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1.
Front Psychiatry ; 14: 1101956, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36896349

RESUMEN

Introduction: There are few studies investigating genetic factors related to suicidal ideation or behavior in older adult populations. Our aim was to test associations between passive and active suicidal ideation and polygenic risk scores (PRSs) for suicidality and other traits of relevance for suicidality in old age (i.e. depression, neuroticism, loneliness, Alzheimer's disease, cognitive performance, educational attainment, and several specified vascular diseases) in a population-based sample aged 70 years and older. Methods: Participants in the prospective H70 study in Gothenburg, Sweden, took part in a psychiatric examination that included the Paykel questions on active and passive suicidal ideation. Genotyping was performed with the Neurochip (Illumina). After quality control of the genetic data the sample included 3467 participants. PRSs for suicidality and other related traits were calculated based on summary statistics from recent GWASs of relevance. Exclusion of persons with dementia or incomplete data on suicidal ideation yielded 3019 participants, age range 70-101 years. Associations between past year suicidal ideation (any level) and selected PRSs were analysed using general estimation equation (GEE) models, adjusted for sex and age. Results: We observed associations between passive/active suicidal ideation and PRSs for depression (three versions), neuroticism, and general cognitive performance. After excluding individuals with current major depressive disorder (MDD), similar associations were seen with PRS for neuroticism, general cognitive performance and two PRSs for depression. No associations were found between suicidal ideation and PRSs for suicidality, loneliness, Alzheimer's disease, educational attainment, or vascular disease. Discussion: Our results could indicate which types of genetic susceptibility that are of importance for suicidality in old age, and these findings can help to shed light on potential mechanisms that may be involved in passive and active suicidal ideation in late-life, also in those with no current MDD. However, due to the limited sample size, the results need to be interpreted with caution until replicated in larger samples.

2.
J Lesbian Stud ; 27(1): 60-73, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35699301

RESUMEN

Lesbians are at greater risk of mental health problems than heterosexual women, and bisexual individuals are even more likely to report mental health problems. No study has yet tested whether there are any mental health differences between German lesbians, bisexual women, and female controls. We tested for mental health differences between matched groups of 161 lesbian and bisexual women and 161 women in the general population, as well as between matched groups of 79 lesbians and 79 bisexual women. Lesbian and bisexual women reported more mental health problems than population-based women. In contrast, bisexual women did not differ in mental health from lesbians. Therefore, German lesbian and bisexual women constitute a risk group for mental health problems. To improve lesbian and bisexual women's mental health, attempts should be made to lower the frequency of minority stressors, and best-practice mental health interventions made available.


Asunto(s)
Homosexualidad Femenina , Minorías Sexuales y de Género , Femenino , Humanos , Homosexualidad Femenina/psicología , Salud Mental , Bisexualidad/psicología , Conducta Sexual
3.
Artículo en Inglés | MEDLINE | ID: mdl-36360856

RESUMEN

BACKGROUND: The study aimed to explore the psychometric properties of two versions of the Patient Health Questionnaires (PHQ-9 and PHQ-2) on screening for Major Depressive Disorder (MDD) among Spanish-speaking Latin American adult immigrants in Santiago, and to explore factors associated with a higher risk of occurrence of MDD among them. METHODS: A representative sample of 897 Spanish-speaking immigrants completed the PHQ-9. The Composite International Diagnostic Interview (CIDI) was employed to evaluate MDD. Internal consistency and structural validity were evaluated using Cronbach's α coefficient and confirmatory factor analysis (CFA). Convergent validity with the 7-item General Anxiety Disorder Scale (GAD-7) was assessed using Spearman's correlations. Sensitivity, specificity, positive predictive values, and area under the receiver operating characteristic (ROC) curve were calculated for different cut-off points. Logistic regression analysis was used to identify factors associated with the risk of MDD. RESULTS: Cronbach's α coefficient of the PHQ-9 was 0.90; item-total correlation coefficients ranged from 0.61 to 0.76 and correlation with the GAD-7 was moderate (r = 0.625; p < 0.001). CFA on three alternative models suggests a plausible fit in the overall sample and among two of the subsamples: Peruvians and Venezuelans. Taking the results of CIDI as the gold standard for MDD, the area under the ROC curve was 0.91 (95% confidence interval (CI): 0.83~1.0). When the cut-off score was equal to 5, values of sensitivity, specificity, and Youden's index were 0.85, 0.90, and 0.75, respectively. Multivariate logistic regression analyses showed that the influence of having three or more children (OR = 3.91, 95% CI: 1.20~12.81; p < 0.05), residency in Chile of up to three years (OR = 1.79, 95% CI: 1.07~3.00; p < 0.05), active debt (OR = 2.74, 95% CI: 1.60~4.70; p < 0.001), a one (OR = 2.01, 95% CI: 1.03~3.94; p < 0.05) and two or more events of adversity during childhood (OR = 5.25, 95% CI: 1.93~14.3; p < 0.01) on the occurrence of MDD was statistically significant. Reliability (α = 0.62), convergent (r = 0.534; p < 0.01) and criterion (AUC = 0.85, 95% CI: 0.67~1.00) validity coefficients of the PHQ-2 were weaker than for the PHQ-9. CONCLUSIONS: The PHQ-2 and the PHQ-9 are reliable and valid instruments for use as screeners for MDD among Spanish-speaking populations of Latin America.


Asunto(s)
Trastorno Depresivo Mayor , Emigrantes e Inmigrantes , Adulto , Niño , Humanos , Cuestionario de Salud del Paciente , Trastorno Depresivo Mayor/diagnóstico , Estudios Transversales , Depresión/diagnóstico , Reproducibilidad de los Resultados , Chile , Encuestas y Cuestionarios , Tamizaje Masivo , Psicometría
4.
Int J Public Health ; 67: 1605048, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36090841

RESUMEN

Objectives: We quantified adherence to COVID-19 preventive measures and explored associated factors, after the first and during the second Swiss epidemic waves. Methods: With an observational cohort study in a representative sample of individuals aged 15 years and more, we analysed the association between self-reported adherence to COVID-19 preventive measures (respect of simple hygiene rules; respect of social distancing rules; wearing a mask) and socio-demographic factors, the existence of a chronic disease, and the existence of a previous confirmed COVID-19 episode. Results: Highest adherence was to simple hygiene rules, followed by social distancing rules and mask wearing, with a slight decrease for simple hygiene rules and a strong increase for mask wearing between visits. Men were significantly less likely to respect simple hygiene rules and wear a mask in public. Participants aged 65 years and more (versus 25-64 years) and those with at least one chronic disease (versus none) were two times more likely to respect social distancing rules and wear a mask. Conclusion: Adherence to social distancing rules and mask wearing was rather poor, especially compared to other countries.


Asunto(s)
COVID-19 , Epidemias , COVID-19/epidemiología , COVID-19/prevención & control , Humanos , Higiene , Masculino , Autoinforme , Suiza/epidemiología
5.
Int J Public Health ; 67: 1604582, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35693196

RESUMEN

Objectives: To evaluate the prevalence of numerous risky driving behaviors (RDBs) and the associated risk of road traffic accidents (RTA) in a population-based sample of adolescent drivers (14-19 years) of Tuscany, Italy. Methods: The frequency of participation -by age and sex- often RDBs were investigated: Multivariable analyses were performed to evaluate the association between RDBs and the risk of RTA and severe RTA. Results: 2,737 adolescents were included in the study. Talking to passenger(s), listening to loud music, speeding, and texting showed the highest weekly participation rates. For all the considered RDBs, the frequency of participation significantly increased with age. Males reported a significantly higher participation in speeding, DUI of alcohol or drugs; while females reported listening to loud music and talking to passenger(s) more frequently. All the considered RDBs were significantly associated with the risk of RTA and severe RTA. Conclusion: The prevalence of RDBs and the associated risk of RTA largely varied in adolescents. Findings provide evidence for tailoring prevention interventions and suggest the need to include common- but traditionally overlooked- RDBs in road safety campaigns.


Asunto(s)
Accidentes de Tránsito , Conducción de Automóvil , Adolescente , Femenino , Humanos , Masculino , Prevalencia , Investigación , Factores de Riesgo , Asunción de Riesgos
6.
Eur Child Adolesc Psychiatry ; 31(6): 979-990, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33566188

RESUMEN

There has been little research on whether younger children with developmental coordination disorder (DCD) symptoms have an increased risk for emotional and behavioral problems. This study examined whether coordination difficulties are associated with emotional and behavioral problems (emotional symptoms, conduct problems, hyperactivity/inattention, peer problems, reduced prosocial behavior) in preschool children and the role of autistic traits in this association. Data (N = 1042, age 58-71 months) were analyzed from the Tama Children's Survey (TCS). The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was used to measure coordination difficulty symptoms. Information was obtained on emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) and on autistic traits with the Social Responsiveness Scale (SRS). Higher autistic traits were based on SRS cutoff scores (53.5 for boys and 52.5 for girls). Logistic regression analysis was used to assess associations between the variables. In adjusted models, children with probable DCD (pDCD) were significantly more likely to score above the clinical thresholds on all SDQ emotional/behavioral domains. However, nearly all of these associations became nonsignificant after including autistic traits in the analysis. Additional analyses showed that children with pDCD with higher autistic traits had significantly increased odds for emotional problems (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.52-13.19), hyperactivity/inattention (OR: 3.74, 95% CI: 1.45-9.64), peer problems (OR: 15.81, 95% CI: 5.96-41.99), and total difficulties (OR: 28.78, 95% CI: 7.23-114.57), compared to children with pDCD alone. These results indicate that the increased risk of emotional/behavioral difficulties in preschool children with pDCD might be mediated by autistic traits.


Asunto(s)
Trastorno Autístico , Problema de Conducta , Preescolar , Emociones , Femenino , Humanos , Japón , Masculino , Problema de Conducta/psicología , Encuestas y Cuestionarios
7.
Psychol Med ; 52(13): 2481-2491, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-33267929

RESUMEN

BACKGROUND: Experimental work in animals has shown that DNA methylation (DNAm), an epigenetic mechanism regulating gene expression, is influenced by typical variation in maternal care. While emerging research in humans supports a similar association, studies to date have been limited to candidate gene and cross-sectional approaches, with a focus on extreme deviations in the caregiving environment. METHODS: Here, we explored the prospective association between typical variation in maternal sensitivity and offspring epigenome-wide DNAm, in a population-based cohort of children (N = 235). Maternal sensitivity was observed when children were 3- and 4-years-old. DNAm, quantified with the Infinium 450 K array, was extracted at age 6 (whole blood). The influence of methylation quantitative trait loci (mQTLs), DNAm at birth (cord blood), and confounders (socioeconomic status, maternal psychopathology) was considered in follow-up analyses. RESULTS: Genome-wide significant associations between maternal sensitivity and offspring DNAm were observed at 13 regions (p < 1.06 × 10-07), but not at single sites. Follow-up analyses indicated that associations at these regions were in part related to genetic factors, confounders, and baseline DNAm levels at birth, as evidenced by the presence of mQTLs at five regions and estimate attenuations. Robust associations with maternal sensitivity were found at four regions, annotated to ZBTB22, TAPBP, ZBTB12, and DOCK4. CONCLUSIONS: These findings provide novel leads into the relationship between typical variation in maternal caregiving and offspring DNAm in humans, highlighting robust regions of associations, previously implicated in psychological and developmental problems, immune functioning, and stress responses.


Asunto(s)
Metilación de ADN , Epigenoma , Recién Nacido , Humanos , Niño , Preescolar , Estudios Prospectivos , Estudios Transversales , Epigénesis Genética , Estudio de Asociación del Genoma Completo , Proteínas de Unión al ADN , Factores de Transcripción
8.
J Pediatr ; 241: 212-220.e2, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34687692

RESUMEN

OBJECTIVE: To test the association of material deprivation and the utilization of vision care services for young children. STUDY DESIGN: We conducted a population-based, repeated measures cohort study using linked health and administrative datasets. All children born in Ontario in 2010 eligible for provincial health insurance were followed from birth until their seventh birthday. The main exposure was neighborhood-level material deprivation quintile, a proxy for socioeconomic status. The primary outcome was receipt of a comprehensive eye examination (not to include a vision screening) by age 7 years from an eye care professional, or family physician. RESULTS: Of 128 091 children included, female children represented 48.7% of the cohort, 74.4% lived in major urban areas, and 16.2% lived in families receiving income assistance. Only 65% (n = 82 833) had at least 1 comprehensive eye examination, with the lowest uptake (56.9%; n = 31 911) in the most deprived and the highest uptake (70.5%; n =19 860) in the least deprived quintiles. After adjusting for clinical and demographic variables, children living in the least materially deprived quintile had a higher odds of receiving a comprehensive eye examination (aOR 1.43; 95% CI 1.36, 1.51) compared with children in the most materially deprived areas. CONCLUSIONS: Uptake of comprehensive eye examinations is poor, especially for children living in the most materially deprived neighborhoods. Strategies to improve uptake and reduce inequities are warranted.


Asunto(s)
Utilización de Instalaciones y Servicios/economía , Accesibilidad a los Servicios de Salud/economía , Disparidades en Atención de Salud/economía , Clase Social , Trastornos de la Visión/diagnóstico , Pruebas de Visión/economía , Niño , Preescolar , Utilización de Instalaciones y Servicios/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Lactante , Estudios Longitudinales , Masculino , Ontario , Pruebas de Visión/estadística & datos numéricos
9.
Alzheimers Dement (N Y) ; 7(1): e12197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34337136

RESUMEN

INTRODUCTION: Subjective cognitive decline (SCD) represents self-reported problems with memory, a possible early sign of dementia. Little is known about SCD among sexual and gender minority (SGM) adults who identify as lesbian, gay, bisexual, and/or transgender or gender non-binary. METHODS: Data were weighted to represent population estimates from 25 states' 2015-2018 Behavioral Risk Factor Surveillance System to describe SCD in adults ≥45 years by SGM status. Logistic regression tested associations between demographic and health conditions. RESULTS: SCD prevalence was higher in SGM (15.7%; 95% confidence interval [CI]:13.1-18.2) than in non-SGM adults (10.5%; 95% CI:10.1-10.9; P < .0001). SGM adults with SCD were also more likely to report functional limitations due to SCD than non-SGM adults with SCD, 60.8% versus 47.8%, P = .0048. Differences in SCD by SGM status were attenuated after accounting for depression. DISCUSSION: Higher prevalence of SCD in SGM adults highlights the importance of ensuring inclusive screenings, interventions, care services, and resources for SGM adults.

10.
Clin Endocrinol (Oxf) ; 95(6): 891-900, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34170568

RESUMEN

OBJECTIVE: Smoking has been associated with a reduced risk of thyroid cancer, but whether the association varies between higher- and lower-risk cancers remains unclear. We aimed to assess the association between smoking and risk of thyroid cancer overall as well as by tumour BRAF mutational status as a marker of potentially higher-risk cancer. DESIGN AND PATIENTS: We recruited 1013 people diagnosed with thyroid cancer and 1057 population controls frequency-matched on age and sex. METHODS: Multivariable logistic regression was used to assess the association overall and in analyses stratified by tumour characteristics. We used sensitivity analysis to assess the potential for selection bias. RESULTS: We found little evidence of an association with current smoking (odds ratio [OR] = 0.93; 95% confidence interval [CI]: 0.69-1.26; current vs. never smoking), but a higher number of pack-years of smoking was associated with a lower risk of thyroid cancer (OR = 0.75; 95% CI: 0.57-0.99; ≥20 pack-years vs. never). However, after correcting for potential selection bias, we observed a statistically significant inverse association between current smoking and risk of thyroid cancer (bias-corrected OR = 0.65; 95% CI: 0.51-0.83). Those with BRAF-positive cancers were less likely to be current smokers than those with BRAF-negative cancers (prevalence ratio: 0.79; 95% CI: 0.62-0.99). CONCLUSION: We found smoking was inversely related to thyroid cancer risk and, in particular, current smoking was associated with a reduced risk of potentially more aggressive BRAF-positive than the likely more indolent BRAF-negative papillary thyroid cancers.


Asunto(s)
Proteínas Proto-Oncogénicas B-raf , Neoplasias de la Tiroides , Humanos , Modelos Logísticos , Proteínas Proto-Oncogénicas B-raf/genética , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides/etiología , Neoplasias de la Tiroides/genética , Fumar Tabaco
11.
Front Pharmacol ; 11: 324, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32390825

RESUMEN

Pharmacogenetic analysis has generated translational data that could be applied to guide treatments according to individual genetic variations. However, pharmacogenetic counseling in some mestizo (admixed) populations may require tailoring to different patterns of admixture. The identification and clustering of individuals with related admixture patterns in such populations could help to refine the practice of pharmacogenetic counseling. This study identifies related groups in a highly admixed population-based sample from Mexico, and analyzes the differential distribution of actionable pharmacogenetic variants. A subsample of 1728 individuals from the Mexican Genomic Database for Addiction Research (MxGDAR/Encodat) was analyzed. Genotyping was performed with the commercial PsychArray BeadChip, genome-wide ancestry was estimated using EIGENSOFT, and model-based clustering was applied to defined admixture groups. Actionable pharmacogenetic variants were identified with a query to the Pharmacogenomics Knowledge Base (PharmGKB) database, and functional prediction using the Variant Effect Predictor (VEP). Allele frequencies were compared with chi-square tests and differentiation was estimated by FST. Seven admixture groups were identified in Mexico. Some, like Group 1, Group 4, and Group 5, were found exclusively in certain geographic areas. More than 90% of the individuals, in some groups (Group 1, Group 4 and Group 5) were found in the Central-East and Southeast region of the country. MTRR p.I49M, ABCG2 p.Q141K, CHRNA5 p.D398N, SLCO2B1 rs2851069 show a low degree of differentiation between admixture groups. ANKK1 p.G318R and p.H90R, had the lowest allele frequency of Group 1. The reduction in these alleles reduces the risk of toxicity from anticancer and antihypercholesterolemic drugs. Our analysis identified different admixture patterns and described how they could be used to refine the practice of pharmacogenetic counseling for this admixed population.

12.
BMJ Open ; 9(6): e026356, 2019 06 19.
Artículo en Inglés | MEDLINE | ID: mdl-31221877

RESUMEN

OBJECTIVES: To assess the level of functional health literacy (HL) and its antecedents and consequences in an adult population-based sample, using the Italian version of Newest Vital Sign (NVS-IT). DESIGN: Cross-sectional study. SETTING: General population. PARTICIPANTS: 984 people were randomly selected from the resident registers of 11 general practitioners; a total of 452 (46.2%) of the selected people completed the study. Inclusion criteria were the following: 18-69 years of age and Italian speaking. Exclusion criteria included cognitive impairment, severe psychiatric diseases and end-stage diseases. OUTCOME MEASURES: HL levels as assessed by the NVS-IT and the following potential HL predictors and consequences were assessed using logistic regression models: sociodemographic characteristics, body mass index, presence of long-term illnesses, self-reported health status, health services use in the last 12 months. RESULTS: High likelihood of limited HL, possibility of limited HL and adequate HL were found in 11.5%, 24.6% and 63.9% of the sample, respectively. The results of the multivariate logistic model for the antecedents showed that the risk of having high likelihood or possibility of limited HL levels increases with age (OR 1.07, 95% CI 1.05 to 1.09), lower educational level (OR 4.03; 95% CI 3.41 to 7.49) and with worse financial situation (OR 1.64; 95% CI 1.17 to 2.63). As far as health outcomes are concerned, HL resulted to be positively associated with self-reported health status (OR 2.25, 95% CI 1.75 to 2.75). CONCLUSIONS: Findings show a good level of functional HL in the population. However, older, less educated and poorer population groups showed to have a higher likelihood of suffering from limited or inadequate HL. Efforts should be made to design and implement public health policies and interventions tailored to different HL levels. TRIAL REGISTRATION NUMBER: CEAVC:10113.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Italia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Reproducibilidad de los Resultados , Traducción , Adulto Joven
13.
Front Psychol ; 10: 1003, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31133937

RESUMEN

The aim of this study was to examine alcohol/drug use and problems across psychiatric diagnoses and to what extent associations between each psychiatric diagnosis and alcohol/drug use and problems were independent from the potential confounding effects of psychiatric comorbidity, socioeconomic status, sex and age. We used a dataset comprising a linkage between a large population-based and cross-sectional study among Norwegian adolescents (the youth@hordaland conducted in 2012) and national registry-based data on specialist mental health care use during the 4 years prior to the survey (2008 to 2011). The study sample included 16 to 19 year olds who participated in the youth@hordaland survey and consented to the linkage with patient registry data (n = 9,408). Among these, 853 (9%) had received specialist mental health care and comprised the clinical group, while the rest (n = 8,555) comprised the comparison group. The main outcome variables were several self-reported indicators for alcohol/drug use, including any alcohol use, frequent alcohol intoxication, high-level alcohol consumption, and lifetime illicit drug use, as well as one indicator for potential alcohol/drug-related problems: a positive CRAFFT-score. Adolescents receiving specialist mental health care (n = 853) reported more frequently alcohol/drug use and problems compared to adolescents not receiving these services (Cohens d's ranging from 0.09 to 0.29, all p ≤ 0.01). Anxiety, depression, conduct disorders, eating disorders, ADHD, and trauma-related disorders were all associated with single measures of alcohol/drug use and problems, with odds ratios (ORs) ranging from 1.58 to 4.63, all p < 0.05) in unadjusted models. Trauma-related disorders, depression and conduct disorders were also positively associated with higher scores on a combined indicator of alcohol/drug use and problems (ORs ranging from 1.89 to 3.15, all p < 0.01), even after the full adjustment from psychiatric comorbidity and sociodemographic variables (adjusted odds ratios ranging from 1.61 to 2.79, p < 0.05). These results suggest that alcohol/drug use and problems were slightly more common among adolescents who received specialist mental health care during the past 4 years compared with the general adolescent population, and adolescents with trauma-related disorders, depression and conduct disorders were high-risk groups for alcohol/drug use and problems.

14.
Thyroid ; 29(3): 341-348, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30700206

RESUMEN

BACKGROUND: The incidence of thyroid cancer has rapidly increased, and ecological evidence suggests this is due in some part to over-diagnosis. Understanding pathways to diagnosis could help determine whether unnecessary diagnosis can be avoided. METHODS: A population-based sample (n = 1007) of thyroid cancer patients diagnosed between July 2013 and August 2016 was recruited from Queensland, Australia (response rate 67%). Information from structured telephone interviews was used to describe diagnostic pathways for thyroid cancer, to investigate factors associated with diagnostic pathways, and to assess the most prevalent modes of diagnoses by which the lowest-risk, potentially over-diagnosed thyroid cancers (intrathyroidal microcarcinomas) are detected. RESULTS: Only 38% of participants presented with symptoms potentially related to thyroid cancer. Older age at diagnosis was associated with a lower prevalence of symptomatic diagnosis (prevalence ratio [PR] = 0.46 [confidence interval (CI) 0.31-0.68] for 70-79 vs. <30 years), as was frequent medical contact, while living in rural/regional areas was associated with a higher prevalence of symptomatic diagnosis (PR = 1.17 [CI 1.00-1.37] for rural/regional areas vs. major cities). Symptomatic diagnosis also occurred more for those whose tumors had adverse histopathological features (larger size, lymph node involvement, lymphovascular invasion). The likelihood of diagnosis of intrathyroidal microcarcinomas was greatest for those having surgical resection or monitoring for benign thyroid disease (PR = 3.87 [CI 2.81-5.32] and PR = 2.21 [CI 1.53-3.18], respectively). CONCLUSIONS: A minority of newly detected thyroid cancer cases were diagnosed because of symptoms. Access to medical care and factors related to cancer aggressiveness were associated with how diagnoses occurred. The likelihood of diagnosing the lowest-risk thyroid cancers was higher in situations related to management of other thyroid conditions. Adherence to thyroid management guidelines could reduce some thyroid cancer over-diagnosis, but ultimately better diagnostic tools are needed to differentiate between indolent cancers and those of clinical significance.


Asunto(s)
Carcinoma Papilar/diagnóstico , Uso Excesivo de los Servicios de Salud/prevención & control , Evaluación de Síntomas , Neoplasias de la Tiroides/diagnóstico , Adolescente , Adulto , Factores de Edad , Anciano , Carcinoma Papilar/epidemiología , Carcinoma Papilar/patología , Estudios de Casos y Controles , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Incidencia , Metástasis Linfática , Masculino , Persona de Mediana Edad , Prevalencia , Queensland , Riesgo , Neoplasias de la Tiroides/epidemiología , Neoplasias de la Tiroides/patología , Adulto Joven
15.
J Adolesc Young Adult Oncol ; 8(1): 40-48, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30222486

RESUMEN

PURPOSE: Contacting childhood cancer survivors (CCS) to assess reasons for declining receipt of follow-up care after treatment is difficult and participation in surveys may be low, resulting in biased results. We sought to demonstrate effective recruitment and population-based sampling methods to improve response and minimize bias. METHODS: Four hundred and seventy CCS diagnosed between 2000 and 2007 at two hospitals in Los Angeles County were selected from the California Cancer Registry and were 15-25 years of age at the time of interview. Surveys of survivors and their parents were completed by multiple methods including mail, online, and telephone. Effectiveness of "plain" versus "designer" formatting of study materials was tested. Variables associated with response were analyzed using univariate and multivariable methods. Effort required for recruitment was quantified. RESULTS: Fifty percent of survivors (n = 235) and 36.5% of parents (n = 171) responded, and there were 160 parent-child dyads among them. Among located survivors, 61% participated. Response was higher for women, parents of younger survivors, and those from higher socioeconomic status areas. Among Hispanics, no variables were related to response. More effort was required to reach men and older survivors, but efforts beyond 15 calls and 7 remailings were unproductive. Formatting (i.e., plain vs. designer) did not affect response. CONCLUSION: Efforts to reach survivors must include multiple methods to be successful. Use of an intensive recruitment strategy and population-based sample resulted in a largely representative sample of CCS, especially for Hispanics. Expensive design efforts had little effect on recruitment, suggesting that plainer materials are sufficient. This example may inform similar studies.


Asunto(s)
Supervivientes de Cáncer/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Masculino , Padres , Encuestas y Cuestionarios , Adulto Joven
16.
Soc Work Health Care ; 57(7): 548-562, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29799361

RESUMEN

Adverse childhood experiences (ACEs) are linked to later life health problems such as behavioral health (BH) service use but less is known about how to counter this association. Using a population based sample of 807 adults, we examined the effects of protective factors in countering this association. ACEs were associated with increased BH service use while protective factors were associated with decreased BH service use. However, no significant interaction effect was found. Research is needed to develop a better measure of protective factors. Social workers need to be aware of ACE prevalence among clients and can foster protective factors.


Asunto(s)
Experiencias Adversas de la Infancia , Servicios de Salud Mental , Factores Protectores , Apoyo Social , Adulto , Experiencias Adversas de la Infancia/estadística & datos numéricos , Femenino , Humanos , Acontecimientos que Cambian la Vida , Modelos Logísticos , Masculino , Servicios de Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , New York , Prevalencia , Religión y Psicología , Servicio Social , Deportes , Encuestas y Cuestionarios
17.
BMC Public Health ; 18(1): 131, 2018 01 12.
Artículo en Inglés | MEDLINE | ID: mdl-29329572

RESUMEN

BACKGROUND: Food intake is a complex behaviour which can be assessed using dietary patterns. Our aim was to characterize dietary patterns and associated factors in French-speaking Switzerland. METHODS: Cross-sectional study conducted between 2009 and 2012 in the city of Lausanne, Switzerland, including 4372 participants (54% women, 57.3 ± 10.3 years). Food consumption was assessed using a validated food frequency questionnaire. Dietary patterns were assessed by principal components analysis. RESULTS: Three patterns were identified: "Meat & fries"; "Fruits & Vegetables" and "Fatty & sugary". The "Meat & fries" pattern showed the strongest correlations with total and animal protein and cholesterol carbohydrates, dietary fibre and calcium. The "Fruits & Vegetables" pattern showed the strongest correlations with dietary fibre, carotene and vitamin D. The "Fatty & sugary" pattern showed the strongest correlations with total energy and saturated fat. On multivariate analysis, male gender, low educational level and sedentary status were positively associated with the "Meat & fries" and the "Fatty & sugary" patterns, and negatively associated with the "Fruits & Vegetables" pattern. Increasing age was inversely associated with the "Meat & fries" pattern; smoking status was inversely associated with the "Fruits & Vegetables" pattern. Being born in Portugal or Spain was positively associated with the "Meat & fries" and the "Fruits & Vegetables" patterns. Increasing body mass index was positively associated with the "Meat & fries" pattern and inversely associated with the "Fatty & sugary" pattern. CONCLUSIONS: Three dietary patterns, one healthy and two unhealthy, were identified in the Swiss population. Several associated modifiable behaviours were identified; the information on socio- demographic determinants allows targeting of the most vulnerable groups in the context of public health interventions.


Asunto(s)
Dieta/estadística & datos numéricos , Conducta Alimentaria , Lenguaje , Estilo de Vida , Adulto , Anciano , Estudios Transversales , Encuestas sobre Dietas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Factores Socioeconómicos , Suiza
18.
Body Image ; 24: 69-75, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29288970

RESUMEN

This study explored the potential for yoga to promote body satisfaction in a general population of young adults. The sample included 1664 participants (M age: 31.1, SD=1.6years) in Project EAT, a 15-year longitudinal study. Data from the third and fourth waves (EAT-III and EAT-IV), collected five years apart, were utilized. Practicing yoga (≥30min/week) was reported by 16.2% of young adults. After adjusting for EAT-III body satisfaction and body mass index, yoga practitioners had higher concurrent body satisfaction at EAT-IV than those not practicing yoga (difference: 1.5 units [95% CI: 0.1-2.8], p=.03). Among participants within the lowest quartile of prior (EAT-III) body satisfaction, there was preliminary evidence that body satisfaction at EAT-IV was higher among yoga practitioners than in other young adults. Findings suggest that yoga may be associated with improved body satisfaction, particularly among young adults with low prior body satisfaction.


Asunto(s)
Imagen Corporal/psicología , Índice de Masa Corporal , Satisfacción Personal , Yoga/psicología , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino
19.
Pers Soc Psychol Bull ; 43(8): 1125-1135, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28903715

RESUMEN

Loneliness has been posited to increase the motivation to repair or replace deficient social relationships and, seemingly paradoxically, to increase the implicit motivation for self-preservation. In the current research, we report a cross-lagged panel analysis of 10 waves of longitudinal data ( N = 229) on loneliness and self-centeredness (as gauged by Feeney and Collins's measure of chronic self-focus) in a representative sample of middle-aged and older adults. As predicted by the proposition that loneliness increases the implicit motivation for self-preservation, loneliness in the current year predicts self-centeredness in the subsequent year beyond what is explained by current-year demographic variables, self-centeredness, depressive symptomatology, and overall negative mood. Analyses also show that self-centeredness in the current year (net covariates) predicts loneliness in the subsequent year, a reciprocal relationship that could potentially contribute to the maintenance of loneliness. Theoretical and practical implications are discussed.


Asunto(s)
Relaciones Interpersonales , Soledad , Motivación , Personalidad , Negro o Afroamericano , Anciano , Femenino , Hispánicos o Latinos , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Población Blanca
20.
Am J Clin Nutr ; 106(1): 217-224, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28592598

RESUMEN

Background: Dietary patterns provide a summary of dietary intake, but to our knowledge, few studies have assessed trends in dietary patterns in the population.Objective: The aim was to assess 20-y trends in dietary patterns in a representative sample of the Geneva, Switzerland, population with the consideration of age, sex, education, and generation.Design: Repeated, independent cross-sectional studies were conducted between 1993 and 2014. Dietary intake was assessed by using a validated food-frequency questionnaire. Dietary patterns were assessed by using principal components analyses.Results: Among 18,763 adults, 1 healthy ("fish and vegetables") and 2 unhealthy ("meat and chips" and "chocolate and sweets") patterns were identified. Scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and "chocolate and sweets" pattern scores decreased in both sexes and across all age groups. The stronger increase in the "fish and vegetables" pattern score among the less well-educated participants led to a narrowing of educational differences (mean ± SD scores in 1993: -0.56 ± 1.39 compared with -0.05 ± 1.58 in low- compared with highly educated groups, respectively; P < 0.001; scores in 2014: 0.28 ± 1.64 compared with 0.24 ± 1.83, respectively; P = 0.772). Generational analysis showed that older age groups tended to show smaller changes than younger age groups: the yearly score change in "chocolate and sweets" was -0.021 (95% CI: -0.027, -0.014; P < 0.001) for the 35- to 44-y cohort compared with -0.002 (95% CI: -0.009, 0.005; P = 0.546) for the 45- to 54-y cohort.Conclusions: Three dietary patterns were identified; scores for the "fish and vegetables" pattern increased, whereas the "meat and chips" and the "chocolate and sweets" pattern scores decreased. The stronger increases in the "fish and vegetables" pattern score among the less well-educated participants led to a smaller difference in dietary intake across the different educational levels.


Asunto(s)
Dieta/tendencias , Composición Familiar , Conducta Alimentaria , Adulto , Factores de Edad , Estudios Transversales , Encuestas sobre Dietas , Dieta Saludable , Escolaridad , Femenino , Francia , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Análisis de Componente Principal , Factores Sexuales , Suiza
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