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1
Gierisch, Jennifer Marie Rimer Barbara K. "Mammography maintenance a longitudinal, population-based study of insured women /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,1993.
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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2008.Title from electronic title page (viewed Feb. 17, 2009). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Gillings School of Global Public Health Department of Health Behavior and Health Education." Discipline: Health Behavior and Health Education; Department/School: Public Health.
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Murray, G. (Graham). "Early development and adult cognitive function in schizophrenia and the general population—a longitudinal perspective." Doctoral thesis, University of Oulu, 2005. http://urn.fi/urn:isbn:9514278925.
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Abstract Many adults with schizophrenia have cognitive deficits, and many children who go on to develop schizophrenia as adults have subtle sub-clinical signs of early developmental deviance. However, the relationship between early markers of neurodevelopment and later neurocognition remains unclear. The present thesis principally investigates infant neurodevelopment, adolescent scholastic function and adult cognition in the Northern Finland 1966 Birth Cohort (n = 12,058). Proxy markers of neurocognition – developmental milestones and school performance – were collected prospectively. Individuals who went on to develop schizophrenia were identified. School performance in pre-schizophrenic individuals was assessed by teacher ratings (n = 100). Cognition in subjects with schizophrenia was assessed at age 33–35 (n = 61). A representative sample of the general population at risk was studied as a comparison group (school assessments n = 9351; neurocognitive assessment n = 104). The schizophrenia group achieved neuromotor milestones later (p < 0.0001) and performed worse than the control group on all cognitive measures (p < 0.0025). In pooled analyses there were associations between infant motor development and adult cognition in executive function (p = 0.006), verbal learning (p = 0.007) and visuospatial working memory (p = 0.02), (earlier development was linked to better adult cognition) but not in visual object learning. The pattern of associations between development and adult cognition was broadly similar in schizophrenia and the general population, whereas associations between development and adolescent scholastic function were stronger in schizophrenia than in controls (p < 0.05). A complementary neuropsychological case study of spontaneous clinical and cognitive improvement in chronic schizophrenia is also presented, showing that cognitive deficits in schizophrenia do not always represent a static encephalopathy, but can be subject to marked improvement. The possibility of using knowledge about premorbid features to help predict and prevent schizophrenia is also critically reviewed, using the school setting as a practical example. It is concluded that many obstacles remain before knowledge about premorbid features can be translated to preventative interventions. Overall, the results of these investigations are consistent with the hypothesis that in schizophrenia, mild infant motor developmental delay, adolescent scholastic performance and cognitive deficits may be age dependent manifestations of the same underlying neural process. Thus, they may be better considered as part of a single longitudinal syndromeTiivistelmä Skitsofreniaa sairastavilla aikuisilla on kognitiivisten toimintojen puutoksia. Kognitiivisia (tiedon prosessoinnin) toimintoja ovat esimerkiksi tarkkaavaisuus, huomiokyky, oppiminen, muisti, asioiden suunnittelu ja ongelmanratkaisu. Monilla lapsilla, jotka sairastuvat aikuisiällä skitsofreniaan, on vähäisiä, kliinisesti merkityksettömiä varhaisen kehityksen poikkeamia tai hitautta. Varhaisen kehityksen ja myöhemmän kognition yhteys on toistaiseksi epäselvä. Tämä tutkimus selvittää varhaisen hermostonkehityksen, nuoruusiän koulunkäynnin ja aikuisiän kognition yhteyttä Pohjois-Suomen 1966 syntymäkohortissa (N = 12 058). Tiedot hermoston tietotoimintoja kuvaavista muuttujista (varhainen kehitys ja koulumenestys) kerättiin prospektiivisesti, samoin tieto skitsofreniaan sairastumisesta. Opettajat arvioivat tutkittavien (n = 100) koulumenestystä ennen sairastumista. Skitsofreniaa sairastavien kognitiivinen suorituskyky arvioitiin 33–35 vuoden iässä (n = 61). Vertailuryhmänä käytettiin edustavaa otosta yleisväestöstä (koulumenestys n = 9351; kognitiivinen suorituskyky n = 104). Skitsofreniaryhmä saavutti motoriset kehityskynnykset (kuten seisomaan ja kävelemään oppiminen) keskimäärin merkittävästi myöhemmin ja suoriutui huonommin kuin kontrolliryhmä kaikissa kognitiivisen suorituskyvyn mittauksissa. Lisäksi varhaisen motorisen kehityksen ja aikuisiän kognitiivisen suorituskyvyn välillä havaittiin yhteys. Erityisesti varhainen motorinen kehitys ennusti hyvää toiminnanohjausta, verbaalista oppimista ja visuospatiaalista työmuistia. Vastaavaa yhteyttä ei havaittu visuaalisen oppimisen alueella. Varhaisen kehityksen ja aikuisiän kognitiivisten toimintojen yhteys oli samantyyppinen sekä skitsofreniassa että yleisväestössä, kun taas varhaisen kehityksen ja nuoruusiän koulumenetyksen yhteys oli vahvempi skitsofreniaan sairastuneilla kuin verrokkihenkilöillä. Yhtenä osatyönä esitetään tapausselostus, jossa kaksi kroonista skitsofreniaa sairastavaa henkilöä toipui spontaanisti sekä kliinisesti ja kognitiivisesti. Tapausselostus osoittaa, että skitsofreniaan liittyvä kognitiivisen tason lasku ei välttämättä heijasta pysyvää aivojen toiminnantason laskua, vaan tila voi huomattavasti korjaantua. Tutkimuksen osana on myös katsaus siitä, missä määrin on mahdollista ennustaa skitsofreniaa sairautta edeltävien piirteiden ja koulussa tehtyjen havaintojen perusteella. Katsauksen valossa on ilmeistä, että on edelleen hyvin vaikea hyödyntää sairautta edeltäviä piirteitä tulevan sairauden ennustamisessa ja etenkin ehkäisyssä. Yhteenvetona voidaan todeta tämän tutkimuksen keskeisten tulosten tukevan hypoteesia, jonka mukaan skitsofreniaan myöhemmin sairastuneilla havaittu lievä varhaisen motorisen kehityksen viive, heikko nuoruusiän koulumenestys ja kognitiivisen tason lasku heijastanevat ikäsidonnaista keskushermoston kehitysprosessia ja voivat olla osa samasta pitkittäisestä oirekokonaisuudesta
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Weber, Daniela. "Differences in physical aging measured by walking speed: evidence from the English Longitudinal Study of Ageing." Springer, 2016. http://dx.doi.org/10.1186/s12877-016-0201-x.
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Background: Physical functioning and mobility of older populations are of increasing interest when populations are
aging. Lower body functioning such as walking is a fundamental part of many actions in daily life. Limitations in
mobility threaten independent living as well as quality of life in old age. In this study we examine differences in
physical aging and convert those differences into the everyday measure of single years of age.
Methods: We use the English Longitudinal Study of Ageing, which was collected biennially between 2002 and 2012.
Data on physical performance, health as well as information on economics and demographics of participants were
collected. Lower body performance was assessed with two timed walks at normal pace each of 8 ft (2.4 m) of survey
participants aged at least 60 years. We employed growth curve models to study differences in physical aging and
followed the characteristic-based age approach to illustrate those differences in single years of age.
Results: First, we examined walking speed of about 11,700 English individuals, and identified differences in aging
trajectories by sex and other characteristics (e.g. education, occupation, regional wealth). Interestingly, higher
educated and non-manual workers outperformed their counterparts for both men and women. Moreover, we
transformed the differences between subpopulations into single years of age to demonstrate the magnitude of those
gaps, which appear particularly high at early older ages.
Conclusions: This paper expands research on aging and physical performance. In conclusion, higher education
provides an advantage in walking of up to 15 years for men and 10 years for women. Thus, enhancements in higher
education have the potential to ensure better mobility and independent living in old age for a longer period. (author's Abstract)
4
Lithner, Ellinor. "Association between work-time control and sickness absence : A longitudinal study among the Swedish working population." Thesis, Stockholms universitet, Institutionen för folkhälsovetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-157581.
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In Sweden, sickness absence due to mental disorder is increasing for both men and women, although more among women. The psychosocial work environment is acknowledged as an important predictor for sickness absence. Employee based work-time control is beneficial for the balance between job stress and recovery and could therefore be of interest when aiming to prevent sickness absence. The aim is to investigate the association between control over daily hours (CoDH) and control over time off (CoT), respectively, and sickness absence. The study also examine whether the association differ by gender and if burnout or depression mediates the associations. Data was derived from two waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH) which is an approximate representation of the Swedish working population (n=8418, of which 4936 were females). Binary logistic regression was used as method of analysis. After adjustment for possible confounders, no association between CoDH and sickness absence was found. Low CoT was significantly associated with sickness absence among men (OR=0.90 [0.84, 0.96]), but not among women. Neither burnout nor depression mediates the associations. CoT is stronger associated with sickness absence than CoDH. CoT with regard to sickness absence is of greater importance for men than women.
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Österlind, Per Olov. "Medical and social conditions in the elderly gender and age differences : the Umeå longitudinal study." Doctoral thesis, Umeå universitet, Geriatrik, 1993. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-102560.
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In 1981, no representative study of the medical and social conditions among elderly persons in northern Scandinavia was performed. Nor was there such a study in a smaller Swedish town than Gothenburg. This study was initiated to fill that knowledge gap. The aim of the study was to evaluate gender and age differences in medical and social conditions among elderly people, including the reference intervals of clinical chemistry parameters and characteristic features of the 24-hour electrocardiogram (ECG) in healthy elderly. By way of longitudinal design with birth cohorts stratified by gender, it was assumed that the effects could be demonstrated. Also, the death risk of various social and medical variables was to be assessed. During the study period 1981 to 1990, the subjects were between 70 and 88 years of age. The proportion of persons living in private housing decreased from almost all at the age of 70 to slightly more than half at 88 years of age. The number of socially active persons decreased considerably during the period. The need of help increased from almost none to 60 % of the persons. The proportions of persons with normal sight and hearing decreased from two thirds to around one tenth The most frequent symptoms were general tiredness, pains, dyspnoea, constipation and dryness of the mouth. Cardiovascular diseases were the most frequent. Hypertensive disease became less, and congestive heart failure more frequent with age. The frequency of dementia increased steeply among the oldest persons; at 88 years of age, 40 % were demented. Drug consumption increased; the oldest persons in both age cohorts used 5 different drugs or more per person regularly. The consumption increase was mainly due to the increasing morbidity accompanying age. The most common drugs taken were cardiovascular preparations, psychoactive agents, drugs to alleviate gastrointestinal symptoms, and analgesics. Drug intake and symptom prevalence were generally higher in women, despite the fact that there was no gender difference in the number of diseases. The reference intervals of many blood components in healthy elderly were shown to be broader than those of younger persons. The intervals of P(lasma)-folate and P- potassium were on a lower and those of the erythrocyte sedimentation rate, P-creati- nine and, in women, S(erum)-cholesterol, were on a higher level than among younger persons. Several features of the 24-hour ECG, e.g. the number of episodes of supraventricular tachycardia as well as supraventricular and ventricular premature beats in healthy elderly were more frequent than among younger persons. Between 80 and 88 years of age, many functions crucial to the chances of living a rich and vital life were found deteriorating in the elderly persons. High age, male sex, dementia, congestive heart failure, and low values of S-creatinine were shown to be independent factors connected with an increased death risk.S. 1-112: sammanfattning, s. 115-177: 5 uppsatser
digitalisering@umu.se
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Nordstrom, Goran. "Oral health and dietary habits in an elderly city population a report from the Umeå longitudinal study /." Umeå, Sweden : Dept. of Prosthetic Dentistry and Geriatric Medicine, 1995. http://catalog.hathitrust.org/api/volumes/oclc/35846862.html.
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Borg-Longhurst, Eugenia. "Social, psychological and functional outcomes after meningococcal disease in adolescents : a longitudinal population-based case-control study." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1444117/.
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Meningococcal disease (MD) remains a major source of mortality and morbidity in adolescence despite the introduction in some countries of the seroGroup C conjugate vaccine. This study is the first which comprehensively assesses the outcomes of MD in adolescence. In pursuing this aim, a population-based matched cohort study was undertaken and 101 sex and age matched case-control pairs (aged 15-19 years at disease) from 6 regions of England (representing 65% of the population of England) were followed up 18-36 months after MD (46% males). Educational, social and vocational function, mental health, social support, cognitive and quality of life data were collected using standardised questionnaires and neuropsychological tests. In addition, demographic and disease factors associated with outcome were also examined. The results show that 57% (N=58) of cases had physical sequelae ranging from minor scarring to bilateral amputations. Survivors had greater mental fatigue, lower social support, greater reduction in quality of life, and lower educational attainment compared with controls. Cognitive testing revealed no overall change in intellectual ability however, cases had deficits in aspects of memory (short and long-term), attention (selective and sustained), cognitive flexibility and psychomotor speed. Greater cognitive deficit was associated with a younger age at diagnosis. Cases with SeroGroup C disease had greater physical sequelae than those with B disease. MD status increased the risk of depression. Only 53/101 cases reported any medical follow-up after MD. The findings suggest that survivors of MD in adolescence have a disturbing series of deficits including poorer physical and mental health, quality of life and educational achievement. SeroGroup C is associated with poorer outcome. Of concern, medical care is poor after discharge from hospital. Routine follow up of adolescent survivors is essential to address issues and concerns that are important for adolescent MD survivors and to mitigate or prevent physical and psychosocial morbidity after MD.
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Nordström, Göran. "Oral health and dietary habits in an elderly city population : a report from the Umeå longitudinal study." Doctoral thesis, Umeå universitet, Protetik, 1995. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96914.
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Gräsbeck, Anne. "The epidemiology of anxiety and depressive syndromes a prospective, longitudinal study of a geographically defined, total population : the Lundby study /." Lund : Dept. of Psychiatry, Lund University Hospital, 1996. http://books.google.com/books?id=sw9sAAAAMAAJ.
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Loucoubar, Cheikh. "Statistical genetic analysis of infectious disease (malaria) phenotypes from a longitudinal study in a population with significant familial relationships." Phd thesis, Université René Descartes - Paris V, 2012. http://tel.archives-ouvertes.fr/tel-00685104.
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Long term longitudinal surveys have the advantage to enable several sampling of the studied phenomena and then, with the repeated measures obtained, find a confirmed tendency. However, these long term surveys generate large epidemiological datasets including more sources of noise than normal datasets (e.g. one single measure per observation unit) and potential correlation in the measured values. Here, we studied data from a long-term epidemiological and genetic survey of malaria disease in two family-based cohorts in Senegal, followed for 19 years (1990-2008) in Dielmo and for 16 years (1993-2008) in Ndiop. The main objectives of this work were to take into account familial relationships, repeated measures as well as effect of covariates to measure both environmental and host genetic (heritability) impacts on the outcome of infection with the malaria parasite Plasmodium falciparum, and then use findings from such analyses for linkage and association studies. The outcome of interest was the occurrence of a P. falciparum malaria attack during each trimester (PFA). The two villages were studied independently; epidemiological analyses, estimation of heritability and individual effects were then performed in each village separately. Linkage and association analyses used family-based methods (based on the original Transmission Disequilibrium Test) known to be immune from population stratification problems. Then to increase sample size for linkage and association analyses, data from the two villages were used together.
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Saraceno, Luca. "Temporal association between childhood depressive symptoms and alcohol problem use in early adolescence : findings from a large longitudinal population-based study." Thesis, Cardiff University, 2011. http://orca.cf.ac.uk/54221/.
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My thesis addresses the nature of the longitudinal relationship between depressive symptoms at age 10 years and alcohol problem use at age 14 years. Using data from 4220 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC), a large population-based UK birth cohort, I examined the impact of relevant covariates on the relationship between these two behaviours and evidence of gender differences; testing furthermore for the moderating effects of peers' influences in this relationship. Childhood depressive symptoms were associated with increased risk of alcohol problem use in early adolescence for girls (O. R. 1.14, p-value = 0.016) but not boys. Covariates describing particularly the family and social environment influenced this association for girls. This association becomes smaller when these covariates were taken into account. Having a strong bond with alcohol-drinking peers interacted with depressive symptoms to increase risk of alcohol problem use in 14 year old girls (O. R. 1.18, p-value = 0.029). These findings provide support to a Family Interactional theoretical model and corroborate the growing evidence that family-related interventions to reduce alcohol use are particularly effective for girls. Future policy will have to consider that girls who experience high levels of depressive symptoms may be at particular risk of alcohol problem use if they affiliate with a peer group exerting strong pressure to drink.
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Costa, Hugo Câmara. "Cognitive, behavioral and familial associations of reading acquisition and academic achievement : a population-based longitudinal study from kindergarten to middle school." Thesis, Paris 5, 2014. http://www.theses.fr/2014PA05H115.
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Les études longitudinales en milieu scolaire débutant en maternelle permettent une analyse des facteurs propres à l'enfant et à son environnement impliqués dans le développement de la lecture et de la réussite scolaire. Cependant, les études visant à analyser l'influence longitudinale de ces facteurs dès l'école maternelle restent exceptionnelles en France. Une étude épidémiologique initiée en 2001 dans la Communauté Urbaine de Creusot Montceau (Saône-et-Loire, France) avait comme objectif l'examen des contributions des facteurs propres à l'enfant et des variables environnementales dans l'acquisition de la lecture et la réussite scolaire dès la maternelle (3-6 ans) jusqu'au milieu de l'école élémentaire (CE2, 8-9 ans). Le travail de thèse présenté a permis le prolongement de la période de recueil de donnés jusqu'à la fin du collège (3ème, 14-15 ans) représentant une période de suivi de 10 ans dans la population générale. L'objectif principal de ce travail est d'identifier les facteurs propres à l'enfant (cognitifs, académiques et comportementaux) et des variables environnementales (facteurs sociodémographiques et caractéristiques familiales) dans le développement de la lecture à la fin de l'école primaire (CM2) et la réussite scolaire à la fin du collège (3ème). Les échantillons comprenaient 829 enfant inscrits en Grande Section de Maternelle pendant l'année scolaire 2001-2001 (Cohorte 1, 90% de l'échantillon initial) suivis jusqu'à la fin du collège (année scolaire 2010-2011) et 812 enfants de Grande Section de Maternelle durant l'année 2003-2004 (Cohorte 3) suivis jusqu'à la fin de l'école élémentaire (Cours Moyen 2, année scolaire 2008-2009). En Grande Section de Maternelle, le recueil de données a compris l'évaluation des compétences cognitives, académiques et comportementales des enfants, ainsi que le recueil des informations concernant le contexte familial. Les mesures de réussite scolaire ont compris les résultats des enfants dans les évaluations nationales réalisées à la fin du collège pour la Cohorte 1, (Diplôme National du Brevet) et les performances des enfants dans une mesure standardisée de lecture de mots à la fin de l'école élémentaire pour la Cohorte 3 (ODEDYS, Jacquier-Roux, Valdois & Zorman, 2002). Les compétences de traitement phonologique, la connaissance de lettres et le comportement attentif étaient les prédicteurs le plus significatifs de la lecture de mots au Cours Moyen 2. Le signalement par les parents d'antécédents familiaux de difficultés de lecture était associé simultanément avec des difficultés de lecture et le comportement inattentif à la fin de l'école élémentaire. En 3ème année du collège, les compétences de langage oral, la connaissance de lettres, la mémoire verbal à court terme, le raisonnement perceptif (facteur non-verbal) et le comportement attentif des enfants en maternelle, ainsi que le niveau d'éducation des parents et le type de famille, ont prédit significativement la mesure de réussite scolaire générale à la fin du collège. En outre, les résultats ont montré l'influence de plusieurs caractéristiques familiales dont la nationalité du père, le mode de garde avant la scolarisation, les rituels d'endormissement et les antécédents familiaux de difficultés de lecture. Ces caractéristiques renvoient à des facteurs qui mettent un enfant en risque d'échec scolaire à la fin du collège. Ce travail contribue à la littérature scientifique existante concernant les facteurs propres à l'enfant et à son environnent familial liés à l'acquisition de la lecture et à la réussite scolaire. Les résultats permettent l'identification des facteurs familiaux mettant un enfant à risque d'échec scolaire. Il ont des importantes implications pour repérer le plus précocement possible les enfants à risque de développer des difficultés de lecture et d'échec scolaire et pour mettre en place des programmes d'intervention adéquats à ses difficultés dès le début des trajectoires académiques de l'enfantLongitudinal studies starting during kindergarten provide an appropriate method to investigate the child- and environmental-level factors that account for children's reading and academic achievement later in their educational trajectories. In France, studies designed to follow-up children longitudinally from kindergarten onwards remain scarce. An epidemiological study started in 2001 in the Urban Community of Creusot Montceau (Saône-et-Loire, France) sought initially to identify the factors associated with children's reading acquisition and academic achievement from preschool (3-6 years) to the middle of elementary school (Grade 3, 8-9 years). The PhD project reported here aimed to extend the original design of data collection to the end of middle school (Grade 9, 14-15 years) spanning a 10-year follow-up period in the general population. This work aimed to investigate the specific contributions of child-level factors (cognitive-academic skills, behavior problems) and environment-level factors (sociodemographic and family characteristics) for children's subsequent reading acquisition at the end of elementary school (Grade 5), as well as academic achievement at the end of middle school (Grade 9). The samples of analysis comprised 829 kindergarteners in the 2001-2002 school year (Cohort 1, 90% of the initial sample) followed through the end of middle school (Cohort 1, 2010-2011 school year) and 812 kindergarteners in the 2003-2004 school year (Cohort 3), from which a sub-sample of 154 participants was followed through the end of elementary school (2008-2009 school year). At kindergarten, assessment included measures of children's cognitive-academic and behavioral skills, as well as family background characteristics. Outcome measures were composed of children's results in the national evaluations performed at the end of middle school for Cohort 1 ("Diplôme National du Brevet") and of children's scores in standardized measures of word reading achievement at the end of elementary school for Cohort 3 (ODEDYS, Jacquier-Roux, Valdois & Zorman, 2002). The results indicated that children's phonological processing skills, letter knowledge and attentive behavior were the most robust predictors of word reading achievement at Grade 5. In addition, parental reports of familial antecedents of reading difficulties also contributed to predict word reading at Grade 5 and were specifically associated with both reading difficulties and inattention behavior at this grade level. At Grade 9, children's oral language skills, letter knowledge, short-term verbal memory, perceptual reasoning (non-verbal cognitive ability) and attentive behavior at kindergarten predicted significantly the outcome measure of general academic achievement at Grade 9, together with parental educational level and family structure. Moreover, results indicated the influence of several family characteristics referring to father's nationality, type of early childcare, language-based bedtime routines and familial antecedents of reading difficulties as risk factors for children's subsequent academic underachievement. The present work contributes to the extant literature regarding the child- and family-level factors associated with subsequent reading acquisition and academic achievement from kindergarten to elementary and middle school. Importantly, these results allowed the identification of novel familial risk factors that influence negatively children's subsequent academic trajectories. These findings have important implications regarding the child and family factors that should be targeted during kindergarten in order to prevent children's subsequent reading and academic difficulties and to promote adequate intervention strategies early in children's educational trajectories
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Chi, Lin-Yang. "Health and hospital service use in the population aged 75 and over : a longitudinal study of a community sample in Cambridge city." Thesis, University of Cambridge, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266234.
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Maund, David. "Moving-on from a rural parish : a multidisciplinary longitudinal study of population trends and migration in an area of the English-Welsh borderland." Thesis, Coventry University, 2008. http://eprints.worc.ac.uk/469/.
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This study is about migration and aims to analyse the complexities which underlie the movement of people in time and space. There are three major interdependent elements essential to such a study – data, a context and longitudinal time scale. The study commences with a discussion of various approaches which have been taken by scholars to the study of migration, drawing particular attention to the behavioural or decision making perspective. This is followed by an assessment of relevant data sources, including census enumerators’ books, parish registers and oral accounts. This piece of research has been structured to use these sources for an analysis of a study area in the middle English /Welsh Borderland, concentrating on the neighbourhood of the parish of Little Hereford. The salient geographical characteristics of the area and family structure are highlighted in Chapter 4, before an examination is made of its culture, ways of life and changing demographic profile in Chapters 5 and 6. The remainder of the study homes in on the details of migration, first looking at the pattern of movement in the decade 1871 to 1881 and then charting the movements of three core families (Bennett, Rowbury and Maund), with a particular focus on the last of these. It is these three families which give the longitudinal dimension to the study. An assessment of the role of place in migration decisions is attempted but even at this micro scale of analysis it proves difficult to get really close to the decisions made over a long time period.
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Butler, Anthony Gordon. "Dystonia : a comprehensive and longitudinal study of the epidemiological, social, economic and psychological implications of dystonia within the population of the North East of England." Thesis, University of Newcastle Upon Tyne, 2000. http://hdl.handle.net/10443/502.
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Dystonia is a little known neurological disease of the central nervous system and consists of a group of related movement disorders, characterised by involuntary and prolonged spasms of muscle contraction. Although it is nearly 90 years since this neurological disorder was first named, relatively little research had been undertaken into dystonia, for the first 65 years and it was not until the mid 1970's that researchers started to look at the disorder. This particular programme of research has taken place exactly over a six year period, starting in May 1993, and relates to a large number of different areas of study. This research has proven that dystonia is far more prevalent than previously thought, it is next to Parkinson's Disease in degree of prevalence and is far more common than other better known neurological conditions, such as Motor Neurone Disease, and yet it remains largely unknown to most members of the medical profession and the general public at large. Dystonia has been historically extremely difficult to diagnosis and this meant it has been previously very difficult to obtain sufficient numbers for study, which in turn has created a number of significant social and economic consequencesw, hich has mainly meant that most cases of people with dystonia have remained undiagnosed or misdiagnosed for many years. This research was designed to measure the severity and prevalence of dystonia in the northern part of the UK, the implication the disease has had on the working life and environment of each patient and how that person is coping with the various personal, social and family relationships caused by the onset and potential gradual deterioration of the disorder, as well as measuring the quality of life of each patient during a number of different therapies. Although there has been research into other neurological disabilities, very little is known about the implications that dystonia can have on the affected person and their families. This is the first time that all types of dystonia have been studied and that certain related subjects have been specifically included. This research has been enormously helped by the tremendous expansion in the use of Botulinurn Toxin therapy and although an enormous amount of work has been completed and accomplished during this research programme, it should never be forgotten that the subjects of this thesis are real people and that the implications and results of this research have had, and will have, a tremendous impact on their lives and that of their families.
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Natanzon, Yanina. "METABOLIC SYNDROME IN AN IMMUNOSUPPRESSED POPULATION: GENETIC CONTRIBUTION TO METABOLIC SYNDROME TRAITS IN THE WOMEN'S INTERAGENCY HIV STUDY." Case Western Reserve University School of Graduate Studies / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=case1449252475.
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Fekadu, Abebaw. "Studies on affective disorders in rural Ethiopia." Doctoral thesis, Umeå universitet, Psykiatri, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-37813.
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Background Affective disorders are poorly defined and studied in sub-Saharan Africa despite their substantial public health impact. Objectives Overall objective: To describe the epidemiology of selected affective disorders in rural Ethiopia. Specific objectives 1. To describe the validity and utility of the concept of minor depressive disorder (mD). 2. To describe the manifestation, prevalence and the short-term clinical and functional course and outcome of bipolar disorder. Subjects and methods Population: Zay community residents (age ≥16), and residents of Butajira (ages 15-49), in Southern Ethiopia. Study design: Population-based cross-sectional and longitudinal studies Case identification: For the identification of cases with bipolar disorder, a two stage process was employed. An initial screen used key informants and interview with the Composite International Diagnostic Interview (CIDI) to identify cases with probable bipolar disorder. A second confirmatory diagnostic assessment stage employed the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). For the identification of cases with mD, data from the CIDI was used. Follow-up: 312 cases with bipolar disorder from Butajira were followed up for a mean of 2.5 years (ranging 1-4 years) through monthly clinical assessments and annual symptom and functional ratings. Results The CIDI was administered to 1714 adults among the Zay and to 68, 378 adults among the Butajira residents. The prevalence of mD among the Zay and Butajira was 20.5% and 2.2% respectively. Up to 80% of cases with mD had used services for their symptoms, while a third to a half of cases had thought about self harm. Up to a sixth of cases had attempted suicide. Age, marital status, education and somatic symptoms were independently associated with mD. The prevalence of bipolar disorder among the Zay was 1.8%. During a 2.5-year follow-up of 312 cases with bipolar disorder from Butajira, 65.9% relapsed (47.8% manic, 44.3% depressive and 7.7% mixed episodes) while 31.1% experienced persistent illness. Female gender predicted depressive relapse whereas male gender predicted manic relapse. Only being on psychotropic medication predicted remission (OR=3.42; 95% CI=1.82, 6.45). Disability was much worse among bipolar patients than in the general population and was predicted by symptom se3verity. Conclusions This is the largest study on mD and bipolar disorder in Africa. mD appears to have potential clinical utility in this setting given its association with service use and risk. The identified risk factors for mD also suggest potential aetiological continuity with major depression. The relatively high prevalence of bipolar disorder among the Zay may be related to genetic predisposition perhaps mediated through a founder effect, but other factors need exploring. In relation to the outcome of bipolar disorder, this study indicates that, contrary to previous assumptions, the course of bipolar disorder is characterised by both manic and depressive relapses in a relatively proportionate fashion. Bipolar disorder also leads to significant levels of disability. This is the only prospective outcome study of bipolar disorder in Africa where cases were monitored systematically at short assessment intervals. Therefore, findings are likely to be more robust than previous reports.
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Halford, Christina, Thorne Wallman, Lennart Welin, Annika Rosengren, Annika Bardel, Saga Johansson, Henry Eriksson, Ed Palmer, Lars Wilhelmsen, and Kurt Svärdsudd. "Effects of self-rated health on sick leave, disability pension, hospital admissions and mortality : A population-based longitudinal study of nearly 15,000 observations among Swedish women and men." Uppsala universitet, Allmänmedicin och preventivmedicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-189468.
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BACKGROUND: Simple global self-ratings of health (SRH) have become increasingly used in national and international public health monitoring, and in recent decades recommended as a standard part of health surveys. Monitoring developments in population health requires identification and use of health measures, valid in relation to targets for population health. The aim of the present study was to investigate associations between SRH and sick leave, disability pension, hospital admissions, and mortality, adjusted for effects of significant covariates, in a large population-based cohort. METHODS: The analyses were based on screening data from eight population-based cohorts in southern and central Sweden, and on official register data regarding sick-leave, disability pension, hospital admissions, and death, with little or no data loss. Sampling was performed 1973--2003. The study population consisted of 11,880 women and men, age 25--99 years, providing 14,470 observations. Information on SRH, socio-demographic data, lifestyle variables and somatic and psychological symptoms were obtained from questionnaires. RESULTS: There was a significant negative association between SRH and sick leave (Beta -13.2, p<0.0001, and -9.5, p<0.01, in women and men, respectively), disability pension (Hazard ratio 0.77, p<0.0001 and 0.76, p<0.0001, in women and men, respectively), and mortality, adjusted for covariates. SRH was also significantly associated with hospital admissions in men (Hazard ratio 0.87, p<0.0001), but not in women (Hazard ratio 0.96, p0.20). Associations between SRH on the one hand, and sick leave, disability pension, hospital admission, and mortality, on the other, were robust during the follow-up period. CONCLUSIONS: SRH had strong predictive validity in relation to use of social insurance facilities and health care services, and to mortality. Associations were strong and robust during follow-up.
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Pontabry, Julien. "Construction d'atlas en IRM de diffusion : application à l'étude de la maturation cérébrale." Thesis, Strasbourg, 2013. http://www.theses.fr/2013STRAD039/document.
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L’IRM de diffusion (IRMd) est une modalité d’imagerie médicale in vivo qui suscite un intérêt croissant dans la communauté de neuro-imagerie. L’information sur l’intra-structure des tissus cérébraux est apportée en complément des informations de structure issues de l’IRM structurelle (IRMs). Ces modalités d’imagerie ouvrent ainsi une nouvelle voie pour l’analyse de population et notamment pour l’étude de la maturation cérébrale humaine normale in utero. La modélisation et la caractérisation des changements rapides intervenant au cours de la maturation cérébrale est un défi actuel. Dans ce but, ce mémoire de thèse présente une chaîne de traitement complète de la modélisation spatio-temporelle de la population à l’analyse des changements de forme au cours du temps. Les contributions se répartissent sur trois points. Tout d’abord, l’utilisation de filtre à particules étendus aux modèles d’ordre supérieurs pour la tractographie a permis d’extraire des descripteurs plus pertinents chez le foetus, utilisés ensuite pour estimer les transformations géométriques entre images. Ensuite, l’emploi d’une technique de régression non-paramétrique a permis de modéliser l’évolution temporelle moyenne du cerveau foetal sans imposer d’à priori. Enfin, les changements de forme sont mis en évidence au moyen de méthodes d’extraction et de sélection de caractéristiquesDiffusion weighted MRI (dMRI) is an in vivo imaging modality which raises a great interest in the neuro-imaging community. The intra-structural information of cerebral tissues is provided in addition to the morphological information from structural MRI (sMRI). These imaging modalities bring a new path for population studies, especially for the study in utero of the normal humanbrain maturation. The modeling and the characterization of rapid changes in the brain maturation is an actual challenge. For these purposes, this thesis memoir present a complete processing pipeline from the spatio-temporal modeling of the population to the changes analyze against the time. The contributions are about three points. First, the use of high order diffusion models within a particle filtering framework allows to extract more relevant descriptors of the fetal brain, which are then used for image registration. Then, a non-parametric regression technique was used to model the temporal mean evolution of the fetal brain without enforce a prior knowledge. Finally, the shape changes are highlighted using features extraction and selection methods
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Degen, Christina [Verfasser], and Johannes [Akademischer Betreuer] Schröder. "Given and acquired risk factors in cognitive decline, the development of Mild Cognitive Impairment, and Alzheimer’s Disease: results of a prospective, population-based, longitudinal study / Christina Degen ; Betreuer: Johannes Schröder." Heidelberg : Universitätsbibliothek Heidelberg, 2016. http://d-nb.info/1180736265/34.
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Park, Seung-Min. "An ageing population in a family and welfare state : the dynamics of family support and public pension systems, and their impact on late-life happiness in contemporary South Korea." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:041dae1e-8b4b-4ca6-9743-2a42b655e5bc.
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The purpose of this thesis is to analyze the dynamics of family support and public pension systems, and their impact on late-life happiness in contemporary South Korea. For this, three specific research questions, namely (1) the dynamics of intergenerational solidarity, public pension systems, and happiness; (2) the association between intergenerational solidarity and happiness; and (3) the association between public pension systems and happiness, are analysed by exploiting the Korean Longitudinal Study of Ageing. The analyses show that (1) the structural solidarity of older people is relatively stronger than of middle-aged people; (2) contacting is the key player in associational solidarity in later life; (3) middle-aged people supply more financial aid to their adult children than they receive from them, but the reverse applies to older people. Both middle-aged and older people actively exchange food, household items, and health-care supplies; (4) more older men receive the National Pension Scheme benefit than older women but the reverse is true for the Basic Old-Age Pension benefit; (5) the level of happiness in later life is very high but decreases as people age; (6) the number of adult children, frequency of contact, and amount of financial support are positively associated with the happiness of older people; and (7) the National Pension Scheme is positively associated with the happiness of older men while the Basic Old-Age Pension is negatively associated with the happiness of older people. The results suggest some policy implications for late-life happiness in contemporary South Korea. At the individual level, increased frequency of contact, availability of the children, and the amount of financial support can enhance late-life happiness. At the governmental level, the research suggests that the gendered structure of the National Pension Scheme and means-tested structure of the Basic Old-Age Pension should be reformed.
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Okeyo, Mercy Akinyi [Verfasser], and Reinhard [Akademischer Betreuer] Straubinger. "Longitudinal study regarding Borrelia burgdorferi sensu lato populations in defined habitats in Latvia / Mercy Akinyi Okeyo ; Betreuer: Reinhard Straubinger." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2020. http://d-nb.info/1219852376/34.
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Coughlin, Chris D. "Family influences on adolescent drug relapse : follow-up study of a treatment population." Thesis, 1990. http://hdl.handle.net/1957/38055.
Full textAbstract:
Relapse is a common occurrence in the treatment of
adolescent substance abuse. It is estimated that one out of
three adolescents will relapse after treatment termination.
Although much attention has been given to family factors which
influence an adolescent's use and abuse of drugs, this same
vigorous attention has not been given to determining if family
factors play a role in an adolescent resuming drug use after
treatment termination. It has been theorized that the same
family factors which increase the risk of an adolescent to use
and abuse drugs also can help in gaining an understanding of why
relapse occurs. Three prominent theories used to explain family
factors associated with drug use/abuse and relapse are genetic
and social learning theories, and family dysfunction.
The purpose of this study was to investigate if familial
factors, as proposed from the theories presented, were predictive
of relapse. The sample in this study consisted of 31 adolescents
who entered drug treatment between 1986 and 1988. Follow-up data
of the adolescent's pattern of drug use since treatment discharge
were collected through telephone interviews with the parent or
guardian of the adolescent one and a half to nineteen months
after treatment. The family information used in this study was
collected through self-report questionnaires given to the
adolescent at time of treatment. Specific family variables used
in this study were: parental and sibling substance abuse history,
number of parents in residence, past experience of physical
and/or sexual abuse, and history of running away from home.
Regression analyses were used to assess if these family variables
were associated with relapse.
Results of the data analyses found partial support for
genetic and social learning theories of relapse, as well as
relapse from a family dysfunction perspective. Findings
indicated that adolescents who lived with only one parent or
neither parent in comparison to those who lived with both
parents, those who had experienced physical and/or sexual abuse,
and those who perceived their father as not having a history of
substance abuse were more at risk to relapse. Findings further
indicated a cross-gender effect in that male adolescents who
reported mother as having a substance abuse history were more
likely to relapse. This same finding was not found for females
in this study. The results indicate that given specific family
dynamics, a sub-population of adolescents may be targeted on
entrance to treatment to be at greater risk to relapse.Graduation date: 1991
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Lee, Cheng Yun, and 李承芸. "A population-based longitudinal study on the combination of multimorbidity in Taiwan." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/37nzu6.
Full textAbstract:
碩士長庚大學
醫務管理學系
104
The prevalence of multimorbidity in general population is increasing due to the population aging. Therefore, the issues of disease burden and health policy changes became more important nowadays. This study aims to explore the combinations and temporality of multimorbidities while examining the differences of prognoses and medical consumptions among difference morbidity combinations. The study used retrospective national health insurance claim database to perform prospective analysis. A total of 131,144 subjects aged 30 years and beyond was collected during 1997-2012. Factor analysis was applied to explore combinations of multicomorbidities while structural equation modeling was used to perform path analysis. Cox proportional hazard model was used to analyze hazard ratio of mortality among multicomorbidity combinations whereas general linear model was used to compare the differences of medical consumptions. The results demonstrated that 87.78% and 74.95% of the study population were with 2 or more and 3 or more multicomorbidities, respectively. Five comorbidity combinations were identified from the analyses. Taking bone and joint degeneration diseases as the reference group, the hazard ratio of dying during study period was 1.684(95% CI: 1.559-1.820), 1.795(95% CI: 1.644-1.960), 1.509(95% CI: 1.392-1.635), and 1.394(95% CI: 1.278-1.520) in disease combinations of metabolic syndrome-derived diseases, neurodegenerative diseases, respiratory diseases, and malignant tumor and mental illness, respectively. Taking metabolic syndrome-derived diseases as the reference group, the total medical expenses were 1.822(95% CI: 0.579-0.621), 1.072(95% CI: 0.054-0.085), 1.060(95% CI: 0.042-0.074), and 1.436(95% CI: 0.345-0.378); the length of hospitalization stay was 1.361(95% CI: 0.297-0.320), 1.033(95% CI: 0.024-0.041), 1.124(95% CI: 0.108-0.125), and 1.225(95% CI: 0.194-0.212, in neurodegenerative diseases, bone and joint degeneration diseases, respiratory diseases, and malignant tumor and mental illness, respectively. This study proposed the major multicomorbidity combinations and their prognoses and medical consumptions among Taiwanese population. The findings are valuable for future health policy and interventions designs. The study also suggests that the integrations of different specialties are necessary based on the nature disease causality in general population.
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Ku, chia-ping, and 古家萍. "Longitudinal study on multi-dimensional interrelationships betweenliving-arrangement changes and medical service utilization amongolder population." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/23629258476280926164.
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碩士國立臺北護理健康大學
健康事業管理研究所
102
Background and objectives According to the definition of World Health Organization, the proportion of people aged over 65 years accounting for more than 7% of the entire population is referred to as an aging country. In addition to Korea (11.4%) and Japan (23.3%), Taiwan is the third country that fulfills this criterion of aging country since 1993. With the changes in the proportion of the population, the increase in the education for women, and the changes in the generation structures, the organization of the family also changes. It is estimated that the proportion of elderly population “who lives with spouse only” and “who lives alone” will continue to rise. There are several studies which focused on the factors to explore the use of health care services for the elderly, as well as quite a lot of changes in living arrangements related research on the use of medical services. However, the results of these studies varied according to the differences in the study design, the statistical methods and the enrolling subjects. In addition, studies which focused on the changes of the living arrangements and the temporal association with the use of dynamic changes of medical services are still relatively lacking. Therefore, we aimed to fill this knowledge gap in the present study. Research methods The serial databases of “Survey of Health and Living Status of the Elderly in Taiwan “ in the Academia Sinica from 1989 to 2003 were used for analysis in the present study. The latent growth curve model, the changes in the state for the use of medical services, and the relative risk trends affecting the elderly population living arrangements were analyzed. Research results We found that low levels of education, more comorbidities, and poor self-reported health status had higher odds to use the resources of outpatient and emergency department. There is a trend of increased use of the resources of emergency department with increasing age. Male gender, more comorbidities, old age, and poor self-rated health status have higher odds of hospitalization. at times higher odds of hospitalization . Male and poor self-rated health statuses are also at higher risk of longer hospitalization days. After controlling the baseline impact factors, cumulative transform living arrangements contents (time invariant) relative risk of various medical services use, only the increased relative risk of hospitalization days has a significant impact. But in the time change angle (time varying) analysis, older persons in long-term tracking process, changes in living arrangements if the content is living alone, which will be reflected in reduced medical outpatient and emergency use. But it will greatly increase the relative risk of hospitalization and number of days of hospitalization. Second, older persons in long-term tracking process, content remain with spouses living arrangement, which has significantly reduced use of emergency medical services and hospitalization risk reduction trends. Conclusions and recommendations Gender, age, number of diseases, level of education and self-rated health status, to some extent, these aging baseline background data, trends change will affect the utilization of medical services for the elderly. However, in the face of our country elderly population structures will inevitably tend to live alone and live with spouse only set contents, through the empirical findings of this study, elderly in long-term tracking process, changes in living arrangements if the content is living alone, which will be reflected in reduced medical outpatient and emergency use, but it will greatly increase the relative risk of hospitalization and number of days of hospitalization. Second, older persons in long-term tracking process, if the arrangement contents remain at has a spouse living, which have significantly reduced use of emergency medical services and hospitalization risk reduction trends.
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Escott, Benjamin. "Childhood Fracture Begets Childhood Fracture: A Population-based Study of Longitudinal Fracture Patterns in Ontario Children." Thesis, 2012. http://hdl.handle.net/1807/33411.
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Objectives: The objectives of this study were two-fold: (1) to describe the epidemiology of childhood fractures in Ontario; (2) to determine if having a fracture in childhood is associated with an increased risk of having a future fracture.
Methods: This was a population-based retrospective cohort study using Ontario health administration data. Children aged 0 to 15 years were grouped according to baseline fracture status. Associations between predictors and future fracture were assessed using Poisson and Cox PH regression.
Results: 43,154 Ontario children experienced a baseline fracture (17.5 per 1000 child years). Children with a baseline fracture had a 60% higher rate of fracture during 7 years of follow-up after adjustment for sex, rurality, history of previous fracture and the occurrence of head injury and soft-tissue injury.
Conclusions: The occurrence of a baseline fracture is associated with an increased rate of future fracture irrespective of age at time of baseline fracture.
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Lee, Hui-Lan, and 李惠蘭. "Community-based longitudinal study on the changes of self-rated health among older population in Taiwan." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/95677696231692180067.
Full textAbstract:
博士國立臺北護理健康大學
護理研究所
103
ABSTRACT Background and Purpose Older population self-rated health(SRH) reflects the multifaceted individual health status, is an important health forecasting and related indicators. The life course of individuals perceived health status, may show a different trend in the interaction of changes related factors. So far, domestic and foreign researchers focus on the older population less self-investigate the longitudinal health evaluation of dynamic change, our practice, in addition to continuing the development and changes longitudinal comparison of different health measure, but also the transverse link self-rated health in terms of gender, and age-period-cohort effect results. Expect from the life course perspective to clarify self-rated health community older population definition and meaning of long-term development framework in Taiwan, as well as for the quality of life of the predictive power; hope to enlarge our vision of successful aging older age groups, older age groups to provide further an important foundation for health promotion and preventive care. Methodology This study used a large national community tracking survey- Taiwan longitudinal study on aging (referred TLSA), the first stage using latent class growth analysis to discuss potential sub-groups of the overall health of the older population distribution formation evaluation, and then analyzed in the course of the life of older generations, socio-demographic, physiological, and psychological factors for the potential impact of sub-groups of classification. Then long-depth discussion with the passage of time, groups of individuals lurking beneath the trajectory of development, as well as track changes in physical and mental health is affected by those factors. The second stage through the age-period-cohort effect and three generations of cross-analysis perspective, an overview of the overall evolution of old population. And further based on self-rated health for three different measurements of self-rated health - global health, self-comparative health, age-comparative health, long-term trends in three different measurement methods compare. Result and conclusion Based on the results and found that pooled the following argument: 1. An overall self-assessment of health of older age groups there are differences in the base line rather produce high, medium and low cluster self-rated health. Factors causing differences in baseline factors covered socio-demographic characteristics, physiological factors, and psychological factors. 2. Differences in baseline health level, in the passage of time, hidden in the change between individuals will begin to emerge, making the cluster can be classified into five similar or dissimilar「classes」，we will be defined as: (1) Class 1 (n = 842, 21.4% of the total sample) represented “persistently poor,” subjects with the lowest SRH scores and with scores remaining persistently low; (2) Class 2 (n = 1160, 29.5%) represented “declined from moderate to poor,” subjects whose SRH scores declined year-by-year from moderate to successively lower; (3) Class 3 (n = 674, 17.1%) represented “steadily moderate,” subjects with persistently moderate SRH scores; (4) Class 4 (n= 802, 20.4%) represented “declined abruptly from good to poor,” subjects with the greatest magnitude of change in SRH, and whose final scores were low; and (5) Class 5 (n = 459, 11.6%) represented “persistently good,” subjects with the highest SRH scores, which remained persistently high. 3. Health "flat track" stable protective factors: more years of education, regular exercise tendencies, as well as the more satisfied with life. Health "track down" the risk factors are: age, ordinary economic conditions or poor, racial minorities, the more we feel the difficulties of daily activities of life, as well as suffering from chronic diseases more. 4. Self-rated health measure of self-comparison type is the most obvious intuitive feelings, prone to "ceiling effect," the results, and has alarm the role of the obvious warning, may decline as a pioneer in health assessment index. However, the overall health of the questions of self-assessment for the older population in the evaluation of the overall health of change has most clearly represented. Three different self-rated health measurement methods have the effects of age and cohort, indicating that changes in self-rated health is subject to birth cohort in effect. 5. Use different measurements had to be self-rated health to gender variables of three common characteristics: health assessment: (a) women are less than men; (2) the rate of decline between male and female health assessment changes are similar, women and magnitude and rate of decline is not greater than men; (3) men and women have very clear on health is good or bad, or change is “incommensurability" between the gender is a healthy feeling of "spatial distance" parallel lines, there is no intersection or overlap, Therefore, the health differences between the gender must be careful to verify the inference. 6. This study proposes: "On the whole self-rated health" measure to track trajectory in the health of the elderly population to grasp, it is important to a comprehensive index. Secondly, the other two comparative questions of self-comparison, peers compare the results of the self-assessment of health must be used with caution. The elderly population is divided generations can 3-5 years away from a level better. Finally, in practice the face, self-rated health for different research groups presented the long-term development and related influencing factors, should care strategy planning three sections of five different generations and ages. Keyword： older population, self-rated health, latent class growth analysis, age-period-cohort effect
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Ziegler, Lucy, M. Mulvey, Alison Blenkinsopp, Duncan R. Petty, and M. I. Bennett. "Opioid prescribing for cancer patients in the last year of life: a longitudinal population cohort study." 2015. http://hdl.handle.net/10454/10495.
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YesWe linked UK cancer registry data with the corresponding electronic primary care medical records of 6080 patients who died of cancer over a 7-year period in a large United Kingdom city. We extracted all prescriptions for analgesics issued to each patient in the linked cohort during the 12 months before death and analysed the extent and duration of strong opioid treatment with clinical and patient characteristics. Strong opioids were prescribed for 48% of patients in the last year of life. Median interval between first prescription of a strong opioid and death was 9 weeks (interquartile range 3-23). Strong opioid prescribing was not influenced by cancer type, duration of illness, or gender but was adversely influenced by older age. Compared with patients who died in a hospice, those who died in a hospital were 60% less likely to receive a strong opioid in primary care before admission (relative risk ratio 0.4, CI 0.3-0.5, P < 0.01). The study provides the first detailed analysis of the relatively late onset and short duration of strong opioid treatment in patients with cancer before death in a representative UK cohort. This pattern of prescribing does not match epidemiological data which point to earlier onset of pain. Although persistent undertreatment of cancer pain is well documented, this study suggests that strategies for earlier pain assessment and initiation of strong opioid treatment in community-based patients with cancer could help to improve pain outcomes.
National Institute for Health Research (NIHR) (RP-PG-0610-10114)
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Zhang, Bo. "Does Duration of Nicotine Replacement Therapy Use Matter in Quitting Smoking? A Longitudinal Study of Smokers in the General Population." Thesis, 2013. http://hdl.handle.net/1807/36077.
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Background and Objectives: Little is known about the impact of nicotine replacement therapy (NRT) use duration on smoking cessation in the general population. This study determines whether duration of NRT use is associated with smoking cessation.
Methods: Data were from the Ontario Tobacco Survey longitudinal study of a population-based cohort of baseline smokers who made serious quit attempts during 18 months of follow-up. The association between NRT (any NRT, patches, or gum) use duration and smoking cessation outcomes (short-term abstinence ≥1 month and long-term abstinence ≥12 months) was estimated by Poisson regression, adjusting for all confounding variables.
Results: Among the 1,590 eligible smokers, 933 (59%) did not use any NRT, 535 (34%) used NRT <8 weeks, and 112 (8%) used NRT ≥8 weeks at follow-up. The median duration of NRT use was 14 days. A consistent “J” shape of associations between quit aid use duration and smoking cessation outcomes (quit rates) was found. Using any NRT, patches, or gum <8 weeks was generally associated with a lower likelihood of quitting, but using them ≥8 weeks was generally associated with a higher likelihood of quitting, compared to not using them. Only using patches for the recommended duration (≥8 weeks) was associated with a higher likelihood of short-term (relative risk, RR 1.74, 95% confidence interval, CI 1.21-2.50) and long-term (RR 2.62, 95% CI 1.25-5.50) abstinence at the end of 18 months of follow-up, compared to not using patches. Using gum ≥8 weeks was not associated with short- or long-term abstinence at the end of 18 months of follow-up.
Conclusions: Using nicotine patches for the recommended duration is associated with successful short- and long-term abstinence in the general population. More efforts are needed to encourage smokers to use nicotine patches for eight or more weeks when attempting to quit.
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Chen, Men-Chun, and 陳孟春. "A Cohort Longitudinal Study of Long-term Survival and Resource Utilization for Patients with Cholangiocarcinoma Underwent Multimodality therapy–- A Population Base Study." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/71009887200350676596.
Full textAbstract:
碩士高雄醫學大學
醫務管理學研究所碩士在職專班
100
Introduction Cholangiocarcinoma is a malignant tumor ,the annual incidence has been rising worldwide over the past decades. Cholangiocarcinoma is highly lethal,the therapeutic intentions are predicted on the location of tumor as well as the resectability of disease . The purpose of this study is to evaluate survival difference and utilization of medical resource between cholangiocarcinoma patients treated with multimodality therapy . Method The study analyzed administrative claims date obtained from the Taiwan Bureau of National Health Insurance (BNHI).The date were collected from 1996 to 2009 with the diagnosis of cholangiocarcinoma (ICD-9-CM code 155.1,156.1,156.8 and 156.9). The statistic analysis was performed by X2-test、Kaplan-Meier analysis with log-rank test and cox-regression multivariate analysis and multiple linear regression test. Results Only 3153(37.3%) of 8458 patients with cholangiocarcinoma underwent cancer direct surgery . Men were accounted for 55.1% in this study group, most of them were older than 65 years, 53.9%. The annual incidence has been increased from 4.33 per 100000 in 1996 to 9.44 per 100000 in 2009(X2 -MH=531.7,P<0.001). The over-all mortality rate is 81.8% in the study period of 14 years. Parametric estimated median survival for patients receiving surgical resection was 16.72 months; bypass operaion 6.67 months; chemotherapy(C) 5.06 months;stent replacement(S)3.38 months;radiotherapy(R) 2.53 months,the difference is statistitally significant (P<0.001).Combination therapy, however, improved the treatment effect,data showed median survival for S+C,7.56 months;for S+R,4.83 months(P<0.001). Using multivariate analysis,surgery alone showed evidence of improved survival compared to non surgical treatment, radiotherapy alone was associated with survival decrement. Intrahepatic tumor ,age older then 65,cci>2,all with poor risk for survival (P<0.001). Regarding resource utilization ,the multiple linear rgression analysis showed surgery,intrahepatic + hilar tumor,cci>2,recent decade were associated with higher resource utilization ,while the elderly and regional hospital consumed lessly (P<0.001). Conclussion The annual incidence of cholangiocarcinoma has been increased,surgical resection carried the most feasible curative outcome by medion OS and cox regression analysis; combination therapy could improved the longterm survival. Medical resource ulilization could afford the data for policy making in BNHI.
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Sung, Ya-Li, and 宋雅俐. "Disability trends in the elderly population in Taiwan -“Longitudinal Study on Health and Living Status of Elderly in Taiwan”." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/u3h95a.
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碩士國立臺北護理健康大學
長期照護研究所
102
Abstract This study was aimed to investigate the key factors in the health functional status, health care, associate factors and trend of disability among the elders in Taiwan. The study was retrospective, derived from the “Longitudinal Study on Health and Living Status of Elderly in Taiwan”; the database included the sociodemography, health function, health seeking & behavior and the relationship between them and Basic Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). There are 3,216 elders enrolled in the study, average age of 70.8(±6.5), slightly more in male than female, low level of education in general. Disability status had been remarkable in elderly, female, lower education leveler, single. Rather, CI-Q & habitual exercising affecting ADL, CI-Q score higher and those without habitual exercise resulted in more severity of disability, the same trend in self-perceiving healthy & with falling record within one year affecting IADL also. As for any decline trend in daily living had been observed in this study; in 1999, IADL limitation observed in 43.7% of sample subjects in total; up-rose to 75.5% and 81.8% in 2003 and 2007, respectively; with regard to ADL in counterpart, ADL limitation observed in 12.1%, up-rose to 20.7% and 39.7% in 2003 and 2007, respectively. This reflected, just within short years, the significant downshift by the time passing in ADL & IADL. The decline curve could be well-depicted. Aging decay of living functioning could occur in all age strata, however the disabled representing in non-elderly subpopulation. It’s easier to gain access in elderly rather than in the disabled. Based on the associated factors and trends in the functioning decline, might facilitate coping & handling of intervention care positioning and designing, i.e. catching the disability, maintaining the functional level rather than morbidity detection, just following the long-term care policy making in advanced countries.
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Kang, Pei-Jen, and 康珮瑱. "The Natural History of Dual Infection with Hepatitis B Virus and Hepatitis C Virus: A Population-Based Longitudinal Study." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/73427970086475787152.
Full textAbstract:
碩士臺灣大學
流行病學研究所
95
Background and Aims: Taiwan is an endemic area of hepatitis B. Dual infection of hepatitis B virus (HBV) and hepatitis C virus (HCV) is not unusual. However, the natural history of dual infection in the population remained unknown. We sought to determine the liver-related morbidity and mortality and the long-term viremia profiles of HBV for dual infection in a population-based longitudinal cohort study. Materials and Methods: The cohort consisted of 5189 men (2643 HBsAg (+) alone, 176 anti-HCV (+) alone, 161 HBsAg (+) and anti-HCV (+), and 2209 HBsAg (−) and anti-HCV (−)) aged 30 years or older who were enrolled between 1989 and 1992, and followed through December 31, 2005. HBV genotype and DNA levels were measured using polymerase chain reaction-based assays. Plasma HBV DNA levels were assessed for multiple samples consecutively collected from each man with dual infection of HBV and HCV. All statistical tests were two-sided. Results: The incidence of hepatocellular carcinoma and liver-related mortality (per 100000 persons) were 296.8 and 202.9, 202.0 and 39.9, 221.9 and 176.4, and 12.6 and 9.5, respectively, in those who were positive for HBsAg alone, those who were positive for anti-HCV alone, those who were positive for HBsAg and anti-HCV, and those who were negative for both markers. During follow-up, 35 men with dual infection developed chronic liver disease (i.e., hepatocellular carcinoma, liver cirrhosis, or longitudinal alanine aminotransferase [ALT] elevation defined as abnormality detected in >=50% of the visits), and 6 had hepatic flare (ALT>5×upper limit of the normal levels). Initial viral load was positively associated with the persistence of high viral load (>=10^4.45 copies/mL). High tracking for viral load, as evidenced by the high predictability of initial viral load, was observed within 6 years. Longitudinal high HBV viral load detected in >=50% of the visits (adjusted odds ratio [OR]=2.71, 95% confidence interval [CI]=1.15~6.36) and anti-HCV optical density (adjusted OR=1.25, 95% CI=1.01~1.55) were significantly associated with the development of chronic liver disease. An extremely high viral load (defined as >=10^5.81 copies/mL) (OR=13.36, 95% CI=1.49~120.0) was the only predictor for hepatic flare. Conclusions: The incidence of HCC and liver-related mortality among men with dual infection were similar to those among men with HBV monoinfection. HBV viral load was fairly stable, as evidenced by long-term persistence of high viral load. Persistently high viral load and anti-HCV optical density were associated with the development of chronic liver disease.
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Yang, Ling-Chun, and 楊玲珺. "A Cohort Longitudinal Study of Long-term Survival and Resource Utilization for Patients with Unresectable Cholangiocarcinoma Undergoing Biliary Tract Stenting- A Nation-wide Population Based Study." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/15135048790499304572.
Full textAbstract:
碩士高雄醫學大學
醫務管理暨醫療資訊學系碩士在職專班
101
Introdution There is only about 15-20% cases of cholangiocarcinoma being resectable when diagnosed. Palliative therapy of biliary drainage became a mainstay for those unresectable cholangiocarcinoma. Percutaneous biliary drainage (PTBD) and endoscopic biliary drainage (ERBD) are two important procedures for biliary drainage to improve cholestasis caused by tumor mass. The purpose of this study is to evaluate survival difference and utilization of medical resource between unresectable cholangiocarcinoma under going biliary stents of ERBD and PTBD. Methods The study analyzed claim date obtained from Tawain Bureau of National Health Insurance. The date were collected from 1996-2009 with the diagnosis of cholangiocarcinomas. Among them, those with unresectable cancers, under went biliary stents were included in this study (ICD-9-CM code 155.1；156.1；156.8 and 156.9) The statistic analysis was performed by X2 –test, Kaplan Meier analysis with log rank test; and multistep Cox hazard regression analysis; multivariate linear regression analysis. Result There are total 2700 cases of unresectable cholangiocarcinomas undergoing biliary stents, 2199 of 2700 case(81.4%) undergoing PTBD, while 501 of 2700 case(18.6%) undergoing ERBD. Clinical outcomes The elderly, old than 75 years, carried poor outcome, HR=1.68, p<0.001; patients undergoing ERBD got better outcome, than those undergoing PTBD, HR=0.82, p=0.001; patients with extrahepatic cholangiocarcinoma, HR=0.75, p=0.001; biliary stent combined with chemotherapy or radiotheraphy had better outcomes, HR=0.77, p=0.001. Residents in Southern or Eastern Taiwan had better outcomes than those in other districts in Taiwan HR=0.88, and HR=1.51, p<0.005. Resource utilization Patients undergoing ERBD expensed less hospital charges and then that of PTBD, also have short hospital study.Patients with extrahepatic cholangiocarcinoma also expensed less hospital charges and short hospital stay than those with intrahepatic cholangiocarcinoma (p<0.005). Combined with chemotherapy, however, expensed more hospital charges and longer in hospital. P<0.004 and p<0.001. Conclusion The patients undergoing ERBD demonstrated better clinical outcome and expsensed less medical resource utilization. On the other hand, patients with extrahepatic cholangiocarcinoma got better clinical outcome and expense less medical resource utilization. Patients with combined therapy of chemotherapy or radiotheraphy expensed more medical resource utilization. While they got better clinical outcomes.
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Pryor, Laura E. "Developmental trajectories of body mass index in early childhood : an 8-year longitudinal study." Thèse, 2010. http://hdl.handle.net/1866/3917.
Full textAbstract:
Trajectoires développementales de l’IMC durant l’enfance: Une étude longitudinale sur 8 ans.
Introduction : L’obésité infantile, origine de nombreux problèmes de santé, représente un grand défi en santé publique. Récemment, l’importance d’étudier l’évolution du surpoids durant l’enfance ainsi que les facteurs de risques précoces pour l’obésité a été reconnue. Les trajectoires développementales d’indice de masse corporelle (IMC) chez les jeunes représentent une approche innovatrice qui nous permet de mieux comprendre cette problématique importante.
Objectifs: 1) Identifier des trajectoires développementales distinctes de groupes d’enfants selon leur IMC durant l’enfance, et 2) Explorer les facteurs de risques précoces qui prédisent l’appartenance de l’enfant à la trajectoire d’IMC le plus élevé
Hypothèses: 1) On s’attend à retrouver un groupe d’enfants qui suit une trajectoire d’IMC élevée durant l’enfance. 2) On s’attend à ce que certaines caractéristiques de la mère (ex : tabac pendant la grossesse et IMC élevé), soient associées à l’appartenance de l’enfant au groupe ayant la trajectoire «IMC élevé ». Méthodes: Estimation des trajectoires développementales d’IMC d’enfants, dans un échantillon populationnel (n=1957) au Québec (ELDEQ). Les IMC ont été calculés à partir de données fournies par les mères des enfants et recueillis chaque année sur une durée de 8 ans. Des données propres à l’enfant sa mère, ainsi que socioéconomiques, ont étés recueillies. Une régression logistique multinomiale a été utilisée pour distinguer les enfants avec un IMC élevé des autres enfants, selon les facteurs de risques précoces.
Les programmes PROC TRAJ (extension de SAS), SPSS (version 16), et SAS (version 9.1.3) ont été utilisés pour ces analyses.
Résultats: Trois trajectoires d’IMC ont étés identifiées : IMC « bas-stable » (54,5%), IMC « modéré » (41,0%) et IMC « élevé et en hausse » (4,5%). Le groupe « élevé et en hausse » incluait des enfants pour qui l’IMC à 8 ans dépassait la valeur limite pour l’obésité. Les analyses de régression logistique ont révélé que deux facteurs de risques maternels étaient significativement associés avec la trajectoire “en hausse” par rapport aux deux autres groupes : le tabac durant la grossesse et le surpoids maternel. Conclusions: Des risques d’obésité infantile peuvent êtres identifiés dès la grossesse. Des études d’intervention sont requises pour identifier la possibilité de réduire le risque d’obésité chez l’enfant en ciblant le tabac et le surpoids maternelle durant la grossesse. Mots clés: Indice de masse corporelle (IMC), obésité infantile, trajectoires développementales de groupe, facteurs de risque précoce, étude populationnelle, tabac pendant la grossesse, obésité maternelle.Developmental Trajectories of Body Mass Index in Early Childhood: An 8-Year Longitudinal Study. Introduction: Childhood obesity has become one of the greatest Public Health challenges this century, affecting not only developed nations, but increasingly low- and middle-income countries as well. Estimating developmental trajectories of Body Mass Index (BMI) during early childhood represents an innovative approach towards a better understanding of the development of this health problem. Objective: To identify groups of children with distinct developmental trajectories of Body Mass Index (BMI) between the ages of five months and eight years, and to identify early-life risk factors that distinguish children in an atypically elevated BMI trajectory group. Methods: Group-based developmental trajectories of BMI were estimated from annual maternal assessments (5 months to 8 years) in a large population sample (n=1957). Measures of height and weight, as well as family and child characteristics were obtained yearly from mothers. Multivariate logistic regression was used to distinguish children with elevated BMI from other children, using pre and early post-natal risk factors. Results: Three trajectories of BMI were identified: low-stable BMI (54.5%), moderate BMI (41.0%) and high-rising BMI (4.5%). The high-rising group included children whose BMI, at eight years of age, exceeded the cut-off value for obesity. Multinomial logit regression analyses revealed that two maternal risk factors were significantly associated with the high-rising BMI trajectory group as compared to both the low and moderate groups: smoking during pregnancy and maternal overweight. Conclusions: Antecedents of childhood obesity can be identified during pregnancy. Intervention studies are needed in order to test the possibility that targeting maternal smoking and maternal obesity during pregnancy would reduce the risk of childhood obesity in the offspring. Keywords: Body Mass Index (BMI), child obesity, Group-based developmental trajectories, early life predictors, population-based study, maternal smoking, maternal obesity.
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Cadieux, Nathalie. "Professions réglementées et détresse psychologique : regards croisés avec la population en emploi au Canada." Thèse, 2012. http://hdl.handle.net/1866/9063.
Full textAbstract:
Cette thèse doctorale poursuit l’objectif de mieux comprendre le rôle joué par la
profession réglementée en tant que déterminant de la détresse psychologique de la population en emploi au Québec et au Canada. Ceci, dans un contexte où plusieurs
ordres professionnels représentant des professions réglementées, s’inquiètent de la santé
mentale de leurs membres et de la pression considérable exercée sur eux dans une
économie caractérisée par des pénuries de main-d’oeuvre importantes. Cette thèse fut
également inspirée par les nombreuses limites constatées à la suite d’une revue de la littérature sur la santé mentale au travail, alors que les risques différenciés auxquels seraient soumis ces professionnels, comparativement à l’ensemble de la population en emploi, demeurent largement à documenter. La profession réglementée s’associe-t-elle directement à l’expérience de détresse psychologique? Quelles sont les conditions de travail susceptibles de conduire au développement ou à l’aggravation de la détresse psychologique pour ces professions? Dans le but de mieux comprendre le rôle joué par la profession réglementée en
matière de détresse psychologique, nous avons eu recours à un modèle théorique
multidimensionnel qui postule que les contraintes et les ressources découlent d’un
ensemble de structures sociales incluant la profession, le travail, la famille, le réseau
social hors-travail et les caractéristiques personnelles. Ce modèle découle des théories
micro et macro en sociologie (Alexander et al., 1987; Ritzer, 1996), de l’approche agent-structure(Archer, 1995; Giddens, 1987) ainsi que de la théorie du stress social (Pearlin,1999). Trois hypothèses sont soumises à l’étude à travers ce modèle. La première hypothèse, est à l’effet que la profession réglementée, les conditions de travail, la famille ainsi que le réseau social hors-travail et les caractéristiques individuelles, contribuent directement et conjointement à l’explication du niveau de détresse psychologique. La seconde hypothèse induite par le modèle proposé, pose que le milieu de travail médiatise la relation entre la profession réglementée et le niveau de détresse psychologique. La troisième et dernière hypothèse de recherche, postule enfin que la relation entre le milieu de travail et le niveau de détresse psychologique est modérée par les caractéristiques individuelles ainsi que par la famille et le réseau social hors-travail.
Ces hypothèses de recherche furent testées à partir des données longitudinales de
l’Enquête nationale sur la santé de la population (ENSP) (cycles 1 à 7). Les résultats obtenus sont présentés sous forme de 3 articles, soumis pour publication, lesquels constituent les chapitres 5 à 7 de cette thèse. Dans l’ensemble, le modèle théorique proposé obtient un soutien empirique important et tend à démontrer que la profession réglementée influence directement les chances de vivre de la détresse psychologique au fil du temps, ainsi que le niveau de détresse psychologique lui-même. Les résultats indiquent que les professions réglementées sont soumises à des risques différenciés en termes de conditions de travail susceptibles de susciter de la détresse psychologique. Notons également que la contribution du milieu de travail et de la profession réglementée s’exerce indépendamment des autres dimensions du modèle (famille, réseau social hors-travail, caractéristiques personnelles). Les résultats corroborent l’importance de considérer plusieurs dimensions de la vie d’un individu dans l’étude de la détresse psychologique et
mettent à l’ordre du jour l’importance de développer de nouveaux modèles théoriques,
mieux adaptés aux contextes de travail au sein desquels oeuvrent les travailleurs du
savoir. Cette thèse conclue sur les implications de ces résultats pour la recherche, et sur les retombées qui en découlent pour le marché du travail ainsi que pour le développement futur du système professionnel québécois et canadien.This doctoral thesis aims to understand the role played by the regulated occupations as a determinant of psychological distress of the working population in Quebec and Canada. This, in a context where several professional organizations, representing regulated occupations, are concerned about the mental health of their members and the pressure exerted on them in an economy characterized by important shortages of labor. This thesis was also inspired by the many limitations observed after a literature review on work and mental health, whereas the differentiated risks which would be subjected to these professionals, compared to the total working population, remains largely undocumented. Is there a direct link between the regulated occupation and the experience of psychological distress? What working conditions contribute to the development or accentuate psychological distress for these regulated occupations? In order to better understand the role played by the regulated occupations in psychological distress, this thesis proposes a multidimensional theoretical model which postulates that the constraints and resources are generated by a set of social structures including the regulated occupation, the working conditions, family, social network outside of work and personal characteristics. This model stems from the micro and macro theories in sociology (Alexander et al., 1987; Ritzer, 1996), the agent-structure approach (Archer, 1995; Giddens, 1987) as well as the social stress theory (Pearlin, 1999). Three hypotheses are subject to analysis through the model. The first hypothesis assumes that regulated occupations, work conditions, family, social network outside the workplace, and individual characteristics contribute directly and jointly to explaining the level of psychological distress. The second hypothesis induced by the proposed model postulates that the workplace mediates the relationship between regulated occupations and psychological distress levels. The third and final research hypothesis postulates that the relationship between the workplace and psychological distress levels is moderated by individual characteristics, as well as by family and the social network outside the workplace.These hypotheses have been validated using longitudinal data from the National population health survey (NPHS) (cycles 1 to 7). The results of these analyses are presented in three articles submitted for publication, which are the chapters 5-7 of this thesis. Overall, the theoretical model gets an important empirical support and suggests that the regulated occupations directly influence the chances of living psychological distress over time as well as the level of psychological distress itself. The results also suggest that the regulated occupations are exposed to differentiated risks in terms of working conditions likely to generate psychological distress. The contribution of the workplace and regulated occupations is exercised independently of other dimensions of the model (family, social network outside of work, personal characteristics). The results also corroborate the importance in considering many dimensions of the life of an individual in the psychological distress and to put on the agenda the importance of developing new theoretical models, better suited to the realities characterizing today’s working environments in which knowledge workers work. This thesis concludes on the implications of these findings for research, and the benefits it brings to the labor market and for the future development of the professional system in Quebec and Canada.
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Sabirova, Alina. "The association between childhood attention-deficit/hyperactivity disorder medication use and symptoms of mental health problems in adolescence : A 15-year longitudinal population-based study." Thèse, 2017. http://hdl.handle.net/1866/20561.
Full text
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Matshipi, Moloko. "The relationship between physical activity and the risk of type 2 diabetes mellitus in Ellisras rural young adults aged 22 to 20 years : Ellisras longitudinal study." Thesis, 2019. http://hdl.handle.net/10386/2935.
Full textAbstract:
Thesis (M.Sc. (Physiology)) -- University of Limpopo, 2019Background Type 2 diabetes mellitus (T2DM) is an increasing challenge globally, and is estimated to affect 439 million adults by 2030. This estimate is linked to an unhealthy lifestyle with characteristics such as low physical activity (PA) and high plasma glucose levels (PGLs). Studies associating PA with insulin resistance and diabetes among adults and adolescents have been conducted widely in developed countries. Such studies are scanty among rural populations, especially in Africa. Assessment of the burden of diabetes and associated lifestyle risk factors in developing countries is essential in order to encourage appropriate intervention strategies to counter the increasing prevalence. Aim and objectives The aim of this study was to investigate the relationship between PA and T2DM among rural young adults aged 22 to 30 years in Ellisras area in Limpopo Province, South Africa Methods A total of 713 young adults (349 males and 364 females) who have been part of the Ellisras Longitudinal Study participated in the current study. Physical activity data was collected using a validated questionnaire. After an overnight fast, participants provided fasting venous blood samples for determination of plasma glucose and insulin. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance. Anthropometric measurements (waist circumference and height) were performed using standard procedures. Linear and logistic regressions were used to assess the relationship between PA, pre-diabetes, insulin resistance and T2DM; and the odds of having T2DM with low PA levels. Results The prevalence of physical inactivity was 67.3 and 71.0% for males and females, respectively. That of pre-diabetes was between 45.7% and 50.2%. The prevalence of diabetes was 9.6% for males and 10.1% for females while for insulin resistance was 22.9% for males and 29.3% for females. Linear regression found a significant relationship (p<0.05) between physical activity and blood glucose (ß =5.715; 95% CI 4.545; 6.885), waist circumference (ß = 37.572; 95% CI 25.970; 49.174) and waist-toheight ratio (ß = 0.192; 95% CI 0.087; 0.296). Logistic regression found a significant (p<0.05) relationship between low physical activity and T2DM (Odds ratio = 2.890; 95% CI 1.715; 4.870) and insulin resistance (Odds ratio = 1.819; 95% CI 1.266; 2.614). Conclusion Physical activity is low in this population, and is independently associated with T2DM and insulin resistance. KEY WORDS Type 2 diabetes mellitus; pre-diabetes; insulin resistance; physical activity; young adults; rural South African population.
Vrije University, Amsterdam, The Netherlands, and the University of Limpopo
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CHENG, SU MIN, and 鄭素敏. "Evaluation of Bone Mineral Density in healthy examination populations: A Three- Year longitudinal study." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/3h8xr4.
Full textAbstract:
碩士元培醫事科技大學
醫學影像暨放射技術系碩士在職專班
104
Evaluation of Bone Mineral Density in healthy examination populations: A Three- Year longitudinal study Student：Su-Min Cheng Advisor：Chiung-Wen Kuo, Ph. D. Institute of Medical Imaging and Radiological Technology Yuanpei University of Medical Technology Abstract The purpose of this study was to investigate the effect of serum biomarkers on bone mineral density (BMD) in three years longitudinal study. A total of 290 subjects (232 males and 58 females), aged 26 to 46 years were enrolled from 2012 to 2015. Measurements of BMD were performed using dual- energy X-ray absorptiometry at L2- L4. Serum was collected including cholesterol, triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), glucose, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). In stepwise regression analysis analyses, the body weight was positively associated with BMD (β = 0.002, p < 0.05) and ALT was negatively associated with BMD (β = -0.001, p < 0.05).This retrospective study still had some limitations. The study showed that the longitudinal tracking study in those measurements of bone mineral density is necessary for further changes. Further experimentation is necessary in order to understand the exact mechanisms involved. Our results suggested low body weight and high ALT were deleterious factor on BMD. Keywords: bone mineral density (BMD), alanine aminotransferase (ALT), dual- energy x-ray absorptiometry