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Ebuenyi ID, Jamali MZ, Smith EM, Kafumba J, Chizala P, Munthali A, MacLachlan M. Age related increase in impairment across the life course: the use of Zomba curves to estimate assistive technology needs in Malawi. Disabil Rehabil Assist Technol 2024; 19:16-23. [PMID: 35426341 DOI: 10.1080/17483107.2022.2060352] [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] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Global population growth and increasing longevity means that the need for Assistive Technology (AT) will continue to increase. The level of unmet need for AT is greatest in low-income settings. The aim of this study is to identify age-related increase in impairment and to estimate the AT needs. MATERIALS AND METHODS We analysed secondary data from the 2018 Malawi Population and Housing Census (MPHC) based on the Washington Group on Disability Statistics (WG) short-set of questions. RESULTS Out of the 1,556,670 persons with one or more functional limitations or disabilities identified in the census, self-reported difficulties in all domains were markedly higher from age 40 and above. The proportion reporting one functional limitation is higher compared to two or more limitations, but at age 78-80 the proportion reporting two or more functional limitations increased above those reporting one functional limitation. Although 60.9% (60.7-61.0) and 63.5% (63.3-63.6) of those who reported difficulty in seeing and hearing were using glasses and hearing aids respectively, the estimated total need for glasses and hearing aids in this group was 98.9% (98.0-99.0) and 98.4% (98.3-98.5) respectively. The unmet need for glasses and hearing aids were therefore 38.1% and 34.9% respectively. CONCLUSION The differential slope of impairment curves against age is a guide to the increasing demand for AT across the life course and across different domains of functioning. Country specific analysis of impairment across age and domains is essential to understand and plan for the growing need for AT globally.IMPLICATIONS FOR REHABILITATIONIt is important to estimate and plan for impairment across life course to address the age-related increase in impairment and the increasing need for AT with age.The Zomba curves show the cumulative nature of impairment with age and the need for age and need specific provision of AT across the life course through proactive policy level actions.The significant high unmet need for glasses and hearing aids attests to similar need for other assistive products and the need for setting specific interventions to address needs of affected persons.The differential slope of impairment curves against age is a guide to the differing and increasing demand for assistive technology across the life course and across different domains of functioning.
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Affiliation(s)
- Ikenna D Ebuenyi
- Assisting Living & Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
- IRIS Centre, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Monica Z Jamali
- Centre for Social Research, University of Malawi, Zomba, Malawi
| | - Emma M Smith
- Assisting Living & Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Juba Kafumba
- Centre for Social Research, University of Malawi, Zomba, Malawi
| | | | | | - Malcolm MacLachlan
- Assisting Living & Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
- Olomouc University Social Health Institute (OUSHI), Palacký University, Olomouc, Czech Republic
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Bekelman TA, Trasande L, Law A, Blackwell CK, Jacobson LP, Bastain TM, Breton CV, Elliott AJ, Ferrara A, Karagas MR, Aschner JL, Bornkamp N, Camargo CA, Comstock SS, Dunlop AL, Ganiban JM, Gern JE, Karr CJ, Kelly RS, Lyall K, O’Shea TM, Schweitzer JB, LeWinn KZ. Opportunities for understanding the COVID-19 pandemic and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) program. Front Pediatr 2023; 11:1171214. [PMID: 37397146 PMCID: PMC10308998 DOI: 10.3389/fped.2023.1171214] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Objective Ongoing pediatric cohort studies offer opportunities to investigate the impact of the COVID-19 pandemic on children's health. With well-characterized data from tens of thousands of US children, the Environmental influences on Child Health Outcomes (ECHO) Program offers such an opportunity. Methods ECHO enrolled children and their caregivers from community- and clinic-based pediatric cohort studies. Extant data from each of the cohorts were pooled and harmonized. In 2019, cohorts began collecting data under a common protocol, and data collection is ongoing with a focus on early life environmental exposures and five child health domains: birth outcomes, neurodevelopment, obesity, respiratory, and positive health. In April of 2020, ECHO began collecting a questionnaire designed to assess COVID-19 infection and the pandemic's impact on families. We describe and summarize the characteristics of children who participated in the ECHO Program during the COVID-19 pandemic and novel opportunities for scientific advancement. Results This sample (n = 13,725) was diverse by child age (31% early childhood, 41% middle childhood, and 16% adolescence up to age 21), sex (49% female), race (64% White, 15% Black, 3% Asian, 2% American Indian or Alaska Native, <1% Native Hawaiian or Pacific Islander, 10% Multiple race and 2% Other race), Hispanic ethnicity (22% Hispanic), and were similarly distributed across the four United States Census regions and Puerto Rico. Conclusion ECHO data collected during the pandemic can be used to conduct solution-oriented research to inform the development of programs and policies to support child health during the pandemic and in the post-pandemic era.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Leonardo Trasande
- Department of Pediatrics, Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lisa P. Jacobson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Amy J. Elliott
- Avera Research Institute, Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Judy L. Aschner
- Departments of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Nicole Bornkamp
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Jody M. Ganiban
- Department of Psychological and Behavioral Sciences, The George Washington University, Washington, DC, United States
| | - James E. Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Catherine J. Karr
- Departments of Pediatrics & Occupational and Environmental Health Sciences, University of Washington, Seattle, WA, United States
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Julie B. Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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3
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Delaporte I, Kulu H. Interaction between childbearing and partnership trajectories among immigrants and their descendants in France: An application of multichannel sequence analysis. Popul Stud (Camb) 2023; 77:55-70. [PMID: 35379080 DOI: 10.1080/00324728.2022.2049856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
While there is a large literature investigating migrant marriage or fertility, little research has examined how childbearing and partnerships are interrelated. In this paper, we investigate how childbearing and partnership trajectories evolve and interact over the life course for immigrants and their descendants and how the relationship varies by migrant origin. We apply multichannel sequence analysis to rich longitudinal survey data from France and find significant differences in family-related behaviour between immigrants, their descendants, and the native French. Immigrants' family behaviour is characterized by stronger association between marriage and childbearing than in the native population. However, there are significant differences across migrant groups. Turkish immigrants exhibit the most conservative family pathways. By contrast, the family behaviour of European immigrants is similar to that of the native population. The study also demonstrates that the family behaviour of some descendant groups has gradually become indistinguishable from that of the native French, whereas for other groups significant differences in family behaviour persist.Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2022.2049856.
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Lin Y, Jiang Y, Du J, Ma H, Shen H, Hu Z. The continuing evolution of birth cohort studies: achievements and challenges. Biol Reprod 2022; 107:358-367. [PMID: 35686808 DOI: 10.1093/biolre/ioac117] [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: 12/30/2021] [Revised: 05/02/2022] [Accepted: 06/09/2022] [Indexed: 11/14/2022] Open
Abstract
Well-designed birth cohorts are able to estimate prevalence/distribution of various health events/outcomes, and to link early-life origins with adult health and function. The past two decades have seen a surge in the establishment of new birth cohorts and their accompanying research. We discussed distinct designs of current birth cohort studies, reviewed their achievements, and highlighted insights obtained from birth cohort studies, as well as challenges we are facing. Birth cohort studies are providing increasing opportunities to identify determining factors for short- and long-term health, yielding substantial evidence to uncover biological mechanisms of diseases and phenotypes, and providing further insights for public health. Dynamic monitoring, accurate measurements, long-term follow-ups and collaborative efforts are warranted in new birth cohorts to elucidate the nature of life course relationships in contemporary generation.
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Affiliation(s)
- Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China.,State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.,Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yangqian Jiang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.,Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China.,State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.,Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongbing Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, China.,State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.,Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
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5
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Sungkar A, Bardosono S, Irwinda R, Manikam NRM, Sekartini R, Medise BE, Nasar SS, Helmyati S, Ariani AS, Nurihsan J, Nurjasmi E, Khoe LC, Dilantika C, Basrowi RW, Vandenplas Y. A Life Course Approach to the Prevention of Iron Deficiency Anemia in Indonesia. Nutrients 2022; 14:277. [PMID: 35057458 DOI: 10.3390/nu14020277] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 12/10/2022] Open
Abstract
Iron deficiency anemia (IDA) has a long-term impact on each life stage and remains worldwide a major public health problem. Eleven experts were invited to participate in a virtual meeting to discuss the present situation and the available intervention to prevent iron deficiency anemia in Indonesia. The experts consisted of obstetric gynecologists, pediatricians, nutritionists, midwives, a clinical psychologist, and an education expert. Existing interventions focus attention on preconception and early childhood stages. Considering the inter-generational effects of IDA, we call attention to expanding strategies to all life stages through integrating political, educational, and nutritional interventions. The experts agreed that health education and nutritional intervention should be started since adolescence. Further research to explore the effectiveness of these interventions would be important for many regions in the world. The outcome of this Indonesian consensus is applicable worldwide.
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Saleem SM, Bhattacharya S. Reducing the infectious diseases burden through " life course approach vaccination" in India-a perspective. AIMS Public Health 2021; 8:553-562. [PMID: 34395705 PMCID: PMC8334644 DOI: 10.3934/publichealth.2021045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/01/2021] [Indexed: 11/29/2022] Open
Abstract
The burden of vaccine-preventable diseases is increasing day by day across all age groups. However as per the universal immunization programme, we vaccinate only under-fives and antenatal mothers, a large portion of the vulnerable population remain unvaccinated and the concept of “life course approach” regarding vaccination is missing. It increases the overall burden to the already constrained Indian health care system. As India, now has become the largest manufacturer of multiple vaccines, we have continuous chain healthcare points (primary-tertiary level), with dedicated manpower in the public health sector that is why in this paper we are proposing to expand the horizon of the vaccination process using a “life course approach”. It will not only directly benefit the vulnerable populations (individual level), but also it can benefit the nation, indirectly. Although we may face challenges at multiple phases (conception to implementation), they can be overcome by multisectoral and multipronged innovations.
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7
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Francis K, Karantanos G, Al-Ozairi A, AlKhadhari S. Prevention in Autism Spectrum Disorder: A Lifelong Focused Approach. Brain Sci 2021; 11:151. [PMID: 33498888 DOI: 10.3390/brainsci11020151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/16/2021] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a complex highly heritable disorder, in which multiple environmental factors interact with the genes to increase its risk and lead to variable clinical presentations and outcomes. Furthermore, the inherent fundamental deficits of ASD in social attention and interaction critically diverge children from the typical pathways of learning, "creating" what we perceive as autism syndrome during the first three years of life. Later in life, training and education, the presence and management of comorbidities, as well as social and vocational support throughout the lifespan, will define the quality of life and the adaptation of an individual with ASD. Given the overall burden of ASD, prevention strategies seem like a cost-effective endeavour that we have to explore. In this paper, we take a life course approach to prevention. We will review the possibilities of the management of risk factors from preconception until the perinatal period, that of early intervention in the first three years of life and that of effective training and support from childhood until adulthood.
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8
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Abstract
In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.
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Affiliation(s)
- Mary E Northridge
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
- Hansjörg Wyss Department of Plastic Surgery, NYU School of Medicine, Brooklyn, New York 11220, USA
| | - Anjali Kumar
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
| | - Raghbir Kaur
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
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9
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Elbæk Pedersen J, Ugelvig Petersen K, Hansen J. Full employment history of Danish firefighters potentially involving additional exposures, 1964-2015. Am J Ind Med 2020; 63:328-336. [PMID: 31953961 DOI: 10.1002/ajim.23089] [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: 10/04/2019] [Revised: 12/04/2019] [Accepted: 01/08/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study aimed to demonstrate the possibility of using data on full employment history to describe occupational patterns of Danish firefighters that may indicate additional hazards encountered by these workers. METHODS An established cohort of Danish full-time and part-time/volunteer firefighters was used in the study (N = 9952) as well as occupational history covering the period 1964-2015, which was retrieved from a nationwide pension fund with compulsory membership. The most frequently held employments other than firefighting, together with temporal patterns of these employments, were explored in descriptive analyses. RESULTS Besides working in the firefighter service, both full-time and part-time/volunteer firefighters had frequently been employed in the military and the police (55% and 38%) and more than 10% of both types of firefighters in a number of blue-collar jobs, including construction-related jobs (eg, masonry, joining, carpentry, insulation, and installation), laundry and dry cleaning, the auto industry, and rubber and plastic production. Part-time/volunteer firefighters had more frequently been employed in the machine industry, fabricated metal production, the wood and furniture industry, and farming. Both types of firefighters were initially employed in other jobs before their employment in firefighting. CONCLUSION The cohort of Danish firefighters had frequently been working in other professions potentially exposing them to additional hazardous exposures, and occupational patterns varied by type of firefighter employment. Accounting for full employment history is, for that reason, considered essential when exploring associations between specific professions and health outcomes.
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Affiliation(s)
| | - Kajsa Ugelvig Petersen
- Department of Occupational and Environmental MedicineBispebjerg University Hospital Copenhagen Denmark
| | - Johnni Hansen
- Danish Cancer Society Research CenterDanish Cancer Society Copenhagen Denmark
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Azzolino D, Passarelli PC, De Angelis P, Piccirillo GB, D’Addona A, Cesari M. Poor Oral Health as a Determinant of Malnutrition and Sarcopenia. Nutrients 2019; 11:E2898. [PMID: 31795351 PMCID: PMC6950386 DOI: 10.3390/nu11122898] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 12/13/2022] Open
Abstract
Aging is accompanied by profound changes in many physiological functions, leading to a decreased ability to cope with stressors. Many changes are subtle, but can negatively affect nutrient intake, leading to overt malnutrition. Poor oral health may affect food selection and nutrient intake, leading to malnutrition and, consequently, to frailty and sarcopenia. On the other hand, it has been highlighted that sarcopenia is a whole-body process also affecting muscles dedicated to chewing and swallowing. Hence, muscle decline of these muscle groups may also have a negative impact on nutrient intake, increasing the risk for malnutrition. The interplay between oral diseases and malnutrition with frailty and sarcopenia may be explained through biological and environmental factors that are linked to the common burden of inflammation and oxidative stress. The presence of oral problems, alone or in combination with sarcopenia, may thus represent the biological substratum of the disabling cascade experienced by many frail individuals. A multimodal and multidisciplinary approach, including personalized dietary counselling and oral health care, may thus be helpful to better manage the complexity of older people. Furthermore, preventive strategies applied throughout the lifetime could help to preserve both oral and muscle function later in life. Here, we provide an overview on the relevance of poor oral health as a determinant of malnutrition and sarcopenia.
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Affiliation(s)
- Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Pier Carmine Passarelli
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Paolo De Angelis
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Giovan Battista Piccirillo
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Antonio D’Addona
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Catholic University of Sacred Hearth, Fondazione Policlinico Universitario Gemelli, 00168 Rome, Italy; (P.C.P.); (P.D.A.); (G.B.P.); (A.D.)
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Abstract
BACKGROUND Few studies have evaluated the association between early life adiposity and ovarian cancer risk. Adiposity during different periods of life may be differentially associated with the risk. PATIENTS AND METHODS We prospectively followed 133 526 women in the Nurses' Health Study (NHS; 1980-2012) and NHSII (1989-2013). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident ovarian cancer (N = 788) according to validated measures for early life adiposity [body mass index (BMI) at age 10 imputed from somatotype and recalled BMI at age 18) as well as BMI change between age 10 and 18 and after age 18 (current weight assessed on every biennial questionnaire since baseline). RESULTS After mutual adjustment for BMI at age 10, BMI at age 18 and current BMI, the HR (95% CI) for ovarian cancer risk per 5 kg/m2 was 0.84 (0.74-0.96) for BMI at age 10 (P-trend = 0.01), 1.17 (1.03-1.33) for BMI at age 18 (P-trend = 0.02), and 1.06 (0.99-1.14) for current BMI (P-trend = 0.08). However, the inverse association with BMI at age 10 was attenuated after adjusting for BMI change between age 10 and 18 and BMI change after age 18 (HR per 5 kg/m2: 1.04; 95% CI 0.91-1.20; P-trend = 0.55). By contrast, BMI change between age 10 and 18 was strongly positively associated with ovarian cancer risk (HR per 5 kg/m2 increase: 1.24; 95% CI 1.11-1.39; P-trend = 0.0002), whereas BMI change since age 18 was only slightly associated with risk (HR per 5 kg/m2 increase: 1.06; 95% CI 0.99-1.14; P-trend = 0.10). These associations were in general stronger for premenopausal cases or non-serous tumors. CONCLUSION Early life changes in adiposity were more strongly associated with ovarian cancer risk than adulthood changes. The specific mechanisms underlying the associations with adiposity changes during early life warrant further investigation.
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Affiliation(s)
- T Huang
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, USA.
| | - S S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - W C Willett
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - M J Stampfer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - B A Rosner
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, USA
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Sharma K, Acharya S, Singhal DK, Singla N. Prosthetic treatment need and associated life course determinants in partially edentulous adults of age 18-35 years in Udupi taluk: A cross-sectional study. J Indian Prosthodont Soc 2019; 19:20-25. [PMID: 30745750 PMCID: PMC6340076 DOI: 10.4103/jips.jips_156_18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/26/2018] [Indexed: 11/30/2022] Open
Abstract
AIM The aims of this study were to assess the prevalence of use and need for dental prostheses and to associate need with the life course determinants in young adults of age 18-35 years in Udupi taluk, Karnataka, India. MATERIALS AND METHODS It was a cross-sectional survey conducted on a total of 580 individuals those attended dental screening camps organized at random locations. A self-administered questionnaire was administered to participants to assess their life course determinants such as socioeconomic, behavioral, and psychological circumstances followed by an oral examination to assess their prosthetic status (WHO, 1997). Bivariate analysis followed by multivariate logistic regression analysis was carried out to determine the adjusted odds ratios (ORs) with 95% confidence interval (CI) for independent variables and the outcome. RESULTS The need and use of dental prostheses was observed in 38% and 2.2% of young adults, respectively. Adjusted multivariable analysis revealed that life course determinants such as parental rearing style (OR = 7.66 [95% CI: 3.88-15.14]) and interaction between expenditure at 10 years of age and economic hardships at 10 years of age (OR = 9.63 [95% CI: 3.12-29.72] and OR = 6.43 [95% CI: 1.89-21.88]) were significantly associated with the need for prostheses. CONCLUSION The need for dental prostheses in the young adults can be related to socioeconomic and psychosocial circumstances during childhood, and thus the concept of life course approach has been highlighted.
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Affiliation(s)
- Kriti Sharma
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Deepak Kumar Singhal
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nishu Singla
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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13
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Lyne J, O'Donoghue B, Roche E, Renwick L, Cannon M, Clarke M. Negative symptoms of psychosis: A life course approach and implications for prevention and treatment. Early Interv Psychiatry 2018; 12:561-571. [PMID: 29076240 DOI: 10.1111/eip.12501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 07/29/2017] [Accepted: 08/20/2017] [Indexed: 01/09/2023]
Abstract
AIM Negative symptoms are a cause of enduring disability in serious mental illness. In spite of this, the development of effective treatments for negative symptoms has remained slow. The challenge of improving negative symptom outcomes is compounded by our limited understanding of their aetiology and longitudinal development. METHODS A literature search was conducted for life course approach of negative symptoms using PubMed. Further articles were included following manual checking of reference lists and other search strategies. The paper contains a theoretical synthesis of the literature, summarized using conceptual models. RESULTS Negative symptom definitions are compared and considered within a context of the life course. Previous studies suggest that several illness phases may contribute to negative symptoms, highlighting our uncertainty in relation to the origin of negative symptoms. CONCLUSIONS Similar to other aspects of schizophrenia, negative symptoms likely involve a complex interplay of several risk and protective factors at different life phases. Concepts suggested in this article, such as "negative symptom reserve" theory, require further research, which may inform future prevention and treatment strategies.
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Affiliation(s)
- John Lyne
- Royal College of Surgeons in Ireland, North Dublin Mental Health Service, Ashlin Centre, Dublin, Ireland.,Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Brian O'Donoghue
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre of Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Eric Roche
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland
| | - Laoise Renwick
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Clarke
- Dublin and East Treatment and Early Care Team (DETECT), Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.,Saint John of God Community Services Ltd, Blackrock, Co., Dublin, Ireland
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14
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Abstract
In the Kuwait context, from January 1991 to December 1991, there were a series of chemical and psychological Gulf War-era exposures that left persistent, long-term damage. Extreme stress from a critical event speeds up the usual disease latency period, and may be part of a synergistic effect that leads to higher disease rates over a shorter period of time. I am interested in the impact of armed conflict on health outcomes over the life course in Kuwait, and particularly the pathways through which armed conflict causes changes in health on a population level. In this paper, I propose a culturally sensitive, post-conflict socio-ecological model that informs a three-pronged health study. I propose a macro-micro mix that includes an ecological study, a case-control study and a qualitative study to investigate Kuwait's post-conflict health concerns. Thus, I revise the concept of 'post-conflict health' as a trajectory that is mediated through different, complex social levels and develops over time during the latency period. The main advantage of a macro-micro mix approach for post-conflict health is that it contextualizes the Gulf War as an environmental health issue.
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Affiliation(s)
- Charles W Cange
- a Department of Health Sciences , The City University of New York , New York , NY , USA.,b The Graduate School, University of Washington , Seattle , WA , USA
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15
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Liebregts N, van der Pol P, Van Laar M, de Graaf R, van den Brink W, Korf DJ. The Role of Study and Work in Cannabis Use and Dependence Trajectories among Young Adult Frequent Cannabis Users. Front Psychiatry 2013; 4:85. [PMID: 23950748 PMCID: PMC3739012 DOI: 10.3389/fpsyt.2013.00085] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 07/27/2013] [Indexed: 11/13/2022] Open
Abstract
Life course theory considers events in study and work as potential turning points in deviance, including illicit drug use. This qualitative study explores the role of occupational life in cannabis use and dependence in young adults. Two and three years after the initial structured interview, 47 at baseline frequent cannabis users were interviewed in-depth about the dynamics underlying changes in their cannabis use and dependence. Overall, cannabis use and dependence declined, including interviewees who quit using cannabis completely, in particular with students, both during their study and after they got employed. Life course theory appeared to be a useful framework to explore how and why occupational life is related to cannabis use and dependence over time. Our study showed that life events in this realm are rather common in young adults and can have a strong impact on cannabis use. While sometimes changes in use are temporary, turning points can evolve from changes in educational and employment situations; an effect that seems to be related to the consequences of these changes in terms of amount of leisure time and agency (i.e., feelings of being in control).
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Affiliation(s)
- Nienke Liebregts
- Law Faculty, Bonger Institute of Criminology, University of Amsterdam , Amsterdam , Netherlands
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