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General Population (general + population)
Kinds of General Population Terms modified by General Population Selected AbstractsNatural History of Gastric Cancer After Helicobacter pylori Eradication in Japan: After Endoscopic Resection, After Treatment of the General Population, and NaturallyHELICOBACTER, Issue 3 2006David Y. Graham First page of article [source] Effect of Fish Oil Supplementation on Quality of Life in a General Population of Older Dutch Subjects: A Randomized, Double-Blind, Placebo-Controlled TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2009Ondine Van De Rest MSc OBJECTIVES: To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Independently living individuals from the general older Dutch population. PARTICIPANTS: Three hundred two individuals aged 65 and older without depression or dementia. INTERVENTION: 1,800 mg/d EPA-DHA (n=96), 400 mg/d EPA-DHA (n=100), or placebo capsules (n=106) for 26 weeks. MEASUREMENTS: QOL was assessed using the short version of the World Health Organization QOL questionnaire (WHOQOL-BREF). The WHOQOL-BREF covers four domains: physical health, psychological health, social relationships, and satisfaction with environment. The total score range is 26 to 130, with higher scores indicating a more favorable condition. RESULTS: Mean age of the participants was 70, and 55% were male. Plasma concentrations of EPA-DHA increased 238% in the high-dose and 51% in the low-dose EPA-DHA group, reflecting excellent adherence. Median baseline total WHOQOL scores ranged from 107 to 110 in the three groups and were not significantly different from each other. After 26 weeks, the mean difference from placebo was ,1.42 (95% confidence interval (CI)=,3.40,0.57) for the high-dose and 0.02 (95% CI=,1.95,1.99) for the low-dose fish oil group. Treatment with 1,800 mg or 400 mg EPA-DHA did not affect total QOL or any of the separate domains after 13 or 26 weeks of intervention. CONCLUSION: Supplementation with high or low doses of fish oil for 26 weeks did not influence the QOL of healthy older individuals. [source] Walking and Talking as Predictors of Falls in the General Population: The Leiden 85-Plus StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2003Annetje Bootsma-van der Wiel MD Objectives: To compare the value of dual tasking in predicting falling in the general population of oldest old with that of easy-to-administer single tasks. Design: Prospective population-based follow-up study. Setting: Municipality of Leiden, the Netherlands. Participants: Representative cohort of 380 individuals, all aged 85 at baseline. Measurements: During enrollment, walking time over a 12-meter distance was measured, as well as the verbal fluency to recite names of animals or professions during a 30-second period. In the dual task, performance was assessed when participants combined walking with reciting names. Incidence of falls and fractures was assessed by interviewing participants and checking their medical histories. Results: After 1 year of follow-up, 42% of the participants reported one or more falls, and 4% suffered a fracture. Total walking time, number of steps, and verbal fluency were all strongly related to incident falls (P for trend for all <.01), but dual-task performance was not a better predictor for incident falls than single-task performance. Conclusion: The dual-task test in this study had no predictive value above that of a single-task test to predict falling. Dual tasks with more-sensitive measures of impaired dual-task execution might have better test characteristics. In this study, history of falls and performance on an easy-to-administer single walking task identified old persons at higher risk for falling who could benefit from fall preventive strategies. [source] Adverse Outcomes of Osteoporotic Fractures in the General Population,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2003L Joseph Melton III MD Abstract Osteoporotic fractures exact a terrible toll on the population with respect to morbidity and cost, and to a lesser extent mortality, which will increase dramatically with the growing elderly population. Attention has focused on the 12-20% excess deaths after hip fracture, but most are caused by underlying medical conditions unrelated to osteoporosis. More important is fracture-related morbidity. An estimated 10% of patients are disabled by hip fracture, and 19% require institutionalization, accounting for almost 140,000 nursing home admissions annually in this country. Distal forearm and vertebral fractures less commonly result in nursing home placement, but about 10% of postmenopausal women have vertebral deformities that cause chronic pain, and a substantial minority have poor function after forearm fracture. These fractures interfere greatly with the activities of daily living, and all of them can have a substantial negative impact on quality of life. Annual expenditures for osteoporotic fracture care in the United States ($17.5 million in 2002 dollars) are dominated by hip fracture treatment, but vertebral fractures, distal forearm fractures, and importantly, the other fractures related to osteoporosis contribute one-third of the total. Although all fracture patients are at increased risk of future fractures, few of them are currently treated for osteoporosis, and only a subset (i.e., those with vertebral fractures) are considered candidates for many clinical trials. Eligibility criteria should be expanded and fracture end-points generalized to acknowledge the overall burden of osteoporotic fractures. [source] Hazardous Drinking: Prevalence and Associations in the Finnish General PopulationALCOHOLISM, Issue 9 2008Jukka T. Halme Background:, Hazardous drinking, defined as consuming alcohol on a risky level and not meeting the diagnostic criteria of alcohol use disorders (AUDs), has been suggested for a new complementary nondependence diagnosis. This study aimed to investigate the prevalence and associations of hazardous drinking in comparison to AUDs, moderate drinking, and abstinence. Methods:, A national representative sample of Finns was examined in the Health 2000 Survey. For 4477 subjects aged 30 to 64 years (76%, 2341 females), both the quantity frequency data about alcohol consumption and Composite International Diagnostic Interview (CIDI) data concerning AUD diagnoses were available. The nationally recommended limits for hazardous dinking were used (males: 24 drinks, females: 16 drinks/wk). Logistic regression models were used to analyze associations. Results:, The prevalence of hazardous drinking was 5.8%. Hazardous drinking was more prevalent among males than females (8.5% vs. 3.1%). It was most prevalent among the subjects aged 40 to 49 years (7.3%), divorced or separated (8.3%), unemployed (8.2%) and subjects living in the southern (Helsinki) region (7.5%). AUDs versus hazardous drinking were more likely to be in males versus females and in the unemployed versus employed. Subjects aged 40 and over had higher odds for hazardous drinking versus AUDs. The odds for hazardous versus moderate drinking were higher for males versus females (adjusted odds ratio = 3.24), for subjects aged over 40 years, unemployed versus employed and cohabiting, divorced/separated or unmarried subjects versus married subjects. Conclusion:, The high prevalence of hazardous drinking makes it an important public health concern. Hazardous drinkers have different sociodemographic characteristics as compared to people in other alcohol use categories. [source] Enhanced Clinical Utility of ,-CDT in a General PopulationALCOHOLISM, Issue 8 2000Pekka Sillanaukee Background: The use of a combination of markers to detect excessive alcohol consumption has been reported to provide better sensitivity in the diagnosis of alcohol abuse than single markers. However, the optimal combination of markers for the diagnosis of alcohol abuse has not yet been found. The aim of this study was to compare the diagnostic value of carbohydrate-deficient transferrin (CDT) and ,-glutamyltransferase (GGT) to discriminate among heavy drinkers (>280 g/week), moderate drinkers (105,280 g/week), and light drinkers (<105 g/week). Their mathematical combination, named ,-CDT, which has been found to be a strong marker of alcohol abuse in a former study, was also evaluated. Methods: The study was conducted in a group of 6962 subjects (3974 males and 2988 females), between the ages of 25 and 74 years, who participated in a large cross-sectional risk factor survey carried out in five geographic areas in Finland. In each study area, an age- and gender-stratified random sample was drawn from the general population. Sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic curves were used to evaluate the performance of CDT, GGT, and ,-CDT. Results: For both sexes, the combined marker had the highest specificity (95%) and sensitivity in detecting heavy drinkers. In all cases, ,-CDT had the highest area under ROC plots. Our results also showed that GGT and CDT have similar, and rather low, sensitivity but high specificity in a general population. Conclusions: Compared with single markers, a significant improvement of sensitivity was obtained when the combination of both markers was used, especially in females. [source] The Prevalence and Impact of Chronic Pain with Neuropathic Pain Symptoms in the General PopulationPAIN MEDICINE, Issue 5 2009Cory Toth BSc, FRCPC ABSTRACT Objective., We performed a prevalence estimate of chronic pain with neuropathic pain (NeP) symptoms to determine its frequency and associations with morbidity. Design., We conducted a telephone-based survey based upon a random sampling of both urban and rural households of the general population in one Canadian province to determine NeP prevalence and its impact upon financial well-being and quality of life. Outcome Measures., Telephonic use of the DN4 questionnaire (DN4Q), used to identify NeP symptoms in those patients with chronic pain, was validated within selected clinical populations of chronic pain. Epidemiological data was obtained for all subjects. EuroQoL (EQ)-5D data estimating quality of life was measured. Results., Chronic pain was present in 35.0% of the surveyed population of 1,207 subjects, with NeP symptoms present in 17.9%. The NeP group had significantly more pain, was female predominant, had a greater belief of being economically disadvantaged, suffered from more restrictions in mobility and in usual activities, and had overall lower EQ-5D utility scores compared with subjects with non-NeP. DN4Q validation demonstrated that pain entities not normally defined as NeP are recorded as such using the DN4Q, and that a spectrum of NeP features may occur across a host of painful conditions. Conclusion., Despite limitations of the DN4Q, symptoms of NeP may be more prevalent in the general population than expected and has a greater impact upon patients' lives than non-NeP. Limitations of the DN4Q may relate to the concept of a spectrum of NeP existent amongst heterogenous NeP and non-NeP syndromes. [source] Round Table: How to Promote Awareness on Sexual Health in the General Population: L22: European Sexual Awareness Event 2003 and 2004THE JOURNAL OF SEXUAL MEDICINE, Issue 2004Edoardo S. Pescatori [source] Carotid Stenosis as Detected by Ultrasound in a General Population is a Strong Predictor of DeathACTA NEUROLOGICA SCANDINAVICA, Issue 5 2001Oddmund Joakimsen Background and Purpose: In the last two decades, ultrasound examinations have increasingly been used as a noninvasive method to screen for carotid stenosis. Several clinical studies have shown that carotid stenosis is a risk factor for ischemic stroke and coronary heart disease and death. However, there is scarce information about stenosis as detected in a general population and the relation with mortality. The purpose of this population-based study was to assess whether carotid stenosis is a predictor of death. Methods: In 1994 to 1995, 248 subjects with suspected carotid stenosis were identified among 6727 men and women 25 to 84 years of age who were examined with ultrasound as part of the population-based Tromsø Study. These subjects and 496 age- and sex-matched control subjects were followed for 4.2 years, and the number and causes of deaths were identified. Results: The unadjusted relative risk for death was 2.72 (95% CI, 1.57 to 4.75) for subjects with stenosis compared with control subjects. Adjusting for cardiovascular risk factors increased the relative risk to 3.47 (95% CI, 1.47 to 8.19). The adjusted relative risk in persons with stenosis and no cardiovascular disease or diabetes was 5.66 (95% CI, 1.53 to 20.90), which was higher than in subjects with stenosis and self-reported disease (1.79; 95% CI, 0.75 to 4.27). There was a dose-response relationship between degree of stenosis and risk of death (P=0.002 for linear trend). Conclusion: Carotid stenosis as detected in a general population is a strong and independent predictor of death. Carotid stenosis was a stronger predictor of death than self-reported cardiovascular disease or diabetes. [source] A taxometric study of alcohol abuse and dependence in a general population sample: evidence of dimensional latent structure and implications for DSM-VADDICTION, Issue 5 2009Tim Slade ABSTRACT Aims To explore, with the aid of taxometric analysis, whether alcohol abuse and alcohol dependence are each conceptualized most effectively as single latent dimensions or distinct latent categories. Design Data were taken from a nationally representative cross-sectional epidemiological survey of psychiatric and substance use disorders. Setting General population of Australia. Participants A subsample of all respondents who had consumed at least 12 drinks in the year prior to the survey and who had consumed at least three drinks on at least one single day (n = 4920 of a possible 10 641). Measurements DSM-IV criteria for alcohol abuse and dependence were assessed with the Composite International Diagnostic Interview, version 2.1. Two independent taxometric procedures, MAXimum EIGenvalue (MAXEIG) and mean above minus below a cut (MAMBAC), together with analysis of simulated dimensional and categorical data sets, were carried out. Findings Consistent evidence was found for a single latent dimension underlying the symptoms of alcohol dependence. Less consistent evidence of dimensionality was found for the symptoms of alcohol abuse. Conclusions These findings support the growing consensus regarding the need for continuous measures of alcohol use disorders to complement the traditional categorical representations in upcoming versions of the major psychiatric classification systems. [source] Valproic acid-induced congenital malformations: Clinical and experimental observationsCONGENITAL ANOMALIES, Issue 4 2000R. Padmanabhan ABSTRACT With a large number of epileptic women being in the childbearing age group, complications of pregnancy in epileptic patients are of concern. Epileptic women are treated with antiepileptic drugs (AED) whether they are pregnant or not. Contrary to prevailing opinion, recent data suggest that epilepsy per se contributes significantly to birth defects possibly because of the same genetic susceptibility that predisposes to epilepsy. Many of these defects closely resemble those attributed to exposure to AED. The syndromes attributed to various AED also considerably overlap with each other. Valproic acid (VPA) induces several minor and major malformations. The relative risk for spina bifida in VPA exposed pregnancies is nearly 20 times higher than that for the general population and about 10 times higher than that attributed to other anticonvulsants. Fetuses of experimental animals treated with VPA during pregnancy exhibit exencephaly unlike the human offspring in whom VPA induces spina bifida. The cranial and spinal malformations observed in humans and laboratory animals indicate that VPA has a preferentially deleterious effect on the neural crest. Several AEDs including VPA tend to lower maternal plasma folate levels. In view of the beneficial effects of periconceptional folate supplementation in prevention of neural tube defects (NTD), future research should be directed at the role of folate in the possible alleviation of VPA-induced NTD. It is also necessary to continue prospective studies to monitor the old and new AED prescribed and to evaluate the role of interactions between drugs used in combinations. [source] Epidemiological data on consumer allergy to p -phenylenediamineCONTACT DERMATITIS, Issue 6 2008Jacob Pontoppidan Thyssen Many women and men now dye their hair. p-Phenylenediamine (PPD) is a frequent and important component of permanent hair dye products; exposure to it may cause allergic contact sensitization, acute dermatitis, and severe facial oedema. To increase our understanding of PPD allergy, we reviewed published literature containing PPD patch test data from dermatitis patients and individuals in the general population. This was performed to estimate the median prevalence and the weighted average of PPD sensitization and thereby assess the burden of PPD-containing hair care products on health. Literature was examined using PubMed,MEDLINE, Biosis, and Science Citation Index. The median prevalence among dermatitis patients was 4.3% in Asia, 4% in Europe, and 6.2% in North America. A widespread increase in the prevalence of PPD sensitization was observed among Asian dermatitis patients. In Europe, a decrease in the 1970s was replaced by a plateau with steady, high prevalences ranging between 2% and 6%. The prevalence remained high in North America, although a decreasing tendency was observed. Contact allergy to PPD is an important health issue for both women and men. More stringent regulation and enforcement are required as public health measures to reduce the burden of disease that exposure to PPD has brought to populations. [source] The epidemiology of contact allergy in the general population , prevalence and main findingsCONTACT DERMATITIS, Issue 5 2007Jacob Pontoppidan Thyssen A substantial number of studies have investigated the prevalence of contact allergy in the general population and in unselected subgroups of the general population. The aim of this review was to determine a median prevalence and summarize the main findings from studies on contact allergy in the general population. Published research mainly originates from North America and Western Europe. The median prevalence of contact allergy to at least 1 allergen was 21.2% (range 12.5,40.6%), and the weighted average prevalence was 19.5%, based on data collected on all age groups and all countries between 1966 and 2007. The most prevalent contact allergens were nickel, thimerosal, and fragrance mix. The median nickel allergy prevalence was 8.6% (range 0.7,27.8%) and demonstrates that nickel was an important cause of contact allergy in the general population and that it was widespread in both men and women. Numerous studies demonstrated that pierced ears were a significant risk factor for nickel allergy. Nickel was a risk factor for hand eczema in women. Finally, heavy smoking was associated with contact allergy, mostly in women. Population-based epidemiological studies are considered a prerequisite in the surveillance of national and international contact allergy epidemics. [source] 10-year prevalence of contact allergy in the general population in Denmark estimated through the CE-DUR methodCONTACT DERMATITIS, Issue 4 2007Jacob Pontoppidan Thyssen The prevalence of contact allergy in the general population has traditionally been investigated through population-based epidemiological studies. A different approach is the combination of clinical epidemiological (CE) data and the World Health Organization-defined drug utilization research (DUR) method. The CE-DUR method was applied in Denmark to estimate the prevalence of contact allergy in the general population and compare it with the prevalence estimates from the Glostrup allergy studies. Contact allergy prevalence estimates ranging from very liberal (,worst case') to conservative (,best case') assumptions were based on patch test reading data in combination with an estimate of the number of persons eligible for patch testing each year based on sales data of the ,standard series'. The estimated 10-year prevalence of contact allergy ranged between 7.3% and 12.9% for adult Danes older than 18 years. The 10-year prevalence of contact allergy measured by CE-DUR was slightly lower than previous prevalence estimates from the Glostrup allergy studies. This could probably be explained by a decrease in nickel allergy. The CE-DUR approach holds the potential of being an efficient and easy monitoring method of contact allergy prevalence. [source] Does PTSD occur in sentenced prison populations?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2007A systematic literature review Background,A systematic review of the literature on mental disorder in prisoners, published in 2002, made no mention of post-traumatic stress disorder (PTSD), but indicators from other studies suggest that a history of serious and chronic trauma is common among offenders. Aims,To conduct a systematic review of the literature with the specific questions: does any epidemiological study of sentenced prisoners include data on prevalence of PTSD while in prison? If so, what is the prevalence in this group? Method,Literature databases EMBASE, Medline, PsychInfo, PILOTS and SIGLE were searched. The Journal of Traumatic Stress was searched manually. Preliminary screening was conducted by reading abstracts of hundreds of papers. Ten exclusion criteria were then applied to the screened selection. Reference sections of all accessed papers were searched for any further studies. Results,One hundred and three potentially relevant papers were identified after preliminary screening. Four met all criteria for inclusion and suffered none of the exclusion criteria. PTSD rates ranged from 4% of the sample to 21%. Women were disproportionately affected. Conclusions and implications for practice,All four papers suggested that the prevalence of PTSD among sentenced prisoners is higher than that in the general population, as reported elsewhere. Overall the findings suggest a likely need for PTSD treatment services for sentenced prisoners. Copyright © 2007 John Wiley & Sons, Ltd. [source] Mortality among mentally disordered offenders: a community based follow-up studyCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2005Tabita Björk Background Follow-up information about outcome for hospitalized mentally disordered offenders (MDO) is necessary for evaluation and improvement in quality of forensic psychiatric care. Aim A study was undertaken to estimate the standard mortality rate (SMR) of a population based sample of people sentenced to forensic psychiatric care. Method All MDOs in Örebro County, Sweden, discharged from a forensic psychiatric treatment unit between 1992 and 1999 were identified (n = 46). The variables were gender, age, offence, diagnosis and duration of admission. Case linkage was made with the National Cause-of-Death register. Median follow-up time was 53 months (0,93). Results The sample yielded a significantly elevated SMR 13.4 (95% CI 4.35,31.3) times higher than that in the general population, mostly due to suicide. Conclusions The cohort size is small but representative, and it provides data from an additional country for the growing international pool confirming the high risk of premature, generally self-inflicted death among MDOs. Resettlement and rehabilitation services for them may need to take as much account of mortality risk as that of reoffending. Copyright © 2005 Whurr Publishers Ltd. [source] Changes in patterns of excessive alcohol consumption in 25 years of high security hospital admissions from England and WalesCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2003Celia McMahon Background It is now generally acknowledged that alcohol abuse increases the risk of violence among people with major mental disorder. Studies in the 1980s and earlier, however, tended to report an inverse relationship between their alcohol use and violence. Aims A study was undertaken to test a hypothesis that among people with major mental disorder considered to pose a serious risk to others the likelihood of excessive alcohol consumption in a period leading up to a violent or dangerous act has increased over time. Methods Analysis was made of annual high security hospital admission cohort case register data of 1 January 1975 to 31 December 1999; alcohol use data were taken from interview and records, and problem drinking defined as consumption of alcohol in excess of 21 units per week during the 12 months prior to the index offence or act. Results There was a linear increase in the proportion of patients in five-year admission cohorts who had engaged in excessive alcohol consumption during the year prior to their index offence or act. The increase was steeper among women than men, but cut across all diagnosis and offending groups. It was strongly associated with increasing tendency to abuse illicit drugs. Conclusions The greater proportion of patients affected by excessive alcohol consumption occurred in spite of a reduction over the same period in admission of people in the diagnostic groups most likely to be implicated in substance misuse (personality disorder). This increased trend may simply reflect similar trends in the general population, but may also be associated with a lack of services or current consensus on appropriate treatment for patients whose mental illness is complicated by excessive alcohol use. Regardless, the trend suggests a growing need for ,dual diagnosis' services within and outside high security hospital. Copyright © 2003 Whurr Publishers Ltd. [source] Homicide and schizophrenia: maybe treatment does have a preventive effectCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2001Martin Erb Background Persons with schizophrenia have been found to be at increased risk for homicide as compared with the general population. The increased risk may be associated with the implementation of the policy of deinstitutionalization. Method Persons with schizophrenia who had committed or attempted homicide in the German state of Hessen from 1992 to 1996 and in the Federal Republic of Germany from 1955 to 1964 were compared. Results Schizophrenia increased the risk of homicide 16.6 times (95% CI 11.2,24.5) in the recent cohort and 12.7 times (95% CI 11.2,14.3) in the older cohort. These odds ratios are not statistically different. The lack of appropriate services for chronic high-risk patients and the non-use of mental health services by first episode, acutely psychotic patients were associated with homicide. Conclusion There has been no increase in the risk of homicide among persons with schizophrenia since the implementation of the policy of deinstitutionalization. The examination of the recent period suggests that the provision of specialized long-term care to persons with schizophrenia who are at high risk for violent behaviour and the use of mental health services by acutely psychotic persons may reduce the risk of homicide. Copyright © 2001 Whurr Publishers Ltd. [source] Levels of literacy among juvenile offenders: the incidence of specific reading difficultiesCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2000Margaret J. Snowling Introduction Academic achievement is low among offenders. Yet there is little evidence that prisoners are less literate than the general population. Do they have more dyslexia? This paper considers three definitions of dyslexia to see whether they relate to young offenders' literacy difficulties. Method The reading and spelling skills of 91 15- to 17-year-old male juvenile offenders who were incarcerated are reported, together with assessments of their vocabulary and non-verbal (spatial) skills. Estimates of the prevalence of reading disability are considered in relation to different definitions of dyslexia. Results The regression of literacy skills on non-verbal ability yielded an estimated prevalence of 57% while a more conservative estimate of 43% followed from the regression of literacy skill on verbal ability, and 38% of the sample had specific phonological deficits. Many of the offenders had experienced social and family adversity and reported poor school attendance. Discussion It is proposed that as a group, juvenile offenders are best described as having general verbal deficits encompassing problems of language and literacy. Copyright © 2000 Whurr Publishers Ltd. [source] Trials update in walesCYTOPATHOLOGY, Issue 2007A. Fiander Three ongoing studies will be presented and discussed. Prevalence of Human Papillomavirus Infection in a South Wales Screening population Methods: A total of 10 000 consecutive, anonymous liquid based cytology screening samples were collected over a five month period in 2004. Age, cytology result and social deprivation score was provided for each specimen. The methodology was chosen to ensure inclusion of all women attending routine cervical screening, avoiding potential constraints associated with obtaining individual informed consent. The liquid based cytology samples were processed and reported by the receiving cytology laboratory and the residual specimens sent to the HPV Research Laboratory, Wales College of Medicine, where they were processed and stored at -80°C until analysis. High risk and low risk HPV Typing was undertaken using PCR , EIA (Jacobs et al 1997). Full high risk typing was performed on HPV positive specimens. Results: The study population had a mean age of 38 years with 92% negative, 5% borderline and 3% dyskaryotic cytology. The average social deprivation score was 17.4 (based upon the Welsh Index of multiple deprivation). The following results will be presented: HPV prevalence by age. HPV prevalence by cytology result. Type specific HPV prevalence in single and multiple infection. Conclusion: This study represents the largest type specific HPV Prevalence Study in the UK to date. As such it will form a useful base line against which to access performance of marketed HPV tests and evaluating the impact following implementation of HPV vaccination. [Funded by Welsh Office for Research and Development] CRISP , 1 Study (Cervical Randomized Intervention Study Protocol -1) Background: Indole-3-carbinol (I3C) and Diindolylmethane (DIM) are found in cruciferous vegetables and have been identified as compounds that could potentially prevent or halt carcinogenesis. I3C spontaneously forms DIM in vivo during acid digestion. I3C has been shown to prevent the development of cervical cancer in HPV 16 transgenic mice and both I3C and DIM have been shown to promote cell death in cervical cancer cell models. DIM is the major active bi-product of I3C and preliminary data indicate that DIM is active in cervical dysplasia and may be better tolerated than I3C. Aim: To investigate chemoprevention of high grade cervical neoplasia using Diindolylmethane (DIM) supplementation in women with low grade cytological abnormalities on cervical cytology. Objectives: To observe any reduction in the prevalence of histological proven high-grade cervical intraepithelial neoplasia (CIN) after 6 months of supplementation. ,,To observe any reduction in the prevalence of cytological abnormalities. ,,To observe any changes in the clinical appearance of the cervix. To assess acceptability and monitor any side effects of DIM supplementation. ,,To assess whether any benefit is seen in relation to Human Papillomavirus (HPV) status including HPV Type, Viral load and integration. Methods: This is a double blind randomized placebo-controlled trial involving 600,700 women with low grade cytological abnormalities on a cervical smear. Randomization is in the ratio of 2 : 1 in favour of active medication. Women with first mildly dyskaryotic smear or second borderline smear are eligible. They are asked to take two capsules daily for 6 months. At the end of 6 months they undergo repeat cervical cytology, HPV testing and colposcopy. Results: A progress report will be given for this ongoing study. [Funded: - Cancer Research UK] Type Specific HPV Infection in Welsh Cervical Cancers Background: Whilst there have been numerous studies of HPV infection associated with cervical cancer and on prevalence of Human Papillomavirus in diverse populations there have been no studies of these variables in the same population. Against a background of prophylactic HPV vaccination it is important to assess potential protection against cervical cancer within a given population. The most comprehensive analysis of HPV type specific cervical cancer is a meta-analysis published by the IARC in 2003. This however included only three UK based studies, totalling 118 cases, 75 of which were only investigated by HPV type PCR for four high risk types. None of this data was presented with associated population based prevalence data. Therefore, the research objectives for this study in combination with the first study above, are as follows: To determine the frequency of specific HPV types in cervical cancers in Wales. To compare the distribution of specific HPV types amongst cervical cancers with their prevalence in the general population. This will allow accurate delineation of the relationship between prevalence of specific HPV types in the general population and their association with clinically relevant disease. This information is a pre-requisite to assess the potential impact of prophylactic vaccination against HPV infection in Wales. Methods: Welsh Cervical Cancer specimens from 2000,2005 will be identified from pathology departments within Wales. The pathology of each tumour will be reviewed by a single Gynaecological Pathologist. The age of the patient and pathological features of the tumour will be noted. DNA will be extracted from the paraffin sections and HPV typed by PCR-EIA. Results: A progress report will be given for this ongoing study. [Funded by Welsh Office for Research and Development] [source] Prevalence and predictors of recurrence of major depressive disorder in the adult populationACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2010F. Hardeveld Hardeveld F, Spijker J, De Graaf R, Nolen WA, Beekman ATF. Prevalence and predictors of recurrence of major depressive disorder in the adult population. Objective:, Knowledge of the risk of recurrence after recovery of a major depressive disorder (MDD) is of clinical and scientific importance. The purpose of this paper was to provide a systematic review of the prevalence and predictors of recurrence of MDD. Method:, Studies were searched in Medline en PsychINFO using the search terms ,recur*', ,relaps*', ,depress*', ,predict*' and course. Results:, Recurrence of MDD in specialised mental healthcare settings is high (60% after 5 years, 67% after 10 years and 85% after 15 years) and seems lower in the general population (35% after 15 years). Number of previous episodes and subclinical residual symptoms appear to be the most important predictors. Gender, civil status and socioeconomic status seem not related to the recurrence of MDD. Conclusion:, Clinical factors seem the most important predictors of recurrence. Data from studies performed in the general population and primary care on the recurrent course of MDD are scarce. [source] Increased lifetime prevalence of dental trauma is associated with previous non-dental injuries, mental distress and high alcohol consumptionDENTAL TRAUMATOLOGY, Issue 1 2001U. Perheentupa Abstract , The purpose of the study was to assess the lifetime prevalence of dental injuries and risk factors involved in a general population-based birth cohort. The study population consisted of 5737 subjects who had participated in a health survey at the age of 31 years. Altogether 52% of the participants were women. This partly computer-based health survey included two questionnaires on previous dental and non-dental injuries, general health, occupational status and lifestyle. The current study was based on these questionnaires. The lifetime prevalence of dental fractures was 43% and the lifetime prevalence of dental luxations and exarticulations 14%. Men more commonly had dental injuries than women. Particularly mental distress and a history of previous injuries were shown to increase the risk for dental injuries. Furthermore, overweight and high alcohol consumption were positively associated with a high lifetime prevalence of tooth trauma. Regular physical activity decreased trauma occurrence. Socioeconomic status further affected the lifetime prevalence of dental injuries. The conclusion of the study was that personal, social and physical factors played a role in the occurrence of dental trauma. [source] Treatment of major depressive disorder in the Finnish general populationDEPRESSION AND ANXIETY, Issue 11 2009Juha Hämäläinen M.D.M.A. Abstract Background: Few general population studies of the treatment of major depressive disorder (MDD) have included the whole spectrum of treatments. We estimated the rates of different treatments and the effect of individual and disorder characteristics plus provider type on treatment received. Methods: In the Health 2000 Study, a representative sample (n=6,005) from the adult Finnish population (,30 years) were interviewed (CIDI) in 2000,2001 for the presence of DSM-IV mental disorders during the past 12 months. Logistic regression models were used to examine factors influencing the type of treatment: either pharmacotherapies (antidepressants, anxiolytics, sedatives/hypnotics, antipsychotics) or psychological treatment. Results: Of the individuals with MDD (n=288), currently 24% used antidepressants, 11% anxiolytics, 16% sedatives/hypnotics, 5% antipsychotics, and 17% reported having received psychological treatment. Overall, 31% received antidepressants or psychological treatment or both; 18% received minimally adequate treatment. Of those 33% (n=94) using health care services for mental reasons, 76% received antidepressants or psychological treatment or both; 54% received minimal adequate treatment. In logistic regression models, the use of antidepressants was associated with female sex, being single, severe MDD, perceived disability, and comorbid dysthymic disorder; psychological treatment with being divorced, perceived disability, and comorbid anxiety disorder. Conclusions: Due to the low use of health services for mental reasons, only one-third of subjects with MDD use antidepressants, and less than one-fifth receives psychological treatment. The treatments provided are determined mostly by clinical factors such as severity and comorbidity, in part by sex and marital status, but not education or income. Depression and Anxiety 26:1049,1059, 2009. © 2009 Wiley-Liss, Inc. [source] Non-remission of depression in the general population as assessed by the HAMD-7 scaleDEPRESSION AND ANXIETY, Issue 5 2008Andrew G. Bulloch Ph.D. Abstract Remission from the symptoms of depression is the optimal outcome for depression treatment. Many studies have assessed the frequency of treatment, but there are none that have estimated the frequency of treated remission in the general population. We addressed this issue in the population of Alberta using a brief Hamilton Depression Rating Scale (HAMD)-7 scale (recently validated against the HAMD-17 scale in a clinical setting) that has been proposed as a suitable indicator for remission in primary care. We used data from a survey conducted within the Alberta Depression Initiative in 2005 (n=3,345 adults), to produce a population-based estimate of the number of respondents taking antidepressant medication for depression. From this group we selected a subpopulation that did not screen positive when the MINI module for major depression was administered (i.e., who did not have an active episode). Non-remission in this subpopulation was assessed with a version of the HAMD-7 scale adapted for telephone administration by a nonclinician. Of the survey respondents, 189 reported taking antidepressant medication for depression. Of these, 115 were found not to have an active episode. However, 49.0% of this subpopulation was not in remission as evaluated by the HAMD-7. We estimate that 1.3% (95% confidence interval, 0.9,2.0%) of the population is in treated non-remission for depression. Our study indicates a substantial degree of non-remission from depression in individuals taking antidepressants in the general population. This suggests that, in addition to increasing the frequency of treatment, increasing the effectiveness of treatment can have an impact on population health. Depression and Anxiety 0:1,5, 2007. © 2007 Wiley-Liss, Inc. [source] Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non-PTSD subjectsDEPRESSION AND ANXIETY, Issue 4 2007Marina Kupchik M.D. Abstract Motor vehicle accidents (MVAs) are the leading cause of posttraumatic stress disorder (PTSD) in the general population, often with enduring symptomatology. This study details epidemiological and clinical features that characterize PTSD among MVA victims living in a nonhospitalized community setting long after the MVA event, and includes exploration of premorbid and peritraumatic factors. MVA victims (n=60; 23 males, 37 females) identified from the registry of a community general health outpatient clinic during a 7-year period were administered an extensive structured battery of epidemiological, diagnostic and clinical ratings. Results indicated that 30 subjects (50%; 12 males, 18 females) had MVA-related PTSD (MVAR-PTSD). Among those with PTSD, 16 individuals exhibited PTSD in partial remission, and six, in full remission. There were no significant demographic or occupational function differences between PTSD and non-PTSD groups. The most common comorbid conditions with MVAR-PTSD were social phobia (20%), generalized anxiety disorder (7.8%) and obsessive,compulsive disorder (0.5%). Previous MVA's were not predictive of PTSD. Subjects with MVAR-PTSD scored worse on the Clinician-Administered Posttraumatic Stress Disorder Scale, Part 2 (CAPS-2), Impact of Event Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Impulsivity Scale, and Toronto Alexithymia Rating Scale. Study observations indicate a relatively high rate of PTSD following an MVA in a community-based sample. The relatively high rate of partially remitted MVAR-PTSD (N=16) underscores the importance of subsyndromal forms of illness. Alexithymia may be an adaptive method of coping with event stress. The development of PTSD appears not to be associated with the severity of MVA-related physical injury. Depression and Anxiety 24:244,250, 2007. © 2006 Wiley,Liss, Inc. [source] Prevalence of social phobia and its comorbidity with psychiatric disorders in IranDEPRESSION AND ANXIETY, Issue 7 2006Mohammad-Reza Mohammadi M.D. Abstract This study explored the prevalence of social phobia (SP) in the general population of Iran, the sociodemographic characteristics of subjects with SP, and its comorbidity with the other lifetime psychiatric disorders. Our study was part of the nationwide study on the prevalence of psychiatric disorders in Iran. Overall, 25,180 Iranian subjects, age 18 years and over, from urban and rural areas of Iran were selected by a clustered random sampling method and interviewed face-to-face by 250 trained clinical psychologists using DSM-IV diagnostic criteria. Out of 12,398,235 households, 7,795 households in the form of 1,559 clusters of five households were selected. The statistical framework was based on the household lists available from the Department of Health in the provinces. The response rate was 90%. The lifetime prevalence of SP was 0.82%. The rate was 0.4% in males and 1.3% in females. The rate was higher in younger age groups and widows/widowers. It was not related to educational level and residential area. Specific phobia (66.7%), obsessive,compulsive disorder (17.4%), major depressive disorder (15%), and panic disorder (12.1%) were the most common lifetime psychiatric disorders among subjects with SP. The rate of SP in Iran is more similar to that in other Asian countries, and it is lower than that in Western countries. The rate of other psychiatric disorders among subjects with SP is more than that in the general population, and the most common psychiatric disorders were the other anxiety disorders and major depressive disorder. Depression and Anxiety 23:405,411, 2006 © 2006 Wiley-Liss, Inc. [source] Nonvisible Insufficient Subcutaneous Reticular Venous Plexus Can Be Observed through the Skin Using a New Illumination MethodDERMATOLOGIC SURGERY, Issue 2010LUIS LOPEZ BUSTOS MD BACKGROUND Insufficient subcutaneous reticular venous plexus (ISRVP) is an overlooked disease because the human eye cannot see many of the insufficient veins. OBJECTIVE To present a total reticular vision (TRV) method that exposes nonvisible ISRVP to normal vision. METHOD & MATERIALS TRV used visual-spectrum white and red light of 700 nm and infrared light of 15 to 850 nm from an ultradigital viewer camera. We studied 124 asymptomatic subjects from the general population without visible ISRVP. Another six patients with ISRVP without other venous pathology were compared with six healthy controls, Very low pressure was applied to the proximal thigh, and minimal volume increments on the medial malleolus were photoplethysmographically registered to validate subcutaneous venous reflux. RESULTS Total reticular vision exposed ISRVP on the lower extremities in 72 of 124 subjects (58%), with observed damaged veins corresponding to more than 90% of nonvisible and 5% of visible portions of ISRVP. Subcutaneous reflux was registered only in patients with ISRVP. CONCLUSION Total reticular vision exposed more than 90% of nonvisible ISRVP, a new pathology, allowing for the study of its relationship with other superficial venous insufficiencies. The authors have indicated no significant interest with commercial supporters. [source] Identifying target groups for the prevention of anxiety disorders in the general populationACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010N. M. Batelaan Batelaan NM, Smit F, de Graaf R, van Balkom AJLM, Vollebergh WAM, Beekman ATF. Identifying target groups for the prevention of anxiety disorders in the general population. Objective:, To avert the public health consequences of anxiety disorders, prevention of their onset and recurrence is necessary. Recent studies have shown that prevention is effective. To maximize the health gain and minimize the effort, preventive strategies should focus on high-risk groups. Method:, Using data from a large prospective national survey, high-risk groups were selected for i) the prevention of first ever (n = 4437) and ii) either first-ever or recurrent incident anxiety disorders (n = 4886). Indices used were: exposure rate, odds ratio, population attributable fraction and number needed to be treated. Risk indicators included sociodemographic, psychological and illness-related factors. Results:, Recognition of a few patient characteristics enables efficient identification of high-risk groups: (subthreshold) panic attacks; an affective disorder; a history of depressed mood; a prior anxiety disorder; chronic somatic illnesses and low mastery. Conclusion:, Preventive efforts should be undertaken in the selected high-risk groups. [source] Illicit substance use and its correlates in first episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010R. Mazzoncini Mazzoncini R, Donoghue K, Hart J, Morgan C, Doody GA, Dazzan P, Jones PB, Morgan K, Murray RM, Fearon P. Illicit substance use and its correlates in first episode psychosis. Objective:, To determine if substance use (particularly cannabis) is more frequent among first episode psychosis patients and associated with a more problematic clinical presentation. Method:, All first episode psychosis (FEP) patients presenting to secondary services were recruited from London and Nottingham, over 2 years, in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study broad framework. Clinical and sociodemographic variables were assessed using a set of standardized instruments. A schedule was created to retrospectively collate substance use data from patients, relatives and clinicians. Results:, Five hundred and eleven FEP were identified. They used three to five times more substances than general population. Substance use was associated with poorer social adjustment and a more acute mode of onset. Cannabis use did not affect social adjustment, but was associated with a more acute mode of onset. Conclusion:, Cannabis has a different impact on FEP than other substances. Large epidemiological studies are needed to disentangle cannabis effect. [source] Psychotic-like experiences are associated with suicidal feelings and deliberate self-harm behaviors in adolescents aged 12,15 yearsACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010A. Nishida Nishida A, Sasaki T, Nishimura Y, Tanii H, Hara N, Inoue K, Yamada T, Takami T, Shimodera S, Itokawa M, Asukai N, Okazaki Y. Psychotic-like experiences are associated with suicidal feelings and deliberate self-harm behaviors in adolescents aged 12,15 years. Objective:, Psychotic disorders are a significant risk factor for suicide, especially among young people. Psychotic-like experiences (PLEs) in the general population may share an etiological background with psychotic disorders. Therefore, the present study examined the association between PLEs and risk of suicide in a community sample of adolescents. Method:, Psychotic-like experiences, suicidal feelings, and self-harm behaviors were studied using a self-report questionnaire administered to 5073 Japanese adolescents. Depression and anxiety were evaluated using the 12-item General Health Questionnaire (GHQ). Results:, The presence of PLEs was significantly associated with suicidal feelings (OR = 3.1, 95% CI = 2.2,4.5) and deliberate self-harm behaviors (OR = 3.1, 95% CI = 2.0,4.8) after controlling for the effects of age, gender, GHQ-12 score, victimization, and substance use. Suicidal feelings and behaviors were more prevalent in subjects with a greater number of PLEs. Conclusion:, Psychotic-like experiences may increase the risk of suicidal problems among adolescents. 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