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Selected AbstractsPerformance of diagnostic mammography differs in the United States and DenmarkINTERNATIONAL JOURNAL OF CANCER, Issue 8 2010Allan Jensen Abstract Diagnostic mammography is the primary imaging modality to diagnose breast cancer. However, few studies have evaluated variability in diagnostic mammography performance in communities, and none has done so between countries. We compared diagnostic mammography performance in community-based settings in the United States and Denmark. The performance of 93,585 diagnostic mammograms from 180 facilities contributing data to the US Breast Cancer Surveillance Consortium (BCSC) from 1999 to 2001 was compared to that of all 51,313 diagnostic mammograms performed at Danish clinics in 2000. We used the imaging workup's final assessment to determine sensitivity, specificity and an estimate of accuracy: area under the receiver-operating characteristics (ROCs) curve (AUC). Diagnostic mammography had slightly higher sensitivity in the United States (85%) than in Denmark (82%). In contrast, it had higher specificity in Denmark (99%) than in the United States (93%). The AUC was high in both countries: 0.91 in United States and 0.95 in Denmark. Denmark's higher accuracy may result from supplementary ultrasound examinations, which are provided to 74% of Danish women but only 37% to 52% of US women. In addition, Danish mammography facilities specialize in either diagnosis or screening, possibly leading to greater diagnostic mammography expertise in facilities dedicated to symptomatic patients. Performance of community-based diagnostic mammography settings varied markedly between the 2 countries, indicating that it can be further optimized. [source] Prevalence and trends in low femur bone density among older US adults: NHANES 2005,2006 compared with NHANES IIIJOURNAL OF BONE AND MINERAL RESEARCH, Issue 1 2010Anne C Looker Abstract Hip fracture incidence appears to be declining in the United States, but changes in bone mineral density (BMD) of the population have not been evaluated. We used femur BMD data from the National Health and Nutrition Examination Survey (NHANES) 2005,2006 to estimate the prevalence of low femoral BMD in adults age 50 years and older and compared it with estimates from NHANES III (1988,1994). Dual-energy X-ray absorptiometry systems (pencil-beam geometry in NHANES III, fan-beam geometry in NHANES 2005,2006) were used to measure femur BMD, and World Health Organization (WHO) definitions of low BMD were used to categorize skeletal status. In 2005,2006, 49% of older US women had osteopenia and 10% had osteoporosis at the femur neck. In men, 30% had femur neck osteopenia and 2% had femur neck osteoporosis. An estimated 5.3 million older men and women had osteoporosis at the femur neck, and 34.5 million more had osteopenia in 2005,2006. When compared with NHANES III, the age-adjusted prevalence of femur neck osteoporosis in NHANES 2005,2006 was lower in men (by 3 percentage units) and women (by 7 percentage units) overall and among non-Hispanic whites. Changes in body mass index or osteoporosis medication use between surveys did not fully explain the decline in osteoporosis. Owing to the increase in the number of older adults in the US population, however, more older adults had low femur neck BMD (osteoporosis + osteopenia) in 2005,2006 than in 1988,1994. Thus, despite the decline in prevalence, the estimated number of affected older adults in 2005,2006 remained high. Copyright © 2010 American Society for Bone and Mineral Research [source] Socioeconomic status, education, and reproduction in modern women: An evolutionary perspectiveAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2010Susanne Huber Although associations between status or resources and reproduction are positive in premodern societies and also in men in modern societies, in modern women the associations are typically negative. We investigated how the association between socioeconomic status and reproductive output varies with the source of status and resources, the woman's education, and her age at reproductive onset (proxied by age at marriage). By using a large sample of US women, we examined the association between a woman's reproductive output and her own and her husband's income and education. Education, income, and age at marriage are negatively associated with a woman's number of children and increase her chances of childlessness. Among the most highly educated two-thirds of the sample of women, husband's income predicts the number of children. The association between a woman's number of children and her husband's income turns from positive to negative when her education and age at marriage is low (even though her mean offspring number rises at the same time). The association between a woman's own income and her number of children is negative, regardless of education. Rather than maximizing the offspring number, these modern women seem to adjust investment in children based on their family size and resource availability. Striving for resources seems to be part of a modern female reproductive strategy,but, owing to costs of resource acquisition, especially higher education, it may lead to lower birthrates: a possible evolutionary explanation of the demographic transition, and a complement to the human capital theory of net reproductive output. Am. J. Hum. Biol. 22:578,587, 2010. © 2010 Wiley-Liss, Inc. [source] Women's fertility and mortality in late mid life: A comparison of three contemporary populationsAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2009Emily Grundy Evolutionary theory suggests a trade-off between reproduction and somatic maintenance implying a negative relationship between parity and longevity, at least in natural fertility populations. In populations in which fertility control is usual, there are also a number of mechanisms that may link reproductive careers and later mortality, but evidence of associations between women's fertility patterns and their later life health has been judged inconclusive due to varying controls for socio-economic characteristics and marital status. Here, we build on three recent studies that followed a common framework to investigate associations between women's parity and timing of first and last birth with mortality in late middle age in three contemporary developed counties, Norway, England and Wales, and the USA. Data were drawn from whole population registers (Norway); a large census-based record linkage study (England and Wales), and a nationally representative survey linked to death records (USA). Results show that teenage childbirth was associated with higher mortality risks in late middle age in all three countries. Risks of death were significantly raised among nulliparous women in Norway and England and Wales, and also raised (although not significantly so) for childless US women. However, although higher parity was associated with a slight mortality disadvantage in England and Wales and the USA, the reverse seemed the case in Norway. These finding suggest that in populations in which fertility control is usual, contextual factors influencing the relative costs and benefits of childbearing may influence associations between fertility histories and later mortality. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] The association between tooth loss and the self-reported intake of selected CVD-related nutrients and foods among US womenCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 3 2005Hsin-Chia Hung Abstract , Objectives:, Many studies have reported associations between oral health and cardiovascular diseases; poor nutritional status due to impaired dentition status has been suggested as a mediator. Our objective is to evaluate the associations between tooth loss and the self-reported consumption of fruits and vegetables and selected CVD-related nutrients. Methods:, A total of 83,104 US women who completed a food frequency questionnaire (FFQ) in 1990 and 1994 and reported number of natural teeth in 1992, were included in a cross-sectional analysis relating dietary intake to number of natural teeth. A longitudinal analysis was also conducted to evaluate whether tooth loss in 1990,1992 was associated with change in diet between 1990 and 1994. Results:, After adjusting for age, total calorie intake, smoking and physical activity, edentulous women appeared to have dietary intake associated with increased risk for CVD, including significantly higher intake of saturated fat, trans fat, cholesterol and vitamin B12, and lower intake of polyunsaturated fat, fiber, carotene, vitamin C, vitamin E, vitamin B6, folate, potassium, vegetables, fruits, and fruits excluding juices compared with women with 25,32 teeth. In the longitudinal analyses, women who lost more teeth were more likely to change their diet in ways that would potentially increase risk for development of CVD. They also tended to avoid hard foods, such as raw carrot, fresh apple or pear. Conclusions:, Women with fewer teeth have unhealthier diets such as decreased intake of fruits and vegetables, which could increase CVD risk. Diet may partially explain associations between oral health and cardiovascular disease. [source] |