Effects of recruitment strategy on response rates and risk factor profile in two cardiovascular surveys

BACKGROUND: The study was set up to assess the effect of recruitment methods on participation rate, response bias and cardiovascular risk factor estimates. METHODS: Two random samples of men and women in Halifax County aged 25-74 were drawn from the same sampling frame. Their respective sizes were 1007 (NSHHS) and 3036 (MONICA) people. Recruitment by Nova Scotia Heart Health Survey (NSHHS) was through face-to-face contact, whereas the MONICA survey relied on invitation by mail. Outcome measures were response rates at various stages of the recruitment process and the differences in cardiovascular risk factor estimates. RESULTS: Face-to-face recruitment located 51% and mail recruitment located 47% of their respective samples; face-to-face recruitment resulted in fewer individuals who refused to participate in the survey, but also produced fewer who were prepared to provide blood samples in addition to answering questionnaires. By-mail recruits were more likely to have post-secondary education, but did not differ in the proportion of smokers, mean diastolic blood pressure or body mass index, if controlled for education level, gender and age. However, the mean systolic blood pressure was 5.7 mmHg higher and the mean cholesterol level 0.44 mmol/l lower in face-to-face recruits. CONCLUSIONS: Controlling for age, gender and education level eliminates the effect of recruitment bias on most cardiovascular risk factors estimates. The exceptions in our study were systolic blood pressure and cholesterol, where methodological factors may have played a role.     

The study of healthy life-style risk factors and health status for cardiovascular diseases for employees in Kaohsiung area

To understand the healthy life style, health status and risk factors of employees, institutional employees in Kaohsiung area were studied by using questionnaire investigation and blood specimen examination. One-thousand-four hundred-fifty subjects were used, but 1147 questionnaires were completed. The complete rate was 79.1%. The reliability and validity of the healthy life style scale achieved an acceptable level. The results are as follows: 1. The mean total score of healthy life-style scale was 63.9. Four healthy behavior scored lowest: "consulted health professional about health information", "monitored self of blood pressure and blood sugar", did moderate exercise at least three times per week", "took leisure activities". 2. The severity of risk factor was as follows: (1) 32.2% of employees had abnormal value for blood cholesterol (> or = 200 mg/dl); (2) 22.9% of employees had abnormal blood pressure value; (3) 22.6% of employees were overweight or obese; (4) 16.7% of employees often smoked; (5) 13.6% of employees had abnormal values for blood triglyceride. (6) 2.1% of employees had abnormal blood sugar values. 3. 10.8% of subjects were perceieved to have a worsing health status; 14.5% of the subjects had chronic disease with physicians diagnosis and most of their (71%) were hypertersion. 4. The findings of demographic data showed that people who were male, aged over forty, had education below junior high school and those of blue collar class should be screened and monitored, for the risk factors at regular intervals. Similarly, People who are male, age below forty and blue-collar class should be encouraged to develop the healthy life-styles.     

Fibrinogen as a cardiovascular risk factor in Spanish children and adolescents. The Ni?o Jesus Group

Studies done on adults reveal a significant role of fibrinogen (FG) in cardiovascular disease. The main purpose of our study was to determine the level of plasma FG in children, its distribution according to age and sex, and its relationship to other cardiovascular risk factors such as cigarette smoking, plasma lipid disturbances, and a positive family history for other cardiovascular risk factors. We studied a population of 2224 children, aged 2 to 18 years, from five different schools located in Madrid. We found a significantly higher level of FG in the groups of females aged 6 to 8 and 16 to 18 years than in males of the same ages (p < 0.001). The study population was distributed into two groups according to the plasma fibrinogen level: > 394 mg/dl and < 394 mg/dl. In both groups we determined plasma levels of total cholesterol, triglycerides, and very low-density lipoprotein (VLDL) cholesterol and found these parameters significantly higher in the group with an FG level > 394 mg/dl (p < 0.05).     

Anger and cardiovascular risk in adolescents.

Examined the relationship between anger and elevations in cardiovascular risk among 213 13–18 yr old adolescents. Ss were assessed on an anger index and also on certain physical (e.g., blood pressure, cholesterol) and psychological (e.g., anxiety, life dissatisfaction) variables associated with increased risk of cardiovascular diseases. The anger index was factor analyzed, producing a terminal solution of 2 factors: Frequent Anger Directed Outward and Anger-Producing Situations. Regression analyses showed that the factor scores were predictive of the physical and psychological measures of cardiovascular risk, and that the factor scores were differentially related to these indices. Findings are supportive of systematic study both of the multidimensional nature of anger and of the associations of the dimensions of anger with indices of cardiovascular risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison between two measures of delay discounting in smokers.

Agreement between computer and questionnaire measures of delay discounting in smokers was compared. Correlations between measures for small, medium, or large rewards were significant. Log κ values decreased as the reward delay increased, with values lower for the computer task than the questionnaire, with significant differences for small rewards. The 2 measures were related to smoking rate but not to age, gender, or obesity. The Bland-Altman test of agreement indicated large within-subject differences in κ values between the 2 measures. The size of the difference between the log κ values and magnitude of the log κ values were positively related. Results suggest κ values from the 2 measures are related but may not be used interchangeably. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The perinatal situation in France. Trends between 1981 and 1995

OBJECTIVES: Assess the main indicators of health status and medical practice at delivery and to determine the feasibility of a routine national survey. POPULATION AND METHOD: A survey conducted in 1995 concerned all live births and stillbirths occurring within one week. The sample included 13,147 women in metropolitan France. The results were compared with those of earlier national perinatal surveys. RESULTS: Since 1981, the perinatal situation in France has shown a rise in maternal age at delivery, development of prenatal care (particularly the number of visits), and an increase in the number of procedures at delivery, notably induction. The preterm delivery calculated for all births has remained unchanged: 5.6% in 1981 and 5.9% in 1995, but the proportion of infants weighing less than 2500 g has increased from 5.2% to 6.2%. CONCLUSION: The 1995 national perinatal survey in France, based on all births during one week and involving minimal data collection has provided a representative sample of births and information well adapted to surveillance of the main health and medical practice parameters. This type of survey should become routine and serve as a basic element for epidemiological surveillance.     

Cholelithiasis and dietary risk factors: an epidemiologic investigation in Vidauban, Southeast France. General Practitioner's Group of Vidauban

Dietary risk factors have been implicated in the development of cholelithiasis. The aim of this study was to determine in a homogeneous French population whether a particular type of diet may be lithogenic. Seventy-six subjects over 30 years of age (26 men, 50 women) with cholelithiasis detected by ultrasound were selected from a population sample of 830 subjects by drawing lots using the polling list. These were matched by 76 control subjects without cholelithiasis randomly selected from the same population. Univariate analysis was significant for a high calorie diet >2500 kcal/day (OR = 3.62, P = 0.0065), a diet rich in carbohydrates with a consumption > or = 55 g/day (OR = 2.98, P = 0.0067), and a diet rich in total lipids (OR = 4.97, P = 0.023) or saturated fatty acids (OR = 3.06, P = 0.0146). An alcohol consumption equivalent to 20-40 g/day was protective (P = 0.018). Multivariate analysis confirmed these results. Our study suggests that a change in dietary habits by limiting excess calories, saturated fats and carbohydrates could reduce the incidence of cholelithiasis.     

Comparison of dietary risk factors for cardiovascular disease in African-American and white women

OBJECTIVE: To compare African-American and white women's knowledge, attitudes, and energy and nutrient intakes related to cardiovascular disease risk. DESIGN: The 1989 through 1991 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey (DHKS). SUBJECTS: A nationally representative sample of 2,684 white and 449 African-American women who completed the DHKS and provided 3 days of dietary information. STATISTICAL ANALYSES PERFORMED: Comparisons between groups were made using t tests and chi 2 analyses. Analysis of covariance was used to adjust for age, percentage of poverty, and education. RESULTS: Significant differences in dietary risk for cardiovascular disease were identified. White women consumed significantly less cholesterol and more potassium than African-American women. African-American women had significantly lower knowledge scores, but they were more likely than white women to indicate that their diets should be lower in fat and salt and to consider nutrition very important when shopping. White women had more positive attitudes toward the impact of diet on health than African-American women. Accounting for differences between the groups in age, education, and income explained few differences between the groups. APPLICATIONS: This study identified differences in nutrient intake, knowledge, and attitudes about diet and health that can influence the willingness and ability of women to choose foods for a more healthful diet. Dietitians can use these findings to target strategies for changing behavior. For example, many African-American women acknowledge the need to change their current diets, so dietitians can help them design implementation plans or specific action plans to accomplish needed changes.     

Race/ethnicity misclassification of persons reported with AIDS. The AIDS Mortality Project Group and The Supplement to HIV/AIDS Surveillance Project Group

Oxidative modification of high density lipoproteins (HDL) may alter their capacity to mediate cellular cholesterol efflux. We studied the kinetics of copper-mediated oxidation of HDL and cholesterol efflux mediated by unmodified and oxidized HDL (oxHDL). Oxidation was measured by increases in absorbance at 234 nm (delta A234), production of thiobarbituric acid reactive substances (TBARS) and loss of trinitrobenzene sulfonic acid reactivity. Oxidation was dependent on copper concentration and showed a lag phase and propagation phase. Efflux of cholesterol from J774 macrophages measured by appearance of cellular [3H]cholesterol in the medium was lower by 16% after 4 h and 36% after 24 h with oxHDL compared to HDL. OxHDL-mediated efflux was also lower by 27% to 37% at lipoprotein concentrations of 10 to 200 micrograms protein/ml. Cholesterol efflux correlated negatively with TBARS production (r = -0.97, P < 0.003) and delta A234 (r = -0.77, P < 0.080). There was no difference in efflux mediated by apoproteins prepared from HDL and oxHDL. Efflux measured by change in cholesterol mass in medium was 78% lower with oxHDL. Inhibition of oxidation with butylated hydroxytoluene maintained the capacity of HDL to stimulate efflux. These results suggest that oxidation of HDL may impair its protective role against atherosclerosis.     

不同类群大学生价值观差异比较及教育的思考

价值观教育是大学生德育教育的核心。大学生在成长过程中会由于一些可控和不可控因素的影响而形成一些有显著特征的类群,不同类群大学生价值观会呈现出一定的差异性。研究结果表明,大学生的目标价值观、手段价值观和规范价值观在性别、年级和专业认同等因子上存在显著差异。大学生价值观教育应根据不同类群大学生的特点和差异有层次地进行,以增强大学生价值观教育的有效性。     

The lack of differentiation between male and female in Schreber's autobiography.

Examined the entire Memoirs of D. P. Schreber, a landmark case in the development of psychoanalytic theories of paranoia, for the contextual correlates among 5 key words: sun, God, Flechsig, male, and female. A computer-based system, WORDS, was used to process the data, with virtually identical contextual correlates of the terms male and female the major finding. This finding and others are compared with a 1960 study by J. Laffal and the interpretations provided by Freud and I. Macalpine and R. A. Hunter. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Official systems of pharmacovigilance in France and in Spain. Comparison of spontaneous reporting in two regional centers: Pays Basque and Bordeaux

This report compares the drug surveillance systems in France and Spain. The Spanish causality assessment method is explained. The Spanish and French drug surveillance systems are rather similar, but with some variations in the data analysis and differences between causality algorithms used. Spontaneous reporting in two drug surveillance centres, Aquitaine (Bordeaux, France) and in the Spanish Basque Country (SBC) (type of reports, reporting form) is compared. Reports received by the two centres during the year 1992 are presented. The SBC Centre has received more reports and differences in the source and type of effects were observed.     

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

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

Peripheral artery disease and cardiovascular risk factors in the elderly. The Honolulu Heart Program

Peripheral vascular disease as measured by the ankle/brachial blood pressure index (ABI) is associated with increased risk of mortality and morbidity. Few sources of data on the relationship of risk factors to ABI are available for the elderly, especially those > 80 years of age, and minority populations. ABI measurements from the Honolulu Heart Program's fourth reexamination of 3450 ambulatory, elderly Japanese American men indicate that the prevalence of an abnormal ABI, defined as a ratio of < 0.9, was 13.6%, increasing from 8.0% in those 71 to 74 years of age to 27.4% in those 85 to 93 years. Associations that were U or J shaped were present for a number or risk factors (higher rates of abnormality [ABI < 0.9] in those in the lowest and highest risk factor quintiles) in a cross-sectional analysis. Risk factors measured at baseline were also predictive of an abnormal ABI 25 years later, even after adjustment for multiple risk factors. The odds ratio (OR) for an ABI < 0.9 at the 80th percentile of cholesterol compared with that at the 20th percentile was 1.4; the OR for 1-hour postload glucose was 1.3, and for alcohol intake 1.2. The OR associated with hypertension was 1.8 and that for smoking, 2.9 (P < .05 for all ORs). These findings are consistent with ABI being a marker for generalized atherosclerotic disease in old and very old Japanese American men.     

Comparison of itraconazole and ketoconazole in HIV-positive patients with oropharyngeal or esophageal candidiasis. Human Immunodeficiency Virus Itraconazole Ketoconazole Project Group

The efficacy of oral itraconazole and ketoconazole in the treatment of oropharyngeal and/or esophageal candidiasis, and the rate of post-treatment relapse, were compared in a multicenter, prospective, double-blind, double-dummy, randomized, parallel-group trial. A total of 143 adult HIV-positive patients with oropharyngeal and/or esophageal candidiasis were assigned to receive either itraconazole or ketoconazole (200 mg/day). Patients with oropharyngeal and esophageal candidiasis were treated for 2 and 4 weeks, respectively. Patients were evaluated clinically and mycologically after 1, 2 and 4 (for esophageal patients) weeks of therapy, and relapses were compared in a 6-week post-treatment follow-up period. Of 129 evaluable patients, 98 had oropharyngeal candidiasis and 31 esophageal infection. CDC classification, CD4+ cell counts, and number of previous episodes of oropharyngeal or esophageal candidiasis were comparable in both groups. Oropharyngeal infection was cleared clinically at 21 days in 71% of patients receiving itraconazole and 60% receiving ketoconazole, and esophageal candidiasis was cleared at 41 days in 100% of patients receiving itraconazole and 91% receiving ketoconazole. Marginally significant differences were found between itraconazole and ketoconazole in rates of clearing of infection clinically in patients with oropharyngeal and esophageal candidiasis (p = 0.0614 and 0.0781, respectively). Mean rates of infection relapse were not statistically different in the two treatment groups. Adverse events were generally mild and not considered drug related. Itraconazole is marginally more efficacious than ketoconazole in the treatment of oropharyngeal and esophageal candidiasis in HIV-positive patients and both drugs appear safe and well tolerated.     

Association between carotid lesions evaluated by Doppler color echocardiography and cardiovascular risk factors in the elderly. Preliminary results

BACKGROUND: The valuation of the extracranial carotid by echo color-Doppler takes on an extraordinary importance for the prevention of cerebral ictus at geriatric age. In this "naturalistic" study a population of old people (> 65 yrs) of Cagliari's province was considered in order to: 1) discriminate the lesions of the carotid that are imputed to atherosclerotic disease by anatomic changes of the arterial wall caused by aging; 2) study relations between lesions of the carotid and cardiovascular risk factors. METHODS: The carotids of 50 old subjects were studied by echo color-Doppler and the lesion classified in different classes of severity, according to the hemodynamic standard, comparing them with the presence of the most important cardiovascular risk factors. Hypercholesterolemia was the most frequent risk factor (76%), followed by hypertension (62%), over-weight (54%) and smoking (42%). Moreover a diffused intima-media thickening (IMT) was constant in all the subjects with values > 0.75 mm; athero-sclerotic plaques were even present in 39 subjects which only in 4 cases could be considered at risk of cerebral ischemia. RESULTS: A significant correlation between the severity of the lesions and levels of total cholesterol and LDL cholesterol for the male sex emerged, while for smoking only a trend of correlation has been obtained. CONCLUSIONS: Considering this experience it is suggested that in old subjects the presence of a diffused IMT with values > 0.75 mm must be considered as a marker of aging of the arterial wall of the carotid and not as a cardiovascular risk factor as reported in the literature for the middleaged.     

Incidence and sexual risk factors of cytomegalovirus seroconversion in HIV-infected subjects. The SEROCO Study Group

BACKGROUND: Data on incidence of cytomegalovirus (CMV) seroconversion in HIV-infected (HIV(+)) subjects was sparse. GOAL: To determine the incidence of CMV seroconversion in sexually active HIV(+) subjects and sexual factors associated with CMV seroconversion. STUDY DESIGN: One hundred eighty four persons not infected by CMV at enrollment in a cohort of HIV(+) persons were studied. A case-control study within the cohort was conducted to determine the effect of sexual behavior in the 6 months prior to CMV seroconversion. Thirty seven cases of CMV seroconversion were compared with 136 controls. RESULTS: The overall incidence of CMV seroconversion was 9.18 per 100 person-years (95% confidence interval (CI), 6.67-12.28) and was particularly high among homosexual men. After adjustment for age, socio-professional category, sexual orientation, and casual sex, the risk of CMV seroconversion was higher in subjects who never used condoms than in those who used them systematically (adjusted odds ratio (OR) 3.37;95% CI, 1.05-11.00). CONCLUSIONS: In addition to the need to protect their sexual partners from HIV infection, HIV(+) subjects free of CMV infection should use condoms to avoid CMV infection and its complications.