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Margozzini P, Tolonen H, Bernabe-Ortiz A, Cuschieri S, Donfrancesco C, Palmieri L, Sanchez-Romero LM, Mindell JS, Oyebode O. National health examination surveys; a source of critical data. Bull World Health Organ 2024; 102:588-599. [PMID: 39070597 PMCID: PMC11276157 DOI: 10.2471/blt.24.291783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 03/31/2024] [Accepted: 05/01/2024] [Indexed: 07/30/2024] Open
Abstract
The aim of this paper is to contribute technical arguments to the debate about the importance of health examination surveys and their continued use during the post-pandemic health financing crisis, and in the context of a technological innovation boom that offers new ways of collecting and analysing individual health data (e.g. artificial intelligence). Technical considerations demonstrate that health examination surveys make an irreplaceable contribution to the local availability of primary health data that can be used in a range of further studies (e.g. normative, burden-of-disease, care cascade, cost and policy impact studies) essential for informing several phases of the health planning cycle (e.g. surveillance, prioritization, resource mobilization and policy development). Examples of the use of health examination survey data in the World Health Organization (WHO) European Region (i.e. Finland, Italy, Malta and the United Kingdom of Great Britain and Northern Ireland) and the WHO Region of the Americas (i.e. Chile, Mexico, Peru and the United States of America) are presented, and reasons why health provider-led data cannot replace health examination survey data are discussed (e.g. underestimation of morbidity and susceptibility to bias). In addition, the importance of having nationally representative random samples of the general population is highlighted and we argue that health examination surveys make a critical contribution to external quality control for a country's health system by increasing the transparency and accountability of health spending. Finally, we consider future technological advances that can improve survey fieldwork and suggest ways of ensuring health examination surveys are sustainable in low-resource settings.
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Affiliation(s)
- Paula Margozzini
- Department of Public Health, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hanna Tolonen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Sarah Cuschieri
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | | | | | - Luz Maria Sanchez-Romero
- Department of Oncology, Georgetown University Medical Centre, WashingtonDC., United States of America
| | - Jennifer S Mindell
- Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London, WC1E 6BT, England
| | - Oyinlola Oyebode
- Wolfson Institute of Population Health, Queen Mary University of London, London, England
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Tiisanoja A, Anttonen V, Syrjälä AM, Ylöstalo P. High Anticholinergic Burden and Dental Caries: Findings from Northern Finland Birth Cohort 1966. JDR Clin Trans Res 2024:23800844241253250. [PMID: 38872382 DOI: 10.1177/23800844241253250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Anticholinergic drugs propose a threat for oral health by causing dry mouth. The aim of this cross-sectional study was to investigate whether a high anticholinergic burden was associated with the presence of initial caries lesions, manifested caries lesions, dental fillings, or tooth loss among 46-y-old people. METHODS The study population consisted of 1,906 participants from the Northern Finland Birth Cohort 1966 who underwent an oral health examination in 2012-2013. Socioeconomic and medical data were collected from questionnaires, medical records, and national registers. Nine previously published anticholinergic scales were combined and used to measure the high anticholinergic burden from the participants' medication data. Cariological status was determined according to the International Caries Detection and Assessment System, and the number of missing teeth (excluding third molars) was used as an indicator for tooth loss. The decayed, missing, and filled surfaces index was used to depict caries experience. Negative binominal regression models were used to estimate prevalence rate ratios (PRRs) and confidence intervals (CIs). RESULTS Fourteen percent of the participants (n = 276) used at least 1 anticholinergic drug and about 3% had a high anticholinergic burden (n = 61). After adjusting for confounding factors, participants with a high anticholinergic burden had a higher likelihood of having manifested carious lesions needing restorative treatment (PRR, 1.60; CI, 1.11-2.29) and more missing teeth (PRR, 1.59; CI, 1.13-2.24) when compared to participants without any or with a lower anticholinergic burden. CONCLUSIONS High anticholinergic burden was associated with a present caries experience and with tooth loss among the general middle-aged population. KNOWLEDGE TRANSFER STATEMENT The findings of this study suggest that middle-aged patients with a high anticholinergic burden may have a heightened risk of dental caries. These patients may benefit from targeted caries preventive regimes.
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Affiliation(s)
- A Tiisanoja
- Social and Health Services, Oulu, Finland
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
| | - V Anttonen
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
| | - A-M Syrjälä
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
| | - P Ylöstalo
- Research Unit of Population Health, University of Oulu
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu
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Sijben J, Huibertse LJ, Rainey L, Broeders MJM, Peters Y, Siersema PD. Oesophageal cancer awareness and anticipated time to help-seeking: results from a population-based survey. Br J Cancer 2024; 130:1795-1802. [PMID: 38555316 PMCID: PMC11130305 DOI: 10.1038/s41416-024-02663-1] [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: 10/13/2023] [Revised: 03/04/2024] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Modifying public awareness of oesophageal cancer symptoms might help to decrease late-stage diagnosis and, in turn, improve cancer outcomes. This study aimed to explore oesophageal cancer symptom awareness and determinants of lower awareness and anticipated time to help-seeking. METHODS We invited 18,156 individuals aged 18 to 75 years using random sampling of the nationwide Dutch population registry. A cross-sectional web-based survey containing items adapted from the Awareness and Beliefs about Cancer measure (i.e., cancer symptom awareness, anticipated time to presentation with dysphagia, health beliefs, and sociodemographic variables) was filled out by 3106 participants (response rate: 17%). Descriptive statistics were calculated and logistic regression analyses were performed to explore determinants of awareness and anticipated presentation (dichotomised as <1 month or ≥1 month). RESULTS The number of participants that recognised dysphagia as a potential symptom of cancer was low (47%) compared with symptoms of other cancer types (change in bowel habits: 77%; change of a mole: 93%; breast lump: 93%). In multivariable analyses, non-recognition of dysphagia was associated with male gender (OR 0.50, 95% CI 0.43-0.58), lower education (OR 0.44, 0.35-0.54), and non-western migration background (OR 0.43, 0.28-0.67). Anticipated delayed help-seeking for dysphagia was associated with not recognising it as possible cancer symptom (OR 1.58, 1.27-1.97), perceived high risk of oesophageal cancer (OR 2.20, 1.39-3.47), and negative beliefs about oesophageal cancer (OR 1.86, 1.20-2.87). CONCLUSION Our findings demonstrate a disconcertingly low public awareness of oesophageal cancer symptoms. Educational interventions targeting groups with decreased awareness and addressing negative cancer beliefs may lead to faster help-seeking behaviour, although additional studies are needed to determine the effect on clinical cancer outcomes.
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Affiliation(s)
- Jasmijn Sijben
- Department of Gastroenterology and Hepatology, Radboud university medical center, Nijmegen, The Netherlands
| | - Lotte J Huibertse
- Department of Gastroenterology and Hepatology, Radboud university medical center, Nijmegen, The Netherlands
| | - Linda Rainey
- IQ Health Science Department, Radboud university medical center, Nijmegen, The Netherlands
| | - Mireille J M Broeders
- IQ Health Science Department, Radboud university medical center, Nijmegen, The Netherlands
- Dutch Expert Centre for Screening, Nijmegen, The Netherlands
| | - Yonne Peters
- Department of Gastroenterology and Hepatology, Radboud university medical center, Nijmegen, The Netherlands.
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, Radboud university medical center, Nijmegen, The Netherlands
- Department of Gastroenterology and Hepatology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
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Bjermo H, Patterson E, Petrelius Sipinen J, Lignell S, Stenberg K, Larsson E, Lindroos AK, Ottoson J, Warensjö Lemming E, Moraeus L. Design, Methods, and Participation in Riksmaten Young Children-A Swedish National Dietary Survey. Curr Dev Nutr 2024; 8:102150. [PMID: 38774498 PMCID: PMC11107201 DOI: 10.1016/j.cdnut.2024.102150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 05/24/2024] Open
Abstract
Background National dietary surveys provide essential data for risk benefit assessments of foods and nutrients, for management and policy development. Physical activity measurement and biomonitoring can provide important complementary data but are less commonly included. Objectives This study aimed to describe the study design and methods of the cross-sectional Swedish national dietary survey Riksmaten Young Children (Riksmaten småbarn), of children aged 9 mo, 18 mo, and 4 y. Participation/dropout rates for the 2 older age groups are also presented. The impact of different recruitment strategies is discussed. Methods Children (N = 16,655) were randomly selected from the population register; invitations to guardians were sent by post and where possible, followed up by telephone. Food intake was assessed by a 2-d food diary and/or questionnaire. Height and weight were reported after measurement. Physical activity (accelerometery, 7 d) and stool, blood, and urine samples were assessed in subgroups. Results Food consumption data were collected in 1828 children (11% of the invited; 18 mo: n = 1078, and 4 y: n = 750). Of participants also in subgroups, 71% provided physical activity data (n = 1307), 60% stool samples (n = 630), and 51% blood and/or urine samples (n = 593). The study population represented all geographic regions and types of municipalities in Sweden, but participating households had both higher education level and higher income than the target population. Only minor differences were seen in participation rates between recruitment via post and telephone compared with those through post only (12% compared with 10%). Repeated contact attempts were needed for the majority of participants (65%). Despite the low-participation rate, 99% of the participants completed the study once started. Conclusions Although it was a challenge to recruit participants, Riksmaten Young Children provides a substantial amount of information at national level, representative in terms of sex, geography, and family structure. The underrepresentation of households with lower socioeconomic position must be considered when generalizing results.
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Affiliation(s)
- Helena Bjermo
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Emma Patterson
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Sanna Lignell
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Karin Stenberg
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Elin Larsson
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Anna Karin Lindroos
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jakob Ottoson
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Eva Warensjö Lemming
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Lotta Moraeus
- Department of Risk Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
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Klee B, Costa D, Frese T, Knoechelmann A, Meyer G, Meyer T, Purschke O, Schildmann J, Steckelberg A, Mikolajczyk R. To Remind or Not to Remind During Recruitment? An Analysis of an Online Panel in Germany. Int J Public Health 2024; 69:1606770. [PMID: 38586472 PMCID: PMC10996063 DOI: 10.3389/ijph.2024.1606770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
Objective: To explore the role of reminders in recruiting and maintaining participation in an online panel. Methods: 50,045 individuals from five German federal states were invited by regular mail to participate in the online study "Health-Related Beliefs and Healthcare Experiences in Germany." Those who did not respond to the first attempt received a postal reminder. Comparisons of sociodemographic characteristics and responses were made between first-attempt respondents and those who enrolled after the second letter. Results: After the initial letter, 2,216 (4.4%, 95%CI: 4.3%-4.6%) registered for the study; after a reminder 1,130 (2.5%, 2.3%-2.6% of those reminded) enrolled. Minor sociodemographic differences were observed between the groups and the content of the responses did not differ. Second-attempt respondents were less likely to participate in subsequent questionnaires: 67.3% of first-attempt vs. 43.3% of second-attempt respondents participated in their fourth survey. Recruitment costs were 79% higher for second-attempt respondents. Conclusion: While reminders increased the number of participants, lower cost-effectiveness and higher attrition of second-attempt respondents support the use of single invitation only for studies with a similar design to ours when the overall participation is low.
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Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Daniela Costa
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Thomas Frese
- Institute for General Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Anja Knoechelmann
- Institute of Medical Sociology, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Gabriele Meyer
- Institute for Health and Nursing Sciences, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Thorsten Meyer
- Institute for Rehabilitation Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Oliver Purschke
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Jan Schildmann
- Institute for History and Ethics of Medicine, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Anke Steckelberg
- Institute for Health and Nursing Sciences, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle, Saxony-Anhalt, Germany
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Lemcke J, Loss J, Allen J, Öztürk I, Hintze M, Damerow S, Kuttig T, Wetzstein M, Hövener C, Hapke U, Ziese T, Scheidt-Nave C, Schmich P. Erratum: Health in Germany: Establishment of a population-based health panel. JOURNAL OF HEALTH MONITORING 2024; 9:2-21. [PMID: 38628568 PMCID: PMC11017686 DOI: 10.25646/11992.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/22/2024] [Indexed: 04/19/2024]
Abstract
[This corrects the article on p. 2,21 in vol. 9, PMID: 38282983.].
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Affiliation(s)
- Johannes Lemcke
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
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7
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Donfrancesco C, Buttari B, Marcozzi B, Sieri S, Di Lonardo A, Lo Noce C, Profumo E, Vespasiano F, Agnoli C, Vannucchi S, Silano M, Galeone D, Bellisario P, Vaia F, Palmieri L. Nutrition, Physical Activity and Smoking Habit in the Italian General Adult Population: CUORE Project Health Examination Survey 2018-2019. Healthcare (Basel) 2024; 12:475. [PMID: 38391850 PMCID: PMC10888300 DOI: 10.3390/healthcare12040475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Tobacco consumption, incorrect nutrition and insufficient physical activity/sedentariness represent modifiable NCDs risk factors in Western countries. To evaluate recent lifestyle indicators in Italy, data from the national Health Examination Survey (HES), implemented in 2018-2019 within the CUORE Project, were assessed. METHODS Age-sex standardized results from random samples of Italian general population (35-74 years) were reported by sex, age-class, educational level and geographical area. From 2106 participants, 2090 were considered for smoking habit, 2016 for physical activity and 1578 for nutrition. Standardized questionnaires were used for smoking habit and physical activity, and the EPIC questionnaire for nutrition. RESULTS Total cigarette current smokers were 23% in men and 19% in women; sedentariness during leisure time was 34% in men and 45% in women and at work 45% and 47% in men and women, respectively. Prevalence of balanced eating behaviours for vegetables was 28% in men and 39% in women; and for fruits 50% and 52%, respectively; prevalence of correct lifestyle (not smoker, regular physical activity and following at least five correct eating behaviours) was 7% and 12% for men and women, respectively. CONCLUSIONS In 2018-2019, levels of unhealthy lifestyles were found to be still epidemic and basically stable compared to 10 years earlier (slight smoking habit decrease, slight sedentariness increase and slight nutrition improvements); intersectoral strategies and monitoring need to be continued.
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Affiliation(s)
| | | | | | - Sabina Sieri
- Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | | | | | | | | | - Claudia Agnoli
- Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
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Leskelä M, Jokelainen J, Huilaja L, Sinikumpu SP. Adult Acne in Middle-age: Effects on Mental Health in General Population of the Northern Finland Birth Cohort 1966. Acta Derm Venereol 2024; 104:adv14733. [PMID: 38270258 PMCID: PMC10831867 DOI: 10.2340/actadv.v104.14733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/28/2023] [Indexed: 01/26/2024] Open
Abstract
The impact of adult acne on patients' mental health has not been widely studied, and most studies have been conducted within specific patient populations. The current study examines the association between adult acne and psychological symptoms in the Northern Finland Birth Cohort 1966 (NFBC1966) (n = 1,907). The cohort members attended a health study at the age of 46 years, which comprised a whole-body examination performed by dermatologists to identify acne, and answering the Beck Depression Inventory II (BDI-II), Athens Insomnia Scale (AIS), Generalized Anxiety Disorder (GAD-7), State-Trait Anxiety Inventory (STAI) and 15-dimensional measure of health-related quality of life (15D HRQoL) questionnaires. The prevalence of adult acne was 7.9% (n = 150) with no statistical differences between the sexes. Cases with acne presented more (18.9%) depressive symptoms (BDI-II > 14 points) compared with those without acne (9.7%) (p < 0.001). In adjusted logistic regression analyses, those with acne had a 2-fold risk (odds ratio (OR) 2.08, 95% confidence interval (95% CI) 1.23-3.38) of having depressive symptoms compared with controls. In conclusion, when treating adult acne patients, it is important to recognize the increased risk of mental health symptoms.
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Affiliation(s)
| | - Jari Jokelainen
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Laura Huilaja
- Department of Dermatology and Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Suvi-Päivikki Sinikumpu
- Department of Dermatology and Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu, Oulu University Hospital, Oulu, Finland.
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Alexiou ZW, van Aar F, Hoenderboom BM, Morre SA, Heijne JCM. Trends in Chlamydia trachomatis IgG seroprevalence in the general population of the Netherlands over 20 years. Sex Transm Infect 2024; 100:31-38. [PMID: 37985129 PMCID: PMC10850662 DOI: 10.1136/sextrans-2023-055888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/08/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To report sex and age-specific Chlamydia trachomatis (Ct) seroprevalence estimates in the general population of the Netherlands between 1996 and 2017 and identify risk factors associated with Ct seropositivity. METHODS Participants (n=5158, aged 15-59 years) were included from three independent nationwide population-based serosurveillance studies in 1996, 2007 and 2017. Participants completed a questionnaire on demographics and sexual behaviour. Serum antibodies were analysed using Medac Ct IgG ELISA test. Census weights were assigned to achieve seroprevalence estimates representative of the general Dutch population. Weighted seroprevalence estimates were stratified by gender, age and birth cohort. Trends and risk factors in men and women were identified using multivariable logistic regression. RESULTS Weighted overall Ct seroprevalence was 10.5% (95% CI: 9.2% to 12.0%) in women and 5.8% (95% CI: 4.7% to 7.0%) in men. Among women <25 years, there was a non-significant increase in seroprevalence from 5.9% (95% CI 3.7% to 9.2%) in 1996, to 7.6% (95% CI 5.1% to 11.1%) in 2007 and 8.8% (95% CI 5.5% to 13.9%) in 2017. Among women ≥25 years, the seroprevalence significantly decreased from 15.6% (95% CI: 12.2% to 19.7%) in 1996 to 9.5% (95% CI: 7.2% to 12.4%) in 2007 but did not further drop (11.2% (95% CI 8.1% to 15.3%) in 2017). In men, we did not observe trends between study rounds. In both men and women, having a non-Western migration background was a risk factor for seropositivity. In women, having had a prior sexually transmitted infection and ≥2 recent sex partners were risk factors for seropositivity as well. CONCLUSIONS We have not found evidence for a decrease in population seroprevalence in those under 25 years old despite decades of intensified testing-and-treatment efforts in the Netherlands. This suggests further monitoring of Ct burden in the general population is needed. If serum banks are used for this, specifically individuals <25 years old and with diverse migration backgrounds should be included.
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Affiliation(s)
- Zoïe Willemijn Alexiou
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Genetics and Cell Biology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Fleur van Aar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Bernice Maria Hoenderboom
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Servaas Antonie Morre
- Department of Genetics and Cell Biology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Dutch Chlamydia trachomatis Reference Laboratory, Department of Medical Microbiology, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Allahabad, India
| | - Janneke Cornelia Maria Heijne
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Sinikumpu SP, Jokelainen J, Huilaja L. Prevalence and Characteristics of Hidradenitis Suppurativa in the Northern Finland Birth Cohort 1986 Study: A Cross-sectional Study of 2,775 Subjects. Acta Derm Venereol 2024; 104:adv14732. [PMID: 38197699 PMCID: PMC10795692 DOI: 10.2340/actadv.v104.14732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/17/2023] [Indexed: 01/11/2024] Open
Abstract
A negative stigmatization related to hidradenitis suppurativa may prevent patients from seeking care. Thus, a large proportion of patients with hidradenitis suppurativa may be missing from studies based on hospital data. The aim of this study was to examine the prevalence and characteristics of hidradenitis suppurativa among 2,775 subjects in the Northern Finland Birth Cohort 1986 Study (NFBC1986), who were in their mid-thirties. The prevalence of hidradenitis suppurativa was 4.0% (n = 110/2,775), being higher in females (4.8%) than in males (2.5%) (p < 0.01). Of those defined as having hidradenitis suppurativa in this study, only 4 cases (n = 4/110, 3.6%) were found to have a hidradenitis suppurativa diagnosis either in the hospital (Care Register for Health Care) or in the primary healthcare data. In an adjusted model in logistic regression analyses, hidradenitis suppurativa was significantly associated with obesity (body mass index 30-55 kg/m2) (odds ratio 3.81, 95% confidence interval 2.80-5.22), female sex (1.99, 1.53-2.61) and smoking (1.56, 1.21-2.00). In addition, there was an association between hidradenitis suppurativa and self-reported poor overall health status. Hidradenitis suppurativa seems to be common at the population level and only a minority of these patients seek care for the condition.
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Affiliation(s)
- Suvi-Päivikki Sinikumpu
- Department of Dermatology, University Hospital of Oulu, Oulu, Finland; Medical Research Center, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
| | - Jari Jokelainen
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Laura Huilaja
- Department of Dermatology, University Hospital of Oulu, Oulu, Finland; Medical Research Center, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
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Pedersen MM, Carstensen TBW, Ørnbøl E, Fink P, Jørgensen T, Dantoft TM, Frostholm L. Translation and examination of construct validity of the Danish version of the Tampa Scale for Kinesiophobia. Scand J Pain 2024; 24:sjpain-2024-0022. [PMID: 39099219 DOI: 10.1515/sjpain-2024-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/26/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES This study investigates the construct validity of the Danish Tampa Scale for Kinesiophobia (TSK). METHODS The English 17-item scale was translated into Danish adhering to WHO's guidelines. The construct validity of the TSK was examined in a random general population sample of 4,884 18- to 72-year olds with pain within the past 4 weeks. Examination of construct validity adhered to the COSMIN checklist. Structural validity was examined by splitting the sample and conducting exploratory factor analysis on one half and confirmatory factor analysis on the other half. Convergent validity was examined through associations with self-report measures and objective physical performance tests. Reference scores for the TSK were calculated. RESULTS After translation, all respondents felt confident that they understood the meaning of the items. All but one found the questionnaire acceptable. The exploratory factor analysis suggested that a 1-factor 13-item version without 4 reversed items resulted in the most consistent fit across subgroups of gender, age, and severe pain report. Five different models of the TSK were tested in the confirmatory factor analysis. While none were excellent fits, both one- and two-factor models of the TSK-13 and TSK-11 were acceptable. Two-factor models marginally outperformed one-factor models on goodness of fit. There was no association between TSK scores and muscular fitness or self-reported physical activity. Cardiorespiratory fitness, self-perceived physical fitness, and self-efficacy had weak correlations with TSK scores. Scores showed modest associations with self-report measures of anxiety, illness worry, pain interference, and daily limitations. CONCLUSIONS Based on an overall consideration of results, we recommend using the TSK-13 as a one-dimensional construct for both research and clinical purposes pending further examinations of the TSK in clinical samples. TSK scores from the present study can serve as a standard of reference for levels of Kinesiophobia in the general population.
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Affiliation(s)
- Majbritt Mostrup Pedersen
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
| | - Tina Birgitte Wisbech Carstensen
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Eva Ørnbøl
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Per Fink
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - Torben Jørgensen
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thomas Meinertz Dantoft
- Centre for Clinical Research and Prevention, Bispebjerg/Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
| | - Lisbeth Frostholm
- The Research Clinic for Functional Disorders, Aarhus University Hospital, Palle Juul Jensens Boulevard 11, 8200, Aarhus N, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
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Tolonen H, Reinikainen J, Zhou Z, Härkänen T, Männistö S, Jousilahti P, Paalanen L, Lundqvist A, Laatikainen T. Development of non-communicable disease risk factors in Finland: projections up to 2040. Scand J Public Health 2023; 51:1231-1238. [PMID: 35891611 PMCID: PMC10642220 DOI: 10.1177/14034948221110025] [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: 03/10/2022] [Revised: 05/19/2022] [Accepted: 06/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Non-communicable diseases are a major cause of mortality and morbidity worldwide. They share the same behavioural risk factors (smoking, sedentary behaviour, alcohol consumption and an unhealthy diet), all of which are modifiable risk factors, and biological consequences (hypertension, elevated total cholesterol, obesity and diabetes). METHODS Using data from a series of cross-sectional health examination surveys conducted among the adult population in Finland from 1997 to 2017, a projection of risk factor development (smoking, leisure time sedentary behaviour, hypertension, elevated total cholesterol, overweight and obesity, and diabetes) up to the year 2040 was made. The projections were estimated using a multiple imputation method. RESULTS Smoking prevalence is estimated to continue to decline up to 2040, similar to hypertension and elevated total cholesterol. By contrast, obesity and diabetes will develop unfavourably, with an increase in prevalence. The increase in obesity is mainly due to polarisation - that is, normal-weight people remain of a normal weight, but overweight people tend to gain more weight and become obese. The observed and estimated changes for leisure time sedentary lifestyle were not statistically significant. CONCLUSIONS Projections of risk factors for non-communicable diseases are needed to guide public health policies and programmes, decision-making and the allocation of health care resources for prevention and care. In Finland, favourable developments have been seen in many of the risk factors, but obesity and diabetes show unfavourable development. There is a need to continue regular, systematic monitoring of the development of risk factors through health examination surveys and to set national goals and programmes to tackle the existing problems.
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Affiliation(s)
- Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Jaakko Reinikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Zhi Zhou
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Tommi Härkänen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Satu Männistö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Laura Paalanen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Annamari Lundqvist
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
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Herrera-Espejel PS, Rach S. The Use of Machine Translation for Outreach and Health Communication in Epidemiology and Public Health: Scoping Review. JMIR Public Health Surveill 2023; 9:e50814. [PMID: 37983078 PMCID: PMC10696499 DOI: 10.2196/50814] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Culturally and linguistically diverse groups are often underrepresented in population-based research and surveillance efforts, leading to biased study results and limited generalizability. These groups, often termed "hard-to-reach," commonly encounter language barriers in the public health (PH) outreach material and information campaigns, reducing their involvement with the information. As a result, these groups are challenged by 2 effects: the medical and health knowledge is less tailored to their needs, and at the same time, it is less accessible for to them. Modern machine translation (MT) tools might offer a cost-effective solution to PH material language accessibility problems. OBJECTIVE This scoping review aims to systematically investigate current use cases of MT specific to the fields of PH and epidemiology, with a particular interest in its use for population-based recruitment methods. METHODS PubMed, PubMed Central, Scopus, ACM Digital Library, and IEEE Xplore were searched to identify articles reporting on the use of MT in PH and epidemiological research for this PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews)-compliant scoping review. Information on communication scenarios, study designs and the principal findings of each article were mapped according to a settings approach, the World Health Organization monitoring and evaluation framework and the service readiness level framework, respectively. RESULTS Of the 7186 articles identified, 46 (0.64%) were included in this review, with the earliest study dating from 2009. Most of the studies (17/46, 37%) discussed the application of MT to existing PH materials, limited to one-way communication between PH officials and addressed audiences. No specific article investigated the use of MT for recruiting linguistically diverse participants to population-based studies. Regarding study designs, nearly three-quarters (34/46, 74%) of the articles provided technical assessments of MT from 1 language (mainly English) to a few others (eg, Spanish, Chinese, or French). Only a few (12/46, 26%) explored end-user attitudes (mainly of PH employees), whereas none examined the legal or ethical implications of using MT. The experiments primarily involved PH experts with language proficiencies. Overall, more than half (38/70, 54% statements) of the summarizing results presented mixed and inconclusive views on the technical readiness of MT for PH information. CONCLUSIONS Using MT in epidemiology and PH can enhance outreach to linguistically diverse populations. The translation quality of current commercial MT solutions (eg, Google Translate and DeepL Translator) is sufficient if postediting is a mandatory step in the translation workflow. Postediting of legally or ethically sensitive material requires staff with adequate content knowledge in addition to sufficient language skills. Unsupervised MT is generally not recommended. Research on whether machine-translated texts are received differently by addressees is lacking, as well as research on MT in communication scenarios that warrant a response from the addressees.
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Affiliation(s)
- Paula Sofia Herrera-Espejel
- Department Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Leibniz ScienceCampus Digital Public Health, Bremen, Germany
| | - Stefan Rach
- Department Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Leibniz ScienceCampus Digital Public Health, Bremen, Germany
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Wright L, Staatz CB, Silverwood RJ, Bann D. Trends in the ability of socioeconomic position to predict individual body mass index: an analysis of repeated cross-sectional data, 1991-2019. BMC Med 2023; 21:434. [PMID: 37957618 PMCID: PMC10644438 DOI: 10.1186/s12916-023-03103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/04/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND The widening of group-level socioeconomic differences in body mass index (BMI) has received considerable research attention. However, the predictive power of socioeconomic position (SEP) indicators at the individual level remains uncertain, as does the potential temporal variation in their predictive value. Examining this is important given the increasing incorporation of SEP indicators into predictive algorithms and calls to reduce social inequality to tackle the obesity epidemic. We thus investigated SEP differences in BMI over three decades of the obesity epidemic in England, comparing population-wide (SEP group differences in mean BMI) and individual-level (out-of-sample prediction of individuals' BMI) approaches to understanding social inequalities. METHODS We used repeated cross-sectional data from the Health Survey for England, 1991-2019. BMI (kg/m2) was measured objectively, and SEP was measured via educational attainment, occupational class, and neighbourhood index of deprivation. We ran random forest models for each survey year and measure of SEP adjusting for age and sex. RESULTS The mean and variance of BMI increased within each SEP group over the study period. Mean differences in BMI by SEP group also increased: differences between lowest and highest education groups were 1.0 kg/m2 (0.4, 1.6) in 1991 and 1.3 kg/m2 (0.7, 1.8) in 2019. At the individual level, the predictive capacity of SEP was low, though increased in later years: including education in models improved predictive accuracy (mean absolute error) by 0.14% (- 0.9, 1.08) in 1991 and 1.05% (0.18, 1.82) in 2019. Similar patterns were obtained for occupational class and neighbourhood deprivation and when analysing obesity as an outcome. CONCLUSIONS SEP has become increasingly important at the population (group difference) and individual (prediction) levels. However, predictive ability remains low, suggesting limited utility of including SEP in prediction algorithms. Assuming links are causal, abolishing SEP differences in BMI could have a large effect on population health but would neither reverse the obesity epidemic nor reduce much of the variation in BMI.
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Affiliation(s)
- Liam Wright
- Centre for Longitudinal Studies, Social Research Institute, University College London, 55-59 Gordon Square, London, WC1H 0NT, UK.
| | - Charis Bridger Staatz
- Centre for Longitudinal Studies, Social Research Institute, University College London, 55-59 Gordon Square, London, WC1H 0NT, UK
| | - Richard J Silverwood
- Centre for Longitudinal Studies, Social Research Institute, University College London, 55-59 Gordon Square, London, WC1H 0NT, UK
| | - David Bann
- Centre for Longitudinal Studies, Social Research Institute, University College London, 55-59 Gordon Square, London, WC1H 0NT, UK
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Schulmeyer CE, Beckmann MW, Fasching PA, Häberle L, Golcher H, Kunath F, Wullich B, Emons J. Improving the Quality of Care for Cancer Patients through Oncological Second Opinions in a Comprehensive Cancer Center: Feasibility of Patient-Initiated Second Opinions through a Health-Insurance Service Point. Diagnostics (Basel) 2023; 13:3300. [PMID: 37958196 PMCID: PMC10647700 DOI: 10.3390/diagnostics13213300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND To improve the quality and cost-effectiveness of care, cancer patients can obtain a second medical opinion on their treatment. Validation of the diagnostic procedure (e.g., imaging), diagnosis, and treatment recommendation allows oncological therapy to be applied in a more targeted way, optimizing interdisciplinary care. This study describes patients who received second opinions at the Comprehensive Cancer Center for Erlangen-Nuremberg metropolitan area in Germany over a 6-year period, as well as the amount of time spent on second-opinion counseling. METHODS This prospective, descriptive, single-center observational study included 584 male and female cancer patients undergoing gynecological, urologic, or general surgery who sought a second medical opinion. The extent to which the first opinion complied with standard guidelines was assessed solely descriptively. RESULTS The first opinion was in accordance with the guidelines and complete in 54.5% of the patients, and guideline compliant but incomplete in 13.2%. The median time taken to form a second opinion was 225 min, and the cancer information service was contacted by patients an average of eight times. CONCLUSIONS The initial opinion was guideline compliant and complete in every second case. Without a second opinion, the remaining patients would have been denied a guideline-compliant treatment recommendation. Obtaining a second opinion gives patients an opportunity to receive a guideline-compliant treatment recommendation and enables them to benefit from newer, individualized therapeutic approaches in clinical trials. Establishing patient-initiated second opinions via central contact points appears to be a feasible option for improving guideline compliance.
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Affiliation(s)
- Carla E. Schulmeyer
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany
| | - Lothar Häberle
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany
- Biostatistics Unit, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany
| | - Henriette Golcher
- Department of Surgery, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany
| | - Frank Kunath
- Department of Urology, Klinikum Bayreuth GmbH, 95445 Bayreuth, Germany
| | - Bernd Wullich
- Department of Urology and Pediatric Urology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany;
| | - Julius Emons
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen–Nuremberg, 91054 Erlangen, Germany
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Chen C, Shi X, Lisabeth LD, Kwicklis M, Malvitz M, Case E, Morgenstern LB. Mexican Americans agree to participate in longitudinal clinical research more than non-Hispanic whites. BMC Public Health 2023; 23:2060. [PMID: 37864242 PMCID: PMC10589976 DOI: 10.1186/s12889-023-16998-6] [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: 06/13/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The National Institutes of Health has advocated for improved minority participation in clinical research, including clinical trials and observational epidemiologic studies since 1993. An understanding of Mexican Americans (MAs) participation in clinical research is important for tailoring recruitment strategies and enrollment techniques for MAs. However, contemporary data on MA participation in observational clinical stroke studies are rare. We examined differences between Mexican Americans (MAs) and non-Hispanic whites (NHWs) participation in a population-based stroke study. METHODS We included 3,594 first ever stroke patients (57.7% MAs, 48.7% women, median [IQR] age 68 [58-79]) from the Brain Attack Surveillance in Corpus Christi Project, 2009-2020 in Texas, USA, who were approached and invited to participate in a structured baseline interview. We defined participation as completing a baseline interview by patient or proxy. We used log-binomial models adjusting for prespecified potential confounders to estimate prevalence ratios (PR) of participation comparing MAs with NHWs. We tested interactions of ethnicity with age or sex to examine potential effect modification in the ethnic differences in participation. We also included an interaction between year and ethnicity to examine ethnic-specific temporal trends in participation. RESULTS Baseline participation was 77.0% in MAs and 64.2% in NHWs (Prevalence Ratio [PR] 1.20; 95% CI, 1.14-1.25). The ethnic difference remained after multivariable adjustment (1.17; 1.12-1.23), with no evidence of significant effect modification by age or sex (Pinteraction by age = 0.68, Pinteraction by sex = 0.83). Participation increased over time for both ethnic groups (Ptrend < 0.0001), but the differences in participation between MAs and NHWs remained significantly different throughout the 11-year time period. CONCLUSION MAs were persistently more likely to participate in a population-based stroke study in a predominantly MA community despite limited outreach efforts towards MAs during study enrollment. This finding holds hope for future research studies to be inclusive of the MA population.
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Affiliation(s)
- Chen Chen
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Xu Shi
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Lynda D Lisabeth
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Madeline Kwicklis
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Madelyn Malvitz
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Erin Case
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Lewis B Morgenstern
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA.
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Philipson A, Hagberg L, Hermansson L, Karlsson J, Ohlsson-Nevo E, Ryen L. Mapping the World Health Organization Disability Assessment Schedule (WHODAS 2.0) onto SF-6D Using Swedish General Population Data. PHARMACOECONOMICS - OPEN 2023; 7:765-776. [PMID: 37322384 PMCID: PMC10471532 DOI: 10.1007/s41669-023-00425-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Mapping algorithms can be used for estimating quality-adjusted life years (QALYs) when studies apply non-preference-based instruments. In this study, we estimate a regression-based algorithm for mapping between the World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the preference-based instrument SF-6D to obtain preference estimates usable in health economic evaluations. This was done separately for the working and non-working populations, as WHODAS 2.0 discriminates between these groups when estimating scores. METHODS Using a dataset including 2258 participants from the general Swedish population, we estimated the statistical relationship between SF-6D and WHODAS 2.0. We applied three regression methods, i.e., ordinary least squares (OLS), generalized linear models (GLM), and Tobit, in mapping onto SF-6D from WHODAS 2.0 at the overall-score and domain levels. Root mean squared error (RMSE) and mean absolute error (MAE) were used for validation of the models; R2 was used to assess model fit. RESULTS The best-performing models for both the working and non-working populations were GLM models with RMSE ranging from 0.084 to 0.088, MAE ranging from 0.068 to 0.071, and R2 ranging from 0.503 to 0.608. When mapping from the WHODAS 2.0 overall score, the preferred model also included sex for both the working and non-working populations. When mapping from the WHODAS 2.0 domain level, the preferred model for the working population included the domains mobility, household activities, work/study activities, and sex. For the non-working population, the domain-level model included the domains mobility, household activities, participation, and education. CONCLUSIONS It is possible to apply the derived mapping algorithms for health economic evaluations in studies using WHODAS 2.0. As conceptual overlap is incomplete, we recommend using the domain-based algorithms over the overall score. Different algorithms must be applied depending on whether the population is working or non-working, due to the characteristics of WHODAS 2.0.
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Affiliation(s)
- Anna Philipson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden.
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Liselotte Hermansson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Jan Karlsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Emma Ohlsson-Nevo
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Linda Ryen
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
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Wright E, Pagliaro C, Page IS, Diminic S. A review of excluded groups and non-response in population-based mental health surveys from high-income countries. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1265-1292. [PMID: 37212903 PMCID: PMC10423166 DOI: 10.1007/s00127-023-02488-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/30/2023] [Indexed: 05/23/2023]
Abstract
National mental health surveys play a critical role in determining the prevalence of mental disorders in a population and informing service planning. However, current surveys have important limitations, including the exclusion of key vulnerable groups and increasing rates of non-response. This review aims to synthesise information on excluded and undersampled groups in national mental health surveys. We conducted a targeted review of nationally representative adult mental health surveys performed between 2005 and 2019 in high-income OECD countries. Sixteen surveys met our inclusion criteria. The response rate for included surveys ranged between 36.3% and 80.0%. The most frequently excluded groups included people who were homeless, people in hospitals or health facilities and people in correctional facilities. Males and young people were the most commonly underrepresented groups among respondents. Attempts to collect data from non-responders and excluded populations were limited, but suggest that mental health status differs among some of these cohorts. The exclusion of key vulnerable groups and high rates of non-response have important implications for interpreting and using the results of national mental health surveys. Targeted supplementary surveys of excluded or hard-to-reach populations, more inclusive sampling methodologies, and strategies aimed at improving response rates should be considered to strengthen the accuracy and usefulness of survey findings.
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Affiliation(s)
- Eryn Wright
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia.
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia.
| | - Claudia Pagliaro
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
| | - Imogen S Page
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Herston, Qld, 4006, Australia
- Queensland Centre for Mental Health Research, Locked Bag 500, Archerfield, Qld, 4108, Australia
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Kumari M, Andrayas A, Al Baghal T, Burton J, Crossley TF, Jones KS, Parkington DA, Koulman A, Benzeval M. A randomised study of nurse collected venous blood and self-collected dried blood spots for the assessment of cardiovascular risk factors in the Understanding Society Innovation Panel. Sci Rep 2023; 13:13008. [PMID: 37563249 PMCID: PMC10415328 DOI: 10.1038/s41598-023-39674-6] [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: 02/16/2023] [Accepted: 07/28/2023] [Indexed: 08/12/2023] Open
Abstract
Dried blood spot (DBS) sample collection has been suggested as a less invasive, cheaper and more convenient alternative to venepuncture, which requires trained personnel, making it a potentially viable approach for self-collection of blood on a large scale. We examine whether participants in a longitudinal survey were willing to provide a DBS sample in different interview settings, and how resulting cardiovascular risk biomarkers compared with those from venous blood to calculate clinical risk. Participants of the Understanding Society Innovation Panel, a representative sample of UK households, were randomly assigned to three modes of interview. Most participants (84%) were interviewed in their allocated mode. Participants (n = 2162) were interviewed by a nurse who collected both a blood sample by venepuncture and a DBS card ('nurse collection') or participants were seen by an interviewer or took part in the survey online to self-collect a DBS card ('self-collection'). All DBS cards were returned in the post after the sample had dried. Lipids (total cholesterol, HDL-cholesterol, triglycerides), HbA1c and C-reactive protein were measured in venous and DBS samples and equivalence was calculated. The resultant values were used to confirm equivalent prevalence of risk of cardiovascular disease in each type of blood sample by mode of participation. Of participants interviewed by a nurse 69% consented to venous blood sample and 74% to a DBS sample, while in the self-collection modes, 35% consented to DBS collection. Demographic characteristics of participants in self-collection mode was not different to those in nurse collection mode. The percentage of participants with clinically raised biomarkers did not significantly differ between type of blood collection (for example, 62% had high cholesterol (> 5 mmol/l) measured by venepuncture and 67% had high cholesterol within the self-collected DBS sample (p = 0.13)). While self-collected DBS sampling had a lower response rate to DBS collected by a nurse, participation did not vary by key demographic characteristics. This study demonstrates that DBS collection is a feasible method of sample collection that can provide acceptable measures of clinically relevant biomarkers, enabling the calculation of population levels of cardiovascular disease risk.
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Affiliation(s)
- Meena Kumari
- Institute for Social and Economic Research, University of Essex, Colchester, UK.
| | - Alexandria Andrayas
- Institute for Social and Economic Research, University of Essex, Colchester, UK
- School of Life Sciences, University of Essex, Colchester, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Tarek Al Baghal
- Institute for Social and Economic Research, University of Essex, Colchester, UK
| | - Jonathan Burton
- Institute for Social and Economic Research, University of Essex, Colchester, UK
| | | | - Kerry S Jones
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Damon A Parkington
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Albert Koulman
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Michaela Benzeval
- Institute for Social and Economic Research, University of Essex, Colchester, UK
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20
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Ogunlayi F, Coleman PC, Fat LN, Mindell JS, Oyebode O. Trends in socioeconomic inequalities in behavioural non-communicable disease risk factors: analysis of repeated cross-sectional health surveys in England between 2003 and 2019. BMC Public Health 2023; 23:1442. [PMID: 37501159 PMCID: PMC10375601 DOI: 10.1186/s12889-023-16275-6] [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: 09/26/2022] [Accepted: 07/09/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Previous studies have shown that those in lower socioeconomic positions (SEPs) generally have higher levels of behavioural non-communicable disease (NCD) risk factors. However, there are limited studies examining recent trends in inequalities. This study examined trends in socioeconomic inequalities in NCD behavioural risk factors and their co-occurrence in England from 2003-19. METHODS This time-trend analysis of repeated cross-sectional data from the Health Survey for England examined the relative index of inequalities (RII) and slope index of inequalities (SII) in four NCD behavioural risk factors: smoking; drinking above recommended limits; insufficient fruit and vegetables consumption; and physical inactivity. FINDINGS Prevalence of risk factors has reduced over time, however, this has not been consistent across SEPs. Absolute and relative inequalities increased for physical inactivity; relative inequalities also increased for smoking; for insufficient fruit and vegetable consumption, the trends in inequalities depended on SEPs measure. Those in lower SEPs experienced persistent socioeconomic inequalities and clustering of behavioural risk factors. In contrast, those in higher SEPs had higher prevalence of excessive alcohol consumption; this inequality widened over the study period. INTERPRETATION Inequalities in smoking and physical inactivity are persisting or widening. The pattern of higher drinking in higher SEPs obscure the fact that the greatest burden of alcohol-related harm falls on lower SEPs. Policy attention is required to tackle increasing inequalities in smoking prevalence, low fruit and vegetable consumption and physical inactivity, and to reduce alcohol harm.
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Affiliation(s)
- Fatai Ogunlayi
- University of Warwick, Warwick Medical School, Coventry, CV4 7AL, UK.
| | - Paul C Coleman
- University of Warwick, Warwick Medical School, Coventry, CV4 7AL, UK
- Centre for Food Policy, City University of London, London, EC1V 0HB, UK
| | - Linda Ng Fat
- Health and Social Surveys Group, Research Department of Epidemiology and Public Health, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Jennifer S Mindell
- Health and Social Surveys Group, Research Department of Epidemiology and Public Health, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Oyinlola Oyebode
- University of Warwick, Warwick Medical School, Coventry, CV4 7AL, UK
- Wolfson Institute of Population Health, Queen Mary University of London, London, EC1M 6BQ, UK
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21
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Margozzini P, Tolonen H, Bernabe-Ortiz A, Cuschieri S, Donfrancesco C, Palmieri L, Sanchez Romero LM, Mindell JS, Oyebode O. National Health Examination Surveys: an essential piece of the health planning puzzle. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.11.23292221. [PMID: 37503238 PMCID: PMC10370235 DOI: 10.1101/2023.07.11.23292221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
National health examination surveys (HESs) have been developed to provide important information that cannot be obtained from other sources. A HES combines information obtained by asking participants questions with biophysical measurements taken by trained field staff. They are observational studies with the highest external validity and make specific contributions to both population (public health) and individual health. Few countries have a track record of a regular wide-ranging HES, but these are the basis of many reports and scientific papers. Despite this, little evidence about HES usefulness and impact or the factors that influence HES effectiveness have been disseminated. This paper presents examples of HES contributions to society in both Europe and the Americas. We sought information by emailing a wide list of people involved in running or using national HESs across Europe and the Americas. We asked for examples of where examination data from their HES had been used in national or regional policymaking. We found multiple examples of HES data being used for agenda-setting, including by highlighting nutritional needs and identifying underdiagnosis and poor management of certain conditions. We also found many ways in which HES have been used to monitor the impact of policies and define population norms. HES data have also been used in policy formation and implementation. HES data are influential and powerful. There is need for global support, financing and networking to transfer capacities and innovation in both fieldwork and laboratory technology.
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Affiliation(s)
- Paula Margozzini
- Department of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hanna Tolonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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22
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Leung AYL, Zhang J, Chan CY, Chen X, Mao J, Jia Z, Li X, Shen J. Validation of evidence-based questionnaire for TCM syndrome differentiation of heart failure and evaluation of expert consensus. Chin Med 2023; 18:70. [PMID: 37296429 DOI: 10.1186/s13020-023-00757-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/23/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Traditional Chinese Medicine (TCM) is widely used to treat heart failure (HF). Syndrome differentiation is a unique and crucial component in TCM practice for guiding disease diagnosis and treatment strategies as well as clinical research. The major bottlenecks in TCM syndrome differentiation are the diversity of the syndrome differentiation criteria and the broad spectrum of syndrome patterns, hindering evidence-based studies for clinical research. In the present study, we aim to develop an evidence-based questionnaire for the diagnosis of HF and establish a definitive set of criteria for syndrome differentiation. METHODS We designed a TCM syndrome differentiation questionnaire for heart failure (SDQHF) based on the "TCM expert consensus for diagnosis and treatment of heart failure" (expert consensus), literature review, and various clinical guidelines. To test the reliability and efficiency of the questionnaire, we performed a large-scale multiple-center clinical trial with the recruitment of 661 HF patients. Cronbach's alpha was used to assess the internal consistency of the SDQHF. Content validity was conducted through expert review. Principal component analysis (PCA) was applied to evaluate the construct validity. We constructed a proposed model for syndrome differentiation for HF based on the PCA results. Tongue analysis was performed to verify the accuracy of syndromes derived from the proposed model and the expert consensus. An evidence-based practical questionnaire for TCM syndrome differentiation patients was developed and validated with the data from 661 HF patients. RESULTS The syndrome differentiation criteria were constructed with five syndrome elements (qi-deficiency, yang-deficiency, yin-deficiency, blood stasis, and phlegm retention). The results revealed good convergent and discriminant validity, satisfactory internal consistency, and feasibility. The significant discoveries include: (1) A total of 91% of the derived TCM syndromes from the proposed model matched with the characterized tongue images of the syndrome patterns; (2) Qi Deficiency Syndrome is the dominant syndrome pattern for HF patients, followed by Yang-Qi Deficiency Syndrome and Qi-yin deficiency Syndrome, and finally, Yin-Yang Dual Deficiency Syndrome; (3) The majority of the HF patients had the combination of Blood Stasis and Phlegm Retention Syndromes; (4) The "Yin-Yang Dual Deficiency" Syndrome was a valid syndrome for HF, suggesting that this syndrome pattern should be included in the criteria for syndrome differentiation; and (5) Through the validation of the expert consensus, several recommendations were proposed to improve the accuracy of syndrome differentiation of HF. CONCLUSIONS The proposed SDQHF and the criteria could be a reliable and valid tool for syndrome differentiation of heart failure with high accuracy. It is recommended to use the proposed model for evidence-based study on Chinese Medicine to diagnose and treat HF. TRIAL REGISTRATION NUMBER The trial was registered at the Chinese Clinical Trial Registry, http://www.chictr.org.cn . (Registration No.: ChiCTR1900021929); Date: 2019-03-16.
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Affiliation(s)
- Alice Yeuk Lan Leung
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Jialing Zhang
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Chun Yin Chan
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Xiaotong Chen
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China
| | - Jingyuan Mao
- Department of Cardiovascular Diseases, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
| | - Zhenhua Jia
- National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, China
- Hebei Yiling Hospital, Key Disciplines of State Administration of TCM for Collateral Disease, Shijiazhuang, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China
| | - Jiangang Shen
- School of Chinese Medicine, University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong, Hong SAR, People's Republic of China.
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23
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Herbenick D, Fu TC, Wasata R, Coleman E. Masturbation Prevalence, Frequency, Reasons, and Associations with Partnered Sex in the Midst of the COVID-19 Pandemic: Findings from a U.S. Nationally Representative Survey. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1317-1331. [PMID: 36575264 PMCID: PMC9794105 DOI: 10.1007/s10508-022-02505-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 05/11/2023]
Abstract
Despite well-documented individual, relational, and health benefits, masturbation has been stigmatized and is understudied compared to partnered sex. In a US nationally representative survey of adults, we aimed to: (1) assess the prevalence and frequency of participants' prior-year masturbation, (2) describe reasons people give for not masturbating, (3) describe reasons people give for masturbating, and (4) examine the association between masturbation frequency and actual/desired partnered sex frequency in the prior year. Significantly more men than women reported lifetime masturbation, past month masturbation, and greater masturbation frequency. The most frequently endorsed reasons for masturbating related to pleasure, feeling "horny," stress relief, and relaxation. The most frequently endorsed reasons for not masturbating were lack of interest, being in a committed relationship, conflict with morals or values, or being against one's religion. Among women, those who desired partnered sex much more often and a little more often were 3.89 times (95% CI: 2.98, 5.08) and 2.07 times (95% CI: 1.63, 2.62), respectively, more likely to report higher frequencies of past-year masturbation than those who desired no change in their partnered sex frequency. Among men, those who desired partnered sex much more often and a little more often were 4.40 times (95% CI: 3.41, 5.68) and 2.37 times (95% CI: 1.84, 3.06), respectively, more likely to report higher frequencies of past-year masturbation activity than those who reported that they desired no change in their current partnered sex frequency. Findings provide contemporary U.S. population-level data on patterns of adult masturbation.
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Affiliation(s)
- Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA.
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
| | - Tsung-Chieh Fu
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Ruhun Wasata
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Eli Coleman
- Department of Family Medicine and Community Health, Institute for Sexual and Gender Health, University of Minnesota Medical School, Minneapolis, MN, USA
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24
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McDiarmid S, Osman F, Sarkadi A, Durbeej N. Associations between social factors and school belonging among newcomer and non-newcomer youth in Sweden. PLoS One 2023; 18:e0280244. [PMID: 36735695 PMCID: PMC9897537 DOI: 10.1371/journal.pone.0280244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 12/26/2022] [Indexed: 02/04/2023] Open
Abstract
Feeling a sense of belonging at school is associated with important positive outcomes for youth and requires youth to engage in positive social relationships. Yet there is a limited understanding of the social factors most associated with youths' school belonging and limited evidence about whether correlates of school belonging vary for marginalized groups like newcomers compared to majority groups. Sweden provides an important context for investigation of these issues because, over the past two decades, the country has experienced an influx of asylum seekers and educational reforms that have altered the composition and functioning of Swedish secondary schools. This study addresses these gaps by (1) investigating which of eight social factors are associated with school belonging among diverse Swedish youth, and (2) examining whether newcomer status moderates the relationship between social factors and school belonging. Hierarchical regression and moderation analyses were used to analyze data from 14 to 19 year-old (n = 233) newcomers and non-newcomers in Sweden. An exploratory factor analysis revealed that the school belonging measure contained two factors: positive perceptions and negative perceptions (reverse coded). For both, stronger school belonging was associated with lower perceived ethnic discrimination. Positive perceptions of school belonging were also associated with more prosocial behaviours and lower emotional problems. Negative perceptions of school belonging were associated with more peer problems. Notably, quantity and quality of peer relationships were not associated with school belonging. There was no consistent evidence of newcomer status moderating the relationship between social factors and school belonging. These results highlight factors associated with school belonging which are modifiable and amenable to intervention or impact by policy-ethnic discrimination, prosocial behaviour, and emotional and peer problems. The absence of moderation by newcomer status suggests that school belonging interventions or related policies are likely to affect newcomer and non-newcomer students similarly.
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Affiliation(s)
- Serena McDiarmid
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Fatumo Osman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Natalie Durbeej
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- * E-mail:
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SINIKUMPU SP, JOKELAINEN J, TASANEN K, TIMONEN M, HUILAJA L. Association between Pruritus and Psychosocial Well-being: A Population-based Study among 6,809 Subjects. Acta Derm Venereol 2023; 103:adv00837. [PMID: 36598159 PMCID: PMC9885286 DOI: 10.2340/actadv.v103.2922] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/03/2022] [Indexed: 01/05/2023] Open
Abstract
Pruritus has an extensive impact on functional, social and psychosocial behaviour. The association between pruritus and psychological well-being has mostly been studied among selected patient groups, whereas population-based studies are lacking. The aim of this study was to determine the association between pruritus and insomnia, quality of life, depression and anxiety at the population level in the general population. A cross-sectional population-based study was conducted in 2012 to 2013. Study subjects (n = 6,809) belonging to the Northern Finland Birth Cohort 1966 Study participated in a large follow-up study at the age of 45-47 years. They completed an extensive health questionnaire including questions on pruritus and several previously validated questionnaires regarding symptoms of psychosocial well-being. Pruritus affected 19.9% of the study subjects weekly, being more common in women than in men (p < 0.001). A significant association was found between both localized and generalized pruritus and symptoms of insomnia, depression, anxiety and decreased quality of life. The association was seen even in those with mild psychological symptoms/insomnia, and it affected both sexes. The severity of psychological symptoms increased with increasing frequency of pruritus. In conclusion, pruritus has a multiple effect on psychosocial well-being. Physicians should consider possible psychosocial symptoms in patients with pruritus.
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Affiliation(s)
- Suvi-Päivikki SINIKUMPU
- Department of Dermatology, University Hospital of Oulu, Oulu, Finland and Medical Research Center, PEDEGO Research Group, University of Oulu
| | - Jari JOKELAINEN
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu
| | - Kaisa TASANEN
- Department of Dermatology, University Hospital of Oulu, Oulu, Finland and Medical Research Center, PEDEGO Research Group, University of Oulu
| | - Markku TIMONEN
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Laura HUILAJA
- Department of Dermatology, University Hospital of Oulu, Oulu, Finland and Medical Research Center, PEDEGO Research Group, University of Oulu
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Herbenick D, Fu TC, Patterson C. Sexual Repertoire, Duration of Partnered Sex, Sexual Pleasure, and Orgasm: Findings from a US Nationally Representative Survey of Adults. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:369-390. [PMID: 36151751 DOI: 10.1080/0092623x.2022.2126417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In a confidential U.S. nationally representative survey of 2,525 adults (1300 women, 1225 men), we examined participants' event-level sexual behaviors, predictors of pleasure and orgasm, and perceived actual and ideal duration of sex, by gender and age. Event-level kissing, cuddling, vaginal intercourse, and oral sex were prevalent. Sexual choking was more prevalent among adults under 40. While women and men reported a similar actual duration of sex, men reported a longer ideal duration. Participants with same-sex partners reported a longer ideal duration than those with other-sex partners. Finally, findings show that gendered sexual inequities related to pleasure and orgasm persist.
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Affiliation(s)
- Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Tsung-Chieh Fu
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Callie Patterson
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
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27
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Wetterberg H, Rydén L, Ahlner F, Falk Erhag H, Gudmundsson P, Guo X, Joas E, Johansson L, Kern S, Mellqvist Fässberg M, Najar J, Ribbe M, Sterner TR, Samuelsson J, Sacuiu S, Sigström R, Skoog J, Waern M, Zettergren A, Skoog I. Representativeness in population-based studies of older adults: five waves of cross-sectional examinations in the Gothenburg H70 Birth Cohort Study. BMJ Open 2022; 12:e068165. [PMID: 36526314 PMCID: PMC9764666 DOI: 10.1136/bmjopen-2022-068165] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To describe representativeness in the Gothenburg H70 1930 Birth Cohort Study. DESIGN Repeated cross-sectional examinations of a population-based study. SETTING Gothenburg, Sweden. PARTICIPANTS All residents of Gothenburg, Sweden, born on specific birth dates in 1930 were invited to a comprehensive health examination at ages 70, 75, 79, 85 and 88. The number of participants at each examination was 524 at age 70, 767 at age 75, 580 at age 79, 416 at age 85, and 258 at age 88. PRIMARY OUTCOME MEASURES We compared register data on sociodemographic characteristics and hospital discharge diagnoses between participants and (1) refusals, (2) all same-aged individuals in Gothenburg and (3) all same-aged individuals in Sweden. We also compared mortality rates between participants and refusals. RESULTS Refusal rate increased with age. At two or more examination waves, participants compared with refusals had higher educational level, more often had osteoarthritis, had lower mortality rates, had lower prevalence of neuropsychiatric, alcohol-related and cardiovascular disorders, and were more often married. At two examination waves, participants compared with same-aged individuals in Gothenburg had higher education and were more often born in Sweden. At two examination waves or more, participants compared with same-aged individuals in Sweden had higher education, had higher average income, less often had ischaemic heart disease, were less often born in Sweden and were more often divorced. CONCLUSIONS Participants were more similar to the target population in Gothenburg than to refusals and same-aged individuals in Sweden. Our study shows the importance of having different comparison groups when assessing representativeness of population studies, which is important in evaluating generalisability of results. The study also contributes unique and up-to-date knowledge about participation bias in these high age groups.
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Affiliation(s)
- Hanna Wetterberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Lina Rydén
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Felicia Ahlner
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Hanna Falk Erhag
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Pia Gudmundsson
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Xinxin Guo
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Department of Mood disorders, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Erik Joas
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Lena Johansson
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Silke Kern
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Mats Ribbe
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jessica Samuelsson
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Simona Sacuiu
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Robert Sigström
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Johan Skoog
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Psychotic Disorders, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP), University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Sulkava S, Haukka J, Sulkava R, Laatikainen T, Paunio T. Association Between Psychological Distress and Incident Dementia in a Population-Based Cohort in Finland. JAMA Netw Open 2022; 5:e2247115. [PMID: 36520436 PMCID: PMC9856411 DOI: 10.1001/jamanetworkopen.2022.47115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Symptoms of psychological distress have shown association with subsequent dementia, but the nature of association remains unclear. OBJECTIVE To examine the association of psychological distress with etiological risk of dementia and incidence of dementia in presence of competing risk of death. DESIGN, SETTING, AND PARTICIPANTS This cohort study consisted of population-based cross-sectional National FINRISK Study surveys collected in 1972, 1977, 1982, 1987, 1992, 1997, 2002, and 2007 in Finland with register-based follow-up; and the cohort was linked to Finnish Health Register data for dementia and mortality for each participant until December 31, 2017. Participants included individuals without dementia who had complete exposure data. Data were analyzed from May 2019 to April 2022. EXPOSURES Self-reported symptoms of psychological distress: stress (more than other people), depressive mood, exhaustion, and nervousness (often, sometimes, never). MAIN OUTCOMES AND MEASURES Incident all-cause dementia, ascertained through linkage to national health registers. Poisson cause-specific hazard model (emphasizing etiological risk) and Fine-Gray subdistribution hazard model (emphasizing effect on incidence) considering dementia and death without dementia as competing risks. Covariates of age, sex, baseline year, follow-up time, educational level, body mass index, smoking, diabetes, systolic blood pressure, cholesterol, and physical activity. Sensitivity analysis was performed to reduce reverse causation bias by excluding individuals with follow-up less than 10 years. RESULTS Among 67 688 participants (34 968 [51.7%] women; age range, 25 to 74 years; mean [SD] age, 45.4 years), 7935 received a diagnosis of dementia over a mean follow-up of 25.4 years (range, 10 to 45 years). Psychological distress was significantly associated with all-cause dementia in a multivariable Poisson model, with incidence rate ratios from 1.17 (95% CI, 1.08-1.26) for exhaustion to 1.24 (95% CI, 1.11-1.38) for stress, and remained significant in sensitivity analyses. A Fine-Gray model showed significant associations (with hazard ratios from 1.08 [95% CI, 1.01-1.17] for exhaustion to 1.12 [95% CI, 1.00-1.25] for stress) for symptoms other than depressive mood (hazard ratio, 1.08 [95% CI, 0.98-1.20]). All the symptoms showed significant associations with competing risk of death in both models. CONCLUSIONS AND RELEVANCE In this cohort study, psychological distress symptoms were significantly associated with increased risk of all-cause dementia in the model emphasizing etiological risk. Associations with real incidence of dementia were diminished by the competing risk of death.
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Affiliation(s)
- Sonja Sulkava
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Programme, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Clinical Genetics, Helsinki University Hospital, Helsinki, Finland
| | - Jari Haukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Raimo Sulkava
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Amia Memory Clinics, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland
| | - Tiina Paunio
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Programme, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Donfrancesco C, Di Lonardo A, Lo Noce C, Buttari B, Profumo E, Vespasiano F, Vannucchi S, Galletti F, Onder G, Gulizia MM, Galeone D, Bellisario P, Palmieri L. Trends of blood pressure, raised blood pressure, hypertension and its control among Italian adults: CUORE Project cross-sectional health examination surveys 1998/2008/2018. BMJ Open 2022; 12:e064270. [PMID: 36375969 PMCID: PMC9664280 DOI: 10.1136/bmjopen-2022-064270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess in the Italian general adult population the trends of blood pressure (BP) and prevalence of raised BP (RBP), hypertension and its control in order to evaluate population health and care, and the achievement of an RBP 25% relative reduction as recommended by the WHO at population level. DESIGN Results comparison of health examination surveys, cross-sectional observational studies based on health examination of randomly selected age and sex stratified samples including residents aged 35-74 years. Data of the 2018/2019 survey were compared with the previous ones collected in 1998/2002 and 2008/2012. SETTING Health examination surveys conducted in Italy within the CUORE Project following standardised methodologies. PARTICIPANTS 2985 men and 2955 women examined in 1998/2002, 2218 men and 2204 women examined in 2008/2012 and 1031 men and 1066 women examined in 2018/2019. PRIMARY AND SECONDARY OUTCOME MEASURES Age-standardised mean of BP, prevalence of RBP (systolic BP and/or diastolic BP ≥140/90 mm Hg), hypertension (presenting or being treated for RBP) and its awareness and control, according to sex, age class and educational level. RESULTS In 2018/2019, a significant reduction was observed in systolic BP and diastolic BP in men (1998/2002: 136/86 mm Hg; 2008/2012: 132/84 mm Hg; and 2018/2019: 132/78 mm Hg) and women (132/82 mm Hg, 126/78 mm Hg and 122/73 mm Hg), and in the prevalence of RBP (50%, 40% and 30% in men and 39%, 25% and 16% in women) and of hypertension (54%, 49% and 44% in men and 45%, 35% and 32% in women). Trends were consistent by age and education attainment. In 2018/2019, hypertensive men and women with controlled BP were only 27% and 41%, but a significant favourable trend was observed. CONCLUSIONS Data from 2018/2019 underlined that RBP is still commonly observed in the Italian population aged 35-74 years, however, the WHO RBP target at that time may be considered met.
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Affiliation(s)
- Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Anna Di Lonardo
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Cinzia Lo Noce
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Brigitta Buttari
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Elisabetta Profumo
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | | | - Serena Vannucchi
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
| | - Michele Massimo Gulizia
- National Enterprise of National Relevance and High Specialization 'Garibaldi-Nesima Hospital', Catania, Italy
- Heart Care Foundation, Florence, Italy
| | | | | | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanita', Rome, Italy
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The Relative Merits of Observational and Experimental Research: Four Key Principles for Optimising Observational Research Designs. Nutrients 2022; 14:nu14214649. [DOI: 10.3390/nu14214649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/21/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
The main barrier to the publication of observational research is a perceived inferiority to randomised designs with regard to the reliability of their conclusions. This commentary addresses this issue and makes a set of recommendations. It analyses the issue of research reliability in detail and fully describes the three sources of research unreliability (certainty, risk and uncertainty). Two of these (certainty and uncertainty) are not adequately addressed in most research texts. It establishes that randomised designs are vulnerable as observation studies to these two sources of unreliability, and are therefore not automatically superior to observational research in all research situations. Two key principles for reducing research unreliability are taken from R.A. Fisher’s early work on agricultural research. These principles and their application are described in detail. The principles are then developed into four key principles that observational researchers should follow when they are designing observational research exercises in nutrition. It notes that there is an optimal sample size for any particular research exercise that should not be exceeded. It concludes that best practice in observational research is to replicate this optimal sized observational exercise multiple times in order to establish reliability and credibility.
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Taanila H, Rönkä AR, Keinänen-Kiukaanniemi S, Jokelainen J, Nordström T, Taanila A, Hurtig T. Associations between cohort study participation and self-reported health and well-being: the Northern Finland Birth Cohort 1966 Study. J Epidemiol Community Health 2022; 76:1019-1026. [DOI: 10.1136/jech-2022-219229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/14/2022] [Indexed: 11/04/2022]
Abstract
AimThe aim of this study was to explore whether active participation in a longitudinal birth cohort study is associated with study participants’ health behaviour and well-being.MethodsThe subjects of this study were part of the Northern Finland Birth Cohort 1966. The follow-up data were collected through clinical examinations and questionnaires when the cohort members were 1, 14, 31 and 46 years old. In this study, cohort participation activity was divided into three categories: active, semiactive and least active.ResultsThe total number of study participants who participated in the 46-year follow-up on both the survey and clinical trials was 6392, of which 66.5% (n=4268) participated actively in the cohort study. A total of 67.6% were female (p<0.001). Of the participants, 23.7% (n=1519) were semiactive and 9.5% (n=605) were the least active. Women who participated least actively experienced statistically significantly more depressive symptoms and poorer health, were more dissatisfied with their lives and had more addiction problems. In men, there was not a statistically significant association between participation activity and these well-being variables other than addiction problems and mental health.ConclusionsThe findings indicate that participation activity is associated with better self-reported health and well-being, especially among women. With this knowledge, people can be encouraged to participate in longitudinal health research and, at the same time, may improve their own health and quality of life.
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Olszewski R, Obiała J, Obiała K, Owoc J, Mańczak M, Ćwiklińska K, Jabłońska M, Zegarow P, Grygielska J, Jaciubek M, Majka K, Stelmach D, Krupienicz A, Rysz J, Jeziorski K. Lost in Communication: Do Family Physicians Provide Patients with Information on Preventing Diet-Related Diseases? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10990. [PMID: 36078700 PMCID: PMC9517834 DOI: 10.3390/ijerph191710990] [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] [Received: 07/22/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Diet-related diseases remain leading causes of death in most developed countries around the world. The aim of the study was to compare opinions of patients and family physicians on receiving and providing recommendations about physical activity, diet and use of medication. Methods: The questionnaire study was conducted among patients of 36 primary health care clinics in Poland between September 2018 and February 2019. Patients and physicians were interviewed separately by trained researchers. Data from 509 patients and 167 family doctors were analyzed. Results: The median age of patients was 44 years (interquartile range: 29-55) and 70% were women. The majority of physicians were women (59%) and the median age was 37 years (IQR: 31-50). There was a significant difference between physicians' declarations on providing recommendations on diet (92% vs. 39%) and activity (90% vs. 37%) versus patients' declarations on receiving them. Conclusions: The results indicate that there is significant room for improvement in providing patients with proper recommendations on diet and physical activity by their family physicians. Primary care physicians should put more emphasis on clear communication of recommendations on diet and physical activity.
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Affiliation(s)
- Robert Olszewski
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
- Department of Ultrasound, Institute of Fundamental Technological Research, Polish Academy of Sciences, Pawinskiego 5B, 02-106 Warsaw, Poland
| | - Justyna Obiała
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Karolina Obiała
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Jakub Owoc
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Małgorzata Mańczak
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Klaudia Ćwiklińska
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Magdalena Jabłońska
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Banacha 1a, 02-091 Warsaw, Poland
| | - Paweł Zegarow
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Jolanta Grygielska
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Marzena Jaciubek
- Department of Fundamental of Nursing, Medical University of Warsaw, Erazma Ciołka 27, 01-445 Warsaw, Poland
| | - Katarzyna Majka
- Department of Fundamental of Nursing, Medical University of Warsaw, Erazma Ciołka 27, 01-445 Warsaw, Poland
| | - Daria Stelmach
- Students’ Scientific Group Affiliated to II Department of Obstetrics and Gynecology, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
| | - Andrzej Krupienicz
- Department of Fundamental of Nursing, Medical University of Warsaw, Erazma Ciołka 27, 01-445 Warsaw, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 92-215 Lodz, Poland
| | - Krzysztof Jeziorski
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, W.K. Roentgena 5, 02-781 Warsaw, Poland
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Lyshol H, Gil AP, Tolonen H, Namorado S, Kislaya I, Barreto M, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Dias CM. Local problem solving in the Portuguese health examination survey: a mixed method study. Arch Public Health 2022; 80:198. [PMID: 36002860 PMCID: PMC9400230 DOI: 10.1186/s13690-022-00939-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other similar health examination surveys. The objective of this article is to describe how local teams of survey personnel conducted the survey, describing strategies used to solve practical survey problems and to try to increase the participation rate.
Methods
After a literature search, informal interviews were conducted with 14 public health officials from local health examination teams, regional and central authorities. Forty-one of the local staff members (survey personnel) also filled in a short questionnaire anonymously. The interviews and self-administered questionnaires were analysed using mixed methods, informed by thematic analysis.
Results
The local teams believed that the detailed manual, described as a “cookbook for making a health examination survey”, made it possible to maintain high scientific standards while allowing for improvising solutions to problems in the local context. The quality of the manual, supported by a series of training workshops with the central research and support team, gave the teams the confidence and knowledge to implement local solutions. Motivation and cohesion within the local teams were among the goals of the training process.
Local teams felt empowered by being given large responsibilities and worked hard to incite people to attend the examination through a close and persuasive approach.
Local teams praised their INSA contacts for being available for assistance throughout the survey, and said they were inspired to try harder to reach participants to please their contacts for interpersonal reasons.
Conclusions
The theory of organizational improvisation or bricolage, which means using limited resources to solve problems, was useful to discuss and understand what took place during INSEF.
A detailed manual covering standard procedures, continuous monitoring of the data collection and face-to-face workshops, including role-play, were vital to assure high scientific standards and high participation rates in this health examination survey. Close contacts between the central team and local focal points in all regions and all survey sites were key to accommodating unexpected challenges and innovative solutions.
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Sharma P, Dhami A, Dhami NB, Dhami GS. Comparison of patient satisfaction with red-free (green) versus yellow light using binocular indirect ophthalmoscope for retinal examination. Indian J Ophthalmol 2022; 70:2038-2040. [PMID: 35647977 PMCID: PMC9359221 DOI: 10.4103/ijo.ijo_3079_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Comparison of patient satisfaction with red-free (green) versus yellow light using binocular indirect ophthalmoscope for retinal examination. Methods This is an observational questionnaire-based study of 100 myopes in the age group of 18-40 years coming for a routine check-up or for refractive surgery workup. The examination was done using an indirect ophthalmoscope and a 20D lens with green or yellow light and was assigned in two groups randomly using the coin toss method, following which, a questionnaire was used to assess the following parameters: a) level of comfort, b) any complaints of discomfort during examination, d) preference of the used light source in future, e) grading of discomfort on a linear scale, and f) patient cooperation and duration of examination. Results Patients were randomized for observation with IDO using either green light (n = 55) or yellow light (n = 45) filter. In the study, 46 patients (83.6%) were very comfortable and only 9 patients (16.4%) experienced mild discomfort when using red-free (green) light, while only 3 patients (6.7%) were very comfortable and 31 (68.9%) had mild discomfort when using yellow light. The complaints of watering with yellow and green light were noted in 36 patients (80.0%) and 15 patients (27.3%), pain in 13 patients (28.9%) and 3 patients (5.5%), light sensitivity in 29 patients (64.4%) and 4 patients (7.3%), respectively, all being significantly more in yellow light category (P < 0.001). The time of examination was significantly more in yellow light category with 83 ± 10.75 seconds (P < 0.001). Conclusion Retinal examination using the green filter of indirect ophthalmoscope is more comfortable in examining the patients as compared to routine yellow light with decreased number of complaints, lesser examination time, and better patient cooperation.
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Affiliation(s)
- Pragya Sharma
- Medical Retina Services, Dhami Eye Care Hospital, Ludhiana, Punjab, India
| | - Abhinav Dhami
- Retina and Cataract Services, Dhami Eye Care Hospital, Ludhiana, Punjab, India,Correspondence to: Dr. Abhinav Dhami, Consultant Vitreo-Retina, Dhami Eye Care Hospital, 82-B Kitchlu Nagar, Ludhiana, Punjab - 141 001, India. E-mail:
| | - Nimrata B Dhami
- Cornea and Refractive Services, Dhami Eye Care Hospital, Ludhiana, Punjab, India
| | - Gobinder S Dhami
- Cataract and Refractive Services, Dhami Eye Care Hospital, Ludhiana, Punjab, India
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De Leefstijlmonitor: Cijfers voor gezondheidsbeleid. TSG - TIJDSCHRIFT VOOR GEZONDHEIDSWETENSCHAPPEN 2022; 100:98-106. [PMID: 35582661 PMCID: PMC9101986 DOI: 10.1007/s12508-022-00349-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/01/2022]
Abstract
SamenvattingIn 2013 is in opdracht van het Ministerie van Volksgezondheid, Welzijn en Sport de Leefstijlmonitor (LSM) gestart om de gegevensverzameling op het gebied van leefstijl in Nederland efficiënter en meer samenhangend te organiseren om te komen tot eenduidige cijfers voor gezondheidsbeleid. Dit artikel beschrijft het ontstaan, de verschillende onderdelen en de thema’s van de LSM, en de taken en rollen van de samenwerkende partijen. Daarnaast beschrijft het hoe de gegevens verzameld worden en waar de gegevensverzamelingen op te vragen zijn voor onderzoek. Tot slot bevat het enkele voorbeelden van cijfers en trends over de periode 2014–2020 ter ondersteuning van gezondheidsbeleid.
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Tolonen H, Moore S, Lermen D, Virgolino A, Knudsen LE, Andersson AM, Rambaud L, Ancona C, Kolossa-Gehring M. What is required to combine human biomonitoring and health surveys? Int J Hyg Environ Health 2022; 242:113964. [DOI: 10.1016/j.ijheh.2022.113964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/17/2022]
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Trends of overweight, obesity and anthropometric measurements among the adult population in Italy: The CUORE Project health examination surveys 1998, 2008, and 2018. PLoS One 2022; 17:e0264778. [PMID: 35231070 PMCID: PMC8887738 DOI: 10.1371/journal.pone.0264778] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/16/2022] [Indexed: 12/23/2022] Open
Abstract
Background/Objectives Obesity is associated with an increased risk of noncommunicable diseases, such as diabetes, coronary heart disease, stroke, cancers, and conditions, including obstructive sleep apnea and osteoarthritis. Obesity is largely preventable, and halting its rise is one of the World Health Organization Global Action Plan for the Prevention of Noncommunicable Diseases targets. This study aimed to assess trends of anthropometric measurements in Italy using the data collected within the CUORE Project health examination surveys (HESs) 1998, 2008, and 2018. Subjects/Methods Within the HESs 1998–2002, 2008–2012, and 2018–2019, anthropometric measurements were collected in random samples of the resident population aged 35–74 years, stratified by age and sex, from 10 Italian Regions in Northern, Central, and Southern Italy (2984 men and 2944 women, 2224 men and 2188 women, 1035 men and 1065 women, respectively). Weight, height, and waist and hip circumferences were measured using standardized methodologies. A standardized questionnaire was used to collect data on education. Indicators were age standardized. Results For both men and women, mean body mass index in 2018 was comparable with those in 1998 and 2008 (in 1998, 2008, and 2018—men: 26.7, 27.5, and 27.0 kg/m2; women: 26.2, 26.6, and 26.3 kg/m2). In 1998, 2008, 2018 prevalence of overweight resulted 49%, 47%, 46% in men and 33%, 32%, 28% in women respectively; prevalence of obesity resulted 17%, 24% 20% in men and 19%, 23%, 23% in women respectively. All indicators of excess weight worsen with increasing age and are more severe in persons with a lower educational level. Conclusions Although the overall trend of excess weight over the past two decades appeared to be substantially stable in the Italian adult population, the continuous strengthening of undertaken initiatives should continue since there remains a high proportion of overweight or obesity and a gap between educational levels.
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Rysstad T, Grotle M, Aasdahl L, Hill JC, Dunn KM, Tingulstad A, Tveter AT. Stratifying workers on sick leave due to musculoskeletal pain: translation, cross-cultural adaptation and construct validity of the Norwegian Keele STarT MSK tool. Scand J Pain 2022; 22:325-335. [PMID: 35148473 DOI: 10.1515/sjpain-2021-0144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Stratified care using prognostic models to estimate the risk profiles of patients has been increasing. A refined version of the popular STarT Back tool, the Keele STarT MSK tool, is a newly developed model for matched treatment across a wide range of musculoskeletal pain presentations. The aim of this study was to translate and culturally adapt the Keele STarT MSK tool into Norwegian, examine its construct validity and assess the representativeness of the included sample. METHODS The Keele STarT MSK tool was formally translated into Norwegian following a multistep approach of forward and backward translation. A pre-final version was tested in 42 patients. Minor changes were implemented. To assess its construct validity, an online survey was conducted among workers aged 18-67 years who were on sick leave (>4 weeks) due to musculoskeletal disorders. Construct validity was evaluated in terms of convergent and discriminant validity using Pearson's correlation coefficient, and known-group validity by comparing risk subgroups as suggested by the COSMIN checklist. The representativeness of the sample was assessed by comparing demographic and sick leave information of participants to eligible non-participants (n=168,137). RESULTS A representative sample of 549 workers participated in the validity assessment; 74 participants (13.5%) were categorised as low risk, 314 (57.2%) as medium risk and 161 (29.3%) as high risk. The construct validity was found sufficient, with 90.9% and 75.0% of the pre-defined hypotheses confirmed for convergent and discriminant validity, and known-group validity, respectively. Floor or ceiling effects were not found. CONCLUSIONS The Keele STarT MSK tool was successfully translated into Norwegian. The construct validity of the tool was acceptable in a representative cohort of workers on sick leave as a result of musculoskeletal pain. However, the analyses raised concerns as to whether one of the questions captures the construct it is intended to measure.
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Affiliation(s)
- Tarjei Rysstad
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Research- and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Jonathan C Hill
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Kate M Dunn
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Alexander Tingulstad
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anne Therese Tveter
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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France CR, France JL, Himawan LK. What would it take to convince you to donate? A survey study of the relationship between motivators, barriers, and payment for whole blood, plasma, and platelet donation. Transfusion 2022; 62:1251-1260. [PMID: 35467768 PMCID: PMC9322277 DOI: 10.1111/trf.16886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 01/05/2023]
Abstract
Background With growing discussion about blood donor remuneration, the present study examined the level of payment that may be required to convince individuals to engage in whole blood, plasma, and platelet donations. Study Design and Methods Anonymous online surveys were completed by a college sample [n = 490; 76.9% female; Mean Age = 20.3 (SD = 4.9) years; 32.9% whole blood donors] and a ResearchMatch sample [n = 323; 70.6% female; Mean Age = 50.7 (SD = 16.6) years; 82.7% whole blood donors]. Level of payment needed to motivate whole blood, plasma, and platelet donation was examined as a function of donation history, sample, and gender. In addition, path analyses examined associations between donation motivators, barriers, and payment level. Results Across all types of donation, history of whole blood donation was related to a greater willingness to donate without payment. At the same time, however, sizeable portions of prior donors indicated that monetary payment would convince them to donate whole blood (24%), plasma (51%), or platelets (57%). Across all types of donation, donation‐related barriers (i.e., anxiety, fear) were indirectly related to higher payment levels via lower self‐efficacy and more negative donation attitudes. Donation‐related motivators (i.e., warm glow, regret, and altruism) were indirectly related to lower payment levels via higher self‐efficacy and more positive donation attitudes. Conclusion Despite reporting a strong commitment to nonremunerated blood donation, many respondents with and without a history of blood donation indicated that money would convince them to engage in whole blood, plasma, and platelet donation.
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Affiliation(s)
| | - Janis L France
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Lina K Himawan
- Department of Psychology, Ohio University, Athens, Ohio, USA
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40
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Survey response in colorectal surgery.A systematic review. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Sheng JY, Skuli SJ, Thorner ED, Zafman N, Riley CD, Ruck JM, Smith KC, Snyder C, Smith KL, Stearns V, Wolff AC. Late effects in a high-risk population of breast cancer survivors. Support Care Cancer 2022; 30:1749-1757. [PMID: 34586509 PMCID: PMC8732297 DOI: 10.1007/s00520-021-06597-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/26/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To better understand the impact of cancer and treatment on outcomes and guide program development, we evaluated breast cancer survivors at risk for long-term medical and psychosocial issues who participated in survivorship care visits (SVs) at Johns Hopkins Hospital. METHODS We conducted a prospective survey study of women with stage I-III breast cancer who participated in SVs from 2010-2016. The same 56-item questionnaire administered at SV and follow-up included an assessment of symptoms, social factors, demographics, anxiety, depression, and comorbidities. We added the Godin Exercise questionnaire to the follow-up. RESULTS In 2018, 74 participants were identified as disease-free and mailed a follow-up survey; 52 (70.3%) completed the survey. At a median follow-up time of 3.1 years after diagnosis, participants were less likely to be employed (54% vs. 67%) than at the SV. About two-thirds were sedentary, and this was associated with high body mass index (p = 0.02). Sufficiently active participants (≥ 150 min per week of moderate-intensity activity) were less likely to report pain (p = 0.02) or fatigue (p = 0.001). Although 19% had moderate/severe anxiety or depression at follow-up, participants who reported employment satisfaction were less likely to be depressed (p = 0.02). CONCLUSIONS Awareness of issues faced by survivors is critical for enhancing care and developing models to identify patients who might benefit most from targeted long-term interventions. IMPLICATIONS FOR CANCER SURVIVORS Interventions to address physical activity, persistent symptoms, and mental health are critical for breast cancer survivors.
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Affiliation(s)
- Jennifer Y Sheng
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA.
| | - Sarah J Skuli
- Department of Medicine, The Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Elissa D Thorner
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
| | - Nelli Zafman
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
| | - Carol D Riley
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
| | - Jessica M Ruck
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Katherine C Smith
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
- The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Claire Snyder
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
- The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen L Smith
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
| | - Vered Stearns
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
| | - Antonio C Wolff
- School of Medicine, The Johns Hopkins University, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, Baltimore, MD, USA
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Heinonen N, Lallukka T, Lahti J, Pietiläinen O, Nordquist H, Mänty M, Katainen A, Kouvonen A. Working Conditions and Long-Term Sickness Absence Due to Mental Disorders: A Prospective Record Linkage Cohort Study Among 19- to 39-Year-Old Female Municipal Employees. J Occup Environ Med 2022; 64:105-114. [PMID: 34723911 PMCID: PMC8812422 DOI: 10.1097/jom.0000000000002421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE We examined associations between working conditions and long-term sickness absence due to mental disorders (LTSA-MD) among younger female public sector employees from different employment sectors. METHODS Survey data collected in 2017 (n = 3048) among 19- to 39-year-old female employees of the City of Helsinki, Finland, were used to examine job demands, job control, physical workload, computer work, and covariates. Register data on LTSA-MD were used over 1-year follow-up. Negative binomial regression models were applied. RESULTS Adverse psychosocial and physical working conditions were associated with higher LTSA-MD during the follow-up. Health and social care workers had the highest number of days of LTSA-MD. CONCLUSION Working conditions are important factors when aiming to prevent LTSA-MD among younger employees, in the health and social care sector in particular.
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Affiliation(s)
- Noora Heinonen
- Faculty of Social Sciences, University of Helsinki, Finland (Heinonen, Dr Nordquist, Dr Katainen, and Dr Kouvonen); Department of Public Health, Faculty of Medicine, University of Helsinki, Finland (Dr Olli, Dr Nordquist, and Dr Mänty); South-Eastern Finland University of Applied Sciences, Kotka, Finland (Dr Nordquist); Department of Public Health, Faculty of Medicine, University of Helsinki, Finland; and Unit of strategy and research, City of Vantaa, Vantaa, Finland (Dr Mänty); Centre for Public Health, Queen's University Belfast, UK (Dr Kouvonen)
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Nordström T, Miettunen J, Auvinen J, Ala-Mursula L, Keinänen-Kiukaanniemi S, Veijola J, Järvelin MR, Sebert S, Männikkö M. Cohort Profile: 46 years of follow-up of the Northern Finland Birth Cohort 1966 (NFBC1966). Int J Epidemiol 2022; 50:1786-1787j. [PMID: 34999878 PMCID: PMC8743124 DOI: 10.1093/ije/dyab109] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 01/17/2023] Open
Grants
- GRANTS NO. 65354, 24000692 University of Oulu
- GRANTS NO. 2/97, 8/97, 24301140 Oulu University Hospital
- GRANTS NO. 23/251/97, 160/97, 190/97 National research funding via City of Oulu, Ministry of Health and Social Affairs
- GRANT NO. 54121 National Institute for Health and Welfare, Helsinki
- GRANTS NO. 50621, 54231 Regional Institute of Occupational Health
- GRANT NO. 539/2010 A31592 ERDF European Regional Development Fund
- PREcisE project and ZonMw The Netherlands no. P75416
- H2020-633595 DynaHealth, H2020-733206 LifeCycle, H2020-824989 EUCANCONNECT, H2020-873749 LongITools, H2020-848158 EarlyCause, the JPI HDHL
- National research funding via City of Oulu
- Ministry of Health and Social Affairs
- National Institute for Health and Welfare
- European Commission research and innovation program Horizon 2020 under the following projects: DynaHealth
- LifeCycle
- EUCANCONNECT
- LongITools
- EarlyCause
- Programming Initiative Healthy Diet Healthy Life (PREcisE project - ZonMw the Netherlands
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Affiliation(s)
- Tanja Nordström
- Northern Finland Birth Cohorts, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Oulunkaari Health Center, Ii, Finland
| | - Leena Ala-Mursula
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Healthcare and Social Services of Selänne, Pyhäjärvi, Finland
- Healthcare and Social Services of City of Oulu, Oulu, Finland
| | - Juha Veijola
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, University Hospital of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Sylvain Sebert
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Minna Männikkö
- Northern Finland Birth Cohorts, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
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Horvath JDC, Bessel M, Kops NL, Souza FMA, Pereira GM, Wendland EM. A Nationwide Evaluation of the Prevalence of Human Papillomavirus in Brazil (POP-Brazil Study): Protocol for Data Quality Assurance and Control. JMIR Res Protoc 2022; 11:e31365. [PMID: 34989680 PMCID: PMC8771346 DOI: 10.2196/31365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/04/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The credibility of a study and its internal and external validity depend crucially on the quality of the data produced. An in-depth knowledge of quality control processes is essential as large and integrative epidemiological studies are increasingly prioritized. OBJECTIVE This study aimed to describe the stages of quality control in the POP-Brazil study and to present an analysis of the quality indicators. METHODS Quality assurance and control were initiated with the planning of this nationwide, multicentric study and continued through the development of the project. All quality control protocol strategies, such as training, protocol implementation, audits, and inspection, were discussed one by one. We highlight the importance of conducting a pilot study that provides the researcher the opportunity to refine or modify the research methodology and validating the results through double data entry, test-retest, and analysis of nonresponse rates. RESULTS This cross-sectional, nationwide, multicentric study recruited 8628 sexually active young adults (16-25 years old) in 119 public health units between September 2016 and November 2017. The Human Research Ethics Committee of the Moinhos de Vento Hospital approved this project. CONCLUSIONS Quality control processes are a continuum, not restricted to a single event, and are fundamental to the success of data integrity and the minimization of bias in epidemiological studies. The quality control steps described can be used as a guide to implement evidence-based, valid, reliable, and useful procedures in most observational studies to ensure data integrity. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/31365.
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Affiliation(s)
- Jaqueline Driemeyer Correia Horvath
- Escritório de Projetos, Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Marina Bessel
- Escritório de Projetos, Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Natália Luiza Kops
- Escritório de Projetos, Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde, Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Flávia Moreno Alves Souza
- Department of Chronic Conditions Diseases and Sexually Transmitted Infections, Health Surveillance Secretariat, Ministry of Health, Brasília, Brazil
| | - Gerson Mendes Pereira
- Department of Chronic Conditions Diseases and Sexually Transmitted Infections, Health Surveillance Secretariat, Ministry of Health, Brasília, Brazil
| | - Eliana Marcia Wendland
- Escritório de Projetos, Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde, Hospital Moinhos de Vento, Porto Alegre, Brazil.,Department of Community Health, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Investigating change across time in prevalence or association: the challenges of cross-study comparative research and possible solutions. DISCOVER SOCIAL SCIENCE AND HEALTH 2022; 2:18. [PMID: 36317190 PMCID: PMC9613735 DOI: 10.1007/s44155-022-00021-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
UNLABELLED Cross-study research initiatives to understand change across time are an increasingly prominent component of social and health sciences, yet they present considerable practical, analytical and conceptual challenges. First, we discuss the key challenges to comparative research as a basis for detecting societal change, as well as possible solutions. We focus on studies which investigate changes across time in outcome occurrence or the magnitude and/or direction of associations. We discuss the use and importance of such research, study inclusion, sources of bias and mitigation, and interpretation. Second, we propose a structured framework (a checklist) that is intended to provide guidance for future authors and reviewers. Third, we outline a new open-access teaching resource that offers detailed instruction and reusable analytical syntax to guide newcomers on techniques for conducting comparative analysis and data visualisation (in both R and Stata formats). SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s44155-022-00021-1.
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Wierucki Ł, Kujawska-Danecka H, Mossakowska M, Grodzicki T, Błędowski P, Chudek J, Kostka T, Więcek A, Hajduk A, Bandosz P, Zagożdżon P, Wojtyniak B, Zdrojewski T. Health status and its socio-economic covariates in the older population in Poland - the assumptions and methods of the nationwide, cross-sectional PolSenior2 survey. Arch Med Sci 2022; 18:92-102. [PMID: 35154530 PMCID: PMC8826695 DOI: 10.5114/aoms.2020.100898] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/07/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Population ageing constitutes an increasing medical, social, and economic burden worldwide. Optimal senior policy should be based on well-assessed knowledge on the prevalence and control of age-related diseases, multimorbidity, disabilities, and their social determinants. The objective of this paper is to describe the assumptions, methods, and sampling procedures of the PolSenior2 survey, which was aimed at characterising the health status of old and very-old adults in Poland. MATERIAL AND METHODS The project was conducted in the period 2018-2019 as a cross-sectional survey of a representative sample of people aged 60 years and over. Subjects were selected using three-stage stratified and proportional random sampling in seven equally sized (n = 850) age groups. The study protocol consisted of face-to-face interviews, specific geriatric scales and tests, and anthropometric and blood pressure measurements performed by well-trained nurses at participants homes as well as blood and urine sample laboratory tests. RESULTS In the Polsenior2 study a group of 5987 subjects underwent the questionnaire parts of the survey, and almost all (n = 5823) agreed to blood or urine sample collection. CONCLUSIONS In recent decades several studies focused on various aspects of elderly health and life conditions had been carried out in Poland and Central and Eastern Europe. However, none of them is so complex and has covered so many issues as PolSenior2, which is the largest study devoted to the health status of older persons in Poland and one of the largest and the most comprehensive in Europe. The results of the study will help to improve health policy targeted at the elderly population in Poland.
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Affiliation(s)
- Łukasz Wierucki
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
| | - Hanna Kujawska-Danecka
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | | | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Błędowski
- Institute of Social Economy, Warsaw School of Economics, Warsaw, Poland
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, Katowice, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Medical University of Lodz, Lodz, Poland
| | - Andrzej Więcek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
| | - Adam Hajduk
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Piotr Bandosz
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
| | - Paweł Zagożdżon
- Department of Hygiene and Epidemiology, Medical University of Gdansk, Gdansk, Poland
| | - Bogdan Wojtyniak
- Department of Population Health Monitoring and Analysis, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Tomasz Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
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Association between psychosocial distress, sexual disorders, self-esteem and quality of life with male androgenetic alopecia: a population-based study with men at age 46. BMJ Open 2021. [PMCID: PMC8719200 DOI: 10.1136/bmjopen-2021-049855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives To study the association between androgenetic alopecia (AGA) and its severity with psychosocial well-being in male subjects aged 46 years at the population level. Design Cross-sectional study. Setting The Northern Finland Birth Cohort 1966 (NFBC1966). Participants Data were available for 892 male subjects aged 46 years. Interventions Study subjects underwent comprehensive health examinations including a skin evaluation by dermatologists and determination of AGA according to the Norwood classification. They also filled in a questionnaire battery that included previously validated questionnaires: the Hopkins Symptom Checklist-25, the Beck Depression Inventory–II; the Generalised Anxiety Disorder Screener; a 15-dimensional measure of health-related quality of life; a 12-Item General Health Questionnaire. The battery also included questions about self-esteem and sexual health. Main outcome measurements The presence of AGA and its severity, psychosocial well-being. Results AGA was found in 68.5% of subjects, 27.8% of the cases were severe, 33.2% moderate and 39.0% mild. There was no significant association between the presence of AGA or its severity with depression, anxiety, quality of life, self-esteem or sexual symptoms. Those with severe AGA reported lower sexual activity when compared with those without AGA; however, the difference was not statistically significant. Conclusions Middle-aged men with AGA did not differ from men without AGA in terms of psychosocial well-being.
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Dornquast C, Reinhold T, Solak S, Durak M, Becher H, Riens B, Icke K, Danquah I, Willich SN, Keil T, Krist L. Strategies to Enhance Retention in a Cohort Study Among Adults of Turkish Descent Living in Berlin. J Immigr Minor Health 2021; 24:1309-1317. [PMID: 34797452 PMCID: PMC9388466 DOI: 10.1007/s10903-021-01309-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
Retention is important for statistical power and external validity in long-term cohort studies. The aims of our study were to evaluate different retention strategies within a cohort study of adults of Turkish descent in Berlin, Germany, and to compare participants and non-participants. In 2011–2012, a population-based study was conducted among adults of Turkish descent to primarily examine recruitment strategies. 6 years later, the participants were re-contacted and invited to complete a self-report questionnaire regarding their health status, health care utilization, and satisfaction with medical services. The retention strategy comprised letters in both German and Turkish, phone calls, and home visits (by bilingual staff). We calculated the response rate and retention rate, using definitions of the American Association for Public Opinion Research, as well as the relative retention rate for each level of contact. Associations of baseline recruitment strategy, sociodemographic, migration-related and health-related factors with retention were investigated by logistic regression analysis. Of 557 persons contacted, 249 (44.7%) completed the questionnaire. This was 50.1% of those whose contact information was available. The relative retention rate was lowest for phone calls (8.9%) and highest for home visits (18.4%). Participants were more often non-smokers and German citizens than non-participants. For all remaining factors, no association with retention was found. In this study, among adults of Turkish descent, the retention rate increased considerably with every additional level of contact. Implementation of comprehensive retention strategies provided by culturally matched study personnel may lead to higher validity and statistical power in studies on migrant health issues.
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Affiliation(s)
- Christina Dornquast
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
| | - Saliha Solak
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
| | - Melike Durak
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
| | - Heiko Becher
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Burgi Riens
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
| | - Katja Icke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
| | - Ina Danquah
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
- Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, 10117, Berlin, Germany.
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Steinberg R, Anderson B, Hu Z, Johnson TM, O'Keefe JB, Plantinga LC, Kamaleswaran R, Anderson B. Associations between remote patient monitoring programme responsiveness and clinical outcomes for patients with COVID-19. BMJ Open Qual 2021; 10:bmjoq-2021-001496. [PMID: 34518302 PMCID: PMC8438571 DOI: 10.1136/bmjoq-2021-001496] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022] Open
Abstract
Objective To assess whether engagement in a COVID-19 remote patient monitoring (RPM) programme or telemedicine programme improves patient outcomes. Methods This is a retrospective cohort study analysing patient responsiveness to our RPM survey or telemedicine visits and outcomes during the COVID-19 pandemic. Daily text message surveys and telemedicine consultations were offered to all patients who tested positive for SARS-CoV-2 at our institutional screening centres. Survey respondents with alarm responses were contacted by a nurse. We assessed the relationship between virtual engagement (telemedicine or RPM survey response) and clinical outcomes using multivariable logistic regression. Results Between 10 July 2020 and 2 January 2021, 6822 patients tested positive, with 1230 (18%) responding to at least one survey. Compared with non-responders, responders were younger (49 vs 53 years) and more likely to be white (40% vs 33%) and female (65% vs 55%) and had fewer comorbidities. After adjustment, individuals who engaged virtually were less likely to experience an emergency department visit, hospital admission or intensive care unit–level care. Conclusion Telemedicine and RPM programme engagement (vs no engagement) were associated with better outcomes, but this was likely due to differences in groups at baseline rather than the efficacy of our intervention alone.
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Affiliation(s)
- Rebecca Steinberg
- Department of Medicine, Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bjorn Anderson
- Department of Medicine, Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ziyue Hu
- Department of Medicine, Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Theodore M Johnson
- Department of Medicine, Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - James B O'Keefe
- Department of Medicine, Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Laura C Plantinga
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rishi Kamaleswaran
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Blake Anderson
- Department of Medicine, Division of General Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Plana-Ripoll O, Lasgaard M, Mneimneh ZN, McGrath JJ. The Evolution of Psychiatric Epidemiology: Where to Next? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:774-777. [PMID: 33601902 PMCID: PMC8504286 DOI: 10.1177/0706743721996110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Mathias Lasgaard
- DEFACTUM-Public Health & Health Services Research, 69688Central Denmark Region, Aarhus, Denmark
| | - Zeina N Mneimneh
- Survey Research Center, Institute for Social Research, 1259University of Michigan, Ann Arbor, MI, USA
| | - John J McGrath
- National Centre for Register-based Research, 1006Aarhus University, Denmark.,Queensland Brain Institute, 1974University of Queensland, St Lucia, Queensland, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
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