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Larsen EN, Brünnich Sloth MM, Nielsen J, Osler M, Jørgensen TSH. The Association of Children and Their Educational Attainment With Diabetes-related Complications and Mortality Among Older Adults With Type 2 Diabetes: A Nationwide Cohort Study. Can J Diabetes 2023; 47:649-657.e6. [PMID: 37460085 DOI: 10.1016/j.jcjd.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Socioeconomic resources and family support have been shown to improve adherence to treatment in people with type 2 diabetes (T2D) and are associated with a lower risk of diabetes-related complications and death. We investigated the associations of having children and their educational level with diabetes-related complications and death among older adults with T2D. METHODS We included 74,588 adults who were at least 65 years of age at the time of T2D diagnosis over the period from 2000 to 2018 in Denmark and grouped them based on having children (yes [reference]/no), and their children's highest educational level (low/medium/high [reference]). Multistate models were performed with 3 states: T2D diagnosis, diabetes-related complications, and death. All models were stratified by other chronic diseases at baseline (yes/no). RESULTS During follow-up (mean, 5.5 years), 14.6% of the adults developed a complication and 24.8% died with or without complications. Not having children was associated with a higher hazard of death without complications among adults without (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.17 to 1.33) and with (HR, 1.10; 95% CI, 1.02 to 1.18) other chronic diseases and after complications among adults without other chronic diseases (HR, 1.25; 95% CI, 1.12 to 1.38). Having children with a lower educational level was associated with a higher hazard of complications (HRlow, 1.14; 95% CI, 1.05 to 1.24; HRmedium, 1.11; 95% CI, 1.05 to 1.17), death without complications (HRlow, 1.26; 95% CI, 1.17 to 1.36; HRmedium, 1.07; 95% CI, 1.02 to 1.14), and after complications (HRlow, 1.22; 95% CI, 1.07 to 1.39) among adults without other chronic diseases. CONCLUSIONS Among adults without other chronic diseases, having no children or having children with lower educational levels was associated with a higher hazard of death. Among these adults, having children with lower educational levels was also associated with a higher hazard of diabetes-related complications.
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Affiliation(s)
- Emma Neble Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Mathilde Marie Brünnich Sloth
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jannie Nielsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Terese Sara Høj Jørgensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
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Chastang J, Bruneau M, Mallick L, Gavet A, Hamidi Y, Roger E, Diaby A, Galvao E, Desportes V, Germanaud D, Desgrez V, Saldanha-Gomes C, Ibanez G. [Use of neurodevelopmental disorder screening tool in primary care : A multicenter observational study]. Rev Epidemiol Sante Publique 2023; 71:101595. [PMID: 37068363 DOI: 10.1016/j.respe.2023.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION Neurodevelopmental disorders (NDD) affect 5 to 15% of the population. Improved management largely depends on early detection in primary care. A screening tool was developed by an expert consensus and its use has been recommended since 2019. This tool has never been evaluated to date. The aim of this study was to investigate the prevalence and factors associated with the identification of neurodevelopmental disorders in primary care in children aged 6 months to 5 years. METHOD This work is a multicentric observational study carried out in general practice in two regions of France: Île-de-France and Auvergne-Rhône-Alpes. A multivariate analysis was performed to identify the factors associated with the presence of abnormal signs on the grid. RESULTS Five hundred and sixty-four (564) children aged 6 months to 4 years were included. The prevalence of children identified on the grid was 3.9%. The factors associated with the neurodevelopmental disorders identified in multivariate analysis were: low socio-professional status of the mother, male gender and parental concern about the child's neurodevelopment. Factors associated with identifying a developmental trajectory gap were male gender (OR = 2.10 (1.22-3.62)) and low socio-professional status of the mother (OR = 2.23 [1.05-4.70]). CONCLUSION This original work allowed us to carry out first-line testing of a tool for the identification of NDD in primary care and to evaluate the prevalence of identification of these disorders. A complementary cohort study will be necessary to evaluate the sensitivity and specificity of this identification tool.
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Affiliation(s)
- J Chastang
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France; Sorbonne Université, Inserm, Institut Pierre Louis d'épidémiologie et de santé publique, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France.
| | - M Bruneau
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - L Mallick
- Université Grenoble Alpes, Faculté de médecine de Grenoble, Département de médecine générale, 23, avenue des Maquis du Grésivaudan, 38700 La Tronche, France
| | - A Gavet
- Université Grenoble Alpes, Faculté de médecine de Grenoble, Département de médecine générale, 23, avenue des Maquis du Grésivaudan, 38700 La Tronche, France
| | - Y Hamidi
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - E Roger
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - A Diaby
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - E Galvao
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - V Desportes
- Filière DéfiScience, Hôpital FME, Neurologie pédiatrique, CHU de Lyon HCL-GH Est, 59 boulevard Pinel, 69677 Bron Cedex, France
| | - D Germanaud
- UNIACT Neurospin, CEA_Inserm UMR1129, Université Paris Descartes, Paris, France
| | - V Desgrez
- Université Grenoble Alpes, Faculté de médecine de Grenoble, Département de médecine générale, 23, avenue des Maquis du Grésivaudan, 38700 La Tronche, France
| | - C Saldanha-Gomes
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France; Sorbonne Université, Inserm, Institut Pierre Louis d'épidémiologie et de santé publique, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
| | - G Ibanez
- Sorbonne Université, Département de médecine générale, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France; Sorbonne Université, Inserm, Institut Pierre Louis d'épidémiologie et de santé publique, Faculté de médecine, Site Saint Antoine, 27 rue Chaligny, 75012 Paris, France
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Norberg SJ, Toohey AM, Hogan DB. How Do Non-Catastrophic Natural Disasters Impact Middle-Aged-to-Older Persons? Using Baseline Canadian Longitudinal Study on Aging Data to Explore Psychological Outcomes Associated with the 2013 Calgary Flood. Can J Aging 2021;:1-9. [PMID: 34431471 DOI: 10.1017/S0714980821000271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The objective of this study was to identify group-level health outcomes associated with the 2013 Calgary flood on Calgary participants (45-85 years of age) in the Canadian Longitudinal Study on Aging (CLSA). We compared baseline CLSA data collected on Calgary participants during the 6 months prior to and following the flood. Logistic regression models were created to explore whether select psychological outcomes were associated with the flood for participants categorized by evacuation status. Participants living in evacuated communities pre-flood had significantly lower levels of a diagnosed anxiety disorder than non-evacuated communities, which disappeared post-flood. Participants with higher household income were less likely to have post-traumatic stress disorder symptoms, worse self-rated mental health, and lower life satisfaction post-flood. Living alone reduced and female gender increased levels of perceived functional social support post-flood. Although natural disasters can shape research findings, the scope of the data being collected and the representativeness of impacted groups may challenge the ability to detect subtle impacts.
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