59 research outputs found
Evaluation of a questionnaire to assess selected infectious diseases and their risk factors: Findings of a multicenter study
Background/objectives The risk to die from an infectious disease in Germany has been continuously decreasing over the last century. Since infections are, however, not only causes of death but risk factors for diseases like cardiovascular diseases, it is essential to monitor and analyze their prevalence and frequency, especially in consideration of the increased life expectancy. To gain more knowledge about infectious diseases as risk factors and their implications on the condition and change of the immune status, the German National Cohort (GNC), a population-based prospective cohort study, will recruit 200,000 subjects between 2014 and 2017. In Pretest 1, a feasibility study for the GNC, we evaluated a self-administered and self-report questionnaire on infectious diseases and on the use of health care facilities (hereinafter called âID Screenâ) for feasibility and validity. Methods: From AugustâNovember 2011, 435 participants between the ages of 20â69 completed the ID Screen. All subjects had been recruited via a random sample from the local residentsâ registration offices by 4 of the 18 participating study centers. The questionnaire encompasses 77 variables in six sections assessing items such as 12-month prevalence of infections, cumulative prevalence of infectious diseases, visit of health care facilities and vaccination. The feasibility was amongst others evaluated by assessing the completeness and comprehensiveness of the questionnaire. To assess the questionnaires ability to measure âimmune statusâ and âsusceptibility to infectionsâ, multivariate analysis was used. Results: The overall practicability was good and most items were well understood, demonstrated by 5 % of missing values. However, direct comparison of the items 12-month prevalence and lifetime prevalence of nephritis/pyelitis showed poor agreement and thereby poor understanding by 80 % of the participants, illustrating the necessity for a clear, lay person appropriate description of rare diseases to increase comprehensibility. The questionnaire will be used to support the assessment of immune dysfunction and frequency of infection. An analysis of these constructs in an exploratory factor analysis revealed limited applicability due to low interitem correlation (Cronbachâs α < 0.5). This is corroborated by the extraction of more than one factor with a KaiserâMeyerâOlkin measure of 0.6 instead of a unidimensional latent construct for âimmune statusâ. Conclusion: All in all, the ID Screen is a good and reliable tool to measure infectious diseases as risk factors and outcome in general, but requires a better translation of infection specific terms into lay person terms. For the assessment of the overall immune status, the tool has strong limitations. Vaccinations status should also rather be assessed based on vaccination certificates than on participantsâ recall. Electronic supplementary material The online version of this article (doi: 10.1007/s00103-014-2052-y) contains supplementary material, which is available to authorized users
A question of scale: How turbulence around aerial roots shapes the seabed morphology in mangrove forests of the Mekong Delta
Mangrove forests are highly productive ecosystems that provide many physical, societal, and ecological services in tropical and subtropical regions. Accurate prediction of the morphological evolution for these areas, in the face of global sea level rise and changes in sediment supply, requires understanding of interactions between vegetation growth, water flows, and sediment transport. Data presented from a wave-exposed mangrove forest in the Mekong Delta, Vietnam, include unique measurements that resolved water flows in and around the aerial mangrove roots (known as pneumatophores) over scales from a few millimeters to hundreds of meters. Flows were highly turbulent, with turbulence values sometimes as large as those measured in surf zones. These energetic processes appear to stir up sediments, with small scour troughs observed around individual pneumatophores, and larger-scale scour around clusters of pneumatophores. The vegetation fringe (the boundary between forest and mudflat) was a particularly dynamic area, with elevated turbulence levels, greater vegetation densities, coarser sediments, and occasional wave breaking. Intense turbulent dissipation at the fringe then reduces the energy of shoreward-propagating waves, sheltering the forest interior. The small-scale processes appear to be linked with forest-wide patterns of sediment transport and deposition. We discuss these links in the context of the biophysical interactions that control the changing shapes of deltas worldwide
Pocket depth and bleeding on probing and their associations with dental, lifestyle, socioeconomic and blood variables: a cross-sectional, multicenter feasibility study of the German National Cohort
Background: To investigate the periodontal disease status in a multi-center cross-sectional study in Germany. Associations of dental, socio-economic, blood and biomedical variables with periodontal outcome parameters were evaluated. Methods: From 4 different centers Nâ=â311 persons were included, drawn randomly from the registration offices. Maximal pocket depth (PD) was used as primary indicator for periodontitis. It was classified as: no/mild â€3 mm, moderate 4-5 mm, severe â„6 mm. Associations between socioeconomic (household income, education), lifestyle, and biomedical factors and PD or bleeding on probing (BOP) per site (âYesâ/âNoâ) was analyzed with logistic regression analysis. Results: Mean age of subjects was 46.4 (range 20â77) years. A significantly higher risk of deeper pockets for smokers (ORâ=â2.4, current vs. never smoker) or persons with higher BMI (ORâ=â1.6, BMI increase by 5) was found. Severity of periodontitis was significantly associated with caries lesions (pâ=â0.01), bridges (pâ<â.0001), crowns (pâ<â.0001), leukocytes (pâ=â0.04), HbA1c (pâ<â.0001) and MCV (pâ=â0.04). PD was positively correlated with BOP. No significant associations with BOP were found in regression analysis. Conclusions: Earlier findings for BMI and smoking with severity of PD were confirmed. Dental variables might be influenced by potential confounding factors e.g. dental hygiene. For blood parameters interactions with unknown systemic diseases may exist
a cross-sectional, multicenter feasibility study of the German National Cohort
Background To investigate the periodontal disease status in a multi-center
cross-sectional study in Germany. Associations of dental, socio-economic,
blood and biomedical variables with periodontal outcome parameters were
evaluated. Methods From 4 different centers Nâ=â311 persons were included,
drawn randomly from the registration offices. Maximal pocket depth (PD) was
used as primary indicator for periodontitis. It was classified as: no/mild â€3
mm, moderate 4-5 mm, severe â„6 mm. Associations between socioeconomic
(household income, education), lifestyle, and biomedical factors and PD or
bleeding on probing (BOP) per site (âYesâ/âNoâ) was analyzed with logistic
regression analysis. Results Mean age of subjects was 46.4 (range 20â77)
years. A significantly higher risk of deeper pockets for smokers (ORâ=â2.4,
current vs. never smoker) or persons with higher BMI (ORâ=â1.6, BMI increase
by 5) was found. Severity of periodontitis was significantly associated with
caries lesions (pâ=â0.01), bridges (pâ<â.0001), crowns (pâ<â.0001), leukocytes
(pâ=â0.04), HbA1c (pâ<â.0001) and MCV (pâ=â0.04). PD was positively correlated
with BOP. No significant associations with BOP were found in regression
analysis. Conclusions Earlier findings for BMI and smoking with severity of PD
were confirmed. Dental variables might be influenced by potential confounding
factors e.g. dental hygiene. For blood parameters interactions with unknown
systemic diseases may exist
which marker is best for prediction? Pooled analysis of four German population-based cohort studies and comparison with a nationwide cohort study
Objective To compare the association between different anthropometric
measurements and incident type 2 diabetes mellitus (T2DM) and to assess their
predictive ability in different regions of Germany. Methods Data of 10â
258
participants from 4 prospective population-based cohorts were pooled to assess
the association of body weight, body mass index (BMI), waist circumference
(WC), waist-to-hip-ratio (WHR) and waist-to-height-ratio (WHtR) with incident
T2DM by calculating HRs of the crude, adjusted and standardised markers, as
well as providing receiver operator characteristic (ROC) curves. Differences
between HRs and ROCs for the different anthropometric markers were calculated
to compare their predictive ability. In addition, data of 3105 participants
from the nationwide survey were analysed separately using the same methods to
provide a nationally representative comparison. Results Strong associations
were found for each anthropometric marker and incidence of T2DM. Among the
standardised anthropometric measures, we found the strongest effect on
incident T2DM for WC and WHtR in the pooled sample (HR for 1 SD difference in
WC 1.97, 95% CI 1.75 to 2.22, HR for WHtR 1.93, 95% CI 1.71 to 2.17 in women)
and in female DEGS participants (HR for WC 2.24, 95% CI 1.91 to 2.63, HR for
WHtR 2.10, 95% CI 1.81 to 2.44), whereas the strongest association in men was
found for WHR among DEGS participants (HR 2.29, 95% CI 1.89 to 2.78). ROC
analysis showed WHtR to be the strongest predictor for incident T2DM.
Differences in HR and ROCs between the different markers confirmed WC and WHtR
to be the best predictors of incident T2DM. Findings were consistent across
study regions and age groups (<65 vs â„65â
years). Conclusions We found stronger
associations between anthropometric markers that reflect abdominal obesity
(ie, WC and WHtR) and incident T2DM than for BMI and weight. The use of these
measurements in risk prediction should be encouraged
Anthropometric markers and their association with incident type 2 diabetes mellitus: which marker is best for prediction? Pooled analysis of four German population-based cohort studies and comparison with a nationwide cohort study
Objective: To compare the association between different anthropometric measurements and incident type 2 diabetes mellitus (T2DM) and to assess their predictive ability in different regions of Germany. Methods: Data of 10â
258 participants from 4 prospective population-based cohorts were pooled to assess the association of body weight, body mass index (BMI), waist circumference (WC), waist-to-hip-ratio (WHR) and waist-to-height-ratio (WHtR) with incident T2DM by calculating HRs of the crude, adjusted and standardised markers, as well as providing receiver operator characteristic (ROC) curves. Differences between HRs and ROCs for the different anthropometric markers were calculated to compare their predictive ability. In addition, data of 3105 participants from the nationwide survey were analysed separately using the same methods to provide a nationally representative comparison. Results: Strong associations were found for each anthropometric marker and incidence of T2DM. Among the standardised anthropometric measures, we found the strongest effect on incident T2DM for WC and WHtR in the pooled sample (HR for 1 SD difference in WC 1.97, 95% CI 1.75 to 2.22, HR for WHtR 1.93, 95% CI 1.71 to 2.17 in women) and in female DEGS participants (HR for WC 2.24, 95% CI 1.91 to 2.63, HR for WHtR 2.10, 95% CI 1.81 to 2.44), whereas the strongest association in men was found for WHR among DEGS participants (HR 2.29, 95% CI 1.89 to 2.78). ROC analysis showed WHtR to be the strongest predictor for incident T2DM. Differences in HR and ROCs between the different markers confirmed WC and WHtR to be the best predictors of incident T2DM. Findings were consistent across study regions and age groups
Birth Order, Caesarean Section, or Daycare Attendance in Relation to Child- and Adult-Onset Type 1 Diabetes: Results from the German National Cohort
Background: Global incidence of type 1 diabetes (T1D) is rising and nearly half occurred in adults. However, it is unclear if certain early-life childhood T1D risk factors were also associated with adult-onset T1D. This study aimed to assess associations between birth order, delivery mode or daycare attendance and type 1 diabetes (T1D) risk in a population-based cohort and whether these were similar for childhood- and adult-onset T1D (cut-off age 15); (2) Methods: Data were obtained from the German National Cohort (NAKO Gesundheitsstudie) baseline assessment. Self-reported diabetes was classified as T1D if: diagnosis age †40 years and has been receiving insulin treatment since less than one year after diagnosis. Cox regression was applied for T1D risk analysis; (3) Results: Analyses included 101,411 participants (100 childhood- and 271 adult-onset T1D cases). Compared to âonly-childrenâ, HRs for second- or later-born individuals were 0.70 (95% CI = 0.50â0.96) and 0.65 (95% CI = 0.45â0.94), respectively, regardless of parental diabetes, migration background, birth year and perinatal factors. In further analyses, higher birth order reduced T1D risk in children and adults born in recent decades. Caesarean section and daycare attendance showed no clear associations with T1D risk; (4) Conclusions: Birth order should be considered in both children and adultsâ T1D risk assessment for early detection
The politics and aesthetics of commemoration: national days in southern Africa
The contributions to the special section in this issue study recent independence celebrations and other national days in South
Africa, Namibia, Zimbabwe, Madagascar and the Democratic Republic of Congo. They explore the role of national days in
state-making and nation-building, and examine the performativity of nationalism and the role of performances in national
festivities. Placing the case studies in a broader, comparative perspective, the introduction first discusses the role of the state in
national celebrations, highlighting three themes: firstly, the political power-play and contested politics of memory involved in
the creation of a countryâs festive calendar; secondly, the relationship between state control of national days and civic or
popular participation or contestation; and thirdly, the complex relationship between regional and ethnic loyalties and national
identifications. It then turns to the role of performance and aesthetics in the making of nations in general, and in national
celebrations in particular. Finally, we look at the different formats and meanings of national days in the region and address the
question whether there is anything specific about national days in southern Africa as compared to other parts of the continent
or national celebrations world-wide.Web of Scienc
Cardiovascular disease, risk factors and heart rate variability in the elderly general population: Design and objectives of the CARdiovascular disease, Living and Ageing in Halle (CARLA) Study
BACKGROUND: The increasing burden of cardiovascular diseases (CVD) in the ageing population of industrialized nations requires an intensive search for means of reducing this epidemic. In order to improve prevention, detection, therapy and prognosis of cardiovascular diseases on the population level in Eastern Germany, it is necessary to examine reasons for the East-West gradient of CVD morbidity and mortality, potential causal mechanisms and prognostic factors in the elderly. Psychosocial and nutritional factors have previously been discussed as possible causes for the unexplained part of the East-West gradient. A reduced heart rate variability appears to be associated with cardiovascular disease as well as with psychosocial and other cardiovascular risk factors and decreases with age. Nevertheless, there is a lack of population-based data to examine the role of heart rate variability and its interaction with psychosocial and nutritional factors regarding the effect on cardiovascular disease in the ageing population. There also is a paucity of epidemiological data describing the health situation in Eastern Germany. Therefore, we conduct a population-based study to examine the distribution of CVD, heart rate variability and CVD risk factors and their associations in an elderly East German population. This paper describes the design and objectives of the CARLA Study. METHODS/DESIGN: For this study, a random sample of 45â80 year-old inhabitants of the city of Halle (Saale) in Eastern Germany was drawn from the population registry. By the end of the baseline examination (2002â2005), 1750 study participants will have been examined. A multi-step recruitment strategy aims at achieving a 70 % response rate. Detailed information is collected on own and family medical history, socioeconomic, psychosocial, behavioural and biomedical factors. Medical examinations include anthropometric measures, blood pressure of arm and ankle, a 10-second and a 20-minute electrocardiogram, a general physical examination, an echocardiogram, and laboratory analyses of venous blood samples. On 200 participants, a 24-hour electrocardiogram is recorded. A detailed system of quality control ensures high data quality. A follow-up examination is planned. DISCUSSION: This study will help to elucidate pathways to CVD involving autonomic dysfunction and lifestyle factors which might be responsible for the CVD epidemic in some populations
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