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PubMedDate not supplied

Psychometric properties of a Russian version of the SF-12 Health Survey in a refugee population.

This project examined psychometric properties of a Russian translation of the 12-item Short-Form health survey questionnaire (SF-12) to assess physical and mental health status in members of the Russian-speaking refugee population. Translation and adaptation included (a) cross-cultural adaptation; (b) translation; (c) pre-testing; and (d) analysis of validity, reliability, and internal consistency. Seventeen Russian-speaking patients at a Russian psychiatric clinic were recruited for the study and were compared to a sample of 42 Russian-speaking members of the community. The instrument showed internal consistency when evaluated with coefficient alpha. As compared with community subjects, clinic patients had significantly lower scores, reflecting poorer physical and mental well being.

Adolescent↗
PubMedDate not supplied

Clinical effects of hyperglycemia in the cardiac surgery population: the Portland Diabetic Project.

OBJECTIVE: To determine the outcome effects of hyperglycemia, and its pharmacologic reduction with continuous intravenous insulin infusions (CII) in the cardiac surgery patient population. METHODS: The Portland Diabetic Project is a prospective, non-randomized, observational study of 5,510 consecutive diabetic cardiac surgery patients treated between January 1987 and November 2005. RESULTS: This study was the first to reveal that hyperglycemia in the first 3 postoperative days is independently predictive of mortality (P<0.0001), deep sternal wound infection (P= 0.0001), and increased length of stay (P<0.002) in diabetic cardiac surgery patients. Conversely, CII, designed to achieve predetermined target glucose levels, was shown to independently reduce the risks of death and deep sternal wound infection by 60% and 77%, respectively (P<0.001 for both). Target glucose levels <150 mg/dL and a 3-day postoperative duration of CII therapy are both important variables that determine the impact of the CII therapy on improved outcomes. CONCLUSIONS: Perioperative hyperglycemia in cardiac surgery patients adversely alters mortality, length of stay, and infection rates. Three days of CII eliminates the incrementally increased risks of these complications previously seen in diabetic patients.

Aged↗
PubMed2006

Stochastic stable population growth in integral projection models: theory and application.

Stochastic matrix projection models are widely used to model age- or stage-structured populations with vital rates that fluctuate randomly over time. Practical applications of these models rest on qualitative properties such as the existence of a long term population growth rate, asymptotic log-normality of total population size, and weak ergodicity of population structure. We show here that these properties are shared by a general stochastic integral projection model, by using results in (Eveson in D. Phil. Thesis, University of Sussex, 1991, Eveson in Proc. Lond. Math. Soc. 70, 411-440, 1993) to extend the approach in (Lange and Holmes in J. Appl. Prob. 18, 325-344, 1981). Integral projection models allow individuals to be cross-classified by multiple attributes, either discrete or continuous, and allow the classification to change during the life cycle. These features are present in plant populations with size and age as important predictors of individual fate, populations with a persistent bank of dormant seeds or eggs, and animal species with complex life cycles. We also present a case-study based on a 6-year field study of the Illyrian thistle, Onopordum illyricum, to demonstrate how easily a stochastic integral model can be parameterized from field data and then applied using familiar matrix software and methods. Thistle demography is affected by multiple traits (size, age and a latent "quality" variable), which would be difficult to accommodate in a classical matrix model. We use the model to explore the evolution of size- and age-dependent flowering using an evolutionarily stable strategy (ESS) approach. We find close agreement between the observed flowering behavior and the predicted ESS from the stochastic model, whereas the ESS predicted from a deterministic version of the model is very different from observed flowering behavior. These results strongly suggest that the flowering strategy in O. illyricum is an adaptation to random between-year variation in vital rates.

Ecosystem↗
PubMed2002

Nutritional characteristics of a rural Southern Italy population: the Ventimiglia di Sicilia Project.

OBJECTIVE: Knowledge of alimentary habits among populations permits a better definition of appropriate public health interventions. We designed the epidemiological project "Ventimiglia di Sicilia" to characterize the risk profile in a rural village with low total cholesterol levels and low early cardiovascular mortality but with a large prevalence of overweight and obesity, which previously have been significantly associated with total mortality. METHODS: 488 individuals of age 20 to 69 years were included in the dietary survey conducted by a seven-day food record. RESULTS: Alimentary habits were characterized by high consumption of total and complex carbohydrates (respectively 52.5 +/- 7.6% and 46.6 +/- 8.2% of daily energy) and by a low cholesterol intake (92.5 +/- 35.0 mg/1000 kcal/day). Fat intake was 34.7 +/- 7.7% of daily energy due to a higher consumption of monounsaturated fats in respect to saturated fats (respectively 20.5 +/- 5.1% and 10.2 +/- 2.9% of daily energy). In particular, in this population there was a large consumption of bread, pasta, fresh vegetables, olive oil and fruits. We also observed an excess of total calories (about 2900 kcal/day in men and 2100 kcal/day in women) not balanced by a high degree of physical activity levels. Furthermore we found a significant higher total and saturated fat consumption in the youngest individuals and in people with higher educational levels. CONCLUSIONS: Dietary habits of Ventimiglia di Sicilia still follow the nutritional characteristics typical of the Mediterranean diet. The high total calorie intake indicates a quantitative more than qualitative problem, which may account the large prevalence of overweight and obesity and may represent a public health issue that needs to be corrected in such a rural population.

Adult↗
PubMedDate not supplied

Correlates of high fat/calorie food intake in a worksite population: the Healthy Worker Project.

Behavioral and sociodemographic correlates of high fat/calorie food consumption were examined in a population-based sample of working adults (N = 2038 men; N = 2335 women). Relative weight, dieting history, and cigarette smoking were significantly related to total energy intake from high fat/calorie foods. Relative weight was positively related to the intake of meat, eggs, fried potatoes, and fats. Current dieting to lose weight was associated with a lower intake of all foods, except alcohol and fats. These foods were unrelated to dieting status in men and positively related to dieting status in women. Physical activity and smoking were related to higher intake of high fat/calorie foods. Smokers consumed fewer sweet foods than nonsmokers, however. These results underscore the importance of controlling for dieting status, as well as other behavioral and demographic variables, in population studies of dietary intake. They also suggest factors that may be important in the etiology of unhealthy eating patterns and potential targets for dietary intervention.

Adult↗
PubMed2005

Experiences from three community health promotion projects in Greenland.

OBJECTIVES AND METHODS: Three community health promotion projects have been implemented in Greenland in the municipalities of Upernavik, Ittoqqortoormiit and Qasigiannguit. Based on project reports and other written material, this paper describes experiences from the three projects and discusses the implications of the differences in project design and organization for potential outcomes. RESULTS: None of the three projects were formally evaluated. They all experienced problems and have only been partially successful in reaching their goals. The Upernavik and the Ittoqqortoormiit projects were organised with strong leadership and a central organisation, whereas the Qasigiannguit project was designed as a community project with population participation in all phases of the project. The two former projects have probably had a greater direct change impact on the community, whereas the latter has strengthened aspects of community capacity building. CONCLUSION: We need to learn more about how to employ the resources of communities, how to achieve better partnerships and how to support people in their efforts in order to secure population participation at all project stages. It is important to build coalitions with broad representation in the community and to secure population participation in order to disseminate the efforts and reach the needs of the whole community.

Community Health Services↗
PubMed2002

Screening for Type 2 diabetes: an exploration of subjects' perceptions regarding diagnosis and procedure.

AIM: To explore the psychological impact of a stepwise population-screening project for Type 2 diabetes. METHODS: As part of a stepwise population screening project for Type 2 diabetes in the Hoorn region, The Netherlands, an explorative interview study was conducted. The psychological impact of screening was studied using semistructured interviews in 40 subjects: 20 who were diagnosed with Type 2 diabetes, and 20 subjects who were at increased risk of having diabetes but who did not meet criteria for diabetes. Transcripts were analysed using techniques of content analysis. RESULTS: Newly diagnosed subjects reported limited understanding of their elevated blood glucose levels. None, with the exception of one, was alarmed by the diagnosis. Having Type 2 diabetes was not experienced as severe and no concerns were expressed. Adjusting diet was perceived as a major change by some. All newly diagnosed subjects had informed close relatives and friends of the diabetes, who were in general not alarmed by the news. Both groups positively judged the screening procedure. In general the screening procedure was considered as useful and not experienced as burdensome. CONCLUSIONS: This explorative study suggests that the psychological impact of screening in newly diagnosed subjects is limited. Both those who were and those who were not diagnosed with Type 2 diabetes judged the screening procedure positively.

Attitude to Health↗
PubMed1977

The prognosis of lung cancer originating as a round lesion. Data from the Philadelphia pulmonary neoplasm research project.

A population of 6,027 men 45 or more years of age was screened every 6 months for 10 years with chest photofluorograms and questionnaires regarding symptoms. Although volunteers, they were similar to older men in the general population with respect to age, race, and smoking habits. Of 121 men who developed lung cancer after the beginning of observation, 48 had neoplasms appearing as round lesions at the time of radiographic detection. Only 8 per cent of the 48 men survived 5 years or more, a rate identical to that of men in whom cancer first appeared in some other form. There was an inverse relationship between initial size of the cancer and survival. Two thirds of the tumors were squamous cell carcinomas. Comparison with the literature suggests that selection accounts for the favorable prognosis of round lung cancers in hospital-based series.

Adenocarcinoma↗
PubMed1998

Epidemiology of IgA nephropathy in central and eastern Kentucky for the period 1975 through 1994. Central Kentucky Region of the Southeastern United States IgA Nephropathy DATABANK Project.

Population-based incidence data for IgA nephropathy (IgAN) are available for some countries but not for the United States. The purpose of this study was to determine the incidence of IgAN in central and eastern Kentucky for 5- and 10-yr periods between 1975 and 1994 and to examine differences among patient groups between those periods. The incidence of IgAN was 5.4 cases per one million population per year (MPPY) for period 1A (1975 through 1979), increasing to 12.4 cases per MPPY for period 2B (1990 through 1994) (P < 0.001). Males had a 2.7 times higher incidence than females for period 1 (1975 through 1984) and 2.2 times higher for period 2 (1985 through 1994). For period 1A, the incidence for Fayette County, which includes the city of Lexington, was lower than that of the rest of the study area (P=0.26), whereas for period 2 the incidence was higher for Fayette County (P=0.052). During period 1, the highest incidence of IgAN for any age and gender group was 24.3 cases per MPPY for males ages 30 through 39. For period 2, the incidence for males was similar for each decade between ages 20 and 59 (approximately 19 cases per MPPY). No African-American was diagnosed during period 1, but in period 2 incidences for blacks and whites were similar (10.7 and 10.2 cases per MPPY, respectively). For the last 5 yr of the study (1990 through 1994), the incidence of end-stage renal disease (ESRD) due to IgAN was 5.5 cases per MPPY: 8.4 for males and 2.7 for females. The incidence of IgAN in Kentucky for period 2B was still much lower than that in European studies, but the incidence of ESRD due to IgAN may be similar. Thus, IgAN may be as important a condition with respect to ESRD in Kentucky as it is in other regions of the world.

Adolescent↗
PubMed1990

[Sports correlate with positive living habits. Results from the population survey the Swiss MONICA project].

Exercise is associated with positive health habits: Findings from the populations survey of the Swiss MONICA-project. Relatively little is known on population-wide relations of habitual exercise to relevant health factors such as diet, cigarette smoking and overweight. Data from a population-based sample of approximately 800 men and women each, aged 25-64, collected in western Switzerland as a part of an international WHO-project, were used to examine cross-sectionally the interrelationships between different lifestyle factors. Men and women training regularly (i.e. greater than or equal to 2 times/wk) exhibited consistently and highly significantly more favourable health habits, regarding diet (i.e. trimming visible fat, higher intake of fruits, salad and vegetables, yogurt and cottage cheese), nonsmoking, and weight control. Men and women with at least some regular physical activity during leisure-time had in turn more favourable health habits than their sedentary counterparts. In both sexes, educational level was directly related to exercise and a healthy diet, and inversely related to smoking and relative weight. Regularly training men and women also had a significantly improved lipid profile compared to inactive ones. It is concluded from this study that leisure-time physical activity and exercise are related to a positive health behaviour including diet, nonsmoking and efficient weight control. This may suggest that exercise should possibly be integrated into any population-wide attempts and efforts to promote health to enhance primary prevention.

Adult↗
PubMed1998

Trace metals and variations of antioxidant enzymes in Arctic bivalve populations.

In the framework of an INTAS project, arctic populations of the clam Macoma balthica were collected from seven stations (Mezen, Khaypudyr, Pechora 3, Pechora 5, Dvina, Keret 1, and Keret 2) in the White Sea and Pechora Sea. The main objectives of this research were to define baseline concentrations of trace metals (As, Cd, Cr, Cu, Fe, Mn, Pb, Zn) in M. balthica and to evaluate antioxidant responses as biomarkers of anthropogenic stress in these organisms. The antioxidant parameters examined included the levels of glutathione and the activities of several glutathione-dependent and antioxidant enzymes: glyoxalase I and glyoxalase II (EC 4.4.1.5 and EC 3.1.2.6), glutathione S-transferases (EC 2.5.1.18), glutathione reductase (EC 1.6.4.2), glutathione peroxidases (EC1.11.1.9 and EC 2.5.1.18, respectively, for Se-dependent and Se-independent forms), superoxide dismutase (SOD, EC 1.15.1.1), and catalase (EC 1.11.1.6). Organisms revealed enhanced concentrations of lead in both Keret stations, Khaypudyr, and Mezen, and high levels of copper in Keret and cadmium in Khaypudyr. At the biochemical level, organisms from Pechora 3, Pechora 5, and Dvina were not statistically different, whereas those from Mezen and Khaypudyr exhibited higher activities of superoxide dismutase, glutathione peroxidase, and glyoxalase II. Catalase levels were lower in Mezen and Khaypudyr. More heterogeneous were the responses of glyoxalase I and glutathione S-transferases, while no significant differences among the stations were observed for glutathione reductase. Multiple regression analyses revealed significant positive relationships between the main antioxidant enzymes (glutathione peroxidases, superoxide dismutase, glyoxalase I, and glyoxalase II), and confirmed the exception of catalase, which, when significant, was negatively correlated with the other parameters. The results support the suitability of antioxidant responses as biomarkers of pollutant exposure and/or toxicity for arctic biomonitoring programs even though only moderately polluted sites were sampled.

Alkyl and Aryl Transferases↗
PubMed2003

Prevalence and risk factors of non-fatal venous thromboembolism in the active population of the VITA Project.

Cost-effective strategies for the identification of subjects at risk of venous thromboembolism (VTE) in the active population are still lacking. Our objectives were to identify risk factors for venous thromboembolism in active subjects. We analyzed data from a population-based sample of 15055 Caucasians aged 18-65 years randomly selected from the census list of the township of Vicenza, Italy. A validated methodology was used to retrospectively identify subjects with previous VTE. Body mass index (BMI), smoking, oral contraceptive use, previous superficial vein thrombophlebitis (SVT) and familial history of VTE, all at the age of first thrombosis, were ascertained by direct interview and by review of available medical records. Ninety-two deep vein thromboses [prevalence: 61.1/10000, 95% confidence interval (CI) 49.2-74.9], three upper deep vein thrombosis (prevalence: 1.9/10000, 95% CI 0.4-5.8) and 21 pulmonary embolism (prevalence: 13.9/10000, 95% CI 8.6-21.3) were identified. After age and sex adjustment, clinically identifiable risk factors were: history of SVT [odds ratio (OR) = 6.8], oral contraceptive use (OR = 4.7), family history of VTE (OR = 4.5), smoking (OR = 1.7) and BMI above the third tertile (OR vs. mid-tertile 2.9). While previous SVT and BMI were associated with VTE in all circumstantial situations (surgery/trauma, pregnancy or idiopathic VTE), for oral contraceptive use, positive family history and smoking the degree of association varied significantly depending on the situation. Non-fatal VTE affects 0.7% of the subjects belonging to an active population, 56% of cases being potentially preventable. In 30% of VTE cases, at least two easily recognizable risk factors are present. Clinical assessment of risk factors remains the mainstay of VTE prevention.

Adolescent↗
PubMed1994

[Arterial hypertension in relation to life style and other cardiovascular risk factors. Epidemiologic study of a population of blood donors. Project AVIS].

The objectives of this research were to determine the prevalence of essential and borderline hypertension in a population of blood donors and their families and to determine if there is a correlation between blood pressure and lifestyle and/or other cardiovascular risk factors. The study was comprised of 1976 individuals, of whom 1290 were men and 686 were women, aged 18-65 years. The prevalence of essential hypertension was 15.1% for males and 12.5% for females: the prevalence of borderline hypertension was 22.3% for males and 15.7% for females. The population was divided into two groups: the first group included only subjects (1170 men, 543 women) who did not regularly use drugs that could modify the blood pressure and the heart rate, the second group included the entire population. In the first group, the multiple regression analysis indicated, in order of importance: age, BMI (body mass index), and heart rate. These variables were important in determining the systolic blood pressure in both sexes, uricemia for males and glycemia for females. The diastolic blood pressure was dependent on BMI, heart rate, and alcohol in both sexes, and glycemia, LDL cholesterol, and uricemia in the men. In the second group, primary and borderline hypertension are significantly correlated with age, BMI, and uricemia in both sexes and glycemia in females. A program of health and nutritional education could modify some factors related to blood pressure, such as obesity and alcohol consumption. The result would be a reduction of the prevalence not only of essential and borderline hypertension, but also of metabolic diseases such as dyslipidaemias, diabetes and hyperuricemia, with a global reduction of the cardiovascular risk.

Adolescent↗
PubMed2006

Determinants of carotid plaque occurrence. A long-term prospective population study: the San Daniele Project.

BACKGROUND: Increased carotid intima media thickness (CIMT) is frequently associated with established modifiable and non-modifiable cardiovascular risk factors, and is thought to be an independent predictor of ischemic cerebrovascular and cardiac events. The presence of carotid plaque is considered an established feature of atherosclerosis. There exist few longitudinal data on the predictive role of CIMT in the occurrence of carotid plaque. METHODS: We restudied the survivors of a cohort of the San Daniele Project, a large randomized general population study, investigated in 1990 regarding the prevalence and determinants of carotid atherosclerosis. Using ultrasonography, we determined in 1,193 subjects (548 men and 645 women), the common carotid IMT and the presence of non-stenotic and stenotic plaque. RESULTS: In 795 subjects without plaques or previous ischemic events at baseline, we found in multivariate analysis that CIMT > or =1 mm, age, hypertension and history of smoking are significant predictive elements of the occurrence of a new carotid plaque. The incremental probability of plaque occurrence is greater in midlife. CIMT and age are the most predictive risk factors with ORs of 3.66 (95% CI 1.4-9.4) and 3.02 (95% CI 2.4-3.7), respectively. The ORs for hypertension and smoking account for 1.5 (95% CI 1.1-3.4) and 1.7 (95% CI 1.1-2.8), respectively. CONCLUSIONS: Age, hypertension, history of smoking and B-mode detection of CIMT increases in subjects without carotid atherosclerosis and free of previous vascular events predict the occurrence of carotid atherosclerotic plaque.

Adult↗
PubMed2005

Pre-hospital coronary care and coronary fatality in the Belfast and Glasgow MONICA populations.

BACKGROUND: The aim of this study was to describe and compare coronary event case fatality and care pathways in two defined populations with access to different models of pre-hospital care provision. METHODS: Secondary analysis of MONItoring of Trends and Determinants in CArdiovascular Disease (MONICA) population coronary event registers (1988, 1989, 1990, 1992 and 1993). RESULTS: Case fatality at 28 days following an acute coronary event was 6.5% greater in the Glasgow MONICA Project (GMP) population (46.7%) than in the Belfast MONICA Project (BMP) population (40.2%). Pre-hospital case fatality was 33.9% in the GMP population and 28.3% in the BMP population. These differences could not be fully explained by mobile coronary care unit (MCCU) responses in the BMP area. Initial care was provided in hospital for 28.3% of the BMP events and only 7.7% of the GMP events. Additional data collected by the Belfast and Glasgow MONICA investigators support a large difference between the median delay to main medical care in the BMP events (120 min) and the median delay to ward admission in the GMP area (220 min) at this time. CONCLUSIONS: Our findings suggest that the delay between coronary event onset and access to specialist coronary care was the most likely critical difference, irrespective of hospital-based MCCU provision in the BMP area. An established 'culture of early intervention' in Belfast may have been an important factor. As a large proportion of coronary event fatalities continue to occur outside hospital, there is a need to strengthen the evidence base underpinning the provision of appropriate skilled care and treatment at the earliest possible opportunity.

Adult↗
PubMed2001

[Distribution and correlation of uric acid with classic cardiovascular risk factors in an adult population in Campania. VIP project data].

BACKGROUND: The aim of this study was to correlate uric acid levels with the classic cardiovascular risk factors in an adult population in Campania. METHODS: The following parameters were assessed in the study population (600 men and 600 women) aged between 25-74 years old, subdivided into 5 age groups (25-34, 35-44, 45-54, 55-64, 65-74): ECG, arterial pressure and body mass index (obtained by dividing weight in kg by height in metres squared). A blood sample was also taken to evaluate uric and other biochemical variables including: total cholesterol, HDL, L DI, glycemia, triglycerides, red and white blood cells, C3, fibrinogen, platelets and insulin serum levels. RESULTS: The results confirmed the positive correlation between uric acid and red and white blood cells in males, and between uric and the following variables in females: cholesterol, C3, LDL, systolic blood pressure, diastolic blood pressure, triglycerides, white blood cells, BMI and fibrinogen. When the correlation was performed in the entire population, uric acid correlated with triglycerides and red and white blood cells. Multivariate analysis for the entire population showed a strong correlation between uric acid, triglycerides and white blood cells. CONCLUSIONS: This study confirms the data reported in the literature and highlights the correlation between uric and the classic cardiovascular risk factors. This association is more evident in females.

Adult↗