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PubMed1987

Longitudinal and secular trends in lipoprotein cholesterol measurements in a general population sample. The Framingham Offspring Study.

Two fasting lipoprotein cholesterol measurements have been made on Framingham Offspring Study participants, first in 1971-75 and again in 1979-83. Longitudinal analysis (n = 2433, age 20-49 at first exam) using multivariate regression found aging, weight gain, vasectomy, menopause, and increased smoking are associated with worsening lipoprotein profiles, while increased alcohol consumption is associated with increased high density lipoprotein cholesterol (HDL-C). Average increases in low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) in women accelerate with age; in men the increases are similar or perhaps decelerate with age. Secular trends were measured using age-adjusted mean values for individuals aged 25-54. Averages of total cholesterol, LDL-C (men only), systolic and diastolic blood pressure, body mass index, number of cigarettes per day, and alcohol consumption were lower at the second examination. Two secular trends in women indicate a possible worsening of population lipoprotein profiles: mean VLDL-C was higher and mean HDL-C lower at the second exam.

Adult↗
PubMed1987

Age-period-cohort analysis of secular trends in onset of major depression: findings in siblings of patients with major affective disorder.

Analyses of data from the NIMH-CRB Collaborative Depression Study on age at onset of Major Depressive Disorder (MDD) in 1144 directly interviewed siblings of patients with major affective disorder show a strong secular trend toward increased lifetime risk and earlier onset in successive cohorts of birth since 1930. The proportionate increases in the instantaneous probabilities (hazard) of onset of MDD for each one year difference in year of birth were 5% for brothers and 7% for sisters. Age-period-cohort analysis suggests a powerful period effect may be responsible for this secular trend in rates of MDD, with rates of onset for siblings between 15 and 50 years of age doubling between the 1960s and 1970s. Possible artifacts are investigated.

Adolescent↗
PubMed1978

Is there a secular trend in age of menopause?

A review of the difficulties encountered in analyzing a secular trend in age of menopause is given with emphasis on the advantages and disadvantages of the recollective and "status quo" methods. It is suggested that no methodology except that which is prospective will give accurate ages of menopause. Accepting this given, a review of the literature from 1864 to 1964 is undertaken, that suggests there may be a secular trend in Denmark, England, France, Germany, Russia and the USA. This must, however, be corroborated by longitudinal, cross cultural, generational research of mothers' and daughters' ages at menopause, or at least, cohort analysis of specific populations.

Adolescent↗
PubMed1992

Components of adult height and height loss. Secular trend and effects of aging in women in the DOM project.

Between 1984 and 1987, adult height, sitting height, arm span, and iliac crest height were measured in 13,386 women of the DOM project. Combined effects of secular trends between cohorts born in 1911 to 1945 and aging between ages 40 to 74 years showed a decrease in stature of 4.9 +/- 0.3 cm (mean +/- standard error of mean) and in sitting height of 3.9 +/- 0.2 cm. Height and sitting height diminished but no effect of aging on arm span was found in 380 women measured again after 5 years. When arm span and iliac crest height did not change with age, they reflected a secular trend (1.6 +/- 0.3 cm and 0.5 +/- 0.3 cm). This implies an age-related decline in stature of -3 cm in 35 years.

Adult↗
PubMed2006

Secular trends in renal dysfunction and outcomes in hospitalized heart failure patients.

BACKGROUND: Renal dysfunction and worsening renal function (WRF) during heart failure (HF) therapy predict outcomes. We determined whether the severity of renal dysfunction, the incidence of WRF or outcomes have changed over time (secular trends) in patients hospitalized for HF therapy. METHODS AND RESULTS: A total of 6440 consecutive unique patients admitted for HF to Mayo Clinic Hospitals Rochester, MN, January 1, 1987, to December 31, 2002, were identified and data extracted from electronic databases. Over the study period, age and admission creatinine increased, whereas estimated glomerular filtration rate and hemoglobin decreased (P < .0001 for all). The prevalence of hypertension and diabetes among HF patients also increased over time (P < .0001). The incidence of WRF was stable. Renal dysfunction and development of WRF were associated with mortality. When adjusted for the changes in baseline characteristics of HF patients, mortality declined over the study period. CONCLUSION: Hospitalized HF patients are increasingly elderly, have a greater prevalence of diseases that lead to renal dysfunction, and have more severe renal dysfunction and anemia on admission. However, adjusting for these secular trends in patient characteristics, mortality after HF admission is improving. These data enhance our understanding of the changing natural history of HF.

Aged↗
PubMed2004

Secular trends in cancer mortality, California 1970-1998.

BACKGROUND: Monitoring mortality is a meaningful way to evaluate the effectiveness of cancer control activities. Results of trend analysis for cancer related deaths by race/ethnicity in California from 1970 to 1998 are reported here. METHODS: Age-adjusted cancer mortality rates in California were used in the analysis of secular trends. Mortality patterns for selected cancers in all races combined are compared with similar patterns in the US for 1973-1998. RESULTS: The overall cancer mortality rates in California began to decline in 1987 in both men and women. Although mortality trends by site, sex, and race/ethnicity showed significant variations, the overall pattern in California is heavily influenced by trends for the non-Hispanic white (NHW) population and is very similar to the patterns in the US with minor differences in the magnitude and trend. CONCLUSIONS: This is the first time that secular trends in cancer mortality for California are presented by race and ethnicity. Despite notable racial differences, the overall trend follows a declining pattern. Detailed explanation of the reasons behind the observed patterns is not included in this report. Some of the differences between California and the US, however, can be explained by differences in the racial and ethnic composition of the two populations. Approximately 45% of the California population has Hispanic (HSP) or Asian origins among whom cancer mortality rates are substantially lower. Another factor is the difference in the intensity and coverage of cancer related activities such as tobacco control. Prevalence of smoking in California is much lower than the rest of the US.

California↗
PubMed2006

Combined volumetric T1, T2 and secular-T2 quantitative MRI of the brain: age-related global changes (preliminary results).

The combined T1, T2 and secular-T2 pixel frequency distributions of 24 adult human brains were studied in vivo using a technique based on the mixed-TSE pulse sequence, dual-space clustering segmentation and histogram gaussian decomposition. Pixel frequency histograms of whole brains and the four principal brain compartments were studied comparatively and as function of age. For white matter, the position of the T1 peak correlates with age (R2 =.7868) when data are fitted to a quadratic polynomial. For gray matter, a weaker age correlation is found (R2 =.3687). T2 and secular-T2 results are indicative of a weaker correlation with age. The technique and preliminary results presented herein may be useful for characterizing normal as well as abnormal aging of the brain, and also for comparison with the results obtained with alternative quantitative MRI methodologies.

Adult↗
PubMed2005

Management of community-acquired pneumonia and secular trends at different hospitals.

STUDY OBJECTIVES: The goal of this study was to assess variability in the management of patients admitted to hospitals with community-acquired pneumonia (CAP), and changes in secular trends of this condition. METHODS: Observational study carried out, in 5 teaching hospitals, in northern Spain of patients admitted with CAP between March 1,1998 and March 1,1999 (baseline period), and between March 1, 2000 and September 30, 2001 (follow-up period). Clinical histories were analyzed retrospectively for relevant parameters for process-of-care and outcome performance. Those parameters among hospitals during the baseline period were compared. For each hospital, changes in these parameters between baseline and follow-up were also measured. All parameters were adjusted for disease severity. RESULTS: A total of 844 patients were included in the baseline period, and 654 in the follow-up period. During the baseline period, adjusted analyses revealed statistically significant differences in all process-of-care parameters except the coverage of atypical pathogens. With regard to clinical outcomes, however, only the 30-day readmission rate was significantly different (P=0.03). Adjusted mean length of stay ranged from 6.3 to 9.2 days (P<0.0001). In adjusted analyses of temporal changes within hospitals for process-of-care and outcome performance, revealed few statistically significant differences. CONCLUSIONS: Variability discovered between hospitals in the management of patients in the absence of relevant secular changes in each hospital points out the necessity to implement measures designed to reduce such variability between hospitals and to improve the quality of medical treatment.

Aged↗
PubMed1995

Secular trends in diet and risk factors for cardiovascular disease: the Framingham Study.

OBJECTIVE: In this study we examined changes in dietary intake and risk factors for cardiovascular disease that occurred over three decades in a US-population-based sample. DESIGN: Secular trends in dietary profiles and risk factors were studied in cross-sectional samples of subjects from the Framingham Study in 1957-1960, 1966-1969, and 1984-1988. RESULTS: Dietary levels of cholesterol appeared to have declined considerably, whereas macronutrient and fatty acid intakes appeared to change only slightly. Men appeared to increase their saturated fat intakes from 16.4% in 1966-1969 to 17.0% in 1984-1988 (P < .01). In spite of relatively stable mean total fat intake levels, 35% to 60% of Framingham Study men and women reported decreased consumption of higher-fat animal products over the 10-year period between 1974-1978 and 1984-1988. Framingham subjects who reported modifying their diets by substituting lower-fat foods for high-fat items between 1974-1978 and 1984-1988 were more likely to achieve the guidelines of the National Cholesterol Education Program and Healthy People 2000 for dietary fat and cholesterol intake and for serum total cholesterol level. Levels of systolic and diastolic blood pressure, total and low-density lipoprotein cholesterol, and cigarette smoking were also lower in 1984-1988 than in earlier times. Compared with 1957-1960, mean body mass index and prevalence rates of overweight and hypertension were higher in 1984-1988, despite higher levels of reported physical activity. CONCLUSIONS: The observed secular trends in diet and risk factor levels for cardiovascular disease in the Framingham population are important to guide the development and implementation of population-based strategies for promoting cardiovascular health, including nutrition interventions.

Adult↗
PubMed1995

Effects of secular trends in obesity on coronary risk factors in children: the Bogalusa Heart Study.

OBJECTIVE: To determine whether a secular trend toward increased weight gain was present in children examined 11 years apart in the Bogalusa Heart Study and, if present, the association of this trend with the cardiovascular risk status of the children. STUDY DESIGN: Two biracial cohorts (approximately 65% white, 35% black) were identified. One cohort was examined first in 1973 at 7 to 9 years of age and was reexamined in 1981 (n = 417). The second was examined first in 1984 at the same age and reexamined in 1992 (n = 235). Measurements made at each assessment included age, gender, race, height, weight, blood pressure, and lipoproteins. The two cohorts were then compared. RESULTS: The two cohorts were comparable at their first assessment. However, at follow-up 8 years later the more recent cohort was 5 to 7 kg heavier without any difference in linear growth; this increased ponderosity was associated with adverse changes in lipids and lipoproteins: the high-density lipoprotein-cholesterol concentration was 0.15 to 0.35 mmol/L (6 to 13 mg/dl) lower, triglyceride values were 0.09 to 0.40 mmol/L (8 to 36 mg/dl) higher, and there were small increases in total cholesterol and low-density lipoprotein-cholesterol concentrations in white girls. Multivariate analyses showed that in the more recent cohort these changes were related more to a change in ponderosity than to ponderosity. Although blood pressure was generally lower in the recent cohort, increasing ponderosity was associated with higher blood pressure. CONCLUSIONS: There is a secular trend toward increased ponderosity in children examined in the Bogalusa Heart Study. This trend is associated with worsening cardiovascular risk, particularly with regard to lipoproteins.

Adolescent↗
PubMed1997

Secular trend and age-period-cohort analysis of prostate cancer mortality in Taiwan.

PURPOSE: We evaluated the secular mortality trend of prostate cancer in Taiwan from 1964 through 1994. MATERIALS AND METHODS: Analyses were based on vital statistics. Relative risks associated with each of the age, period and cohort effects on secular mortality were estimated from a log-linear Poisson model. RESULTS: Age adjusted mortality rates increased more than 2-fold during the last 30 years in Taiwan. Age-period-cohort analysis showed that the age effect was the strongest. CONCLUSIONS: Factors related to aging are the main reason for the increase in prostate cancer mortality in Taiwan during the least 3 decades.

Adult↗
PubMed1993

Secular trends in rates and etiology of nosocomial urinary tract infections at a university hospital.

To examine changing trends in the microbial etiology of nosocomial urinary tract infections, we reviewed culture data from a surveillance database for the calendar years 1982 to 1991. The overall rates of nosocomial urinary tract infections have increased significantly during the last decade from 2.63 per 1,000 patient-days to 4.35 per 1,000 patient-days (p = 0.0023). For specific isolates the rates of yeasts, Klebsiella pneumoniae and group B streptococcus have increased significantly during the last decade. The rates of Escherichia coli, Proteus species and Pseudomonas species have all decreased. Analysis of these secular trends can provide important information relating to the etiology of nosocomial urinary tract infections. It is likely that antibiotic "pressure" has influenced the microbiology of infections and that altered case-mix would explain much of the increase in rates. However, the multiple reasons for these secular trends and their precise contributions to them are unknown.

Bacteria↗
PubMed2004

[Secular growth changes. Weight, height and body mass index values in infant, children, adolescent and young adults from Barcelona population].

BACKGROUND AND OBJECTIVE: A secular trend in growth has been reported in developed countries. Our aim was to evaluate weight, height and body mass index values in a middle class sample of people from Barcelona and compare these values with those obtained before 1987. SUBJECTS AND METHOD: Height, weight and body mass index were evaluated in a) 268 male and 243 female newborns from normal gestations of 40 weeks, born in 2001 and 2002; b) 158 boys and 146 girls born during 1998-2000 and evaluated every 0.25-0.50 years from 0.25 to 3 years of age; c) 2,781 boys and 2,476 girls, aged 3-18 years, evaluated in 2002 and 2003, and distributed in 0.5 year intervals, and d) 394 males and 364 females, aged 18-24 years, evaluated in 2002 and 2003. RESULTS: Mean, standard deviation and percentiles values with 0.25-0.5 year-period intervals from birth to adulthood are reported. In comparison with data obtained before 1987 in Spanish populations, an increase of 3.5 cm was observed in adult height in both sexes as well as an increase of 7-8.3 kg in percentiles 3, 50 and 97 values in male adult weight with no significant differences in female adult weight. Moreover, pubertal growth spurt begins one year earlier in both boys and girls. Age of menarche (12.78 [1.30] years) was similar in our adult female population and in the female population evaluated before 1987. CONCLUSIONS: A secular trend in growth was observed in our population. There is a need to update periodically the growth data used in the evaluation of children and adolescents.

Adolescent↗
PubMed1998

Secular trends in the rates and seasonality of violent and nonviolent suicide occurrences in Finland during 1980-95.

BACKGROUND: Because secular trends in seasonality of different types of suicides has not been studied before, we utilized a novel statistical method to evaluate this phenomenon by using national Finnish suicide statistics during 1980-95. METHODS: Rates were analyzed with ordinary linear regression analysis. Secular trends were evaluated using ratio-statistic and its 95% confidence intervals. RESULTS: The rate of violent suicides increased before year 1990 and decreased since that. The nonviolent suicide rate increased continuously. The decreasing tendency of seasonality in nonviolent suicides and a slight decrease in violent suicides are seen within the three successive time periods studied. CONCLUSIONS: Trends in rates and in seasonality of suicides might be related to changes in the health politics in Finland. LIMITATIONS: The short time-series and lack of studying associations of suicides with socioeconomic, environmental or biological factors are limitations of our study. CLINICAL RELEVANCE: Studying the time-dependent changes in rates and in seasonality of suicides provide a novel perspective for the evaluation of the aetiology of suicidal behaviour.

Finland↗
PubMedDate not supplied

A study of values of baccalaureate nursing students and graduate nurses from a secular and a nonsecular program.

This study examined the relationship between professional values of senior baccalaureate nursing students and graduate nurses compared to the values reflected in the Code for Nurses. A questionnaire was completed by 199 students and graduates of a secular and a nonsecular university. Data were analyzed using content analysis, frequency distributions, and multivariate procedures. Findings indicated that values identified most frequently by all respondents related to patient care issues rather than social issues of the profession. Analyses showed no significant difference in value identification between respondents from the secular and the nonsecular institutions. Implications for nursing education, nursing service, and future research are also discussed.

Adult↗
PubMed2000

Secular trend and intrapopulational variation in age at menopause in Spanish women.

Menopause is associated with the general ageing process and marks the end of follicular depletion, a process that begins in the intrauterine stage and lasts throughout the lifetime of women until their reproductive senescence. Controversy persists about whether the age at menopause is sensitive to the ecological determinants prevailing during the lifecycle or whether it has a predominantly genetic component that would allow groups of women to be characterized with respect to particular menstrual characteristics manifested throughout their fertile life. By contrast, there is a definite secular trend in age at menarche in populations that have registered improvements in their environment: sexual maturation is closely associated with the general processes of growth and development. These aspects were analysed in a sample of Spanish women, mothers and daughters, born between 1883 and 1941. The results show (a) indications--although not conclusive--of a secular trend in the age at menopause, (b) a possible association between the age at menopause of mothers and their daughters, and (c) an association at the individual level between age at menarche, particular characteristics of ovarian function (fetal loss) and age at menopause. The reproductive ageing process therefore seems to result from the expression of the influence of ecological conditions in which the lifecycle of the women develops and of a degree of heritability that affects not only the age at menopause but also a range of characteristics of ovarian function.

Age Factors↗
PubMed2000

Secular trends in growth.

Since the 19th century there have been clearly documented secular trends to increasing adult height in most European countries, with current rates of 10-30 mm/decade. Over the same period menarcheal age has also fallen steeply, but has now stabilized at approximately 13 years and may be rising again. Height trends tend to be greater in childhood than in adulthood due to the associated advance in maturation, but no trends are apparent before the age of 2 years. In particular, birth-weight trends are small and different in shape from height trends. The adult height trend matches that at age 2 years, so that the increment in adult height has already been achieved by age 2 years. To try to identify factors relating to the secular trend, increased height gain in late infancy is hypothesized to be equivalent to a reduction in stunting, and stunting is thought to be caused by impaired growth in the long bones of the leg in later infancy. Leg growth may be regulated by the expression of growth-hormone receptors on the growth plates, which it is hypothesized are susceptible to the interaction between concurrent nutrition and the nominal growth rate set during pregnancy. The timing of menarche is also likely to be determined by some growth factor operating near the time of birth, which also affects later weight, but not height.

Adolescent↗
PubMed2002

Paracelsus, Paracelsianism, and the secularization of the worldview.

This paper examines Paracelsus and Paracelsianism in the light of the ideas of Max Weber concerning the social consequences of the Reformation, with special reference to his theories of Entzauberung and secularization. He linked these tendencies both to the rise of capitalism and the growth of experimental science. The detailed case study of Paracelsus' account of diseases linked with saints, in common with his interpretation of many other conditions, demonstrates that he self-consciously extended the boundaries of medicine and eroded the role of magic and witchcraft associated with the church. On the other hand, Paracelsus adopted the Neoplatonic worldview, was immersed in popular magic, and evolved a system of medicine that self-consciously revolved around magic. These factors seem to place a distinct limit on his role in the demystification of knowledge. However, the magic of Paracelsus entailed a decisive break with the entrenched elitist and esoteric tradition of the occultists and hermeticists. It is argued that this reconstructed magic re-establishes the credentials of Paracelsus as a significant contributor to the disenchantment and secularization of the worldview.

Europe↗