Increasing trends of sleep complaints in the city of São Paulo, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Trends in nutrient intakes and chronic health conditions among Mexican-American adults : a 25-year profile : United States, 1982-2006 /

Mode of access: Internet.

Gender differentials in the evolution of cigarette smoking habits in a general European adult population from 1993-2003

Background: Describe the recent evolution of cigarette smoking habits by gender in Geneva, where incidence rates of lung cancer have been declining in men but increasing in women. Methods: Continuous cross-sectional surveillance of the general adult ( 35 - 74 yrs) population of Geneva, Switzerland for 11 years ( 1993 - 2003) using a locally-validated smoking questionnaire, yielding a representative random sample of 12,271 individuals ( 6,164 men, 6,107 women). Results: In both genders, prevalence of current cigarette smoking was stable over the 11-year period, at about one third of men and one quarter of women, even though smoking began at an earlier age in more recent years. Older men were more likely to be former smokers than older women. Younger men, but not women, tended to quit smoking at an earlier age. Conclusion: This continuous ( 1993 - 2003) risk factor surveillance system, unique in Europe, shows stable prevalence of smoking in both genders. However, sharp contrasts in age-specific prevalence of never and former smoking and of ages at smoking initiation indicate that smoking continues a long-term decline in men but has still not reached its peak in women.

How is leflunomide prescribed and used in Australia? analysis of prescribing and adverse effect reporting

Purpose To evaluate the use of leflunomide in the Australian community since introduction in 2000. Trends in adverse drug reaction (ADR) reporting were also studied. Methods Annual Australian prescription and dispensing statistics were analysed. Drug utilisation was estimated as defined daily doses (DDD)/1000 inhabitants/day. ADR data from the Therapeutic Goods Administration's Adverse Drug Reactions Advisory Committee (ADRAC) national monitoring system were compared with the World Health Organisation (WHO) Vigibase records. Results Leflunomide use in Australia (dispensing data) increased from 0.2 in 2000 to 0.4 DDD/1000 inhabitants/day in 2002. The same overall pattern was observed in the 'authority to prescribe' data. From 2000-2002, prescribing of the starter pack (3 x 100 mg loading dose plus 30 x 20 mg tablets) declined (down 74%); likewise for the 20mg (30 tablets) pack. Gradual increases were noted for the 10 mg (30 tablets) pack (up 40%). Approximately 135 reports, detailing about 370 individual ADR, were generated annually. Gastro-intestinal disorders predominated, accounting for 24% of reactions reported to ADRAC. Skin and appendages disorders constituted 14% of reported reactions. Deaths in leflunomide users were attributed to a combination of haematological and gastro-intestinal complications, but it was not possible to ascertain other medication usage or contributing factors. Trends observed with the ADRAC reports were consistent with the WHO database. Conclusions Leflunomide was the first registered DMARD in Australia in over a decade and its use has increased within the community. The ADR reports might have contributed to Australian rheumatologists gradually abandoning loading patients with high doses of leflunomide in favour of starting therapy at lower doses. Copyright (c) 2006 John Wiley & Sons, Ltd.

Determinants of pharmaceutical innovation diffusion: social contagion and prescribing characteristics

This article studies the determinants of pharmaceutical innovation diffusion among specialists. To this end, it investigates the influences of six categories of factors—social embeddedness, socio-demography, scientific orientation, prescribing patterns, practice characteristics, and patient panel composition—on the use of new drugs for the treatment of type 2 diabetes mellitus in Hungary. Here, in line with international trends, 11 brands were introduced between April 2008 and April 2010, outperforming all other therapeutic classes. The Cox proportional hazards model identifies three determinants—social contagion (in the social embeddedness category) and prescribing portfolio and insulin prescribing ratio (in the prescribing pattern category). First, social contagion has a positive effect among geographically close colleagues—the higher the adoption ratio, the higher the likelihood of early adoption—but no influence among former classmates and scientific collaborators. Second, the wider the prescribing portfolio, the earlier the new drug uptake. Third, the lower the insulin prescribing ratio, the earlier the new drug uptake—physicians’ therapeutic convictions and patients’ socioeconomic statuses act as underlying influencers. However, this finding does not extend to opinion-leading physicians such as scientific leaders and hospital department and outpatient center managers. This article concludes by arguing that healthcare policy strategists and pharmaceutical companies may rely exclusively on practice location and prescription data to perfect interventions and optimize budgets.

Feeding habits of the deep-snouted pipefish Syngnathus typhle in a temperate coastal lagoon

Feeding habits of Syngnathus typhle were determined based on monthly sampling during experimental fishing in a coastal lagoon (Ria Formosa, South Portugal) from April 2004 to May 2002. The gut contents of 856 individuals were analysed and quantified with numerical and gravimetric methods, as well as with some complementary indices and measures (vacuity, fullness and relative importance). In this study, this species fed mainly on Copepoda, Mysidacea, small caridean grass shrimps (Hippolytidae and Palaemonidae) and small fishes (Gobiidae) and to a lesser degree on other small invertebrates. No significant differences were found between the diets of males and females. However, significant differences in the fullness indexes of both sexes were observed during the reproductive period. Significant differences in the diet among seasons were also verified but no seasonal trends were discovered. Snout length showed a linear increase with growth while mouth area and total length displayed an allometric relation. Mouth shape varied between an ellipse and an almost perfect circle. The increase in mouth area and snout length as S. typhle grows contributed to the observed ontogenic diet shift with specimens smaller than 10 cm feeding almost exclusively on Copepoda, medium sized specimens feeding mainly on Hippolytidae and Mysidacea, while larger specimens preyed on Hippolytidae, Palaemonidae and Gobiidae. Prey size generally increased with size of S. typhle. (c) 2007 Elsevier Ltd. All rights reserved.

The future of office property

The following paper considers the question, where to office property? In doing so, it focuses, in the first instance, on identifying and describing a selection of key forces for change present within the contemporary operating environment in which office property functions. Given the increasingly complex, dynamic and multi-faceted character of this environment, the paper seeks to identify only the primary forces for change, within the context of the future of office property. These core drivers of change have, for the purposes of this discussion, been characterised as including a range of economic, demographic and socio-cultural factors, together with developments in information and communication technology. Having established this foundation, the paper proceeds to consider the manner in which these forces may, in the future, be manifested within the office property market. Comment is offered regarding the potential future implications of these forces for change together with their likely influence on the nature and management of the physical asset itself. Whilst no explicit time horizon has been envisioned in the preparation of this paper particular attention has been accorded short to medium term trends, that is, those likely to emerge in the office property marketplace over the coming two decades. Further, the paper considers the question posed, in respect of the future of office property, in the context of developed western nations. The degree of commonality seen in these mature markets is such that generalisations may more appropriately and robustly be applied. Whilst some of the comments offered with respect to the target market may find application in other arenas, it is beyond the scope of this paper to explicitly consider highly heterogeneous markets. Given also the wide scope of this paper key drivers for change and their likely implications for the commercial office property market are identified at a global level (within the above established parameters). Accordingly, the focus is necessarily such that it serves to reflect overarching directions at a universal level (with the effect being that direct applicability to individual markets - when viewed in isolation on a geographic or property type specific basis – may not be fitting in all instances)

Long-term trends in fine particle number concentrations in the urban atmosphere of Brisbane : the relevance of traffic emissions and new particle formation

The measurement of submicrometre (< 1.0 m) and ultrafine particles (diameter < 0.1 m) number concentration have attracted attention since the last decade because the potential health impacts associated with exposure to these particles can be more significant than those due to exposure to larger particles. At present, ultrafine particles are not regularly monitored and they are yet to be incorporated into air quality monitoring programs. As a result, very few studies have analysed their long-term and spatial variations in ultrafine particle concentration, and none have been in Australia. To address this gap in scientific knowledge, the aim of this research was to investigate the long-term trends and seasonal variations in particle number concentrations in Brisbane, Australia. Data collected over a five-year period were analysed using weighted regression models. Monthly mean concentrations in the morning (6:00-10:00) and the afternoon (16:00-19:00) were plotted against time in months, using the monthly variance as the weights. During the five-year period, submicrometre and ultrafine particle concentrations increased in the morning by 105.7% and 81.5% respectively whereas in the afternoon there was no significant trend. The morning concentrations were associated with fresh traffic emissions and the afternoon concentrations with the background. The statistical tests applied to the seasonal models, on the other hand, indicated that there was no seasonal component. The spatial variation in size distribution in a large urban area was investigated using particle number size distribution data collected at nine different locations during different campaigns. The size distributions were represented by the modal structures and cumulative size distributions. Particle number peaked at around 30 nm, except at an isolated site dominated by diesel trucks, where the particle number peaked at around 60 nm. It was found that ultrafine particles contributed to 82%-90% of the total particle number. At the sites dominated by petrol vehicles, nanoparticles (< 50 nm) contributed 60%-70% of the total particle number, and at the site dominated by diesel trucks they contributed 50%. Although the sampling campaigns took place during different seasons and were of varying duration these variations did not have an effect on the particle size distributions. The results suggested that the distributions were rather affected by differences in traffic composition and distance to the road. To investigate the occurrence of nucleation events, that is, secondary particle formation from gaseous precursors, particle size distribution data collected over a 13 month period during 5 different campaigns were analysed. The study area was a complex urban environment influenced by anthropogenic and natural sources. The study introduced a new application of time series differencing for the identification of nucleation events. To evaluate the conditions favourable to nucleation, the meteorological conditions and gaseous concentrations prior to and during nucleation events were recorded. Gaseous concentrations did not exhibit a clear pattern of change in concentration. It was also found that nucleation was associated with sea breeze and long-range transport. The implications of this finding are that whilst vehicles are the most important source of ultrafine particles, sea breeze and aged gaseous emissions play a more important role in secondary particle formation in the study area.

International epidemiology of prostate cancer : geographical distribution and secular trends

This review outlines current international patterns in prostate cancer incidence and mortality rates and survival, including recent trends and a discussion of the possible impact of prostate-specific antigen (PSA) testing on the observed data. Internationally, prostate cancer is the second most common cancer diagnosed among men (behind lung cancer), and is the sixth most common cause of cancer death among men. Prostate cancer is particularly prevalent in developed countries such as the United States and the Scandinavian countries, with about a six-fold difference between high-incidence and low-incidence countries. Interpretation of trends in incidence and survival are complicated by the increasing impact of PSA testing, particularly in more developed countries. As Western influences become more pronounced in less developed countries, prostate cancer incidence rates in those countries are tending to increase, even though the prevalence of PSA testing is relatively low. Larger proportions of younger men are being diagnosed with prostate cancer and living longer following diagnosis of prostate cancer, which has many implications for health systems. Decreasing mortality rates are becoming widespread among more developed countries, although it is not clear whether this is due to earlier diagnosis (PSA testing), improved treatment, or some combination of these or other factors.