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Inconsistent Associations (inconsistent + association)
Selected AbstractsSystematic review: frequency and reasons for consultation for gastro-oesophageal reflux disease and dyspepsiaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2009A. P. S. HUNGIN Summary Background, Upper gastrointestinal symptoms impose a substantial illness burden and management costs. Understanding perceptions and reasons for seeking healthcare is a prerequisite for meeting patients' needs effectively. Aim, To review systematically findings on consultation frequencies for gastro-oesophageal reflux disease (GERD) and dyspepsia and patients' reasons for consultation. Methods, Systematic literature searches. Results, Reported consultation rates ranged from 5.4% to 56% for GERD and from 26% to 70% for dyspepsia. Consultation for GERD was associated with increased symptom severity and frequency, interference with social activities, sleep disturbance, lack of timetabled work, higher levels of comorbidity, depression, anxiety, phobia, somatization and obsessionality. Some consulted because of fears that their symptoms represented serious disease; others avoided consultation because of this. Inconsistent associations were seen with medication use. Patients were less likely to consult if they felt that their doctor would trivialize their symptoms. Few factors were consistently associated with dyspepsia consultation. However, lower socio-economic status and Helicobacter pylori infection were associated with increased consultation. Conclusion, Patients' perceptions of their condition, comorbid factors and external reasons such as work and social factors are related to consultation rates for GERD. Awareness of these factors can guide the clinician towards a more effective strategy than one based on drug therapy alone. [source] Blood pressure, seasonal body fat, heart rate, and ecological differences in Caboclo populations of the Brazilian AmazonAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2006H.P. Silva This study compares blood pressure (BP) and related cardiovascular risk factors among three Caboclo communities from the Brazilian Amazon. Its purpose is to investigate possible risk differentials related to variable ecological settings and Western influences. Caxiuanã is characterized as a more "traditional" group, while Aracampina and Santana are viewed as more "transitional" in lifestyle. A total of 348 subjects from the three communities were evaluated in the wet or the dry season or in both. Measurements across the communities were compared by season and sex. Results suggest little seasonal variation in average BP, BP change, body fat, or body fat change among men. Conversely, there is substantial seasonal and intercommunity variation among women. Additional analyses reveal (1) an inconsistent association between age and BP across the communities; (2) that BMI is not associated with BP transitional communities in either season but is associated with both systolic and diastolic pressure in the most traditional community; and (3) little to no sex effect on BP. These results suggest increased Western influence affects body composition particularly of women. However, increased BMI and fat among transitional Caboclo women does not directly translate into higher BP; rather, their BP appears to be more affected by seasonal stresses. Finally, conditions during the wet season diminish age-related variation in BP, suggesting that during the wet season these Caboclo may be less active. Am. J. Hum. Biol. 18:10,22, 2006. © 2005 Wiley-Liss, Inc. [source] Prevalence of risk and protective factors for falls in the home environment in a population-based survey of young and middle-aged adult New ZealandersAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2010Bridget Kool Abstract Objective: To estimate the prevalence of hazards in the home environment that may contribute to unintentional falls among young and middle-aged New Zealanders. Methods: A random sample of 352 young and middle-aged people (25-60 years) residing in Auckland was drawn from the electoral roll. The prevalence of environmental factors that may have an impact on risk of falls was investigated using a structured interviewer-administered questionnaire. Results: Potential risk factors for falls were common in the study population (ladder use in the past year , 64%; inability to reach a light from bed , 21%; lack of handrails for stairs , 54%). Only 9% and 11% of baths and showers, respectively, had grab or hand rails; 42% and 56% had anti-skid mats/surfaces. Compared to those reporting no socio-economic deprivation characteristics, respondents reporting one or more such characteristics were less likely to use a ladder and have indoor stairs, but more likely to have outdoors stairs. There was no significant relationship between socio-economic status and presence of a grab/handrail or antiskid mats/surfaces in or near showers/baths. Conclusion and implications: Structural hazards that are likely to result in falls at home are common in New Zealand. The greater prevalence of some environmental risk factors for falls among the least socially deprived population may account for the inconsistent association between socio-economic deprivation and fall-related injuries reported in previous research. Information regarding the contribution of these and associated factors to the occurrence of falls can help target and reduce the risks involved. [source] Validity of the indicator ,death in low-mortality diagnosis-related groups' for measuring patient safety and healthcare quality in hospitalsINTERNAL MEDICINE JOURNAL, Issue 4 2010S. Mihrshahi Abstract The indicator ,death in low-mortality diagnosis-related groups (DRG)' is a patient safety indicator (PSI) that can be derived from routinely collected administrative data sources. It is included in a group of PSI that have been proposed to compare and monitor standards of hospital care in Australia. To summarize the attributes of this indicator as a measure of quality and safety in healthcare and examine issues regarding the development process, definitions and use of the indicator in practice. A structured literature search was conducted using the Ovid Medline database to identify peer-reviewed published literature which used ,death in low-mortality DRG' as a quality/safety indicator. Key quality websites were also searched. The studies were critically appraised using a standardized method. A total of 12 articles was identified which met our search criteria. Most were of low methodological quality because of their retrospective study designs. Only three studies provided evidence that the quality of care gap is higher in ,deaths in low-mortality DRG' than in other cases. Most of the studies reviewed show that there are several limitations of the indicator for assessing patient safety and quality of care. The few studies that have assessed associations with other measures of hospital quality have shown only weak and inconsistent associations. Higher quality, prospective, analytic studies are required before ,death in low-mortality DRG' is used as an indicator of quality and safety in healthcare. Based on current evidence, the most appropriate use is as a screening tool for institutions to quickly and easily identify a manageable number of medical records to investigate in more detail. [source] Gas cooking, kitchen ventilation, and asthma, allergic symptoms and sensitization in young children , the PIAMA studyALLERGY, Issue 5 2006S. M. Willers Background:, Several studies reported inconsistent associations between using gas for cooking and respiratory symptoms or lung function in children. Kitchen ventilation characteristics may modify the relationship between gas cooking and respiratory health. The aim of this study was to investigate the effect of kitchen ventilation (while cooking) on the relationship between gas cooking, combustion product dispersal, and respiratory and allergic outcomes in children. Methods:, Data on respiratory and allergic symptoms and diagnoses were collected by yearly questionnaires in a population of over 3000 children participating in a birth cohort study on development of allergy and asthma. At 4 years of age, a sub-sample of 647 children provided blood samples for antibody testing. Data on gas cooking and kitchen ventilation were collected when the children were 5 years old. Based on these data a model was constructed to determine the chance of accumulation of combustion products (CACP) in the kitchen. Results:, No relationship was found between gas cooking and any of the respiratory or allergy outcomes except nasal symptoms. The overall results did not change when the ,CACP' was used as exposure variable instead, while the association for nasal symptoms decreased to borderline significance. Conclusion:, Our results suggest that gas cooking per se is associated with nasal symptoms in young children and not with the other respiratory symptoms that were investigated. Taking kitchen ventilation characteristics into account did not lead to different conclusions in this population where, according to the classification system, the majority of households using gas for cooking have insufficient kitchen ventilation. [source] Identification of genetic markers associated with fatness and leg weakness traits in the pigANIMAL GENETICS, Issue 6 2009B. Fan Summary Pigs have undergone long-term selection in commercial conditions for improved rate and efficiency of lean gain. Interestingly, it has been observed in both experimental and field conditions that leg weakness has increased over time, concurrent with the selection for improved rate of lean gain, while fatter animals tend to have better leg action, and foot and leg (FL) structure. The exact molecular mechanisms or individual genes responsible for this apparent genetic correlation between fatness and leg weakness and other physical adaptability traits have been less well reported. Based on our recent studies involving candidate genes and leg weakness traits, the present investigation has identified 30 SNPs from 26 genes that were found to be associated with 10th rib backfat in a sow population consisting of 2066 animals. The specific alleles associated with increased backfat tended to be associated with better overall leg action, as shown for the genes including MTHFR, WNT2, APOE, BMP8, GNRHR and OXTR, while inconsistent associations with the single FL structure trait and backfat were observed for other genes. This study suggests that in some cases there may be a common genetic mechanism or linked genes regulating fatness and leg weakness. Such relationships are clearly complex, and the utilization of genetic markers associated with both traits should be treated cautiously. [source] | |||||||||||||