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Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

Volumen 11 (2017): Heft 6 (December 2017)

Zeitschriftendaten
Format
Zeitschrift
eISSN
1875-855X
Erstveröffentlichung
01 Jun 2007
Erscheinungsweise
6 Hefte pro Jahr
Sprachen
Englisch

Suche

6 Artikel

Editorial

access type Uneingeschränkter Zugang

Initiation and maintenance of breastfeeding: the need for essential support

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 433 - 434

Zusammenfassung

Original article

access type Uneingeschränkter Zugang

Determinants of consanguinity and inbreeding coefficient in the multiethnic population of Mardan, Khyber Pakhtunkhwa, Pakistan

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 451 - 460

Zusammenfassung

Abstract

Despite the high sociocultural preferences in contracting marriages among close relatives in Pakistan, marked regional differences exist in the prevalence of consanguinity. There is great interest to elucidate the sociodemographic variables underlying the heterogeneity in consanguinity prevalence in the various populations. The present study was conducted in the Mardan district of Pakistan, the second largest multiethnic Pashtun metropolis.

To find determinants of consanguineous unions.

In a cross-sectional study design, a convenience sample of 1,202 ever-married men from 3 tehsils of Mardan district was recruited in an unselected manner and data regarding their marital union types and sociodemographic variables were obtained by a structured interview. Descriptive statistics and multivariable logistic regression analyses were used.

Consanguineous unions accounted for 44% of all marriages, and the inbreeding coefficient was calculated as 0.0258. Regression analyses revealed that 6 variables were significant predictors of consanguinity, namely, tehsil, age, year of marriage, caste (zaat/biradari) system, area of house, and marriage arrangement of the respondent, while 6 other variables, namely, rural/urban origin, literacy, occupation, monthly income, household type, and number of family members, were not found to be significant. Regression analyses showed that there were different combinations of variables predictive of consanguinity among the various tehsils.

The prevalence of consanguinity in the Mardan district was found to be lower than that in many other districts of Pakistan. National regional differences exist in consanguinity, and the combination of predictive factors varies greatly.

Schlüsselwörter

  • consanguinity
  • cousin unions
  • epidemiology
  • inbreeding coefficient
  • Khyber Pakhtunkhwa
  • Mardan, Pakistani
  • Pashtuns
  • public health
access type Uneingeschränkter Zugang

Factors associated with glycemic control in children and adolescents with type 1 diabetes mellitus at a tertiary-care center in Thailand: a retrospective observational study

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 443 - 450

Zusammenfassung

Abstract

Children and adolescents with type 1 diabetes mellitus (T1D), even those with intensive insulin treatment regimens, often have higher glycated hemoglobin (HbA1c) levels than adults.

To delineate the medical and psychosocial factors associated with glycemic control in an unselected pediatric population with T1D.

We included a cross-section of 58 adolescents (28 boys and 30 girls) aged 13.6 ± 4.0 years with T1D ≥1 year attending a well-established pediatric diabetes clinic in Thailand. Median diabetes duration was 4.1 years (range 1–18 years). Participants were divided into 2 subgroups according to their average HbA1c level over the past year. Those with good control (HbA1c <8%) (n = 13) were compared with those with poor control (HbA1c ≥8%) (n = 45). Data collected from self-report standardized questionnaires and medical records were used to compare variables between groups.

Adolescents with good control used significantly less daily insulin and had higher family income, higher scores for family support, and quality of life (QoL) than those in the group with poor control (P < 0.05). Age, sex, puberty, duration of diabetes, insulin regimen, frequency of blood glucose monitoring, and self-report adherence did not differ between groups. By univariate logistic regression, the only factor associated significantly with poor glycemic control was a QoL score <25.

Adolescents with T1D may be at a higher risk of poor glycemic control if they have poor QoL, impaired family functioning, poor coping skills, and lower socioeconomic status, suggesting that psychosocial interventions could potentially improve glycemic control in this population.

Schlüsselwörter

  • adherence
  • adolescents
  • children
  • glycemic control type 1 diabetes mellitus (DM)
access type Uneingeschränkter Zugang

Paid maternity leave extension and exclusive breastfeeding practice: evidence from Brunei

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 435 - 442

Zusammenfassung

Abstract

Exclusive breastfeeding (EBF) of infants in their first 6 months postpartum is beneficial. However, maternal employment and short maternity leave impede EBF practice. In 2011, Brunei implemented a new Maternity Leave Regulation to extend paid maternity leave.

To compare the prevalence of EBF between employed and nonworking mothers in Brunei, before and after extending paid maternity leave, to determine its effect on EBF and to determine the effects of maternal and infant sociodemographic characteristics.

Cross-sectional review of feeding records for infants born in 2010 (n = 6412, 85.5% all live births) and 2013 (n = 6680, 85.7%).

EBF prevalence at 6 months postpartum increased from 29% in 2010 to 41% in 2013. EBF prevalence was higher among multiparous mothers (P < 0.001), mothers of Malay ethnicity (P < 0.05), and mothers of girls (P < 0.01 only in 2013) in both years. EBF prevalence among government-employed mothers (81.0%, 67.7%, and 57.8%) was greater than it was among nonworking mothers (79.1%, 66.3%, and 56.9%) by 1.9, 1.4, and 0.9 percentage points, respectively, during the first 3 months of active paid maternity leave in 2013. Mothers employed in the government and private sectors showed greater increases in the practice of EBF (15.5 and 10.8 percentage points respectively) than nonworking mothers (8.8 percentage points) from 2010 to 2013.

EBF prevalence increased after extending paid maternity leave, with the greatest increases seen among employed mothers. Maternal ethnicity, parity, and the sex of the infant were also correlated with EBF.

Schlüsselwörter

  • breastfeeding
  • child health and nutrition
  • early life
  • health policies
  • maternal
  • parity

Brief communication

access type Uneingeschränkter Zugang

Epidemiological, clinical, and genotype characterization of spinocerebellar ataxia type in families in Buriram province, northeast Thailand

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 469 - 474

Zusammenfassung

Abstract

In Thais, the most prevalent type of spinocerebellar ataxia (SCA) is type 3, most commonly known as Machado–Joseph disease (MJD), followed by SCA type 1 (SCA1), SCA2, and SCA6.

To describe the epidemiological, clinical, and genotypic features of SCA in northeastern Thailand and to study 2 associations: between syndromic features and the genotype of SCA, and between health determinants and scores on the scale for the assessment and rating of ataxia (SARA).

We conducted a cross-sectional study of 24 patients with autosomal dominant SCA from 13 families recruited from Buriram province in northeast Thailand between December 2009 and January 2014. Patients provided a clinical history and were examined by a neurologist. DNA was extracted from the peripheral blood of each patient. We analyzed associations between the type of SCA and sex, age, family history, clinical features, any underlying disease, age at onset, body weight, smoking status, family history, alcohol consumption, head injury history, and SARA.

Seven of the families were positive for SCA1 and 6 for MJD. There were 24 index patients from these autosomal dominant SCA families, including 13 with SCA1 and 11 with MJD. Their average age was 43.7 years (range 20–72 years), whereas their average age at disease onset was 36.9 years (range 18–59 years). Pyramidal signs between MJD and SCA1 were not significantly different. Extrapyramidal features appeared uncommon. Horizontal nystagmus and upward gaze paresis were significantly associated with MJD. There were no significant differences in demographic data between the groups with SARA scores ≥15 or <15.

MJD and SCA1 were the 2 adult-onset cerebellar degenerative diseases found in Buriram province. Clinical clues for differentiating between them were upward gaze paresis and horizontal nystagmus, which were significantly more common in MJD.

Schlüsselwörter

  • clinical characteristic
  • epidemiology
  • northeast Thailand
  • spinocerebellar ataxia type
access type Uneingeschränkter Zugang

Postoperative cure in Iranian patients with gastric cancer: estimating the crude conditional probability in a relative survival setting in the presence of competing risks

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 461 - 467

Zusammenfassung

Abstract

Following treatment, cancer patients may be clinically cured. However, they may die for reasons other than cancer, called competing risks.

To estimate postoperative cure while considering the competing risks in Iranian patients with gastric cancer.

Data were obtained from the Cancer Institute of Imam Hospital in Tehran. The analysis was conducted within the framework of relative survival by fitting the data to a flexible parametric cure model, taking into account the competing risks using general population data by adjusting for age, sex, and year of diagnosis.

Of the 326 patients (224 male and 102 female) whose data were included, 235 deaths (72.1%) occurred during the follow-up period. The probability of conditional cure in terms of crude ratios of dying from causes other than gastric cancer in the surviving patients increased with the passage of time, and the slope of excess mortality approached almost 0 after 7 years. The estimated cure ratios showed a variation from 69% for 50-year-old men with diagnosis at early stages (I and II) to 3% for 80-year-old women with diagnosis at stage IV.

The ratio of patients in Iran who were estimated to die from cancer reduced significantly with the passage of time following the diagnosis, and the statistical cure point was estimated to be 7 years after diagnosis. However, aging was shown to be inversely associated. Although the same trend was observed in both sexes, we showed that men were statistically more likely to reach the cure point.

Schlüsselwörter

  • competing risk
  • cure
  • gastric cancer
  • Iran
  • relative survival
6 Artikel

Editorial

access type Uneingeschränkter Zugang

Initiation and maintenance of breastfeeding: the need for essential support

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 433 - 434

Zusammenfassung

Original article

access type Uneingeschränkter Zugang

Determinants of consanguinity and inbreeding coefficient in the multiethnic population of Mardan, Khyber Pakhtunkhwa, Pakistan

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 451 - 460

Zusammenfassung

Abstract

Despite the high sociocultural preferences in contracting marriages among close relatives in Pakistan, marked regional differences exist in the prevalence of consanguinity. There is great interest to elucidate the sociodemographic variables underlying the heterogeneity in consanguinity prevalence in the various populations. The present study was conducted in the Mardan district of Pakistan, the second largest multiethnic Pashtun metropolis.

To find determinants of consanguineous unions.

In a cross-sectional study design, a convenience sample of 1,202 ever-married men from 3 tehsils of Mardan district was recruited in an unselected manner and data regarding their marital union types and sociodemographic variables were obtained by a structured interview. Descriptive statistics and multivariable logistic regression analyses were used.

Consanguineous unions accounted for 44% of all marriages, and the inbreeding coefficient was calculated as 0.0258. Regression analyses revealed that 6 variables were significant predictors of consanguinity, namely, tehsil, age, year of marriage, caste (zaat/biradari) system, area of house, and marriage arrangement of the respondent, while 6 other variables, namely, rural/urban origin, literacy, occupation, monthly income, household type, and number of family members, were not found to be significant. Regression analyses showed that there were different combinations of variables predictive of consanguinity among the various tehsils.

The prevalence of consanguinity in the Mardan district was found to be lower than that in many other districts of Pakistan. National regional differences exist in consanguinity, and the combination of predictive factors varies greatly.

Schlüsselwörter

  • consanguinity
  • cousin unions
  • epidemiology
  • inbreeding coefficient
  • Khyber Pakhtunkhwa
  • Mardan, Pakistani
  • Pashtuns
  • public health
access type Uneingeschränkter Zugang

Factors associated with glycemic control in children and adolescents with type 1 diabetes mellitus at a tertiary-care center in Thailand: a retrospective observational study

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 443 - 450

Zusammenfassung

Abstract

Children and adolescents with type 1 diabetes mellitus (T1D), even those with intensive insulin treatment regimens, often have higher glycated hemoglobin (HbA1c) levels than adults.

To delineate the medical and psychosocial factors associated with glycemic control in an unselected pediatric population with T1D.

We included a cross-section of 58 adolescents (28 boys and 30 girls) aged 13.6 ± 4.0 years with T1D ≥1 year attending a well-established pediatric diabetes clinic in Thailand. Median diabetes duration was 4.1 years (range 1–18 years). Participants were divided into 2 subgroups according to their average HbA1c level over the past year. Those with good control (HbA1c <8%) (n = 13) were compared with those with poor control (HbA1c ≥8%) (n = 45). Data collected from self-report standardized questionnaires and medical records were used to compare variables between groups.

Adolescents with good control used significantly less daily insulin and had higher family income, higher scores for family support, and quality of life (QoL) than those in the group with poor control (P < 0.05). Age, sex, puberty, duration of diabetes, insulin regimen, frequency of blood glucose monitoring, and self-report adherence did not differ between groups. By univariate logistic regression, the only factor associated significantly with poor glycemic control was a QoL score <25.

Adolescents with T1D may be at a higher risk of poor glycemic control if they have poor QoL, impaired family functioning, poor coping skills, and lower socioeconomic status, suggesting that psychosocial interventions could potentially improve glycemic control in this population.

Schlüsselwörter

  • adherence
  • adolescents
  • children
  • glycemic control type 1 diabetes mellitus (DM)
access type Uneingeschränkter Zugang

Paid maternity leave extension and exclusive breastfeeding practice: evidence from Brunei

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 435 - 442

Zusammenfassung

Abstract

Exclusive breastfeeding (EBF) of infants in their first 6 months postpartum is beneficial. However, maternal employment and short maternity leave impede EBF practice. In 2011, Brunei implemented a new Maternity Leave Regulation to extend paid maternity leave.

To compare the prevalence of EBF between employed and nonworking mothers in Brunei, before and after extending paid maternity leave, to determine its effect on EBF and to determine the effects of maternal and infant sociodemographic characteristics.

Cross-sectional review of feeding records for infants born in 2010 (n = 6412, 85.5% all live births) and 2013 (n = 6680, 85.7%).

EBF prevalence at 6 months postpartum increased from 29% in 2010 to 41% in 2013. EBF prevalence was higher among multiparous mothers (P < 0.001), mothers of Malay ethnicity (P < 0.05), and mothers of girls (P < 0.01 only in 2013) in both years. EBF prevalence among government-employed mothers (81.0%, 67.7%, and 57.8%) was greater than it was among nonworking mothers (79.1%, 66.3%, and 56.9%) by 1.9, 1.4, and 0.9 percentage points, respectively, during the first 3 months of active paid maternity leave in 2013. Mothers employed in the government and private sectors showed greater increases in the practice of EBF (15.5 and 10.8 percentage points respectively) than nonworking mothers (8.8 percentage points) from 2010 to 2013.

EBF prevalence increased after extending paid maternity leave, with the greatest increases seen among employed mothers. Maternal ethnicity, parity, and the sex of the infant were also correlated with EBF.

Schlüsselwörter

  • breastfeeding
  • child health and nutrition
  • early life
  • health policies
  • maternal
  • parity

Brief communication

access type Uneingeschränkter Zugang

Epidemiological, clinical, and genotype characterization of spinocerebellar ataxia type in families in Buriram province, northeast Thailand

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 469 - 474

Zusammenfassung

Abstract

In Thais, the most prevalent type of spinocerebellar ataxia (SCA) is type 3, most commonly known as Machado–Joseph disease (MJD), followed by SCA type 1 (SCA1), SCA2, and SCA6.

To describe the epidemiological, clinical, and genotypic features of SCA in northeastern Thailand and to study 2 associations: between syndromic features and the genotype of SCA, and between health determinants and scores on the scale for the assessment and rating of ataxia (SARA).

We conducted a cross-sectional study of 24 patients with autosomal dominant SCA from 13 families recruited from Buriram province in northeast Thailand between December 2009 and January 2014. Patients provided a clinical history and were examined by a neurologist. DNA was extracted from the peripheral blood of each patient. We analyzed associations between the type of SCA and sex, age, family history, clinical features, any underlying disease, age at onset, body weight, smoking status, family history, alcohol consumption, head injury history, and SARA.

Seven of the families were positive for SCA1 and 6 for MJD. There were 24 index patients from these autosomal dominant SCA families, including 13 with SCA1 and 11 with MJD. Their average age was 43.7 years (range 20–72 years), whereas their average age at disease onset was 36.9 years (range 18–59 years). Pyramidal signs between MJD and SCA1 were not significantly different. Extrapyramidal features appeared uncommon. Horizontal nystagmus and upward gaze paresis were significantly associated with MJD. There were no significant differences in demographic data between the groups with SARA scores ≥15 or <15.

MJD and SCA1 were the 2 adult-onset cerebellar degenerative diseases found in Buriram province. Clinical clues for differentiating between them were upward gaze paresis and horizontal nystagmus, which were significantly more common in MJD.

Schlüsselwörter

  • clinical characteristic
  • epidemiology
  • northeast Thailand
  • spinocerebellar ataxia type
access type Uneingeschränkter Zugang

Postoperative cure in Iranian patients with gastric cancer: estimating the crude conditional probability in a relative survival setting in the presence of competing risks

Online veröffentlicht: 30 Dec 2017
Seitenbereich: 461 - 467

Zusammenfassung

Abstract

Following treatment, cancer patients may be clinically cured. However, they may die for reasons other than cancer, called competing risks.

To estimate postoperative cure while considering the competing risks in Iranian patients with gastric cancer.

Data were obtained from the Cancer Institute of Imam Hospital in Tehran. The analysis was conducted within the framework of relative survival by fitting the data to a flexible parametric cure model, taking into account the competing risks using general population data by adjusting for age, sex, and year of diagnosis.

Of the 326 patients (224 male and 102 female) whose data were included, 235 deaths (72.1%) occurred during the follow-up period. The probability of conditional cure in terms of crude ratios of dying from causes other than gastric cancer in the surviving patients increased with the passage of time, and the slope of excess mortality approached almost 0 after 7 years. The estimated cure ratios showed a variation from 69% for 50-year-old men with diagnosis at early stages (I and II) to 3% for 80-year-old women with diagnosis at stage IV.

The ratio of patients in Iran who were estimated to die from cancer reduced significantly with the passage of time following the diagnosis, and the statistical cure point was estimated to be 7 years after diagnosis. However, aging was shown to be inversely associated. Although the same trend was observed in both sexes, we showed that men were statistically more likely to reach the cure point.

Schlüsselwörter

  • competing risk
  • cure
  • gastric cancer
  • Iran
  • relative survival

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