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PubMed2002

Using general population data to project idiopathic physical symptoms in the U.S. Army.

Many personnel deployed to the 1991 Persian Gulf War complained of symptoms that sometimes remained unexplained after comprehensive clinical examinations. We used existing population-based data from the Epidemiologic Catchment Area survey to estimate the expected incidence, prevalence, resolution, and mortality for multiple idiopathic physical symptoms (MIPS) among Army active duty personnel. Multinomial logistic regression was used to model the relationship between sociodemographic characteristics and the distribution of MIPS in U.S. workers. We used logit coefficients and known sociodemographic characteristics of U.S. Army active duty personnel to predict MIPS status in the Army. High, medium, and low estimates of MIPS incidence, prevalence, resolution, and MIPS-related mortality were obtained by altering logit intercepts. Among workers, the estimated MIPS prevalence and annual incidence, resolution, and mortality were 4.62%, 2.11%, 63.85%, and 0.26%, respectively. In contrast, the same predicted rates among Army active duty personnel were 3.89%, 1.64%, 71.33%, and 0.15%.

Adult↗
PubMed1997

Antidepressant use over time in a rural older adult population: the MoVIES Project.

OBJECTIVE: To examine the use of antidepressant drugs over time among community-based older persons. DESIGN: A longitudinal community study with four approximately biennial data collection waves (1987-1996). SETTING: A low-socioeconomic status rural older community-based population in Southwestern Pennsylvania. PARTICIPANTS: A total of 1681 individuals with a mean age of 72.9 years at study entry, MEASUREMENTS: Antidepressant drug use, demographics, and health services utilization by self-report. RESULTS: Antidepressant use was reported by less than 5% of the population during all four waves. It was associated with female gender, use of mental health services, presence of five or more depressive symptoms, and use of five or more prescription drugs, but not with age. During the four waves, tricyclics accounted for 84.6%, 85.3%, 78.4%, and 45.5% of total antidepressants used, whereas selective serotonin reuptake inhibitors (SSRIs) accounted for 2.6%, 11.8%, 8.1%, and 36.4%. CONCLUSIONS: Overall, our data on antidepressant use in this rural older population mirror national trends away from tricyclics and towards SSRIs. Our findings also suggest underutilization of mental health services and antidepressant drugs in this population.

Aged↗
PubMed1989

Morbidity of very low birthweight infants at corrected age of two years in a geographically defined population. Report from Project on Preterm and Small for gestational age infants in The Netherlands.

In a nationwide prospective survey on very preterm and very-low-birthweight infants in the Netherlands, a neurodevelopmental assessment was made at the corrected age of two years in a virtually complete population. The study achieved a 97.4% follow-up rate. A major handicap was found in 59 children and a minor handicap in 111 children (4.4% and 8.3% of liveborn infants, respectively). Unlike mortality, handicap was apparently unrelated to gestational age or birthweight.

Age Factors↗
PubMed1980

[Electrocardiographic findings in a middle-aged rural population. Tyrolean Heart Project--Oberperfuss 1977 (author's transl)].

A field study on coronary risk factors has been carried out in a Tyrolean village on persons between 50 and 64 years. An Ecg was made on 69 men and 85 women, corresponding to 81.2% of the male and 90.4% of th female population. The Ecg was coded by the Minnesota Code. Only a few minor findings suggesting an association with ischaemic heart disease were revealed in men. However, more frequent and more severe ST-segment depressions, T wave changes and rhythm disturbances were discovered in women. The pulse rate was significantly higher in women than in men. Possible reasons for these discrepancies with regard to the myocardial infarction incidence are discussed.

Electrocardiography↗
PubMed2005

Learning from experience: three community health population-based outreach projects for graduate and undergraduate students.

Three outreach activities by a school of nursing, in partnership with community agencies, provided learning experiences in primary and secondary preventive health care for graduate and undergraduate nursing students while addressing health needs in the community. The activities included administration of immunizations to a newly arrived Somali Bantu refugee population, targeted screening of an African-American population at risk for diabetic retinopathy, and general health screening for an underserved Hispanic immigrant population. These activities lend insight and depth to a community health curriculum by allowing students to provide needed services while engaging with culturally diverse clients of varying socioeconomic status. Learner objectives, resources, processes and outcomes are provided for each example.

Black or African American↗
PubMed2024

Genetics of Latin American Diversity Project: Insights into population genetics and association studies in admixed groups in the Americas.

Latin Americans are underrepresented in genetic studies, increasing disparities in personalized genomic medicine. Despite available genetic data from thousands of Latin Americans, accessing and navigating the bureaucratic hurdles for consent or access remains challenging. To address this, we introduce the Genetics of Latin American Diversity (GLAD) Project, compiling genome-wide information from 53,738 Latin Americans across 39 studies representing 46 geographical regions. Through GLAD, we identified heterogeneous ancestry composition and recent gene flow across the Americas. Additionally, we developed GLAD-match, a simulated annealing-based algorithm, to match the genetic background of external samples to our database, sharing summary statistics (i.e., allele and haplotype frequencies) without transferring individual-level genotypes. Finally, we demonstrate the potential of GLAD as a critical resource for evaluating statistical genetic software in the presence of admixture. By providing this resource, we promote genomic research in Latin Americans and contribute to the promises of personalized medicine to more people.

Humans↗
PubMed1987

[Cholesterol, arterial pressure and cigarette smoking in the Swiss population: the MONICA project].

Elevated plasma cholesterol, high blood pressure and cigarette smoking are three major risk factors for coronary heart disease. Within the framework of Switzerland's participation in the multicenter study MONICA (MONItoring of trends and determinants in CArdiovascular disease), proposed by the WHO, a first risk factor survey was conducted in a representative sample of the population (25-74 years) of two reporting units (cantons of Vaud and Fribourg, canton of Tessin). A high blood cholesterol level (greater than 6,7 mmol/l) is the most common risk factor for coronary heart disease among the studied population. Among men, about 13% have elevated blood pressure, the proportion being about one in ten among women; these proportions increase with age and are slightly above these values in Tessin. Cigarette smoking is still a common behavior; between 25 and 45 years one third of the population (male and female) regularly smoke cigarettes.

Adult↗
PubMed2004

The AMC Linear Disability Score project in a population requiring residential care: psychometric properties.

BACKGROUND: Currently there is a lot of interest in the flexible framework offered by item banks for measuring patient relevant outcomes, including functional status. However, there are few item banks, which have been developed to quantify functional status, as expressed by the ability to perform activities of daily life. METHOD: This paper examines the psychometric properties of the AMC Linear Disability Score (ALDS) project item bank using an item response theory model and full information factor analysis. Data were collected from 555 respondents on a total of 160 items. RESULTS: Following the analysis, 79 items remained in the item bank. The remaining 81 items were excluded because of: difficulties in presentation (1 item); low levels of variation in response pattern (28 items); significant differences in measurement characteristics for males and females or for respondents under or over 85 years old (26 items); or lack of model fit to the data at item level (26 items). CONCLUSIONS: It is conceivable that the item bank will have different measurement characteristics for other patient or demographic populations. However, these results indicate that the ALDS item bank has sound psychometric properties for respondents in residential care settings and could form a stable base for measuring functional status in a range of situations, including the implementation of computerised adaptive testing of functional status.

Activities of Daily Living↗
PubMedDate not supplied

Building population data bases: lessons from a community project.

Observational data bases that tract patient outcomes and quality of life over long periods of time offer an alternative to traditional randomized clinical trials in assessing treatment effectiveness. This article reviews our experience building an observational database in a community setting. Thirty-eight urologists, radiation therapists, oncologists, and pathologists working at the five major hospitals in Hartford County, Connecticut, established a community-based observational data base to quantify the risks and benefits associated with different treatment options for clinically localized prostate cancer. In addition to classic demographic data, the data base includes information concerning patient comorbidities, bowel and bladder function, sexual function, and quality of life captured both before and after medical intervention. Case finding is accomplished via a rapid case ascertainment system. As part of this system, a trained abstractor reviews all the pathology reports generated by each hospital on a weekly basis and forwards reports of prostate biopsies and surgical specimens to the study office within 1 week. Patients with positive prostate biopsies are contacted by a trained nurse registrar to gather additional information using a structured interview. Patient consent for this project is obtained at the time of biopsy in the participating physician's office. To date, biopsy reports have been obtained on 581 patients of whom 202 have been diagnosed with localized prostate cancer. Interviews have been conducted with 42 patients. Initial review of the data base shows that prostate biopsies in Hartford are being performed primarily on men aged 59 to 77 years, but ages range from age 45 to 93.(ABSTRACT TRUNCATED AT 250 WORDS)

Community Health Services↗
PubMed2001

Ontogeny of modulatory inputs to motor networks: early established projection and progressive neurotransmitter acquisition.

Modulatory information plays a key role in the expression and the ontogeny of motor networks. Many developmental studies suggest that the acquisition of adult properties by immature networks involves their progressive innervation by modulatory input neurons. Using the stomatogastric nervous system of the European lobster Homarus gammarus, we show that contrary to this assumption, the known population of projection neurons to motor networks, as revealed by retrograde dye migration, is established early in embryonic development. Moreover, these neurons display a large heterogeneity in the chronology of acquisition of their full adult neurotransmitter phenotype. We performed retrograde dye migration to compare the neuronal population projecting to motor networks located in the stomatogastric ganglion in the embryo and adult. We show that this neuronal population is quantitatively established at developmental stage 65%, and each identified projection neuron displays the same axon projection pattern in the adult and the embryo. We then combined retrograde dye migration with FLRFamide-like, histamine, and GABA immunocytochemistry to characterize the chronology of neurotransmitter expression in individual identified projection neurons. We show that this early established population of projection neurons gradually acquires its neurotransmitter phenotype complement. This study indicates that (1) the basic architecture of the known population of projection inputs to a target network is established early in development and (2) ontogenetic plasticity may depend on changes in neurotransmitter phenotype expression within preexisting neurons rather than in the addition of new projection neurons or fibers.

Animals↗
PubMed2000

Development, neurochemical properties, and axonal projections of a population of last-order premotor interneurons in the white matter of the chick lumbosacral spinal cord.

There is general agreement that last-order premotor interneurons-a set of neurons that integrate activities generated by the spinal motor apparatus, sensory information and volleys arising from higher motor centres, and transmit the integrated signals to motoneurons through monosynaptic contacts-play crucial roles in the initiation and maintenance of spinal motor activities. Here, we demonstrate the development, neurochemical properties, and axonal projections of a unique group of last-order premotor interneurons within the ventrolateral aspect of the lateral funiculus of the chick lumbosacral spinal cord. Neurons expressing immunoreactivity for neuron-specific enolase were first detected in the ventrolateral white matter at embryonic day 9 (E9). The numbers of immunoreactive neurons were significantly increased at E10-E12, while most of them were gradually concentrated in small segmentally arranged nuclei (referred to as major nuclei of Hofmann) protruding from the white matter in a necklace like fashion dorsal to the ventral roots. The major nuclei of Hofmann became more prominent at E12-E16, but substantial numbers of cells were still located within the ventrolateral white matter (referred to as minor nucleus of Hofmann). The distribution of immunoreactive neurons achieved by E16 was maintained during later developmental stages and was also characteristic of adult animals. After injection of Phaseolus vulgaris-leucoagglutinin unilaterally into the minor nucleus of Hofmann, labeled fibres were detected in the ventrolateral white matter ipsilateral to the injection site. Ascending and descending fibres were revealed throughout the entire rostro-caudal length of the lumbosacral spinal cord. Axon terminals were predominantly found within the lateral motor column and the ventral regions of lamina VII ipsilateral to the injection site. Several axon varicosities made close appositions with somata and dendrites of motoneurons, which were identified as synaptic contacts in a consecutive electron microscopic study. With the postembedding immunogold method, 21 of 97 labeled terminals investigated were immunoreactive for glycine and 2 of them showed immunoreactivity for gamma-aminobutyric acid (GABA). The axon trajectories of neurons within the minor nucleus of Hofmann suggest that some of these cells might represent a population of last-order premotor interneurons. J. Exp. Zool. 286:157-172, 2000.

Animals↗
PubMed2000

Standards of compliance for abortion-related services in family planning services projects. Office of Population Affairs, OPHS, DHHS. Final rules.

The rules issues below revise the regulations that apply to grantees under the federal family planning program by readopting the regulations, with one revision, that applied to the program prior to February 2, 1988. Several technical changes to the regulation are also made to remove and/or update obsolete regulatory references. The effect of the revisions made by the rules below is to revoke the compliance standards, promulgated in 1988 and popularly known as the "Gag Rule," that restricted family planning grantees from providing abortion-related information in their grant-funded projects.

Abortion, Induced↗
PubMedDate not supplied

Cognitive stability over 2 years in a rural elderly population: the MoVIES project.

In an ongoing prospective community study, a random sample of rural elderly persons was screened with cognitive tests (including the CERAD neuropsychological battery) at study entry and an average of 2 years later. We examined 1,017 subjects, nondemented at study entry, at both waves, with the Mini-Mental State Exam, Story Recall, Word List Recall and Recognition, Boston Naming Test, Verbal Fluency, Praxis, Clock Drawing, and Trailmaking. Overall, the cognitive performance was stable, with either no mean change or a small mean decline over 2 years; however, standard deviations were relatively large, implying individual variation of questionable clinical significance. These data provide a set of population-based longitudinal cognitive norms and have implications for dementia screening.

Aged↗
PubMed2001

Depressive symptoms and associated factors in a cognitively normal elderly population: the Tajiri Project.

BACKGROUND AND OBJECTIVE: Since depression is one of the main problems of elderly subjects, it is important to examine the prevalence of this condition and to identify associated factors. METHODS: A total of 1525 cognitively normal subjects aged 65 years and over in the town of Tajiri, a typical agricultural town in Japan, were analysed. Their MMSE (mini-mental state examination) scores were 24 or over. Depressive state was assessed by Zung's SDS (self-rating depression scale) with a comprehensive interview to examine ADL, demographics and symptoms associated with illness, etc. The prevalence of depression was calculated. To determine the factors associated with depression, the t-test and the Chi-square test were used. To examine the relative strength of each factor, logistic regression analysis was performed. RESULTS: The ratio of the depressive subjects was 6.4%, lower than those of previous reports, probably due to the effect of excluding dementia subjects. The ratio for older females aged 80 years and over was 14.3%, which was significantly higher than that of the males. Among socio-demographic factors, sex, age, number of children and perception of economic status, were significantly related. For health status and ADL, such factors as perception of health and medical history of heart disease and rheumatism were related. For familial and social status, factors such as daily activity and several conversation abilities were related. The logistic regression analysis indicated that perception of health and daily activity were associated. CONCLUSIONS: In this study, we isolated some factors related to depression in a cognitively normal population. Knowledge of such factors is important for appropriate mental care of aged subjects.

Activities of Daily Living↗
PubMed1998

Activation of adenosine A2A and dopamine D1 receptors stimulates cyclic AMP-dependent phosphorylation of DARPP-32 in distinct populations of striatal projection neurons.

In the striatum, adenosine A2A and dopamine D1 receptors are segregated in striatopallidal and striatonigral projection neurons, respectively. In this study, we have examined the effects of activating adenosine A2A and dopamine D1 receptors on the state of phosphorylation of DARPP-32 (dopamine- and cyclic AMP-regulated phosphoprotein of mol. wt 32,000), a potent endogenous regulator of protein phosphatase-1 that is highly expressed in striatal medium-sized spiny neurons. In rat striatal slices, the D1 receptor agonist SKF 81297 and the A2A receptor agonist CGS 21680 transiently increased the levels of phosphorylated DARPP-32 in a concentration-dependent manner. In the same preparation, the two agonists were also able to induce a significant increase in cyclic AMP formation. When striatal slices were incubated with a combination of CGS 21680 and SKF 81297, the effects of the two agonists on both DARPP-32 phosphorylation and cyclic AMP formation were additive. The maximal effects of SKF 81297 and CGS 21680 on DARPP-32 phosphorylation were of similar magnitude, and were completely abolished by the cyclic AMP-dependent protein kinase inhibitor, Rp-cAMPS. The present results show that DARPP-32 phosphorylation in the striatum is stimulated by adenosine, acting on A2A receptors, and dopamine, acting on D1 receptors, and that cyclic AMP is the mediator in both cases. Our data also suggest that dopamine and adenosine regulate the state of phosphorylation of DARPP-32 in distinct sub-populations of medium-sized spiny neurons expressing dopamine D1 and adenosine A2A receptors, respectively.

Animals↗
PubMed2000

Ten-year incidence of dementia in a rural elderly US community population: the MoVIES Project.

OBJECTIVE: To determine incidence rates by age, sex, and education of overall dementia and probable/ possible AD in a largely rural community. METHODS: Ten-year prospective study of a randomly selected community sample aged 65+; biennial cognitive screening followed by standardized clinical evaluation. Incidence rates were estimated for overall dementia (Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., revised, criteria and Clinical Dementia Rating [CDR]) and for probable/possible AD (National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria). RESULTS: The cohort consisted of 1,298 individuals free of dementia at study entry. Among these, 199 incident (new) cases of overall (all-cause) dementia with CDR stage > or = 0.5, including 110 with CDR > or = 1, were detected during follow-up. Among the incident cases, 153 (76.9%) had probable/ possible AD. Age-specific incidence rates are reported for all dementia and for probable/possible AD, by sex and CDR stage. Among all-cause dementias with CDR = 0.5, controlling for age and education, men had a higher incidence rate than women. In the same group, those with less than high school education had significantly higher incidence rates than those with more education. Rates did not vary significantly by sex or education for probable/possible AD or for dementia with CDR > or = 1. CONCLUSIONS: Incidence rates of all dementias and of AD increased with age; men and those with lesser education had higher rates of possible/incipient dementia (CDR = 0.5) in this community. Potential explanations for these sex and education effects are discussed.

Aged↗