To compare the secular trends of sleep/wake patterns in school-aged children in Hong Kong and Shanghai, two major metropolitan cities in China with two different policies that school start time was ...delayed in Shanghai, but advanced in Hong Kong in 10 years' time.
Participants were from two waves of cross-sectional school-based surveys of children aged 6 to 11 years. In Shanghai, 4,339 and 13,795 children participated in the 2005 and 2014 surveys, respectively. In Hong Kong, 6,231 and 4,585 children participated in the 2003 and 2012 surveys, respectively. Parents reported their children's bedtime and wakeup time, and thus sleep duration, short sleep (≤ 9 hours) and weekend oversleep (difference in sleep duration between weekday and weekend > 2 hours) were determined.
Hong Kong children had later bedtime and wakeup time and slept consistently less than their Shanghai counterparts at both survey time points. The shorter sleep duration was particularly marked during weekdays. Over the interval period, weekday sleep duration significantly decreased from 9.2 to 8.9 hours as wakeup time became earlier for Hong Kong children, but increased from 9.4 to 9.6 hours as wakeup time became later for children in Shanghai. Children from both cities slept longer on the weekends. Prevalence of weekend oversleep significantly increased in Hong Kong children, but no interval change was found in Shanghai children.
The findings indicate subcultural differences in sleep/wake patterns in Shanghai and Hong Kong school-aged children. In particular, sleep duration had increased for Shanghai children, but decreased for Hong Kong children over 10 years. The benefits and barriers of delaying school start time for optimizing sleep health in school-aged children should be further explored.
Adenomyosis symptoms are disabling. Population-based data on incidence and prevalence of adenomyosis are lacking that could guide future evidence-based treatments and clinical management.
To evaluate ...the incidence, 10-year secular trends, and prevalence of adenomyosis diagnoses and to describe symptoms and treatment patterns in a large U.S. cohort.
We performed a retrospective population-based cohort study of women aged 16–60 years in 2006–2015, enrolled in Kaiser Permanente Washington, a mixed-model health insurance and care delivery system. Adenomyosis diagnoses identified by ICD codes from the International Classification of Diseases 9th and 10th editions and potential covariates were extracted from computerized databases. Women with prior hysterectomy, and for incidence estimates women with prior adenomyosis diagnoses, were excluded. Linear trends in incidence rates over the 10-year study period were evaluated using Poisson regression. Rates and trend tests were examined for all women adjusting for age using direct standardization to the 2015 study population, by age groups, and by race/ethnicity. Chart reviews were performed to validate diagnostic accuracy of ICD codes in identifying adenomyosis incidence. Symptoms and treatment patterns at diagnosis and in the following 5 years were assessed.
A total of 333,693 women contributed 1,185,855 woman-years (2006–2015) for incidence calculations. Associated symptom-related codes (menorrhagia or abnormal uterine bleeding, dysmenorrhea or pelvic pain, dyspareunia, and infertility) were observed in 90.8%; 18.0% had co-occurrent endometriosis codes and 47.6% had co-occurrent uterine fibroid codes. The overall adenomyosis incidence was 1.03% or 28.9 per 10,000 woman-years, with a high of 30.6 in 2007 and a low of 24.4 in 2014. Overall age-adjusted estimated incidence rates declined during the 10-year study interval (linear trend P < .05). Incidence was highest for women aged 41–45 years (69.1 per 10,000 woman-years in 2008) and was higher for black (highest 44.6 per 10,000 woman-years in 2011) vs white women (highest 27.9 per 10,000 woman-years in 2010). Overall prevalence in 2015 was 0.8% and was highest among women aged 41–45 years (1.5%). Among the 624 potential adenomyosis cases identified by diagnostic codes in 2012–2015 and with sufficient information in the medical record to determine true case status, 490 were confirmed as incident cases, yielding a 78.5% (95% confidence interval, 75.1%, 81.7%) positive predictive value of adenomyosis ICD-9/ICD-10 codes for identifying an incident adenomyosis case. Health care burden was substantial: 82.0% of women had hysterectomies, nearly 70% had imaging studies suggestive of adenomyosis, and 37.6% used chronic pain medications.
Adenomyosis burden to the individual and the health care system is high. Incidence rates are disproportionately high among black women. These findings are of concern, as currently available long-term medical therapies remain limited beyond hysterectomy. Our data and methodologies are novel and could serve as a foundation to guide clinicians and health care systems to develop clinical management plans and track outcomes for women with adenomyosis.
Objectives
The question whether mental illness prevalence rates are increasing is a controversially debated topic. Epidemiological articles and review publications that look into this research issue ...are often compromised by methodological problems. The present study aimed at using a meta‐analysis technique that is usually applied for the analysis of intervention studies to achieve more transparency and statistical precision.
Methods
We searched PubMed, PsycINFO, CINAHL, Google Scholar and reference lists for repeated cross‐sectional population studies on prevalence rates of adult mental illness based on ICD‐ or DSM‐based diagnoses, symptom scales and distress scales that used the same methodological approach at least twice in the same geographical region. The study is registered with PROSPERO (CRD42018090959).
Results
We included 44 samples from 42 publications, representing 1 035 697 primary observations for the first time point and 783 897 primary observations for the second and last time point. Studies were conducted between 1978 and 2015. Controlling for a hierarchical data structure, we found an overall global prevalence increase in odds ratio of 1.179 (95%‐CI: 1.065–1.305). A multivariate meta‐regression suggested relevant associations with methodological characteristics of included studies.
Conclusions
We conclude that the prevalence increase in adult mental illness is small, and we assume that this increase is mainly related to demographic changes.
Summary Dementia is receiving increasing attention from governments and politicians. Epidemiological research based on western European populations done 20 years ago provided key initial evidence for ...dementia policy making, but these estimates are now out of date because of changes in life expectancy, living conditions, and health profiles. To assess whether dementia occurrence has changed during the past 20–30 years, investigators of five different studies done in western Europe (Sweden Stockholm and Gothenburg, the Netherlands Rotterdam, the UK England, and Spain Zaragoza) have compared dementia occurrence using consistent research methods between two timepoints in well-defined geographical areas. Findings from four of the five studies showed non-significant changes in overall dementia occurrence. The only significant reduction in overall prevalence was found in the study done in the UK, powered and designed explicitly from its outset to detect change across generations (decrease in prevalence of 22%; p=0·003). Findings from the study done in Zaragoza (Spain) showed a significant reduction in dementia prevalence in men (43%; p=0·0002). The studies estimating incidence done in Stockholm and Rotterdam reported non-significant reductions. Such reductions could be the outcomes from earlier population-level investments such as improved education and living conditions, and better prevention and treatment of vascular and chronic conditions. This evidence suggests that attention to optimum health early in life might benefit cognitive health late in life. Policy planning and future research should be balanced across primary (policies reducing risk and increasing cognitive reserve), secondary (early detection and screening), and tertiary (once dementia is present) prevention. Each has their place, but upstream primary prevention has the largest effect on reduction of later dementia occurrence and disability.
To assess changes in the prevalence of overweight and obesity among Canadian children and adults between 1981 and 1996 using recent recommendations for the classification of overweight and obesity. ...Epidemiological study comparing the prevalence of overweight and obesity from the 1981 Canada Fitness Survey (CFS) to the 1996 National Longitudinal Survey of Children and Youth (NLSCY) and the 1996 National Population Health Survey (NPHS). Adults 20-64 y of age and children 7-13 y of age from the CFS, NLSCY and NPHS. BMI was calculated from directly measured or self-reported body mass and height. For adults 20-64 y of age, overweight and obesity were defined as BMI greater than or equal to 25 kg/m super(2) and BMI greater than or equal to 30 kg/m super(2), respectively. Age- and sex-specific cut-off points for children that correspond to the adulthood categories were used to define overweight and obesity for children 7-13 y of age. The prevalence of overweight increased from 48 to 57% among men and from 30 to 35% among women, while the prevalence of obesity increased from 9 to 14% in men and from 8 to 12% in women. The corresponding increases were from 11 to 33% in boys and from 13 to 27% in girls for overweight and from 2 to 10% in boys and from 2 to 9% in girls for obesity. The results indicate dramatic increases in the prevalence of both overweight and obesity in Canada over the last 15 y, and the problem is particularly pronounced among children.
Multiple meta-analyses have shown sperm count declines in Western countries spanning eight decades. Secular trends in other parameters remain unclear, as are potential predictors of these trends.
To ...analyze secular trends in semen quality and to evaluate whether factors previously found to be related to semen quality were responsible for these patterns.
This is a prospective study including 936 men of couples seeking infertility treatment who provided 1618 semen samples at a single center (2000–2017). Self-reported demographic, nutritional and reproductive characteristics were collected using standardized questionnaires. Urinary concentrations of bisphenol A, parabens and phthalates were quantified by isotope-dilution tandem mass spectrometry. Semen samples were analyzed for volume, sperm concentration, count, motility and morphology following WHO guidelines. We estimated the differences in semen parameters over time by fitting generalized linear mixed models with random intercepts to account for repeated samples while adjusting for abstinence time. We also adjusted for demographic, nutritional and environmental factors to investigate these as potential predictors of time trends.
Sperm concentration and count declined by 2.62% per year (95% CI −3.84, −1.38) and 3.12% per year (95% CI: −4.42, −1.80), corresponding to an overall decline of 37% and 42%, respectively, between 2000 and 2017. Decreasing trends were also observed for total motility (per year: −0.44 percentage units, 95% CI −0.71, −0.17) and morphologically normal sperm (per year: −0.069 percentage units, 95% CI −0.116, −0.023). These decreases reflected relative percentage declines of 15% and 16% over the 17 year study period, respectively. When reproductive factors were included in the model, the downward trends in sperm concentration and sperm count were attenuated by 29% and 26%, respectively, while the trends in motility and morphology were attenuated by 54% and 53%, respectively. Also, the downward trends in both sperm concentration and sperm morphology over time were attenuated by 19% when including the DEHP and non-DEHP metabolites, respectively.
Sperm concentration, total count, motility and morphology significantly declined between 2000 and 2017 among subfertile men. These negative trends were attenuated when considering simultaneous changes in reproductive characteristics and urinary phthalates during the course of the study.
•Sperm concentration and count declined 37% and 42%, respectively, between 2000 and 2017 among men attending a fertility center in Boston.•Total motility and morphologically normal sperm declined 15% and 16% over the 17 year study period, respectively.•When reproductive factors were included in the model, the downward trends in semen parameters were attenuated between 29% and 54%.•The downward trends in sperm concentration and morphology were attenuated by 19% when including the DEHP and non-DEHP metabolites, respectively.
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