Patterns of sex-specific and age-specific risk indicators of suicide: a population-nested case-control study

To determine the age- and sex-specific prevalence and risk indicators of uncorrected refractive error and unmet refractive need among a population-based sample of Latino adults. Self-identified Latinos 40 years of age and older (n = 6129) from six census tracts in La Puente, California, underwent a complete ophthalmic examination, and a home-administered questionnaire provided self-reported data on potential risk indicators. Uncorrected refractive error was defined as a >or=2-line improvement with refraction in the better seeing eye. Unmet refractive need was defined as having <20/40 visual acuity in the better seeing eye and achieving >or=20/40 after refraction (definition 1) or having <20/40 visual acuity in the better seeing eye and achieving a >or=2-line improvement with refraction (definition 2). Sex- and age-specific prevalence and significant risk indicators for uncorrected refractive error and unmet refractive need were calculated. The overall prevalence of uncorrected refractive error was 15.1% (n = 926). The overall prevalence of unmet refractive need was 8.9% (n = 213, definition 1) and 9.6% (n = 218, definition 2). The prevalence of uncorrected refractive error and either definition of unmet refractive need increased with age (P < 0.0001). No sex-related difference was present. Older age, <12 years of education, and lack of health insurance were significant independent risk indicators for uncorrected refractive error and unmet refractive need. The data suggest that the prevalence of uncorrected refractive error and unmet refractive need is high in Latinos of primarily Mexican ancestry. Better education and access to care in older Latinos are likely to decrease the burden of uncorrected refractive error in Latinos.

Suicide is a public health problem, with multiple causes that are poorly understood. The increased focus on combining health care data with machine-learning approaches in psychiatry may help advance the understanding of suicide risk. To examine sex-specific risk profiles for death from suicide using machine-learning methods and data from the population of Denmark. A case-cohort study nested within 8 national Danish health and social registries was conducted from January 1, 1995, through December 31, 2015. The source population was all persons born or residing in Denmark as of January 1, 1995. Data were analyzed from November 5, 2018, through May 13, 2019. Exposures included 1339 variables spanning domains of suicide risk factors. Death from suicide from the Danish cause of death registry. A total of 14 103 individuals died by suicide between 1995 and 2015 (10 152 men [72.0%]; mean [SD] age, 43.5 [18.8] years and 3951 women [28.0%]; age, 47.6 [18.8] years). The comparison subcohort was a 5% random sample (n = 265 183) of living individuals in Denmark on January 1, 1995 (130 591 men [49.2%]; age, 37.4 [21.8] years and 134 592 women [50.8%]; age, 39.9 [23.4] years). With use of classification trees and random forests, sex-specific differences were noted in risk for suicide, with physical health more important to men's suicide risk than women's suicide risk. Psychiatric disorders and possibly associated medications were important to suicide risk, with specific results that may increase clarity in the literature. Generally, diagnoses and medications measured 48 months before suicide were more important indicators of suicide risk than when measured 6 months earlier. Individuals in the top 5% of predicted suicide risk appeared to account for 32.0% of all suicide cases in men and 53.4% of all cases in women. Despite decades of research on suicide risk factors, understanding of suicide remains poor. In this study, the first to date to develop risk profiles for suicide based on data from a full population, apparent consistency with what is known about suicide risk was noted, as well as potentially important, understudied risk factors with evidence of unique suicide risk profiles among specific subpopulations.

Familial Abdominal Aortic Aneurysms Don't Occur Earlier in Life, Neither do they Progress More Rapidly – Observations from Two Population Based Screening Trials

Chronic kidney disease (CKD) is a growing health issue that is becoming more prevalent globally, increasing financial cost on healthcare systems. The purpose of this study is to investigate the incidence of eye diseases in patients diagnosed with CKD in Sweden and to evaluate which eye diseases are most likely to develop. A longitudinal population-based retrospective case-control study was conducted including all individuals diagnosed with chronic kidney disease during the time period 2001-2019. A total of 19 455 cases and 38 890 controls were included. For each case, two controls were matched with the same sex, age, and county of residence. CKD patients had a significantly higher risk of contracting any eye disease compared to individuals without kidney disease HR 1.73 (CI 1.67-1.79), with an elevated risk for all blocks of diagnoses except for glaucoma HR 0.95 (CI 0.85-1.06). However, this condition developed earlier in cases than in controls. Subanalyses showed an increased risk for chronic eye disease patients to develop cataract HR 1.70 (CI 1.63-1.78), other retinal disorders HR 1.86 (CI 1.72-2.02), and retinal vascular occlusions HR 2.08 (CI 1.73-2.51). In general, diagnosis of an eye disease occurred earlier in cases than controls. The results from this study suggest that CKD patients have an increased risk to develop eye disease. Ocular disease seems to develop considerably earlier in CKD, even without staging the severity of the disease, with particularly high risk of developing retinal diseases and cataracts. Screening for eye disease in CKD should be considered.

Socioeconomic disparities associated with 29 common infectious diseases in Sweden, 2005–14: an individually matched case-control study

The incidence of early-onset colorectal cancer (CRC), diagnosed younger than 50 years of age, has increased worldwide. Gut dysbiosis throughout the life course is hypothesized as a leading mechanism, yet epidemiologic data are limited. To prospectively examine the association between birth by cesarean delivery and early-onset CRC among offspring. In this population-based, nationwide case-control study in Sweden, adults diagnosed with CRC between 18 and 49 years of age from 1991 to 2017 were identified through the Epidemiology Strengthened by Histopathology Reports in Sweden (ESPRESSO) cohort. Up to 5 general population control individuals without CRC were matched with each case on age, sex, calendar year, and county of residence. Pathology-confirmed end points were linked with the Swedish Medical Birth Register and other national registers. Analyses were conducted from March 2022 through March 2023. Birth by cesarean delivery. The primary outcome was development of early-onset CRC in the overall population and by sex. We identified 564 case patients with incident early-onset CRC (mean [SD] age, 32.9 [6.2] years; 284 [50.4%] male) and 2180 matched controls (mean [SD] age, 32.7 [6.3] years; 1104 [50.6%] male). Compared with vaginal delivery, birth by cesarean delivery was not associated with early-onset CRC in the overall population (adjusted odds ratio [aOR], 1.28; 95% CI, 0.91-1.79) after multivariable adjustment for matching and maternal and pregnancy-related factors. A positive association was found for females (aOR, 1.62; 95% CI, 1.01-2.60), but there was no association for males (aOR, 1.05; 95% CI, 0.64-1.72). In this nationwide, population-based case-control study, birth by cesarean delivery was not associated with early-onset CRC compared with birth by vaginal delivery in the overall population in Sweden. However, females born by cesarean delivery had greater odds of early-onset CRC compared with individuals born through vaginal delivery. This finding suggests that early-life gut dysbiosis may contribute to early-onset CRC in females.

Mortality in people with mental disorders in the Czech Republic: a nationwide, register-based cohort study

BackgroundIdentifying the dental caries risk factors helps plan interventions. This scoping review mapped the existing literature on dental caries risk indicators for children, adolescents, and adults in Nigeria. It elucidated the commonalities and differences in these populations' behavioral, biological, and social risk indicators, and identified the local government areas in Nigeria where information on dental caries risk indicators are missing.MethodsA search of the literature search was performed in July 2023 in PubMed, African Journal Online, Google Scholar, and Cochrane Library [CENTRAL] using a combination of keywords related to dental caries, risk factors, early childhood, children, adults, and Nigeria. Only peer-reviewed full-length articles on risk factors for dental caries in Nigeria published in English were included. Descriptive statistics were used to summarize the study's characteristics and risk indicators for dental caries. The risk indicators for dental caries were categorized into behavioral, biological, and social. Differences and commonalities of the identified behavioral, biological, and social risk indicators for the three populations were identified.ResultsAfter screening 570 studies, 27 publications for preschoolers, 37 for school children/adolescents, and 17 for adults met the inclusion criteria. For all groups, key social risk indicators were age, gender, socioeconomic, and educational status, biological risk indicators were anthropometric measurements and bacterial counts, and behavioral risks indicators were toothbrushing, snacking, and oral hygiene. Peculiar behavioral, biological, and social risk indicators were identified for each age group. Most studies are clustered in southern Nigeria. In addition, studies in preschoolers was skew to southwestern Nigeria, that of children/adolescents were skewed to Ife Central LGA in Osun State, while that for adults were skewed to Egor LGA in Edo State. Furthermore, participants recruitment was most diverse in Lagos State.ConclusionsThe shared risk indicators for dental caries can facilitate the development of overarching caries prevention program for the difference age groups in Nigeria. while the age specific risk indicators can inform the development of population specific interventions. This scoping review underscores the importance of a holistic, life course approach to dental caries risk management.

This study aimed to identify risk indicators associated with periodontitis and the contribution of each of the indicators towards the prevalence, extent and severity of periodontitis in a rural Indian population. A cross-sectional study design was used to collect data according to National Survey of Adult Oral Health Australia guidelines. A multistage stratified random sampling was followed to select 1401 participants, who were in the age group of 35-54years. The participants were selected from 50 villages belonging to the 5 sub-provinces of 2 Indian districts. Data were collected through face-to-face interviews and oral examination. Statistical analysis was performed using SAS version 9.3. The univariate, bivariate and multivariate analyses were performed to determine the risk indicators of prevalence, extent and severity of periodontitis. Population attributable fraction was estimated for each of the significant risk indicators of prevalence and extent. In this study, factors such as age, education, tobacco chewing and plaque accumulation were significantly associated with the prevalence of periodontitis. Age, socioeconomic status, method of tooth cleaning, alcohol consumption and plaque accumulation were significant risk indicators for generalized periodontitis. Age, tobacco chewing and plaque were associated with severity of periodontitis in the population. The rural population had a high prevalence of periodontitis. Sociodemographic factors, poor oral hygiene, tobacco and alcohol were the main risk indicators attributable to periodontitis.

Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study

Background: Somatization disorder is multiple medically unexplained symptoms of long duration&amp; involve multiple organ systems.Objectives: To study the prevalence of somatization disorder among patients of PHC. Centers and the role of the various sociodemographic factors also demonstrate the presentation &amp; clinical pattern of somatization disorder.Methods: Out of 678 patients who were selected randomly from two of primary health care centers in Diwaniya city over a period from the first of October 2009 to 31th December 2009. These patients were interviewed using the International Diagnostic checklist for ICD-10 somatization disorder.Results: The study reveals that 14.6%of the patients have Somatization Disorder. and it is most common among (46-55) years age group(19.1%), females(19.7%), divorced (27.8%), illiterate(24.3%), low family income(21.2%) &amp; unemployed (17.0%) patients.&#x0D; Somatization Disorder was least common among age group(15-25) years(4.5%), male(8.1%), married(12%), highly educated (7.3%), high family income(6.7%) &amp; employed(11.8%) patients. The most common presentation of somatization disorder. was pain in limbs, extremities or joints( 81.8%) .Conclusions : Somatization Disorder. is relatively common in PHC. visitors &amp; this represent a big burden on health institutions if remain undiagnosed for long period.

To assess the prevalence of clustering of risk indicators for periodontal disease and association of clustering of the risk indicators with sociodemographic factors and the prevalence of moderate/severe periodontal disease in rural Indian 35-54 year-olds. A multi-stage cluster random sampling design was used for this population-based cross-sectional study. Data were collected through in-person interviews relating to sociodemographic factors and habits. Plaque index and periodontal findings were recorded from oral examination. Clustering of risk indicators such as smoking, tobacco chewing, alcohol and plaque were assessed for association with periodontal disease and various other sociodemographic indicators using logistic regression models. Results: Of 1,401 people approached, 873 completed data; a response rate of 62.3%. Clustering of two or more risk indicators was present in 31% of the population. Prevalence of moderate-severe periodontal disease was 46.6%. Simultaneous presence of two/more risk indicators was strongly associated with sociodemographic factors and periodontal disease. Clustering of two or more of the factors plaque, smoking, chewing tobacco and alcohol, was strongly associated with periodontitis.

The resemblance between fallopian tube cells and serous borderline ovarian tumors (BOTs) suggests a potential origin link, with salpingitis proposed as a contributing factor in the pathogenesis of BOT. This study aimed to explore the potential association between pelvic inflammatory disease (PID) and the risk of developing BOT. A national population-based case-control study in Sweden included women with BOT between 1999 and 2020 and 10 matched controls. Data from nationwide registers were analyzed using conditional logistic regression, adjusting for age, residential district, educational level and parity. Among 4782 cases and 45,167 controls, 2.0% of cases and 1.3% of controls had a history of PID. Previous PID was associated with an increased risk of BOT overall (aOR, 1.48; 95% CI, 1.19-1.85). Significant association was observed with serous tumors (aOR, 1.76; 95% CI, 1.36-2.29), while not with mucinous tumors (aOR, 0.95; 95% CI, 0.60-1.49). A dose-response relationship between number of PID episodes and serous BOT risk was noted (Ptrend < .001). This study demonstrates that PID is associated with increased risk of serous BOT, with a dose response relationship. The study highlights the potential serious implications of upper reproductive tract infections and inflammation. This underscores the need for further investigation of biological mechanisms and possible impact of PID on serous BOT development.

BackgroundDetermining risk indicators behind dental caries is important for identifying children in need of enhanced dental care. The aim of this register-based study was to investigate the association of family-related risk indicators and dental attendance in the development of dental caries in preschool children.MethodsThe data for this study were collected from the medical records of 206 randomly chosen preschool children who lived in the city of Oulu, Finland, during 2014–2020. Data on challenges in family life, missing appointments and utilization of oral health care were collected. Sum functions were formed of risk indicators. Analyses were carried out for three age groups (1- to 2-, 3- to 4- and 5- to 6-year-olds) born between 2014 and 2018.ResultsThere was a significant association between the number of family-related risk indicators and the prevalence of manifested caries lesions in the age group of 5- to 6-year-olds. All family-related risk indicators and information about health care utilization were associated with dental caries risk. Challenges in a child’s family life were present among 20.3% of the 5- to 6-year-olds. In all age groups, the most common challenges in family life were parental exhaustion and problems in the parents’ relationship or divorce.ConclusionFamily-related risk indicators and dental attendance should be considered when determining caries risk. The caries risk indicators investigated here are associated with each other.

Falls are common in community-dwelling elderly persons and are a frequent source of morbidity. Simple indices to prospectively stratify people into categories at different fall-risk would be useful to health care practitioners. Our goal was to develop a fall-risk index that discriminated between people at high and low risk of falling. We evaluated the risk of falling over a one-year period in 557 elderly persons (mean age 81.6) living in a retirement community. On the baseline interview, we asked subjects if they had fallen in the previous year and evaluated risk factors in six additional conceptual categories. On the follow-up interview one year later, we again asked subjects if they had fallen in the prior year. We evaluated risk factors in the different conceptual categories and used logistic regression to determine the independent predictors of falling over a one-year period. We used these independent predictors to create a fall-risk index. We compared the ability of a prior falls history with other risk factors and with the combination of a falls history and other risk factors to discriminate fallers from nonfallers. A fall in the previous year (OR = 2.42, 95% CI = 1.49-3.93), a symptom of either balance difficulty or dizziness (OR = 1.83, 95% CI = 1.16-2.89), or an abnormal mobility exam (OR = 2.64, 95% CI = 1.64-4.26) were independent predictors of falling over the subsequent year. These three risk factors together (c statistic =.71) discriminated fallers from nonfallers better than previous history of falls alone (c statistic =.61) or the symptomatic and exam risk factors alone (c statistic =.68). When combined into a risk index, the three independent risk factors stratify people into groups whose risk for falling over the subsequent year ranges from 10% to 51%. A history of falling over the prior year, a risk factor that can be obtained from a clinical history (balance difficulty or dizziness), and a risk factor that can be obtained from a physical exam (mobility difficulty) stratify people into groups at low and high risk of falling over the subsequent year. This risk index may provide a simple method of assessing fall risk in community-dwelling elderly persons. However, it requires validation in other subjects before it can be recommended for widespread use.