RESUMEN
OBJECTIVES: To investigate the concurrent use of 'at-risk' (AR) drinking (>10 units of alcohol per week) and prescription medications, while controlling for sociodemographic, and health-related factors, among older adults (aged 65-89 years). DESIGN: Cross-sectional survey. SETTING: Data from Health Survey of England, 2013. INTERVENTIONS: None. PARTICIPANTS: General population survey of 2169 adults aged 65-89 years. PRIMARY OUTCOME MEASURES: AR drinking (>10 units per week). Secondary outcome was AR drinking defined as >14 units of alcohol per week limit (the cut-off used by the Department of Health for AT drinking). RESULTS: Twenty-seven per cent (n=568) of the sample were AR drinkers. Factors associated with alcohol consumption were gender, age, social class, marital status, rurality of dwelling, deprivation index, self-reported general health, cigarette smoking, body mass index, exercise level, health and well-being scores' and number of prescription drugs. Logistic regression analysis showed that males were more likely to be AR drinkers (OR 3.44, 95% CI 2.59 to 4.57, p<0.0001) than females. Each year increase in age, lowered the probability of AR drinking by a factor of 0.95 (95% CI 0.93 to 0.98, p<0.0001). Using prescription drugs reduced AR drinking by a factor of 0.92 (95% CI 0.85 to 0.93, p=0.033), after controlling for age, sex and rurality of dwelling. No other predictors were significant. Similar results were obtained for AR drinking of >14units per week. CONCLUSION: AR drinking is more likely in older men than women. The odds of AR drinking lessens, as individuals age, and using prescription drugs also reduces AR drinking.
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Consumo de Bebidas Alcohólicas/epidemiología , Medicamentos bajo Prescripción/uso terapéutico , Anciano , Anciano de 80 o más Años , Estudios Transversales , Inglaterra/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , MasculinoRESUMEN
BACKGROUND: The high prevalence of children's asthma symptoms, worldwide, is unexplained. We examined the relation between maternal pre-pregnancy weight and body mass index (BMI), and asthma symptoms in adolescents. METHODS: Data from 6945 adolescents born within the Northern Finland Birth Cohort 1986 were used. Prospective antenatal and birth outcome data, including maternal pre-pregnancy weight and BMI, and asthma symptoms in adolescent offspring at age 15-16 years, were employed. Logistic regression analyses were performed to examine the associations between relevant prenatal factors and asthma symptoms during adolescence. RESULTS: Current wheeze (within the past year) was reported by 10.6% of adolescents, and physician-diagnosed asthma by 6.0%. High maternal pre-pregnancy BMI was a significant predictor of wheeze in the adolescents (increase per kilogram per square metre unit; 2.7%, 95% CI 0.9 to 4.4 for ever wheeze; 3.5%, 95% CI 1.3 to 5.8 for current wheeze), and adjusting for potential confounders further increased the risk (2.8%, 95% CI 0.5 to 5.1; 4.7%, 95% CI 1.9 to 7.7, respectively). High maternal pre-pregnancy weight, in the top tertile, also significantly increased the odds of current wheeze in the adolescent by 20% (95% CI 4 to 39), and adjusting for potential confounders further increased the risk (OR=1.52, 95% CI 1.19 to 1.95). Results were similar for current asthma. Furthermore, these significant associations were observed only among adolescents without parental history of atopy but not among those with parental history of atopy. CONCLUSIONS: The association demonstrated here between maternal pre-pregnancy overweight and obesity, and asthma symptoms in adolescents suggests that increase in asthma may be partly related to the rapid rise in obesity in recent years.
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Asma/epidemiología , Obesidad/epidemiología , Mujeres Embarazadas/psicología , Adolescente , Asma/patología , Índice de Masa Corporal , Peso Corporal , Estudios de Cohortes , Femenino , Finlandia/epidemiología , Edad Gestacional , Humanos , Modelos Logísticos , Embarazo , Diagnóstico Prenatal/psicología , Diagnóstico Prenatal/estadística & datos numéricos , Prevalencia , Estudios Prospectivos , Ruidos Respiratorios/diagnóstico , Índice de Severidad de la Enfermedad , Fumar/epidemiología , Fumar/psicología , Factores Socioeconómicos , Encuestas y Cuestionarios , Aumento de Peso/fisiologíaRESUMEN
Little attention has been given to the relationship between fever and the severity of asthma. The authors studied 202 successive admissions of children with asthma over a period of 16 months to investigate the relationship between fever and the clinical course of asthma. There were 38 febrile children (18.8%), who were mostly younger than 5 years. Febrile children had a shorter mean hospital stay than afebrile children (1.7 vs 2.0 days). There were 25 episodes of acute severe asthma (13%): 2 among the 38 febrile children (5.2%), compared with 23 episodes among the remaining 164 afebrile children (14%). Three children, who had very severe asthma requiring transfer to an intensive care unit, were afebrile. Radiological abnormalities (collapse/consolidation) occurred in 13 cases: 3 from the febrile and 10 from the afebrile group. Monitoring body temperature is important in cases of asthma. Febrile children tend to be younger and are more likely to have a less severe clinical course of asthma.
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Asma/complicaciones , Asma/diagnóstico , Fiebre/virología , Adolescente , Factores de Edad , Asma/tratamiento farmacológico , Asma/epidemiología , Niño , Preescolar , Femenino , Fiebre/tratamiento farmacológico , Fiebre/epidemiología , Humanos , Lactante , Tiempo de Internación/estadística & datos numéricos , Masculino , Monitoreo Fisiológico/métodos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Reino Unido/epidemiologíaRESUMEN
BACKGROUND: Considerable variation in the prevalence of childhood asthma and its symptoms (wheezing) has been observed in previous studies and there is evidence that the prevalence has been increasing over time. METHODS: We have systematically reviewed the reported prevalence and time trends of wheezing symptoms among children, worldwide and within the same country over time. All studies comprising more than 1000 persons and meeting certain other quality criteria published over a 16-year period, between January 1990 and December 2005, are reported and a comparison of ISAAC (International Study of Asthma and Allergies in Childhood) and non-ISAAC studies is made, in part as a way of expanding the power to examine time trends (the older studies tend to be non-ISAAC), but also to examine possible methodological differences between ISAAC and non-ISAAC questions. RESULTS: A wide range of current prevalence of wheeze was observed between and within countries over time. The UK had the highest recorded prevalence of 32.2% in children aged 13-14 in 1994-5 and Ethiopia had the lowest prevalence, 1.7% in children aged 10-19 in 1996. All studies in Australia and the UK were compared using multiple logistic regression. ISAAC phase I and III studies reported significantly higher prevalence of current wheeze (OR = 1.638) compared with non-ISAAC studies, after adjusting for various other factors (country, survey year, age of child, parental vs child response to the survey). Australia showed a significantly higher prevalence of current wheezing (OR = 1.343) compared with the UK, there was a significant increase in the prevalence odds ratio per survey year (2.5% per year), a significant decrease per age of child (0.7% per year), and a significantly higher response in current wheezing if the response was self-completed by the child (OR = 1.290). These factors, when explored separately for ISAAC and non-ISAAC studies, showed very different results. In ISAAC studies, or non-ISAAC studies using ISAAC questions, there was a significant decrease in current wheezing prevalence over time (2.5% per year). In non-ISAAC studies, which tend to cover an earlier period, there was a significant increase (2.6% per year) in current wheezing prevalence over time. This is very likely to be a result of prevalence of wheezing increasing from the 1970s up to the early 1990s, but decreasing since then. CONCLUSION: The UK has the highest recorded prevalence of wheezing and Ethiopia the lowest. Prevalence of wheezing in Australia and the UK has increased from the 1970s up to the early 1990s, but decreased since then and ISAAC studies report significantly higher prevalences than non-ISAAC studies.
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Asma/epidemiología , Recolección de Datos/métodos , Recolección de Datos/normas , Salud Global , Ruidos Respiratorios/diagnóstico , Adolescente , Asma/patología , Niño , Países Desarrollados , Países en Desarrollo , Femenino , Humanos , Masculino , Prevalencia , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
There is little agreement as to the most appropriate thermometer, the anatomical site to carry out temperature measurement in children with cancer, or the type of thermometer preferred by the patients. The authors carried out this study to assess temperature measurement in children with cancer who were admitted for febrile episodes. The body temperatures of children with cancer who were admitted consecutively between January and October 2005 to the paediatric department because of febrile episodes were measured on admission and over the next 24-36 hours using an electronic thermometer sublingually as the standard reference site. These measurements were compared with those obtained with two ear-based thermometers, a forehead thermometer, and from the axilla (representing current practice). The parents were asked about the type of thermometer they used at home and the children were asked about the type of thermometer they preferred. There were 34 admissions during this period, of which 19 (56%) were confirmed as febrile. Altogether, 108 sets of temperature measurements were obtained, producing a total of 540 measurements from these admissions. Measurements with the two ear-based thermometers in febrile children achieved higher sensitivity than that with axillary and the forehead measurements. The ear-based thermometer was the most common type used at home while the forehead thermometer was the one preferred by the children. In conclusion, ear-based temperature measurements in febrile children were more accurate than axillary and forehead temperature measurements. The current practice of axillary temperature measurement needs to be re-considered.
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Fiebre/diagnóstico , Neoplasias/complicaciones , Evaluación en Enfermería/métodos , Termografía/métodos , Termómetros/normas , Adolescente , Análisis de Varianza , Axila , Temperatura Corporal , Niño , Preescolar , Conducta de Elección , Investigación en Enfermería Clínica , Fiebre/etiología , Fiebre/psicología , Frente , Humanos , Suelo de la Boca , Mucosa Bucal , Evaluación en Enfermería/normas , Enfermería Oncológica , Aceptación de la Atención de Salud/psicología , Psicología Infantil , Sensibilidad y Especificidad , Termografía/instrumentación , Termografía/enfermería , Membrana TimpánicaRESUMEN
BACKGROUND: While some studies suggest that poor fetal growth rate, as indicated by lower birth weight, is associated with poor respiratory function in childhood, findings among adults remain inconsistent. A study was undertaken to determine the association between early growth and adult respiratory function. METHODS: A longitudinal birth cohort study was performed of 5390 men and women born full term and prospectively followed from the fetal period to adulthood. Weight at birth and infancy were recorded, and forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were assessed by standard spirometry at age 31 years. RESULTS: Adult FEV(1) and FVC increased linearly with higher birth weight in both men and women with no apparent threshold. After adjustment for sex, adult height and other potential confounders operating through the life course, every 500 g higher birth weight was associated with a higher FEV(1) of 53.1 ml (95% CI 38.4 to 67.7) and higher FVC of 52.5 ml (95% CI 35.5 to 69.4). These positive associations persisted across categories of smoking, physical activity and body mass index, with the lowest respiratory function noted among those with lower birth weight who were smokers, led a sedentary lifestyle or were overweight. Weight gain in infancy was also positively associated with adult lung function. CONCLUSION: Birth weight is continuously and independently associated with adult respiratory function. It is plausible that poor growth in early life may restrict normal lung growth and development, which could have long-term consequences on lung function later in life.
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Crecimiento/fisiología , Pulmón/fisiología , Adulto , Peso al Nacer/fisiología , Estatura/fisiología , Estudios de Cohortes , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Masculino , Capacidad Vital/fisiologíaRESUMEN
Allergen-induced secretion of Th2-type cytokines and IgE production have recently been reported to be increased in mice treated with 1,25(OH)(2)D, the active form of vitamin D. Our objective was to investigate whether vitamin D supplementation in infancy is associated with the risk of atopy, allergic rhinitis, and asthma. The Northern Finland Birth Cohort consists of all individuals in the two most northern provinces of Finland who were due to be born in 1966. Data on vitamin D supplementation during the first year of life was obtained in 1967. Current asthma and allergic rhinitis were reported at age 31 years (n = 7,648), and atopy determined by skin-prick test in a sub-sample still living in northern Finland or the Helsinki area (n = 5,007). The prevalence of atopy and allergic rhinitis at age 31 years was higher in participants who had received vitamin D supplementation regularly during the first year compared to others (OR 1.46, 95%CI 1.4-2.0, and OR 1.66, 95%CI 1.1-1.6, respectively). A similar association was observed for asthma (OR 1.35, 95%CI 0.99-1.8). These associations persisted after adjustment for a wide range of behavioral and social factors (adjusted: OR 1.33 for all, P = 0.01 for atopy, P = 0.001 for allergic rhinitis, and P = 0.08 for asthma). We observed an association between vitamin D supplementation in infancy and an increased risk of atopy and allergic rhinitis later in life. Further study is required to determine whether these observations reflect long-term effects on immune regulation or differences in unmeasured determinants of vitamin D supplementation.