1
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Marr C, Gaskin C, Kasinathan J, Kaye S, Singh Y, Dean K. The prevalence of mental illness in young people in custody over time: a comparison of three surveys in New South Wales. Psychiatr Psychol Law 2023; 31:235-253. [PMID: 38628250 PMCID: PMC11018085 DOI: 10.1080/13218719.2023.2192257] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 02/09/2023] [Indexed: 04/19/2024]
Abstract
Few studies have examined the prevalence of mental illness in young people over time within the same jurisdiction. In the current study, we compared data from three large surveys of youth in custody in New South Wales, conducted in 2003, 2009 and 2015. We examined rates of mental illness, self-harm and suicidal behaviours, substance use and childhood trauma and found little consistent change over time, though some fluctuations were observed regarding certain mental illnesses and substance use. We also descriptively compared findings with observed rates for the general population and found that young people in custody showed higher levels of all examined variables. In sum, these data suggest little improvement in the well-being of young people in custody in New South Wales over time. Better identification and treatment of these issues are vital if young people are to be prevented from becoming enmeshed in the criminal justice system.
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Affiliation(s)
- Carey Marr
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
| | - Claire Gaskin
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
| | - John Kasinathan
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
| | - Sharlene Kaye
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Yolisha Singh
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
| | - Kimberlie Dean
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, NSW, Australia
- Justice Health and Forensic Mental Health Network, University of New South Wales, Randwick, NSW, Australia
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2
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Tran VH, Mehawej J, Abboud DM, Tisminetzky M, Hariri E, Filippaios A, Gore JM, Yarzebski J, Goldberg JH, Lessard D, Goldberg R. Age and Sex Differences and Temporal Trends in the Use of Invasive and Noninvasive Procedures in Patients Hospitalized With Acute Myocardial Infarction. J Am Heart Assoc 2022; 11:e025605. [PMID: 36000439 PMCID: PMC9496437 DOI: 10.1161/jaha.122.025605] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Few studies have examined age and sex differences in the receipt of cardiac diagnostic and interventional procedures in patients hospitalized with acute myocardial infarction and trends in these possible differences during recent years. Methods and Results Data from patients hospitalized with a first acute myocardial infarction at the major medical centers in the Worcester, Massachusetts, metropolitan area were utilized for this study. Logistic regression analysis was used to examine age (<55, 55–64, 65–74, and ≥75 years) and sex differences in the receipt of echocardiography, exercise stress testing, coronary angiography, percutaneous coronary interventions, and coronary artery bypass graft surgery, and trends in the use of those procedures during patients' acute hospitalization, between 2005 and 2018, while adjusting for important confounding factors. The study population consisted of 1681 men and 1154 women with an initial acute myocardial infarction who were hospitalized on an approximate biennial basis between 2005 and 2018. A smaller proportion of women underwent cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft surgery, while there were no sex differences in the receipt of echocardiography and exercise stress testing. Patients aged ≥75 years were less likely to undergo cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft surgery, but were more likely to receive echocardiography compared with younger patients. Between 2005 and 2018, the use of echocardiography and coronary artery bypass graft surgery nonsignificantly increased among all age groups and both sexes, while the use of cardiac catheterization and percutaneous coronary intervention increased nonsignificantly faster in women and older patients. Conclusions We observed a continued lower receipt of invasive cardiac procedures in women and patients aged ≥75 years with acute myocardial infarction, but age and sex gaps associated with these procedures have narrowed during recent years.
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Affiliation(s)
| | - Jordy Mehawej
- Division of Cardiovascular Medicine, Department of Medicine University of Massachusetts Medical School Worcester MA
| | - Donna M Abboud
- Department of Medicine Lebanese American University Beirut Lebanon
| | - Mayra Tisminetzky
- Division of Geriatric Medicine, Department of Medicine University of Massachusetts Medical School Worcester MA.,Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA
| | - Essa Hariri
- Department of Medicine Cleveland Clinic Cleveland OH
| | - Andreas Filippaios
- UMass Memorial Medical Group Fitchburg MA.,Division of Cardiovascular Medicine, Department of Medicine University of Massachusetts Medical School Worcester MA
| | - Joel M Gore
- Division of Cardiovascular Medicine, Department of Medicine University of Massachusetts Medical School Worcester MA.,Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA
| | - Jorge Yarzebski
- Division of Geriatric Medicine, Department of Medicine University of Massachusetts Medical School Worcester MA
| | - Jordan H Goldberg
- Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA
| | - Darleen Lessard
- Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA
| | - Robert Goldberg
- Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA
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3
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Bonenkamp AA, Hoekstra T, Hemmelder MH, van Eck van der Sluijs A, Abrahams AC, van Ittersum FJ, van Jaarsveld BC. Trends in home dialysis use differ among age categories in past two decades: A Dutch registry study. Eur J Clin Invest 2022; 52:e13656. [PMID: 34293185 PMCID: PMC9286376 DOI: 10.1111/eci.13656] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although the number of patients with end-stage kidney disease is growing, the number of patients who perform dialysis at home has decreased during the past two decades. The aim of this study was to explore time trends in the use of home dialysis in the Netherlands. METHODS Dialysis episodes of patients who started dialysis treatment were studied using Dutch registry data (RENINE). The uptake of home dialysis between 1997 through 2016 was evaluated in time periods of 5 years. Home dialysis was defined as start with peritoneal dialysis or home haemodialysis, or transfer to either within 2 years of dialysis initiation. All analyses were stratified for age categories. Mixed model logistic regression analysis was used to adjust for clustering at patient level. RESULTS A total of 33 340 dialysis episodes in 31 569 patients were evaluated. Mean age at dialysis initiation increased from 62.5 ± 14.0 to 65.5 ± 14.5 years in in-centre haemodialysis patients, whereas it increased from 51.9 ± 15.1 to 62.5 ± 14.6 years in home dialysis patients. In patients <65 years, the uptake of home dialysis was significantly lower during each 5-year period compared with the previous period, whereas kidney transplantation occurred more often. In patients ≥65 years, the incidence of home dialysis remained constant, whereas mortality decreased. CONCLUSIONS In patients <65 years, the overall use of home dialysis declined consistently over the past 20 years. The age of home dialysis patients increased more rapidly than that of in-centre dialysis patients. These developments have a significant impact on the organization of home dialysis.
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Affiliation(s)
- Anna A Bonenkamp
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam, Research institute Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Tiny Hoekstra
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam, Research institute Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.,Dutch Renal Registry (RENINE), Nefrovisie Foundation, Utrecht, the Netherlands
| | - Marc H Hemmelder
- Dutch Renal Registry (RENINE), Nefrovisie Foundation, Utrecht, the Netherlands.,Department of Nephrology, Medical University Centre Maastricht, Maastricht, the Netherlands
| | | | - Alferso C Abrahams
- Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Frans J van Ittersum
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam, Research institute Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Brigit C van Jaarsveld
- Department of Nephrology, Amsterdam UMC, Vrije Universiteit Amsterdam, Research institute Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
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Jin W, Hughes K, Sim S, Shemer S, Sheehan P. The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre. J Perinat Med 2021; 49:1048-1057. [PMID: 34018380 DOI: 10.1515/jpm-2021-0020] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/14/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Preterm birth clinics provide dedicated obstetric care to women at high risk of spontaneous preterm birth (SPTB). There remains a lack of conclusive evidence to support the overall utility of such clinics, attributable to a paucity and heterogeneity of primary data. This study audits Australia's largest and oldest dedicated preterm birth clinic with the aim to add primary data to the area and offer opportunities for similar clinics to align practice. METHODS A retrospective audit of referrals to the Preterm Labour Clinic at the Royal Women's Hospital, Melbourne, Australia, between 2004 and 2018 was conducted. 1,405 singleton pregnancies met inclusion criteria. The clinic's key outcomes, demographics, predictive tests and interventions were analysed. The primary outcomes were SPTB before 37, 34 and 30 weeks' gestation. RESULTS The overall incidence of SPTB in the clinic was 21.2% (n=294). Linear regression showed reductions in the adjusted rates of overall SPTB and pre-viable SPTB (delivery <24 weeks) from 2004 (108%; 8%) to 2018 (65%; 2% respectively). Neonatal morbidity and post-delivery intensive care admission concurrently declined (p=0.02; 0.006 respectively). Rates of short cervix (cervical length <25 mm) increased over time (2018: 30.9%) with greater uptake of vaginal progesterone for treatment. Fetal fibronectin, mid-trimester short cervix, and serum alkaline phosphatase were associated with SPTB on logistic regression. CONCLUSIONS Dedicated preterm birth clinics can reduce rates of SPTB, particularly deliveries before 24 weeks' gestation, and improve short-term neonatal outcomes in pregnant women at risk of preterm birth.
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Affiliation(s)
- Wallace Jin
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia.,Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
| | - Kelly Hughes
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia.,Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
| | - Shirlene Sim
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
| | - Scott Shemer
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia.,Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
| | - Penelope Sheehan
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia.,Pregnancy Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia
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5
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Bloom AJ, Plant RE. Wheat grain yield decreased over the past 35 years, but protein content did not change. J Exp Bot 2021; 72:6811-6821. [PMID: 34318881 DOI: 10.1093/jxb/erab343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
The extent to which rising atmospheric CO2 concentration has already influenced food production and quality is uncertain. Here, we analyzed annual field trials of autumn-planted common wheat in California from 1985 to 2019, a period during which the global atmospheric CO2 concentration increased 19%. Even after accounting for other major factors (cultivar, location, degree-days, soil temperature, total water applied, nitrogen fertilization, and pathogen infestation), wheat grain yield and protein yield declined 13% over this period, but grain protein content did not change. These results suggest that exposure to gradual CO2 enrichment over the past 35 years has adversely affected wheat grain and protein yield, but not grain protein content.
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Affiliation(s)
- Arnold J Bloom
- Department of Plant Sciences, University of California at Davis, Davis, CA, USA
| | - Richard E Plant
- Department of Plant Sciences and Biological and Agricultural Engineering, University of California at Davis, Davis, CA, USA
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6
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Roche A, McEntee A, Kim S, Chapman J. Changing patterns and prevalence of daily tobacco smoking among Australian workers: 2007-2016. Aust N Z J Public Health 2021; 45:290-298. [PMID: 34028952 DOI: 10.1111/1753-6405.13126] [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: 09/01/2020] [Revised: 03/01/2021] [Accepted: 04/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To map patterns and prevalence of daily smoking among employed Australians over time. METHODS Data from four waves of the triennial National Drug Strategy Household Survey (2007, 2010, 2013 and 2016) were used to assess daily smoking. Frequency analyses and significance testing examined smoking prevalence by sex, age, state, remoteness, Indigeneity, socioeconomic status (SES) and psychological distress. Logistic regression models estimated adjusted effects of demographics on smoking prevalence. RESULTS Workers' daily smoking prevalence reduced by 32% between 2007 and 2016. The adjusted model showed the lowest smoking reductions among men and non-metropolitan workers. Other interaction effects showed the highest daily smoking rates for: male workers aged 14-39 years; low SES non-metropolitan workers; and low SES workers aged 40-59 years. CONCLUSIONS Specific workplace policies, prevention and intervention strategies are warranted for male workers, especially those aged 14-39; non-metropolitan workers, especially low SES rural workers; and low SES workers especially 40-59-year-olds. Implications for public health: In spite of significant smoking reductions among workers over time, reductions were unevenly distributed. Tailored, innovative workplace prevention and intervention strategies that apply principles of proportionate universalism and address individual, workplace settings and cultural factors are warranted to reduce smoking disparities among male, rural and low SES workers.
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Affiliation(s)
- Ann Roche
- National Centre for Education and Training on Addiction, Flinders University, South Australia
| | - Alice McEntee
- National Centre for Education and Training on Addiction, Flinders University, South Australia
| | - Susan Kim
- National Centre for Education and Training on Addiction, Flinders University, South Australia
| | - Janine Chapman
- National Centre for Education and Training on Addiction, Flinders University, South Australia
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7
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Ekstein-Badichi N, Shoham-Vardi I, Weintraub AY. Temporal trends in the incidence of and associations between the risk factors for obstetrical anal sphincter injuries. Am J Obstet Gynecol MFM 2020; 3:100247. [PMID: 33451614 DOI: 10.1016/j.ajogmf.2020.100247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/22/2020] [Accepted: 09/26/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Obstetrical anal sphincter injuries are an important complication of vaginal deliveries that may result in short- and long-term pelvic floor morbidity and a diminished quality of life in young, healthy women. The prevalence of obstetrical anal sphincter injuries ranges from 0.1% to 8.7%. Over recent years, there seems to be a trend of increasing occurrence of obstetrical anal sphincter injuries worldwide. It is unclear why the rates are rising. Previous studies have examined the effect of different risk factors on the prevalence of obstetrical anal sphincter injuries. The change in the incidence of some risk factors for obstetrical anal sphincter injuries can partially explain the overall increase in obstetrical anal sphincter injuries. There is no previous study that explored the impact of the changes of individual risk factors over time on the risk for obstetrical anal sphincter injuries. OBJECTIVE The main aim of this study was to examine the temporal trends in the prevalence and odds ratio of the major risk factors known to be associated with obstetrical anal sphincter injuries in the period from 1988 to 2016. STUDY DESIGN This was a retrospective cohort study that included all women who underwent vaginal deliveries between 1988 and 2016 at a tertiary university medical center. The time intervals were divided into 4 periods (1988-1997, 1998-2007, 2008-2016, and the total time from 1988 to 2016) and the incidence of each risk factor was calculated for each time period. Correlation models and regression analysis were performed to examine the association between obstetrical anal sphincter injuries and the different risk factors over time. Furthermore, the trends in the odds ratios of the important risk factors over the time periods were evaluated using a multivariate regression analysis in which the primiparous women were separated from the multiparous women. RESULTS During the study period, there were 295,668 vaginal deliveries. Of these, 591 women were diagnosed with obstetrical anal sphincter injuries (0.2%). The significant risk factors for obstetrical anal sphincter injuries (P<.05) in the multivariable analysis were the following: primiparity, vaginal birth after cesarean delivery, vacuum extraction, and a birthweight of >4 kg. There was a significant (P<.05) increase in the incidence over the study period for the following risk factors: primiparity, vaginal birth after cesarean delivery, and vacuum extraction. No change was found in the incidence of the risk factor of a birthweight of >4 kg. In addition, we found a strengthening of the association between vaginal birth after cesarean delivery and macrosomia with obstetrical anal sphincter injuries, as opposed to a decline in the relative contribution of vacuum extraction to the overall risk for obstetrical anal sphincter injuries. Moreover, we found that obstetrical anal sphincter injuries among primiparous women increased 7-fold over the study period but was unchanged among multiparous women. CONCLUSION We have shown significant (P<.05) temporal trends in the incidence and odds ratio of some of the known risk factors for obstetrical anal sphincter injuries. A better understanding of the changes in the incidence and specific contribution of important risk factors for obstetrical anal sphincter injuries may explain, in part, the worldwide increase in the prevalence of this important and detrimental complication of vaginal birth.
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Affiliation(s)
- Naava Ekstein-Badichi
- Department of Public Health, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er Sheva, Israel.
| | - Ilana Shoham-Vardi
- Department of Public Health, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Adi Y Weintraub
- Department of Public Health, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er Sheva, Israel; Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er Sheva, Israel
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8
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Grossman L, Pariente G, Baumfeld Y, Yohay D, Rotem R, Weintraub AY. Trends of changes in the specific contribution of selected risk factors for shoulder dystocia over a period of more than two decades. J Perinat Med 2020; 48:567-573. [PMID: 32598318 DOI: 10.1515/jpm-2019-0463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/12/2020] [Indexed: 11/15/2022]
Abstract
Objectives Shoulder dystocia (SD) is an obstetrical emergency with well-recognized risk factors. We aimed to identify trends of changes in the specific contribution of risk factors for SD over time. Methods A nested case control study comparing all singleton deliveries with and without SD was undertaken. A multivariable logistic regression model was used in order to identify independent risk factors for SD and a comparison of the prevalence and the specific contribution (odds ratio (OR)) of the chosen risk factors in three consecutive eight-year intervals from 1988 to 2014 was performed. Results During the study period, there were 295,946 deliveries. Of them 514 (0.174%) were complicated with SD. Between 1988 and 2014 the incidence of SD has decreased from 0.3% in 1988 to 0.1% in 2014. Using a logistic regression model grandmultiparity, diabetes mellitus (DM), fetal weight, and large for gestational age (LGA) were found to be independent risk factors for SD (OR 1.25 95% CI 1.04-1.51, p=0.02; OR 1.53 95% CI 1.19-1.97, p=0.001; OR 1.002 95% CI 1.001-1.002, p < 0.001; OR 3.88 95% CI 3.09-4.87, p < 0.001; respectively). While the OR for grandmultiparity, fetal weight, and LGA has significantly changed during the study period with a mixed trend, the OR of DM has demonstrated a significant linear increase over time. Conclusions The individual contribution of selected risk factors for the occurrence of SD has significantly changed throughout the years. The contribution of DM has demonstrated a linear increase over time, emphasizing the great impact of DM on SD.
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Affiliation(s)
- Leah Grossman
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gali Pariente
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yael Baumfeld
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - David Yohay
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Reut Rotem
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem, Israel
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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9
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Heath AF, Di Stasio V. Racial discrimination in Britain, 1969-2017: a meta-analysis of field experiments on racial discrimination in the British labour market. Br J Sociol 2019; 70:1774-1798. [PMID: 31168788 DOI: 10.1111/1468-4446.12676] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
Field experiments represent the gold standard for determining whether discrimination occurs. Britain has a long and distinguished history of field experiments of racial discrimination in the labour market, with pioneering studies dating back to 1967 and 1969. This article reviews all the published reports of these and subsequent British field experiments of racial discrimination in the labour market, including new results from a 2016/17 field experiment. The article finds enduring contours of racial discrimination in Britain. Firstly, there is an enduring pattern of modest discrimination against white minorities of European heritage in contrast to much greater risks of discrimination faced by the main non-white groups, suggesting a strong racial component to discrimination. Secondly, while there is some uncertainty about the magnitude of the risks facing applicants with Chinese and Indian names, the black Caribbean, black African and Pakistani groups all face substantial and very similar risks of discrimination. Thirdly, there is no significant diminution in risks of discrimination over time either for Caribbeans or for South Asians as a whole. These results are broadly in line with those from the ethnic penalties literature, suggesting that discrimination is likely to be a major factor explaining the disproportionately and enduringly high unemployment rates of ethnic minorities.
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10
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Jonklaas J, Tefera E, Shara N. Short-Term Time Trends in Prescribing Therapy for Hypothyroidism: Results of a Survey of American Thyroid Association Members. Front Endocrinol (Lausanne) 2019; 10:31. [PMID: 30761091 PMCID: PMC6363658 DOI: 10.3389/fendo.2019.00031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 12/08/2018] [Accepted: 01/16/2019] [Indexed: 12/27/2022] Open
Abstract
Objective: Hypothyroid patients frequently request specific therapies from their physicians. Combination therapy is vigorously discussed at professional meetings. We wished to determine if physician prescribing patterns for hypothyroidism changed during 2017 after specific educational events. Methods: A survey addressing treatment of hypothyroidism was emailed to American Thyroid Association (ATA) members on three occasions in 2017. The Spring emails were sent prior to a satellite symposium addressing hypothyroidism, and prior to the annual Endocrine Society and ATA meetings; the December emails were sent after these events. Physicians were presented with thirteen theoretical patients and chose from 6 therapeutic options, including levothyroxine, synthetic combination therapy, thyroid extract, and liothyronine monotherapy. The patient scenarios successively incorporated factors potentially providing reasons for considering combination therapy. Multivariate repeated measures logistic regression analyses first examined effects of physician characteristics on prescribing the various therapies. Then, analyses also incorporated timing, by comparing prescribing patterns in February, March, and December. Results: In analyses of prescribing levothyroxine monotherapy vs. any T3 therapy, there was a trend of borderline significance (p = 0.053) for T3 therapy to be prescribed more in December compared with February-March combined. When multivariate analyses were performed controlling for time and physician characteristics, choice of therapy was only significantly affected by country of practice (OR 1.7, CI 1.3-2.2). Physician choice of therapies was also examined for the options of continuing (1) levothyroxine, vs. (2) increasing levothyroxine, (3) adding liothyronine either with or without levothyroxine reduction, or (4) replacing levothyroxine with desiccated thyroid extract or liothyronine. When multivariate analyses incorporating time and physician characteristics were performed, respondents in December (OR 1.5, CI 1.0-2.3) and those practicing in North America (OR 1.8, CI 1.2-2.6) were more likely to prescribe liothyronine. Conclusions: This survey shows that although current North American guidelines do not recommend combination therapy, such therapy is being prescribed more over time and is also more commonly prescribed in North America. It is possible our guidelines are failing to incorporate evidence that physicians are considering when prescribing combination therapy. Such evidence could include data about patient preferences, and this needs to be a focus of future studies.
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Affiliation(s)
- Jacqueline Jonklaas
- Division of Endocrinology, Georgetown University, Washington, DC, United States
- *Correspondence: Jacqueline Jonklaas
| | - Eshetu Tefera
- Department of Biostatistics and Biomedical Informatics, Medstar Health Research Institute, Hyattsville, MD, United States
| | - Nawar Shara
- Division of Endocrinology, Georgetown University, Washington, DC, United States
- Department of Biostatistics and Biomedical Informatics, Medstar Health Research Institute, Hyattsville, MD, United States
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11
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Waller M, Lissner L, Hange D, Sund V, Blomstrand A, Björkelund C. Socioeconomic disparities in physical activity among Swedish women and trends over time - the population study of women in Gothenburg. Scand J Prim Health Care 2018; 36:363-371. [PMID: 30394815 PMCID: PMC6381527 DOI: 10.1080/02813432.2018.1499599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 06/26/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To explore secular trends in physical activity in relation to socioeconomic position in middle-aged women, with focus on whether the social gaps have become wider, narrower, or remain unchanged. DESIGN Cohort comparisons between two representative samples of women, recruited in 1980-81 and 2004-05 as a part of the Population Study of Women in Gothenburg. SETTING Gothenburg, the second largest city of Sweden, with ≈ 450 000 inhabitants. SUBJECTS Population-based cohorts of 38- and 50-year-old women, invited in 1980-81 and 2004-05 to free health examinations. The study population in 1980 was n = 477, 38- and 50-year-old women born in 1930 (n = 355) and 1942 (n = 122), and in 2004 n = 500, 38- and 50-year- old women born in 1966 (n = 207) and 1954 (n = 293). MAIN OUTCOME MEASURE Physical activity at work and leisure time. Socioeconomic position was defined based on socio-occupational group and level of education. Physical activity during work and leisure time was based on questionnaires. RESULTS On average 38- and 50-year-old women were more physically active at work and leisure time in 2004-05 compared to 1980-81; odds ratio (OR) for increase over time for physical activity at work for 38-year-olds: 2.59, (95% confidence interval (CI) 1.65-4.07), and for 50-year-olds: OR 2.09 (1.52-2.88); OR for increase physical activity leisure time in 38-year-olds: 1.93 (1.25-2.98), and in 50-year-olds 2.04 (1.49-2.79). There were no significant differences between socioeconomic groups in physical activity levels changes over time. CONCLUSION Women in different socioeconomic groups improved their physical activity at work and leisure time to the same extent from 1980 to 2004, indicating that the socioeconomic gap in physical activity is neither increasing nor decreasing. Key Points The gap in physical activity levels between socioeconomic groups seems to have remained stable for middle-aged women the last 25 years. • However, women were more physically active in 2004 at work and during leisure time, independent of socioeconomic position, compared to 1980. • It remains a great challenge to create structures that enable these behaviours for all social groups.
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Affiliation(s)
- Maria Waller
- Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- Department of Public Health and Community Medicine/Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Dominique Hange
- Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Valter Sund
- Department of Public Health and Community Medicine/Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Blomstrand
- Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Cecilia Björkelund
- Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Beck B, Gantner D, Cameron PA, Braaf S, Saxena M, Cooper DJ, Gabbe BJ. Temporal Trends in Functional Outcomes after Severe Traumatic Brain Injury: 2006-2015. J Neurotrauma 2018; 35:1021-1029. [PMID: 29256832 DOI: 10.1089/neu.2017.5287] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Severe traumatic brain injury (TBI) is associated with poor outcomes; however, little is known about whether these outcomes are improving over time. This study examined temporal trends in functional outcomes of severe TBI at six months post-injury. We conducted a retrospective cohort study (January 1, 2006 to December 31, 2015) of hospitalized adult (≥16 years) patients with severe TBI using data from the population-based Victorian State Trauma Registry. The primary outcome was the Glasgow Outcome Scale-Extended (GOS-E) at six months post-injury, dichotomized as upper severe disability or worse (GOS-E ≤4, termed "unfavorable outcome") and lower moderate disability or better (GOS-E ≥5; termed "favorable outcome"). Multivariable logistic regression was used to investigate temporal trends in functional outcomes at six months post-injury. Of the 1966 patients with severe TBI who were followed up at six months post-injury (median age, 42 years (interquartile range [IQR]: 25-68); male, 73%), a majority of patients had an unfavorable outcome (GOS-E ≤4; n = 1372, 70%). After adjusting for confounders, there was no change in functional outcomes over time (adjusted odds ratio [AOR] = 1.02, 95% confidence interval [CI]: 0.98,1.06; p = 0.35). Similarly, there was no change in the adjusted odds of death (GOS-E = 1) at six months post-injury (AOR = 1.04, 95% CI: 1.00,1.08; p = 0.08). Using a population-wide, high quality, comprehensive registry, we demonstrated no change in death or functional outcomes after severe TBI between 2006 and 2015 in a mature trauma system. There is a clear need to identify targeted improvements in the treatment of these patients with the aim of reducing in-hospital death and improving long-term outcomes.
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Affiliation(s)
- Ben Beck
- 1 Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Victoria, Australia
| | - Dashiell Gantner
- 2 Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Victoria, Australia .,3 Department of Intensive Care and Hyperbaric Medicine, The Alfred , Melbourne, Victoria, Australia
| | - Peter A Cameron
- 1 Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Victoria, Australia .,4 Emergency and Trauma Centre, The Alfred Hospital , Melbourne, Victoria, Australia
| | - Sandra Braaf
- 1 Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Victoria, Australia
| | - Manoj Saxena
- 5 Intensive Care Unit, St George Hospital , Sydney, New South Wales, Australia .,6 Critical Care & Trauma Division, The George Institute for Global Health , University of New South Wales, Sydney, New South Wales, Australia
| | - D James Cooper
- 2 Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Victoria, Australia .,3 Department of Intensive Care and Hyperbaric Medicine, The Alfred , Melbourne, Victoria, Australia
| | - Belinda J Gabbe
- 1 Department of Epidemiology and Preventive Medicine, Monash University , Melbourne, Victoria, Australia .,7 Farr Institute, Swansea University Medical School, Swansea University , Swansea, United Kingdom
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van de Luijtgaarden MWM, Jager KJ, Segelmark M, Pascual J, Collart F, Hemke AC, Remón C, Metcalfe W, Miguel A, Kramar R, Aasarød K, Abu Hanna A, Krediet RT, Schön S, Ravani P, Caskey FJ, Couchoud C, Palsson R, Wanner C, Finne P, Noordzij M. Trends in dialysis modality choice and related patient survival in the ERA-EDTA Registry over a 20-year period. Nephrol Dial Transplant 2015; 31:120-8. [PMID: 26311215 DOI: 10.1093/ndt/gfv295] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/09/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although previous studies suggest similar patient survival for peritoneal dialysis (PD) and haemodialysis (HD), PD use has decreased worldwide. We aimed to study trends in the choice of first dialysis modality and relate these to variation in patient and technique survival and kidney transplant rates in Europe over the last 20 years. METHODS We used data from 196 076 patients within the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry who started renal replacement therapy (RRT) between 1993 and 2012. Trends in the incidence rate and prevalence on Day 91 after commencing RRT were quantified with Joinpoint regression. Crude and adjusted hazard ratios (HRs) for 5-year dialysis patient and technique survival were calculated using Cox regression. Analyses were repeated using propensity score matching to control for confounding by indication. RESULTS PD prevalence dropped since 2007 and HD prevalence stabilized since 2009. Incidence rates of PD and HD decreased from 2000 and 2009, respectively, while the incidence of kidney transplantation increased from 1993 onwards. Similar 5-year patient survival for PD versus HD patients was found in 1993-97 [adjusted HR: 1.02, 95% confidence interval (95% CI): 0.98-1.06], while survival was higher for PD patients in 2003-07 (HR: 0.91, 95% CI: 0.88-0.95). Both PD (HR: 0.95, 95% CI: 0.91-1.00) and HD technique survival (HR: 0.93, 95% CI: 0.87-0.99) improved in 2003-07 compared with 1993-97. CONCLUSIONS Although initiating RRT on PD was associated with favourable patient survival when compared with starting on HD treatment, PD was often not selected as initial dialysis modality. Over time, we observed a significant decline in PD use and a stabilization in HD use. These observations were explained by the lower incidence rate of PD and HD and the increase in pre-emptive transplantation.
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Affiliation(s)
- Moniek W M van de Luijtgaarden
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mårten Segelmark
- Department of Nephrology, Linköping University, Linköping, Sweden Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Julio Pascual
- Department of Nephrology, Hospital del Mar, Barcelona, Spain
| | | | | | - César Remón
- SICATA (The Information System of the Andalusian Transplant Autonomic Coordination Registry), Andalusia, Spain
| | | | - Alfonso Miguel
- Department of Nephrology, University Clinic Hospital, Valencia, Spain
| | - Reinhard Kramar
- OEDTR, Austrian Dialysis and Transplant Registry, Linz, Austria
| | - Knut Aasarød
- Department of Nephrology, St Olavs Hospital HF, Trondheim, Norway
| | - Ameen Abu Hanna
- Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Raymond T Krediet
- Division of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Pietro Ravani
- Department of Medicine and Community Health Science, University of Calgary, Calgary, Alberta, Canada
| | | | - Cecile Couchoud
- REIN Registry, Biomedicine Agency, La Plaine-Saint Denis, France
| | - Runolfur Palsson
- Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Christoph Wanner
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Division of Nephrology, University Hospital Würzburg, Würzburg, Germany
| | - Patrik Finne
- Finnish Registry for Kidney Diseases, Helsinki, Finland
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
OBJECTIVE To monitor the changes in dental caries prevalence of 5- to 7-year-old children living in a fluoridated area, a newly fluoridated area and in an area without water fluoridation, in NSW, Australia. METHODS Dental caries prevalence was recorded for 5- to 7-year-old children, living in the three study locations, by six trained and calibrated examiners in 2008, 2010 and 2012. A questionnaire recorded demographic data, toothbrushing behaviour and sugary drink consumption. Caries experience was measured using the decayed, missing, and filled teeth (dmft) index for primary teeth, the percentage of children who were caries free and the significant caries index. Univariate analysis was undertaken to determine independent predictors of caries. RESULTS The caries prevalence changed over time. In 2008, the mean dmft index was 1.40 for the fluoridated area, 2.02 for the area about to fluoridate and 2.09 for the unfluoridated control. By 2012, these mean dmft scores were 0.69, 0.72 and 1.21, respectively. In the two areas where children received fluoridated water, the significant caries index was 2.30 for the fluoridated area and 2.40 for the newly fluoridated area. The significant caries score for children in the unfluoridated location was 3.93. Multivariate analysis showed that over time the differences in dental caries prevalence between the established fluoride area and the newly fluoridated area diminished. However, children in the unfluoridated control area continued to demonstrate significant differences in the mean number of decayed teeth compared with children in the fluoridated comparator sites, and the proportions of children free from decay were significantly higher in the fluoridated areas than in the unfluoridated area. CONCLUSION Fluoridation of public water supplies in Gosford and Wyong offers young children better dental health than those children who do not have access to this public health measure.
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Affiliation(s)
| | - Roy Byun
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia.,South Western Local Health District, Sydney, NSW, Australia
| | - Pathik Mehta
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Meredith Kay
- Breast Screen NSW, Northern Sydney and Central Coast Local Health Districts, St Leonards, NSW, Australia
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Abstract
OBJECTIVE The aim of the article is to provide an update on medication use in infants admitted to the neonatal intensive care unit (NICU) in the United States and examine how use has changed over time. STUDY DESIGN We performed a retrospective review (2005-2010) of a large prospectively collected administrative database. RESULT Medications most commonly administered during the study period were ampicillin, gentamicin, caffeine citrate, vancomycin, beractant, furosemide, fentanyl, dopamine, midazolam, and calfactant (56-681 exposures per 1,000 infants). Those with the greatest relative increase in use included azithromycin, sildenafil, and milrinone. Medications with the greatest relative decrease in use included theophylline, metoclopramide, and doxapram. CONCLUSION Medication use in the NICU has changed substantially over time, and only 35% of the most commonly prescribed medications are Food and Drug Administration -approved in infants.
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Affiliation(s)
- Emily M. Hsieh
- Duke-National University of Singapore Graduate Medical School, Singapore
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Christoph P. Hornik
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - Reese H. Clark
- Pediatrix-Obstetrix Center for Research and Education, Sunrise, Florida, USA
| | - Matthew M. Laughon
- Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Daniel K. Benjamin
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - P. Brian Smith
- Duke Clinical Research Institute, Durham, North Carolina, USA
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
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