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Crude Analysis (crude + analysis)
Selected AbstractsEffect of NSAIDs on the recurrence of nonmelanoma skin cancerINTERNATIONAL JOURNAL OF CANCER, Issue 3 2006Maria V. Grau Experimental studies have consistently shown a protective effect of nonsteroidal antiinflammatory drugs (NSAIDs) against nonmelanoma skin cancers (NMSC). However, little human epidemiological research has been done in this regard. We used data from the Skin Cancer Chemoprevention Study to explore the association of NSAID use and with the risk of basal-cell carcinoma (BCC) and squamous-cell carcinoma (SCC). 1,805 subjects with a recent history of NMSC were randomized to placebo or 50 mg of daily ,-carotene. Participants were asked about their use of over-the-counter and prescription medications at baseline and every 4 months during the trial. Skin follow-up examinations were scheduled annually with a study dermatologist; confirmed lesions were the endpoints in the study. We used a risk set approach to the analysis of grouped times survival data and unconditional logistic regression to compute odds ratios [ORs] for various exposures to NSAIDs. The use of NSAIDs was reported in over 50% of questionnaires. For BCC, NSAIDs exhibited a weak protective effect in crude analyses, which attenuated markedly after adjustment. For SCC, the use of NSAIDs in the year previous to diagnosis reduced the odds by almost 30% (adjusted OR= 0.71, 95% CI 0.48,1.04). When we accounted for frequency of use, results for BCC were not striking, and there were inconsistent suggestions of an inverse association with SCC. There were some indications of a modest, nonsignificant reduction on the number of BCCs and SCCs with NSAID use. Our data suggest a weak and inconsistent chemopreventive effect of NSAIDs on BCC and SCC. © 2006 Wiley-Liss, Inc. [source] Psychiatric Comorbidity in Epilepsy: A Population-Based AnalysisEPILEPSIA, Issue 12 2007Jose F. Tellez-Zenteno Summary Purpose: The estimated prevalence of mental health disorders in those with epilepsy in the general population varies owing to differences in study methods and heterogeneity of epilepsy syndromes. We assessed the population-based prevalence of various psychiatric conditions associated with epilepsy using a large Canadian national population health survey. Methods: The Canadian Community Health Survey (CCHS 1.2) was used to explore numerous aspects of mental health in persons with epilepsy in the community compared with those without epilepsy. The CCHS includes administration of the World Mental Health Composite International Diagnostic Interview to a sample of 36,984 subjects. Age-specific prevalence of mental health conditions in epilepsy was assessed using logistic regression. Results: The prevalence of epilepsy was 0.6%. Individuals with epilepsy were more likely than individuals without epilepsy to report lifetime anxiety disorders or suicidal thoughts with odds ratio of 2.4 (95% CI = 1.5,3.8) and 2.2 (1.4,3.3), respectively. In the crude analysis, the odds of lifetime major depression or panic disorder/agoraphobia were not greater in those with epilepsy than those without epilepsy, but the association with lifetime major depression became significant after adjustment for covariates. Conclusions: In the community, epilepsy is associated with an increased prevalence of mental health disorders compared with the general population. Epilepsy is also associated with a higher prevalence of suicidal ideation. Understanding the psychiatric correlates of epilepsy is important to adequately manage this patient population. [source] Mitigating on-call symptoms through organizational justice and job control: a cross-sectional study among Finnish anesthesiologistsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2009P. M. LINDFORS Background: On-call duty has been shown to be associated with health problems among physicians. However, it cannot be abolished, as patient safety has to be assured. Thus, we need to find factors that could mitigate the negative health effects of on-call duty. Methods: The cross-sectional questionnaire of the buffering effects of organizational justice, job control, and social support on on-call stress symptoms was sent to all working Finnish anesthesiologists (n=550). Results: The response rate was 60% (n=328, 53% men). High organizational justice, job control, and social support were associated with a low number of symptoms while on call or the day after in crude analysis and when adjusted for age, gender, and place of work. Only the association between justice and symptoms was robust to additional adjustments for on-call burden and self-rated health. In the interaction analysis among those being on call at the hospital, we found that the higher the levels of job control or organizational justice, the lower the number of symptoms. Conclusions: Job control and organizational justice successfully mitigated stress symptoms among those who had on-call hospital duties. It would be worth enhancing decision-making procedures, interpersonal treatment, and job control routines when aiming to prevent on-call stress and related symptoms. [source] Bronchopulmonary dysplasia and brain white matter damage in the preterm infant: a complex relationshipPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2009Luigi Gagliardi Summary We analysed the relationship between bronchopulmonary dysplasia (BPD) and brain white matter damage (WMD) in very preterm infants, adjusting for common risk factors and confounders. We studied a cohort of infants <32 weeks gestational age (GA) and <1500 g, admitted to 12 hospitals in Northern Italy in 1999,2002. The association between BPD and WMD was estimated by generalised estimating equations and conditional logistic models, adjusting for centre, GA, propensity score for prolonged ventilation and other potential confounders. Directed acyclic graphs (DAG) were used to depict the underlying causal structure and guide analysis. Of the 1209 infants reaching 36 weeks, 192 (15.8%) developed BPD (supplemental oxygen at 36 weeks) and 88 (7.3%) ultrasound-defined WMD (cystic periventricular leukomalacia). In crude analysis, BPD was a strong risk factor for WMD [odds ratio (OR) = 5.9]. With successive adjustments, the OR progressively decreased to 3.88 when adjusting for GA, to 2.72 adding perinatal risk factors, and further down to 2.16 [95% confidence interval 1.1, 3.9] when ventilation was also adjusted for. Postnatal factors did not change the OR. Significant risk factors for WMD, in addition to BPD, were a low GA, a lower Apgar score, a higher illness severity score, ventilation and early-onset sepsis, while antenatal steroids, being small for GA, and surfactant were associated with a reduced risk. In conclusion, our data suggest that BPD is associated with an increased risk of WMD; most of the effect is due to shared risk factors and causal pathways. DAGs helped clarify the complex confounding of this scenario. [source] Associations of Rural Residence With Timing of HIV Diagnosis and Stage of Disease at Diagnosis, South Carolina 2001-2005THE JOURNAL OF RURAL HEALTH, Issue 2 2010Kristina E. Weis PhD Abstract Context: Rural areas in the southern United States face many challenges, including limited access to health care services and stigma, which may lead to later HIV diagnosis among rural residents. Purpose: To investigate the associations of rural residence with timing of HIV diagnosis and stage of disease at diagnosis. Methods: Timing of HIV diagnosis was categorized as a diagnosis of acquired immune deficiency syndrome within 1 year of a first positive HIV test or HIV-only. Stage of disease was based on initial CD4+ T-cell count taken within 1 year of diagnosis. County of residence at HIV diagnosis was classified as urban if the population of the largest city was at least 25,000; it was classified as rural otherwise. Logistic regression was used to analyze timing of HIV diagnosis, and analysis of covariance was used to analyze stage of disease. Findings: From 2001 to 2005, 4,137 individuals were diagnosed with HIV infection. Of these, 1,129 (27%) were rural and 3,008 (73%) were urban residents. Among rural residents, 533 (47%) were diagnosed late, compared with 1,258 (42%) urban residents. Rural residents were significantly more likely to be diagnosed late (OR 1.19 [95% CI, 1.02-1.38]). Rural residence was associated with lower initial CD4+ T-cell count in crude analysis (P= .01) but not after adjustment (P > .05). Conclusions: Rural residence is a risk factor for late HIV diagnosis. This may lead to reduced treatment response to antiretroviral medications, increased morbidity and mortality, and greater HIV transmission risks among rural residents. New testing strategies are needed that address challenges to HIV testing and diagnosis specific to rural areas. [source] Reliance on erythema scores may mask severe atopic dermatitis in black children compared with their white counterpartsBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2002M.A. Ben-Gashir SummaryBackground The prevalence of atopic dermatitis (AD) has been shown to be higher in London-born black Caribbean children than in their white counterparts, but little is known about the severity of the disease. Objectives To carry out a longitudinal survey to investigate potential risk factors for AD severity in children. We report our findings in relation to differences in disease severity between white and black children and the effect of inclusion and exclusion of erythema scores on this comparison. Methods The recruited children were identified by their general practitioners (GPs) as having presented with AD, and the U.K. diagnostic criteria for AD were used to verify the diagnosis. Interview and clinical examination of children took place up to four times, 6 months apart. Each time, the same observer assessed AD severity using the SCORAD (SCORe Atopic Dermatitis) index. Potential risk factors and confounders were evaluated with a five-page questionnaire. Non-parametric tests were used for statistical analysis and the study participant remained the unit of the analysis. Results In total, 137 children (82 urban and 55 rural) were recruited, and each seen up to four times. This gave 380 observations (69% of an expected 548). The urban population contained 42 (51%) white children, 26 (32%) black children and 14 (17%) from other races. The rural population was entirely white. The 14 children from other races were completely excluded from the statistical analysis. The black children were all born in the U.K. On crude analysis, children with black skin showed a non-significantly lower risk of severe disease when compared with white children (odds ratio, OR 0·84; 95% confidence interval, CI 0·4,1·76; P = 0·65), while a highly significantly increased risk was found after adjusting for erythema score (OR 5·93; 95% CI 1·94,18·12; P = 0·002). The difference remained significant even after controlling for other potential confounders. Conclusions Black children with AD are about six times more at risk of having severe AD than their white counterparts. GPs and dermatologists should note that erythema can be a misleading indicator of severity in black children. Difficulties of assessment due to skin pigmentation might mean that severe cases are not being detected and appropriately treated. [source] Family and school determinants of overweight in 13-year-old Portuguese adolescentsACTA PAEDIATRICA, Issue 2 2007Elisabete Ramos Abstract Aims: To identify familial and school determinants of overweight in 13-year-old adolescents. Methods: All 27 public and 19 (79%) private schools allowed to contact age eligible students, 77.5% accepting to participate (1116 girls, 1045 boys). Self-administered questionnaires were completed and physical examination performed, including weight and height measurements. Overweight (>95th percentile) and at risk of overweight (85th,95th) were defined using CDC standards. Its determinants were identified using logistic regression models, entering parents' education and all variables significantly associated in crude analysis. Results: Prevalence of overweight (10.2%) and at risk of overweight (16.5%) was not influenced by type of school, vending machines and number of school canteen meals. In girls, the prevalence of body mass index (BMI) >85th percentile increased significantly with decreasing age at menarche (45.7% if menstruating before 11-year and 13.2% when pre-menarche), and increasing parental BMI or time spent on sedentary activities. In multivariate analysis, age at menarche and increasing parental BMI remained significant risks in girls. In boys, besides parental BMI, ever smoking, sleeping <9 h and sedentary leisure activities were significant determinants. Conclusions: Food offered at school had no significant impact on adolescents overweight, which was mainly dependent on parental anthropometrics and leisure time activities. [source] | ||||||||||