Visual impairment and age-related eye diseases in Florida: Findings from 2006 Behavioral Risk Factors Surveillance System (BRFSS) in Nine states

Yan Li, Amy Z Fan, Lina S BalluzBehavioral Surveillance Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USAPurpose: To compare the prevalence of age-related eye disease, visual impairment, and eye care service utilization among adults aged 65 and older in Florida with eight other states. Methods: In 2006, nine states conducted the visual impairment and access to eye care module using the Behavioral Risk Factors Surveillance System (BRFSS) survey (N = 62,750). Visual impairment was based on self-reported ability to see distant and near objects. Age-related eye diseases including cataract, glaucoma, macular degeneration, and diabetic retinopathy were self-reported with diagnosis confirmed by a health care professional. Eye care visit or examination was assessed by whether a respondent reported an eye visit or dilated eye examination within the past year.Results: The estimated prevalence of distant and near visual impairment was lower in Florida than in the eight other states (distant: 11.5% vs 15.2%, P < 0.001; near: 22.3% vs 28.7%, P < 0.001). There was no significant difference with the prevalence of age-related macular degeneration and diabetic retinopathy between these two groups. The prevalence of glaucoma and cataract was higher in Florida. The rates of eye care visits (80.5% vs 74.8%, P < 0.01) and dilated eye examinations (74.7% vs 64.0%, P < 0.01) were higher in Florida. After controlling for demographic variables, chronic conditions, insurance, and eye examination, results for elderly in Florida continued to demonstrate less visually impaired.Conclusion: Fewer elderly in Florida reported visual impairment in spite of comparable or higher prevalence of age-related eye diseases with other states. Health care utilization and health insurance for eye care coverage were also higher in Florida, which may account for the phenomena. More research is needed to investigate the association.Keywords: visual impairment, age-related eye disease, eye care service utilization, health insurance, BRFS

Validation of reported physical activity for cholesterol control using two different physical activity instruments

The National Cholesterol Education Program recommends increasing physical activity to improve cholesterol levels and overall cardiovascular health. We examined whether US adults who reported increasing their physical activity to control or lower blood cholesterol following physician’s advice or on their own efforts had higher levels of physical activity than those who reported that they did not. We used data from the National Health and Nutrition Examination Survey 2003–2004, which implemented two physical activity assessment instruments. The physical activity questionnaire (PAQ) assessed self-reported frequency, intensity, and duration of leisure-time, household, and transportation-related physical activity in the past month. Physical movement was objectively monitored using a waist accelerometer that assessed minute-by-minute intensity (counts of movement/minute) during waking time over a 7-day period. We adjusted our analysis for age, gender, race/ethnicity, educational attainment, and body mass index. Participants who reported increasing physical activity to control blood cholesterol had more PAQ-assessed physical activity and more accelerometer-assessed active days per week compared to those who did not. However, there were no significant differences in cholesterol levels between comparison groups. These findings suggest that self-report of exercising more to control or lower cholesterol levels among US adults might be valid

Need for and Access to Health Care and Medicines: Are There Gender Inequities?

Objective: Differences between women and men in political and economic empowerment, education, and health risks are well-documented. Similar gender inequities in access to care and medicines have been hypothesized but evidence is lacking. Methods: We analyzed 2002 World Health Survey data for 257,922 adult respondents and 80,932 children less than 5 years old from 53 mostly low and middle-income countries. We constructed indicators of need for, access to, and perceptions of care, and we described the number of countries with equal and statistically different proportions of women and men for each indicator. Using multivariate logistic regression models, we estimated effects of gender on our study outcomes, overall and by household poverty. Findings: Women reported significantly more need for care for three of six chronic conditions surveyed, and they were more likely to have at least one of the conditions (OR 1.41 [95% CI 1.38, 1.44]). Among those with reported need for care, there were no consistent differences in access to care between women and men overall (e.g., treatment for all reported chronic conditions, OR 1.00 [0.96, 1.04]) or by household poverty. Of concern, access to care for chronic conditions was distressingly low among both men and women in many countries, as was access to preventive services among boys and girls less than 5 years old. Conclusions: These cross-country results do not suggest a systematic disadvantage of women in access to curative care and medicines for treating selected chronic conditions or acute symptoms, or to preventive services among boys and girls

Phosphorylation of the Human La Antigen on Serine 366 Can Regulate Recycling of RNA Polymerase III Transcription Complexes

AbstractThe human La antigen is an RNA-binding protein that facilitates transcriptional termination and reinitiation by RNA polymerase III. Native La protein fractionates into transcriptionally active and inactive forms that are unphosphorylated and phosphorylated at serine 366, respectively, as determined by enzymatic and mass spectrometric analyses. Serine 366 comprises a casein kinase II phosphorylation site that resides within a conserved region in the La proteins from several species. RNA synthesis from isolated transcription complexes is inhibited by casein kinase II-mediated phosphorylation of La serine 366 and is reversible by dephosphorylation. This work demonstrates a novel mechanism of transcriptional control at the level of recycling of stable transcription complexes

Principal Component Analysis of SDSS Stellar Spectra

We apply Principal Component Analysis (PCA) to ~100,000 stellar spectra obtained by the Sloan Digital Sky Survey (SDSS). In order to avoid strong non-linear variation of spectra with effective temperature, the sample is binned into 0.02 mag wide intervals of the g-r color (-0.20<g-r<0.90, roughly corresponding to MK spectral types A3 to K3), and PCA is applied independently for each bin. In each color bin, the first four eigenspectra are sufficient to describe the observed spectra within the measurement noise. We discuss correlations of eigencoefficients with metallicity and gravity estimated by the Sloan Extension for Galactic Understanding and Exploration (SEGUE) Stellar Parameters Pipeline. The resulting high signal-to-noise mean spectra and the other three eigenspectra are made publicly available. These data can be used to generate high quality spectra for an arbitrary combination of effective temperature, metallicity, and gravity within the parameter space probed by the SDSS. The SDSS stellar spectroscopic database and the PCA results presented here offer a convenient method to classify new spectra, to search for unusual spectra, to train various spectral classification methods, and to synthesize accurate colors in arbitrary optical bandpasses.Comment: 25 pages, 15 figures, accepted by the Astronomical Journa

Impact of the 2009 US Preventive Services Task Force Guidelines on Screening Mammography Rates on Women in Their 40s

Background: The 2009 US Preventive Services Task Force breast cancer screening update recommended against routine screening mammography for women aged 40–49; confusion and release of conflicting guidelines followed. We examined the impact of the USPSTF update on population-level screening mammography rates in women ages 40–49. Methods and Findings: We conducted a retrospective, interrupted time-series analysis using a nationally representative, privately-insured population from 1/1/2006-12/31/2011. Women ages 40–64 enrolled for ≥1 month were included. The primary outcome was receipt of screening mammography, identified using administrative claims-based algorithms. Time-series regression models were estimated to determine the effect of the guideline change on screening mammography rates. 5.5 million women ages 40–64 were included. A 1.8 per 1,000 women (p = 0.003) decrease in monthly screening mammography rates for 40–49 year-old women was observed two months following the guideline change; no initial effect was seen for 50–64 year-old women. However, two years following the guideline change, a slight increase in screening mammography rates above expected was observed in both age groups. Conclusions: We detected a modest initial drop in screening mammography rates in women ages 40–49 immediately after the 2009 USPSTF guideline followed by an increase in screening rates. Unfavorable public reactions and release of conflicting statements may have tempered the initial impact. Renewal of the screening debate may have brought mammography to the forefront of women's minds, contributing to the observed increase in mammography rates two years after the guideline change. This pattern is unlikely to reflect informed choice and underscores the need for improved translation of evidence-based care and guidelines into practice