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PubMed2006

Secular trends in desired weight of adults.

CONTEXT: The prevalence of overweight and obese adults in the United States is at record levels. OBJECTIVE: The primary purpose is to describe secular trends in desired weight among adults from 1994 to 2003, and secondarily, to examine the hypothetical impact of achieving desired weight on obesity prevalence. DESIGN: Data were from the Behavioral Risk Factor Surveillance System (1994, 1996, 1998, 2000, 2003), a random-digit-dialed telephone survey. SETTING: Sample included respondents from 47 states and the District of Columbia. PARTICIPANTS: Non-institutionalized adults aged 18 years or older were included (N=703 286). MAIN OUTCOME MEASURES: Primary outcome measures included reported weight and desired weight. RESULTS: Means for desired weight increased 2.3 kg between 1994 and 2003, and reported weights increased 3.9 kg. The increased trend was observed across several subgroups for age, race/ethnicity and education. Within subgroups of weight status, the trend has remained relatively stable, particularly when examined in relation to the difference between reported and desired weight as a percentage of reported body weight. Generally, overweight men desired weights approximately 4.5% less than their reported weight, and obese men desired weights approximately 15% less than their reported weight for each corresponding year. For women, approximate values of desired weight were 12% less than reported weight for overweight women and 24% less for obese women. The prevalence of obesity would decrease to 4.4% if individuals weighed their desired weight. CONCLUSIONS: Americans are shifting their desired weight upward, concomitantly with an increase in their reported body weight.

Adult↗
PubMed2004

Secular decrease in blood pressure and reduction in mortality from cardiovascular disease in Israeli workers.

The reasons for the dramatic reduction in age-adjusted mortality from cardiovascular disease (CVD) since the 1970s in developed countries remain uncertain. In the following study we compare the cardiovascular and all-cause mortality rates over an 11-year period in two well-defined employed male cohorts aged 40-69 years old recruited 24 years apart. Blood pressure and other risk markers for CVD were assessed at the time of inception (1963 for 10 048 male civil servants and 1985-1987 for 2237 male industrial workers). Compared to the 1987 cohort, the 1963 cohort show an increase of 8.7 mmHg in the mean systolic blood pressure (SBP) (95% confidence interval (CI): 7.7, 9.6) and a concomitant hazard ratio for CVD mortality of 1.47 (95% CI: 1.16, 1.87). After adding SBP to the analysis, the hazard ratio for CVD mortality in the 1963 cohort decreased to 1.18 (95% CI: 0.88, 1.43). Adding the other risk modifiers to the analysis did not modify the hazard ratio to the same extent. Similar results were obtained for all-cause mortality. We conclude that declining blood pressure values are a major factor in explaining the secular decrease in CVD mortality over a period of 24 years in Israel.

Adult↗
PubMedDate not supplied

Spiritual and religious components of patient care in the neonatal intensive care unit: sacred themes in a secular setting.

OBJECTIVE: We hypothesized that spiritual distress was a common, unrecognized theme for neonatal intensive care unit (NICU) care providers. STUDY DESIGN: An anonymous questionnaire form assigned to a data table in a relational database was designed. RESULTS: Surveys were completed by 66% of NICU staff. All respondents viewed a family's spiritual and religious concerns as having a place in patient care. Eighty-three percent reported praying for babies privately. Asked what theological sense they made of suffering of NICU babies, 2% replied that children do not suffer in the NICU. Regarding psychological suffering of families, the majority felt God could prevent this, with parents differing (p = 0.039) from nonparents. CONCLUSION: There exists a strong undercurrent of spirituality and religiosity in the study NICU. These data document actual religious and spiritual attitudes and practices and support a need for pastoral resources for both families and care providers. NICU care providers approach difficulties of their work potentially within a religious and spiritual rather than a uniquely secular framework.

Adult↗
PubMed1986

Secular trends in face size.

Comparison of lateral and postero-anterior radiographs of parents and their adult children shows a differential secular trend in facial depths, heights, and breadths. Children tend to have deeper, longer, and narrower faces than their same-sex parents.

Adult↗
PubMed1998

Does a secular trend exist in the distribution of occlusal patterns?

The existence of a secular trend in the distribution of occlusal patterns was studied in two generations of children. Study models and demographic data of a sample of 265 children from the previous generation (group A) and recordings of clinical examinations of 988 children from the present generation (group B) served as the data base for this study. Children in whom caries affected the occlusion and those in the deciduous dentition stage were excluded. Thus, occlusal analysis was performed for 102 children in group A and 703 in group B. A dramatic decrease was found in the prevalence of caries affecting the occlusion. No difference existed between the two groups with respect to molar and canine anteroposterior relationships. However, there was a decrease in the prevalence of normal occlusion accompanied by an increase of Class I malocclusion.

Adolescent↗
PubMed2002

Religious and secular students' sense of self-efficacy and attitudes towards inclusion of pupils with intellectual disability and other types of needs.

BACKGROUND: The aim of the present study was to investigate whether Judaism's positive attitudes toward people with disabilities would influence greater willingness towards inclusion of such people in regular classes and a greater sense of self-efficacy in working with them. METHODS: The present authors compared religious (n = 175) and secular (n = 420) Jewish students at a teacher's college with regard to these variables. The authors used the Regular Education Initiative questionnaire, which investigates teachers' self-efficacy and attitudes towards including pupils with different types of disabilities in regular education. They analysed the results according to the college students' major and the type of disability (five types at three levels of severity). RESULTS: The results indicate that religious students are more willing than non-religious students to consider the inclusion of people with four types of disabilities and have a greater sense of efficacy for dealing with all types of disabilities. The hypothesis that the milder the disability, the higher would be the teacher's sense of self-efficacy and her/his willingness for such children to be included in a regular class was sustained. The religious special education students were the only ones who exhibited willingness to include pupils with intellectual disability, and moderate and severe emotional disturbances. Students who majored in special education scored higher than all their counterparts on both measures. The results also sustain the hypothesis that there would be a positive correlation between both measures. CONCLUSIONS: To facilitate inclusive education amongst teachers and students, the present authors recommend an intervention programme designed to help students acquire knowledge and strategies about inclusion. They also suggest enriching this programme with Jewish religious sources, which reflect positive attitudes toward people with disabilities.

Adult↗
PubMed2000

Secular changes in cardiovascular risk factors over 30 years in Swedish men aged 50: the study of men born in 1913, 1923, 1933 and 1943.

OBJECTIVES: To study secular trends in cardiovascular risk factors in men aged 50 over a period of 30 years. DESIGN: Cross-sectional studies of successive cohorts of men from 1963 to 1993. SETTING: City of Göteborg, Sweden. SUBJECTS: Four random population samples of men born in 1913, 1923, 1933 and 1943, aged 50 when they were examined in 1963, 1973, 1983, and 1993 (n = 855, 226, 776, and 798, respectively). MAIN OUTCOME MEASURES: Anthropometric measurements, blood pressure, serum cholesterol and triglycerides and smoking habits over three decades. RESULTS: Over 30 years, men increased in weight from a mean (SD) of 75.9 (11.0) kg to 82.8 (12.1) kg and gained 3.4 cm in height, with a net increase in body mass index from 24.8 (3.2) to 26.0 (3.4) kg m-2 (P < 0.0001), and a concomitant increase in waist circumference. The proportion of men who were overweight but not obese (BMI = 25-30 kg m-2) increased from 38 to 47%, whereas the prevalence of frank obesity (more than 30 kg m-2) increased from 6% in 1963 to 11% in 1993. Despite the increase in weight, mean systolic blood pressure fell by almost 10 mmHg (P < 0.0001). Mean serum cholesterol concentration decreased from 6.42 (1.12) to 5.88 (1.04) (P < 0.0001). Serum triglycerides increased from 1.26 (0.77) to 1.69 (1.04) mmol L-1 (P = 0.001). The proportion of men who smoked decreased from 56% in 1963 to 30% in 1993 (P < 0.0001). This was due more to an increase in smoking cessation rates than to an increase in the proportion of men who had never smoked. In particular, smokers and former smokers are now more obese than the corresponding categories 30 years ago and smokers are no longer leaner than men who have never smoked. CONCLUSIONS: Over a period of 30 years, serum cholesterol as well as systolic blood pressure and the prevalence of smoking decreased. This favourable decline in coronary risk factors was offset by an appreciable increase in body mass index and waist circumference.

Aged↗
PubMed2003

Secular trend in medical education regarding infectious disease.

OBJECTIVE: The paradigm of global medical health has been re-characterised by a shift in its major focus from infectious disease to chronic illness. Opinions vary as to the declining emphasis on infectious disease. This paper provides clinicians with an understanding of a secular trend in medical education regarding the topic of infectious diseases over a period of 26 years. METHODS: A survey was carried out to evaluate coverage of infectious disease topics within recent general medicine textbooks and journals. RESULTS: The percentage of content dedicated to infectious disease has remained static in 2 major medical textbooks, whereas a trend towards decreasing coverage was shown in 4 major medical journals. Of 901 original articles published in 2000, 16.4% covered certain aspects of infectious disease, as compared with 20.9% of 790 articles published in 1985. Increasing rates of infectious disease mortality in developing countries were not consistently matched with the trend in coverage of infectious disease topics in either medical textbooks or journals. CONCLUSIONS: Our data demonstrate that coverage of infectious disease topics in publications issued in developed countries was more indicative of global trends in disease mortality rather than those of developing countries. Medical education and knowledge, which are usually delivered by the rich nations where influential medical textbooks and journals are published, place less emphasis on infectious disease relative to the burden infectious disease places on the developing world.

Bibliometrics↗
PubMed2003

Secular trends in neonatal macrosomia in Berlin: influences of potential determinants.

To investigate the trend in the prevalence of neonatal macrosomia and to evaluate the influences of potential determinants, key features of 206 308 hospital deliveries (97% of all) in Berlin in the years 1993-99, collected by the Berlin Medical Board, were analysed using SPSS 10.0. After exclusion of multiple births and preterm infants, there was a significant increase over 7 years (P < 0.01) in the prevalence of birthweights >or= 4000 g, maternal age >or= 30 years, height of >or= 165 cm, prepregnancy BMI (body mass index) >or= 26 kg/m2 and pregnancy weight gain> 16 kg, but no substantial trend in the prevalence of recognised diabetes or maternal smoking. The adjusted model (OR [95% CI]) for delivering a newborn >or= 4000 g was statistically significant for post-term delivery (2.56 [2.39, 2.75]), women aged >or= 30 years (1.06 [1.02-1.11]), >or= 165 cm tall (1.94 [1.87,2.01]), multiparae (1.98 [1.91, 2.05]), not smoking in pregnancy (2.03 [1.93, 2.14]), prepregnancy BMI >or= 26 compared with < 20 (4.01 [3.77, 4.26]), pregnancy weight gain >or= 16 kg compared with < 10 kg (3.37.[3.22, 3.53]) and for recognised diabetes (1.85.[1.69, 2.04]). It is speculated that this increase in the prevalence of neonatal macrosomia may contribute to the secular trend of overweight and obesity under affluent living conditions.

Berlin↗
PubMed1998

Secular trends in recombinant erythropoietin therapy among the U.S. hemodialysis population: 1990-1996.

BACKGROUND: Chronic anemia is a major cause of morbidity among the end-stage renal disease (ESRD) population. Recombinant erythropoietin (rHuEPO) has been recognized as a major advance in the treatment of anemia among the ESRD population. This study examines the secular trends in the use of and response to rHuEPO therapy among severely, moderately and mildly anemic hemodialysis patients. METHODS: We designed a cohort analytic study using seven years of claims data. The study population comprised all facility-based adult hemodialysis patients receiving rHuEPO therapy, who were initially reimbursed by Medicare in each of the first quarter of the calendar years 1990 through 1996 (N = 64,957). RESULTS: Between 1990 and 1996, the mean rHuEPO dose increased by 139% for the patient cohorts with a first observed hematocrit < 0.25, 122% for the 0.25 to 0.29 cohorts, and 107% for the > or = 0.30 cohorts, and produced a 0.02 to 0.03 increase in achieved hematocrit (A-Hct) over this time. Dosing of rHuEPO did not appear to be influenced by patient or provider characteristics, although African-Americans, the elderly, non-diabetics and persons receiving dialysis in a non-profit facility had a larger percent change in hematocrit compared to their counterparts (P < 0.001). CONCLUSIONS: The results of the clinical use of rHuEPO seven years after FDA approval found in the general ESRD hemodialysis population have not equaled the results obtained in the initial clinical trials. Overall, our findings suggest that substantial increases in rHuEPO dose provided to anemic patients have resulted in only modest increases in hematocrit in the seven years since rHuEPO's introduction. Resistance to rHuEPO, prior rHuEPO treatment, inadequate use of supplemental iron, and policy and financial incentives may explain this finding.

Adolescent↗
PubMed2001

Optimal risk factors in the population: prognosis, prevalence, and secular trends; data from Göteborg population studies.

AIMS: To assess the prognosis and prevalence of optimal risk factors in the population. METHODS AND RESULTS: Data from several Göteborg population studies were used. Optimal risk factors were defined as serum cholesterol <5 mmol x l(-1), blood pressure <140/90 without treatment and being a non-smoker. In a 20-year follow-up of 7130 men aged 47 to 55 at baseline a group of 117 men who were optimal with respect to cholesterol, blood pressure and smoking were identified. In this group there was only one death from coronary disease, corresponding to 0.4 deaths per 1000 years, whereas the overall risk of coronary death in the study was 4.8 per 1000 years. Among men and women aged 25 to 34 in the Göteborg MONICA study 1995, less than half were optimal on all three scores, and in men and women aged 55 to 64, only 7% and 6%, respectively, were optimal. If body mass index below 25 was included only 34% and 37%, respectively, of men and women aged 25 to 34 were optimal, and 11% and 22% among men and women aged 35 to 44. In an analysis of secular trends over 30 years in four successive cohorts of men aged 50 the prevalence of optimal risk factors with respect to cholesterol, blood pressure and smoking increased from 1963 to 1993 but was still only 11% in 1993. CONCLUSIONS: As expected, optimal risk factors with respect to serum cholesterol, blood pressure and smoking confers a very low risk of coronary death. However, the prevalence of optimal risk factor status in the Swedish population is still low.

Adult↗
PubMed2002

Secular growth and its harmful ramifications.

Secular growth has been occurring in Europe for about 150 years. In the USA, since 1900, each new generation has increased by an average of 1in (2.54cm) in height and about 10lb (4.54kg) in weight. This trend has generally been viewed as favorable and tallness is admired, with the current ideal height for a man in the Western world being 6ft 2in (188cm). The Japanese have increased in height since the end of the Second World War by about 5in (12.7cm) in height and the Chinese have been growing at the rate of 2.54cm/decade since the 1950s. In spite of admiring greater height, a world population of increasing height and body-weight is a major threat to our environment, health and survival. Based on more than two decades of research, quantitative data are given for increased use of resources, and increased pollution, energy and fiscal costs resulting from a population of larger people. The laws of scaling are described to show why the impact of increasing stature has a non-linear impact on consumption, body-weight, strength, pollution and economic costs. Paleontological findings indicating that larger body size increases the risk of extinction are also discussed. Various studies indicate a loss of 0.47 year of longevity for each cm increment of height. Caloric restricted diets are also reviewed for their applicability to humans. Recommendations are made for dietary practices to moderate growth in our youth and to postpone development of chronic or degenerative diseases.

Animals↗
PubMed2005

Secular motion around synchronously orbiting planetary satellites.

We investigate the secular motion of a spacecraft around the natural satellite of a planet. The satellite rotates synchronously with its mean motion around the planet. Our model takes into account the gravitational potential of the satellite up to the second order, and the third-body perturbation in Hill's approximation. Close to the satellite, the ratio of rotation rate of the satellite to mean motion of the orbiter is small. When considering this ratio as a small parameter, the Coriolis effect is a first-order perturbation, while the third-body tidal attraction, the ellipticity effect, and the oblateness perturbation remain at higher orders. Then, we apply perturbation theory and find that a third-order approach is enough to show the influence of the satellite's ellipticity in the pericenter dynamics. Finally, we discuss the averaged system in the three-dimensional parametric space, and provide a global description of the flow.

Journal Article↗
PubMedDate not supplied

Evolution of information on women and heart disease 1957-2000: a review of archival records and secular literature.

This project explores the evolution of public information on cardiac disease in women, focusing on warning signs and symptoms. Historical documents available from the American Heart Association of Wisconsin and selected professional and secular literature were reviewed. Analysis revealed little information specific to women's symptoms until the 1980s. During the 1960s, articles and programs focused on how women could take care of their husbands' hearts. The 1980s brought a dramatic surge in literature on women's health, specifically on women's risk for heart disease. The evolution of information about women has mirrored the evolution of women's social roles. Despite the growing body of literature, more information and educational programs are needed to increase public awareness of cardiac warning signs and symptoms in women.

Bibliometrics↗
PubMed1979

Secular change in the variability of temperature.

The mean temperatures for January, April, summer and October at New Haven, Connecticut, for 1781-1970 were analyzed for evidence of a secular change in several indices of variability. The January-July difference decreased significantly. Although the standard deviation (SD) of the summer temperature within decades decreased significantly, the SDs of January, April, and October did not, and none of the SDs were correlated with means. The SD about trends within decades was not correlated with the magnitude of the trends except in April. There was no significant trend in the January-to-January persistence during the 19 decades.

Journal Article↗
PubMed2004

Secular trends in diet among elderly Swedes -- cohort comparisons over three decades.

OBJECTIVE: The purpose of this study was to compare dietary practices among different birth cohorts of 70-year-old Swedes, who were examined between 1971 and 2000. SETTING: Göteborg, Sweden. DESIGN: Four population-based samples of 1360 70-year-olds, born in 1901, 1911, 1922 and 1930, have undergone health examinations and dietary assessments over a period of almost three decades. One-hour diet history (DH) interviews were conducted in 1971, 1981, 1992 and 2000 with a total of 758 women and 602 women. The formats and contents of the dietary examinations were similar over the years. Statistical analysis of linear trends was conducted, using year of examination as the independent variable, to detect secular trends in food and nutrient intakes across cohorts. RESULTS: At the 2000 examination, the majority of 70-year-olds consumed nutritionally adequate diets. Later-born cohorts consumed more yoghurt, breakfast cereals, fruit, vegetables, chicken, rice and pasta than earlier-born cohorts. Consumption of low-fat spread and milk also increased, along with that of wine, light beer and candy. In contrast, potatoes, cakes and sugar were consumed less in 2000 than in 1971. The ratio of reported energy intake to estimated basal metabolic rate did not show any systematic trend over time in women, but showed a significant upward trend in men. CONCLUSIONS: The diet history method has captured changes in food selections in the elderly without changing in general format over three decades. Dietary quality has improved in a number of ways, and these findings in the elderly are consistent with national food consumption trends in the general population.

Aged↗
PubMedDate not supplied

Blood lead secular trend in a cohort of children in Mexico City. II. 1990-1995.

The authors determined the secular trend in blood lead levels in a cohort of 91 children born in Mexico City between 1987 and the beginning of 1993. The authors grouped children by calendar year in which they reached 36 mo of age (i.e., 1990-1995), and their blood lead levels were measured every 6 mo during a 66-mo period. The overall geometric mean blood lead level was 8.6 microg/dl (range = 1.0-61.0 microg/dl). A repeated measures analysis of variance revealed a significant downward linear trend in blood lead levels by year (p < .001)--from an estimated marginal geometric mean of 14.2 microg/dl in 1990 to 6.3 microg/dl in 1995. There was also a significant linear age effect (p < .001); blood lead levels generally fell during the 36th-66th mo. Family use of lead-glazed pottery significantly elevated blood lead levels (p = .006), and the effect magnified as age increased (Age x Pottery Interaction [p = .014]). Although the overall downward trend in blood lead levels during the time period described corresponded to a reduction in various sources of lead exposure, there was no alteration in production, distribution, or use of leaded pottery. Currently, use of lead-glazed ceramic pottery is one of the most profound sources of lead exposure in the Mexican population.

Age Factors↗
PubMedDate not supplied

Secular trend in blood lead levels in a cohort of Mexico City children.

We determined the secular trend in blood lead levels in a cohort of 104 children born in Mexico City between 1987 and 1993. We grouped children by the calendar year in which they reached 6 mo of age and measured blood lead levels every 6 mo until they attained 36 mo of age. The overall geometric mean blood lead level was 9.6 microg/dl (range = 1.5-59.5 microg/dl). A repeated measures analysis of variance revealed a highly significant linear trend in blood lead level with year (p < .001); there was a maximum decrease of 7.6 microg/dl between 1989 and 1993. There was a highly significant quadratic age effect (p < .001); blood lead levels rose between 6 and 18 mo of age and decreased thereafter. There was a marginally significant interaction between age of the child and year. Family use of lead-glazed pottery significantly elevated blood lead levels (p = .028). The downward trend in blood lead levels during the time period of study corresponded to the reduction in various sources of lead exposure.

Child, Preschool↗