scholarly journals Trends and inequalities in breastfeeding continuation from 1 to 6 weeks: findings from six population-based British cohorts, 1985–2010

2021 ◽  
Author(s):  
Deon A. Simpson ◽  
Claire Carson ◽  
Jennifer J. Kurinczuk ◽  
Maria A. Quigley
Keyword(s):  
Logistic Regression ◽  
Time Trends ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Full Time ◽  
Heterogeneity Test ◽  
Breastfeeding Practices ◽  
Breastfeeding Rates ◽  
Birth Time ◽  
Over Time

Abstract Background Understanding inequalities in breastfeeding practices may help to explain the UK’s persistently low breastfeeding rates. A recent study using the quinquennial UK Infant Feeding Surveys (IFS) found that sociodemographic inequalities in breastfeeding initiation persisted between 1985 and 2010. The present study investigates the sociodemographic inequalities in breastfeeding continuation at 6 weeks after birth among mothers who initiated and maintained breastfeeding at 1 week in 1985–2010. Methods Data were drawn from the 1985 to 2010 IFS and restricted to mothers who were breastfeeding at 1 week after birth. Time trends in the proportion of mothers in each sociodemographic group were examined. Logistic regression was used to estimate associations between breastfeeding at 6 weeks and sociodemographic factors, adjusting for confounders. Heterogeneity test was used to assess changes in these associations over time. Results Sociodemographic inequalities in breastfeeding continuation at 6 weeks persisted over the 25-year period. In most survey years, mothers were most likely to breastfeed at 6 weeks if they were 30 or older versus under 25 (OR 1.49–1.99 across survey years, I2 = 0%, heterogeneity P = 0.45); completed full-time education over age 18 compared to 18 or younger (OR 1.56-2.51, I2 = 58.7%, P = 0.03); or of Black, Asian, Mixed, or other ethnicity compared to White (OR 1.45–2.48, I2 = 44.8%, P = 0.16). Conclusions Among mothers breastfeeding at 1 week, those who were younger, White or had fewer years of full-time education were at greatest risk of discontinuing before 6 weeks. This risk persisted over time and was independent of their high risk of not initiating breastfeeding.

scholarly journals Changes in serum TG levels during pregnancy and their association with postpartum hypertriglyceridemia: a population-based prospective cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yandi Zhu ◽  
Haiyan Zhu ◽  
Qinyu Dang ◽  
Qian Yang ◽  
Dongxu Huang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Blood Lipid ◽  
Roc Curves ◽  
Population Based ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Adverse Pregnancy ◽  
Stratified Analysis ◽  
Over Time

Abstract Background Blood lipid increases during gestation are considered a physiological adaption, and decrease after delivery. However, some adverse pregnancy outcomes are thought to be related to gestational lipid levels. Therefore, it is necessary to have a reference range for lipid changes during gestation. The present study aims to describe triglyceride (TG) changes during pregnancy and 42 days postpartum and to find cut-off points for TG levels during the first, second, and third trimesters. Methods A total of 908 pregnant women were followed from recruitment to 42 days postpartum, and their serum lipids were collected at gestational weeks 6–8, 16, 24, and 36 and 42 days postpartum. The major outcome was postpartum hypertriglyceridemia. The association between gestational and postpartum TG levels was analysed by stepwise multiple linear regression. A two-stage approach including a linear mixed-effect model and linear or logistic regression was conducted to explore the contribution of the changes in TG over time in pregnancy to postpartum hypertriglyceridemia. Logistic regression was constructed to examine the association between gestational TG levels and postpartum hypertriglyceridemia. Cut-off points were calculated by receiver operating characteristic (ROC) curves. Results There was a tendency for serum TG to increase with gestational age and decrease at 42 days postpartum. Prepregnancy overweight, obesity, and GDM intensified this elevation. Higher TG levels at gestational weeks 6–8, 16, 24, and 36 were positively associated with a higher risk of postpartum hypertriglyceridemia [OR 4.962, 95 % CI (3.007–8.189); OR 2.076, 95 % CI (1.303–3.309); OR 1.563, 95 % CI (1.092–2.236); and OR 1.534, 95 % CI (1.208–1.946), respectively]. The trend of the change in TG over time was positively associated with the TG level and risk of postpartum hypertriglyceridemia [OR 11.660, 95 % CI (6.018–22.591)]. Based on ROC curves, the cut-off points of serum TG levels were 1.93, 2.35, and 3.08 mmol/L at gestational weeks 16, 24, and 36, respectively. Stratified analysis of prepregnancy body mass index (pre-BMI) and GDM showed that higher gestational TG was a risk factor for postpartum hypertriglyceridemia in women with normal pre-BMI and without GDM. Conclusions Gestational TG and its elevation were risk and predictive factors of postpartum hypertriglyceridemia, especially in pregnant women with normal pre-BMI or without GDM.

Cluster headache

Neurology ◽  
2019 ◽  
Vol 93 (4) ◽  
pp. e404-e413 ◽  
Author(s):  
Anna Steinberg ◽  
Pontus Josefsson ◽  
Kristina Alexanderson ◽  
Christina Sjöstrand
Keyword(s):  
Cluster Headache ◽  
Sickness Absence ◽  
Disability Pension ◽  
Comparison Group ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Main Diagnosis ◽  
Full Time ◽  
Aged People ◽  
Headache Patients

ObjectiveTo estimate the prevalence of cluster headache in working-aged people, compare sickness absence rates and disability pension in cluster headache patients to rates in a matched comparison group, and explore associations of sociodemographic factors with such rates.MethodsThrough population-based registers, we identified 3,240 people aged 16–64, living in Sweden in 2010, who at least once during 2001–2010 received inpatient or specialized outpatient health care with cluster headache (ICD-10 code G44.0) as main diagnosis. A comparison group (n = 16,200), matched for age, sex, type of living area, and educational level, from the total population aged 16–64 (n = 5,945,895) was used. Outcomes were sickness absence (>14 days) and disability pension during 2010. Crude and adjusted prevalence rates and odds ratios with 95% confidence intervals were computed.ResultsThe prevalence of cluster headache in working-aged people was 0.054%. In 2010, 17.30% of the cluster headache group and 9.16% of the comparison group had been on sickness absence. In the cluster headache group, female patients had higher sickness absence rates (25.31%) and full-time disability pension (13.17%) than male patients (13.38% and 8.79%). Cluster headache patients older than 35 had higher rates than those of the same age in the comparison group. Further, cluster headache patients born outside Sweden were more likely to have full-time disability pension than patients born in Sweden.ConclusionsMuch higher rates of the patients had sickness absence or disability pension than in the comparison group. Further shown differences related to sex, age, and other sociodemographic factors need to be addressed.

Change in Working Time in a Population-Based Cohort of Patients With Breast Cancer

2012 ◽  
Vol 30 (23) ◽  
pp. 2853-2860 ◽  
Author(s):  
Marie Høyer ◽  
Karin Nordin ◽  
Johan Ahlgren ◽  
Leif Bergkvist ◽  
Mats Lambe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Diagnosis ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Working Time ◽  
Full Time ◽  
Logistic Regression Models ◽  
Work Limitations ◽  
Quality Register

Purpose We examined changes in working time 16 months after a breast cancer diagnosis and identified factors associated with job discontinuation and/or decreased working time. Patients and Methods This was a population-based cohort study with 735 patients identified in the Regional Breast Cancer Quality Register of Central Sweden. The study sample consisted of 505 women (age < 63 years at diagnosis) who completed questionnaires at baseline and at follow-up (on average 4 and 16 months after diagnosis, respectively). Clinical register data and questionnaire data on sociodemographic factors were obtained at baseline. Self-reported work-related data were obtained at follow-up. Odds ratios were estimated by using logistic regression models. Results Compared with prediagnosis working time, 72% reported no change in working time, 2% reported an increase, 15% reported a decrease, and 11% did not work at follow-up. Chemotherapy increased the likelihood (odds ratio [OR], 2.45; 95% CI, 1.38 to 4.34) of job discontinuation/decreased working time. Among chemotherapy recipients, associated factors included full-time work prediagnosis (OR, 3.25; 95% CI, 1.51 to 7.01), cancer-related work limitations (OR, 5.26; 95% CI, 2.30 to 12.03), and less value attached to work (OR, 3.69; 95% CI, 1.80 to 7.54). In the nonchemotherapy group, older age (OR, 1.09; 95% CI, 1.02 to 1.17) and less value attached to work (OR, 5.00; 95% CI, 2.01 to 12.45) were associated with the outcome. Conclusion The majority of women treated for breast cancer returned to their prediagnosis working time. Chemotherapy and cancer-related work limitations are important factors to take into account in identifying women in need of support. Moreover, it is important to consider the woman's own valuation of labor market participation.

scholarly journals Social Inequalities and Loneliness as Predictors of Ageing Well: A Trend Analysis Using Mixed Models

2020 ◽  
Vol 17 (15) ◽  
pp. 5314 ◽  
Author(s):  
Jens Klein ◽  
Olaf von dem Knesebeck ◽  
Daniel Lüdecke
Keyword(s):  
Physical Functioning ◽  
Mixed Models ◽  
Time Trends ◽  
Social Inequalities ◽  
Strong Association ◽  
Total Sample ◽  
Population Based ◽  
Ageing Population ◽  
Educational Inequalities ◽  
Over Time

Background: This study examines if education, income, and loneliness are associated with physical functioning and optimism in an ageing population in Germany. Furthermore, time trends of physical functioning and optimism as well as of associations with social inequality and loneliness are analyzed. Methods: The German Ageing Survey (DEAS), a longitudinal population-based survey of individuals aged 40 years and older, was used (four waves between 2008 and 2017, total sample size N = 23,572). Physical functioning and optimism were introduced as indicators of ageing well. Educational level, net equivalent income, and loneliness were used as predictors in linear mixed models for longitudinal data. Results: Time trends show that physical functioning decreases over time, while optimism slightly increases. Education and income are positively associated with physical functioning, while higher loneliness correlates with lower physical functioning. Higher optimism was associated with higher income and particularly with lower loneliness. Income and notable educational inequalities in physical functioning increase over time. Time trends of the associations with optimism show decreasing income inequalities and increasing disparities in loneliness. Conclusions: Increasing educational inequalities in physical functioning and a strong association of loneliness with optimism provide information for further interventions. Targeted health promotion among the aged and addressing maladaptive social cognition are options to tackle these issues. Key areas for action on healthy ageing include, for instance, the alignment of health systems to the needs of older populations or the creation of age-friendly environments.

scholarly journals Encounters with Rheumatologists in a Publicly Funded Canadian Healthcare System: A Population-based Study

2019 ◽  
Vol 47 (3) ◽  
pp. 468-476 ◽  
Author(s):  
Jessica Widdifield ◽  
Sasha Bernatsky ◽  
Janet E. Pope ◽  
Vandana Ahluwalia ◽  
Claire E.H. Barber ◽  
...  
Keyword(s):  
Healthcare System ◽  
Clinical Care ◽  
Workforce Planning ◽  
Population Level ◽  
Population Based ◽  
Annual Number ◽  
Clinical Activity ◽  
Full Time ◽  
Population Based Study ◽  
Over Time

Objective.To quantify population-level and practice-level encounters with rheumatologists over time.Methods.We conducted a population-based study from 2000 to 2015 in Ontario, Canada, where all residents are covered by a single-payer healthcare system. Annual total number of unique patients seen by rheumatologists, the number of new patients seen, and total number of encounters with rheumatologists were identified.Results.From 2000 to 2015, the percentage of the population seen by rheumatologists was constant over time (2.7%). During this time, Ontario had a stable supply of rheumatologists (0.8 full-time equivalents/75,000). From 2000 to 2015, the number of annual rheumatology encounters increased from 561,452 to 786,061, but the adjusted encounter rates remained stable over time (at 62 encounters per 1000 population). New patient assessment rates declined over time from 10 new outpatient assessments per 1000 in 2000 to 6 per 1000 in 2015. The crude volume of new patients seen annually decreased and an increasing proportion of rheumatology encounters were with established patients. We observed a shift in patient case mix over time, with more assessments for systemic inflammatory conditions. Rheumatologists’ practice volumes, practice sizes, and the annual number of days providing clinical care decreased over time.Conclusion.Over a 15-year period, the annual percentage of the population seen by a rheumatologist remained constant and the volume of new patients decreased, while followup patient encounters increased. Patient encounters per rheumatologist decreased over time. Our findings provide novel information for rheumatology workforce planning. Factors affecting clinical activity warrant further research.

Population-Based study of Echocardiography: Time Trends in Utilization and Diagonistic Profile of an Evolving Technology, 1975–1987

1989 ◽  
Vol 5 (2) ◽  
pp. 249-261 ◽  
Author(s):  
David J. Ballard ◽  
Bijoy K. Khandheria ◽  
A. Tamil Tajik ◽  
James B. Seward ◽  
Vernon P. Weber ◽  
...  
Keyword(s):  
United States ◽  
Heart Disease ◽  
Technology Assessment ◽  
Time Trends ◽  
The United States ◽  
Population Based ◽  
Valvular Regurgitation ◽  
Olmsted County ◽  
Population Based Study ◽  
Over Time

AbstractWe evaluated trends in the use of echocardiography among residents of Olmsted County, Minnesota, from January 1, 1975, through June 30, 1987. Annual examinations per 100,000 population among Olmsted County residents increased 6-fold from 264 in 1975 to 1,644 in 1986. Given the pattern of echo use in Olmsted County, these population-based data project a potential annual utilization of 4 million echo exams in the United States. Marked increases over time in labeling of patients with regurgitant valvular heart disease were noted following the introduction of Doppler echocardiography. The diagnostic labeling associated with this evolving technology and the resultant apparent epidemic of valvular regurgitation present a significant clinical technology assessment dilemma.

The Oxford Handbook of Integrative Health Science

2018 ◽  
Keyword(s):  
Adult Life ◽  
The United States ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Health Science ◽  
National Study ◽  
Integrative Health ◽  
Social Structural ◽  
Research Population ◽  
Psychosocial Influences

This handbook signals a paradigm shift in health research. Population-based disciplines have employed large national samples to examine how sociodemographic factors contour rates of morbidity and mortality. Behavioral and psychosocial disciplines have studied the factors that influence these domains using small, nonrepresentative samples in experimental or longitudinal contexts. Biomedical disciplines, drawing on diverse fields, have examined mechanistic processes implicated in disease outcomes. The collection of chapters in this handbook embraces all such prior approaches and, via targeted questions, illustrates how they can be woven together. Diverse contributions showcase how social structural influences work together with psychosocial influences or experiential factors to impact differing health outcomes, including profiles of biological risk across distinct physiological systems. These varied biopsychosocial advances have grown up around the Midlife in the United States (MIDUS) national study of health, begun over 20 years ago and now encompassing over 12,000 Americans followed through time. The overarching principle behind the MIDUS enterprise is that deeper understanding of why some individuals remain healthy and well as they move across the decades of adult life, while others succumb to differing varieties of disease, dysfunction, or disability, requires a commitment to comprehensiveness that attends to the interplay of multiple interacting influences. Put another way, all of the disciplines mentioned have reliably documented influences on health, but in and of themselves, each is inherently limited because it neglects factors known to matter for health outside the discipline’s purview. Integrative health science is the alternative seeking to overcome these limitations.

scholarly journals Trends and Inequalities in Overall and Abdominal Obesity by Sociodemographic Factors in Korean Adults, 1998–2018

2021 ◽  
Vol 18 (8) ◽  
pp. 4162
Author(s):  
Ha-Jin Jang ◽  
Hannah Oh
Keyword(s):  
Body Mass Index ◽  
Abdominal Obesity ◽  
Sociodemographic Factors ◽  
Nutrition Examination Survey ◽  
Obesity Prevalence ◽  
Korean Adults ◽  
Health And Nutrition ◽  
Education College ◽  
Small Change ◽  
Over Time

Few studies have comprehensively examined the nationwide trends in overall and abdominal obesity prevalence and related sociodemographic inequalities in Korea. In the Korea National Health and Nutrition Examination Survey 1998–2018, we estimated the age-standardized prevalence of overall (body mass index ≥ 25 kg/m2) and abdominal obesity (waist circumference ≥ 90 cm men, ≥85 cm women) in each sociodemographic subgroup of Korean adults (aged 19–79 years). For each survey year, weighted logistic regression was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between obesity prevalence and sociodemographic factors. During the study period, the prevalence of overall and abdominal obesity increased in men (24.8% to 42.4%; 20.1% to 32.1%; respectively) but only a small change was observed in women (26.5% to 26.0%; 22.7% to 20.9%; respectively). Obesity prevalence increased in all sociodemographic groups of men but varied across groups in women. In women, income (4th vs. 1st quartiles in 2016–2018: OR (95% CI) = 0.66 (0.56–0.78) overall obesity; 0.60 (0.51–0.71) abdominal obesity) and education (college or higher vs. high school or less: 0.62 (0.54–0.72) overall obesity; 0.58 (0.50–0.68) abdominal obesity) were inversely associated with obesity prevalence, and the gaps became more pronounced since 2007. Our data suggest that the inequalities in obesity prevalence by sex and by socioeconomic status have become more apparent over time in Korea.

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