BACKGROUND: Quantifying the burden of parasitic diseases in relation to other diseases and injuries requires reliable estimates of prevalence for each disease and an analytic framework within which ...to estimate attributable morbidity and mortality. Here we use data included in the Global Atlas of Helminth Infection to derive new global estimates of numbers infected with intestinal nematodes (soil-transmitted helminths, STH: Ascaris lumbricoides, Trichuris trichiura and the hookworms) and use disability-adjusted life years (DALYs) to estimate disease burden. METHODS: Prevalence data for 6,091 locations in 118 countries were sourced and used to estimate age-stratified mean prevalence for sub-national administrative units via a combination of model-based geostatistics (for sub-Saharan Africa) and empirical approaches (for all other regions). Geographical variation in infection prevalence within these units was approximated using modelled logit-normal distributions, and numbers of individuals with infection intensities above given thresholds estimated for each species using negative binomial distributions and age-specific worm/egg burden thresholds. Finally, age-stratified prevalence estimates for each level of infection intensity were incorporated into the Global Burden of Disease Study 2010 analytic framework to estimate the global burden of morbidity and mortality associated with each STH infection. RESULTS: Globally, an estimated 438.9 million people (95% Credible Interval (CI), 406.3 - 480.2 million) were infected with hookworm in 2010, 819.0 million (95% CI, 771.7 – 891.6 million) with A. lumbricoides and 464.6 million (95% CI, 429.6 – 508.0 million) with T. trichiura. Of the 4.98 million years lived with disability (YLDs) attributable to STH, 65% were attributable to hookworm, 22% to A. lumbricoides and the remaining 13% to T. trichiura. The vast majority of STH infections (67%) and YLDs (68%) occurred in Asia. When considering YLDs relative to total populations at risk however, the burden distribution varied more considerably within major global regions than between them. CONCLUSION: Improvements in the cartography of helminth infection, combined with mathematical modelling approaches, have resulted in the most comprehensive contemporary estimates for the public health burden of STH. These numbers form an important benchmark upon which to evaluate future scale-up of major control efforts.
Evaluation of the Healthy Eating Index-2015 Reedy, Jill; Lerman, Jennifer L.; Krebs-Smith, Susan M. ...
Journal of the Academy of Nutrition and Dietetics,
September 2018, 2018-09-00, 20180901, Letnik:
118, Številka:
9
Journal Article
Recenzirano
Odprti dostop
The Healthy Eating Index (HEI), a diet quality index that measures alignment with the Dietary Guidelines for Americans, was updated with the 2015-2020 Dietary Guidelines for Americans.
To evaluate ...the psychometric properties of the HEI-2015, eight questions were examined: five relevant to construct validity, two related to reliability, and one to assess criterion validity.
Three data sources were used: exemplary menus (n=4), National Health and Nutrition Examination Survey 2011-2012 (N=7,935), and the National Institutes of Health-AARP (formally known as the American Association of Retired Persons) Diet and Health Study (N=422,928).
Exemplary menus: Scores were calculated using the population ratio method. National Health and Nutrition Examination Survey 2011-2012: Means and standard errors were estimated using the Markov Chain Monte Carlo approach. Analyses were stratified to compare groups (with t tests and analysis of variance). Principal components analysis examined the number of dimensions. Pearson correlations were estimated between components, energy, and Cronbach’s coefficient alpha. National Institutes of Health-AARP Diet and Health Study: Adjusted Cox proportional hazards models were used to examine scores and mortality outcomes.
For construct validity, the HEI-2015 yielded high scores for exemplary menus as four menus received high scores (87.8 to 100). The mean score for National Health and Nutrition Examination Survey was 56.6, and the first to 99th percentile were 32.6 to 81.2, respectively, supporting sufficient variation. Among smokers, the mean score was significantly lower than among nonsmokers (53.3 and 59.7, respectively) (P<0.01), demonstrating differentiation between groups. The correlation between diet quality and diet quantity was low (all <0.25) supporting these elements being independent. The components demonstrated multidimensionality when examined with a scree plot (at least four dimensions). For reliability, most of the intercorrelations among the components were low to moderate (0.01 to 0.49) with a few exceptions, and the standardized Cronbach’s alpha was .67. For criterion validity, the highest vs the lowest quintile of HEI-2015 scores were associated with a 13% to 23% decreased risk of all-cause, cancer, and cardiovascular disease mortality.
The results demonstrated evidence supportive of construct validity, reliability, and criterion validity. The HEI-2015 can be used to examine diet quality relative to the 2015-2020 Dietary Guidelines for Americans.
Update of the Healthy Eating Index: HEI-2015 Krebs-Smith, Susan M.; Pannucci, TusaRebecca E.; Subar, Amy F. ...
Journal of the Academy of Nutrition and Dietetics,
September 2018, 2018-09-00, 20180901, Letnik:
118, Številka:
9
Journal Article
Recenzirano
Odprti dostop
The Healthy Eating Index (HEI) is a measure for assessing whether a set of foods aligns with the Dietary Guidelines for Americans (DGA). An updated HEI is released to correspond to each new edition ...of the DGA, and this article introduces the latest version, which reflects the 2015-2020 DGA. The HEI-2015 components are the same as in the HEI-2010, except Saturated Fat and Added Sugars replace Empty Calories, with the result being 13 components. The 2015-2020 DGA include explicit recommendations to limit intakes of both Added Sugars and Saturated Fats to <10% of energy. HEI-2015 does not account for excessive energy from alcohol within a separate component, but continues to account for all energy from alcohol within total energy (the denominator for most components). All other components remain the same as for HEI-2010, except for a change in the allocation of legumes. Previous versions of the HEI accounted for legumes in either the two vegetable or the two protein foods components, whereas HEI-2015 counts legumes toward all four components. Weighting approaches are similar to those of previous versions, and scoring standards were maintained, refined, or developed to increase consistency across components; better ensure face validity; follow precedent; cover a range of intakes; and, when applicable, ensure the DGA level corresponds to a score >7 out of 10. HEI-2015 component scores can be examined collectively using radar graphs to reveal a pattern of diet quality and summed to represent overall diet quality.
Summary Background Data on causes of vision impairment and blindness are important for development of public health policies, but comprehensive analysis of change in prevalence over time is lacking. ...Methods We did a systematic analysis of published and unpublished data on the causes of blindness (visual acuity in the better eye less than 3/60) and moderate and severe vision impairment (MSVI visual acuity in the better eye less than 6/18 but at least 3/60) from 1980 to 2012. We estimated the proportions of overall vision impairment attributable to cataract, glaucoma, macular degeneration, diabetic retinopathy, trachoma, and uncorrected refractive error in 1990–2010 by age, geographical region, and year. Findings In 2010, 65% (95% uncertainty interval UI 61–68) of 32·4 million blind people and 76% (73–79) of 191 million people with MSVI worldwide had a preventable or treatable cause, compared with 68% (95% UI 65–70) of 31·8 million and 80% (78–83) of 172 million in 1990. Leading causes worldwide in 1990 and 2010 for blindness were cataract (39% and 33%, respectively), uncorrected refractive error (20% and 21%), and macular degeneration (5% and 7%), and for MSVI were uncorrected refractive error (51% and 53%), cataract (26% and 18%), and macular degeneration (2% and 3%). Causes of blindness varied substantially by region. Worldwide and in all regions more women than men were blind or had MSVI due to cataract and macular degeneration. Interpretation The differences and temporal changes we found in causes of blindness and MSVI have implications for planning and resource allocation in eye care. Funding Bill & Melinda Gates Foundation, Fight for Sight, Fred Hollows Foundation, and Brien Holden Vision Institute.
Recent neurocomputational theories have hypothesized that abnormalities in prior beliefs and/or the precision-weighting of afferent interoceptive signals may facilitate the transdiagnostic emergence ...of psychopathology. Specifically, it has been suggested that, in certain psychiatric disorders, interoceptive processing mechanisms either over-weight prior beliefs or under-weight signals from the viscera (or both), leading to a failure to accurately update beliefs about the body. However, this has not been directly tested empirically. To evaluate the potential roles of prior beliefs and interoceptive precision in this context, we fit a Bayesian computational model to behavior in a transdiagnostic patient sample during an interoceptive awareness (heartbeat tapping) task. Modelling revealed that, during an interoceptive perturbation condition (inspiratory breath-holding during heartbeat tapping), healthy individuals (N = 52) assigned greater precision to ascending cardiac signals than individuals with symptoms of anxiety (N = 15), depression (N = 69), co-morbid depression/anxiety (N = 153), substance use disorders (N = 131), and eating disorders (N = 14)-who failed to increase their precision estimates from resting levels. In contrast, we did not find strong evidence for differences in prior beliefs. These results provide the first empirical computational modeling evidence of a selective dysfunction in adaptive interoceptive processing in psychiatric conditions, and lay the groundwork for future studies examining how reduced interoceptive precision influences visceral regulation and interoceptively-guided decision-making.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical ...activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.
The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on the use of actigraphy.
The American Academy of Sleep Medicine commissioned a task force of ...experts in sleep medicine. A systematic review was conducted to identify studies that compared the use of actigraphy, sleep logs, and/or polysomnography. Statistical analyses were performed to determine the clinical significance of using actigraphy as an objective measure of sleep and circadian parameters. Finally, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence for making recommendations.
The literature search resulted in 81 studies that met inclusion criteria; all 81 studies provided data suitable for statistical analyses. These data demonstrate that actigraphy provides consistent objective data that is often unique from patient-reported sleep logs for some sleep parameters in adult and pediatric patients with suspected or diagnosed insomnia, circadian rhythm sleep-wake disorders, sleep-disordered breathing, central disorders of hypersomnolence, and adults with insufficient sleep syndrome. These data also demonstrate that actigraphy is not a reliable measure of periodic limb movements in adult and pediatric patients. The task force provided a detailed summary of the evidence along with the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.
Objectives: Guided by Fredrickson's broaden and build theory of positive emotions and Zautra's dynamic model of affect, the current study examines the relation between savoring positive experiences ...(i.e., the ability to notice and regulate positive feelings) and psychological well-being for older adults with higher and lower levels of resilience.
Method: A sample of 164 (74% female) older adults living in a large metropolitan area participated in this study. Participants were recruited from a continuing care retirement community and community centers in the surrounding area. Participants completed a survey measuring savoring, resilience, happiness, depression, and satisfaction with life.
Results: In older adults, greater ability to savor positive experiences and higher resilience both predicted greater happiness, lower depression, and greater satisfaction with life (i.e., greater psychological well-being). Savoring is associated with positive outcomes for people with higher and lower levels of resilience. However, the relationship between savoring and psychological well-being is stronger for people with lower resilience.
Conclusion: These findings have implications for the development of positive psychological interventions to enhance resilience and well-being in older adults. From a practical standpoint, adaptable interventions to enhance savoring and boost positive emotions in older adults may improve well-being and resilience to life's stressors.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The purpose of this guideline is to establish clinical practice recommendations for the use of actigraphy in adult and pediatric patients with suspected or diagnosed sleep disorders or circadian ...rhythm sleep-wake disorders.
The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assigned strengths based on a systematic review of the literature and an assessment of the evidence using the GRADE process. The task force provided a summary of the relevant literature and the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations that support the recommendations. The AASM Board of Directors approved the final recommendations.
The following recommendations are intended as a guide for clinicians using actigraphy in evaluating patients with sleep disorders and circadian rhythm sleep-wake disorders, and only apply to the use of FDA-approved devices. Each recommendation statement is assigned a strength ("Strong" or "Conditional"). A "Strong" recommendation (ie, "We recommend…") is one that clinicians should follow under most circumstances. A "Conditional" recommendation (ie, "We suggest…") reflects a lower degree of certainty regarding the outcome and appropriateness of the patient-care strategy for all patients. The ultimate judgment regarding any specific care must be made by the treating clinician and the patient, taking into consideration the individual circumstances of the patient, available treatment options, and resources. We suggest that clinicians use actigraphy to estimate sleep parameters in adult patients with insomnia disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of pediatric patients with insomnia disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of adult patients with circadian rhythm sleep-wake disorder. (Conditional). We suggest that clinicians use actigraphy in the assessment of pediatric patients with circadian rhythm sleep-wake disorder. (Conditional). We suggest that clinicians use actigraphy integrated with home sleep apnea test devices to estimate total sleep time during recording (in the absence of alternative objective measurements of total sleep time) in adult patients suspected of sleep-disordered breathing. (Conditional). We suggest that clinicians use actigraphy to monitor total sleep time prior to testing with the Multiple Sleep Latency Test in adult and pediatric patients with suspected central disorders of hypersomnolence. (Conditional). We suggest that clinicians use actigraphy to estimate total sleep time in adult patients with suspected insufficient sleep syndrome. (Conditional). We recommend that clinicians
use actigraphy in place of electromyography for the diagnosis of periodic limb movement disorder in adult and pediatric patients. (Strong).
Frontal electroencephalographic (EEG) alpha asymmetry is widely researched in studies of emotion, motivation, and psychopathology, yet it is a metric that has been quantified and analyzed using ...diverse procedures, and diversity in procedures muddles cross-study interpretation. The aim of this article is to provide an updated tutorial for EEG alpha asymmetry recording, processing, analysis, and interpretation, with an eye towards improving consistency of results across studies. First, a brief background in alpha asymmetry findings is provided. Then, some guidelines for recording, processing, and analyzing alpha asymmetry are presented with an emphasis on the creation of asymmetry scores, referencing choices, and artifact removal. Processing steps are explained in detail, and references to MATLAB-based toolboxes that are helpful for creating and investigating alpha asymmetry are noted. Then, conceptual challenges and interpretative issues are reviewed, including a discussion of alpha asymmetry as a mediator/moderator of emotion and psychopathology. Finally, the effects of two automated component-based artifact correction algorithms—MARA and ADJUST—on frontal alpha asymmetry are evaluated.
•Frontal EEG asymmetry is widely but inconsistently quantified and analyzed.•This review overviews of data acquisition and processing procedures.•Spatial transformations will enhance recording of frontal activity specifically.•A special focus is provided on ICA-based artifact correction procedures.•Statistical and conceptual models are reviewed.
PDF
