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Prevalence Ratio (prevalence + ratio)
Selected AbstractsThymus size and head circumference at birth and the development of allergic diseasesCLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2001C. S. Benn Background The positive association between a large head circumference at birth and total serum IgE levels has been suggested to be due to negative associations between head circumference at birth and thymus development and between thymus development and total serum IgE levels. Objectives To examine the associations between head circumference and thymus size at birth and the development of allergic disease. Methods The size of the thymus was assessed by sonography during the first week of life in 149 healthy term infants. Information on birth characteristics and mode of delivery was collected at delivery. The presence of allergic disease was assessed 5 years later by mailed questionnaires, which were returned by 85% of the eligible families. Results At birth, head circumference was positively associated with thymus size (P < 0.001). In all, 27 (23%) of the children had developed at least one allergic disease. Multivariate analysis revealed that both parental allergy (Prevalence Ratio and 95% CI) = 3.18 (1.49,6.78)) and caesarean delivery (2.62 (1.48,4.64)) were independently correlated with allergic disease, whereas thymus size was not. Conclusions Our study does not support that a large head circumference is associated with a small thymus size, nor that a small thymus size is associated with allergic disease. Whether thymus size at birth is related to total serum IgE levels still remains to be elucidated. [source] Complementary Log,Log Regression for the Estimation of Covariate-Adjusted Prevalence Ratios in the Analysis of Data from Cross-Sectional StudiesBIOMETRICAL JOURNAL, Issue 3 2009Alan D. Penman Abstract We assessed complementary log,log (CLL) regression as an alternative statistical model for estimating multivariable-adjusted prevalence ratios (PR) and their confidence intervals. Using the delta method, we derived an expression for approximating the variance of the PR estimated using CLL regression. Then, using simulated data, we examined the performance of CLL regression in terms of the accuracy of the PR estimates, the width of the confidence intervals, and the empirical coverage probability, and compared it with results obtained from log,binomial regression and stratified Mantel,Haenszel analysis. Within the range of values of our simulated data, CLL regression performed well, with only slight bias of point estimates of the PR and good confidence interval coverage. In addition, and importantly, the computational algorithm did not have the convergence problems occasionally exhibited by log,binomial regression. The technique is easy to implement in SAS (SAS Institute, Cary, NC), and it does not have the theoretical and practical issues associated with competing approaches. CLL regression is an alternative method of binomial regression that warrants further assessment. [source] Interpreting changes in the epidemiology of anencephaly and spina bifida following folic acid fortification of the U.S. grain supply in the setting of long-term trends, Atlanta, Georgia, 1968,2003,BIRTH DEFECTS RESEARCH, Issue 11 2007Lilah M. Besser Abstract BACKGROUND: The prevalence of anencephaly (AN) and spina bifida (SB) was declining long before fortification of enriched grains in the U.S. with folic acid. We examined whether changes in these defects surrounding fortification could be distinguished from preexisting trends. METHODS: We used data from the Metropolitan Atlanta Congenital Defects Program to identify three ascertainment periods: Period 1 (1968,1981), prenatal diagnoses rarely made; Period 2 (1981,1993), prenatal diagnoses made but not ascertained; Period 3 (1994,2003), prenatal diagnoses ascertained. We compared the annual percent change (APC) in AN and SB for each period using Poisson regression, then compared prevalences during each period for categories of pregnancy outcome, sex, race, gravidity, and maternal age. RESULTS: The prevalence of AN (N = 434) and SB (N = 663) declined during 1968,2003. The APCs in Periods 1, 2, and 3, respectively, were ,6.9%, ,2.9%, and ,6.8% for AN, and ,7.1%, ,7.0%, and ,6.2% for SB; 95% confidence intervals around the APCs for Periods 2 and 3 overlapped for both defects. Prevalence ratios (PRs) for females relative to males decreased for AN (2.3 in Period 1; 1.2 in Period 3); PRs for whites relative to blacks or African Americans decreased for both AN (2.7 in Period 1; 1.2 in Period 3) and SB (2.5 in Period 1; 1.1 in Period 3). CONCLUSIONS: Our analysis suggests that changes in AN and SB surrounding folic acid fortification (Period 3) could be part of preexisting trends. This must be considered when evaluating prevention efforts. Birth Defects Research (Part A) 79:730,736, 2007. © 2007 Wiley-Liss, Inc. [source] Metalworking exposures and persistent skin symptoms in the ECRHS II and SAPALDIA 2 cohortsCONTACT DERMATITIS, Issue 5 2009Maria C. Mirabelli Background:, Diseases of the skin are important and often preventable conditions occurring among workers with dermal exposures to irritant and sensitizing agents. Objective:, We conducted this analysis to assess the associations between metalworking exposures and current and persistent skin symptoms among male and female participants in two population-based epidemiologic studies. Methods:, We pooled data from the European Community Respiratory Health Survey II (ECRHS II) and the Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults 2 (SAPALDIA 2), two prospective cohort studies in Europe. Each participant completed interviewer-administered questionnaires to provide information about symptoms and exposures related to selected occupations, including metalworking, during the follow-up periods. We assessed associations between skin symptoms and the frequency of metalworking exposures among 676 ECRHS II/SAPALDIA 2 respondents. Results:, Current skin symptoms were reported by 10% of metalworkers and were associated with frequent use, defined as four or more days per week, of oil-based metalworking fluids [prevalence ratio (PR): 1.76, 95% confidence interval (CI): 1.25,2.49)] and organic solvent/degreasing agents (PR: 2.06, 95% CI: 1.21,3.50). Conclusions:, Skin symptom prevalence is associated with increasing frequency of oil-based metalworking fluid and degreasing agent use. Our findings justify assessing strategies for reducing the frequency of metal-related exposures. [source] Dental injury among Brazilian schoolchildren in the state of São PauloDENTAL TRAUMATOLOGY, Issue 3 2004Sylvia Grimm Abstract ,,,To describe the distribution of dental trauma in Brazilian schoolchildren and its association with demographic, environmental and clinical factors. A random sample of 73 243 schoolchildren's oral examination records from private and public units, selected from 131 cities within the state of São Paulo, Brazil, was analysed. Trauma was assessed based on international methodological standards prescribed by the World Health Organization for Oral Health Surveys (1997). Proportions obtained were compared between urban and rural schools, as well as between private and public units. Oral health status indices were estimated based on the decayed, missing and filled teeth (DMFT) index , the average number of decayed, missing and filled teeth; the proportion of caries-free 5-year-old schoolchildren and anterior maxillary overjet among 12-year-old schoolchildren. The prevalence of dental trauma in anterior dentition was of 2.4, enrolling average 1.2 teeth per child. A rate of 2.4 impaired anterior teeth per thousand was obtained, upper central incisors being those that were most affected , 7.7 in every 10. Among 8- to 11-year-old children, the rates grew regularly. The proportion of dental trauma was significantly higher in boys than in girls (P < 0.01), and gender prevalence ratio was of 1.58 for boys. The results showed positive associations between dental trauma and caries-free 5-year-old schoolchildren (P = 0.003), anterior maxillary overjet,3 mm (P < 0.001), and private school as a socio-economic proxy indicator (P = 0.048). [source] Substance use and periodontal disease among Australian Aboriginal young adultsADDICTION, Issue 4 2010Lisa M. Jamieson ABSTRACT Aim To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. Design Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. Participants Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. Measurements Clinical dental examination and self-report questionnaire. Findings Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06,2.40], marijuana (PR = 1.44, 95% CI = 1.05,1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08,3.11), but not alcohol (PR = 0.92, 95% CI = 0.67,1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03,2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. Conclusions This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation. [source] Specific human leukocyte antigen class I and II alleles associated with hepatitis C virus viremia,,§HEPATOLOGY, Issue 5 2010Mark H. Kuniholm Studies of human leukocyte antigen (HLA) alleles and their relation with hepatitis C virus (HCV) viremia have had conflicting results. However, these studies have varied in size and methods, and few large studies assessed HLA class I alleles. Only one study conducted high-resolution class I genotyping. The current investigation therefore involved high-resolution HLA class I and II genotyping of a large multiracial cohort of U.S. women with a high prevalence of HCV and HIV. Our primary analyses evaluated associations between 12 HLA alleles identified through a critical review of the literature and HCV viremia in 758 HCV-seropositive women. Other alleles with >5% prevalence were also assessed; previously unreported associations were corrected for multiple comparisons. DRB1*0101 (prevalence ratio [PR] = 1.7; 95% confidence interval [CI] = 1.1,2.6), B*5701 (PR=2.0; 95% CI = 1.0,3.1), B*5703 (PR = 1.7; 95% CI = 1.0,2.5), and Cw*0102 (PR = 1.9; 95% CI = 1.0,3.0) were associated with the absence of HCV RNA (i.e., HCV clearance), whereas DRB1*0301 (PR = 0.4; 95% CI = 0.2,0.7) was associated with HCV RNA positivity. DQB1*0301 was also associated with the absence of HCV RNA but only among HIV-seronegative women (PR = 3.4; 95% CI = 1.2,11.8). Each of these associations was among those predicted. We additionally studied the relation of HLA alleles with HCV infection (serostatus) in women at high risk of HCV from injection drug use (N = 838), but no significant relationships were observed. Conclusion: HLA genotype influences the host capacity to clear HCV viremia. The specific HLA associations observed in the current study are unlikely to be due to chance because they were a priori hypothesized. (HEPATOLOGY 2010.) [source] Inappropriate eating behaviors during pregnancy: Prevalence and associated factors among pregnant women attending primary care in southern Brazil,INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 5 2009Rafael Marques Soares RD Abstract Objective: To examine the prevalence of inappropriate eating behaviors and associated factors among pregnant women in primary care. Method: The Eating Disorder Examination Questionnaire was used to assess eating disorders and the Primary Care Evaluation of Mental Disorders was used to examine anxiety and depressive symptoms. Body mass index (BMI) and pregestational weight were also assessed. Results: Prevalence of binge eating during pregnancy was 17.3% [95% confidence interval (CI) 14.5,20.0], followed by excessive shape (5.6%; 95% CI 4,8) and weight concerns (5.5%; 95% CI 4,8). Binge eating during pregnancy was significantly associated with binge eating before pregnancy [prevalence ratio (PR) = 3.1; 95% CI 2.2,4.3], current anxiety symptoms (PR = 1.8; 95% CI 1.3,2.4), and prepregnancy BMI < 19.8 kg/m2 (PR = 1.6; 95% CI 1.1,2.5). The prevalence of eating disorders was 0.6% (95% CI 0.01,1.11). Discussion: Eating disorder symptoms should be routinely assessed and treated during prenatal care, along with other comorbid psychiatric symptoms such as anxiety. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord, 2009 [source] The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveysINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 1 2003Laura Andrade Abstract Absence of a common diagnostic interview has hampered cross-national syntheses of epidemiological evidence on major depressive episodes (MDE). Community epidemiological surveys using the World Health Organization Composite International Diagnostic Interview administered face-to-face were carried out in 10 countries in North America (Canada and the US), Latin America (Brazil, Chile, and Mexico), Europe (Czech Republic, Germany, the Netherlands, and Turkey), and Asia (Japan). The total sample size was more than 37,000. Lifetime prevalence estimates of hierarchy-free DSM-III-R/DSM-IV MDE varied widely, from 3% in Japan to 16.9% in the US, with the majority in the range of 8% to 12%. The 12-month/lifetime prevalence ratio was in the range 40% to 55%, the 30-day/12-month prevalence ratio in the range 45% to 65%, and median age of onset in the range 20 to 25 in most countries. Consistent socio-demographic correlates included being female and unmarried. Respondents in recent cohorts reported higher lifetime prevalence, but lower persistence than those in earlier cohorts. Major depressive episodes were found to be strongly co-morbid with, and temporally secondary to, anxiety disorders in all countries, with primary panic and generalized anxiety disorders the most powerful predictors of the first onset of secondary MDE. Major depressive episodes are a commonly occurring disorder that usually has a chronic-intermittent course. Effectiveness trials are needed to evaluate the impact of early detection and treatment on the course of MDE as well as to evaluate whether timely treatment of primary anxiety disorders would reduce the subsequent onset, persistence, and severity of secondary MDE. Copyright © 2003 Whurr Publishers Ltd. [source] Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United StatesJOURNAL OF DIABETES, Issue 4 2009Earl S. FORD Abstract Background:, Some reports suggest that concentrations of vitamin D are inversely, whereas concentrations of parathyroid hormone (PTH) are directly, associated with prevalent metabolic syndrome. Because of lingering uncertainty about these associations, we examined the cross-sectional associations between serum concentrations of 25-hydroxyvitamin D3 and PTH with metabolic syndrome in a representative sample of adults in the US. Methods:, We used data from 1705 participants in the 2005,2006 National Health and Nutrition Examination Survey. Vitamin D was measured by radioimmunoassay, whereas PTH was measured using an electrochemiluminescent process. Results:, The mean concentration of vitamin D for participants with and without metabolic syndrome was 20.3 and 22.9 ng/mL, respectively (P = 0.001). The mean concentration of PTH for participants with and without metabolic syndrome was 44.5 and 41.0 pg/mL, respectively (P = 0.002). The age-adjusted mean concentrations of vitamin D (P for linear trend <0.001) decreased linearly, whereas PTH (P for linear trend = 0.002) increased linearly, as the number of components of metabolic syndrome increased. After adjusting for age, gender, physical activity, urinary albumin creatinine ratio, and concentrations of C-reactive protein and calcium, concentrations in the highest quintile of vitamin D [prevalence ratio (PR) = 0.59; 95% confidence interval (CI) 0.44,0.79], but not PTH (PR = 1.18; 95% CI 0.97,1.43), was significantly associated with prevalent metabolic syndrome. Conclusion:, Concentrations of vitamin D, but not PTH, were significantly associated with prevalent metabolic syndrome among US adults. [source] Time trends in asthma and wheeze in Swedish children 1996,2006: prevalence and risk factors by sexALLERGY, Issue 1 2010A. Bjerg Abstract Background:, Recent data suggest that the previously rising trend in childhood wheezing symptoms has plateaued in some regions. We sought to investigate sex-specific trends in wheeze, asthma, allergic conditions, allergic sensitization and risk factors for wheeze. Methods:, We compared two population-based cohorts of 7 to 8-year olds from the same Swedish towns in 1996 and 2006 using parental expanded ISAAC questionnaires. In 1996, 3430 (97%) and in 2006, 2585 (96%) questionnaires were completed. A subset was skin prick tested: in 1996, 2148 (88%) and in 2006, 1700 (90%) children participated. Results:, No significant change in the prevalence of current wheeze (P = 0.13), allergic rhinitis (P = 0.18) or eczema (P = 0.22) was found despite an increase in allergic sensitization (20.6,29.9%, P < 0.01). In boys, however, the prevalence of current wheeze (12.9,16.4%, P < 0.01), physician-diagnosed asthma (7.1,9.3%, P = 0.03) and asthma medication use increased. In girls the prevalence of current symptoms and conditions tended to decrease. The prevalence of all studied risk factors for wheeze and asthma increased in boys relative to girls from 1996 to 2006, thus increasing the boy-to-girl prevalence ratio in risk factors. Conclusions:, The previously reported increase in current wheezing indices has plateaued in Sweden. Due to increased diagnostic activity, physician diagnoses continue to increase. Time trends in wheezing symptoms differed between boys and girls, and current wheeze increased in boys. This was seemingly explained by the observed increases in the prevalence of risk factors for asthma in boys compared with girls. In contrast to the current symptoms of wheeze, rhinitis or eczema, the prevalence of allergic sensitization increased considerably. [source] Geographic variation in opioid prescribing for acute, work-related, low back pain and associated factors: A multilevel analysisAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2009Barbara S. Webster BSPT, PA-C Abstract Background Given reports about variation in opioid prescribing, concerns about increasing opioid use and its associated negative consequences make understanding the sources of variability important. The aims of the study were to assess the extent of and factors associated with geographic variation in early opioid prescribing for acute, work-related, low back pain (LBP). Methods Cases were selected from workers compensation administrative data filed between January 1, 2002 and December 31, 2003 and included claims from states with more than 40 cases. Early opioid prescribing (one or more prescriptions within first 15 days) was the outcome. Weighted coefficient of variation (wCOV) estimated geographic variation, and multilevel models measured variability controlling for individual and contextual factors. Results Of the 8,262 claimants, 21.3% received at least one early opioid prescription. Significant between-state variation was found (wCOV,=,53%), from 5.7% (Massachusetts) to 52.9% (South Carolina). Seventy-nine percent of the between-state variation was explained by three contextual factors: state household income inequality (prevalence ratio [PR] 1.06, 95% confidence interval [CI],=,1.01, 1.12), number of physicians per capita (PR 0.99, 95% CI,=,0.98, 0.99), and workers compensation cost containment effort score (PR 1.12, 95% CI,=,1.02, 1.24). Individual-level factors, including severity, explained only a small portion of the geographic variability. Conclusion Geographic variation of early opioid prescribing for acute LBP is important and almost fully explained by state-level contextual factors. The study suggests that clinician and patient interaction and the subsequent decision to use opioids are substantially framed by social conditions and control systems. Am. J. Ind. Med. 52:162,171, 2009. © 2008 Wiley-Liss, Inc. [source] Fruit and vegetable consumption among older adults by tooth loss and socio-economic statusAUSTRALIAN DENTAL JOURNAL, Issue 2 2010DS Brennan Abstract Background:, The aim of this study was to examine consumption of fruit and vegetables in relation to tooth loss and income. Methods:, Data were collected in 2004,06, using a three-stage, stratified clustered sample, involving a computer-assisted telephone interview (CATI), oral examination and mailed questionnaire followed by a food frequency questionnaire. Results:, A total of 14 123 adults responded to the CATI (49% response) of whom 5505 (44% of those interviewed) agreed to undergo an oral epidemiological examination. In the nutrition sub-study, a total of n = 1218 persons were approached in New South Wales and Queensland, with n = 1129 responding (92.7% response rate). Among respondents aged 55 years or more 34.5% had <21 teeth. Adjusting for income the prevalence of infrequent consumption (,never or less than once a month') was associated with [PR = prevalence ratio (95% CI)] fewer teeth for the fruits, ,peach, nectarine, plum, apricot' PR = 1.91 (1.12, 3.25) and ,grapes or berries' PR = 1.69 (1.03, 2.76), and for the vegetables ,stir-fried or mixed' PR = 2.34 (1.14, 4.78), ,sweetcorn' PR = 1.45 (1.001, 2.10), ,mushrooms' PR = 1.62 (1.05, 2.50), ,lettuce' PR = 3.99 (1.31, 12.17) and ,soy beans' PR = 1.11 (1.01, 1.21). Conclusions:, An inadequate dentition was associated with lower consumption of a range of fruits and vegetables indicating that dentition-related impairment of chewing ability could have adverse consequences on nutritional intake among Australian adults. [source] The Log Multinomial Regression Model for Nominal Outcomes with More than Two AttributesBIOMETRICAL JOURNAL, Issue 6 2007L. Blizzard Abstract An estimate of the risk or prevalence ratio, adjusted for confounders, can be obtained from a log binomial model (binomial errors, log link) fitted to binary outcome data. We propose a modification of the log binomial model to obtain relative risk estimates for nominal outcomes with more than two attributes (the "log multinomial model"). Extensive data simulations were undertaken to compare the performance of the log multinomial model with that of an expanded data multinomial logistic regression method based on the approach proposed by Schouten et al. (1993) for binary data, and with that of separate fits of a Poisson regression model based on the approach proposed by Zou (2004) and Carter, Lipsitz and Tilley (2005) for binary data. Log multinomial regression resulted in "inadmissable" solutions (out-of-bounds probabilities) exceeding 50% in some data settings. Coefficient estimates by the alternative methods produced out-of-bounds probabilities for the log multinomial model in up to 27% of samples to which a log multinomial model had been successfully fitted. The log multinomial coefficient estimates generally had lesser relative bias and mean squared error than the alternative methods. The practical utility of the log multinomial regression model was demonstrated with a real data example. The log multinomial model offers a practical solution to the problem of obtaining adjusted estimates of the risk ratio in the multinomial setting, but must be used with some care and attention to detail. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Perceived Discrimination and Depressive Symptoms, Smoking, and Recent Alcohol Use in PregnancyBIRTH, Issue 2 2010Ian M. Bennett MD Abstract:, Background:, Perceived discrimination is associated with poor mental health and health-compromising behaviors in a range of vulnerable populations, but this link has not been assessed among pregnant women. We aimed to determine whether perceived discrimination was associated with these important targets of maternal health care among low-income pregnant women. Methods:, Face-to-face interviews were conducted in English or Spanish with 4,454 multiethnic, low-income, inner-city women at their first prenatal visit at public health centers in Philadelphia, Penn, USA, from 1999 to 2004. Perceived chronic everyday discrimination (moderate and high levels) in addition to experiences of major discrimination, depressive symptomatology (CES-D , 23), smoking in pregnancy (current), and recent alcohol use (12 months before pregnancy) were assessed by patients' self-report. Results:, Moderate everyday discrimination was reported by 873 (20%) women, high everyday discrimination by 238 (5%) women, and an experience of major discrimination by 789 (18%) women. Everyday discrimination was independently associated with depressive symptomatology (moderate = prevalence ratio [PR] of 1.58, 95% CI: 1.38,1.79; high = PR of 1.82, 95% CI: 1.49,2.21); smoking (moderate = PR of 1.19, 95% CI: 1.05,1.36; high = PR of 1.41, 95% CI: 1.15,1.74); and recent alcohol use (moderate = PR of 1.23, 95% CI: 1.12,1.36). However, major discrimination was not independently associated with these outcomes. Conclusions:, This study demonstrated that perceived chronic everyday discrimination, but not major discrimination, was associated with depressive symptoms and health-compromising behaviors independent of potential confounders, including race and ethnicity, among pregnant low-income women. (BIRTH 37:2 June 2010) [source] Increasing prevalence of atopic eczema in Taiwanese adolescents from 1995 to 2001CLINICAL & EXPERIMENTAL ALLERGY, Issue 4 2007Y.-L. Lee Summary Background The prevalence of atopic eczema in adolescents has recently been reported as increasing in many countries, a phenomenon yet to be fully explained. This study compared the prevalence of atopic eczema among Taiwanese adolescents with individual-level risk factors and community-level data of temperature, relative humidity, and air pollutants to determine whether changes in these factors could explain the observed change in prevalence. Methods We conducted two nationwide, cross-sectional surveys of atopic illness and symptoms among Taiwanese 12,15-year-old schoolchildren in 1995,1996 and 2001. The effects of personal and environmental factors were assessed and temporal changes of outdoor monitoring data were also compared with the prevalence difference of atopic eczema. Results A total of 42 919 adolescents from the 1995 to 1996 survey and 10 215 adolescents from the 2001 survey attended schools located within 1 km of 22 monitoring stations. The 12-month prevalence of atopic eczema increased significantly during this period [adjusted prevalence ratio (PR)=1.43, 95% confidence interval (CI) 1.21,1.70 in boys; PR=1.77, 95% CI 1.49,2.10 in girls]. After adjustment for potential risk factors, the prevalence differences were statistically unchanged. Although parental education level contributed the most, changes in personal and environmental factors might not explain the observed prevalence increases of atopic eczema. Temporal change in the relative humidity was significantly associated with prevalence increase among boys but its contribution was also small. Conclusion Correlates of the investigated risk factors that have changed over time still underlie the prevalence increases of atopic eczema in Taiwanese adolescents. The exact reasons for the rising trends remain to be elucidated. [source] Nocturnal sleep duration and cognitive impairment in a population-based study of older adultsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2010Adrian Loerbroks Abstract Objective We aimed to investigate the association between nocturnal sleep duration, changes in nocturnal sleep duration and cognitive impairment in older adults. Methods 4010 participants of a population-based cohort study provided information on nocturnal sleep duration at baseline (1991,1995) and at follow-up (2002/2003). 792 follow-up participants aged 70+ by 2006 participated in telephone-based cognitive assessments. Several cognitive tests were used including the telephone interview for cognitive status (TICS). Cognitive impairment was defined as <31 points on the TICS (13.0%) and as below this percentile on the other tests. Based on individual tests, a verbal memory score and a total score were constructed. Multivariable prevalence ratios (PRs) of cognitive impairment and 95% confidence intervals (95%CIs) were computed using Poisson regression. Analyses were restricted to those free of depression in 2002/2003 (n,=,695). Results Sleeping ,6 or 8,h per night (versus 7,h) were unrelated to cognitive impairment. Sleeping ,9,h was positively, although imprecisely, associated with impairment of verbal memory (PR,=,1.7, 95%CI,=,1.0, 3.0), and less pronounced with the other cognitive measures. An increase in sleep duration from 7,8,h in 1992,1995 to ,9,h 8.5 years later (versus sleeping 7,8,h at both time points) was associated with an increased prevalence of cognitive impairment according to the TICS (PR,=,2.1, 95%,=,1.0, 4.5) and the verbal memory score (PR,=,2.0, 95%CI,=,1.0, 3.8). Conclusions Increases in sleep duration are associated with cognitive impairment. A biological explanation for this association is currently lacking. Increases in sleep duration could be a marker of cognitive deficits. Copyright © 2009 John Wiley & Sons, Ltd. [source] Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort studyALLERGY, Issue 10 2010A. Loerbroks To cite this article: Loerbroks A, Gadinger MC, Bosch JA, Stürmer T, Amelang M. Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study. Allergy 2010; 65: 1298,1305. Abstract Background:, There is an extensive literature linking stressful work conditions to adverse health outcomes. Notwithstanding, the relationship with asthma has not been examined, although various other measures of psychological stress have been associated with asthma. Therefore, we aimed to investigate the relation between work stress and asthma prevalence and incidence. Methods:, We used data from a population-based cohort study (n = 5114 at baseline in 1992,1995 and n = 4010 at follow-up in 2002/2003). Asthma was measured by self-reports. Two scales that assessed psychologically adverse work conditions were extracted from a list of work-condition items by factor analysis (these scales were termed ,work stress' and ,inability to relax after work'). For each scale, the derived score was employed both as continuous z -score and as categorized variable in analyses. Associations with asthma were estimated by prevalence ratios (PRs) and risk ratios (RRs) using Poisson regression with a log-link function adjusting for demographics, health-related lifestyles, body mass index and family history of asthma. Analyses were restricted to those in employment (n = 3341). Results:, Work stress and inability to relax z -scores were positively associated with asthma prevalence (PR = 1.15, 95%CI = 0.97, 1.36 and PR = 1.43, 95%CI = 1.12, 1.83, respectively). Prospective analyses using z -scores showed that for each 1 standard deviation increase in work stress and inability to relax, the risk of asthma increased by approximately 40% (RR for work stress = 1.46, 95%CI = 1.06, 2.00; RR for inability to relax = 1.39, 95%CI = 1.01, 1.91). Similar patterns of associations were observed in analyses of categorized exposures. Conclusions:, This is the first study to show a cross-sectional and longitudinal association of work stress with asthma. [source] Body mass index and waist circumference in Mozambique: urban/rural gap during epidemiological transitionOBESITY REVIEWS, Issue 9 2010A. Gomes Summary In 2005 we evaluated a nationally representative sample of the Mozambican adult population (n = 2913; 25,64 years old) following the STEPwise approach to chronic disease risk factor surveillance to estimate urban,rural differences in overweight and obesity and waist circumferences. The prevalences of obesity and overweight were, respectively, 6.8% (95% CI: 5.1,8.6) and 11.8% (95% CI: 8.4,15.4) among women, and 2.3% (95% CI: 1.1,3.6) and 9.4% (95% CI: 5.7,13.1) among men. Overweight/obesity was more frequent in urban settings (age-, income- and education-adjusted prevalence ratios; women, 2.76, 95% CI: 1.82,4.18; men, 1.76, 95% CI: 0.80,3.85). The average waist circumference in Mozambique was 75.2 cm (95% CI: 74.3,76.0) in women, significantly higher in urban than rural areas (age-, income- and education-adjusted , = 3.6 cm, 95% CI: 1.6,5.5) and 76.1 cm (95% CI: 75.0,77.3) in men, with no urban,rural differences (adjusted , = 1.3 cm, 95% CI: ,0.9 to 3.5). Our results show urban,rural differences, as expected in a country under epidemiological transition, with urban areas presenting a higher prevalence of overweight/obesity, but age- and education-specific estimates suggesting a trend towards smaller divergences. The development and implementation of strategies to manage the foreseeable obesity-related healthcare demands are needed. [source] Industry-wide medical surveillance of California flavor manufacturing workers: Cross-sectional resultsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Thomas J. Kim MD Abstract Background Two cases of bronchiolitis obliterans in flavor manufacturing workers prompted California health and labor agencies to initiate industry-wide surveillance. Methods Companies' physicians submitted cross-sectional questionnaire and spirometry data for 467 workers in 16 workplaces. We compared prevalence ratios of respiratory symptoms, diagnoses, and abnormal spirometry to a general population sample. We calculated odds ratios for risk factors for spirometric obstructive abnormality. Results Flavoring workers were 2.7 times more likely than the general population to have severe airways obstruction. Risk factors identified for 18 cases with obstruction from six companies included younger age, Hispanic ethnicity, liquid and powder production work, greater company diacetyl usage, and having a coworker with obstruction. Severity of obstruction was related to tenure. At least 12 workers had probable occupational fixed airways obstruction. Conclusions The flavoring industry risk of severe lung disease justifies lowering flavoring exposures and medical screening for secondary prevention until worker safety is demonstrated. Am. J. Ind. Med. 53:857,865, 2010. © 2010 Wiley-Liss, Inc. [source] Upper -extremity musculoskeletal symptoms and physical health related quality of life among women employed in poultry processing and other low -wage jobs in Northeastern North Carolina,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2009C.S. McPhee MSPH Abstract Background The purpose of this study was to evaluate the association between upper -extremity musculoskeletal symptoms (MS ) and diminished physical health related quality of life (PHRQoL ) in a population of women, mostly African -American working in poultry processing and other low -wage jobs in rural northeastern North Carolina. Methods A cross -sectional analysis was performed on baseline data of self -reported PHRQoL and musculoskeletal symptoms for 291 poultry processing workers and 299 community comparison women. Logarithmic binomial regression was performed to assess the relationship between moderate to severe MS on low PHRQoL. Results Prevalence of poor PHRQoL was 35.5 % among poultry processing workers, and 14.7 % among community comparison group. Moderate to severe upper -extremity musculoskeletal symptoms were present in 34.4 % of the poultry workers and 10.7 % of the comparison group. After adjusting for age and other chronic conditions, moderate to severe musculoskeletal symptoms were associated with low PHRQoL in both groups. Although the observed effect was stronger among the comparison group (adjusted prevalence ratios (95 % confidence interval ): poultry workers , = ,1.89 (1.36, 2.64 ), community comparison , = ,4.26 (2.51, 7.24 ), the population attributable risk percent was similar (poultry workers , = ,28.9, community comparison , = ,31.3 % ) ) due to the higher prevalence of moderate to severe symptoms in the poultry workers. Conclusions Significant upper-extremity musculoskeletal symptoms were associated with poor PHRQoL among both groups of women employed in low -wage jobs. Nationwide, poultry work is over -represented by minorities and immigrants. Though challenging, we need to search for ways to improve the conditions of these women as a matter of social justice. Am. J. Ind. Med. 52:331,340, 2009. © 2009 Wiley-Liss, Inc. [source] The relationship between chronic rhinosinusitis and occupation: The 1998, 2001, and 2005 Korea National health and nutrition examination survey (KNHANES),AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009Dong-Hee Koh MD, DrPH Abstract Objectives We examined the relationship between chronic rhinosinusitis and occupation. Methods We analyzed data from the 1998, 2001, and 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Men and women aged 20,59 who participated in the three KNHANES were included to analyze the relationship between chronic rhinosinusitis and occupation. Trained interviewers visited subjects' homes and administered a standardized questionnaire on diagnosed diseases. Subjects were asked if they had experienced chronic rhinosinusitis during the previous year or had had rhinosinusitis for three or more consecutive months. Occupational classification followed the major groups of the Korean Standard Classification of Occupations (KSCO). We calculated the prevalence ratios (PRs) of chronic rhinosinusitis by major groups compared with clerical workers in the three KNHANES. Poisson regression with robust standard error was conducted, adjusting for age in 10-year strata. Results There were significantly increased PRs of chronic rhinosinusitis in plant and machinery operators and assemblers, elementary occupations, crafts and related trade workers, and the unemployed. Conclusions These results support the relationship between chronic rhinosinusitis and occupational exposure at the macro level. Am. J. Ind. Med. 52:179,184, 2009. © 2008 Wiley-Liss, Inc. [source] Low vitamin K status is associated with osteoarthritis in the hand and knee,ARTHRITIS & RHEUMATISM, Issue 4 2006Tuhina Neogi Objective Poor intake of vitamin K is common. Insufficient vitamin K can result in abnormal cartilage and bone mineralization. Furthermore, osteophyte growth, seen in osteoarthritis (OA), may be a vitamin K,dependent process. We undertook this study to determine whether vitamin K deficiency is associated with radiographic features of OA. Methods We conducted an analysis among 672 participants (mean age 65.6 years, 358 women) in the Framingham Offspring Study, a population-based prospective observational cohort. Levels of plasma phylloquinone (the primary form of vitamin K) had previously been measured in these participants, for whom we also had bilateral hand and knee radiographs. The main outcomes were 1) prevalence ratios (PRs) of OA, osteophytes, and joint space narrowing (JSN) per quartile of plasma phylloquinone level for each joint, adjusting for correlated joints using generalized estimating equations, and 2) adjusted mean number of joints with each feature per quartile of plasma phylloquinone level. Analyses were conducted in hands and knees separately and adjusted for age, sex, body mass index, total energy intake, plasma vitamin D, and femoral neck bone mineral density. Results The PRs for OA, osteophytes, and JSN and adjusted mean number of joints with all 3 features in the hand decreased significantly with increasing plasma phylloquinone levels (P , 0.03 for all). For example, as plasma phylloquinone levels rose, the PR for hand OA decreased from 1.0 to 0.7 (P = 0.005). For the knee, only the PR for osteophytes and the adjusted mean number of knee joints with osteophytes decreased significantly with increasing plasma phylloquinone levels (PR decreased from 1.0 to 0.6, P = 0.01). Conclusion These observational data support the hypothesis of an association between low plasma levels of vitamin K and increased prevalence of OA manifestations in the hand and knee. [source] Complementary Log,Log Regression for the Estimation of Covariate-Adjusted Prevalence Ratios in the Analysis of Data from Cross-Sectional StudiesBIOMETRICAL JOURNAL, Issue 3 2009Alan D. Penman Abstract We assessed complementary log,log (CLL) regression as an alternative statistical model for estimating multivariable-adjusted prevalence ratios (PR) and their confidence intervals. Using the delta method, we derived an expression for approximating the variance of the PR estimated using CLL regression. Then, using simulated data, we examined the performance of CLL regression in terms of the accuracy of the PR estimates, the width of the confidence intervals, and the empirical coverage probability, and compared it with results obtained from log,binomial regression and stratified Mantel,Haenszel analysis. Within the range of values of our simulated data, CLL regression performed well, with only slight bias of point estimates of the PR and good confidence interval coverage. In addition, and importantly, the computational algorithm did not have the convergence problems occasionally exhibited by log,binomial regression. The technique is easy to implement in SAS (SAS Institute, Cary, NC), and it does not have the theoretical and practical issues associated with competing approaches. CLL regression is an alternative method of binomial regression that warrants further assessment. [source] Characteristics of sleep disturbances in Poland , results of the National Health Interview SurveyACTA NEUROPSYCHIATRICA, Issue 3 2004Andrzej Kiejna Background:, Apart from insomnia, poor quality of sleep, decreased sleep duration, tiredness after awakening and frequency of using sleeping drugs are important indicators of sleep problems. Objectives:, The aim of this study was to assess the prevalence of indicators of sleep disturbance, such as quality of sleep, sleep duration, feeling of restfulness in the morning and drug utilization in a randomly selected Polish adult population. Methods:, A stratified scheme of sampling involving two steps was used. A representative Polish population sample of 47 924 non-institutionalized adults was interviewed. Assessments of sleep-related problems were based on six questions. Standardized prevalence ratios (SPRs and their 95% confidence intervals) were calculated. Results:, Almost one-tenth of Polish inhabitants usually slept badly or very badly, a problem that was more common among women than men. Quality of sleep decreased together with ageing and this process was more rapid in women than in men over 40 years of age. Highly educated respondents had the highest quality of sleep. Up to one-fifth of the general Polish population usually woke up tired in the morning. Mean sleep duration was 7.7 h, with no gender differences. Usage of over-the-counter (OTC) medications was significantly lower than usage of those prescribed by the physician (5 vs. 16%). Women used OTC drugs twice as often as men. Conclusions:, It would appear to be necessary to introduce educational programmes for the community as well as for general practitioners in order to correct improper attitudes. [source] Prevalence of insomnia in Poland , results of the National Health Interview SurveyACTA NEUROPSYCHIATRICA, Issue 2 2003A. Kiejna Background: Sleep disturbances are one of the most common underdiagnosed and undertreated health problems among the adult population. Objectives: The aim of the study was to assess the prevalence of sleeping problems and their relation to sociodemographic characteristics in the Polish population, based on the results of the National Health Interview Survey carried out by the Central Statistical Office in 1996. Methods: A stratified sampling scheme, involving two steps, was used. Standardized prevalence ratios (SPRs and their 95% confidence intervals) were calculated. Assessment of sleep-related problems was based on six questions. A representative Polish sample (47 924 non-institutionalized, adult respondents) was interviewed. Results: Nearly one-fourth of Polish inhabitants suffered from insomnia. The percentage was significantly higher among women (28.1%) than among men (18.1%). The prevalence of insomnia increased with age and was highest in divorced respondents. Respondents of both sexes with higher educational levels suffered from insomnia less often than individuals with lower levels of education. The problem of insomnia applies in a similar degree to inhabitants of both rural and urban regions. About one-twentieth of inhabitants of Poland experienced recent sleep deterioration related to problems. It was associated positively with age, female gender and lower education. About 20% of the population get up not rested in the morning, women significantly more often than men, urban residents more often than rural ones. Conclusions: Sleep-related problems are common and the results are comparable with those from other countries. The findings have important implications, such as the necessity of better education of the public community about the identification and possibilities of treatment of sleep disturbance. [source] Oral health inequalities between young Aboriginal and non-Aboriginal children living in Ontario, CanadaCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 6 2009Herenia P. Lawrence Abstract,,, Objectives:, To investigate (i) oral health inequalities between off-reserve Aboriginal and non-Aboriginal children entering junior kindergarten (JK) in the Thunder Bay District, Northwest Ontario, Canada, (ii) oral health inequalities between kindergarten-aged (4 years old) Aboriginal children living on reserves in the Sioux Lookout Zone (SLZ), Northwest Ontario and those living off-reserve in the Thunder Bay District and (iii) early childhood caries (ECC) trends among SLZ children between 2001 and 2005. Methods:, Cross-sectional oral health data (dmft/s Indices) for 416 (2003/2004), 687 (2004/2005) and 544 (2005/2006) 3- to 5-year olds attending JK in the Thunder Bay District were collected by calibrated dental hygienists with the District's Health Unit. Secondary analysis of oral health status data from two studies conducted in the SLZ between 2001 and 2005 provided the dmft of random samples of children younger than 6 years of age living in 16,20 First Nations communities. Results:, When compared with non-Aboriginal children aged 3,5 years attending the same schools in the Thunder Bay District between 2003 and 2006, off-reserve Aboriginal children had 1.9 to 2.3 times the risk of having ECC (dmft > 0), 2.9 to 3.5 times the risk of a dmft > 3 and 1.8 to 2.5 times the risk of untreated decayed teeth after adjusting the prevalence ratios for child's age and sex, school's risk level and clustered-correlated data. The mean dmft of on-reserve Aboriginal 4-year olds in 2005 was 11.2 and 5.9 for their off-reserve Aboriginal counterparts. In 2001, the mean dmft scores (95% confidence interval) of 2-, 3- and 4-year-old Aboriginal children in the SLZ were: 9.1 (8.3,9.9), 12.4 (11.8,13.1), 13.1 (12.1,14.2). In 2005, similarly aged SLZ children had a mean dmft of: 6.2 (5.2,7.1), 8.9 (8.2,9.6), 11.2 (10.5,11.9), representing significant reductions in caries severity (32%, 28% and 14.5%, respectively). Conclusions:, Significant disparities in caries experience exist between off-reserve Aboriginal and non-Aboriginal children living in the same locales and between Aboriginal children living on- and off-reserve in northwestern Ontario. The study showed decreased trends in the severity of ECC for children in the SLZ occurring over the 5-year period. Despite this progress, the oral health of young Aboriginal children in Ontario continues to lag far behind that of non-Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities. [source] | |||||||||||||||||||||||||