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Borg DJ, Haritopoulou-Sinanidou M, Gabrovska P, Tseng HW, Honeyman D, Schweitzer D, Rae KM. Barriers and facilitators for recruiting and retaining male participants into longitudinal health research: a systematic review. BMC Med Res Methodol 2024; 24:46. [PMID: 38389065 PMCID: PMC10882922 DOI: 10.1186/s12874-024-02163-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/28/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Successfully recruiting male participants to complete a healthcare related study is important for healthcare study completion and to advance our clinical knowledgebase. To date, most research studies have examined the barriers and facilitators of female participants in longitudinal healthcare-related studies with limited information available about the needs of males in longitudinal research. This systematic review examines the unique barriers and facilitators to male recruitment across longitudinal healthcare-related research studies. METHODS Following PRIMSA guidelines, MEDLINE, Embase, CINAHL and Web of Science databases were systematically searched using the terms recruitment and/or retention, facilitators and/or barriers and longitudinal studies from 1900 to 2023 which contained separate data on males aged 17-59 years. Health studies or interventions were defined longitudinal if they were greater than or equal to 12 weeks in duration with 3 separate data collection visits. RESULTS Twenty-four articles published from 1976-2023 met the criteria. One-third of the studies had a predominantly male sample and four studies recruited only male participants. Males appear disinterested towards participation in health research, however this lack of enthusiasm can be overcome by clear, non-directive communication, and studies that support the participants interests. Facilitating factors are diverse and may require substantial time from research teams. CONCLUSIONS Future research should focus on the specific impact of these factors across the spectrum of longitudinal health-related studies. Based on the findings of this systematic review, researchers from longitudinal health-related clinical trials are encouraged to consider male-specific recruitment strategies to ensure successful recruitment and retention in their studies. REGISTRATION This systemic review is registered with the PROSPERO database (CRD42021254696).
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Affiliation(s)
- Danielle J Borg
- Pregnancy and Development Group, Mater Research - The University of Queensland, Aubigny Place, South Brisbane, 4101, Australia
- Faculty of Medicine, University of Queensland, Herston, 4006, Australia
| | | | - Pam Gabrovska
- Indigenous Health Group, Mater Research Institute - The University of Queensland, Aubigny Place, South Brisbane, 4101, Australia
| | - Hsu-Wen Tseng
- Stem Cell Biology Group, Mater Research Institute - The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, QLD, 4102, Australia
| | - David Honeyman
- Library, University of Queensland, St Lucia, 4072, Australia
| | - Daniel Schweitzer
- Faculty of Medicine, University of Queensland, Herston, 4006, Australia
- Department of Neurology, Mater Health, South Brisbane, 4101, Australia
| | - Kym M Rae
- Faculty of Medicine, University of Queensland, Herston, 4006, Australia.
- Indigenous Health Group, Mater Research Institute - The University of Queensland, Aubigny Place, South Brisbane, 4101, Australia.
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2
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Gooden TE, Wang J, Carvalho Goulart A, Varella AC, Tai M, Sheron VA, Wang H, Zhang H, Zhong J, Kumarendran B, Nirantharakumar K, Surenthirakumaran R, Bensenor IM, Guo Y, Lip GYH, Thomas GN, Manaseki-Holland S. Generalisability of and lessons learned from a mixed-methods study conducted in three low- and middle-income countries to identify care pathways for atrial fibrillation. Glob Health Action 2023; 16:2231763. [PMID: 37466418 PMCID: PMC10360996 DOI: 10.1080/16549716.2023.2231763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Identifying existing care pathways is the first step for understanding how services can be improved to enable early diagnosis and effective follow-up care for non-communicable diseases (NCDs); however, evidence on how care pathways can and should be identified in low- and middle-income countries (LMICs) is lacking. OBJECTIVE To describe generalisability and lessons learned from recruitment and data collection for the quantitative component of a mixed methods study designed to determine the care pathway for atrial fibrillation (AF) in Brazil, China and Sri Lanka. METHODS Adults (≥18 years) that spoke the local language and with an AF diagnosis were eligible. We excluded anyone with a hearing or cognitive impairment or ineligible address. Eligible participants were identified using electronic records in Brazil and China; in Sri Lanka, researchers attended the outpatient clinics to identify eligible participants. Data were collected using two quantitative questionnaires administered at least 2-months apart. A minimum sample size of 238 was required for each country. RESULTS The required sample size was met in Brazil (n = 267) and China (n = 298), but a large proportion of AF patients could not be contacted (47% and 27%, respectively) or refused to participate (36% and 38%, respectively). In Sri Lanka, recruitment was challenging, resulting in a reduced sample (n = 151). Mean age of participants from Brazil, China and Sri Lanka was 69 (SD = 11.3), 65 (SD = 12.8) and 58 (SD = 11.7), respectively. Females accounted for 49% of the Brazil sample, 62% in China and 70% in Sri Lanka. CONCLUSIONS Generalisability was an issue in Brazil and China, as was selection bias. Recruitment bias was highlighted in Sri Lanka. Additional or alternative recruitment methods may be required to ensure generalisability and reduce bias in future studies aimed at identifying NCD care pathways in LMICs.
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Affiliation(s)
- Tiffany E Gooden
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jingya Wang
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Alessandra Carvalho Goulart
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Ana C Varella
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
| | - Meihui Tai
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Vethanayagan Antony Sheron
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Hao Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hui Zhang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Jiaoyue Zhong
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Balachandran Kumarendran
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | | | - Rajendra Surenthirakumaran
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Isabela M Bensenor
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Yutao Guo
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Lykke C, Ekholm O, Olsen M, Sjøgren P. Paediatric end-of-life care - symptoms and problems: parent assessment. BMJ Support Palliat Care 2023; 13:e327-e333. [PMID: 33707300 DOI: 10.1136/bmjspcare-2021-002891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Symptoms and problems (S&P) are under-reported in children in end-of-life care.To target future interventions, the primary aim was to examine S&P in children in end-of-life care. METHODS All parents, who lost a child under the age of 18 years due to life-limiting diagnoses in the period 2012-2014 in Denmark, were invited to complete a self-administered questionnaire in 2017. In all, 152 (38%) children were represented by 136 mothers and 57 fathers. In the present study, parents' assessments of S&P during the last month of life were restricted to children aged 3-18 years. Data were analyses by means of descriptive statistics. RESULTS Children ≥3 years at the time of death were represented by 71 parents (48 mothers and 23 fathers) representing 56 out of the 152 children. Physical fatigue (93%), sleepiness (90%), poor appetite (87%), pain (84%) and nausea (84%) were the five most frequent symptoms reported by the parents. In all, 65% of the parents reported that satisfactory pain relief was obtained and 64% of the parents reported that the healthcare services to a large extent reacted quickly, when the child and/or family needed help. However, 46% of the parents experienced 'mess-ups' or sloppy services in the primary ward and 27% experienced that the children suffered from fear of death. CONCLUSION According to the parents, children with life-limiting diagnosis are highly symptomatic and have substantial problems during end-of-life care. Our findings indicate that systematic screening of S&P in children should be considered.
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Affiliation(s)
- Camilla Lykke
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
- Department of Oncology and Palliative Care, Nordsjællands Hospital, Hillerod, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
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4
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Quinlan-Davidson M, Shan D, Courtney D, Barbic S, Cleverley K, Hawke LD, Ma C, Prebeg M, Relihan J, Szatmari P, Henderson JL. Associations over the COVID-19 pandemic period and the mental health and substance use of youth not in employment, education or training in Ontario, Canada: a longitudinal, cohort study. Child Adolesc Psychiatry Ment Health 2023; 17:105. [PMID: 37679811 PMCID: PMC10486040 DOI: 10.1186/s13034-023-00653-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND The economic shutdown and school closures associated with the COVID-19 pandemic have negatively influenced many young people's educational and training opportunities, leading to an increase in youth not in education, employment, or training (NEET) globally and in Canada. NEET youth have a greater vulnerability to mental health and substance use problems, compared to their counterparts who are in school and/or employed. There is limited evidence on the association between COVID-19 and NEET youth. The objectives of this exploratory study included investigating: longitudinal associations between the COVID-19 pandemic and the mental health and substance use (MHSU) of NEET youth; and MHSU among subgroups of NEET and non-NEET youth. METHODS 618 youth (14-28 years old) participated in this longitudinal, cohort study. Youth were recruited from four pre-existing studies at the Centre for Addiction and Mental Health. Data on MHSU were collected across 11 time points during the COVID-19 pandemic (April 2020-August 2022). MHSU were measured using the CoRonavIruS Health Impact Survey Youth Self-Report, the Global Appraisal of Individual Needs Short Screener, and the PTSD Checklist for DSM-5. Linear Mixed Models and Generalized Estimating Equations were used to analyze associations of NEET status and time on mental health and substance use. Exploratory analyses were conducted to investigate interactions between sociodemographic characteristics and NEET status and time. RESULTS At baseline, NEET youth were significantly more likely to screen positive for an internalizing disorder compared to non-NEET youth (OR = 1.92; 95%CI=[1.26-2.91] p = 0.002). No significant differences were found between youth with, and without, NEET in MHSU symptoms across the study time frame. Youth who had significantly higher odds of screening positive for an internalizing disorder included younger youth (OR = 1.06, 95%CI=[1.00-1.11]); youth who identify as Trans, non-binary or gender diverse (OR = 8.33, 95%CI=[4.17-16.17]); and those living in urban areas (OR = 1.35, 95%CI=[1.03-1.76]), compared to their counterparts. Youth who identify as White had significantly higher odds of screening positive for substance use problems (OR = 2.38, 95%CI=[1.72-3.23]) compared to racialized youth. CONCLUSIONS Our findings indicate that sociodemographic factors such as age, gender identity, ethnicity and area of residence impacted youth MHSU symptoms over the course of the study and during the pandemic. Overall, NEET status was not consistently associated with MHSU symptoms over and above these factors. The study contributes to evidence on MHSU symptoms of NEET youth.
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Affiliation(s)
| | - Di Shan
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Darren Courtney
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Skye Barbic
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, the University of British Columbia, Vancouver, Canada
- Foundry British Columbia, Vancouver, BC, Canada
| | - Kristin Cleverley
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Clement Ma
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Matthew Prebeg
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
| | - J L Henderson
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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5
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Burns M, Bally J, Burles M, Peacock S. Critically Ill Patients: Family Experiences of Interfacility Transfers From Rural to Urban Centers and Impact on Family Relationships. JOURNAL OF FAMILY NURSING 2023; 29:74-88. [PMID: 36172740 PMCID: PMC9850375 DOI: 10.1177/10748407221124254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A critical illness event is intensely stressful for family members and can lead to negative psychological, emotional, social and financial consequences. In geographically rural areas, critically ill patients may require an interfacility transfer to an urban centre for advanced critical care services. In this context, research suggests that these family members from rural areas experience additional burdens, yet little is known about these experiences. An interpretive phenomenological approach was used to explore lived experiences of family members from rural areas whose critically ill relative undergoes an interfacility transfer to an urban centre for advanced critical care services. Participants described feelings of vulnerability in the urban centre, the need to protect the critically ill patient and other relatives, maintaining responsibilities at home, navigating family relationships, and a loss of connection during the transfer window. These findings may better position nurses to address family members' stress and anxiety during this experience.
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Affiliation(s)
- Margie Burns
- University of Prince Edward Island,
Charlottetown, Canada
| | - Jill Bally
- University of Saskatchewan, Saskatoon,
Canada
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6
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Harasym P, Beaupre LA, Juby AG, Kivi P, Majumdar SR, Hanson HM. Cultural Knowledge in Context - People Aged 50 Years and Over Make Sense of a First Fracture and Osteoporosis. J Patient Exp 2023; 10:23743735231151537. [PMID: 36687165 PMCID: PMC9850129 DOI: 10.1177/23743735231151537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Catch a Break (CaB) is a secondary fracture prevention program that uses medical understandings of osteoporosis to assess first fractures and determine appropriateness for secondary fracture prevention. In this study, we interviewed CaB program participants to identify the understandings that patients themselves used to make sense of first fractures and the osteoporosis suggestion as cause. Semi-structured interviews were conducted with female and male participants of the CaB program in Canada. An interpretive practice approach was used to analyze the data. A random sample of 20 individuals, 12 women, and eight men all aged 50 years and over participated. First fractures were produced as meaningful in the context of osteoporosis only for seniors of very advanced age, and for people of any age with poor nutrition. The trauma events that led to a first fracture were produced as meaningful only if perceived as accidents, and having an active lifestyle was produced as beneficial only for mental health and well-being unrelated to osteoporosis. Cultural knowledge shapes, but does not determine, how individuals make sense of their health and illness experiences. Risk prevention program designers should include patients on the design team and be more aware of the presumptive knowledge used to identify individuals at risk of disease.
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Affiliation(s)
- Patricia Harasym
- Cumming School of Medicine, University of
Calgary, Calgary, Alberta, Canada,Heather M Hanson, Cumming School of
Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, Alberta
T2N 4Z6 Canada.
| | - Lauren A Beaupre
- Department of Physical Therapy, Faculty of Rehabilitation Medicine,
University of
Alberta, Edmonton, Alberta, Canada,Department of Orthopedics, Faculty of Medicine, University of
Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - Angela G Juby
- Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton,
Alberta, Canada
| | - Paul Kivi
- Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton,
Alberta, Canada
| | - Sumit R Majumdar
- Department of Medicine, Faculty of Medicine and Dentistry,
University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, Edmonton,
Alberta, Canada,School of Public Health, University of Alberta, 3-300 Edmonton
Clinic Health Academy, Edmonton, Alberta, Canada
| | - Heather M Hanson
- Cumming School of Medicine, University of
Calgary, Calgary, Alberta, Canada,Provincial Seniors Health and Continuing Care, Alberta Health
Services, Calgary, Alberta, Canada
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Molaug I, Engdahl B, Degerud E, Mehlum IS, Aarhus L. Occupation and 20-year hearing decline: findings from The HUNT Study. Occup Med (Lond) 2022; 72:622-628. [PMID: 36039845 PMCID: PMC9805300 DOI: 10.1093/occmed/kqac085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Studies show that certain occupations are associated with an increased risk of hearing loss. However, many studies are cross-sectional, and the few longitudinal studies are mostly small or focus on only one occupation. AIMS We aimed to quantify the long-term hearing decline among workers in different occupations and assess whether the change differs between the occupations. METHODS The study population was 4525 adults who participated in two population-based health studies in Norway, HUNT2 1996-1998 and HUNT4 2017-2019. Linear regression models assessed the association between occupations (clerks as reference) and 20-year hearing decline (hearing thresholds at 3-6 kHz, averaged over both ears) from HUNT2 to HUNT4. Models were adjusted for age, sex, recurrent ear infections, smoking and ear pathology. RESULTS Among the participants (40% men), the mean age at HUNT2 was 31.2 ± 5.4 years (range 20-39) and the average 20-year hearing decline was 11.3 ± 9.8 dB. Occupations that were associated with larger hearing decline included other craft and related trades workers (3.9 dB, 95% confidence interval [CI] 0.2-7.7) and building frame and related trades workers (3.4 dB, 95% CI 1.3-5.4). Among occupations with larger hearing decline, a higher proportion of the workers reported exposure to noise. CONCLUSIONS This large longitudinal study shows a larger long-term hearing decline among building frame workers and craft and related trades workers. Differences between occupations were modest, which may indicate successful preventive measures in Norway during the last two decades.
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Affiliation(s)
- I Molaug
- The National Institute of Occupational Health in Norway, Oslo, Norway
| | - B Engdahl
- The Norwegian Institute of Public Health, Oslo, Norway
| | - E Degerud
- The National Institute of Occupational Health in Norway, Oslo, Norway
| | - I S Mehlum
- The National Institute of Occupational Health in Norway, Oslo, Norway
- The Institute of Health and Society, University of Oslo, Oslo, Norway
| | - L Aarhus
- The National Institute of Occupational Health in Norway, Oslo, Norway
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8
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The effect of non-participation on the prevalence of food insecurity in a population-based cohort in Portugal. J Public Health Policy 2022; 43:391-402. [PMID: 36038767 DOI: 10.1057/s41271-022-00362-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 11/21/2022]
Abstract
Non-participation can be a source of selection bias. We evaluated the effect of non-participation on food insecurity prevalence among 2942 young adults from the EPITeen cohort (Portugal), which we have followed since assembling the cohort in 2003-2004. We conducted a cross-sectional study when the cohort participants were 26 years old. To examine the effect of non-participation, we statistically imputed the missing data on food security status using multivariate imputation by chained equations based on characteristics associated with food insecurity, specifically household income perception, education and household structure from 21 or 24 years of age follow-ups. In our cohort, non-participation caused ~ 2% difference in the food insecurity prevalence: 11.0% (95% CI 9.0-13.0) for 954 participants and 12.6% (95% CI 11.1-14.1) after imputation. These estimates are close to evidence from other European countries and sustain the relevance of developing public health interventions to promote food security, especially considering the negative nutritional and health outcomes associated with food insecurity.
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Wilson C, Spencer G. The mental health support needs of university students with long-term physical health conditions. HEALTH EDUCATION 2022. [DOI: 10.1108/he-01-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeSupporting the mental health of university students is a key priority for higher education. Students living with long-term health conditions are at increased risk of poor mental health; yet little work has focused on their particular mental health needs or indeed, the implications for health education in the university setting. This study sought to identify the mental health support needs of students with long-term conditions, including best ways for universities to support these students.Design/methodology/approachA UK national online survey of 200 university students living with long-term physical health conditions (e.g. asthma, endometriosis, epilepsy) was conducted in 2019.Findings95% of respondents reported that their long-term condition/s had at least a moderate impact on their mental wellbeing, with 81% reporting that they felt depressed and anxious at least once a month because of their health. The most common suggestion for how universities can better support their mental wellbeing was to raise awareness about long-term conditions on campuses, with many reporting a lack of understanding about long-term conditions from academic and support services staff members – with negative impacts on their mental health. Because of this, some respondents reported a reluctance to come forward and seek help from university services, with 25% not formally disclosing their conditions.Originality/valueThese reported concerns underscore the need to develop health education amongst university staff about long-term conditions and to ensure these students are supported with their health at university.
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Willems LM, Hochbaum M, Frey K, Schulz J, Menzler K, Langenbruch L, Kovac S, Immisch I, von Podewils F, Hamacher M, Siebenbrodt K, Rosenow F, Reese JP, Strzelczyk A. Multicenter, cross-sectional study of the costs of illness and cost-driving factors in adult patients with epilepsy. Epilepsia 2022; 63:904-918. [PMID: 35192210 DOI: 10.1111/epi.17174] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/02/2022] [Accepted: 01/12/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study was undertaken to quantify epilepsy-related costs of illness (COI) in Germany and identify cost-driving factors. METHODS COI were calculated among adults with epilepsy of different etiologies and severities. Multiple regression analysis was applied to determine any epilepsy-related and sociodemographic factors that serve as cost-driving factors. RESULTS In total, 486 patients were included, with a mean age of 40.5 ± 15.5 years (range = 18-83 years, 58.2% women). Mean 3-month COI were estimated at €4911, €2782, and €2598 for focal, genetic generalized, and unclassified epilepsy, respectively. The mean COI for patients with drug-refractory epilepsy (DRE; €7850) were higher than those for patients with non-DRE (€4720), patients with occasional seizures (€3596), or patients with seizures in remission for >1 year (€2409). Identified cost-driving factors for total COI included relevant disability (unstandardized regression coefficient b = €2218), poorer education (b = €2114), living alone (b = €2612), DRE (b = €1831), and frequent seizures (b = €2385). Younger age groups of 18-24 years (b = -€2945) and 25-34 years (b = -€1418) were found to have lower overall expenditures. A relevant disability (b = €441), DRE (b = €1253), frequent seizures (b = €735), and the need for specialized daycare (b = €749) were associated with higher direct COI, and poorer education (b = €1969), living alone (b = €2612), the presence of a relevant disability (b = €1809), DRE (b = €1831), and frequent seizures (b = €2385) were associated with higher indirect COI. SIGNIFICANCE This analysis provides up-to-date COI data for use in further health economics analyses, highlighting the high economic impacts associated with disease severity, disability, and disease-related loss of productivity among adult patients with epilepsy. The identified cost drivers could be used as therapeutic and socioeconomic targets for future cost-containment strategies.
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Affiliation(s)
- Laurent M Willems
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University and University Hospital Frankfurt, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Maja Hochbaum
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University and University Hospital Frankfurt, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Katharina Frey
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University and University Hospital Frankfurt, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Juliane Schulz
- Department of Neurology, University Hospital Greifswald, Greifswald, Germany
| | - Katja Menzler
- Epilepsy Center Hessen and Department of Neurology, Philipps University Marburg, Marburg (Lahn), Germany
| | - Lisa Langenbruch
- Epilepsy Center Münster-Osnabrück, Department of Neurology, Institute of Translational Neurology, University of Münster, Münster, Germany.,Department of Neurology, Osnabrück Hospital, Osnabrück, Germany
| | - Stjepana Kovac
- Epilepsy Center Münster-Osnabrück, Department of Neurology, Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Ilka Immisch
- Epilepsy Center Hessen and Department of Neurology, Philipps University Marburg, Marburg (Lahn), Germany
| | - Felix von Podewils
- Department of Neurology, University Hospital Greifswald, Greifswald, Germany
| | - Mario Hamacher
- Department of Neurology, University Hospital Greifswald, Greifswald, Germany
| | - Kai Siebenbrodt
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University and University Hospital Frankfurt, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University and University Hospital Frankfurt, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jens-Peter Reese
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main and Department of Neurology, Goethe University and University Hospital Frankfurt, Frankfurt am Main, Germany.,LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University Frankfurt, Frankfurt am Main, Germany
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11
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Development, validation, and application of a Brazilian sleep myths and truths assessment scale (SLEEP-MTAS). Sleep Med 2022; 90:17-25. [DOI: 10.1016/j.sleep.2021.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/15/2021] [Accepted: 12/30/2021] [Indexed: 11/22/2022]
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12
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Touray MM, Cohen DR, Williams SRP, Alam MF, Groves S, Longo M, Gage H. Overweight/Obesity and Time Preference: Evidence from a Survey among Adults in the UK. Obes Facts 2022; 15:428-441. [PMID: 35203081 PMCID: PMC9210003 DOI: 10.1159/000522651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Overweight and obesity is a global problem incurring substantial health and economic implications. This has also been highlighted by the ongoing COVID-19 pandemic which has disproportionately affected overweight and obese individuals. Most of the interventions have concentrated on promotion of physical activities and healthy eating which may involve current sacrifices for future health gains. The purpose of this study was to explore the relationship between bodyweight and how individuals state they would trade-off immediate income for higher amounts in the future (time preference). METHODS An online survey was conducted targeting adults aged >16 years in the UK (England, Northern Ireland, Scotland, and Wales) from January 1, 2016 to July 31, 2016. Using paid online adverts, as well as personal and professional networks for distribution of links to the online survey, the questionnaire asked respondents to report socio-economic and demographic information, height, and weight and to complete a time preference exercise. Data were analysed using descriptive statistics; associations were explored between BMI and respondents' characteristics and time preference using Spearman rank-order correlation and χ2 tests as appropriate. We adopted STROBE guidelines for the reporting of the study. RESULTS A total of 561 responses were analysed (female = 293, males = 268). The relationship between time preference and overweight/obesity, using BMI as the measure is highly significant (χ2 = 95.92: p < 0.001). Individuals of normal weight have low time preferences and are more likely to invest in activities in a bid to reap future health benefits. There are also significant relationships between BMI and employment status (χ2 = 37.03; p < 0.001), physical activities (p < 0.0001), income levels (χ2 = 6.68; p < 0.035), family orientation, i.e., with or without children (χ2 = 12.88; p < 0.012), and ethnicity (χ2 = 18.31; p < 0.001). These imply that individuals in employment and with children in their families are less likely to be overweight or obese compared to those who do not. People from black backgrounds are also more likely to be overweight or obese and have higher time preferences compared to people from white backgrounds. DISCUSSIONS/CONCLUSIONS People's preventive behaviours today can be predicted by their time preference and this understanding could be vital in improving population's uptake and maintenance of overweight and obesity prevention actions. People who have low time preference are more likely to invest time and resources in physical activities and healthy lifestyles to reap future health benefits hence value utilities-in-anticipation. Public health programmes should therefore use the knowledge of the association between time preference and overweight/obesity to inform designs of intervention programmes.
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Affiliation(s)
- Morro M.L. Touray
- Surrey Health Economics Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- School of Care Sciences, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, United Kingdom
- *Morro M.L. Touray,
| | - David R. Cohen
- School of Care Sciences, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, United Kingdom
| | - Simon Robert Pask Williams
- Institute of Management & Health, University of Wales Trinity Saint David, Carmarthen, United Kingdom
- Weight Management Service, Aneurin Bevan University Health Board, Saint Cadoc's Hospital, Caerleon, United Kingdom
| | - Mohammed Fasihul Alam
- Department of Public Health, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Sam Groves
- Swansea Centre for Health Economics, Swansea University, Swansea, United Kingdom
| | - Mirella Longo
- Marie Curie Palliative Care Research Centre, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Heather Gage
- Surrey Health Economics Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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13
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Increased interaction and procedural flexibility favoured participation: Study across European cohorts of preterm born individuals. J Clin Epidemiol 2021; 143:169-177. [PMID: 34965477 DOI: 10.1016/j.jclinepi.2021.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 11/18/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To understand participation and attrition phenomena variability in European cohorts of individuals born preterm through in-depth exploration of the interplay of situational elements involved. STUDY DESIGN AND SETTING Multi-situated qualitative design, using focus groups, semi-structured interviews and collaborative visual methodology with a purposive sample of adults born preterm, parents and professionals (N=124) from eight cohorts in seven European countries. RESULTS Most cohort participants were motivated by altruism/solidarity and gratitude/sense of duty to reciprocate (only absent in adults aged 19-21), followed by expectation of direct benefit to one's health and knowledge amongst participating adults. Common deterrents were perceived failure in reciprocity as in insufficient/inadequate interaction and information sharing, and postal questionnaires. Combining multipurpose, flexible strategies for contact and assessment, reminders, face-to-face and shorter periodicity and not simply adding retention strategies or financial incentives favoured participation. Professionals' main challenges entailed resources, funding and, European societal changes related to communication and geopolitical environment. CONCLUSION Retention would benefit from tailoring inclusive strategies throughout the cohorts' life cycle and consistent promotion of reciprocal altruistic research goals. Investing in regular interaction, flexibility in procedures, participant involvement and return of results can help mitigate attrition as well as considering mothers as main facilitators to participating children and impaired adults.
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14
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Shi W, Hall BJ. Help-seeking intention among Chinese college students exposed to a natural disaster: an application of an extended theory of planned behavior (E-TPB). Soc Psychiatry Psychiatr Epidemiol 2021; 56:1273-1282. [PMID: 33426599 DOI: 10.1007/s00127-020-01993-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/10/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE Professional mental health help-seeking is generally low among Chinese populations with mental problems, and this may also the case following natural disasters. The help-seeking intention within Chinese populations exposed to natural disaster remain unclear. This study aims to explore the intention to seek professional mental health help utilizing an extended theory of planned behavior (E-TPB) model among Chinese college students exposed to Typhoon Hato. METHODS In total, 1876 Chinese participants were recruited using convenience sampling at baseline and 817 participants (mean age = 20.9 years, SD = 2.8, 28.4% male) were followed up 6 months later. The online questionnaire was applied to measure six constructs including help-seeking intention, attitude, subjective norm, perceived behavioral control, self-stigma, and social stigma. RESULTS Structural equation modeling showed the subjective norm (β = 0.374, p < 0.001) was the strongest predictor of help-seeking intention, followed by attitude (β = 0.271, p < 0.001) and perceived behavioral control (β = 0.213, p < 0.001), and self-stigma (β = - 0.117, p = 0.006). Unexpectedly, public stigma was not significantly associated with help-seeking intention. Moreover, multi-group analyses revealed paths of the E-TPB model were invariant across gender. CONCLUSION These results supported the efficacy of the E-TPB model in explaining help-seeking intention and emphasized the importance of subjective norm (e.g., support or disproval from significant others or society) in influencing help-seeking intention among Chinese young adults exposed to a natural disaster.
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Affiliation(s)
- Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, Sichuan, People's Republic of China.,Global and Community Mental Health Research Group, New York University (Shanghai), 1555 Century Ave., Pudong, Shanghai, 200122, People's Republic of China
| | - Brian J Hall
- Global and Community Mental Health Research Group, New York University (Shanghai), 1555 Century Ave., Pudong, Shanghai, 200122, People's Republic of China.
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15
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Lee JC, Dick AS, Tomblin JB. Altered brain structures in the dorsal and ventral language pathways in individuals with and without developmental language disorder (DLD). Brain Imaging Behav 2020; 14:2569-2586. [PMID: 31933046 PMCID: PMC7354888 DOI: 10.1007/s11682-019-00209-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Developmental Language Disorder (DLD) is a neurodevelopmental disorder characterized by difficulty learning and using language, and this difficulty cannot be attributed to other developmental conditions. The aim of the current study was to examine structural differences in dorsal and ventral language pathways between adolescents and young adults with and without DLD (age range: 14-27 years) using anatomical magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Results showed age-related structural brain differences in both dorsal and ventral pathways in individuals with DLD. These findings provide evidence for neuroanatomical correlates of persistent language deficits in adolescents/young adults with DLD, and further suggest that this brain-language relationship in DLD is better characterized by taking account the dynamic course of the disorder along development.
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Affiliation(s)
- Joanna C Lee
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, 52242, USA.
| | | | - J Bruce Tomblin
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, 52242, USA
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16
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Menyanu EK, Corso B, Minicuci N, Rocco I, Russell J, Ware LJ, Biritwum R, Kowal P, Schutte AE, Charlton KE. Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3. BMC Nutr 2020; 6:54. [PMID: 33005430 PMCID: PMC7523323 DOI: 10.1186/s40795-020-00379-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022] Open
Abstract
Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub sample that had valid urine collection, along with matched survey, anthropometric and BP data (n = 839, mean age = 60y), from the World Health Organization's Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, n = 3053). We also investigated the relationship between salt intake and blood pressure (BP) among the cohort. BP was measured in triplicate and 24 h urine was collected for the determination of urinary sodium (Na), potassium (K), creatinine (Cr) and iodine levels. Hypertension prevalence was 44.3%. Median salt intake was 8.3 g/day, higher in women compared to men (8.6, interquartile range (IQR) 7.5 g/day vs 7.5, IQR 7.4 g/day, p < 0.01), younger participants (18-49 y) compared to older ones (50+ y) (9.7, IQR 7.9 g/day vs 8.1, IQR 7.1 g/day, p < 0.01) and those with higher Body Mass Index (BMI) (> 30 kg/m2) compared to a healthy BMI (18.5-24.9 kg/m2) (10.04, IQR 5.1 g/day vs 6.2, IQR 5.6 g/day, p < 0.01). More than three quarters (77%, n = 647) of participants had salt intakes above the WHO maximum recommendation of 5 g/d, and nearly two thirds (65%, n = 548) had daily K intakes below the recommended level of 90 mmol. Dietary sodium to potassium (Na: K) ratios above 2 mmol/mmol were positively associated with increasing BP with age. Population-based interventions to reduce salt intake and increase K consumption are needed.
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Affiliation(s)
- Elias K. Menyanu
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522 Australia
| | - Barbara Corso
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Nadia Minicuci
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Ilaria Rocco
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Joanna Russell
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522 Australia
| | - Lisa J. Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Biritwum
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Paul Kowal
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
- World Health Organization (WHO), Geneva, Switzerland
| | - Aletta E. Schutte
- School of Public Health and Community Medicine, University of New South Wales; The George Institute for Global Health, Sydney, NSW 2052 Australia
- Hypertension in Africa Research Team, North-West University, Potchefstroom, 2520 South Africa
| | - Karen E. Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522 Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522 Australia
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17
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Rufus‐Membere P, Holloway‐Kew KL, Kotowicz MA, Diez‐Perez A, Pasco JA. Normative Data for Impact Microindentation for Australian Men: Cross-Sectional Data From the Geelong Osteoporosis Study. JBMR Plus 2020; 4:e10384. [PMID: 32995688 PMCID: PMC7507064 DOI: 10.1002/jbm4.10384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 11/10/2022] Open
Abstract
Impact microindentation (IMI) is a novel technique for assessing the bone material strength index (BMSi) in vivo. However, no studies have presented normative data for BMSi. The aim of this study was to develop such normative data using a population-based sample of men, randomly selected from electoral rolls for the Barwon Statistical Division in southeastern Australia to participate in the Geelong Osteoporosis Study. BMSi was measured on the tibial plateau using an OsteoProbe in 405 men (ages 33 to 96 years) during the period 2016 to 2019. Associations between BMSi, age, and anthropometry were examined using linear regression models. BMSi values ranged from 49.0 to 100.5. BMSi was negatively correlated with age (r = -0.152, p = 0.002), weight (r = -0.103, p = 0.039), and BMI (r = -0.187, p < 0.001), and positively correlated with height (r = +0.107, p = 0.032). Mean ± SD BMSi was 82.6 ± 7.0 for the whole group, and ranged from 85.6 ± 6.0 for ages 30 to 39 years to 79.8 ± 6.6 for ages 80+ years. This study provides normative data that can be used to calculate T- and Z-scores for BMSi. These data will be useful for identifying men with low BMSi. Further research is warranted to derive optimal cut points for BMSi that discriminate fracture risk. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
| | | | - Mark A Kotowicz
- School of Medicine, Deakin UniversityGeelongVictoriaAustralia
- Department of Medicine‐Western HealthMelbourne Medical School, The University of MelbourneMelbourneVictoriaAustralia
- Barwon HealthGeelongVictoriaAustralia
| | - Adolfo Diez‐Perez
- Department of Internal MedicineHospital del Mar‐IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos IIIMadridSpain
| | - Julie A Pasco
- School of Medicine, Deakin UniversityGeelongVictoriaAustralia
- Department of Medicine‐Western HealthMelbourne Medical School, The University of MelbourneMelbourneVictoriaAustralia
- Barwon HealthGeelongVictoriaAustralia
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18
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Gianfrancesco MA, McCulloch CE, Trupin L, Graf J, Schmajuk G, Yazdany J. Reweighting to address nonparticipation and missing data bias in a longitudinal electronic health record study. Ann Epidemiol 2020; 50:48-51.e2. [PMID: 32807591 DOI: 10.1016/j.annepidem.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE We examined whether weighting techniques could account for longitudinal differences in disease activity by race/ethnicity between research participants and nonparticipants with rheumatoid arthritis (RA). METHODS We included 377 patients with RA from a public hospital in San Francisco, CA. We estimated the probability of not enrolling in a research study by constructing weights using inverse probability weighting. Disease activity over time by race/ethnicity was analyzed across the entire patient population and among research participants only using multivariable mixed-effects models. RESULTS There were no differences in RA disease activity scores between research participants and nonparticipants at baseline; however, longitudinal differences in disease activity between research participants and nonparticipants were found by race/ethnicity. Weighting research participants in accordance with sociodemographic and clinical characteristics of the nonparticipant population did not result in any meaningful changes in disease activity by race/ethnicity over time. CONCLUSIONS In our study of patients with RA, inverse probability weighting using select sociodemographic and clinical variables was not sufficient to account for longitudinal disease activity differences by race/ethnicity between research participants and nonparticipants.
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Affiliation(s)
- Milena A Gianfrancesco
- Division of Rheumatology, Department of Medicine, University of California, San Francisco.
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Laura Trupin
- Division of Rheumatology, Department of Medicine, University of California, San Francisco
| | - Jonathan Graf
- Division of Rheumatology, Department of Medicine, University of California, San Francisco
| | - Gabriela Schmajuk
- Division of Rheumatology, Department of Medicine, University of California, San Francisco; Veterans Affairs Medical Center, San Francisco, CA
| | - Jinoos Yazdany
- Division of Rheumatology, Department of Medicine, University of California, San Francisco
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19
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Validity of self-reported cancer: Comparison between self-report versus cancer registry records in the Geelong Osteoporosis Study. Cancer Epidemiol 2020; 68:101790. [PMID: 32745997 DOI: 10.1016/j.canep.2020.101790] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Determining the validity of self-reported data is important. The aim of this study was to assess the validity of self-reported cancer and investigate factors associated with accurate reporting in men and women. METHODS Study participants (n = 1727) from the Geelong Osteoporosis Study, located in south-eastern Australia, were utilised. Self-reported cancer data were compared to Victorian Cancer Registry records. Age, socioeconomic status (SES), education and time between cancer diagnosis and study appointment were investigated as factors associated with accuracy of self-report. RESULTS There were 142 participants who self-reported a cancer and 135 with a VCR record. Comparing self-report to any registry record, sensitivity was 63.7 %, specificity 96.5 %, PPV 60.6 %, NPV 96.9 %, and overall agreement ĸ0.588. Comparing exact-match records, sensitivity was 58.8 %, specificity 95.5 %, PPV 49.3 %, NPV 96.9 % and overall agreement ĸ0.499. In logistic regression models, post-secondary education was independently associated with accuracy of any (OR 1.72, 95 % CI 1.10-2.70) and exact-match (OR 1.59, 95 % CI 1.05-2.42) self-report, compared to cancer registry record. For any cancer, being aged >70 years was inversely associated with accuracy (OR 0.24, 95 % CI 0.15-0.38). Likewise, for matched cancer reporting, those aged 60-70 years (OR 0.51, 95 %CI 0.30-0.88) and >70 years (OR 0.23, 95 % CI 0.15-0.35) were less accurate. No other significant associations were detected. CONCLUSION Results suggest moderate agreement between self-report and registry data for any cancer among men and women. However, when comparing self-report to registry data for exact-match cancer type, level of overall agreement deteriorated. Self-report cancer data may be acceptable for determining a history of cancer, although, is less accurate in identifying history of specific cancer types documented in registry-based data.
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20
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Marques SCS, Doetsch J, Brødsgaard A, Cuttini M, Draper ES, Kajantie E, Lebeer J, van der Pal S, Pedersen P, Barros H. Improving Understanding of Participation and Attrition Phenomena in European Cohort Studies: Protocol for a Multi-Situated Qualitative Study. JMIR Res Protoc 2020; 9:e14997. [PMID: 32667901 PMCID: PMC7391162 DOI: 10.2196/14997] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/17/2020] [Accepted: 03/23/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cohort studies represent a strong methodology for increasing one's understanding of human life-course development and etiological mechanisms. Retention of participants, especially during long follow-up periods, is, however, a major challenge. A better understanding of the motives for participation and attrition in cohort studies in diverse sociogeographic and cultural settings is needed, as this information is most useful in developing effective retention strategies. OBJECTIVE This study aims to improve our understanding of participation and attrition phenomena in a European cohort study of very preterm/very-low-birth-weight (VPT/VLBW) infants from various sociogeographic and cultural settings to better understand variability and ultimately contribute to developing novel and more "in-context" strategies to improve retention. METHODS This study uses a triangulation of multisituated methods to collect data on various cohorts in the Research on European Children and Adults Born Preterm (RECAP) network, which include focus group discussions, individual semidriven interviews, and a collaborative, reflexive visual methodology (participant-generated VideoStories) with relevant key actors involved with these cohort studies such as adult participants, parents (caregivers), cohort staff, health care professionals, and academic researchers. The methodological strategy aims to provide a shared flexible framework of various qualitatively driven methods to collect data on VPT/VLBW adult and child cohorts, from which research partners may choose and combine those most pertinent to apply in their own specific contexts. Data from all sources and sites will be submitted to a triangulation of phenomenological thematic analysis with discourse analysis. RESULTS As of January 2020, in this study, we enrolled 92 participants variously involved with child and adult RECAP partnering cohorts from six countries. Multisite enrollment and data collection are expected to be completed in all seven study settings by June 2020. Findings will be reported in future publications. CONCLUSIONS Qualitative research methods are a useful complement for enriching and illuminating quantitative results. We expect that opting for a multisituated study approach addressing the interplay of the lived experience of individuals in both researcher and researched stances of particular cohort study settings will contribute to filling some gaps in the understanding of participation variability and effectiveness of different implemented strategies in context. Moreover, health research subjects have traditionally been positioned as passive objects of study rather than active participants, even though they have the greatest stake in improving health care policies and practices. Including collaborative methods allows us to counteract the "top-down" model by handing over some research control to the very people who are providing the data on which research findings will be based while also acknowledging the value of their involvement. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14997.
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Affiliation(s)
- Sandra C S Marques
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Universidade do Porto, Porto, Portugal.,Centro em Rede de Investigação em Antropologia, Instituto Universitário de Lisboa, Lisbon, Portugal
| | - Julia Doetsch
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Universidade do Porto, Porto, Portugal.,School of Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Anne Brødsgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark
| | - Marina Cuttini
- Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Ospedale Pediatrico Bambino Gesù Institute for Research Hospitalization and Health Care, Rome, Italy
| | - Elizabeth S Draper
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Eero Kajantie
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University for Science and Technology, Trondheim, Norway.,Children's Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Jo Lebeer
- Department ELIZA Primary & Interdisciplinary Care, Faculty of Medicine & Health Sciences University of Antwerp, Antwerp, Belgium
| | | | - Pernille Pedersen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark
| | | | - Henrique Barros
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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21
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Hartford W, Backman C, Li LC, McKinnon A, Nimmon L. Appropriating and asserting power on inflammatory arthritis teams: A social network perspective. Health Expect 2020; 23:813-824. [PMID: 32185848 PMCID: PMC7495070 DOI: 10.1111/hex.13051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 11/27/2022] Open
Abstract
Background Therapeutic interventions for people with inflammatory arthritis (IA) increasingly involve multidisciplinary teams and strive to foster patient‐centred care and shared decision making. Participation in health‐care decisions requires patients to assert themselves and negotiate power in encounters with clinicians; however, clinical contexts often afford less authority for patients than clinicians. This disadvantage may inhibit patients' involvement in their own health care. Objective To identify communication attributes, IA patients use to influence and negotiate their treatment with members of their health‐care network. Method A qualitative social network approach was used to analyse data from a larger study that investigated IA patients' overall experiences of multidisciplinary care. Fourteen patients with IA attended individual semi‐structured interviews. Researchers used thematic analysis to identify patterns of assertiveness and influence in the data. Results Participants experienced loss of identity, control and agency in addition to the physical symptoms of IA. However, they had a sense of personal responsibility for managing their health care. Perceptions of health‐care team support enhanced patients' influence in treatment negotiations. Notably, there appeared to be an underlying tension between being empowered or disempowered. Discussion and conclusions The findings have significant implications for treatment decision communication approaches to IA care. A social network perspective may provide a pathway for clinicians to better understand the complexities of communication with their patients. This approach may reduce unequal power dynamics that occur within clinician/patient interactions and afford people with IA agency, control and affirmation of identity within their health‐care network.
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Affiliation(s)
- Wendy Hartford
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Catherine Backman
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Annette McKinnon
- Arthritis Research Canada's Patient Advisory Board, Vancouver, BC, Canada
| | - Laura Nimmon
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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22
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Loggia G, Attoh-Mensah E, Pothier K, Morello R, Lescure P, Bocca ML, Marcelli C, Chavoix C. Psychotropic Polypharmacy in Adults 55 Years or Older: A Risk for Impaired Global Cognition, Executive Function, and Mobility. Front Pharmacol 2020; 10:1659. [PMID: 32082159 PMCID: PMC7002919 DOI: 10.3389/fphar.2019.01659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/17/2019] [Indexed: 01/05/2023] Open
Abstract
Objectives With their broad spectrum of action, psychotropic drugs are among the most common medications prescribed to the elderly. Consequently, the number of older adults taking multiple psychotropic drugs has more than doubled over the last decade. To improve knowledge about the deleterious effects of psychotropic polypharmacy, we investigated whether there is a threshold number of psychotropic molecules that could lead to impairment of global cognition, executive function, or mobility. Furthermore, relationships between the number of psychotropic molecules and cognitive and mobility impairment were examined. Design Cross-sectional study Setting University Hospital of Caen (France) and advertisements in medical offices Participants Community-dwelling older adults 55 years and older (n = 177; 69.8 ± 9.3 years; 81% women) Measurements Number of psychotropic molecules taken daily, global cognition assessed with the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), processing speed with the Trail Making Test (TMT) A, executive function with the TMT B and TMT B-A, and mobility with the Time Up and Go (TUG). The threshold numbers of psychotropic molecules were determined by ROC curves analysis. Based on these threshold values, multinomial logistic regression adjusting for covariates was then performed. Results Logistic regressions showed that the threshold of two daily psychotropic molecules, identified by the ROC curves analysis, increases the risk of impaired executive function (p = .05 and.005 for the TMT B and TMT B-A, respectively), global cognition (p = .006 and.001 for the MMSE and MoCA, respectively), and mobility (p = .005 for the TUG), independent of confounding factors, including comorbidities. Furthermore, psychotropic polypharmacy would affect mobility through executive functions. Conclusion Impairment of global cognition, executive function, and mobility when as few as two psychotropic molecules are consumed in relatively healthy young older adults should alert physicians when prescribing combinations of psychotropic medications.
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Affiliation(s)
- Gilles Loggia
- Normandie Univ, UNICAEN, INSERM, COMETE, Caen, France.,Department of Geriatrics, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | | | | | - Rémy Morello
- Department of Statistics and Clinical Research, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Pascale Lescure
- Normandie Univ, UNICAEN, INSERM, COMETE, Caen, France.,Department of Geriatrics, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | | | - Christian Marcelli
- Normandie Univ, UNICAEN, INSERM, COMETE, Caen, France.,Department of Rheumatology, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
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Lykke C, Ekholm O, Schmiegelow K, Olsen M, Sjøgren P. Anxiety and Depression in Bereaved Parents After Losing a Child due to Life-Limiting Diagnoses: A Danish Nationwide Questionnaire Survey. J Pain Symptom Manage 2019; 58:596-604. [PMID: 31276811 DOI: 10.1016/j.jpainsymman.2019.06.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
CONTEXT Losing a child is the most burdensome event parents can experience involving risks of developing anxiety and depression. OBJECTIVES To investigate anxiety and depression in bereaved parents during their child's life-limiting illness and imminent death and three to five years after the loss to target future interventions. METHODS A Danish nationwide cross-sectional questionnaire survey. From 2012 to 2014, a register-based study identified causes of deaths of 951 children aged zero to 18 years. Potential palliative diagnoses were classified according to previously used classification. A total of 402 families were included. A modified version of the self-administered questionnaire "To lose a child" was used. Non-response surveys identified reasons for lack of response. RESULTS In all, 136 mothers and 57 fathers completed a questionnaire, representing parents of 152 children (38%). Sixty-five percent of mothers and 63% of fathers reported moderate-to-severe anxiety during the child's illness. However, three to five years after their loss anxiety had decreased markedly. Thirty-five percent of mothers and 39% of fathers reported moderate-to-severe depression during the child's illness; three to five years after the loss they were suffering equivalently from depression. The Center for Epidemiologic Studies Depression Scale indicated that severe depression was significantly associated with lower education and being unmarried. CONCLUSION The reporting of anxiety during the child's illness and prolonged depression in bereaved parents three to five years after the loss indicates a potential need for psychological interventions. In the process of implementing specialized pediatric palliative care in Denmark, our findings should be considered for future treatment programs.
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Affiliation(s)
- Camilla Lykke
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Abu-Helalah M, Alshraideh HA, Al-Sarayreh SA, Al Shawabkeh AHK, Nesheiwat A, Younes N, Al-Hader A. A Cross-Sectional Study to Assess the Prevalence of Adult Thyroid Dysfunction Disorders in Jordan. Thyroid 2019; 29:1052-1059. [PMID: 31146635 DOI: 10.1089/thy.2018.0579] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Insufficient production of thyroid hormones results in hypothyroidism, while overproduction results in hyperthyroidism. These are common adult disorders, with hypothyroidism more common in the elderly. Jordan has had past problems with dietary iodine deficiency but there are no published studies assessing the population prevalence of these disorders in the Arab Middle East. Methods: A cross-sectional study was conducted in three representative areas of Jordan. There were 7085 participants with a mean age of 40.8 years. Participants completed a questionnaire and had blood taken for thyroid analysis. Results:Hypothyroidism: The prevalence of any hypothyroidism (already diagnosed and/or identified by blood testing) was 17.2% in females and 9.1% in males. Undiagnosed prevalence was 8% and 6.2% for females and males, respectively. The prevalence of subclinical hypothyroidism, defined as high serum thyrotropin (TSH) and normal serum-free thyroxine (fT4), was 5.98% among females and 4.40% among males. The prevalence of overt hypothyroidism, defined as high TSH and low fT4, was 2.00% among females and 1.80% among males. Only 53.5% (55.3% for females, 42.1% males) of those previously diagnosed with hypothyroidism had TSH levels within the appropriate range. Hyperthyroidism: The prevalence of any hyperthyroidism (already diagnosed and/or identified by blood testing) was 1.8% in females and 2.27% in males. The undiagnosed prevalence was 1.4% and 2.1% for females and males, respectively. The prevalence of subclinical hyperthyroidism (low TSH and normal fT4) was 1.20% and 1.80% among males and females accordingly. The prevalence of overt hyperthyroidism (low TSH and high fT4) was 0.2% among females and 0.3% among males. About 85.7% (83.3% for females, 100% males) of those previously diagnosed with hyperthyroidism had TSH levels within the appropriate range. Conclusions: The results of this study reveal that the total prevalence of thyroid dysfunction among adult females and males in Jordan is very high compared with international statistics, particularly in the rates of undiagnosed cases. This indicates the need for further assessment of the value of screening for adult hypothyroidism in Jordan.
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Affiliation(s)
- Munir Abu-Helalah
- 1Department of Public Health, Faculty of Medicine, Mutah University, Karak, Jordan
- 2Faculty of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Hussam Ahmad Alshraideh
- 3Industrial Engineering Department; Jordan University of Science and Technology, Irbid, Jordan
- 4Industrial Engineering Department, American University of Sharjah, Sharjah, United Arab Emirates
| | | | | | - Adel Nesheiwat
- 7King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Nidal Younes
- 8Department of Surgery, University of Jordan, Amman, Jordan
| | - AbdelFattah Al-Hader
- 9Department of Physiology, Faculty of Medicine; Jordan University of Science and Technology, Irbid, Jordan
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25
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Blumenberg C, Menezes AMB, Gonçalves H, Assunção MCF, Wehrmeister FC, Barros AJD. How different online recruitment methods impact on recruitment rates for the web-based coortesnaweb project: a randomised trial. BMC Med Res Methodol 2019; 19:127. [PMID: 31217008 PMCID: PMC6585038 DOI: 10.1186/s12874-019-0767-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/05/2019] [Indexed: 02/08/2023] Open
Abstract
Background The number of web-based E-epidemiologic studies using online recruitment methods is increasing. However, the optimal online recruitment method in terms of maximizing recruitment rates is still unknown. Our aim was to compare the recruitment rates of three online recruitment methods and to describe how these rates differ according to individual’s socioeconomic and demographic factors. Methods A total of 2394 members of the 1993 Pelotas birth cohort that provided an e-mail address, a Facebook name, and a WhatsApp number during a face-to-face follow-up were randomly allocated to be recruited by e-mail, Facebook or WhatsApp (798 individuals per method). This was a parallel randomised trial applying a block randomisation (block size = 3). Between January and February 2018, we sent messages inviting them to register into the web-based coortesnaweb platform. Recruitment rates were calculated for each method, and stratified according to the individual’s socioeconomic and demographic characteristics. We also analysed absolute and relative inequalities on recruitment according to schooling and socioeconomic position. Results Out of the 2394 individuals analysed, 642 registered into the platform. The overall recruitment rate was 26.8%. Recruitment rates for women were almost 10 percentage points higher compared to men. Facebook was the most effective recruitment method, as 30.6% of those invited through the social network were recruited. Recruitment rates of e-mail and WhatsApp were similar (recruitment rate = 24.9%). E-mail and Facebook were the most effective recruitment methods to invite highly educated and wealthier individuals. However, sending e-mails to recruit individuals also reflected in the highest inequalities according to schooling and socioeconomic position. In contrast, the lowest inequalities according to socioeconomic position were observed using Facebook. Conclusions Facebook was the most effective online recruitment method, also achieving the most equitable sample in terms of schooling and socioeconomic position. The effectiveness of online recruitment methods depends on the characteristics of the sample. It is important to know the profile of the target sample in order to decide which online recruitment method to use. Trial registration Brazilian Registry of Clinical Trials, identifier: RBR-3dv7gc, retrospectively registered in 10 April 2018. Electronic supplementary material The online version of this article (10.1186/s12874-019-0767-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cauane Blumenberg
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St. - 3rd floor - 96020-220, Pelotas, Brazil.
| | - Ana Maria Baptista Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St. - 3rd floor - 96020-220, Pelotas, Brazil
| | - Helen Gonçalves
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St. - 3rd floor - 96020-220, Pelotas, Brazil
| | - Maria Cecília Formoso Assunção
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St. - 3rd floor - 96020-220, Pelotas, Brazil
| | - Fernando César Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St. - 3rd floor - 96020-220, Pelotas, Brazil
| | - Aluísio J D Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, 1160 Marechal Deodoro St. - 3rd floor - 96020-220, Pelotas, Brazil
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Ting CY, Ismail MB, Ting H, Bahri SB, Sidek AB, Idris SFB, Tan RTH, Abu Seman SSB, Sethiaram MRA, Md Ghazali MHB, Lim QH, Mohd Zaki MSB, Sohot MSB. Consumer behaviour towards pharmaceutical products: a model development. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2019. [DOI: 10.1108/ijphm-07-2018-0040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Despite the extant literature on purchasing behaviour, little is known about why and how consumers purchase and use pharmaceutical products in Malaysia. This paper aims to develop a holistic model that articulates the factors underlying pharmaceutical product purchase and use and their relationships.
Design/methodology/approach
Drawing upon the grounded theory approach, in-depth interviews and analysis on the basis of theoretical saturation were conducted. Enumerators, trained to perform interviews, the transcription and content analysis, sampled 120 Malaysian consumers in the first phase and 40 in the second. ATLAS.ti was used to assist the coding and analytical process.
Findings
The findings largely support extant literature on purchasing decisions. Particularly, the evaluation of product attributes was found to be an immediate determinant of purchase and use. The effect, in turn, was moderated by personal factors and facilitating conditions. The need for healthcare products and the knowledge about them were constructed as antecedents in the model. The study also highlights that consumers’ purchase and use of pharmaceutical products could be better understood and managed with a holistic view of the decision-making process.
Originality/value
This study proposes the conbe-hepro model to explicate the antecedents and determinants of consumers’ purchase and use of pharmaceutical products in the Malaysian context. It provides a theoretical grounding that enriches our knowledge of the changing behaviour of consumers in healthcare literature. It also yields practical insights to the government bodies and the healthcare providers in Malaysia and other developing countries.
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27
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Stuart AL, Pasco JA, Brennan-Olsen SL, Berk M, Betson AG, Bennett KE, Timney EN, Williams LJ. Sample selection and reasons for non-participation in the PRedictors and Outcomes of incident FRACtures (PROFRAC) study. J Public Health Res 2019; 8:1475. [PMID: 31205902 PMCID: PMC6547023 DOI: 10.4081/jphr.2019.1475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/12/2019] [Indexed: 11/23/2022] Open
Abstract
Background. Fragility fractures, associated with osteoporosis, are an escalating public health problem. We aim to describe sample selection, recruitment methods and reasons for non-participation in The PRedictors and Outcomes of incident FRACtures (PROFRAC) study. Design and Methods. Barwon Statistical Division residents aged 20+ years, with a radiologically-confirmed fracture between June 1st 2012 and May 31st 2013, were eligible. Individuals identified as fracture cases were invited by mail to complete a questionnaire. Reasons for non-participation were documented. Logistic regression techniques were used to determine odds ratios for participation and non-participation reasons. Results. A total of 1,458 of 2,155 (67.7%) adults with fracture (48.7% men) participated. Individuals were excluded due to inability to give informed consent, death, no knowledge of fracture, or inability to be contacted. The odds of participation decreased with age (OR 0.99, 95%CI 0.99-0.99, P=0.011) and increased among specific fracture groups [clavicle/scapula (OR 2.50, 1.30-4.68, P=0.006), forearm/humerus (OR 2.00, 1.22-3.27, P=0.006), wrist (OR 2.08, 1.31-3.32, P=0.002), hip (OR 2.12, 1.20-3.75, P=0.009), ankle (OR 1.85, 1.20-2.87, P=0.001), compared to face/skull fractures]. The odds of reporting disinterest, time constraints or personal reasons as the reason for non-participation decreased with age, whereas the odds of reporting frailty, language-related issues or illness as the reason for non-participation increased with of age [disinterest (OR 0.98, 0.97-0.98, P<0.001), time constraints (OR 0.97, 0.96-0.98, P<0.001), personal reasons (OR 0.98, 0.97-0.99, P=0.007), frailty (OR 1.12, 1.09-1.15, P<0.001), language-related issues (OR 1.02, 1.01-1.04, P<0.001), illness (OR 1.03, 1.02-1.05, P<0.001)]. Conclusions. Understanding drivers of research participation can inform study design to achieve optimal participation in health research.
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Affiliation(s)
- Amanda L Stuart
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University
| | - Julie A Pasco
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University.,Department of Medicine - Western Health, University of Melbourne.,Department of Epidemiology and Preventive Medicine, Monash University
| | - Sharon L Brennan-Olsen
- Department of Medicine - Western Health, University of Melbourne.,Australian Institute for Musculoskeletal Science (AIMSS), Melbourne
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University.,Department of Psychiatry, Florey Institute of Neuroscience and Mental Health, University of Melbourne.,Orygen the National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - Amelia G Betson
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University
| | - Katherine E Bennett
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University
| | - Elizabeth N Timney
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University
| | - Lana J Williams
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University
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van Eijk RPA, Westeneng HJ, Nikolakopoulos S, Verhagen IE, van Es MA, Eijkemans MJC, van den Berg LH. Refining eligibility criteria for amyotrophic lateral sclerosis clinical trials. Neurology 2019; 92:e451-e460. [PMID: 30626653 PMCID: PMC6369899 DOI: 10.1212/wnl.0000000000006855] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 09/19/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the effect of eligibility criteria on exclusion rates, generalizability, and outcome heterogeneity in amyotrophic lateral sclerosis (ALS) clinical trials and to assess the value of a risk-based inclusion criterion. METHODS A literature search was performed to summarize the eligibility criteria of clinical trials. The extracted criteria were applied to an incidence cohort of 2,904 consecutive patients with ALS to quantify their effects on generalizability and outcome heterogeneity. We evaluated the effect of a risk-based selection approach on trial design using a personalized survival prediction model. RESULTS We identified 38 trials. A large variability exists between trials in all patient characteristics for enrolled patients (p < 0.001), except for the proportion of men (p = 0.21). Exclusion rates varied widely (from 14% to 95%; mean 59.8%; 95% confidence interval 52.6%-66.7%). Stratification of the eligible populations into prognostic subgroups showed that eligibility criteria lead to exclusion of patients in all prognostic groups. Eligibility criteria neither reduce heterogeneity in survival time (from 22.0 to 20.5 months, p = 0.09) nor affect between-patient variability in functional decline (from 0.62 to 0.65, p = 0.25). In none of the 38 trials were the eligibility criteria found to be more efficient than the prediction model in optimizing sample size and eligibility rate. CONCLUSIONS The majority of patients with ALS are excluded from trial participation, which questions the generalizability of trial results. Eligibility criteria only minimally improve homogeneity in trial endpoints. An individualized risk-based criterion could be used to balance the gains in trial design and loss in generalizability.
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Affiliation(s)
- Ruben P A van Eijk
- From the Department of Neurology (R.P.A.v.E., H.-J.W., I.E.V., M.A.v.E., L.H.v.d.B.), Brain Center Rudolf Magnus, and Biostatistics & Research Support (R.P.A.v.E., S.N., M.J.C.E.), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Henk-Jan Westeneng
- From the Department of Neurology (R.P.A.v.E., H.-J.W., I.E.V., M.A.v.E., L.H.v.d.B.), Brain Center Rudolf Magnus, and Biostatistics & Research Support (R.P.A.v.E., S.N., M.J.C.E.), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Stavros Nikolakopoulos
- From the Department of Neurology (R.P.A.v.E., H.-J.W., I.E.V., M.A.v.E., L.H.v.d.B.), Brain Center Rudolf Magnus, and Biostatistics & Research Support (R.P.A.v.E., S.N., M.J.C.E.), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Iris E Verhagen
- From the Department of Neurology (R.P.A.v.E., H.-J.W., I.E.V., M.A.v.E., L.H.v.d.B.), Brain Center Rudolf Magnus, and Biostatistics & Research Support (R.P.A.v.E., S.N., M.J.C.E.), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Michael A van Es
- From the Department of Neurology (R.P.A.v.E., H.-J.W., I.E.V., M.A.v.E., L.H.v.d.B.), Brain Center Rudolf Magnus, and Biostatistics & Research Support (R.P.A.v.E., S.N., M.J.C.E.), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Marinus J C Eijkemans
- From the Department of Neurology (R.P.A.v.E., H.-J.W., I.E.V., M.A.v.E., L.H.v.d.B.), Brain Center Rudolf Magnus, and Biostatistics & Research Support (R.P.A.v.E., S.N., M.J.C.E.), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Leonard H van den Berg
- From the Department of Neurology (R.P.A.v.E., H.-J.W., I.E.V., M.A.v.E., L.H.v.d.B.), Brain Center Rudolf Magnus, and Biostatistics & Research Support (R.P.A.v.E., S.N., M.J.C.E.), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.
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Stacey TL, Froude EH, Trollor J, Foley KR. Leisure participation and satisfaction in autistic adults and neurotypical adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:993-1004. [PMID: 30132680 DOI: 10.1177/1362361318791275] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leisure participation is important for well-being and has been attributed to improved quality of life for autistic individuals. Rigorous studies exploring the leisure participation of autistic adults are sparse. This study aimed to compare the type of leisure activity and frequency of participation between autistic adults and neurotypical adults as well as compare and identify factors associated with their leisure satisfaction. Data for 145 autistic and 104 neurotypical adults were obtained from time point one of the Australian Longitudinal Study of Adults with Autism. The primary outcome measure used was the Leisure Satisfaction Scale. Autistic adults were less satisfied with their leisure overall (mean = 3.29, standard deviation = 0.75) compared with neurotypical adults (mean = 3.69, standard deviation = 0.55). Multiple linear regression revealed being younger and reporting less depressive symptoms were significantly associated with higher leisure satisfaction in autistic but not neurotypical adults. Engagement in solitary leisure activities was comparable across participants, but socialising in person was predominated by neurotypical adults. Leisure activity preferences of autistic adults' and the frequency of their leisure participation are important factors for clinicians to understand when working with this population and tailoring well-being interventions.
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Affiliation(s)
| | | | - Julian Trollor
- 2 UNSW, Australia.,3 Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Kitty-Rose Foley
- 2 UNSW, Australia.,3 Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,4 Southern Cross University, Australia
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30
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Finlay A, Wittert G, Short CE. A systematic review of physical activity-based behaviour change interventions reaching men with prostate cancer. J Cancer Surviv 2018; 12:571-591. [PMID: 29770953 DOI: 10.1007/s11764-018-0694-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/07/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Men who are survivors of prostate cancer report a variety of psychological and physical factors contributing to a lower quality of life, and physical activity can assist to mitigate these issues. This review aims to provide a summary of physical activity behaviour change trials targeting prostate cancer survivors, assess the feasibility of these interventions and, if possible, identify intervention and study characteristics associated with significant intervention effects. METHOD Four databases (PubMed, CINAHL, PsycINFO and EMBASE) were systematically searched for randomised controlled trials containing at least one behavioural outcome relating to physical activity published up until July 2016. Forward and backwards, hand, key author citation searching and known research were also considered. RESULTS From a total of 13, 828 titles, the search resulted in 12 studies (6 prostate cancer only and 6 mixed cancer interventions), eight of which found positive results most often related immediately to post-intervention aerobic activity. Factors relating to efficacy were not conclusive due to the heterogeneity of studies and lack of cancer-specific data in mixed cancer trials. Future research focusing on intervention reach, maintenance of intervention effects and resistance training outcomes is needed. CONCLUSION There is preliminary evidence to suggest that a variety of physical activity behaviour change interventions targeting men with a history of prostate cancer can be efficacious, at least in the short term. Experimental studies are required to identify key intervention features. IMPLICATIONS FOR CANCER SURVIVORS Physical activity interventions can assist prostate cancer survivors in relation to short-term lifestyle change, though more evidence is required to improve the clarity of factors related to efficacy.
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Affiliation(s)
- A Finlay
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia.
| | - G Wittert
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia
| | - C E Short
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia
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Abstract
OBJECTIVES To explore the possible reasons for concealing type 1 diabetes (T1D) at work. METHODS The main set of data came from a cross-sectional survey (response rate 49.3%), the participants of which were 688 wage earners with T1D. Concealment of T1D was measured by asking respondents have they ever during their working career hidden their diabetes from their (A) colleagues and (B) line manager. Furthermore, semistructured interviews (n=20) were conducted to obtain deeper understanding. Questionnaire data were analysed using logistic regression analyses and qualitative interviews with inductive thematic analysis. RESULTS About 30% of wage earners with T1D had concealed their condition during their working career from their colleagues and almost 20% from their line manager. Individuals aged 18-44 years age were more likely to conceal their T1D from their colleagues than older workers during their working career. Not disclosing T1D to the extended family (OR 5.24 (95% CI 2.06 to 13.35)), feeling an outsider at work (OR 2.47 (95% CI 1.58 to 3.84)), being embarrassed by receiving special attention at work (OR 1.99 (95% CI 1.33 to 2.96)) and neglecting treatment at work (OR 1.59 (95% CI 1.01 to 2.48)) were all associated with concealment of T1D from colleagues. The youngest age group of 18-24 years were more likely to conceal their T1D from their line managers than the older age groups during their working career. Not disclosing T1D to the extended family (OR 4.41 (95% CI 1.72 to 11.32)), feeling like an outsider at work (OR 2.51 (1.52 to 4.14)) and being embarrassed by receiving special attention at work (OR 1.81 (95% CI 1.13 to 2.91)) were associated with concealment of T1D from line managers. From the interviews, five main themes related to concealment emerged, expressing fears related to the consequences of telling: (1) being perceived as weak, (2) job discrimination, (3) unwanted attention, (4) being seen as a person who uses their T1D for seeking advantages and (5) losing privacy. CONCLUSIONS A considerable proportion of wage earners with T1D are concealing their diagnosis often because of feelings associated with stigma. Both overemphasis and underestimation of T1D at work by the colleagues or line manager may lead to concealing T1D and may thus be harmful to self-management of T1D. The obstacles in disclosing T1D might be diminished by giving adequate information at the workplace about the condition and its significance.
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Affiliation(s)
- Pirjo Hakkarainen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Leena Moilanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Kimmo Räsänen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Vilma Hänninen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
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Kam S, Bylstra Y, Forrest L, Macciocca I, Foo R. Experience of Asian males communicating cardiac genetic risk within the family. J Community Genet 2018; 9:293-303. [PMID: 29308542 DOI: 10.1007/s12687-017-0352-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/09/2017] [Accepted: 12/18/2017] [Indexed: 11/24/2022] Open
Abstract
The genetic nature of an inherited cardiac condition (ICC) places first- and second-degree relatives at risk of cardiac complications and sudden death, even in the absence of symptoms. Communication of cardiac genetic risk information allows at-risk relatives to clarify, manage, and potentially prevent ICC-associated risks through cardiac screening. Literature regarding family communication of genetic risk information are predominantly based on Western populations, with limited insight into the Asian experience. This qualitative exploratory study provides a male perspective into the communication of ICC risks within families in Singapore. Eight male participants with clinically diagnosed cardiomyopathy, who had all received genetic counseling, were recruited. A phenomenological perspective was used to identify emergent themes from semi-structured interviews. In this study, most participants recalled their healthcare professional's emphasis on family communication. Notably, participants revealed that at-risk relatives were not accessing screening, and many described family members as currently asymptomatic and "healthy." These findings coincide with documented Asian beliefs regarding perceptions of health, which have important implications for the provision of genetic counseling support within Asian communities, especially in facilitating family communication such that at-risk relatives are informed about their ICC risks and available management options.
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Affiliation(s)
- Sylvia Kam
- POLARIS @ SingHealth, Singapore Health Services, 20 College Road, The Academia, Discovery Tower, Level 10, Singapore, 169856, Singapore.
- Department of Paediatrics, The University of Melbourne, Reception Level 2, West Building, Royal Children's Hospital, 50 Flemington Road, Parkville, VIC, 3052, Australia.
| | - Yasmin Bylstra
- SingHealth Duke-NUS Institute of Precision Medicine, Level 9, National Heart Centre, 5 Hospital Drive, Singapore, 169609, Singapore
- Inherited Cardiac Conditions Clinic, National University Heart Centre Singapore, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Laura Forrest
- Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Ivan Macciocca
- Victorian Clinical Genetics Services, Murdoch Childrens Research Institute, 4th Floor, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia
| | - Roger Foo
- Cardiovascular Research Institute, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 9, Singapore, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore, 119228, Singapore
- Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Level 8, MD6, 14 Medical Drive, Singapore, 117599, Singapore
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Ware LJ, Charlton K, Schutte AE, Cockeran M, Naidoo N, Kowal P. Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco. Nutr Metab Cardiovasc Dis 2017; 27:784-791. [PMID: 28800936 DOI: 10.1016/j.numecd.2017.06.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/14/2017] [Accepted: 06/26/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS In June 2016, South Africa implemented legislation mandating maximum sodium levels in a range of processed foods with a goal of reducing population salt intake and disease burden from hypertension. Our aim was to explore the relationship between salt and blood pressure (BP) in a subsample of the World Health Organization Study on global AGEing and adult health (SAGE) Wave 2 before implementation of legislation in South Africa. METHODS & RESULTS Blood pressure (BP) was measured in triplicate (n = 2722; median age 56 years; 33% male) and 24-h urine collected in a nested subsample (n = 526) for sodium, potassium and creatinine analysis. Hypertension prevalence was 55% in older adults (50-plus years) and 28% in younger adults (18-49 years). Median salt intake (6.8 g/day) was higher in younger than older adults (8.6 g vs 6.1 g/day; p < 0.001), and in urban compared to rural populations (7.0 g vs 6.0 g/day; p = 0.033). Overall, 69% of participants had salt intakes above 5 g/day. Potassium intakes were generally low (median 35 mmol/day) with significantly lower intakes in rural areas and older adults. Overall, 91% of adults failed to meet the daily potassium recommendation of 90 mmol/d. Salt intakes above 5 g/day, and to a greater extent, a dietary sodium-to-potassium (Na:K) ratio above 2 mmol/mmol, were associated with significantly steeper regression slopes of BP with age. CONCLUSION These preliminary results indicate that high dietary Na:K ratio may lead to a greater increase in BP and hypertension risk with age. Interventions to increase potassium intakes alongside sodium reduction initiatives may be warranted.
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Affiliation(s)
- L J Ware
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - K Charlton
- School of Medicine, University of Wollongong, New South Wales, Australia.
| | - A E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, South Africa.
| | - M Cockeran
- Statistical Consultation Services, North-West University, Potchefstroom, South Africa.
| | - N Naidoo
- World Health Organization (WHO), Geneva, Switzerland.
| | - P Kowal
- World Health Organization (WHO), Geneva, Switzerland; University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, Australia; University of Oregon, Department of Anthropology, Eugene, OR, USA.
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Pasco JA, Mohebbi M, Holloway KL, Brennan-Olsen SL, Hyde NK, Kotowicz MA. Musculoskeletal decline and mortality: prospective data from the Geelong Osteoporosis Study. J Cachexia Sarcopenia Muscle 2017; 8:482-489. [PMID: 28025860 PMCID: PMC5476862 DOI: 10.1002/jcsm.12177] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/20/2016] [Accepted: 11/13/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We aimed to examine the relationship between musculoskeletal deterioration and all-cause mortality in a cohort of women studied prospectively over a decade. METHODS A cohort of 750 women aged 50-94 years was followed for a decade after femoral neck bone mineral density (BMD) and appendicular lean mass (ALM) were measured using dual energy X-ray absorptiometry, in conjunction with comorbidities, health behaviour data, and other clinical measures. The outcome was all-cause mortality identified from the Australian National Deaths Index. Using Cox proportional hazards models and age as the time variable, mortality risks were estimated according to BMD groups (ideal-BMD, osteopenia, and osteoporosis) and ALM groups (T-scores > -1.0 high, -2.0 to -1.0 medium, <-2.0 low). RESULTS During 6712 person years of follow-up, there were 190 deaths, the proportions increasing with diminishing BMD: 10.7% (23/215) ideal-BMD, 23.5% (89/378) osteopenia, 49.7% (78/157) osteoporosis; and with diminishing ALM: 17.0% (59/345) high, 26.2% (79/301) medium, 50.0% (52/104) low. In multivariable models adjusted for smoking, polypharmacy, and mobility, compared with those with ideal BMD, mortality risk was greater for those with osteopenia [hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.11-2.81] and osteoporosis (HR 2.61, 95%CI 1.60-4.24). Similarly, compared with those with high ALM, adjusted mortality risk was greater for medium ALM (HR 1.36, 95%CI 0.97-1.91) and low ALM (HR 1.65, 95%CI 1.11-2.45). When BMD and ALM groups were tested together in the model, BMD remained a predictor of mortality (HR 1.74, 95%CI 1.09-2.78; HR 2.82, 95%CI 1.70-4.70; respectively), and low ALM had borderline significance (HR 1.52, 95%CI 1.00-2.31), which was further attenuated after adjusting for smoking, polypharmacy, and mobility. CONCLUSIONS Poor musculoskeletal health increased the risk for mortality independent of age. This appears to be driven mainly by a decline in bone mass. Low lean mass independently exacerbated mortality risk, and this appeared to operate through poor health exposures.
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Affiliation(s)
- Julie A Pasco
- Deakin University, Geelong, Australia.,Melbourne Medical School-Western Campus, University of Melbourne, St Albans, Australia.,University Hospital Geelong, Geelong, Australia
| | | | | | - Sharon L Brennan-Olsen
- Deakin University, Geelong, Australia.,Melbourne Medical School-Western Campus, University of Melbourne, St Albans, Australia.,Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia
| | | | - Mark A Kotowicz
- Deakin University, Geelong, Australia.,Melbourne Medical School-Western Campus, University of Melbourne, St Albans, Australia.,University Hospital Geelong, Geelong, Australia
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Simpson R, Mair FS, Mercer SW. Mindfulness-based stress reduction for people with multiple sclerosis - a feasibility randomised controlled trial. BMC Neurol 2017; 17:94. [PMID: 28511703 PMCID: PMC5434553 DOI: 10.1186/s12883-017-0880-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 05/09/2017] [Indexed: 01/14/2023] Open
Abstract
Background Multiple sclerosis (MS) is a stressful condition. Mental health comorbidity is common. Stress can increase the risk of depression, reduce quality of life (QOL), and possibly exacerbate disease activity in MS. Mindfulness-Based Stress Reduction (MBSR) may help, but has been little studied in MS, particularly among more disabled individuals. Methods The objective of this study was to test the feasibility and likely effectiveness of a standard MBSR course for people with MS. Participant eligibility included: age > 18, any type of MS, an Expanded Disability Status Scale (EDSS) </= 7.0. Participants received either MBSR or wait-list control. Outcome measures were collected at baseline, post-intervention, and three-months later. Primary outcomes were perceived stress and QOL. Secondary outcomes were common MS symptoms, mindfulness, and self-compassion. Results Fifty participants were recruited and randomised (25 per group). Trial retention and outcome measure completion rates were 90% at post-intervention, and 88% at 3 months. Sixty percent of participants completed the course. Immediately post-MBSR, perceived stress improved with a large effect size (ES 0.93; p < 0.01), compared to very small beneficial effects on QOL (ES 0.17; p = 0.48). Depression (ES 1.35; p < 0.05), positive affect (ES 0.87; p = 0.13), anxiety (ES 0.85; p = 0.05), and self-compassion (ES 0.80; p < 0.01) also improved with large effect sizes. At three-months post-MBSR (study endpoint) improvements in perceived stress were diminished to a small effect size (ES 0.26; p = 0.39), were negligible for QOL (ES 0.08; p = 0.71), but were large for mindfulness (ES 1.13; p < 0.001), positive affect (ES 0.90; p = 0.54), self-compassion (ES 0.83; p < 0.05), anxiety (ES 0.82; p = 0.15), and prospective memory (ES 0.81; p < 0.05). Conclusions Recruitment, retention, and data collection demonstrate that a RCT of MBSR is feasible for people with MS. Trends towards improved outcomes suggest that a larger definitive RCT may be warranted. However, optimisation changes may be required to render more stable the beneficial treatment effects on stress and depression. Trial registration ClinicalTrials.gov Identifier NCT02136485; trial registered 1st May 2014. Electronic supplementary material The online version of this article (doi:10.1186/s12883-017-0880-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Robert Simpson
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, House 1, 1 Horselethill Road, Glasgow, Scotland, G12 9LX, UK.
| | - Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, House 1, 1 Horselethill Road, Glasgow, Scotland, G12 9LX, UK
| | - Stewart W Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, House 1, 1 Horselethill Road, Glasgow, Scotland, G12 9LX, UK
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McDonald T, Bhattarai J, Akin B. Predictors of Consent in a Randomized Field Study in Child Welfare. ACTA ACUST UNITED AC 2017; 14:243-265. [PMID: 28486033 DOI: 10.1080/23761407.2017.1319774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Randomized controlled trials (RCTs) are often viewed as the "gold standard" for proving the efficacy and effectiveness of new interventions. However, some are skeptical of the generalizability of the findings that RCTs produce. The characteristics of those willing to participate in research studies have the potential to affect the generalizability of its findings. This study examined factors that could influence consent among families recruited to participate in a randomized field trial in a real-world child welfare setting. METHODS This study tested the Parent Management Training Oregon Model for children in foster care with serious emotional disturbance. It employed a post-randomization consent design, whereby the entire sample of eligible participants, not just those who are willing to consent to randomization, are included in the sample. Initial eligibility assessment data and data from the federally mandated reporting system for public child welfare agencies provided the pool of potential predictors of consent. Bivariate and multivariate analyses were conducted to identify statistically significant predictors of consent. RESULTS Being a dual reunification family was the most significant factor in predicting consent. Unmarried individuals, younger, female parents, cases where parental incarceration was the reason for removal and cases where the removal reason was not due to their children's behavioral problem(s) were also more likely to participate. DISCUSSION As one of the first research studies to examine predictors of consent to a randomized field study in child welfare settings, results presented here can act as a preliminary guide for conducting RCTs in child welfare settings.
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Affiliation(s)
- Tom McDonald
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
| | - Jackie Bhattarai
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
| | - Becci Akin
- a School of Social Welfare, University of Kansas , Lawrence , Kansas , USA
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Knapstad M, Löve J, Holmgren K, Hensing G, Øverland S. Registry-based analysis of participator representativeness: a source of concern for sickness absence research? BMJ Open 2016; 6:e012372. [PMID: 27798012 PMCID: PMC5093686 DOI: 10.1136/bmjopen-2016-012372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Selective participation can bias results in epidemiological surveys. The importance of health status is often suggested as a possible explanation for non-participation but few empirical studies exist. In a population-based study, explicitly focused on sickness absence, health and work, we examined whether a history of high levels of sickness absence was associated with non-participation. DESIGN The study is based on data from official sickness absence registers from participants, non-participants and the total target population of the baseline survey of the Health Assets Project (HAP). SETTING HAP is a population-based cohort study in the Västra Götaland region in South Western Sweden. PARTICIPANTS HAP included a random population cohort (n=7984) and 2 cohorts with recent sickness absence (employees (n=6140) and non-employees (n=990)), extracted from the same overall general working-age population. PRIMARY OUTCOME MEASURES We examined differences in participation rates between cohorts (2008), and differences in previous sickness absence (2001-2008) between participants (individual-level data) and non-participants or the target population (group-level data) within cohorts. RESULTS Participants had statistically significant less registered sickness absence in the past than non-participants and the target population for some, but not all, of the years analysed. Yet these differences were not of substantial size. Other factors than sickness absence were more important in explaining differences in participation, whereby participants were more likely to be women, older, born in Nordic countries, married and have higher incomes than non-participants. CONCLUSIONS Although specifically addressing sickness absence, having such experience did not add any substantial layer to selective participation in the present survey. Detailed measures are needed to gain a better understanding for health selection in health-related surveys such as those addressing sickness absence, for instance in order to discriminate between selection due to ability or motivation for participation.
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Affiliation(s)
- Marit Knapstad
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Jesper Löve
- Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Holmgren
- Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- Department of Public Health and Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Simon Øverland
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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O'Neil A, Fisher AJ, Kibbey KJ, Jacka FN, Kotowicz MA, Williams LJ, Stuart AL, Berk M, Lewandowski PA, Atherton JJ, Taylor CB, Pasco JA. The addition of depression to the Framingham Risk Equation model for predicting coronary heart disease risk in women. Prev Med 2016; 87:115-120. [PMID: 26906397 DOI: 10.1016/j.ypmed.2016.02.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 02/02/2016] [Accepted: 02/18/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Depression is widely considered to be an independent and robust predictor of Coronary Heart Disease (CHD), however is seldom considered in the context of formal risk assessment. We assessed whether the addition of depression to the Framingham Risk Equation (FRE) improved accuracy for predicting 10-year CHD in a sample of women. DESIGN A prospective, longitudinal design comprising an age-stratified, population-based sample of Australian women collected between 1993 and 2011 (n=862). METHODS Clinical depressive disorder was assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-I/NP), using retrospective age-of-onset data. A composite measure of CHD included non-fatal myocardial infarction, unstable angina coronary intervention or cardiac death. Cox proportional-hazards regression models were conducted and overall accuracy assessed using area under receiver operating characteristic (ROC) curve analysis. RESULTS ROC curve analyses revealed that the addition of baseline depression status to the FRE model improved its overall accuracy (AUC:0.77, Specificity:0.70, Sensitivity:0.75) when compared to the original FRE model (AUC:0.75, Specificity:0.73, Sensitivity:0.67). However, when calibrated against the original model, the predicted number of events generated by the augmented version marginally over-estimated the true number observed. CONCLUSIONS The addition of a depression variable to the FRE equation improves the overall accuracy of the model for predicting 10-year CHD events in women, however may over-estimate the number of events that actually occur. This model now requires validation in larger samples as it could form a new CHD risk equation for women.
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Affiliation(s)
- Adrienne O'Neil
- Melbourne School of Population & Global Health, University of Melbourne, Carlton, VIC, Australia; School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia.
| | - Aaron J Fisher
- Department of Psychology, University of California Berkeley, CA, USA
| | - Katherine J Kibbey
- Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Monash Health, Melbourne, VIC, Australia; School of Clinical Sciences, Monash University VIC, Australia
| | - Felice N Jacka
- School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Centre, Parkville, VIC, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Mark A Kotowicz
- School of Medicine, Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Amanda L Stuart
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen Youth Health Research Centre, Parkville, VIC, Australia; Mental Health Research Institute, Parkville, VIC, Australia
| | | | - John J Atherton
- Department of Cardiology, Royal Brisbane and Women's Hospital, QLD, Australia; School of Medicine, University of Queensland, QLD, Australia
| | - Craig B Taylor
- Department of Psychiatry & Behavioral Medicine, Stanford University & Palo Alto University, CA, USA
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, VIC, Australia; Western Medical School, The University of Melbourne, St Albans, VIC, Australia
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O'Neil A, Fisher AJ, Kibbey KJ, Jacka FN, Kotowicz MA, Williams LJ, Stuart AL, Berk M, Lewandowski PA, Taylor CB, Pasco JA. Depression is a risk factor for incident coronary heart disease in women: An 18-year longitudinal study. J Affect Disord 2016; 196:117-24. [PMID: 26921864 DOI: 10.1016/j.jad.2016.02.029] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/12/2015] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND According to a recent position paper by the American Heart Association, it remains unclear whether depression is a risk factor for incident Coronary Heart Disease (CHD). We assessed whether a depressive disorder independently predicts 18-year incident CHD in women. METHOD A prospective longitudinal study of 860 women enrolled in the Geelong Osteoporosis Study (1993-2011) was conducted. Participants were derived from an age-stratified, representative sample of women (20-94 years) randomly selected from electoral rolls in South-Eastern Australia. The exposure was a diagnosis of a depressive disorder using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Outcomes data were collected from hospital medical records: (1) PRIMARY OUTCOME: a composite measure of cardiac death, non-fatal Myocardial Infarction or coronary intervention. (2) Secondary outcome: any cardiac event (un/stable angina, cardiac event not otherwise defined) occurring over the study period. RESULTS Seven participants were excluded based on CHD history. Eighty-three participants (9.6%) recorded ≥1 cardiac event over the study period; 47 had a diagnosis that met criteria for inclusion in the primary analysis. Baseline depression predicted 18-year incidence, adjusting for (1) anxiety (adj. OR:2.39; 95% CIs:1.19-4.82), plus (2) typical risk factors (adj. OR:3.22; 95% CIs:1.45-6.93), plus (3) atypical risk factors (adj. OR:3.28; 95% CIs:1.36-7.90). This relationship held when including all cardiac events. No relationship was observed between depression and recurrent cardiac events. CONCLUSION The results of this study support the contention that depression is an independent risk factor for CHD incidence in women. Moreover, the strength of association between depression and CHD incidence was of a greater magnitude than any typical and atypical risk factor.
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Affiliation(s)
- Adrienne O'Neil
- Melbourne School of Population & Global Health, University of Melbourne, Carlton, VIC, Australia; School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia.
| | - Aaron J Fisher
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Katherine J Kibbey
- Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Monash Health, Melbourne, VIC, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Felice N Jacka
- School of Medicine, Deakin University, Geelong, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Adolescent Health, Murdoch Children's Research Centre, Parkville, VIC, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Mark A Kotowicz
- School of Medicine, Deakin University, Geelong, VIC, Australia; Barwon Health, Geelong Hospital, Geelong, VIC, Australia; Department of Psychiatry & Behavioral Medicine, Stanford University & Palo Alto University, CA, USA
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Amanda L Stuart
- School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, VIC, Australia; Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Orygen Youth Health Research Centre, Parkville, VIC, Australia; Mental Health Research Institute, Parkville, VIC, Australia
| | | | - Craig B Taylor
- Department of Psychiatry & Behavioral Medicine, Stanford University & Palo Alto University, CA, USA
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, VIC, Australia; Western Medical School, The University of Melbourne, St Albans, VIC, Australia
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Pasco JA, Foulkes C, Doolan B, Brown K, Holloway KL, Brennan-Olsen SL. A conduit between epidemiological research and regional health policy. Aust N Z J Public Health 2016; 40:250-4. [PMID: 27027274 DOI: 10.1111/1753-6405.12520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 10/01/2015] [Accepted: 12/01/2015] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To transform data from a research setting into a format that could be used to support strategies encouraging healthy lifestyle choices and service planning within local government. METHODS Details of the health status and lifestyle behaviours of the Geelong, Victoria, population were generated independently by the Geelong Osteoporosis Study (GOS), a prospective population-based cohort study. Recent GOS follow-up phases provided evidence about patterns of unhealthy diet, physical inactivity, smoking and harmful alcohol use. These factors are well-recognised modifiable risk factors for chronic disease; the dataset was complemented with prevalence estimates for musculoskeletal disease, obesity, diabetes, cardiovascular disease, asthma and cancer. RESULTS Data were provided to Healthy Together Geelong in aggregate form according to age, sex and suburb. A population statistics company used the data to project health outcomes by suburb for use by local council. This data exchange served as a conduit between epidemiological research and policy development. CONCLUSION AND IMPLICATIONS Regional policy makers were informed by local evidence, rather than national or state health survey, thereby optimising potential intervention strategies.
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Affiliation(s)
- Julie A Pasco
- School of Medicine, Deakin University, Victoria.,Melbourne Medical School - Western Campus, The University of Melbourne, Victoria
| | | | | | | | | | - Sharon L Brennan-Olsen
- School of Medicine, Deakin University, Victoria.,Melbourne Medical School - Western Campus, The University of Melbourne, Victoria
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Public Attitudes toward an Epidemiological Study with Genomic Analysis in the Great East Japan Earthquake Disaster Area. Prehosp Disaster Med 2016; 31:330-4. [PMID: 27019378 DOI: 10.1017/s1049023x16000182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
UNLABELLED Introduction The Great East Japan Earthquake of March 11, 2011 may have influenced the long-term health of those in the disaster area. It is important to collect current and future health information of the people living in the post-disaster area to provide appropriate health support and quality-oriented care. However, public perceptions of health and genomic studies in the Great East Japan Earthquake disaster area are still unknown. METHODS A questionnaire survey was conducted in one town affected by the Great East Japan Earthquake and subsequent tsunami. The results of the questionnaire were tailed and the differences in responses to each question were assessed by sex and age. RESULTS In 284 eligible people (137 men, 147 women), almost all participants agreed to join a health survey investigating the adverse effects of the disaster, and over 80% of the total participants agreed to genomic analysis. Over 70% of the participants wanted to receive pharmacogenetic testing and to receive feedback on which medications were suitable or unsuitable for them. CONCLUSIONS Most people living in the disaster area are interested in health surveys. Most of the participants also showed interest in genomic analysis. Ishikuro M , Nakaya N , Obara T , Sato Y , Metoki H , Kikuya M , Tsuchiya N , Nakamura T , Nagami F , Kuriyama S , Hozawa A , the ToMMo Study Group. Public attitudes toward an epidemiological study with genomic analysis in the Great East Japan Earthquake disaster area. Prehosp Disaster Med. 2016;31(3):330-334.
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Stuart AL, Williams LJ, Brennan SL, Kotowicz MA, Pasco JA. Poor agreement between self-reported diagnosis and bone mineral density results in the identification of osteoporosis. J Clin Densitom 2015; 18:13-6. [PMID: 24912958 DOI: 10.1016/j.jocd.2014.04.123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 10/25/2022]
Abstract
Osteoporosis is a major health concern, estimated to affect millions worldwide. Bone mineral density (BMD) assessment is not practical for many large-scale epidemiological studies resulting in the reliance of self-report methods to ascertain diagnostic information. The aim of the study was to assess the validity of self-reported diagnosis of osteoporosis in a population-based study. This study examined data collected from 906 men and 843 women participating in the Geelong Osteoporosis Study. Osteoporosis was self-reported and compared against results of BMD scans of the hip and spine. Validity was examined by calculating sensitivity, specificity, positive predictive value, negative predictive value, and kappa statistic. Osteoporosis was self-reported by 118 (6.7%) participants and identified using BMD results for 64 (3.7%) participants. Specificity and negative predictive value were good (95.1% and 96.0%, respectively), whereas sensitivity and positive predictive value were poor (35.9% and 31.4%, respectively). The overall level of agreement (kappa) was 0.29. The results changed only slightly when we included participants with osteopenia and adult fracture as osteoporotic. Reliance on self-report methods to ascertain osteoporosis status is not recommended.
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Affiliation(s)
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia
| | - Sharon L Brennan
- School of Medicine, Deakin University, Geelong, Australia; NorthWest Academic Centre, The University of Melbourne, Sunshine Hospital, St Albans, Australia; Australian Institute for Musculoskeletal Sciences, St Albans, Australia
| | - Mark A Kotowicz
- School of Medicine, Deakin University, Geelong, Australia; NorthWest Academic Centre, The University of Melbourne, Sunshine Hospital, St Albans, Australia; Division of Medicine, Barwon Health, Geelong, Australia
| | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, Australia; NorthWest Academic Centre, The University of Melbourne, Sunshine Hospital, St Albans, Australia; Division of Medicine, Barwon Health, Geelong, Australia
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Holloway KL, Brennan SL, Kotowicz MA, Bucki-Smith G, Dobbins AG, Timney EN, Williams LJ, Pasco JA. Age- and sex-related patterns of first fracture and fracture prevalence. Calcif Tissue Int 2015; 96:38-44. [PMID: 25467009 DOI: 10.1007/s00223-014-9936-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
Abstract
There are few data documenting the pattern of prevalent fracture across the entire adult age range, so we aimed to address this gap by investigating the prevalence of fractures in an Australian cohort. All-cause (ever) fractures were identified for males and females enrolled in the Geelong Osteoporosis Study (Australia) using a combination of radiology-confirmed and self-reported data. First fractures were used to generate age-related frequencies of individuals who had ever sustained a fracture. Of 1,538 males and 1,731 females, 927 males and 856 females had sustained at least one fracture since birth. The proportion of all prevalent fractures in the 0-10 year age group was similar for both sexes (~10%). In males, the proportion with prevalent fracture increased to 34.1% for age 11-20 year. Smaller increases were observed into mid-life, reaching a plateau at ~50% from mid to late life. The age-related prevalence of fracture for females showed a more gradual increase until mid-life. For adulthood prevalent fractures, approximately 20% of males had sustained a first adulthood fracture in the 20-30 year age group, with a gradual increase up to the oldest age group (49.1%), while females showed an exponential pattern of increase from the 20-30 year age group (6.8%) to the oldest age group (60.4%). In both sexes, those who had not sustained a fracture in childhood or early adulthood generally appeared to remain fracture-free until at least the sixth decade. When considering the prevalence of adulthood fractures across the age groups, males showed a gradual increase while females showed an exponential increase.
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Affiliation(s)
- Kara L Holloway
- School of Medicine, Epi-Centre for Healthy Ageing, Deakin University, 285 Ryrie Street, PO Box 281, Geelong, VIC, 3220, Australia,
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Pasco JA, Holloway KL, Dobbins AG, Kotowicz MA, Williams LJ, Brennan SL. Body mass index and measures of body fat for defining obesity and underweight: a cross-sectional, population-based study. BMC OBESITY 2014. [PMID: 26217501 PMCID: PMC4511447 DOI: 10.1186/2052-9538-1-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The body mass index (BMI) is commonly used as a surrogate marker for adiposity. However, the BMI indicates weight-for-height without considering differences in body composition and the contribution of body fat to overall body weight. The aim of this cross-sectional study was to identify sex-and-age-specific values for percentage body fat (%BF), measured using whole body dual energy x-ray absorptiometry (DXA), that correspond to BMI 18.5 kg/m(2) (threshold for underweight), 25.0 kg/m(2) (overweight) and 30.0 kg/m(2) (obesity) and compare the prevalence of underweight, overweight and obesity in the adult white Australian population using these BMI thresholds and equivalent values for %BF. These analyses utilise data from randomly-selected men (n = 1446) and women (n = 1045), age 20-96 years, who had concurrent anthropometry and DXA assessments as part of the Geelong Osteoporosis Study, 2001-2008. RESULTS Values for %BF cut-points for underweight, overweight and obesity were predicted from sex, age and BMI. Using these cut-points, the age-standardised prevalence among men for underweight was 3.1% (95% CI 2.1, 4.1), overweight 40.4% (95% CI 37.7, 43.1) and obesity 24.7% (95% CI 22.2, 27.1); among women, prevalence for underweight was 3.8% (95% CI 2.6, 5.0), overweight 32.3% (95% CI 29.5, 35.2) and obesity 29.5% (95% CI 26.7, 32.3). Prevalence estimates using BMI criteria for men were: underweight 0.6% (95% CI 0.2, 1.1), overweight 45.5% (95% CI 42.7, 48.2) and obesity 19.7% (95% CI 17.5, 21.9); and for women, underweight 1.4% (95% CI 0.7, 2.0), overweight 30.3% (95% CI 27.5, 33.1) and obesity 28.2% (95% CI 25.4, 31.0). CONCLUSIONS Utilising a single BMI threshold may underestimate the true extent of obesity in the white population, particularly among men. Similarly, the BMI underestimates the prevalence of underweight, suggesting that this body build is apparent in the population, albeit at a low prevalence. Optimal thresholds for defining underweight and obesity will ultimately depend on risk assessment for impaired health and early mortality.
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Affiliation(s)
- Julie A Pasco
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT SRC, Deakin University, PO Box 281, Geelong, Victoria 3220 Australia ; NorthWest Academic Centre, The University of Melbourne, St Albans, Victoria Australia
| | - Kara L Holloway
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT SRC, Deakin University, PO Box 281, Geelong, Victoria 3220 Australia
| | - Amelia G Dobbins
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT SRC, Deakin University, PO Box 281, Geelong, Victoria 3220 Australia
| | - Mark A Kotowicz
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT SRC, Deakin University, PO Box 281, Geelong, Victoria 3220 Australia ; NorthWest Academic Centre, The University of Melbourne, St Albans, Victoria Australia
| | - Lana J Williams
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT SRC, Deakin University, PO Box 281, Geelong, Victoria 3220 Australia
| | - Sharon L Brennan
- Epi-Centre for Healthy Ageing, School of Medicine, IMPACT SRC, Deakin University, PO Box 281, Geelong, Victoria 3220 Australia ; NorthWest Academic Centre, The University of Melbourne, St Albans, Victoria Australia
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Stuart AL, Pasco JA, Jacka FN, Brennan SL, Berk M, Williams LJ. Comparison of self-report and structured clinical interview in the identification of depression. Compr Psychiatry 2014; 55:866-9. [PMID: 24467941 DOI: 10.1016/j.comppsych.2013.12.019] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 12/18/2013] [Accepted: 12/23/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND A self-report method seeking a binary response for assessing depression is a cost-effective and time-efficient way to obtain a psychiatric history, yet the reliability of this method is largely unknown. The aim of the study was to compare and assess the validity of two methods for identifying a past history of depression in a population-based study. METHODS This study examined data collected from 891 men and 1086 women participating in the Geelong Osteoporosis Study. Self-reports of depression were compared with results obtained using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition (SCID-I/NP). RESULTS Using the SCID-I/NP, 146 (16.4%) men and 285 (26.2%) women met criteria for a lifetime depression. Of those participants, 61.0% (n=263) self-reported a history of depression. The level of agreement between self-reporting depression and the SCID-I/NP depression module was reasonably high; 61% sensitivity, 89.5% specificity and the overall level of agreement (kappa) was 0.5. LIMITATIONS Results may not be generalizable to other self-report instruments or be suitable for use in clinical samples. CONCLUSION The SCID-I/NP remains the gold standard for identifying depression; however, given the moderate level of agreement between the self-report questionnaire and SCID-I/NP in our current study, we conclude that simple self-report methods can be used to identify depression with some degree of confidence.
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Affiliation(s)
| | - Julie A Pasco
- Deakin University, School of Medicine, Geelong, Australia; NorthWest Academic Centre, The University of Melbourne, Sunshine Hospital, St Albans, Australia; Barwon Health, Geelong, Australia.
| | - Felice N Jacka
- Deakin University, School of Medicine, Geelong, Australia; The University of Melbourne, Department of Psychiatry, Parkville, Australia.
| | - Sharon L Brennan
- Deakin University, School of Medicine, Geelong, Australia; NorthWest Academic Centre, The University of Melbourne, Sunshine Hospital, St Albans, Australia; Australian Institute for Musculoskeletal Sciences, St Albans, Australia.
| | - Michael Berk
- Deakin University, School of Medicine, Geelong, Australia; The University of Melbourne, Department of Psychiatry, Parkville, Australia; Orygen Youth Health Research Centre, Parkville, Australia; Florey Institute for Neuroscience and Mental Health, Parkville, Australia.
| | - Lana J Williams
- Deakin University, School of Medicine, Geelong, Australia; The University of Melbourne, Department of Psychiatry, Parkville, Australia.
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