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Recent Estimates (recent + estimate)
Selected AbstractsWhat happens after diagnosis?HEALTH EXPECTATIONS, Issue 2 2009Understanding the experiences of patients with newly-diagnosed bipolar disorder Abstract Bipolar disorder is chronic condition involving episodes of both depression and elevated mood, associated with significant disability and high relapse rates. Recent estimates suggest a lifetime prevalence of 5%. Little is known about the subjective experiences of patients after receiving a diagnosis of bipolar disorder, and the impact of these experiences on patients' willingness and ability to work with their health professionals to find the most effective combination of treatments and to set up self-management plans. Objective, This paper describes a qualitative study exploring the experiences and difficulties faced by patients after they have received a diagnosis of bipolar disorder, as expressed online to expert patients trained to provide informed support. Design, Qualitative study. Setting, Online communication within a public health service setting. Participants, Twenty-six participants with recently-diagnosed bipolar disorder communicated online with ,Informed Supporters', people who had been managing their bipolar disorder effectively for 2 years or more, as part of an online psycho-education programme. Results, Participants cited unwanted side-effects of medication, coping with unpleasant symptoms, positive and negative reactions to the diagnosis, identifying early warning signs and triggers of the illness, the loss of a sense of self, uncertainty about their future and stigma as issues of major importance after diagnosis. Conclusions, Personal concerns and difficulties following diagnosis can undermine effective treatment, thwart self-management efforts and interfere with effective functioning. Such data are important for clinicians to take into account when they work in partnership with their patients to fine-tune treatments and help them set up self-management plans. [source] Caries prevalence in Belgian children: a reviewINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2001J. Vanobbergen A review of epidemiological surveys on dental caries prevalence, published between 1980 and 1999 in Belgian children, was compiled through a literature search. The number of studies performed in Belgium to date is limited. Methodological differences and confounding factors, especially socio-demographic influences, limit national comparisons of caries prevalence data. Although exact comparisons are difficult, data suggests a decline in caries prevalence in 5, 7 and 12 year-old Belgian schoolchildren in the last 20 years. In the primary dentition dmft values have decreased from 2·66 (1981) to 1·38 (1994) in 5-year-olds and from 4·1 (1983) to 2·24 (1996) in 7-year-olds. In 12-year-olds DMFT values in the permanent dentition have decreased from 3·9 (1983) to 1·93 (1994). WHO goals for the year 2000 appear to have been already reached in Flanders, with a recent estimate of 1·93 for DMFT in 12-year-olds and 56% of children being recorded as caries free at the age of 5. Continuing efforts are needed to screen the oral health of different age groups but standardised criteria and sampling procedures should be used if benefits are to be gained from national and international comparison. Data has often been limited to small selected areas and information representing the entire community of Flanders or Wallonia would be of particular value. [source] Could the tree diversity pattern in Europe be generated by postglacial dispersal limitation?ECOLOGY LETTERS, Issue 6 2007Jens-Christian Svenning Abstract The relative importance of contemporary climate and history as controls of geographical diversity patterns is intensely debated. A key example is the controversy over the extent to which temperate tree distributions and diversity patterns reflect postglacial dispersal limitation. Here, we focus on Central and Northern Europe, and show that recent estimates of tree migration rates < 100 m year,1 imply that many species have probably not reached equilibrium with climate in this region. We then demonstrate that geographical accessibility from glacial refuges explains 78% of the geographical variation in the region's tree diversity and is a much stronger diversity predictor than climate. Finally, we show that realistic estimates of migration rates can be derived from the observed tree diversity pattern by assuming it to be purely dispersal driven. In conclusion, the tree diversity pattern in Central and Northern Europe could, to a large extent, be a result of postglacial dispersal limitation. [source] Fire and the Miocene expansion of C4 grasslandsECOLOGY LETTERS, Issue 7 2005Jon E. Keeley Abstract C4 photosynthesis had a mid-Tertiary origin that was tied to declining atmospheric CO2, but C4 -dominated grasslands did not appear until late Tertiary. According to the ,CO2 -threshold' model, these C4 grasslands owe their origin to a further late Miocene decline in CO2 that gave C4 grasses a photosynthetic advantage. This model is most appropriate for explaining replacement of C3 grasslands by C4 grasslands, however, fossil evidence shows C4 grasslands replaced woodlands. An additional weakness in the threshold model is that recent estimates do not support a late Miocene drop in pCO2. We hypothesize that late Miocene climate changes created a fire climate capable of replacing woodlands with C4 grasslands. Critical elements were seasonality that sustained high biomass production part of year, followed by a dry season that greatly reduced fuel moisture, coupled with a monsoon climate that generated abundant lightning-igniting fires. As woodlands became more open from burning, the high light conditions favoured C4 grasses over C3 grasses, and in a feedback process, the elevated productivity of C4 grasses increased highly combustible fuel loads that further increased fire activity. This hypothesis is supported by paleosol data that indicate the late Miocene expansion of C4 grasslands was the result of grassland expansion into more mesic environments and by charcoal sediment profiles that parallel the late Miocene expansion of C4 grasslands. Many contemporary C4 grasslands are fire dependent and are invaded by woodlands upon cessation of burning. Thus, we maintain that the factors driving the late Miocene expansion of C4 were the same as those responsible for maintenance of C4 grasslands today. [source] Impact of Chest Pain on Cost of Migraine Treatment With Almotriptan and SumatriptanHEADACHE, Issue 2002Joseph T. Wang MS Chest-related symptoms occur with all triptans; up to 41% of patients with migraine who receive sumatriptan experience chest symptoms, and 10% of patients discontinue treatment. Thus, the cost of chest pain-related care was estimated in migraineurs receiving almotriptan 12.5 mg versus sumatriptan 50 mg. A population-based, retrospective cohort study used data to quantify the incidence and costs of chest pain-related diagnoses and procedures. An economic model was constructed to estimate annual cost savings per 1000 patients receiving almotriptan versus sumatriptan based on the reported rates of chest pain. Annual direct medical cost avoided was calculated for a hypothetical health plan covering 1 million lives. Among a cohort of 1390 patients, the incidence of chest pain-related diagnoses increased significantly by 43.6% with sumatriptan (P=.003). Aggregate costs for chest pain-related diagnoses and procedures increased from $22 713 to $30 234. Payments for inpatient hospital services, costs for primary care visits, and costs for outpatient hospital visits increased by over 100%, 53.1%, and 14.4%, respectively. The model predicted $11 215 in direct medical cost savings annually per 1000 patients treated with almotriptan versus sumatriptan. Annual direct medical costs avoided totaled $194 358, and when applied to recent estimates of 86 million lives currently covered by almotriptan treatment, translates into an annual cost savings of just under $17 million for chest pain and associated care. Thus, using almotriptan in place of sumatriptan will likely reduce the cost of chest pain-related care. [source] The 2dF Galaxy Redshift Survey: correlation functions, peculiar velocities and the matter density of the UniverseMONTHLY NOTICES OF THE ROYAL ASTRONOMICAL SOCIETY, Issue 1 2003Ed Hawkins ABSTRACT We present a detailed analysis of the two-point correlation function, ,(,, ,), from the 2dF Galaxy Redshift Survey (2dFGRS). The large size of the catalogue, which contains ,220 000 redshifts, allows us to make high-precision measurements of various properties of the galaxy clustering pattern. The effective redshift at which our estimates are made is zs, 0.15, and similarly the effective luminosity, Ls, 1.4L*. We estimate the redshift-space correlation function, ,(s), from which we measure the redshift-space clustering length, s0= 6.82 ± 0.28 h,1 Mpc. We also estimate the projected correlation function, ,(,), and the real-space correlation function, ,(r), which can be fit by a power law (r/r0), with r0= 5.05 ± 0.26 h,1 Mpc, ,r= 1.67 ± 0.03. For r, 20 h,1 Mpc, , drops below a power law as, for instance, is expected in the popular , cold dark matter model. The ratio of amplitudes of the real- and redshift-space correlation functions on scales of 8,30 h,1 Mpc gives an estimate of the redshift-space distortion parameter ,. The quadrupole moment of ,(,, ,) on scales 30,40 h,1 Mpc provides another estimate of ,. We also estimate the distribution function of pairwise peculiar velocities, f(v), including rigorously the significant effect due to the infall velocities, and we find that the distribution is well fit by an exponential form. The accuracy of our ,(,, ,) measurement is sufficient to constrain a model, which simultaneously fits the shape and amplitude of ,(r) and the two redshift-space distortion effects parametrized by , and velocity dispersion, a. We find ,= 0.49 ± 0.09 and a= 506 ± 52 km s,1, although the best-fitting values are strongly correlated. We measure the variation of the peculiar velocity dispersion with projected separation, a(,), and find that the shape is consistent with models and simulations. This is the first time that , and f(v) have been estimated from a self-consistent model of galaxy velocities. Using the constraints on bias from recent estimates, and taking account of redshift evolution, we conclude that , (L=L*, z= 0) = 0.47 ± 0.08, and that the present-day matter density of the Universe, ,m, 0.3, consistent with other 2dFGRS estimates and independent analyses. [source] Epidemiology of tardive dyskinesia: Is risk declining with modern antipsychotics?MOVEMENT DISORDERS, Issue 5 2006Daniel Tarsy MD Abstract Second-generation antipsychotic drugs (APDs), including aripiprazole, clozapine, olanzapine, risperidone, quetiapine, and ziprasidone dominate outpatient and inpatient clinical practice, having largely displaced the older neuroleptics. Modern APDs have relatively low risk for acute extrapyramidal syndromes characteristic of older neuroleptics, particularly acute dystonia and Parkinsonism, with variable risks of akathisia and the rare neuroleptic malignant syndrome. Anticipated reduction in risk of tardive dyskinesia (TD) is less well documented. Nearly 50 years after initial reports on TD, it is appropriate to reexamine the epidemiology of this potentially severe late adverse effect of long-term APD treatment in light of current research and practice. We compared recent estimates of incidence and prevalence of TD identified with some modern APDs to the epidemiology of TD in the earlier neuroleptic era. Such comparisons are confounded by complex modern APD regimens, uncommon exposure limited to a single modern APD, effects of previous exposure to typical neuroleptics, and neurological assessments that are rarely prospective or systematic. Available evidence suggests that the risk of TD may be declining, but longitudinal studies of patients never treated with traditional neuroleptics and exposed to only a single modern APD are required to quantify TD risks with specific drugs. Long-term use of APDs should continue to be based on research-supported indications, with regular specific examination for emerging TD. © 2006 Movement Disorder Society [source] Possibilities and challenges in occupational injury surveillance of day laborersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Sarah J. Lowry MPH Abstract Background Day laborers in the US, comprised largely of undocumented immigrants from Mexico and Central America, suffer high rates of occupational injury according to recent estimates. Adequate surveillance methods for this highly transient, largely unregulated group do not currently exist. This study explores chart abstraction of hospital-based trauma registry records as a potential injury surveillance method for contingent workers and day laborers. We sought to determine the degree of completeness of work information in the medical records, and to identify day laborers and contingent workers to the extent possible. Methods Work-related injury cases from a hospital-based trauma registry (2001,2006) were divided by ethnicity (Hispanic vs. non-Hispanic origin) and presence of social security number (SSN: yes, no), resulting in four groups of cases. Medical records were abstracted for 40 cases from each group; each case was assigned values for the variables "day labor status" (yes, no, probably not, probable, unknown) and "employment type" (contingent, formal, unknown). Results Work information was missing for 60% of Hispanic cases lacking SSN, as compared with 33,47% of the other three groups. One "probable" day laborer was identified from the same group. Non-Hispanics with SSN were less frequently identified as contingent workers (5% as compared with 15,19%). Conclusions This method revealed severe limitations, including incomplete and inconsistent information in the trauma registry and medical records. Approaches to improve existing resources for use in surveillance systems are identified. The potential of an active surveillance approach at day labor hiring centers is also briefly discussed. Am. J. Ind. Med. 53:126,134 2010. © 2009 Wiley-Liss, Inc. [source] Secular changes of LOD associated with a growth of the inner coreASTRONOMISCHE NACHRICHTEN, Issue 4 2006C. Denis Abstract From recent estimates of the age of the inner core based on the theory of thermal evolution of the core, we estimate that nowadays the growth of the inner core may perhaps contribute to the observed overall secular increase of LOD caused mainly by tidal friction (i.e., 1.72 ms per century) by a relative decrease of 2 to 7 µs per century. Another, albeit much less plausible, hypothesis is that crystallization of the inner core does not produce any change of LOD, but makes the inner core rotate differentially with respect to the outer core and mantle. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Overweight and obesity in Norwegian children: Secular trends in weight-for-height and skinfoldsACTA PAEDIATRICA, Issue 9 2007PB Júlíusson Abstract Aim: The prevalence of overweight and obesity in paediatric populations has been rapidly increasing in many countries over the past decades. The aims of the present study were to provide new data on weight-for-height and skinfolds, and to compare these to growth references for children between 3 and 17 years, collected in the same city between 1971 and 1974. Material: The present study is based on cross-sectional data of 4115 children (2086 boys and 2029 girls) aged 4,15 years measured in 2003,6. Results: Overall, 18.0% of the boys and 20.1% of the girls were above the 90th weight-for-height percentile of the 1971,1974 references, 8.0% and 7.2% were above the 97.5th percentile, indicating an upward shift in weight-for-height. An even more prominent increase was observed for skinfold thicknesses; for triceps skinfolds about 30% of the boys and 28% of the girls were above the 90th percentile of the 1971,1974 references, and corresponding values for subscapular skinfolds were 26.5% and 25.9%. Using international cut-off values for body mass index, the overall prevalence of overweight and obesity was 12.5% and 2.1% in boys, and 14.8% and 2.9% in girls. Conclusions: Our study has demonstrated a significant increase in weight-for-height in Norwegian children over the last 30 years, and that these changes are caused by an increase in fat tissue, as shown by skinfold measurements. The current prevalence of overweight and obesity is comparable to recent estimates from most Western and Northern European countries. [source] | |||||||||||||