Predictors of uptake of aspirin (ASA) chemoprevention in Lynch syndrome (LS).

49 Background: Substantial data support efficacy of ASA in colorectal adenoma and cancer (CRC) chemoprevention. In 2011, the CaPP2 Phase 3 trial showed benefit of 600 mg ASA daily for prevention of LS-associated CRC (HR 0.41,p=0.02) in persons w/ASA adherence >2 yrs. Anecdotally, uptake of ASA by LS pts has been low, but few data exist. We examined uptake and predictors of ASA chemoprevention among LS pts receiving follow-up at our center since 2011. Methods: Pts evaluated by Fox Chase’s Risk Assessment Program receive in-person medical recommendations and written information about cancer (CA) prevention measures including ASA. Medical records of 127 LS pts were retrospectively reviewed. Demographics, gene affected, personal Hx of CA, ASA use, and ASA dose were collected. Majority (94.5%) of cohort had documentation of ongoing LS endoscopic screening at our center—only 3.2% had no recent follow-up (past 3 yrs) and 2.4% had recently died (past 3 yrs). Chi-square tests and multivariable logistic regression were used in analyses. Results: Overall 24.4% (31/127) of pts reported ASA use for chemoprevention (see Table). Nearly half (48.4%) of ASA users took 81 mg ASA daily, and only 22.6% reported taking >600 mg ASA daily. ASA use was associated with older age, MLH1/ MSH2+ vs MSH6/ PMS2+, and personal Hx of CRC. In the multivariable logistic model, older age (OR 2.80, p=0.04) and MLH1/ MSH2+ (OR 2.64,p=0.07) were significant and borderline significant, respectively. Adding race/ethnicity and gender strengthened the effect of age>60 (OR 3.11, p=0.03), and improved fit (pseudoR2=16.8%). Conclusions: Uptake of ASA chemoprevention by LS pts is overall modest, but older age is associated with ASA uptake for chemoprevention. Among ASA users, fewer than 1 in 4 take the 600 mg daily dose shown effective in CaPP2. Confirmatory trials as well as efforts to elucidate barriers to ASA chemoprevention in LS are needed. [Table: see text]

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Anorectal Malformations and the Risk of Colorectal Cancer—Is Early Routine Endoscopic Screening Indicated?

European Journal of Pediatric Surgery ◽

10.1055/s-0040-1718749 ◽

2020 ◽

Author(s):

Anna Svenningsson ◽

Anna Gunnarsdottir ◽

Tomas Wester

Keyword(s):

Colorectal Cancer ◽

Early Adulthood ◽

Anorectal Malformations ◽

Population Based ◽

Observational Period ◽

Endoscopic Screening ◽

Medical Birth Register ◽

National Patient ◽

And Gender

Abstract Introduction Colorectal cancer (CRC) has been reported in early adulthood in patients with anorectal malformation (ARM), and therefore, the need of endoscopic controls has been discussed. The aim of this study was to assess the risk of CRC in patients with ARM. Materials and Methods This was a nationwide population-based study with data from Swedish national health care registers. All patients diagnosed with ARM born in Sweden between 1964 and 1999 were identified in the National Patient Register. The same group was followed up in the Swedish Cancer Register from birth to December 31, 2014, for occurrences of CRC. Five age- and gender-matched individuals randomly selected from the Medical Birth Register served as controls for each ARM patient born between 1973 and 1999. Results A total of 817 patients (474 males) with ARM were included and followed up from birth to the end of observational period. Time of follow-up ranged from 15 to 50 years (mean: 28 years). None of the patients was diagnosed with CRC during the observational period. One case of rectal cancer and one case of sigmoid cancer were detected among the 3,760 controls. Conclusion In our study, the risk of CRC in early adulthood in patients with ARM is low. Our result does not support routine endoscopic follow-up for patients with ARM during the first decade of life.

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Rationale for Timing of Follow-Up Visits to Assess Gluten-Free Diet in Celiac Disease Patients Based on Data Mining

Nutrients ◽

10.3390/nu13020357 ◽

2021 ◽

Vol 13 (2) ◽

pp. 357

Author(s):

Alfonso Rodríguez-Herrera ◽

Joaquín Reyes-Andrade ◽

Cristina Rubio-Escudero

Keyword(s):

Data Mining ◽

Celiac Disease ◽

Cultural Context ◽

Gluten Free Diet ◽

Gluten Free ◽

Adherence To Diet ◽

And Gender ◽

Few Data

The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.

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Masking Real Unemployment: The Overall and Racial Impact of Survey Non-Response on Measured Labor Market Outcomes

10.36687/inetwp150 ◽

2021 ◽

pp. 1-22

Author(s):

Yixia Cai ◽

Dean Baker

Keyword(s):

Labor Market ◽

Labor Force ◽

Black Men ◽

Labor Market Outcomes ◽

Market Outcomes ◽

Percentage Points ◽

Market Status ◽

And Gender ◽

Ethnicity And Gender

A large and growing percentage of households are missed in the monthly Current Population Survey (CPS). For the survey as a whole, the rate of nonresponse is roughly 13 percent. This is higher for Blacks, with the share for young Black men being about 30 percent. The BLS’s current methodology effectively assumes that, with adjustment for various characteristics, people who are not included in a follow-up survey may not differ systematically from those who are included. The present paper, however, provides evidence that this may not be the case. With the rotation panel structure of the CPS data from 2003 to 2019, we investigate bias from nonresponse in CPS and its association with one’s prior labor market status, paying particular attention to how the relationship differs by race, ethnicity, and gender. Our analysis suggests that people are considerably more likely to be missing in a subsequent observation if they are unemployed or not in the labor force in the prior observation. We also estimate what the real labor market outcomes might have been when adjusting for nonresponse and undercoverage. Findings indicate that the current methodology may underestimate the national unemployment and labor force participation rates by about 0.7 and 1.2 percentage points, respectively. The gap between observed and adjusted unemployment rates tends to grow beginning in 2015. The unemployment rate is more understated for Blacks than for whites, particularly with a gap of about 3.3 percentage points for young Black men (age 16 to 34).

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Prevalence and Occlusal Risk Factors for Fractured Incisors among 11–12-Year-Old Children in the Trinidad and Tobago Population

Dentistry Journal ◽

10.3390/dj8010025 ◽

2020 ◽

Vol 8 (1) ◽

pp. 25

Author(s):

Trudee Hoyte ◽

Anne Kowlessar ◽

Anil Ali ◽

David Bearn

Keyword(s):

Trinidad And Tobago ◽

Dental Treatment ◽

Dental Trauma ◽

Binary Logistic Regression ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

And Gender ◽

Ethnicity And Gender

This cross-sectional survey was carried out to ascertain the prevalence of fractured incisors in 11–12-year-olds. In addition we explored the relationship with overjet, incompetent lips, incisor inclination and to determine if there was any association with ethnicity and gender. All permanent incisors were examined in 672 children comprising 356 females (53.1%) and 315 males (46.9%). The sample comprised 11–12-year-olds in high schools across Trinidad and Tobago. Statistical analysis was undertaken using Chi-square test, independent t-test, and binary logistic regression. The prevalence of fractured incisors was 18.9%. Boys presented with an increased incidence of fractured incisors than girls. 86.3% of dental trauma was untreated. The average overjet of subjects with fractured incisors was 4.2 mm. 18.62% of subjects with fractured incisors had incompetent lips. The most common malocclusion (18.81%) with fractured incisors was class 2 division 1. The Afro-Trinidadian ethnicity had the highest prevalence of fractured incisors (11.0%) when compared to mixed ethnicities, which was statistically significant. Maxillary central incisors were the most commonly injured teeth. Most patients delayed in seeking dental treatment for fractured incisors in our population. Early orthodontic treatment is recommended to help reduce the risk of dental trauma.

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Social inequalities over the lifecourse and healthy ageing in Aotearoa/New Zealand: differences by Māori ethnicity and gender

Ageing and Society ◽

10.1017/s0144686x20001130 ◽

2020 ◽

pp. 1-20

Author(s):

Christine Stephens ◽

Ágnes Szabó ◽

Mary Breheny

Keyword(s):

Social Inequalities ◽

Economic Status ◽

Late Life ◽

Later Life ◽

Healthy Ageing ◽

Older Age ◽

Latent Growth ◽

Structured Groups ◽

And Gender ◽

Ethnicity And Gender

Abstract Lifecourse approaches to healthy ageing recognise that health in older age is affected by long-term cumulative inequalities between socio-economic status (SES), gender and ethnicity groups, which begin in childhood. Combining longitudinal survey data with lifecourse history interviews from 729 older New Zealanders aged 61–81 (mean = 72, standard deviation = 4.5), we tested a lifecourse model of predictors of physical, mental and social health in older age. Latent growth curve and mediation analysis showed that the link between childhood SES and late-life health (over 10 years) was mediated by education, occupation and adult wealth. To account for the moderating effects of gender and ethnicity, we modelled the effects for sub-groups separately (225 non-Māori women, 158 Māori women, 219 non-Māori men and 127 Māori men). Childhood SES was an important predictor of later-life health, mediated by education and adult SES for all participants and for non-Māori men. However, there were significantly different pathways for Māori men and for women. Māori men and women and non-Māori women did not attain the same health benefits from higher childhood SES and education as non-Māori men. Findings point to the importance of considering the mediators of lifelong impacts on health in older age, and recognition of how membership of different socially structured groups produces different pathways to late-life health.

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Assessment of Demographic Variables on Mental Illness in Malaysia

International Journal of Engineering & Technology ◽

10.14419/ijet.v7i3.14.16855 ◽

2018 ◽

Vol 7 (3.14) ◽

pp. 16

Author(s):

Mohd Khairul Amri Kamarudin ◽

Mohd Ekhwan Toriman ◽

Nursabrina Abdullah ◽

Nur Atikah Md Shariff ◽

Nurul Ain Shalilie Shari ◽

...

Keyword(s):

Mental Illness ◽

Action Plan ◽

Demographic Variables ◽

Mental Illnesses ◽

Ministry Of Health ◽

Positive Action ◽

And Gender ◽

Ethnicity And Gender ◽

Commit Suicide

One of the growing mental illnesses experienced in Malaysia is depression. There was once when one stage was among Malaysians at a critical and higher stage until the attempt to commit suicide. This study has observed a survey conducted by the Ministry of Health Malaysia to identify and understand the vulnerability experienced by every state in Malaysia focuses on the effect of demographic on mental patients by state, age, ethnicity and gender. The data was collected from the Malaysian Health and Morbidity Survey. The findings showed that the highest state of mental illness was the state of Selangor. The overall depression of Malaysians was increasing at an all-time high. The action taken by the Ministry of Health to address mental illness is by using a positive action plan instead of negative. In conclusion, depression at the highest level is one of the first causes of Malaysians to experience mental disorders in every state. This study suggested some proposals as follow-up action at the end of this study.

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