publica 2014; 48:750-7. [PMID: 25372165 PMCID: PMC4211576 DOI: 10.1590/s0034-8910.2014048005317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/08/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the factors associated with back pain in adults who live in quilombola territories. METHODS A population-based survey was performed on quilombola communities of Vitória da Conquista, state of Bahia, Northeastern Brazil. The sample (n = 750) was established via a raffle of residences. Semi-structured interviews were conducted to investigate sociodemographics and employment characteristics, lifestyle, and health conditions. The outcome was analyzed as a dichotomous variable (Poisson regression). RESULTS The prevalence of back pain was of 39.3%. Age ≥ 30 years and being a smoker were associated with the outcome. The employment status was not related to back pain. CONCLUSIONS The survey identified a high prevalence of back pain in adults. It is suggested to support the restructuring of the local public service in order to outline programs and access to healthy practices, assistance, diagnosis, and treatment of spine problems.
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Affiliation(s)
- Luis Rogério Cosme Silva Santos
- Faculdade de Enfermagem, Universidade Federal da Bahia, Vitória da Conquista, BA, Brasil, Faculdade de Enfermagem. Universidade Federal da Bahia. Vitória da Conquista, BA, Brasil
| | - Ada Ávila Assunção
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil, Departamento de Medicina Preventiva e Social. Faculdade de Medicina. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
| | - Eduardo de Paula Lima
- Núcleo de Estudos em Saúde e Trabalho, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil, Núcleo de Estudos em Saúde e Trabalho. Faculdade de Medicina. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
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302
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Gilmour H. Positive mental health and mental illness. Health Rep 2014; 25:3-9. [PMID: 25229895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Based on the Mental Health Continuum Short Form administered in the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), the percentages of Canadians aged 15 or older classified as having flourishing, moderate or languishing mental health were 76.9%, 21.6% and 1.5%, respectively. Compared with estimates for other countries, a higher percentage of Canadians were flourishing. In accordance with the complete mental health model, mental health was also assessed in combination with the presence or absence of mental illness (depression; bipolar disorder; generalized anxiety disorder; alcohol, cannabis or other drug abuse or dependence). An estimated 72.5% of Canadians (19.8 million) were classified as having complete mental health; that is they were flourishing and did not meet the criteria for any of the six past 12-month mental or substance use disorders included in the CCHS-MH. Age, marital status, socio-economic status, spirituality and physical health were associated with complete mental health. Men and women were equally likely to be in complete mental health.
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Affiliation(s)
- Heather Gilmour
- Health Analysis Division, Statistics Canada, Ottawa, Ontario K1A0T6
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303
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Stopa SR, César CLG, Segri NJ, Goldbaum M, Guimarães VMV, Alves MCGP, Barros MBDA. Self-reported diabetes in older people: comparison of prevalences and control measures. Rev Saude Publica 2014; 48:554-662. [PMID: 25210814 PMCID: PMC4181106 DOI: 10.1590/s0034-8910.2014048005219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 02/03/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. METHODS Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5%) and the Pearson's Chi-square (Rao-Scott) tests were performed. The variables without overlap between the confidence intervals were not tested. RESULTS The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between > 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6) in 2003 and 20.1% (95%CI 17.3;23.1) in 2008, which indicates a growth over this period (p at the limit of significance). The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. CONCLUSIONS Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients.
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Affiliation(s)
- Sheila Rizzato Stopa
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil, Programa de Pós-graduação em Saúde Pública. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Chester Luiz Galvão César
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil, Departamento de Epidemiologia. Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo, SP, Brasil
| | - Neuber José Segri
- Departamento de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, MT, Brasil, Departamento de Saúde Coletiva. Universidade Federal de Mato Grosso. Cuiabá, MT, Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil, Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Vanessa Martins Valente Guimarães
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brasil, Escola de Artes, Ciências e Humanidades. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Maria Cecília Goi Porto Alves
- Instituto de Saúde, Secretaria de Estado da Saúde, São Paulo, SP, Brasil, Instituto de Saúde. Secretaria de Estado da Saúde. São Paulo, SP, Brasil
| | - Marilisa Berti de Azevedo Barros
- Departamento de Medicina Preventiva e Social, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil, Departamento de Medicina Preventiva e Social. Faculdade de Ciências Médicas, Universidade Estadual de Campinas. Campinas, SP, Brasil
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304
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Brumback BA, Cai Z, Dailey AB. Methods of estimating or accounting for neighborhood associations with health using complex survey data. Am J Epidemiol 2014; 179:1255-63. [PMID: 24723000 DOI: 10.1093/aje/kwu040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Reasons for health disparities may include neighborhood-level factors, such as availability of health services, social norms, and environmental determinants, as well as individual-level factors. Investigating health inequalities using nationally or locally representative data often requires an approach that can accommodate a complex sampling design, in which individuals have unequal probabilities of selection into the study. The goal of the present article is to review and compare methods of estimating or accounting for neighborhood influences with complex survey data. We considered 3 types of methods, each generalized for use with complex survey data: ordinary regression, conditional likelihood regression, and generalized linear mixed-model regression. The relative strengths and weaknesses of each method differ from one study to another; we provide an overview of the advantages and disadvantages of each method theoretically, in terms of the nature of the estimable associations and the plausibility of the assumptions required for validity, and also practically, via a simulation study and 2 epidemiologic data analyses. The first analysis addresses determinants of repeat mammography screening use using data from the 2005 National Health Interview Survey. The second analysis addresses disparities in preventive oral health care using data from the 2008 Florida Behavioral Risk Factor Surveillance System Survey.
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305
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Helander S, Hakama M, Malila N. Effect of a pre-screening survey on attendance in colorectal cancer screening: a double-randomized study in Finland. J Med Screen 2014; 21:82-8. [PMID: 24803481 DOI: 10.1177/0969141314534229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To explore effects of a pre-screening life style survey on the subsequent attendance proportion in colorectal cancer screening. SETTING Finnish colorectal cancer screening programme in 2011. DESIGN Double randomized and controlled follow-up design. METHODS The study population comprised of 31,951 individuals born in 1951. In 2010 to a random sample of every sixth (n = 5,312) person we sent a 7-paged life style questionnaire, and to another random sample of every sixth person (n = 5,336) a 10-paged life style and quality of life questionnaire. One year later, in 2011, 31,484 individuals of the original cohort were independently randomized (1:1) for colorectal cancer screening (n = 15,748) or control group (n = 15,736). Of those who were invited for screening, 5185 had received a questionnaire during the previous year. RESULTS 5870 individuals (55.1 %) responded to the questionnaire in 2010. The overall attendance at screening in 2011 was 59.0 % in those born in 1951 (i.e. the 60-year-olds). In those who had been sent the survey the attendance in screening was 56.6% (57.3% for the short and 56.0% for the long questionnaire) and in those who had not received the questionnaire it was 60.2% (P < 0.001). CONCLUSIONS We believe that the observed reduction in attendance in those who had been sent a questionnaire earlier is generally true. Thus, if any survey is enclosed in the screening invitation, this finding should be taken into account when planning the programme. Any extra effort requested may reduce the attendance proportion for screening, reducing the population level impact of screening.
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Affiliation(s)
- Sanni Helander
- Researcher, Mass Screening Registry, Finnish Cancer Registry, Helsinki, Finland
| | - Matti Hakama
- Professor of Epidemiology, Mass Screening Registry, Finnish Cancer Registry, Helsinki, Finland and University of Tampere, Tampere, Finland
| | - Nea Malila
- Director, Finnish Cancer Registry, Helsinki, Finland and Professor of Cancer Epidemiology, University of Tampere, Tampere, Finland
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306
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Lykke M, Helbech B, Glümer C. Temporal changes in the attitude towards smoking bans in public arenas among adults in the Capital Region of Denmark from 2007 to 2010. Scand J Public Health 2014; 42:401-8. [PMID: 24728934 DOI: 10.1177/1403494814529034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM The population's attitude towards smoking bans in public arenas is important for their passing, implementation and compliance. Smoking bans are believed to reduce the social acceptability of smoking, and once people experience them, public support increases--also among pre-ban sceptics. This study aimed to examine the temporal changes in public attitude towards smoking bans in public arenas from 2007 to 2010 and whether these changes differed across educational attainment, smoking status and intention to quit among smokers. METHODS Data from two surveys among adults (aged 25-79 years) in 2007 and 2010 in the Capital Region of Denmark (n=36,472/42,504, response rate = 52.3) was linked with data on sex, age and educational attainment from central registers. Age-standardised prevalence of supportive attitude towards smoking bans was estimated. Temporal changes in supportive attitude were explored in workplaces, restaurants and bars using logistic regression models. RESULTS The prevalence of supportive attitude towards smoking bans increased significantly in all arenas from 2007 to 2010. Positive temporal changes in supportive attitude towards smoking bans were seen across educational attainment, smoking status and intention to quit smoking in restaurants and across smoking status for smoking bans in workplaces and bars. CONCLUSIONS The results of this study show that the public's attitude towards smoking in public arenas has changed after the implementation of a comprehensive smoking ban. This change in attitude can support implementation of future legislation on smoking and may lead to positive changes in smoking norms.
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Affiliation(s)
- Maja Lykke
- Research Centre for Prevention and Health, Capital Region of Denmark, Denmark
| | - Bodil Helbech
- Research Centre for Prevention and Health, Capital Region of Denmark, Denmark
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Capital Region of Denmark, Denmark Department of Health Science and Technology, University of Aalborg, Denmark
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307
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Funkhouser E, Fellows JL, Gordan VV, Rindal DB, Foy PJ, Gilbert GH. Supplementing online surveys with a mailed option to reduce bias and improve response rate: the National Dental Practice-Based Research Network. J Public Health Dent 2014; 74:276-82. [PMID: 24707895 DOI: 10.1111/jphd.12054] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/21/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Dentists in the National Dental Practice-Based Research Network are offered online and mail options for most questionnaire studies. We sought to quantify differences a) in characteristics of dentists who completed a questionnaire online as compared with those who completed a mail option offered to online nonresponders and b) in prevalence estimates for certain practice characteristics. METHODS Invitation letters to participants provided an identification number and log-in code with which to complete the online survey. Nonrespondents received a reminder letter after the fourth week, and after an additional 4-week period, a final reminder was sent, along with a paper questionnaire version, allowing completion online or by paper. RESULTS Of 632 US dentists who completed the survey, 84 (13 percent) used the paper version. Completion by paper was more common among males, older dentists, and those in general practice (P<0.05). The proportions of dentists who used electronic dental records, who consistently used a rubber dam when performing root canals, and who either worked with or employed expanded-function auxiliaries were lower among dentists who completed the survey using the paper-mail version than among those who completed it online; these differences remained significant in models adjusted for gender, age, and practice type. CONCLUSION Even in an era of increasingly electronic communication by dentists, not including a paper option when conducting surveys can result in overestimation of the prevalence of key dental practice characteristics.
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308
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O'Brien KK, Solomon P, Worthington C, Ibáñez-Carrasco F, Baxter L, Nixon SA, Baltzer-Turje R, Robinson G, Zack E. Considerations for conducting Web-based survey research with people living with human immunodeficiency virus using a community-based participatory approach. J Med Internet Res 2014; 16:e81. [PMID: 24642066 PMCID: PMC3971118 DOI: 10.2196/jmir.3064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/27/2014] [Accepted: 02/11/2014] [Indexed: 12/03/2022] Open
Abstract
Background Web or Internet-based surveys are increasingly popular in health survey research. However, the strengths and challenges of Web-based surveys with people living with human immunodeficiency virus (HIV) are unclear. Objective The aim of this article is to describe our experience piloting a cross-sectional, Web-based, self-administered survey with adults living with HIV using a community-based participatory research approach. Methods We piloted a Web-based survey that investigated disability and rehabilitation services use with a sample of adults living with HIV in Canada. Community organizations in five provinces emailed invitations to clients, followed by a thank you/reminder one week later. We obtained survey feedback in a structured phone interview with respondents. Participant responses were transcribed verbatim and analyzed using directed content analysis. Results Of 30 people living with HIV who accessed the survey link, 24/30 (80%) initiated and 16/30 (53%) completed the survey instrument. A total of 17 respondents participated in post-survey interviews. Participants described the survey instrument as comprehensive, suggesting content validity. The majority (13/17, 76%) felt instruction and item wording were clear and easy to understand, and found the software easy to navigate. Participants felt having a pop-up reminder directing them to missed items would be useful. Conclusions Strengths of implementing the Web-based survey included: our community-based participatory approach, ease of software use, ability for respondents to complete the questionnaire on one’s own time at one’s own pace, opportunity to obtain geographic variation, and potential for respondent anonymity. Considerations for future survey implementation included: respondent burden and fatigue, the potentially sensitive nature of HIV Web-based research, data management and storage, challenges verifying informed consent, varying computer skills among respondents, and the burden on community organizations. Overall, results provide considerations for researchers conducting community-based participatory Web-based survey research with people living with HIV.
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309
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Whitfield GP, Gabriel KKP, Rahbar MH, Kohl HW. Application of the American Heart Association/American College of Sports Medicine Adult Preparticipation Screening Checklist to a nationally representative sample of US adults aged >=40 years from the National Health and Nutrition Examination Survey 2001 to 2004. Circulation 2014; 129:1113-20. [PMID: 24421370 PMCID: PMC4094111 DOI: 10.1161/circulationaha.113.004160] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Although the American Heart Association/American College of Sports Medicine's Preparticipation Questionnaire (AAPQ) is a recommended preexercise cardiovascular screening tool, it has never been systematically evaluated. The purpose of this research is to provide preliminary evidence of its effectiveness among adults aged ≥40 years. METHODS AND RESULTS Under the assumption that participants would respond to AAPQ items as they responded to a general health survey, we calculated the sex- and age-specific proportions of adult participants in the National Health and Nutrition Examination Survey 2001 to 2004 who would receive a recommendation for physician consultation based on AAPQ referral criteria. Additionally, we compared recommended AAPQ referrals to a similar assessment using the Physical Activity Readiness Questionnaire in the study sample. AAPQ referral proportions were higher with older age. Across all age groups ≥40 years, 95.5% (94.3% to 96.8%) of women and 93.5% (92.2% to 94.7%) of men in the United States would be advised to consult a physician before exercise. Prescription medication use and age were the most commonly selected items. When referral based on AAPQ was compared with that of the Physical Activity Readiness Questionnaire, the 2 screening tools produced similar results for 72.4% of respondents. CONCLUSIONS These results suggest that >90% of US adults aged ≥40 years would receive a recommendation for physician consultation by the AAPQ. Excessive referral may present an unnecessary barrier to exercise adoption and stress the healthcare infrastructure.
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Affiliation(s)
- Geoffrey P Whitfield
- The University of Texas School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences, Austin, TX
| | - Kelley K Pettee Gabriel
- The University of Texas School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences, Austin, TX
| | - Mohammad H Rahbar
- The University of Texas School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences, Austin, TX
- The University of Texas Health Science Center, Center for Clinical and Translational Sciences, Houston, TX
| | - Harold W. Kohl
- The University of Texas School of Public Health, Division of Epidemiology, Human Genetics, and Environmental Sciences, Austin, TX
- The University of Texas at Austin, Department of Kinesiology and Health Education, Austin, TX
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310
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Arthur C, Mahomed K. Intrahepatic cholestasis of pregnancy: diagnosis and management; a survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows. Aust N Z J Obstet Gynaecol 2014; 54:263-7. [PMID: 24506294 DOI: 10.1111/ajo.12178] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 12/16/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Intrahepatic cholestasis of pregnancy (ICP) is an uncommon obstetric condition characterised by intense maternal pruritis and biochemical abnormality. There is a degree of contention regarding the diagnosis and management of ICP, and currently, there are no nationally accepted guidelines. AIMS To conduct a survey of Fellows and Members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) regarding their diagnosis and management ICP. METHODS An online survey of currently practising RANZCOG Fellows and Members, utilising Survey Monkey. RESULTS Thirty percent of those sent the survey responded, comprising approximately 40% of practising obstetricians. Fasting bile acid and serum transaminase elevation in association with the characteristic itch define the disease process for the majority of respondents and also inform management decisions. There was no critical level of bile acid elevation that mandated treatment for the majority of respondents. Nearly 90% of respondents induce women with ICP at 37-38 completed weeks of pregnancy, due to concerns regarding possible fetal demise. About one-third of respondents refer to the Royal College of Obstetricians and Gynaecologists (RCOG) Green-top Guideline to advise their decision-making process, and a similar proportion use local or hospital-based guidelines. CONCLUSIONS Elevated fasting bile acids and abnormal liver function tests define the diagnosis and inform management of ICP by Australian obstetricians. Routine induction of labour for patients with ICP at 37-38 completed weeks of pregnancy is widely practised in Australia. An evidence-based guideline would assist clinicians who manage such cases in Australia.
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Affiliation(s)
- Chris Arthur
- Redcliffe Hospital, Redcliffe, Queensland, Australia
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311
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LaMori J, Gross HJ, DiBonaventura M, Bookhart BK, Schein J. Prior myocardial infarction and presence of upper gastrointestinal conditions among patients with venous thromboembolism: prevalence, associated comorbidities and burden. J Clin Pharm Ther 2014; 39:253-8. [PMID: 24494931 DOI: 10.1111/jcpt.12133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 12/16/2013] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a serious, life-threatening condition that often complicates treatment of individuals who are already ill and increases in risk with age. The comorbidity burden of VTE can complicate treatment; therefore, treatment should be influenced by the presence of comorbidities (Kearon 2012). The prevalence of common conditions in the VTE population is, therefore, an important subject of research. Prevalence of two common comorbid burdens, prior myocardial infarction (MI) and upper gastrointestinal (GI) conditions, was studied among survey respondents who reported DVT or PE. METHODS Responses to the 2010 wave of the National Health and Wellness Survey (NHWS), a self-administered, internet-based questionnaire from a nationwide, demographically representative sample of adults, were evaluated. RESULTS AND DISCUSSION Among the 814 participants reporting a history of VTE, 9·7% (n = 60) of the DVT subpopulation and 13·2% (n = 39) of the PE subpopulation also reported prior MI. In respondents with prior MI, cardiovascular, urological, and pain comorbidities were each reported as additional comorbidities by at least two thirds of respondents in both the PE and DVT subpopulations, with cardiovascular and urological conditions reported significantly (P < 0·05) more often than among respondents with no prior MI. Among the respondents reporting VTE, 48·9% (n = 302) of the subpopulation reporting DVT and 52·2% (n = 154) of those reporting PE also reported upper GI comorbidities. Cardiovascular and pain conditions in the respondents reporting upper GI comorbidities were each reported by more than three quarters of VTE patients in both the DVT and PE subpopulations and were significantly more common (P < 0·05) than among their counterparts without upper GI comorbidities. WHAT IS NEW AND CONCLUSION The results of the NHWS indicate that VTE patients who have either of two common comorbid burdens, prior MI and concomitant upper GI conditions, also showed high levels of additional, concurrent comorbidities and generally poor health status. Clinicians must be aware of the total comorbidity profile of their patients who have experienced VTE in order to best manage them and prescribe appropriate therapy.
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Affiliation(s)
- J LaMori
- Janssen Scientific Affairs, LLC, Raritan, NJ, USA
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312
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Nunes MA, Campos-Neto I, Ferraz LC, Lima CA, Rocha TO, Rocha TF. Adaptation to prostheses among patients with major lower-limb amputations and its association with sociodemographic and clinical data. SAO PAULO MED J 2014; 132:80-4. [PMID: 24714987 PMCID: PMC10896576 DOI: 10.1590/1516-3180.2014.1322572] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Revised: 02/05/2013] [Accepted: 05/28/2013] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Lower-limb amputation compromises patients' independence and autonomy, and therefore they should be referred for rehabilitation in order to adapt to prostheses and regain autonomy. The aim here was to assess adaptation to prostheses among patients with major lower-limb amputations and its association with sociodemographic and clinical data. DESIGN AND SETTING This was a cross-sectional study in the city of Aracaju, Brazil. METHODS The patients were identified by primary healthcare teams. The inclusion criterion was that these should be patients who underwent major lower-limb amputations of any etiology. Associations between sociodemographic and clinical variables and the adaptation to lower-limb prostheses were assessed. RESULTS 149 patients were examined. Adaptation to the prosthesis occurred in 40% (60/149) of them, but only 62% (37/60) were using it. Adaptation occurred more often among male patients (P = 0.017) and among those who had a higher educational level (P = 0.013), with a longer time since amputation (P = 0.049) and when the etiology was trauma (P = 0.003). The result from logistic regression analysis showed that only patients with low education (P = 0.031) were significantly associated with a lower frequency of adaptation to prostheses. CONCLUSION It was found that patients with a low educational level became adapted to the prosthesis less frequently.
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Affiliation(s)
- Marco Antonio Nunes
- PhD. Adjunct Professor and Head of Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Ivo Campos-Neto
- MD. Researcher and Student in the Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Leonardo Costa Ferraz
- MD. Researcher and Student in the Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Camilla Andrade Lima
- MD. Researcher and Student in the Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Tâmara Oliviera Rocha
- MD. Researcher and Student in the Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil
| | - Thaisa Fátima Rocha
- MD. Researcher and Student in the Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, Sergipe, Brazil
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McElligott K, McElligott J, Rivell G, Rolfe R, Sharpe R, Lambright K, Charles L. Assessment of cardiovascular disease risk factors in the coastal region of South Carolina. Ethn Dis 2014; 24:155-161. [PMID: 24804360 PMCID: PMC4487604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To assess risk factors for cardiovascular disease, barriers to health care, and desired health care education topics for Hispanics in the coastal region of South Carolina known as the Lowcountry. METHODS 174 Hispanic adults were surveyed at visits at the Mexican consulate using a novel interview instrument. The prevalence of cardiovascular risk factors was compared to the Behavioral Risk Factor Surveillance System (BRFSS), an annual telephone survey, to evaluate the validity of the survey instrument. RESULTS Results are comparable to the BRFSS telephone study of the Hispanics in the same area. However, participants in our study were older (Age > 35 = 41.4% vs. 34.9%) and reported fewer years of formal education (higher level education = 12.9% vs. 44.2%). Cost of care (72.8%) and language barriers (46.8%) were the main difficulties reported in obtaining health care access. The main educational topics of interest were diabetes (61.5%), hypertension (43.7%), stress (42.5%), and cardiac disease (40.2%). CONCLUSION Our study supports the evidence that there is a demand and need for cardiovascular disease and diabetes education among Hispanics. Our study also shows that a large proportion of Hispanics experience barriers to health care. and that large telephone studies may underrepresent higher risk Hispanic populations.
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314
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Whitehouse SR, Lam PY, Balka E, McLellan S, Deevska M, Penn D, Issenman R, Paone M. Co-Creation With TickiT: Designing and Evaluating a Clinical eHealth Platform for Youth. JMIR Res Protoc 2013; 2:e42. [PMID: 24140595 PMCID: PMC3806391 DOI: 10.2196/resprot.2865] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/12/2013] [Accepted: 09/15/2013] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND All youth are susceptible to mental health issues and engaging in risky behavior, and for youth with chronic health conditions, the consequences can be more significant than in their healthy peers. Standardized paper-based questionnaires are recommended by the American Academy of Pediatrics in community practice to screen for health risks. In hospitals, psychosocial screening is traditionally undertaken using the Home Education, Eating, Activities, Drugs, Depression, Sex, Safety (HEEADDSS) interview. However, time constraints and patient/provider discomfort reduce implementation. We report findings from an eHealth initiative undertaken to improve uptake of psychosocial screening among youth. OBJECTIVE Youth are sophisticated "technology natives." Our objective was to leverage youth's comfort with technology, creating a youth-friendly interactive mobile eHealth psychosocial screening tool, TickiT. Patients enter data into the mobile application prior to a clinician visit. Response data is recorded in a report, which generates alerts for clinicians, shifting the clinical focus from collecting information to focused management. Design goals included improving the patient experience, improving efficiency through electronic patient based data entry, and supporting the collection of aggregated data for research. METHODS This paper describes the iterative design and evaluation processes undertaken to develop TickiT including co-creation processes, and a pilot study utilizing mixed qualitative and quantitative methods. A collaborative industry/academic partnership engaged stakeholders (youth, health care providers, and administrators) in the co-creation development process. An independent descriptive study conducted in 2 Canadian pediatric teaching hospitals evaluated the feasibility of the platform in both inpatient and ambulatory clinical settings, evaluating both providers and patient responses to the platform. RESULTS The independent pilot feasibility study included 80 adolescents, 12-18 years, and 38 medical staff-residents, inpatient and outpatient pediatricians, and surgeons. Youth uptake was 99% (79/80), and survey completion 99% (78/79; 90 questions). Youth found it easy to understand (92%, 72/78), easy to use (92%, 72/78), and efficient (80%, 63/79 with completion rate < 10 minutes). Residents were most positive about the application and surgeons were least positive. All inpatient providers obtained new patient information. CONCLUSIONS Co-creative design methodology with stakeholders was effective for informing design and development processes to leverage effective eHealth opportunities. Continuing stakeholder engagement has further fostered platform development. The platform has the potential to meet IHI Triple Aim goals. Clinical adaptation requires planning, training, and support for health care providers to adjust their practices.
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Affiliation(s)
- Sandy R Whitehouse
- BC Children's Hospital, Division of Adolescent Medicine, University of British Columbia, Vancouver, BC, Canada.
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315
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Lim S, Immerwahr S, Lee S, Harris TG. Estimating nonresponse bias in a telephone-based health surveillance survey in New York City. Am J Epidemiol 2013; 178:1337-41. [PMID: 23985129 DOI: 10.1093/aje/kwt121] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Despite concerns about nonresponse bias due to decreasing response rates, telephone surveys remain a viable option for conducting local population-based surveillance. However, this becomes problematic for urban populations, which typically have higher nonresponse rates. Unfortunately, traditional methods of evaluating nonresponse bias pose challenges for public health practitioners due to high costs. In this study, we sought to increase understanding of survey nonresponse at the zip code level in an urban area and to demonstrate the use of a practical tool for assessing nonresponse bias. Data from the 2008 New York City Community Health Survey, a landline telephone survey of residential households in New York, New York, were matched with zip-code-level data from the 2000 US Census. Although response rates varied across zip codes and zip-code-level sociodemographic characteristics, estimated nonresponse bias for the 5 health measures (general health status, current health insurance coverage, asthma, binge drinking, and physical activity) was not substantial (ranging from -3.8% to 2.4%). Findings confirmed previous research that survey participation rates can vary a great deal across small areas and that there is no direct relationship between response rates and nonresponse bias. This study highlights the importance of assessing nonresponse bias for local urban surveys and demonstrates a workable assessment tool.
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316
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Nadeau C, Wong SL, Flanagan WM, Oderkirk J, Manuel D, Wall R, Tremblay MS. Development of a population-based microsimulation mode of physical activity in Canada. Health Rep 2013; 24:11-19. [PMID: 24259125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Computer simulation modeling makes it possible to project physical activity levels and the prevalence of related health outcomes. Such projections can help to inform programs that aim to increase physical activity levels and improve population health. DATA AND METHODS The Population Health Model (POHEM) platform was used to develop a dynamic microsimulation model of physical activity among Canadian adults. Key parameters were derived from the National Population Health Survey (1994/1995 to 2006/2007) and the 2000/2001 Canadian Community Health Survey. To assess the validity of the physical activity module (POHEM-PA), estimates from the simulation projections were compared with results from nationally representative surveys. RESULTS Trends over time in physical activity levels, chronic disease prevalence, and Health Utilities Index based on POHEM-PA projections were similar to those based on data from subsequent cycles of the Canadian Community Health Survey. INTERPRETATION The addition of a physical activity module to POHEM provides a tool that can improve understanding of the complex dynamics underlying the relationship between physical activity and health outcomes as a population ages.
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Affiliation(s)
- Claude Nadeau
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
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317
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Kristjansson AL, Sigfusson J, Sigfusdottir ID, Allegrante JP. Data collection procedures for school-based surveys among adolescents: the Youth in Europe Study. J Sch Health 2013; 83:662-7. [PMID: 23879786 DOI: 10.1111/josh.12079] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 10/15/2012] [Accepted: 12/02/2012] [Indexed: 05/11/2023]
Abstract
BACKGROUND Collection of valid and reliable surveillance data as a basis for school health promotion and education policy and practice for children and adolescence is of great importance. However, numerous methodological and practical problems arise in the planning and collection of such survey data that need to be resolved in order to ensure the validity of the data and to maximize the response rate without being prohibitively costly. METHOD This article builds on a 15-yearlong experience of such annual data collections in Iceland and describes the preparation, process, and collection of data that provide a common methodologic framework for the school-based survey, Youth in Europe, a population-based survey of 14- to 16-year-old adolescents, being collected across 18 European cities now participating in the European Cities Against Drugs (ECAD) program. RESULTS We identified 11 critical steps for developing and implementing the surveys in light of the recent literature on the preparation and implementation practices in school-based data collection among adolescents. CONCLUSION Limiting the disruption of daily operations in schools while at the same time ensuring both quality and clarity of data collection procedures in school-based surveys are of paramount importance for researchers, school personnel, and students.
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Affiliation(s)
- Alfgeir Logi Kristjansson
- Department of Health and Behavior Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027, USA.
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318
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Bienek AS, Gee ME, Nolan RP, Kaczorowski J, Campbell NR, Bancej C, Gwadry-Sridhar F, Robitaille C, Walker RL, Dai S. Methodology of the 2009 Survey on Living with Chronic Diseases in Canada--hypertension component. Chronic Dis Inj Can 2013; 33:267-276. [PMID: 23987223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION The Survey on Living with Chronic Diseases in Canada--hypertension component (SLCDC-H) is a 20-minute cross-sectional telephone survey on hypertension diagnosis and management. Sampled from the 2008 Canadian Community Health Survey (CCHS), the SLCDC-H includes Canadians (aged ≥ 20 years) with self-reported hypertension from the ten provinces. METHODS The questionnaire was developed by Delphi technique, externally reviewed and qualitatively tested. Statistics Canada performed sampling strategies, recruitment, data collection and processing. Proportions were weighted to represent the Canadian population, and 95% confidence intervals (CIs) were derived by bootstrap method. RESULTS Compared with the CCHS population reporting hypertension, the SLCDC-H sample (n = 6142) is slightly younger (SLCDC-H mean age: 61.2 years, 95% CI: 60.8-61.6; CCHS mean age: 62.2 years, 95% CI: 61.8-62.5), has more post-secondary school graduates (SLCDC-H: 52.0%, 95% CI: 49.7%-54.2%; CCHS: 47.5%, 95% CI: 46.1%-48.9%) and has fewer respondents on hypertension medication (SLCDC-H: 82.5%, 95% CI: 80.9%-84.1%; CCHS: 88.6%, 95% CI: 87.7%-89.6%). CONCLUSION Overall, the 2009 SLCDC-H represents its source population and provides novel, comprehensive data on the diagnosis and management of hypertension. The survey has been adapted to other chronic conditions--diabetes, asthma/chronic obstructive pulmonary disease and neurological conditions. The questionnaire is available on the Statistics Canada website; descriptive results have been disseminated by the Public Health Agency of Canada.
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Affiliation(s)
- A S Bienek
- Public Health Agency of Canada, Ottawa, Ontario, Canada.
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319
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Sanmartin C, Finès P, Khan S, Peters P, Tjepkema M, Bernier J, Burnett R. Modelling risk factor information for linked census data: The case of smoking. Health Rep 2013; 24:9-15. [PMID: 24258239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Statistics Canada has initiated a series of data linkages of Census of Population long form and health outcome data. These linked data lack risk factor information. This study assesses the feasibility of using statistical modelling techniques to assign smoking status to census respondents. DATA AND METHODS The 2000/2001 Canadian Community Health Survey (CCHS) was used to develop age-/sex-specific predictive models to model smoking status based on variables available on the 1991 Census. The 2002/2003 CCHS was used to validate the modelled variable. Data from the 2002/2003 CCHS linked to data from the Hospital Morbidity Database (2001/2002 to 2004/2005) were used to evaluate the use of modelled versus self-reported smoking status on smoking-related hospitalizations. RESULTS For the current daily smoker models, income, education, marital status, dwelling ownership and region of birth were significant predictors. For the never smoker models, marital status, dwelling ownership, Aboriginal identity and region of birth were significant predictors. Modelled current daily smoker status was associated with increased odds of smoking-related hospitalization, compared with being a never smoker, even when adjusting for covariates. INTERPRETATION This study demonstrates the feasibility of using statistical modelling techniques to assign smoking status to census data, provided socio-economic and identity information is available.
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Affiliation(s)
- Claudia Sanmartin
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
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320
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Leite MS, Cardoso AM, Coimbra CEA, Welch JR, Gugelmin SA, Lira PCI, Horta BL, Santos RV, Escobar AL. Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People's Health and Nutrition. Nutr J 2013; 12:69. [PMID: 23714275 PMCID: PMC3681561 DOI: 10.1186/1475-2891-12-69] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 05/15/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anemia is the most prevalent nutritional deficiency globally, affecting about a quarter of the world population. In Brazil, about one-fifth of children under five years of age are anemic. Previous case studies indicate prevalence rates much higher among indigenous peoples in the country. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first survey based on a nationwide representative sample to study the prevalence of anemia and associated factors among indigenous children in Brazil. METHODS The survey assessed the health and nutritional status of indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Prevalence rates of anemia were calculated for independent variables and hierarchical multivariate analysis were conducted to assess associations. RESULTS Evaluation of hemoglobin levels was conducted for 5,397 children (88.1% of the total sample). The overall prevalence of anemia was 51.2%. Higher risk of presenting anemia was documented for boys, lower maternal schooling, lower household socioeconomic status, poorer sanitary conditions, presence of maternal anemia, and anthropometric deficits. Regional differences were observed, with the highest rate being observed in the North. CONCLUSIONS The prevalence rates of anemia in indigenous children were approximately double than those reported for non-indigenous Brazilian children in the same age group. Similarly notable differences in the occurrence of anemia in indigenous and non-indigenous children have been reported for other countries. Deeper knowledge about the etiology of anemia in indigenous children in Brazil is essential to its proper treatment and prevention.
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Affiliation(s)
- Maurício S Leite
- Departamento de Nutrição, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Andrey M Cardoso
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - Carlos EA Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - Silvia A Gugelmin
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Av. Fernando Correa da Costa 2367, Cuiabá, MT 78060-900, Brazil
| | - Pedro Cabral I Lira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Avenida Professor Moraes Rego 1235, Recife, PE 50670-901, Brazil
| | - Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS 96020-220, Brazil
| | - Ricardo Ventura Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ 20940-040, Brazil
| | - Ana Lúcia Escobar
- Departamento de Ciências Biomédicas, Universidade Federal de Rondônia, Rodovia BR-364 Km 9.5, Porto Velho, RO 76801-059, Brasil
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321
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Macek MD, Yellowitz JA. Oral cancer examinations among smokers and moderate-heavy drinkers, United States, 2008. J Public Health Dent 2013; 73:280-8. [PMID: 23668942 DOI: 10.1111/jphd.12021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 04/07/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Smoking and moderate-heavy alcohol consumption are primary risk factors for oral cancer. This report uses national data to test whether adults with these risk factors received oral cancer examinations (OCEs) at a rate consistent with their risk. METHODS Data from the 2008 National Health Interview Survey (NHIS) were used for this analysis. The main outcome variables described lifetime receipt of extraoral or intraoral OCEs. Other variables described health-care visits, as well as the timing of, reasons for, and type of practitioner providing the most recent OCE. Descriptor variables were smoking and drinking status. Covariates included several sociodemographic factors. Weighted bivariate and multivariable analyses were conducted using SUDAAN software. RESULTS According to the 2008 NHIS, about 34 percent of adults aged 40 years or older reported receiving either an extraoral or intraoral examination during their lifetime. Current smokers were no more likely to have received an OCE than were never smokers, controlling for relevant covariates. Moderate-heavy drinkers and light drinkers were significantly more likely to have received an OCE than were lifetime abstainers. CONCLUSIONS Current smokers did not receive OCEs at a rate consistent with their increased risk, whereas moderate-heavy drinkers did. One explanation for this finding is that medical and dental visit behaviors indirectly influenced OCE rates. Dentition status played an important role, as having teeth is strongly associated with dental visit behaviors. Health-care practitioners are encouraged to consider the smoking and drinking statuses of their patients when they conduct routine physical examinations of the head and neck.
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Affiliation(s)
- Mark D Macek
- Division of Dental Public Health, University of Maryland School of Dentistry, Baltimore, MD, USA
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322
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Rumsfeld JS, Alexander KP, Goff DC, Graham MM, Ho PM, Masoudi FA, Moser DK, Roger VL, Slaughter MS, Smolderen KG, Spertus JA, Sullivan MD, Treat-Jacobson D, Zerwic JJ. Cardiovascular health: the importance of measuring patient-reported health status: a scientific statement from the American Heart Association. Circulation 2013; 127:2233-49. [PMID: 23648778 DOI: 10.1161/cir.0b013e3182949a2e] [Citation(s) in RCA: 400] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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323
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Joffres M, Shields M, Tremblay MS, Connor Gorber S. Dyslipidemia prevalence, treatment, control, and awareness in the Canadian Health Measures Survey. Can J Public Health 2013; 104:e252-7. [PMID: 23823891 DOI: 10.17269/cjph.104.3783] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 04/18/2013] [Accepted: 03/13/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND The most recent Canadian population-level data on lipid levels are from 1992. This study presents current estimates of Canadians with dyslipidemia, the proportion aware of their condition, and the proportion being treated and below target values. METHODS The Canadian Health Measures Survey (2007-2009) assessed the prevalence, awareness and treatment of dyslipidemia. Dyslipidemia was defined as TC/HDL-C ratio ≥5; measured LDL-C ≥3.5 mmol/L; or taking lipid-modifying medications. The 2009 guidelines for the diagnosis and treatment of dyslipidemia were used to define low, moderate or high cardiovascular disease (CVD) risk and treatment initiation and targets. RESULTS Forty-five percent of Canadians aged 18-79 years have dyslipidemia. Fifty-seven percent of respondents were not aware of their condition. Lipid-modifying therapy was initiated in individuals where treatment would be recommended in 49%, 20% and 54% of those at high, moderate, and low risk levels, respectively. The majority (81%) of those taking medication had their lipid levels under desirable levels, however, only 24% of those with dyslipidemia reported medication use. Overall, only 19% of those with dyslipidemia had their lipids under recommended levels. Only 41% of those taking lipid-modifying medication reached a recommended target of LDL-C <2 mmol/L or ApoB <0.8 g/L. CONCLUSION There is still a high proportion of Canadians at high risk of CVD, with dyslipidemia, who are not being treated to recommended levels. These data need to be integrated into CVD reduction recommendations and represent an important baseline for assessing progress.
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Affiliation(s)
- Michel Joffres
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
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324
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Horta BL, Santos RV, Welch JR, Cardoso AM, dos Santos JV, Assis AMO, Lira PCI, Coimbra Jr CEA. Nutritional status of indigenous children: findings from the First National Survey of Indigenous People's Health and Nutrition in Brazil. Int J Equity Health 2013; 12:23. [PMID: 23552397 PMCID: PMC3637628 DOI: 10.1186/1475-9276-12-23] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/26/2013] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. METHODS A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. RESULTS Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. CONCLUSIONS The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.
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Affiliation(s)
- Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil
| | - Ricardo Ventura Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ, 20940-040, Brazil
| | - James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Andrey M Cardoso
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Janaína Vieira dos Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS, 96020-220, Brazil
| | | | - Pedro CI Lira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Avenida Professor Moraes Rego 1235, Recife, PE, 50670-901, Brazil
| | - Carlos EA Coimbra Jr
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil
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Rotermann M, Langlois KA, Severini A, Totten S. Prevalence of Chlamydia trachomatis and herpes simplex virus type 2: Results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep 2013; 24:10-15. [PMID: 24258059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Chlamydia, caused by Chlamydia trachomatis, and genital herpes, caused by simplex virus type 2 (HSV-2), are common sexually transmitted infections. Their prevalence has been estimated in selected populations, but overall prevalence in Canada is not known. DATA AND METHODS Data are from the 2009 to 2011 Canadian Health Measures Survey. Socio-demographic, health and lifestyle information was obtained via a household questionnaire; blood and urine collected at a mobile examination centre were used to identify the presence of Chlamydia trachomatis and HSV-2 among 14- to 59-year-olds. RESULTS An estimated 13.6% of Canadians (2.9 million) tested positive for HSV-2, and another 0.7% (158,000), for chlamydia. HSV-2 affects higher percentages of women than men, and individuals aged 35 to 59 versus 15 to 34. No significant differences in HSV-2 prevalence were detected by marital status, household income, education, or racial background. Nearly all individuals with laboratory-confirmed chlamydia or HSV-2 were unaware that they were infected. INTERPRETATION This study is the first in Canada to report laboratory-confirmed prevalence of chlamydia and HSV-2 using a nationally representative sample. Results suggest that most infected people are unaware of their status.
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Ruiz-Canela M, Burgo CLD, Carlos S, Calatrava M, Beltramo C, Osorio A, de Irala J. Observational research with adolescents: a framework for the management of the parental permission. BMC Med Ethics 2013; 14:2. [PMID: 23286743 PMCID: PMC3585740 DOI: 10.1186/1472-6939-14-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 12/31/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Waiving parent permission can be an option in some epidemiological and social research with adolescents. However, exemptions have not been uniformly considered or applied. Our aim is to critically assess the different factors that could be taken into account when making decisions about waiving active parental permission in observational research with adolescents. DISCUSSION In some cases alternatives to parental permission could be applied to protect the rights of both adolescents and parents and also to assure the benefits to adolescents as a group that can come from appropriately conducted studies. However, the criteria of ensuring minimal risk can be difficult to define and apply and a distinction between harm and discomfort is reviewed. Waiving active parental permission could be acceptable when the risk of harm is minimal; when the research questions are related to an activity for which adolescents are not legally considered to be children; when the risk of harm or discomfort may increase if parental permission is required; and when risk of discomfort is low because the questionnaire is not potentially offensive for some adolescents and/or for some parents. SUMMARY Stringent rules concerning parental permission in some studies could be detrimental to adolescents. A framework and a decision tree guide are proposed to help researchers and Research Ethics Committees in their decisions on whether active parental permission must be obtained.
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Affiliation(s)
- Miguel Ruiz-Canela
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Department of Biomedical Humanities, University of Navarra, Pamplona, Spain
| | - Cristina Lopez-del Burgo
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Silvia Carlos
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Maria Calatrava
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Carlos Beltramo
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | - Alfonso Osorio
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Department of Education, University of Navarra, Pamplona, Spain
| | - Jokin de Irala
- Institute for Culture and Society, University of Navarra, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
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Allin S, Bayoumi AM, Law MR, Laporte A. Comparability of self-reported medication use and pharmacy claims data. Health Rep 2013; 24:3-9. [PMID: 24259111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Many studies of medicine use rely on self-reports. Based on pharmacy claims data, this analysis tests whether such self-reports constitute a valid and reliable data source. DATA AND METHODS Linked data from the Canadian Community Health Survey and the Ontario Drug Benefit Program were used to estimate the agreement, based on kappa statistics, between seniors' self-reported medication use and the claims data. Health, demographic and socio-economic factors associated with the likelihood of agreement were modeled with logistic regression. RESULTS The prevalence of antihypertensive medication use among Ontario residents aged 65 or older was about 40% in 2001, based on both self-report and pharmacy claims, and in 2005, it was 52% for self-report and 49% based on claims data. The prevalence of oral diabetes medication use was comparable between the two data sources. Overall agreement between self-reported and claims data was "good" to "very good" for oral diabetes medications (kappa = 0.79 in 2001; 0.87 in 2005), but "moderate" for antihypertensive medications (kappa = 0.46 in 2001; 0.55 in 2005). Agreement improved somewhat from 2001 to 2005, with implementation of a more targeted survey question. INTERPRETATION Self-reports appear to be an accurate data source for measuring medication use; however, for antihypertensive medications, self-reports by the oldest and sickest subpopulations should be used cautiously.
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328
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Norberg M, Blomstedt Y, Lönnberg G, Nyström L, Stenlund H, Wall S, Weinehall L. Community participation and sustainability--evidence over 25 years in the Västerbotten Intervention Programme. Glob Health Action 2012; 5:1-9. [PMID: 23528041 PMCID: PMC3525921 DOI: 10.3402/gha.v5i0.19166] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 10/16/2012] [Accepted: 11/21/2012] [Indexed: 11/14/2022] Open
Abstract
Background Selection bias and declining participation rates are of concern in many long-term epidemiological studies. The Västerbotten Intervention Programme (VIP) was launched in 1985 as a response to alarming reports on elevated cardiovascular disease (CVD) mortality in Västerbotten County in Northern Sweden. The VIP invites women and men to a health examination and health counselling during the year of their 40th, 50th, and 60th birthdays. Objective To evaluate trends in participation rates and determinants of participation in the VIP from 1990 to 2006. Design Registry data on socio-economic status from Statistics Sweden, and mortality and hospitalisation data from the National Board of Health and Welfare, both covering the whole Swedish population, were linked to the VIP and analysed for participants and non-participants. Results During 1990–2006, 117,710 individuals were eligible to participate in the VIP, and 40,472 of them were eligible to participate twice. There were 96,560 observations for participants and 61,622 for non-participants. The overall participation rate increased from 56 to 65%. Participants and non-participants had minimal differences in education and age. Initial small differences by sex and degree of urban residence decreased over time. Despite an increasing participation rate in all groups, those with low income or who were single had an approximately 10% lower participation rate than those with high or medium-income or who were married or cohabitating. Conclusion Sustainability of the VIP is based on organisational integration into primary health care services and targeting of the entire middle-aged population. This enables the programme to meet population expectations of health promotion and to identify high-risk individuals who are then entered into routine preventive health care services. This has the potential to increase participation rates, to minimise social selection bias, and to reinforce other community-based interventions.
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Affiliation(s)
- Margareta Norberg
- Ageing and Living Conditions Programme, Centre for Population Studies, Umeå University, Umeå, Sweden.
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329
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Abstract
OBJECTIVE To determine whether C-reactive protein (CRP) can serve as a marker for alterations in immune function prior to the manifestation of significant psychiatric and medical disorders. METHOD Ninety-two healthy adults were recruited from the community and determined to be free of psychiatric or medical disorders. The concentration of plasma CRP from a single resting sample was examined in relation to current mental and physical health as well as to self-reported history of early life adversity. RESULTS C-reactive protein showed a significant positive correlation with body mass index (BMI; r = 0.477, P < 0.001). Non-specific pain, fatigue, and lower overall quality of physical health were all associated with higher CRP concentrations (all P < 0.05 or P < 0.01), after controlling for effect of BMI and other relevant covariates. Subthreshold depression symptoms and other indices of mental/emotional wellbeing were not associated with CRP, nor was CRP significantly linked to any measures of early life adversity. CONCLUSION Lower-quality physical health and wellbeing, but not the presence of mood/anxiety symptoms or early life stress (ELS), were significantly related to plasma CRP. Elevated CRP does not appear to be a fundamental consequence of ELS among healthy adults.
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Affiliation(s)
- L. L. Carpenter
- Mood Disorders Research Program and Laboratory for Clinical Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University, Providence, RI
| | - C. E. Gawuga
- Department of Molecular Pharmacology, Physiology and Biotechnology, Brown University, Providence, RI, USA
| | - A. R. Tyrka
- Mood Disorders Research Program and Laboratory for Clinical Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University, Providence, RI
| | - L. H. Price
- Mood Disorders Research Program and Laboratory for Clinical Neuroscience, Butler Hospital, Providence, RI,Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University, Providence, RI
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330
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Marres GM, Leenen LP, van der Slikke JW, Vermetten E. Use of a web portal for support and research after a disaster: opportunities and lessons learned. Interact J Med Res 2012; 1:e18. [PMID: 23612349 PMCID: PMC3626128 DOI: 10.2196/ijmr.1588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Revised: 09/15/2012] [Accepted: 09/21/2012] [Indexed: 11/13/2022] Open
Abstract
Background In this report we describe the development and use of a web portal in the aftermath of the 2004 tsunami. This large scale disaster confronted many displaced people with death, despair and need for information and support. Awareness and insight in the emotional impact of disasters can provide opportunities for surveillance and early treatment. Moreover, online support systems can contribute to community building, empowerment of victims and resilience. Objective We evaluate the development and use of a multilingual web portal that combined a platform for information, emotional support, self assessment and referral with research opportunities. The rapid development, use, advantages, difficulties and learning points are discussed. Methods A multidisciplinary working group from the University Medical Centre Utrecht, the Major Incident Hospital and the Central Military Hospital developed a web portal for tsunami victims. The webportal combined: (1) a forum aimed at community building, (2) self assessment tools that in the same time function as a reseach survey, (3) e-consultation, and (4) an information portal. Results Within 3 weeks after the tsunami, the working group launched an open, online service (www.TISEI.org. Tsunami Intrenational Survey on Emotional Impact) to foster community) support in the aftermath of the disaster. It combined four functionalities that were earlier previously only used separately. The portal had over 36.800 unique visitors in the first two years. At least 31% (144/464) percent of the Dutch surviving victims could be reached for a survey through the site. The TISEI-environment was available in 15 languages and visitors came from all over the world. Ninety-five percent of all visitors came from Europe or the United States. Subsequent to immediate disaster support, the web portal also served as a memorial archive for anniversary meetings and follow-up incentives. Difficulties we experienced were lack of funding, time pressure, victim-anonymisation, international collaboration and long term maintenance. Conclusions A multilingual website with combined modalities for emotional care and research after a natural disaster proved feasible. Web based services like www.TISEI.org in the aftermath of mass disasters can help community building and deliver low level, patient centred and easily accessible information and care. A multilingual website with combined modalities for emotional care and research after a natural disaster proved feasible. Growing Internet penetration world wide and especially the rapid expansion and influence of online communities enables delivery of care and perform research with the internetInternet as a platform. The unpredictable nature of disaster does put time pressure on the development of online solutions and influenced the yield of our site. This highlights the necessity of developing methods and (inter) national collaborations in advance, secure funding, and learn from earlier initiatives.
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Affiliation(s)
- Geertruid Mh Marres
- University Medical Centre Utecht, Central Military Hospital, Major Incident Hospital, Utrecht, Netherlands.
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331
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Svensson AC, Fredlund P, Laflamme L, Hallqvist J, Alfredsson L, Ekbom A, Feychting M, Forsberg B, Pedersen NL, Vågerö D, Magnusson C. Cohort profile: The Stockholm Public Health Cohort. Int J Epidemiol 2012; 42:1263-72. [PMID: 23042793 DOI: 10.1093/ije/dys126] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The Stockholm Public Health Cohort was set up within the Stockholm County Council public health surveys to inform on determinants and consequences of significant contributors to the current burden of disease. Participants are 89 268 randomly selected individuals from the adult population of Stockholm County. Baseline surveys took place in 2002, 2006 and 2010 via self-administered questionnaires. So far, participants recruited in 2002 were re-surveyed twice, in 2007 and 2010, and those enrolled in 2006 were re-surveyed once, in 2010. Self-reported data are regularly supplemented by information from national and regional health data and administrative registers, for study participants and their relatives (including their offspring). Available data are extensive and include a wide array of health, lifestyle, perinatal, demographic, socio-economic and familial factors. The cohort is an international resource for epidemiological research, and the data available to the research community for specific studies obtained approval from the Stockholm Public Health Cohort Steering Committee and the Stockholm Regional Ethical Review Board.
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Affiliation(s)
- Anna C Svensson
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden, Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden, Department of Development, Stockholm County Council, Stockholm, Sweden, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden and CHESS-Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
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332
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Muller S, Hider S, Helliwell T, Bailey J, Barraclough K, Cope L, Dasgupta B, Foskett R, Hughes R, Mayson Z, Purcell C, Roddy E, Wathall S, Zwierska I, Mallen CD. The epidemiology of polymyalgia rheumatica in primary care: a research protocol. BMC Musculoskelet Disord 2012; 13:102. [PMID: 22703582 PMCID: PMC3406947 DOI: 10.1186/1471-2474-13-102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 06/15/2012] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Polymyalgia Rheumatica (PMR) is the commonest inflammatory condition seen in older patients in primary care. To date, however, research has been focused on secondary care cohorts rather than primary care where many patients are exclusively managed. This two year prospective inception cohort study of PMR patients will enable us to understand the full spectrum of this condition. METHODS Patients diagnosed with PMR in primary care will be identified via Read codes and mailed a series of postal questionnaires over a two-year period to assess their levels of pain, stiffness and functioning, as well as medication usage and other health-related and socio-demographic characteristics. In addition, participants will be asked for permission to link their survey data to their general practice electronic medical record and to national mortality and cancer registers. DISCUSSION This will be the first large-scale, prospective, observational cohort of PMR patients in primary care. The combination of survey data with medical records and national registers will allow for a full investigation of the natural history and prognosis of this condition in the primary care setting, in which the majority of patients are treated, but where little research on the treatment and outcome of consultation has been undertaken. This will provide information that may lead to improved primary care management of PMR.
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Affiliation(s)
- Sara Muller
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Samantha Hider
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Toby Helliwell
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Joanne Bailey
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Kevin Barraclough
- Painswick Surgery, Hoyland House, Painswick, Gloucestershire, GL6 6RD, UK
| | - Louise Cope
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Bhaskar Dasgupta
- Southend University Hospital, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 ORY, UK
| | - Rebecca Foskett
- Primary Care Research West Midlands North, Unit 2, Badhan Court, Telford, TF1 5QX, UK
| | - Rhian Hughes
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Zoe Mayson
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Charlotte Purcell
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Edward Roddy
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Simon Wathall
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Irena Zwierska
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Christian D Mallen
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK
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333
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Savard N, Levallois P, Rivest LP, Gingras S. A study of the association between characteristics of CLSCs and the risk of small for gestational age births among term and preterm births in Quebec, Canada. Can J Public Health 2012; 103:152-157. [PMID: 22530541 PMCID: PMC6973727 DOI: 10.1007/bf03404222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 09/17/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The objective of this study was to describe whether the social environment of the territory of residence is associated with indicators of foetal growth retardation. METHODS All newborns (n = 667,254) from 143 Centres locaux de services communautaires (CLSC) territories of Quebec, Canada, 2000-2008 were included in this study. Small for gestational age (SGA), very small for gestational age (VSGA) and SGA-preterm births were identified. Social characteristics and access to medical services of the population in the CLSCs were obtained from the Canadian Community Health Survey. Data on material deprivation, racial diversity and social isolation were obtained from the 2001 and 2006 Canadian censuses. A compromise between two methods, stepwise and best subset, was used to select variables for multivariate logistic modelling. The model was fitted on each studied outcome: SGA, VSGA and SGA among preterm births. RESULTS When investigating material deprivation, racial diversity, social isolation, proportion of sedentary residents and proportion with fair or poor availability of health care services in the CLSC territories, material deprivation, racial diversity, social isolation and sedentary residents showed increased adjusted risk of SGA. Results of the model fit on VSGA birth and on SGA among preterm births were similar. CONCLUSION CLSC characteristics of material deprivation, racial diversity, social isolation as well as the contextual variable of sedentary lifestyle were associated with indicators of foetal growth retardation. Further work on features of the CLSCs could help understand how the outcome of SGA is associated with contextual factors and identify groups for intervention.
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Affiliation(s)
- Nathalie Savard
- Department of Social and Preventive Medicine, Université Laval, Institut national de santé publique du Québec, QC.
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334
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Clarke MP, Coughlin JR. Prevalence of smoking among the lesbian, gay, bisexual, transsexual, transgender and queer (LGBTTQ) subpopulations in Toronto--the Toronto Rainbow Tobacco Survey (TRTS). Can J Public Health 2012; 103:132-6. [PMID: 22530537 PMCID: PMC6974290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 10/16/2011] [Indexed: 03/29/2024]
Abstract
OBJECTIVES Research in the United States has found a higher likelihood of smoking among lesbian, gay and bisexual people compared to the general population. However, the smoking prevalence of these subpopulations in Canada is not well documented. The objective of this study was to determine the prevalence of smoking among the LGBTTQ subpopulations in Toronto, Ontario. METHODS A self-report questionnaire was administered from April to July 2006 to a convenience sample of lesbian, gay, bisexual, transsexual, transgender and queer (LGBTTQ) community members in Toronto, Ontario. Items measured included: past and current smoking behaviour, sexual orientation, gender identity, age and residential area. RESULTS In total, 3,140 LGBTTQ community members completed the Toronto Rainbow Tobacco Survey (TRTS). Overall, 36% of LGBTTQ participants reported current smoking, 25% were former smokers and 39% had never smoked. The smoking prevalence rates ranged from 24% to 45% across the different sexual orientation and gender identity groups of the sample, with bisexual women and bisexual men reporting the highest smoking rate at 45%. The study also reports the first known smoking prevalence rate for gender queer people at 44%. Younger LGBTTQ participants reported even higher smoking rates. CONCLUSION This study corroborates prior research done in other jurisdictions by finding similar and higher smoking rates among Toronto's LGBTTQ subpopulations compared to the "mainstream" population. The relatively higher rates among LGBTTQ youth, bisexual and gender queer people have implications for targeted awareness and cessation initiatives. Need for future research is discussed.
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Affiliation(s)
| | - J. Robert Coughlin
- Performance Management, Planning and Performance, Toronto Public Health, 277 Victoria Street, Toronto, ON M5B 1W2 Canada
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335
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Abstract
BACKGROUND Mixing survey administration modes has generated concern about the comparability of responses between modes. OBJECTIVE To explore the differences in respondent profiles, and responses between Internet and telephone questionnaires in a survey on respiratory diseases. METHODS The data were generated from a mixed Internet and telephone survey of respiratory diseases among children in Montreal (Quebec), in 2006. Comparison of 12 selected questions was performed after standardization for respondent education and income. Stratification of analysis on education and income categories was also performed for the questions with significantly divergent responses. RESULTS Six questions showed significant differences in responses between modes after standardization. The largest differences among the closed-ended questions were observed for highly prevalent symptoms, dry cough during the night (difference of 9% for positive answer [P<0.01]) and symptoms of allergic rhinitis (difference of 7% for positive answer [P<0.01]). A large discrepancy was also found in the multiple choice question and with an open-ended response (ie, free answer). For the three potentially sensitive questions, a desirability bias was probably present in one question on smoking habits (difference of 2.6 % for positive answer [P<0.05]). CONCLUSION The differences observed between Internet and telephone responses to selected questions were not completely explained by socioeconomic disparities among the respondents. In a mixed-mode survey (Internet and telephone), caution should be used when formulating sensitive, complex, open-ended and long-ended questions, and those related to highly prevalent and nonspecific symptoms.
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336
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Smith M, Davis MA. Immunization status of adult chiropractic patients in analyses of national health interview survey. J Manipulative Physiol Ther 2011; 34:602-8. [PMID: 21943651 PMCID: PMC3586316 DOI: 10.1016/j.jmpt.2011.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 07/10/2011] [Accepted: 07/13/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Two recent studies that examined National Health Interview Survey data reported divergent findings regarding the propensity of adult chiropractic users to receive seasonal influenza immunization. Although one study found a statistically significant negative association between chiropractic use and influenza vaccination, another found that chiropractic users were significantly more likely to be vaccinated. The purpose of this study is to extend previous works by delving more deeply into recent data to identify adult chiropractic users at high risk and high priority for vaccination against influenza and pneumococcal disease. METHODS We used data from the 2007 National Health Interview Survey in an attempt to replicate previous methodologies and further examine vaccination among adult chiropractic users (age ≥18 years) who, according to the Center for Disease Control and Prevention guidelines, should receive influenza and/or pneumococcal vaccination. We used complex survey design methods to make national estimates and used logistic regression to determine if having used chiropractic care predicted vaccination. RESULTS We found major methodological differences between the prior studies. In our analyses, we found that chiropractic users were significantly less likely than nonusers to have received the pneumococcal vaccine, and we found no significant difference between chiropractic users and nonusers relative to having received the seasonal flu vaccine. CONCLUSIONS Methodological differences in previous studies that investigated the association between chiropractic care and adult vaccination likely explain divergent findings reported in the literature. Future studies should consider these differences.
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Affiliation(s)
- Monica Smith
- National University of Health Sciences, Pinellas Park, FL, USA.
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337
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Galinsky AM, Sonenstein FL. The association between developmental assets and sexual enjoyment among emerging adults. J Adolesc Health 2011; 48:610-5. [PMID: 21575822 PMCID: PMC3096843 DOI: 10.1016/j.jadohealth.2010.09.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 09/15/2010] [Accepted: 09/15/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the associations between three key developmental assets and an aspect of sexual health, sexual enjoyment, which has rarely been studied in young adults, although its importance is stressed in all recent sexual health policy statements. METHODS Using data from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health, and multiple logistic and ordered logistic regression, we explored the associations between sexual pleasure and autonomy, self-esteem, and empathy among 3,237 respondents aged 18-26 years in heterosexual relationships of ≥ 3-month duration. We also examined the distribution of sexual pleasure across various socio-demographic groups. RESULTS Compared with young women, young men reported more regular orgasms and more enjoyment of two kinds of partnered sexual behavior. Sexual enjoyment was not associated with age, race/ethnicity, or socioeconomic status. Among women, autonomy, self-esteem, and empathy co-varied positively with all three sexual enjoyment measures. Among men, all associations were in the same direction, but not all were statistically significant. CONCLUSION A substantial gender difference in enjoyment of partnered sexual behavior exists among emerging adults in the United States. This study is the first to use a representative population sample to find a relationship between developmental assets and a positive aspect of sexual health - sexual pleasure.
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Affiliation(s)
- Adena M Galinsky
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
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Sun S, Chen J, Johannesson M, Kind P, Xu L, Zhang Y, Burström K. Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the National Health Services Survey 2008. Qual Life Res 2011; 20:309-20. [PMID: 21042861 PMCID: PMC3052443 DOI: 10.1007/s11136-010-9762-x] [Citation(s) in RCA: 163] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2010] [Indexed: 01/10/2023]
Abstract
PURPOSE To measure and analyse national EQ-5D data and to provide norms for the Chinese general population by age, sex, educational level, income and employment status. METHODS The EQ-5D instrument was included in the National Health Services Survey 2008 (n = 120,703) to measure health-related quality of life (HRQoL). All descriptive analyses by socio-economic status (educational level, income and employment status) and by clinical characteristics (discomfort during the past 2 weeks, diagnosed with chronic diseases during the past 6 months and hospitalised during the past 12 months) were stratified by sex and age group. RESULTS Health status declines with advancing age, and women reported worse health status than men, which is in line with EQ-5D population health studies in other countries and previous population health studies in China. The EQ-5D instrument distinguished well for the known groups: positive association between socio-economic status and HRQoL was observed among the Chinese population. Persons with clinical characteristics had worse HRQoL than those without. CONCLUSIONS This study provides Chinese population HRQoL data measured by the EQ-5D instrument, based on a national representative sample. The main findings for different subgroups are consistent with results from EQ-5D population studies in other countries, and discriminative validity was supported.
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Affiliation(s)
- Sun Sun
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
- Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
| | - Jiaying Chen
- School of Health Policy and Management, Nanjing Medical University, Hanzhong Rd 140, 210 029 Nanjing, P. R. China
| | - Magnus Johannesson
- Department of Economics, Stockholm School of Economics, Box 6501, 113 83 Stockholm, Sweden
| | - Paul Kind
- Centre for Health Economics, University of York, York, YO10 5DD UK
| | - Ling Xu
- Centre for Health Statistics and Information, Ministry of Health, Xizhimenwainanlu 1, 100 044 Beijing, P. R. China
| | - Yaoguang Zhang
- Centre for Health Statistics and Information, Ministry of Health, Xizhimenwainanlu 1, 100 044 Beijing, P. R. China
| | - Kristina Burström
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
- Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Nobels väg 15a, 171 77 Stockholm, Sweden
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Baca-Garcia E, Perez-Rodriguez MM, Keyes KM, Oquendo MA, Hasin DS, Grant BF, Blanco C. Suicidal ideation and suicide attempts among Hispanic subgroups in the United States: 1991-1992 and 2001-2002. J Psychiatr Res 2011; 45:512-8. [PMID: 20937507 PMCID: PMC3032009 DOI: 10.1016/j.jpsychires.2010.09.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 07/21/2010] [Accepted: 09/11/2010] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the prevalence of suicidal ideation/attempts among Hispanic subgroups in the US in 1991-1992 and 2001-2002, and identify high-risk groups. METHOD Data were drawn from the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES, n = 42,862) and the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC, n = 43,093), two nationally representative surveys of individuals aged 18 years and older. RESULTS 1) Puerto Ricans are the Hispanic ethnic subgroup with the highest rates of suicide attempts; 2) 45- to 64-year-old Puerto Rican women are a high-risk group for suicide attempts; 3) Over the 10 year period between the two surveys, the lifetime prevalence of suicide attempts significantly increased among 18- to 24-year-old Puerto Rican women and Cuban men, and among 45- to 64-year-old Puerto Rican men. CONCLUSION Hispanics in the US are not a homogeneous group. We identify high-risk groups among Hispanics. Specific interventions for subgroups of Hispanics at high risk for suicidal behaviors may be required.
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Affiliation(s)
- Enrique Baca-Garcia
- New York State Psychiatric Institute, New York, NY 10032, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Fundacion Jimenez Diaz Hospital, Autonoma University, CIBERSAM, Madrid, Spain
| | - M. Mercedes Perez-Rodriguez
- Ramón y Cajal Hospital, CIBERSAM, Madrid 28034, Spain
- Department of Psychiatry, Mount Sinai School of Medicine. New York, NY 10029, USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Maria A. Oquendo
- New York State Psychiatric Institute, New York, NY 10032, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Deborah S. Hasin
- New York State Psychiatric Institute, New York, NY 10032, USA
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA
| | - Carlos Blanco
- New York State Psychiatric Institute, New York, NY 10032, USA
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340
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Wells JE, McGee MA, Scott KM, Browne MAO. Bipolar disorder with frequent mood episodes in the New Zealand Mental Health Survey. J Affect Disord 2010; 126:65-74. [PMID: 20307906 PMCID: PMC2897902 DOI: 10.1016/j.jad.2010.02.136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 02/27/2010] [Accepted: 02/27/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Rapid cycling bipolar disorder has been studied almost exclusively in clinical samples. METHODS A national cross-sectional survey in 2003-2004 in New Zealand used the Composite International Diagnostic Interview (CIDI 3.0). Diagnosis was by DSM-IV. Depression severity was assessed with the Quick Inventory of Depressive Symptoms (QIDS) and role impairment using Sheehan Scales. Complex survey analyses compared percentages and means, and used logistic regression and discrete-time survival analyses. Frequent mood episodes (FMEs) in the past 12 months (4+) were used as an indicator of rapid cycling. RESULTS The lifetime prevalence of bipolar disorder (I + II) was 1.7%. Twelve-month prevalence was 1.0%: 0.3% with FME and 0.7% with No FME (1-3 episodes). Another 0.7% had no episodes in that period. Age of onset was earliest for FME (16.0 years versus 19.5 and 20.1, p<.05). In the past 12 months, weeks in episode, total days out of role and role impairment in the worst month were all worse for the FME group (p<.0001) but both the FME and No-FME groups experienced severe and impairing depression. Lifetime suicidal behaviours and comorbidity were high in all three bipolar groups but differed little between them. About three-quarters had ever received treatment but only half with twelve-month disorder made treatment contact. LIMITATIONS Recall, not observation of episodes. CONCLUSIONS Even in the community the burden of bipolar disorder is high. Frequent mood episodes in bipolar disorder are associated with still more disruption of life than less frequent episodes. Treatment is underutilized and could moderate the distress and impairment experienced.
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Affiliation(s)
- J. Elisabeth Wells
- Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
| | - Magnus A. McGee
- Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand
| | - Kate M. Scott
- Psychological Medicine, University of Otago, Wellington, New Zealand
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Abstract
OBJECTIVE To estimate the prevalence of alarm symptoms for breast, colorectal, urinary tract, and lung cancer in the general population. DESIGN Cross-sectional questionnaire survey. SETTING The former County of Funen, Denmark, with 480,000 inhabitants. PARTICIPANTS A total of 13,777 randomly selected persons aged 20 years and older. MAIN OUTCOME MEASURES Prevalence estimates of having experienced cancer alarm symptoms during the past 12 months: a lump in the breast, blood in bowel movements, blood in urine, or coughing for more than six weeks. The number of alarm symptoms experienced within the past 12 months was also calculated. RESULTS With a response rate of 69%, 3.3% of responders (95% CI 2.9% to 3.7%) reported a lump in their breast, 5.7% (5.2% to 6.3%) reported blood in bowel movements, 2.2% (1.9% to 2.5%) reported blood in urine, and 6.5% (6.1% to 7.5%) reported coughing for more than six weeks within the past 12 months. Overall, 15.3% (95% confidence interval 14.3% to 16.3%) of the females and 12.7% (11.6% to 13.7%) of the males reported having experienced at least one cancer alarm symptom within the past 12 months. CONCLUSION Alarm symptoms of breast, colorectal, urinary tract, and lung cancer are common in the general population and approximately 15% of the population have experienced at least one of these cancer alarm symptom within the past 12 months.
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Affiliation(s)
- Rikke Pilsgaard Svendsen
- Research Unit for General Practice in Odense, Institute of Public Health, University of Southern Denmark, Denmark.
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342
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McGregor S, Hilsden R, Yang H. Physician barriers to population-based, fecal occult blood test-based colorectal cancer screening programs for average-risk patients. Can J Gastroenterol 2010; 24:359-64. [PMID: 20559577 PMCID: PMC2898489 DOI: 10.1155/2010/591326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 10/06/2009] [Indexed: 12/24/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) screening is an efficacious but underused means to reduce the burden of CRC. Population-based CRC screening programs are currently being implemented in Canada and physicians are key partners in increasing screening uptake. The current study identified physician attitudes and barriers that need to be addressed by provincial programs. METHODS A mailed survey of primary care physicians in Alberta. RESULTS The survey response rate was 42.4% (806 of 1903). The majority of physicians suggested CRC screening as part of a routine periodic examination; however, the approach to test selection and the type of tests recommended varied by geographical region. The majority of physicians agreed (48%) or strongly agreed (36%) that a provincewide screening program is the best approach to reducing mortality from CRC. However, there were many serious concerns identified - the most common was endoscopic capacity for follow-up of patients with a positive fecal occult blood test (FOBT), which was cited by 55% to 69% of the physicians surveyed. The barriers to three commonly available tests (FOBT, flexible sigmoidoscopy and colonoscopy) varied according to health region, and the types of barriers identified varied according to the specific test. INTERPRETATION Screening for CRC is gradually being accepted among primary care physicians in Alberta. A key finding of the present descriptive study was the regional variation in practices, perceived barriers and concerns about provincial population-based screening programs based on FOBT as the primary screening test. Provincial programs will need to address the issue of endoscopic capacity and perceived barriers to FOBT to gain primary care physician acceptance of FOBT-based CRC screening programs.
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Affiliation(s)
- S McGregor
- Population Health Research, Alberta Health Services Cancer Care, Calgary, Alberta.
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343
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Gershon R, Rothrock NE, Hanrahan RT, Jansky LJ, Harniss M, Riley W. The development of a clinical outcomes survey research application: Assessment Center. Qual Life Res 2010; 19:677-85. [PMID: 20306332 PMCID: PMC3686503 DOI: 10.1007/s11136-010-9634-4] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The National Institutes of Health sponsored Patient-Reported Outcome Measurement Information System (PROMIS) aimed to create item banks and computerized adaptive tests (CATs) across multiple domains for individuals with a range of chronic diseases. PURPOSE Web-based software was created to enable a researcher to create study-specific Websites that could administer PROMIS CATs and other instruments to research participants or clinical samples. This paper outlines the process used to develop a user-friendly, free, Web-based resource (Assessment Center) for storage, retrieval, organization, sharing, and administration of patient-reported outcomes (PRO) instruments. METHODS Joint Application Design (JAD) sessions were conducted with representatives from numerous institutions in order to supply a general wish list of features. Use Cases were then written to ensure that end user expectations matched programmer specifications. Program development included daily programmer "scrum" sessions, weekly Usability Acceptability Testing (UAT) and continuous Quality Assurance (QA) activities pre- and post-release. RESULTS Assessment Center includes features that promote instrument development including item histories, data management, and storage of statistical analysis results. CONCLUSIONS This case study of software development highlights the collection and incorporation of user input throughout the development process. Potential future applications of Assessment Center in clinical research are discussed.
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Affiliation(s)
- Richard Gershon
- Department of Medical Social Sciences, Northwestern University, 625 North Michigan Avenue, Suite 2700, Chicago, IL 60611, USA
| | - Nan E. Rothrock
- Department of Medical Social Sciences, Northwestern University, 625 North Michigan Avenue, Suite 2700, Chicago, IL 60611, USA
| | - Rachel T. Hanrahan
- Department of Medical Social Sciences, Northwestern University, 625 North Michigan Avenue, Suite 2700, Chicago, IL 60611, USA
| | | | | | - William Riley
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
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344
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Baca-Garcia E, Perez-Rodriguez MM, Keyes KM, Oquendo MA, Hasin DS, Grant BF, Blanco C. Suicidal ideation and suicide attempts in the United States: 1991-1992 and 2001-2002. Mol Psychiatry 2010; 15:250-9. [PMID: 18779820 PMCID: PMC2825279 DOI: 10.1038/mp.2008.98] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Revised: 07/29/2008] [Accepted: 08/07/2008] [Indexed: 11/09/2022]
Abstract
The aim of the study is to compare the prevalence of suicidal ideation and attempts in the United States in 1991-1992 and 2001-2002, and identify sociodemographic groups at increased risk for suicidal ideation and attempts. Data were drawn from the National Institute on Alcohol Abuse and Alcoholism 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (n=42,862) and the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n=43,093), two nationally representative household surveys of non-institutionalized civilians aged 18 years and older, residing in the United States. The lifetime prevalence of suicide attempts remained unchanged in the United States between 1991-1992 and 2001-2002. Specific groups, namely 18- to 24-year-old white and black women, 25- to 44-year-old white women and 45- to 64-year-old Native American men were identified as being at high risk for suicide attempts. Despite prevention and treatment efforts, the lifetime prevalence of suicide attempts remains unchanged. Given the morbidity and mortality associated with suicide attempts, urgent action is needed to decrease the prevalence of suicide attempts in the United States.
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Affiliation(s)
- Enrique Baca-Garcia
- New York State Psychiatric Institute, New York, NY 10032
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032
- Fundacion Jimenez Diaz Hospital, Autonoma University, Madrid, Spain
| | - M. Mercedes Perez-Rodriguez
- Ramón y Cajal Hospital. Madrid. Spain 28034
- Department of Psychiatry, Mount Sinai School of Medicine. New York, NY, 10029
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032
| | - Maria A. Oquendo
- New York State Psychiatric Institute, New York, NY 10032
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - Deborah S. Hasin
- New York State Psychiatric Institute, New York, NY 10032
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Carlos Blanco
- New York State Psychiatric Institute, New York, NY 10032
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345
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Evans MK, Lepkowski JM, Powe NR, LaVeist T, Kuczmarski MF, Zonderman AB. Healthy aging in neighborhoods of diversity across the life span (HANDLS): overcoming barriers to implementing a longitudinal, epidemiologic, urban study of health, race, and socioeconomic status. Ethn Dis 2010; 20:267-275. [PMID: 20828101 PMCID: PMC3040595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE Examine the influences of race, socioeconomic status, sex, and age on barriers to participation in a study of cross-sectional differences and longitudinal changes in health-related outcomes. METHODS We designed a multidisciplinary, community-based, prospective longitudinal epidemiologic study among socioeconomically diverse African Americans and Whites. We recruited 3722 participants from Baltimore, Md. with a mean age of 47.7 (range 30-64) years, 45% males; 2200 African Americans (59%) and 1522 whites (41%); 41% reported household incomes below the 125% poverty delimiter. RESULTS There were no significant age differences associated with sex or race. Participants below the 125% poverty delimiter were slightly younger than those above the delimiter. Age, race, and sex, but not poverty status, were associated with the likelihood of a physical examination. Older participants, women, and Whites were more likely to complete their examinations. Among those who completed their examinations, there were no age differences associated with sex and poverty status, but African Americans were negligibly younger than Whites. CONCLUSIONS Although some literature suggests that minorities and low-income people are less willing to participate in clinical research, these baseline data suggest that African Americans individuals and individuals from households with incomes below 125% of the poverty level are at least as willing to participate in observational clinical studies as Whites and higher income individuals of similar age and sex.
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Affiliation(s)
- Michele K Evans
- National Institute on Aging Intramural Research Program, National Institutes of Health, Baltimore, MD 21224-2816, USA.
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346
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Gabilondo A, Rojas-Farreras S, Vilagut G, Haro JM, Fernández A, Pinto-Meza A, Alonso J. Epidemiology of major depressive episode in a southern European country: results from the ESEMeD-Spain project. J Affect Disord 2010; 120:76-85. [PMID: 19428121 PMCID: PMC3756284 DOI: 10.1016/j.jad.2009.04.016] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 04/14/2009] [Accepted: 04/14/2009] [Indexed: 12/12/2022]
Abstract
BACKGROUND Information of the epidemiology of Major Depressive Episode (MDE) in Spain, one of the biggest southern European countries, is scarce and heterogeneous. The objective of this study was to assess the epidemiology of the disorder in the Spanish sample of the ESEMeD project. METHODS The ESEMED-Spain project is a cross-sectional, general population, household survey conducted with a representative sample of Spanish non-institutionalized adult population. The survey instrument was the CIDI 3.0, a structured diagnostic interview to assess disorders and treatment. RESULTS Lifetime prevalence was 10.6% while 12-month prevalence was 4.0%. A monotonic increase in lifetime overall prevalence was found from the youngest to the 50-64 cohort, declining then in the oldest group. Median age of onset was 30.0. Being a woman (OR=2.7), previously married (OR=1.8), unemployed or disabled to work (OR=2.9) was associated to higher risk of 12-month-MDE. The highest comorbid associations were with dysthymia (OR=73.1) and panic disorder (OR=41.8). LIMITATIONS 1. Psychiatric diagnoses were made by trained lay interviewers and this could have an imperfect sensitivity/specificity; 2. Individuals with mental illness could have more frequently rejected to participate in the survey; 3. Age-related recall bias could have affected the accuracy of age of onset estimates. CONCLUSIONS The study shows that prevalence MDE in Spain is lower than in other Western countries. Important findings are the early age of onset, the high proportion of chronicity, and the high female/male ratio. Taken together, results offer a complex picture of the epidemiology of MDE in Spain, when compared to other countries in Europe. The role of cultural factors is discussed.
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Affiliation(s)
- Andrea Gabilondo
- Departament de Salut, Generalitat de Catalunya, Spain,Health Services Research Unit (IMIM-Hospital del Mar), Barcelona, Spain
| | | | - Gemma Vilagut
- Health Services Research Unit (IMIM-Hospital del Mar), Barcelona, Spain,CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - Josep M. Haro
- Fundació Sant Joan de Déu (FSD), Barcelona, Spain,CIBER en Salud Mental (CIBERSAM), Spain
| | - Ana Fernández
- Fundació Sant Joan de Déu (FSD), Barcelona, Spain,redIAPP (Red de Investigación en Actividades Preventivas y Promoción de la Salud en Atención Primaria)
| | - Alejandra Pinto-Meza
- Fundació Sant Joan de Déu (FSD), Barcelona, Spain,redIAPP (Red de Investigación en Actividades Preventivas y Promoción de la Salud en Atención Primaria)
| | - Jordi Alonso
- Health Services Research Unit (IMIM-Hospital del Mar), Barcelona, Spain,CIBER en Epidemiología y Salud Pública (CIBERESP), Spain,Author for correspondence: Jordi Alonso, IMIM-Hospital del Mar. Parc de Recerca Biomèdica de Barcelona (PRBB) Doctor Aiguader, 88. 08003. Barcelona. Phone: +34 933160760; Fax: +34 933160797;
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Salomon JA, Nordhagen S, Oza S, Murray CJL. Are Americans feeling less healthy? The puzzle of trends in self-rated health. Am J Epidemiol 2009; 170:343-51. [PMID: 19564169 PMCID: PMC2714952 DOI: 10.1093/aje/kwp144] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 05/06/2009] [Indexed: 01/12/2023] Open
Abstract
Although self-rated health is proposed for use in public health monitoring, previous reports on US levels and trends in self-rated health have shown ambiguous results. This study presents a comprehensive comparative analysis of responses to a common self-rated health question in 4 national surveys from 1971 to 2007: the National Health and Nutrition Examination Survey, Behavioral Risk Factor Surveillance System, National Health Interview Survey, and Current Population Survey. In addition to variation in the levels of self-rated health across surveys, striking discrepancies in time trends were observed. Whereas data from the Behavioral Risk Factor Surveillance System demonstrate that Americans were increasingly likely to report "fair" or "poor" health over the last decade, those from the Current Population Survey indicate the opposite trend. Subgroup analyses revealed that the greatest inconsistencies were among young respondents, Hispanics, and those without a high school education. Trends in "fair" or "poor" ratings were more inconsistent than trends in "excellent" ratings. The observed discrepancies elude simple explanations but suggest that self-rated health may be unsuitable for monitoring changes in population health over time. Analyses of socioeconomic disparities that use self-rated health may be particularly vulnerable to comparability problems, as inconsistencies are most pronounced among the lowest education group. More work is urgently needed on robust and comparable approaches to tracking population health.
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Affiliation(s)
- Joshua A Salomon
- Harvard University Initiative for Global Health, Cambridge, MA 02138, USA.
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348
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Bautista LE, Casas JP, Herrera VM, Miranda JJ, Perel P, Pichardo R, González A, Sanchez JR, Ferreccio C, Aguilera X, Silva E, Oróstegui M, Gómez LF, Chirinos JA, Medina-Lezama J, Pérez CM, Suárez E, Ortiz AP, Rosero L, Schapochnik N, Ortiz Z, Ferrante D. The Latin American Consortium of Studies in Obesity (LASO). Obes Rev 2009; 10:364-70. [PMID: 19438980 PMCID: PMC2687094 DOI: 10.1111/j.1467-789x.2009.00591.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Current, high-quality data are needed to evaluate the health impact of the epidemic of obesity in Latin America. The Latin American Consortium of Studies of Obesity (LASO) has been established, with the objectives of (i) Accurately estimating the prevalence of obesity and its distribution by sociodemographic characteristics; (ii) Identifying ethnic, socioeconomic and behavioural determinants of obesity; (iii) Estimating the association between various anthropometric indicators or obesity and major cardiovascular risk factors and (iv) Quantifying the validity of standard definitions of the various indexes of obesity in Latin American population. To achieve these objectives, LASO makes use of individual data from existing studies. To date, the LASO consortium includes data from 11 studies from eight countries (Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Peru, Puerto Rico and Venezuela), including a total of 32,462 subjects. This article describes the overall organization of LASO, the individual studies involved and the overall strategy for data analysis. LASO will foster the development of collaborative obesity research among Latin American investigators. More important, results from LASO will be instrumental to inform health policies aiming to curtail the epidemic of obesity in the region.
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Affiliation(s)
- L E Bautista
- Department of Population Health Sciences, University of Wisconsin, Madison, WI 53726-2397, USA.
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349
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Kroth PJ, McPherson L, Leverence R, Pace W, Daniels E, Rhyne RL, Williams RL. Combining web-based and mail surveys improves response rates: a PBRN study from PRIME Net. Ann Fam Med 2009; 7:245-8. [PMID: 19433842 PMCID: PMC2682960 DOI: 10.1370/afm.944] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The advent of Web-based survey tools has provided the investigator with an alternative to paper-based survey methods that in many instances may be less expensive to implement than traditional paper-based surveys. Newer technology, however, does not diminish the importance of obtaining an adequate response rate. METHODS We analyzed response rate data obtained from a survey implemented across 3 practice-based research networks (PBRNs) in which the survey was first implemented electronically with 5 rounds of electronic solicitation for an Internet-based questionnaire and then by 2 rounds of a paper-based version mailed only to nonresponders. RESULTS Overall, 24% of the total survey responses received were in the paper mode despite intense promotion of the survey in the electronic phase. CONCLUSIONS Our results suggest there is still an important role for the use of paper-based methods in PBRN survey research. Both hard copy and electronic survey collection methods may be required to enhance clinician response rates in PBRNs.
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Affiliation(s)
- Philip J Kroth
- Health Sciences Informatics Program Development, Health Sciences Library and Informatics Center, MSC09 5100, University of New Mexico, Albuquerque, NM 87131-0001, USA.
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350
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Pizacani BA, Dent CW, Maher JE, Rohde K, Stark MJ, Biglan A, Thompson J. Smoking patterns in Oregon youth: effects of funding and defunding of a comprehensive state tobacco control program. J Adolesc Health 2009; 44:229-36. [PMID: 19237108 PMCID: PMC4186742 DOI: 10.1016/j.jadohealth.2008.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2007] [Revised: 07/01/2008] [Accepted: 07/08/2008] [Indexed: 11/16/2022]
Abstract
PURPOSE Comprehensive tobacco control programs have included school-based prevention programs as a key strategy to reach adolescents. Unfortunately, these programs have undergone extensive budget reductions in recent years. In 2003, funding for the Oregon Tobacco Prevention and Education Program was reduced by about 70%, and the school component was entirely defunded. To assess the effects of program funding and subsequent defunding on smoking prevalence within targeted Oregon schools, we compared the change in 30-day smoking prevalence between grades 8 and 11 in school districts in two periods: namely, during funding and after funding was eliminated. METHODS We used annual school-based survey data for grades 8 and 11 to describe district-level changes in smoking prevalence in five age cohorts: two during the funding period and three after defunding. Each cohort was comprised of districts whose 8th-graders completed the survey and participated again 3 years later. Using mixed models, we compared the change in 30-day adjusted smoking prevalence among cohorts in funded districts, defunded districts, and districts that never received funding. RESULTS Smoking prevalence growth was significantly higher among cohorts from the defunded period than for cohorts from the funded period (p=.04) and was not significantly different from schools that were never-funded (p=.79). CONCLUSIONS In Oregon, funding a school component of a comprehensive tobacco control strategy was associated with depressed uptake of smoking. Gains were quickly lost upon program defunding. School programs are an important strategy if they are long term, comprehensive, and reinforced in the larger environment.
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Affiliation(s)
- Barbara A Pizacani
- Program Design and Evaluation Services, Multnomah County Health Department and Oregon Public Health Division, Portland, Oregon 97232, USA.
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