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Population Perspective (population + perspective)
Selected AbstractsThe population prevalence of adverse concentrations and associations with adiposity of liver tests among Australian adolescentsJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2008Michael L Booth Aim: Paediatric overweight has a high incidence and has serious consequences for health, including non-alcoholic fatty liver disease (NAFLD). However, very little is known about NAFLD among young people, particularly from a population perspective. This paper reports the prevalence of elevated concentrations of four liver enzymes and their associations with adiposity in a representative population sample of Australian adolescents. Methods: Overnight fasting blood samples were collected from a representative population sample of 500 Grade 10 students (15-years-old) attending schools in Sydney, Australia, between February and May, 2004. Weight, height and waist girth were measured. The prevalence of adverse concentrations of the enzymes alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were described for all boys and girls and by body mass index (BMI) categories. The nature of the associations between the enzyme concentrations and indices of adiposity were characterised, and regression equations for estimating enzyme concentrations from BMI were prepared. Results: The prevalence of adverse concentrations of ALT (most likely as a result of NAFLD) and GGT were approximately 10%, while the prevalence of adverse concentrations of AST and ALP were approximately 7% and 5% respectively. The prevalence of adverse concentrations of ALT, GGT and AST increased across BMI categories, while the prevalence of adverse concentrations of ALP declined across BMI categories. Conclusions: The high prevalence of NAFLD in a population sample of healthy Australian adolescents represents a significant burden of disease. [source] Sticky issue of adherenceJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1 2003SM Sawyer Abstract: The phenomenon of adherence, also known as compliance, is the vital link that allows effective medications to have the desired clinical effect when self-administered. It is often assumed that the population is generally adherent, but more than 50% of people with chronic illness do not take their medication as prescribed. We highlight how the terminology and language of non-adherence act to conceptualize adherence as a patient problem in a manner that is inadvertently judgmental, narrowly focused and clinically unhelpful. In contrast, knowledge of the dynamic nature of adherence promotes the conceptualization of adherence as the common problem that it is, where the responsibility for improving it lies primarily with the health professional. The example of asthma is used to highlight how individually focused clinical strategies can fit within a population perspective that, in its entirety, can be conceptualized as a framework of adherence-promoting strategies. [source] Use of antisecretory drugs among consumers of non-steroidal anti-inflammatory drugs in the general populationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2006E. REY Summary Background, Overall success of prophylactic strategies against non-steroidal anti-inflammatory drug (NSAID) complications depends on the use of gastroprotective drugs. Aim, We examined the use of antisecretory drugs in NSAID users in the general population of Spain. Participants and Methods, In 2002, a phone interview was conducted with 2500 persons representative of the general population of Spain. Using a validated questionnaire, we asked about the use of NSAID, aspirin and antisecretory drugs, and history of digestive diseases. We estimated the use of antisecretory drugs in NSAID users, according to risk factors for gastrointestinal (GI) lesions associated with NSAID. Results, In total, 425 persons [17.0% (95% CI 15.5,18.5%)] were NSAID users. Of them, 69 persons (16.2%; 95% CI 12.7,19.7%) used antisecretory drugs [proton pump inhibitor (PPI) 11.8% and H2-blocker 4.9%]. Forty-four of the 224 NSAID users (19.6%) with one risk factor for GI lesions were antisecretory drug users (PPI 16%; H2-blocker 4%), compared with 24 of the 197 NSAID users (12.7%) without risk factors (PPI 6.6%; H2-blocker 6.1%). NSAID users with risk factors for GI lesions but without upper GI (UGI) symptoms did not consume more antisecretory drugs than equivalent non-NSAID users (12.9% vs. 10.7%). Conclusion, Current strategies to prevent GI lesions in NSAID users are not effective from a population perspective, especially in subjects without UGI symptoms. [source] Being a pretty good citizen: an analysis and monetary valuation of formal and informal voluntary work by gender and educational attainment1THE BRITISH JOURNAL OF SOCIOLOGY, Issue 1 2008Muriel Egerton Abstract This paper is set in the context of macrosocial/macroeconomic theories of the organization of both paid and unpaid work. The specific topic investigated is engagement in unpaid voluntary work, an activity which is thought to be important for social cohesion, civil society and citizenship. Research on the sources of social cohesion has focused on organizational membership and voluntary organization activity. There has been little investigation of informal helping of non-resident kin, friends or acquaintances, an activity which is not measured in most social surveys but is measured in time use surveys. Previous research shows that the highly educated are more likely to engage in formal voluntary organizations and data from the UK 2000 HETUS survey confirm that the highly educated spend more time on formally organised voluntary work. However, the less qualified, particularly women, spend more time on extra-household unpaid helping activities. Since both types of voluntary work are partly dependent on available time, these findings are modelled adjusting for time allocated to paid work, study, family and personal care. The findings remain statistically significant. Drawing on work carried out by the Office for National Statistics, a monetary value is placed on both formally organized and informal voluntary work. Although the median wage rates for formal voluntary work are greater than those for informal helping, the latter is greater in frequency and duration and therefore more economically valuable from a population perspective. This finding is discussed in the light of recent debates on citizenship and gender. [source] Infertility in Australia circa 1980: an historical population perspective on the uptake of fertility treatment by Australian women born in 1946-51AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2009Danielle L. Herbert Abstract Objective: To estimate the prevalence of lifetime infertility in Australian women born in 1946-51 and examine their uptake of treatment. Methods: Participants in the Australian Longitudinal Study on Women's Health born in 1946-51 (n=13,715) completed up to four mailed surveys from 1996 to 2004. The odds of infertility were estimated using logistic regression with adjustment for socio-demographic and reproductive factors. Results: Among participants, 92.1% had been pregnant. For women who had been pregnant (n=12738): 56.5% had at least one birth but no pregnancy loss (miscarriage and/or termination); 39.9% experienced both birth and loss; and 3.6% had a loss only. The lifetime prevalence of infertility was 11.0%. Among women who reported infertility (n=1511), 41.7% used treatment. Women had higher odds of infertility when they had reproductive histories of losses only (OR range 9.0-43.5) or had never been pregnant (OR=15.7, 95%CI 11.8-20.8); and higher odds for treatment: losses only (OR range 2.5-9.8); or never pregnant (1.96, 1.28-3.00). Women who delayed their first birth until aged 30+ years had higher odds of treatment (OR range 3.2-4.3). Conclusions: About one in ten women experienced infertility and almost half used some form of treatment, especially those attempting pregnancy after 1980. Older first time mothers had an increased uptake of treatment as assisted reproductive technologies (ART) developed. Implications: This study provided evidence of the early uptake of treatment prior to 1979 when the national register of invasive ART was developed and later uptake prior to 1998 when data on non-invasive ART were first collected. [source] Infertility, medical advice and treatment with fertility hormones and/or in vitro fertilisation: a population perspective from the Australian Longitudinal Study on Women's HealthAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 4 2009Danielle L. Herbert Abstract Objective: To identify the factors associated with infertility, seeking advice and treatment with fertility hormones and/or in vitro fertilisation (IVF) among a general population of women. Methods: Participants in the Australian Longitudinal Study on Women's Health aged 28-33 years in 2006 had completed up to four mailed surveys over 10 years (n=9,145). Parsimonious multivariate logistic regression was used to identify the socio-demographic, biological (including reproductive histories), and behavioural factors associated with infertility, advice and hormonal/IVF treatment. Results: For women who had tried to conceive or had been pregnant (n=5,936), 17% reported infertility. Among women with infertility (n=1031), 72% (n=728) sought advice but only 50% (n=356) used hormonal/IVF treatment. Women had higher odds of infertility when: they had never been pregnant (OR=7.2, 95% CI 5.6-9.1) or had a history of miscarriage (OR range=1.5-4.0) than those who had given birth (and never had a miscarriage or termination). Conclusion: Only one-third of women with infertility used hormonal and/or IVF treatment. Women with PCOS or endometriosis were the most proactive in having sought advice and used hormonal/IVF treatment. Implications: Raised awareness of age-related declining fertility is important for partnered women aged ,30 years to encourage pregnancy during their prime reproductive years and reduce the risk of infertility. [source] Monoclonal B cell lymphocytosis: Clinical and population perspectives,CYTOMETRY, Issue S1 2010Neil E. Caporaso Abstract Monoclonal B Cell Lymphocytosis (MBL) refers to clones of CLL-like cells that exhibit CLL characteristics that fall short of the numbers required for CLL diagnosis. Data from large CLL kindreds document increased prevalence of MBL suggesting a genetic contribution to its etiology. The molecular features that favor progression of MBL to CLL are poorly understood but an elevated B-cell count is a risk factor for progression. An important consideration when evaluating volunteers from CLL families who are willing to donate bone marrow is that MBL be ruled out since the MBL donor clone could result in a second CLL in the recipient. Further studies of MBL are needed to identify the molecular features and how they evolve during progression. Published 2010 Wiley-Liss, Inc. [source] |