An investigation of the role of poly(ADP-Ribosyl)ation in Arabidopsis thaliana stress responses

Abstract available: p.ii

Lavindkomst og antal kontakter med almen praksis

Introduction: The purpose of this study is to examine whether there exist differences in utilization of general practice between low income groups and citizens with higher income after adjustment for social and health-related factors Material and methods: Various registers from Statistics Denmark with information on all adult citizens of Odense Municipality in 2003-2005 are applied. Income is measured as equivalent disposable income and adjustment for social and health-related personal characteristics are conducted using Poisson regression. Results: Poor with income below 73.000 DKK have 2-3 fewer contacts with general practice annually than those with an income of 73.000-146.000 DKK, depending upon age groups. The difference in contacts with general practice between the poor and those with a higher income is statistically significant. The difference is reduced to 1.5 fewer contacts after adjustment for differences in social and health-related characteristics. Conclusion: Poor adults have significantly fewer contacts with general practice than those with higher income. The difference is not explained by social and health-related factors. This is in contrast to results from earlier studies and may be an indication of underutilization of general practice. Other explanations may be that the poor enter the primary health sector through other channels, that the type and quality of contacts vary between income groups or that adjustment for health or other need indicators are not sufficient.Health care utilization; General Practice; poverty; Social inequality

Self-reported vs. objectively assessed adherence to inhaled corticosteroids in asthma

BACKGROUND: Adherence to inhaled corticosteroids (ICS) in asthma is vital for disease control. However, obtaining reliable and clinically useful measures of adherence remains a major challenge. We investigated the association between patient-reported adherence and objectively measured adherence based on filled prescriptions with inhaled corticosteroids in adults with asthma. METHODS: In total, 178 patients with asthma were asked to self-assess adherence during routine visits at a respiratory outpatient clinic. Self-assessment was performed using Foster score (“How many days in a 7-day week do you take your medication as prescribed?”, with the answer divided by 7). Objective adherence was calculated as medication possession ratio (MPR). Bivariate and multivariable linear regression, adjusted for age, sex, FEV(1), GINA treatment step, excessive use of SABA, and history of exacerbations were used for analyses. RESULTS: Of the included patients, 87.6% reported a Foster score of 100%, while the mean ICS MPR was 54.0% (SD 25%). Complex regimens such as twice-daily dosing or dual inhaler-use were associated with lower adherence (p = 0.015 and p < 0.001, respectively). Foster score was predictive of ICS MPR, with an absolute 32% increase in MPR between patients reporting Foster scores of 0 and 100% (95% CI 13–50%, p < 0.001). Female sex predicted higher ICS MPR (p = 0.019). Previous asthma-related hospitalization(s) predicted lower ICS MPR (p = 0.039). CONCLUSION: Although a weak association was found between Foster score and ICS MPR, findings do not support the use of Foster score, and by that self-reported adherence, as a reliable marker of controller adherence in asthma due to significant mismatch between patient-reported adherence and MPR. Future studies should address the complex interplay between patient-reported and objectively assessed adherence to controller medication in asthma. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40733-021-00072-2

Associations between birth weight and colon and rectal cancer risk in adulthood

AbstractBackgroundBirth weight has inconsistent associations with colorectal cancer, possibly due to different anatomic features of the colon versus the rectum. The aim of this study was to investigate the association between birth weight and colon and rectal cancers separately.Methods193,306 children, born from 1936 to 1972, from the Copenhagen School Health Record Register were followed prospectively in Danish health registers. Colon and rectal cancer cases were defined using the International Classification of Disease version 10 (colon: C18.0–18.9, rectal: 19.9 and 20.9). Only cancers classified as adenocarcinomas were included in the analyses. Cox regressions were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Analyses were stratified by birth cohort and sex.ResultsDuring 3.8 million person-years of follow-up, 1465 colon and 961 rectal adenocarcinomas were identified. No significant sex differences were observed; therefore combined results are presented. Birth weight was positively associated with colon cancers with a HR of 1.14 (95% CI, 1.04–1.26) per kilogram of birth weight. For rectal cancer a significant association was not observed for birth weights below 3.5kg. Above 3.5kg an inverse association was observed (at 4.5kg, HR=0.77 [95% CI, 0.61–0.96]). Further, the associations between birth weight and colon and rectal cancer differed significantly from each other (p=0.006).ConclusionsBirth weight is positively associated with the risk of adult colon cancer, whereas the results for rectal cancer were inverse only above values of 3.5kg. The results underline the importance of investigating colon and rectal cancer as two different entities