Case-control study on uveal melanoma (RIFA): rational and design

BACKGROUND: Although a rare disease, uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence rate of up to 1.0 per 100,000 persons per year in Europe. Only a few consistent risk factors have been identified for this disease. We present the study design of an ongoing incident case-control study on uveal melanoma (acronym: RIFA study) that focuses on radiofrequency radiation as transmitted by radio sets and wireless telephones, occupational risk factors, phenotypical characteristics, and UV radiation. METHODS/DESIGN: We conduct a case-control study to identify the role of different exposures in the development of uveal melanoma. The cases of uveal melanoma were identified at the Division of Ophthalmology, University of Essen, a referral centre for tumours of the eye. We recruit three control groups: population controls, controls sampled from those ophthalmologists who referred cases to the Division of Ophthalmology, University of Duisburg-Essen, and sibling controls. For each case the controls are matched on sex and age (five year groups), except for sibling controls. The data are collected from the study participants by short self-administered questionnaire and by telephone interview. During and at the end of the field phase, the data are quality-checked. To estimate the effect of exposures on uveal melanoma risk, we will use conditional logistic regression that accounts for the matching factors and allows to control for potential confounding

Larger and More Prominent Graphic Health Warnings on Plain-Packaged Tobacco Products and Avoidant Responses in Current Smokers: a Qualitative Study

Background: The introduction of tobacco plain packaging legislation in Australia meant that all tobacco products were to be sold in plain dark-brown packaging with 75 % front-of-pack graphic health warnings and standardised font type and size for brand name and product variant. The change in the size and prominence of the warnings has been proposed as a reason for behaviour change in smokers in terms of increased intentions to quit and quit attempts. Purpose: The current research examined attitudes and beliefs of cigarette smokers toward the increased size and prominence of the warnings and effects on their behaviour. Method: Participants (N = 160) completed open-ended responses to questions on beliefs, attitudes and responses to plain packaging. Responses were subjected to inductive thematic content analysis for key themes. Results: Four themes emerged from the analysis: emotional response to packaging, scepticism of health warnings, warnings and cessation behaviour, and avoidant coping behaviours. Participants reported increased negative emotional responses to the packaging and made specific reference to the graphic health warnings. Some participants attempted to discredit the messages. Others reported increased intentions to quit or quitting attempts. There were pervasive reports of avoidant responses including covering or hiding the warnings. Conclusion: Consistent with theories of illness perceptions and coping, current findings indicate that the larger, prominent graphic health warnings on plain-packaged tobacco products had pervasive effects on threat perceptions and subsequent behavioural responses. While some of the reported responses were adaptive (e.g. attempts to quit), others were maladaptive (e.g. avoiding the warnings)

False-Positive Maternal Serum Screens in the Second Trimester as Markers of Placentally Mediated Complications Later in Pregnancy: A Systematic Review and Meta-Analysis

Background. Multiple-marker, maternal serum screening (MSS) has been the cornerstone of prenatal diagnosis since the 1980s. While combinations of these markers are used to predict fetal risk of Down syndrome and other genetic conditions, there is some evidence that individual markers may also predict nongenetic pregnancy complications, particularly those related to placental dysfunction. The objective of this meta-analysis was to investigate the utility of false-positive, second-trimester MSS for Down syndrome as a marker of placentally mediated complications amongst singleton pregnancies globally. Methods. Electronic searches of PubMed, Medline, Embase, CINAHL, Web of Science, Scopus, and grey literature to 2019 were performed to identify observational studies comparing risk of pregnancy complications amongst pregnancies with false-positive MSS versus controls. A random-effects model of pooled odds ratios by outcome of interest (stillbirth, preeclampsia, fetal growth restriction, and preterm birth) and subgrouped by type of MSS test (double-, triple-, and quadruple-marker MSS) was used. Results. 16 studies enrolling 68515 pregnancies were included. There were increased odds of preeclampsia (OR 1.28, 95% CI 1.09-1.51) and stillbirth (OR 2.46, 95% CI 1.94-3.12) amongst pregnancies with false-positive MSS. There was no significant association with preterm birth or growth restriction. Conclusions. There is some evidence of an association between false-positive, second-trimester MSS for Down syndrome and increased odds of preeclampsia and stillbirth. Future large-scale prospective studies are still needed to best determine the predictive value of false-positive MSS as a marker of placentally mediated complications later in pregnancy and evaluate potential clinical interventions to reduce these risks

Iodine nutrition among indigenous Tarahumara schoolchildren in Mexico

<p>Among indigenous boarding school children in northern Mexico, the total goiter rate was 7.0% and the median UI was 125 mg/l, suggesting the presence of a mild deficiency. </p

Measuring serum ferritin under field conditions

<p>Monárrez-Espino J and Greiner T. Measuring serum ferritin under field conditions. American Journal of Clinical Nutrition 76:1138, 2002.</p> <p>This research letter discusses some of the challenges of using the dried blood spot method of determining serum ferritin concentrations from capillary blood in isolated communities. </p

Qualitative evaluation: A critical and interpretative complementary approach to improve health programs and services

This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders’ perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries

Nutritional status of indigenous children at boarding schools in northern Mexico

<p>Monárrez-Espino J, Martínez H, Martínez-Juárez V, Greiner T. Nutritional status of indigenous children at boarding schools in northern Mexico. European Journal of Clinical Nutrition 58:532-540, 2004.</p

Tomographic assessment of pulmonary abnormalities of Long COVID: a cohort study

Introduction: SARS-CoV-2 infection primarily affects the lungs leading to a range of tomographic findings, from ground-glass opacity to emphysema. However, studies on the long-term effects of the infection, known as Long COVID, are still limited. Therefore, this cohort aimed to identify pulmonary abnormalities in adult patients with Long COVID, assessed by chest computed tomography (CT) 6 to 30 months after the initial infection. Material and Methods: A cohort of patients from northern Mexico, diagnosed with COVID-19 in 2020-2021 using RT-PCR and undergoing a simple chest CT examination, was followed up for 6 to 30 months. Logistic regression was used to determine predictors of Long COVID. Results: A total of 67 patients were included. Pulmonary tomographic abnormalities at 6 to 30 months were interstitial thickening (n = 41, 61.2%), subpleural bands (n = 41, 61.2%), ground-glass opacity (n = 30, 44.8%), pleural thickening (n = 18, 26.9%), bronchiectasis (n = 13, 19.4%), lymphadenomegaly (n = 11, 16.4%), emphysema (n = 6, 9.0%), and consolidation (n = 2, 3.0%). Ground-glass opacity and fibrotic abnormalities decreased with increasing follow-up time: e.g., interstitial thickening from 6 to 11 months (84.6%), 12 to 18 (65.0%), and 19 to 30 months (50.0%). Hypertension was the most significant predictor of Long COVID. Conclusion: Our study showed a high prevalence of persistent pulmonary abnormal tomographic findings in patients with Long COVID, probably due to the high prevalence of hypertension and diabetes. Ground-glass opacity and fibrotic abnormalities were the most commonly observed findings, which showed a decreasing trend over time

Young, inexperienced and on the road - do novice drivers comply with road rules?

Young novice drivers are at considerable risk of injury and fatality, particularly when they first drive independently. Graduated Driver Licensing (GDL) has been introduced in numerous jurisdictions to allow more driving experience in conditions of reduced risk and increasing driving privileges over a longer duration. Queensland, Australia, enhanced GDL July 2007. Learners must record 100 hours in a logbook (10 hours at night) over 1 year, no mobile handsfree/loudspeaker by driver or any passenger. Provisional 1 (P1) drivers must not carry 2 or more peer passengers 11pm - 5am, no mobile handsfree/loudspeaker by any passenger. Self-reported compliance with new GDL and general road rules has not been examined