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PubMed1995

Secular trends and birth cohort effects in unprovoked seizures: Rochester, Minnesota 1935-1984.

The incidence of idiopathic/cryptogenic epilepsy and isolated unprovoked seizures has been relatively stable in the population of Rochester, Minnesota, for the 50-year period 1935 through 1984. In each decade, the age-specific rates exhibited a consistent U-shaped pattern of decreasing rates from infancy to age 40-49 and a progressive increase thereafter to a second peak at age 70 years. Males had a 15% higher incidence of cryptogenic unprovoked seizures than females. The most pronounced secular trend was a decrease in the incidence in children aged < 10 years for the first 4 decades of the study; however, this trend was interrupted by a slight rebound in the decade 1975-1984. There has been a progressive decrease in the incidence of cryptogenic unprovoked seizures in individuals aged > or = 50 from 1965 through 1984. This decrease paralleled the decrease in cerebrovascular disease in the community. The decrease in idiopathic unprovoked seizures may be related to a concurrent trend in "silent stroke." Plots and Poisson regression analysis did not show patterns in the incidence of idiopathic unprovoked seizures related to successive birth cohorts. However, significantly lower incidence rates were observed for the 1930-1934 birth cohort, about half that of all others, between the ages of 5 and 54 years.

Adult↗
PubMed2004

Secular trends in physical fitness and obesity in Danish 9-year-old girls and boys: Odense School Child Study and Danish substudy of the European Youth Heart Study.

INTRODUCTION: Low physical fitness and obesity have been shown to be associated with cardiovascular disease (CVD) risk. Obesity is on the increase in many countries, but little is known about physical fitness trends. Monitoring of changes in fitness and obesity in the population is important for preventive strategies, and the aim of this study was to analyse the secular trends in fitness and body composition in Danish children. MATERIALS AND METHODS: Two representative population studies were conducted 12 years apart on 9-year-old children in the same location: the Odense School Child Study in 1985-86 and the European Youth Heart Study in 1997-98. In both studies, physical fitness was determined by a maximal cycle ergometer test, and obesity was assessed by skinfolds. RESULTS: Boys had a lower physical fitness and were fatter in 1997-98 than in 1985-86. In addition, an increased polarization is emerging, with the difference between the fit and the unfit and the difference between the lean and the fat being greater in 1997-98 than in 1985-86. In girls, a similar polarization was found, but no overall change in fitness or obesity. CONCLUSION: The negative trend and increased polarization for physical fitness and obesity in Danish children suggest a future generation with a higher degree of CVD risk.

Cardiovascular Diseases↗
PubMed1996

Secular trend in the sexual maturation of southern Chinese boys.

A random sample of 3872 southern Chinese boys ranging from 7 to 21 years of age were selected from primary and secondary schools in Hong Kong for the assessment of sexual maturation. The median ages of onset of puberty and pubic hair development were 11.4 and 12.7 years, respectively. The advancement of sexual maturation coincides with the secular increase in height and weight for Chinese children in Hong Kong.

Adolescent↗
PubMed1985

Effect of secular decline in caries on the evaluation of preventive dentistry demonstrations.

Studies of dental preventive interventions often do not incorporate a concurrent, longitudinal control group in their study design. The existence of a secular decline in dental caries during the conduct of these studies may result in an overstatement of the effectiveness of the preventive intervention. Results of a recent large caries preventive study are analyzed using both a concurrent, longitudinal control group and an historical comparison group to demonstrate this effect. Differences in effectiveness of preventive procedures determined using the two types of control groups are sufficient to suggest a probable misinterpretation of results of studies using only historical comparisons.

Adolescent↗
PubMed2004

Secular trends in obesity in Mexico City and in San Antonio.

The San Antonio Heart Study--conducted from 1979 to 1996--and the Mexico City Diabetes Study--conducted from 1990 to 1999--both show significant secular increases in obesity as indicated by mean body mass index values and proportions of the populations who were obese or overweight. The increase in obesity accounts for an estimated 28% of the increase in the incidence of diabetes in San Antonio. This increase in the incidence of diabetes occurred across all age groups (25-34, 35-44, 45-54, and 55-64). Thus the generational acceleration of diabetes, expected as a result of the greater tendency for people whose mothers were diabetic when pregnant to become diabetic themselves, may not be as severe as would be expected had the increases in diabetes incidence occurred disproportionately more among women prior to or during their child-bearing years.

Adult↗
PubMed2003

Secular trends in sex ratios at birth in North America and Europe over the second half of the 20th century.

CONTEXT: A previous study showed that significantly more boys were born in southern latitudes in Europe than in northern latitudes and the converse pattern was observed in North America. OBJECTIVE: This study analyses secular trends in gender ratios for live births over the second half of the 20th century. DESIGN, SETTING, PARTICIPANTS: Analysis was carried out from a World Health Organisation dataset comprising live births over the above period. This included 127034732 North American and 157947117 European live births. MAIN OUTCOME MEASURES: Analysis of trends in gender ratios for countries in both continents. RESULTS: The findings show a highly significant overall decline in male births in both Europe and North America (p<0.0001), particularly in Mexico (p<0.0001). Interestingly, in Europe, male births declined in North European countries (latitude>40 degrees, p<0.0001) while rising in Mediterranean countries (latitude congruent with 35-40 degrees, p<0.0001). These trends produced an overall European male live birth deficit 238693 and a North American deficit of 954714 (total male live birth deficit 1193407). CONCLUSIONS: No reasonable explanation/s for the observed trends have been identified and the causes for these trends may well be multifactorial.

Birth Rate↗
PubMed1995

Epilepsy in a population of 6000 re-examined: secular trends in first attendance rates, prevalence, and prognosis.

It is important to document changes in the vital statistics of epilepsy in the general population so that the success or failure of prevention and treatment can be assessed and health provisions planned. A population of 6000 persons was studied 10 years apart to determine secular trends in the prevalence and prognosis of epilepsy. The lifetime prevalence of all patients with one or more afebrile seizures was 20.3/1000 (95% CI 16.9-24.3) in 1983 and 21.0/1000 (95% CI 17.6-25.1) in 1993. The prevalence of active epilepsy was 5.3/1000 (95% CI 3.6-7.5) in 1983 and 4.3 (95% CI 2.8-6.3) in 1993. To assess trends in incidence rates the annual first attendance rates were measured from 1964 to 1993. Annual first attendance rates in children (age < 20 years) have declined from 152.4/100,000 (90% CI 106.0-212.9) in the years 1974-83, to 60.9/100,000 (90% CI 33.0-103.3) in the years from 1984-93, suggesting that the incidence of epilepsy in children is falling. Also noteworthy was the first attendance rates for epilepsy in elderly people (61-80 years) in the years 1984-93, of 82.0 (90% CI 38.5-154.0), higher than in any other age group. This increase in the number of elderly patients with epilepsy is important, and has health planning implications, especially with the overall increase in the total elderly population. There was, however, no evidence that prognosis has significantly altered in the past 40 years.

Adolescent↗
PubMed2004

Secular trends in dietary intake in the United States.

This review focuses on dietary intake and dietary supplement use among the U.S. population age 1-74 based on four National Health and Nutrition Examination Surveys conducted in 1971-74, 1976-80, 1988-94, and 1999-2000. Secular trends in intake of energy, macronutrients, cholesterol, sodium, calcium, iron, folate, zinc, vitamins A and C, fruits, vegetables, and grain products are summarized. During the 30-year period, mean energy intake increased among adults, and changed little among children age 1-19, except for an increase among adolescent females. Factors contributing to increases in energy intake include increases in the percentage of the population eating away from home (particularly at fast-food restaurants), larger portion sizes of foods and beverages, increased consumption of sweetened beverages, changes in snacking habits, and improved dietary methodology. Dietary supplement use increased among adult men and women, decreased among children age 1-5, and was stable for children age 6-11 and adolescents.

Adolescent↗
PubMed1999

Bone maturation reflects the secular trend in growth.

The aim of this study was to compare a series of X-rays from the mid-1990s with another taken in the mid-1980s in order to test the possibility that environmental causes affect the skeletal maturation. The first group of subjects included a total of 1,057 girls and 1, 055 boys participating in a project for Japan and China health research in 1986. The second group of subjects included a total of 382 girls and 629 boys participating in a project for bone mineral density research in 1996. The skeletal maturity score using the Tanner-Whitehouse 2-RUS method was used as the fundamental datum. This score was used to represent each group. The Wilcoxon's rank sum test was applied to examine the significance of the difference between the 1986 and the 1996 groups. The 1996 children had not matured more than the 1986 children; children in both groups reached the given scores at almost the same ages. In girls, there was little difference between the groups at 7 years of age, but it declined from 8 years of age onward. Some apparent differences arose at ages 14 and 15, but ceased by age 16 in girls. In boys, no differences were found in those aged from 7 to 17 years, except for 12-year-olds. We did not detect much of a difference in bone maturation between the 1986 and 1996 groups of children, and no differences in height during the same period. Our findings suggest that bone maturation reflects the secular trend in growth.

Adolescent↗
PubMed2005

Secular trend of timing of puberty.

During the last decades, a secular trend of growth and timing of puberty occurred consisting of increased adult height and earlier onset of puberty. In The Netherlands although the most recent survey showed an increase of final height again, the timing of puberty onset appears to level off, and in boys pubertal onset was even slightly retarded. Different findings were reported from the United States, where a strong advancement of the onset of puberty was observed in both white and black girls, although the effect was more evident in black girls. Timing of puberty follows a familial pattern and therefore seems to be controlled by genetic factors, whereas environmental factors may influence and mediate the genetic regulation. Environmental factors such as nutritional status, chronic diseases, migration to a healthy environment, frequent infectious diseases, pollution and exposure to insecticides are all thought to influence the endocrine regulation status and therefore differentiation and development of endocrine organs. In this chapter, the physiologic mechanisms of puberty onset with the different regulatory aspects, as well as pathologic processes interfering with the onset of puberty will be discussed.

Adolescent↗
PubMed1986

Correcting for variable age of onset in the estimation of familial relative risk when there is a secular trend in incidence of disease.

We discuss the effects that a secular trend in incidence would have on estimation of familial relative risk (ratio of observed to expected cumulative incidence among relatives of index cases). For example, when age-specific incidence rates of a condition have increased during the lifetimes of relatives among whom relative risk is to be estimated, familial relative risk will be biased downward if cross-sectional, age-specific incidence data are used to estimate expected cumulative incidence among relatives. The stronger the trend and the older the ages of unaffected relatives, the greater the bias will be. Incorporating different age-specific incidence curves for different birth cohorts into the analysis is an approach we suggest for correcting the bias.

Adolescent↗
PubMedDate not supplied

Methodological issues in linkage analyses for psychiatric disorders: secular trends, assortative mating, bilineal pedigrees. Report of the MacArthur Foundation Network I Task Force on Methodological Issues.

A Task Force was assembled to address three data problems in genetic linkage analyses: (1) a secular trend, e.g. cohort effect; (2) positive assortative mating, and (3) bilineal pedigrees. All are cited as reasons for failure to replicate genetic linkage reports. However, we knew of no work demonstrating that these factors could invalidate or bias linkage analyses, nor that they were complications (e.g., variable age of onset). The Task Force concluded that these factors can reduce the power of linkage analyses and result in bias in the estimate of the recombination frequency due to the fact that they represent 'noise' in the system. There was little evidence that the three factors would invalidate a linkage analysis or be directly responsible for negating a linkage finding.

Cohort Effect↗
PubMed1988

Secular changes in mortality among survivors of unstable angina and myocardial infarction.

Seven hundred and ninety-four males under 60 years who survived a first episode of unstable angina or myocardial infarction by 28 days were admitted to St. Vincent's Hospital between 1965 and 1981 inclusive. They were followed for at least 4 years: 1-, 2- and 4-year mortality during the follow-up period did not alter significantly during the 17 years. Significant changes did take place over time in the severity of the coronary attacks and in the risk profile of the patients. A greater number of complicated infarcts occurred in the later years and there were fewer smokers and more hypertensives. There was a significant increase over time in the number of initial cigarette smokers who stopped after the coronary attack. Changing methodology made secular changes in cholesterol levels difficult to interpret.

Adult↗
PubMed1993

Anthropometry in adolescence--secular trends, adoption, ethnic and environmental differences.

A secular trend towards higher final height and earlier pubertal maturation is seen in countries with favourable socio-economic development and higher social classes in countries are also associated with taller height and earlier maturation. Environmental factors, such as nutrition and infections, appear to be the main causes for differences in growth and maturation between ethnic and social groups. Differences in final height are mainly due to prepubertal growth. Studies on immigrant children and children adopted into privileged conditions from developing countries confirm the influence of early growth on subsequent growth. Catch-up growth in adopted children could only partially compensate for early stunting, and in several cases was cut short by early pubertal development. A minority developed very early puberty and eventually very short final height. The optimal rate of catch-up growth, the trigger mechanism for early puberty, and the effect of various types of nutritional intervention need to be studied. The studies reported here indicate the critical importance of optimal intra-uterine, infant and childhood growth as a basis for satisfactory growth during adolescence.

Adolescent↗
PubMed1983

Secular trends in ischemic heart disease mortality: regional variation.

We compared secular trends in ischemic heart disease (IHD) mortality in four southeastern states (North Carolina, Georgia, South Carolina, and Virginia) with those in three selected other states (California, New York, and Utah). Mortality data were obtained from U.S. vital statistics and population information from the U.S. Census Bureau. Age-adjusted IHD mortality increased until 1968 in the southeastern states and then declined and declines were greatest in the nonwhite female population. In contrast, IHD mortality in all groups in California and in the female population in New York and Utah began to decline in the early 1950s, with accelerated declines since 1968. In all states the decline in rates in nonwhite populations have been greatest in the younger age groups. This has not been true in the white populations. Declining IHD mortality correlated moderately well with the decline in death from all cardiovascular disease and from all causes, but not with the declining cerebrovascular disease mortality. Respiratory cancer mortality increased in similar proportions in California and South Carolina, two states with dissimilar IHD trends. These findings suggest that improved control of hypertension and changing patterns of cigarette smoking may not be responsible for the recent decline in IHD mortality.

Adult↗
PubMed1996

Secular trends in cardiac transplant recipient and donor management in the United States, 1990 to 1994. A multi-institutional study. Cardiac Transplant Research Database Group.

BACKGROUND: The growth of the US cardiac transplant waiting list has outpaced the increase in donors, resulting in a widening gap between the number of waiting recipients and available donors. These trends have generated concern that longer waiting times may result in more patients deteriorating to urgent status and that transplanting only patients who are in an advanced state of decompensation will reduce posttransplant survival. Furthermore, the shortage of donors may result in extending the guidelines for donor acceptability to a degree that increases graft failure and posttransplant mortality. We measured these secular trends in the Cardiac Transplant Research Database to provide current data on time-dependent changes in US cardiac transplant practice and survival. METHODS AND RESULTS: At the time of this analysis, the Cardiac Transplant Research Database included all 2749 patients transplanted from January 1, 1990, to June 30, 1994, in the 25 participating transplant centers. During this 4.5-year period, the median waiting time for recipients who received a transplant increased from 2.7 to 3.5 months (P < .0001), and the proportion of recipients whose status was urgent at transplantation increased from 41% to 60% (P < .0001). Donor ischemic time increased from 150 to 166 minutes (P < .0001), and the proportion of donors requiring pressor support increased from 68% to 85% (P < .0001). Despite these changes in practice, the 1-year survival rate remained constant at 84% during this 4.5-year interval. There was no significant difference in 1-year survival rate between urgent status patients (83%) and nonurgent status patients (85%) (P = .08). CONCLUSIONS: The widening gap between the number of waiting recipients and the number of donors has resulted in a continuing trend toward transplanting urgent status recipients and to a liberalization of donor acceptance criteria. Despite these changes, posttransplant survival has remained constant.

Adult↗
PubMed2003

Will the "secular priests" of bioethics work among the sinners?

In this paper I explore briefly the "secular priesthood" metaphor often applied to bioethicists. I next ask: if, despite our discomfort with the metaphor, we were to embrace the best aspects of the priesthood(s)--which I identify as the missionaries' willingness to work among sinners and lepers, at their own peril--would we be able to live up to that standard of bravery? I then draw a parallel with the fears of contagion currently be voiced (by Carl Elliott and others), with regard to bioethicists working in or near coporate settings. I argue that such fears may themselves have a number of deleterious effects, and I suggest several possible positive steps in response to that fear.

Bioethics↗
PubMed1996

Secular trends in hip fracture occurrence and survival: age and sex differences.

The National Hospital Discharge Survey was used to analyze secular trends from 1965 to 1993 in hip fracture incidence and in-hospital survival in the White U.S. population 50 years of age and older. Age-specific fracture rates increased significantly for males in age groups 80-84 years and 85 years and older but not for younger males. For females, age-specific rates did not change significantly over the time period. Age-specific survival rates increased for both older males and females, but the increase was greatest for the older men. Why hip fracture incidence is increasing in older males but not in females and younger males is not clear. But the high lifetime prevalence of smoking in the older cohort of males may be a factor. With rising incidence rates in elderly males, prevention efforts, which have focused primarily on women because of their high fracture rates, should target both sexes.

Age Factors↗