738 research outputs found
Evidence for regulatory diversity and auto-regulation at the TAC1 locus in sensory neurones
Peer reviewedPublisher PD
Cardiac rehabilitation: a comprehensive review
Abstract Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these studies. The safety, relevance to special populations, challenges, and future directions of CR will also be reviewed.</p
Suburbanisation of oral cavity cancers: evidence from a geographically-explicit observational study of incidence trends in British Columbia, Canada, 1981–2010
Population-based incidence trends of oropharyngeal and oral cavity cancers by sex among the poorest and underprivileged populations
BACKGROUND: Oral cancer is an important health issue, with changing incidence in many countries. Oropharyngeal cancer (OPC, in tonsil and oropharygeal areas) is increasing, while oral cavity cancer (OCC, other sites in the mouth) is decreasing. There is the need to identify high risk groups and communities for further study and intervention. The objective of this study was to determine how the incidence of OPC and OCC varied by neighbourhood socioeconomic status (SES) in British Columbia (BC), including the magnitude of any inequalities and temporal trends. METHODS: ICDO-3 codes were used to identify OPC and OCC cases in the BC Cancer Registry from 1981–2010. Cases were categorized by postal codes into SES quintiles (q1-q5) using VANDIX, which is a census-based, multivariate weighted index based on neighbourhood average household income, housing tenure, educational attainment, employment and family structure. Age-standardized incidence rates were determined for OPC and OCC by sex and SES quintiles and temporal trends were then examined. RESULTS: Incidence rates are increasing in both men and women for OPC, and decreasing in men and increasing in women for OCC. This change is not linear or proportionate between different SES quintiles, for there is a sharp and dramatic increase in incidence according to the deprivation status of the neighbourhood. The highest incidence rates in men for both OPC and OCC were observed in the most deprived SES quintile (q5), at 1.7 times and 2.2 times higher, respectively, than men in the least deprived quintile (q1). For OPC, the age-adjusted incidence rates significantly increased in all SES quintiles with the highest increase observed in the most deprived quintile (q5). Likewise, the highest incidence rates for both OPC and OCC in women were observed in the most deprived SES quintile (q5), at 2.1 times and 1.8 times higher, respectively, than women in the least deprived quintile (q1). CONCLUSION: We report on SES disparities in oral cancer, emphasizing the need for community-based interventions that address access to medical care and the distribution of educational and health promotion resources among the most SES deprived communities in British Columbia
A Randomized Controlled Trial of an Extensive Lifestyle Management Intervention (ELMI) Following Cardiac Rehabilitation: Study Design and Baseline Data
Availability, aff ordability, and consumption of fruits and vegetables in 18 countries across income levels: fi ndings from the Prospective Urban Rural Epidemiology (PURE) study
Background Several international guidelines recommend the consumption of two servings of fruits and three servings
of vegetables per day, but their intake is thought to be low worldwide. We aimed to determine the extent to which such
low intake is related to availability and aff ordability.
Methods We assessed fruit and vegetable consumption using data from country-specifi c, validated semi-quantitative
food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants
from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data
from participants in these communities; we also recorded the diversity and non-sale prices of fruits and vegetables
from grocery stores and market places between Jan 1, 2009, and Dec 31, 2013. We determined the cost of fruits and
vegetables relative to income per household member. Linear random eff ects models, adjusting for the clustering of
households within communities, were used to assess mean fruit and vegetable intake by their relative cost.
Findings Of 143 305 participants who reported plausible energy intake in the food frequency questionnaire, mean
fruit and vegetable intake was 3·76 servings (95% CI 3·66–3·86) per day. Mean daily consumption was 2·14 servings
(1·93–2·36) in low-income countries (LICs), 3·17 servings (2·99–3·35) in lower-middle-income countries (LMICs),
4·31 servings (4·09–4·53) in upper-middle-income countries (UMICs), and 5·42 servings (5·13–5·71) in highincome
countries (HICs). In 130 402 participants who had household income data available, the cost of two servings
of fruits and three servings of vegetables per day per individual accounted for 51·97% (95% CI 46·06–57·88) of
household income in LICs, 18·10% (14·53–21·68) in LMICs, 15·87% (11·51–20·23) in UMICs, and 1·85% (–3·90 to
7·59) in HICs (ptrend=0·0001). In all regions, a higher percentage of income to meet the guidelines was required in
rural areas than in urban areas (p<0·0001 for each pairwise comparison). Fruit and vegetable consumption among
individuals decreased as the relative cost increased (ptrend=0·00040).
Interpretation The consumption of fruit and vegetables is low worldwide, particularly in LICs, and this is associated
with low aff ordability. Policies worldwide should enhance the availability and aff ordability of fruits and vegetables
Socioeconomic and Geographic Patterning of Smoking Behaviour in Canada: A Cross-Sectional Multilevel Analysis
Objective: To describe the socioeconomic and geographic distribution of smoking behaviour in Canada among 19,383 individuals (51% women) aged 15–85 years. Methods: Current smoking and quitting were modeled using standard and multilevel logistic regression. Markers of socioeconomic status (SES) were education and occupation. Geography was defined by Canadian Provinces. Results: The adjusted prevalence of current smoking was 20.2% (95% confidence interval [CI]: 18.8–21.7) and 63.7% (95% CI: 61.1–66.3) of ever smokers had quit. Current smoking decreased and quitting increased with increasing SES. The adjusted prevalence of current smoking was 32.8% (95% CI: 28.4–37.5) among the least educated compared to 11.0% (95% CI: 8.9–13.4) for the highest educated. Among the least educated, 53.0% (95% CI: 46.8–59.2) had quit, rising to 68.7% (95% CI: 62.7–74.1) for the most educated. There was substantial variation in current smoking and quitting at the provincial level; current smoking varied from 17.9% in British Columbia to 26.1% in Nova Scotia, and quitting varied from 57.4% in Nova Scotia to 67.8% in Prince Edward Island. Nationally, increasing education and occupation level were inversely associated with current smoking (odds ratio [OR] 0.64, 95% CI: 0.60–0.68 for education; OR 0.82, 95% CI: 0.77–0.87 for occupation) and positively associated with quitting (OR 1.27, 95% CI: 1.16–1.40 for education; OR 1.20, 95% CI: 1.12–1.27 for occupation). These associations were consistent in direction across provinces although with some variability in magnitude. Conclusion: Our findings indicate that socioeconomic inequalities in smoking have persisted in Canada; current smoking was less likely and quitting was more likely among the better off groups and in certain provinces. Current prevention and cessation policies have not been successful in improving the situation for all areas and groups. Future efforts to reduce smoking uptake and increase cessation in Canada will need consideration of socioeconomic and geographic factors to be successful
Innovative Test Operations to Support Orion and Future Human Rated Missions
This paper describes how the Orion program is implementing new and innovative test approaches and strategies in an evolving development environment. The early flight test spacecraft are evolving in design maturity and complexity requiring significant changes in the ground test operations for each mission. The testing approach for EM-2 is planned to validate innovative Orion production acceptance testing methods to support human exploration missions in the future. Manufacturing and testing at Kennedy Space Center in the Neil Armstrong Operations and Checkout facility will provide a seamless transition directly to the launch site avoiding transportation and checkout of the spacecraft from other locations
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