ZusammenfassungHintergrundLärmbelästigung, insbesondere durch Verkehrslärm, stellt ein massives Problem in der Bevölkerung dar und ist mit gesundheitlichen Einschränkungen assoziiert.Ziel der ...ArbeitAnhand von Daten der bevölkerungsrepräsentativen Gutenberg-Gesundheitsstudie (GHS) werden die Prävalenz der Lärmbelästigung durch verschiedene Quellen sowie relevante Determinanten bestimmt.Material und MethodenDie GHS ist eine populationsbasierte, prospektive Kohortenstudie in Deutschland, die Personen im Alter von 35 bis 74 Jahren einbezieht. 15.010 Probanden aus der Stadt Mainz und dem Landkreis Mainz-Bingen wurden von 2007 bis 2012 befragt, inwiefern sie sich in letzter Zeit durch Flug‑, Straßen‑, Schienen‑, Industrie- und Nachbarschaftslärm belästigt gefühlt haben (Angaben von „überhaupt nicht“ bis „äußerst“). Es wurde jeweils zwischen der Lärmbelästigung am Tag sowie während des Schlafens differenziert. Um die Beziehungen zwischen soziodemographischen Variablen, kardiovaskulären Risikofaktoren sowie Erkrankungen und Lärmbelästigung zu untersuchen, wurden multivariable logistische Regressionsmodelle verwendet.ErgebnisseEtwa 80 % der Probanden fühlten sich durch Lärm belästigt. Fluglärmbelästigung am Tag stellte die vorherrschende Lärmbelästigungsquelle mit der höchsten Prävalenz stark (9,6 %) und äußerst lärmbelästigter Probanden dar (5,4 %), gefolgt von Straßenverkehrs- (stark: 4,0 %; äußerst: 1,6 %) und Nachbarschaftslärmbelästigung (stark: 3,5 %; äußerst: 1,3 %). Die Lärmbelästigung nahm eher mit zunehmender Altersdekade ab. Relevante Determinanten der Lärmbelästigung umfassten mitunter Geschlecht, Alter, sozioökonomischen Status, Depression, Angststörung, Schlafstörung und Vorhofflimmern.DiskussionLärmbelästigung betrifft einen Großteil der Bevölkerung und ist assoziiert mit soziodemographischen Variablen und kardiovaskulären Risikofaktoren sowie Erkrankungen.
In many different fields, social scientists desire to understand temporal variation associated with age, time period, and cohort membership. Among methods proposed to address the identification ...problem in age-period-cohort analysis, the intrinsic estimator (IE) is reputed to impose few assumptions and to yield good estimates of the independent effects of age, period, and cohort groups. This article assesses the validity and application scope of IE theoretically and illustrates its properties with simulations. It shows that IE implicitly assumes a constraint on the linear age, period, and cohort effects. This constraint not only depends on the number of age, period, and cohort categories but also has nontrivial implications for estimation. Because this assumption is extremely difficult, if not impossible, to verify in empirical research, IE cannot and should not be used to estimate age, period, and cohort effects.
The English Longitudinal Study of Ageing (ELSA) is a panel study of a representative cohort of men and women living in England aged ≥50 years. It was designed as a sister study to the Health and ...Retirement Study in the USA and is multidisciplinary in orientation, involving the collection of economic, social, psychological, cognitive, health, biological and genetic data. The study commenced in 2002, and the sample has been followed up every 2 years. Data are collected using computer-assisted personal interviews and self-completion questionnaires, with additional nurse visits for the assessment of biomarkers every 4 years. The original sample consisted of 11 391 members ranging in age from 50 to 100 years. ELSA is harmonized with ageing studies in other countries to facilitate international comparisons, and is linked to financial and health registry data. The data set is openly available to researchers and analysts soon after collection (http://www.esds.ac.uk/longitudinal/access/elsa/l5050.asp).
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common, associated with acute inflammation, and may increase subsequent cardiovascular disease (CVD) risk.
Determine whether ...AECOPD events are associated with increased risk of subsequent CVD.
We performed a secondary cohort analysis of the SUMMIT (Study to Understand Mortality and Morbidity) trial, a convenience sample of current/former smokers with moderate COPD from 1,368 centers in 43 countries. All had CVD or increased CVD risk. AECOPD was defined as an increase in respiratory symptoms requiring treatment with antibiotics, systemic corticosteroids, and/or hospitalization. CVD events were a composite outcome of cardiovascular death, myocardial infarction, stroke, unstable angina, and transient ischemic attack. All CVD events were adjudicated. Cox proportional hazards models compared the hazard for a CVD event before AECOPD versus after AECOPD.
Among 16,485 participants in SUMMIT, 4,704 participants had at least one AECOPD and 688 had at least one CVD event. The hazard ratio (HR) for CVD events after AECOPD was increased, particularly in the first 30 days after AECOPD (HR, 3.8; 95% confidence interval, 2.7-5.5) and was elevated up to 1 year after AECOPD. The 30-day HR after hospitalized AECOPD was more than twofold greater (HR, 9.9; 95% confidence interval, 6.6-14.9).
In patients with COPD with CVD or risk factors for CVD, exacerbations confer an increased risk of subsequent CVD events, especially in hospitalized patients and within the first 30 days after exacerbation. Patients and clinicians should have heightened vigilance for early CVD events after AECOPD. Clinical trial registered with www.clinicaltrials.gov (NCT 01313676).
Introduction: While video endoscopy capsule (VCE) and balloon assisted enteroscopy (BAE) have emerged as the gold standard for the evaluation and treatment of suspected small bowel bleeds (SSBB), ...little is known regarding the clinical efficacy when used in combination. Patient outcomes are described in Table 1. Clinical Efficacy of the Study Population Diagnostic Yield Inter-Modality Agreement Waiting Interval (days) VCE BAE P-Value Kappa 95% CI Strength Total (N=151) 68 (45%) 85 (56%) 0.06 0.22 0.14-0.30 Fair 1-7 (N=67) 23 (34%) 36 (53%) 0.04 0.16 0.05-0.27 Slight 1-30 (N=92) 31 (34%) 50 (54%) 0.01 0.18 0.08-0.27 Slight > 30 (N=59) 37 (62%) 35 (59%) 0.85 0.43 0.29-0.56 Moderate Subtypes Overt (N=68) 22 (32%) 39 (57%) 0.01 0.15 0.04-0.26 Slight Occult (N=83) 46 (55%) 46 (55%) 1 0.29 0.18-0.40 Fair Author Notes *Presenter
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