RESUMO
Here, an epidemiological model considering pro and anti-vaccination groups is proposed and analyzed. In this model, susceptible individuals can migrate between these two groups due to the influence of false and true news about safety and efficacy of vaccines. From this model, written as a set of three ordinary differential equations, analytical expressions for the disease-free steady state, the endemic steady state, and the basic reproduction number are derived. It is analytically shown that low vaccination rate and no influx to the pro-vaccination group have similar impacts on the long-term amount of infected individuals. Numerical simulations are performed with parameter values of the COVID-19 pandemic to illustrate the analytical results. The possible relevance of this work is discussed from a public health perspective.
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COVID-19 , Vacinas , Animais , Movimento contra Vacinação , Número Básico de Reprodução , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controleRESUMO
We propose a new scheme for ultrasensitive laser gyroscopes that utilizes the physics of exceptional points. By exploiting the properties of such non-Hermitian degeneracies, we show that the rotation-induced frequency splitting becomes proportional to the square root of the gyration speed (Ω), thus enhancing the sensitivity to low angular rotations by orders of magnitudes. In addition, at its maximum sensitivity limit, the measurable spectral splitting is independent of the radius of the rings involved. This Letter paves the way toward a new class of ultrasensitive miniature ring laser gyroscopes on chip.
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BACKGROUND AND PURPOSE: Information about metabolic comorbidities in patients with multiple sclerosis (MS) is scarce. Our aim was to examine the prevalence of the metabolic syndrome (MetS) and its components in patients with long duration of MS and significant disability. METHODS: Demographic and clinical data, weight, height, waist circumference, blood pressure, and levels of fasting glucose, triglycerides and high density lipoprotein cholesterol (HDL-C) were obtained from 130 MS patients with Extended Disability Status Scale (EDSS) score ≥3.0. RESULTS: Seventy-two percent were female, mean ± SD age 55.8 ± 6.0, range 45-65 years, disease duration 18.2 ± 10.1 years, EDSS 5.5 ± 1.0. Obesity [body mass index (BMI) ≥ 30 kg/m(2) ] was present in 18.5% and overweight (BMI 25.0-29.9 kg/m(2) ) in 34.6%. The prevalence of the MetS was 30% with no gender difference. Fifty-six percent had central obesity by waist circumference, 28% treated hypertension, 45.8% elevated blood pressure, 11% type 2 diabetes mellitus, 31.4% treated dyslipidemia, 28.8% elevated triglyceride levels and 31.4% had low HDL-C. MS patients with MetS were significantly older (59.0 ± 5.5 vs. 53.8 ± 5.5, P < 0.0001) and heavier (BMI 29.0 ± 6.9 vs. 25.1 ± 4.7, P = 0.0009). There were no differences between the groups in neurological disability by the EDSS (5.7 ± 1.0 vs. 5.4 ± 1.0), disease duration (18.4 ± 9.9 vs. 18.2 ± 10.2 years) and number of steroid courses received (6.6 ± 9.5 vs. 6.3 ± 8.4). CONCLUSIONS: Compared to the general population, adult disabled MS patients had lower rates of obesity and overweight, as assessed by BMI. Despite these reduced rates, the prevalence of the MetS was similar to the general population. Specifically higher rates of increased waist circumference were found, suggesting that the lower BMI may be misleading in terms of health risk.
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Síndrome Metabólica/epidemiologia , Esclerose Múltipla/epidemiologia , Sobrepeso/epidemiologia , Índice de Gravidade de Doença , Idoso , Comorbidade , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , PrevalênciaRESUMO
Matching the language or content of a message to the psychological profile of its recipient (known as "personalized persuasion") is widely considered to be one of the most effective messaging strategies. We demonstrate that the rapid advances in large language models (LLMs), like ChatGPT, could accelerate this influence by making personalized persuasion scalable. Across four studies (consisting of seven sub-studies; total N = 1788), we show that personalized messages crafted by ChatGPT exhibit significantly more influence than non-personalized messages. This was true across different domains of persuasion (e.g., marketing of consumer products, political appeals for climate action), psychological profiles (e.g., personality traits, political ideology, moral foundations), and when only providing the LLM with a single, short prompt naming or describing the targeted psychological dimension. Thus, our findings are among the first to demonstrate the potential for LLMs to automate, and thereby scale, the use of personalized persuasion in ways that enhance its effectiveness and efficiency. We discuss the implications for researchers, practitioners, and the general public.
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Clima , Idioma , Marketing , Princípios Morais , Comunicação PersuasivaRESUMO
BACKGROUND: Current risk calculations for trisomy 21, which are based on multiples of median (MoM), do not take into account possible differences between euploid and trisomy 21 pregnancies that may develop with gestational age. In order to optimize the predictive value of screening tests, we calculated the ratio between maternal serum concentration of alpha-fetoprotein (AFP) and that of human chorionic gonadotropin (hCG) in euploid and in trisomy 21 pregnancies. METHODS: The medians of the concentration ratios, [AFP]/[hCG] at 16-21 weeks of gestation, were plotted as a function of gestational age for 307 cases of trisomy 21 and were compared with the medians of 30 549 normal karyotype cases. RESULTS: [AFP]/[hCG] ratio medians were independent of body weight and maternal age. There was a significant difference in the [AFP]/[hCG] ratio when comparing trisomy 21 and euploid pregnancies at each week. This difference became greater with advancing gestational age (P < 0.01). CONCLUSION: There is a significant difference in ratios of [AFP]/[hCG] between euploid and trisomy 21 pregnancies, which may be used to improve detection rates of Down syndrome screening.
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Gonadotropina Coriônica/sangue , Síndrome de Down/sangue , Idade Gestacional , Mães , alfa-Fetoproteínas/análise , Adulto , Gonadotropina Coriônica/análise , Síndrome de Down/diagnóstico , Feminino , Humanos , Ploidias , Gravidez , Diagnóstico Pré-Natal , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
In general, blood pressure is higher in winter than in summer, and this factor may be partly responsible for the higher mortality from cardiovascular disease in winter. Cigarette smoking causes an acute pressor response that may interact with this cardiovascular response to cold exposure. We sought to determine whether the seasonal variation in blood pressure and heart rate differs between cigarette smokers and nonsmokers. We evaluated 24-hour ambulatory systolic blood pressure (SBP), ambulatory diastolic blood pressure (DBP), and ambulatory heart rate of 97 healthy men (73 nonsmokers and 24 smokers), 28 to 63 years of age, during the summer and winter, taking indoor temperatures into consideration. Smokers and nonsmokers both had higher daytime ambulatory SBPs and DBPs in winter than in summer (after adjustment for potential confounders). However, the winter increase seen in the smokers was significantly higher for mean daytime SBP (7.3 versus 2.7 mm Hg, P<.01), for mean daytime DBP (4.4 versus 3.1 mm Hg, P=.051), and for ambulatory heart rate (3.9 versus -1.7 beats/min, P<.001). The double product increased from summer to winter (daytime) by 10.53 for smokers and by only 0.11 for nonsmokers (P<.01). There was an independent interaction between season and smoking status that affected SBP (standardized beta=0.66, P<.0001) and DBP (standardized beta=0.32, P<.0001). Smokers have a greater seasonal variation in blood pressure and heart rate than nonsmokers and show a larger increase in the cardiovascular load in winter. Smoking apparently potentiates the cardiovascular response to various climatic conditions. Season should be taken into account in studies of blood pressure and in the diagnosis and treatment of hypertension, particularly among cigarette smokers.
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Pressão Sanguínea/fisiologia , Ritmo Circadiano , Frequência Cardíaca/fisiologia , Estações do Ano , Fumar , Adulto , Monitorização Ambulatorial da Pressão Arterial , Diástole , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , SístoleRESUMO
The purpose of this study was to clarify the possible associations between the serum 1,25-dihydroxyvitamin D (calcitriol) level and blood pressure. Cross-sectional analysis of data was performed. Data collected included levels of serum calcitriol, parathyroid hormone, serum calcium, and blood lead; blood pressure; dietary history; and demographic and anthropometric variables. One hundred normotensive male industrial employees made up the study population. Systolic blood pressure and diastolic blood pressure were main outcome measures. After possible confounders were controlled for, multivariate analyses yielded an inverse, independent, and statistically significant association between calcitriol level and systolic blood pressure (standardized beta= -0.2704, P=.0051). A similar trend of borderline significance was found for the association between calcitriol and diastolic blood pressure (standardized beta= -0.1814, P=.0611). Parathyroid hormone, serum calcium, and blood lead levels were not associated with blood pressure. When subjects were divided into four groups by calcitriol level, those in the lowest quartile showed significantly higher systolic and diastolic blood pressures than those in the upper quartile (difference=11 mmHg, P=.007, and difference=4 mmHg, P=.071, respectively). There is an inverse association between serum calcitriol level and blood pressure. This suggests that in addition to its role in calcium homeostasis, the active metabolite of vitamin D may play a role in determining blood pressure. The differences in both systolic and diastolic blood pressures between the upper and lower quartiles of serum calcitriol were substantial and may be of clinical significance.
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Pressão Sanguínea/fisiologia , Calcitriol/sangue , Adulto , Estudos de Coortes , Estudos Transversais , Diástole , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Valores de Referência , SístoleRESUMO
In cross-sectional studies, significant differences in cardiovascular disease risk factors have been observed between smokers and non-smokers. The aim of this study was to examine the effects of smoking initiation and cessation on these factors in a population-based prospective study. 987 male employees in Israeli industry underwent health screening in the CORDIS study and were re-examined an average of two and a half years later. We examined the associations between smoking initiation and cessation and changes in blood count, serum lipids and lipoproteins, body weight and blood pressure. After adjusting for potential confounders, smoking cessation was associated with significant decreases in leukocyte count, hemoglobin and hematocrit whereas smoking initiation resulted in increased leukocyte count. There were moderate, non-significant increases in both serum HDL cholesterol (HDL-C) and LDL-C, and a slight decrease in serum triglycerides. Blood pressure remained essentially unchanged, despite the fact that smoking cessation resulted in a significant weight increase and smoking initiation in a significant decline in weight. These findings demonstrate that changes in smoking habits result in fairly rapid changes in blood count and body weight, but have much smaller effects on serum lipids and blood pressure.
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Pressão Sanguínea , Peso Corporal , Lipídeos/sangue , Fumar/fisiopatologia , Adulto , Fatores Etários , Estudos de Coortes , Emprego , Humanos , Israel/epidemiologia , Contagem de Leucócitos , Lipoproteínas/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Fumar/sangue , Fumar/epidemiologia , Abandono do Hábito de FumarRESUMO
Comprehensive surveys on the characteristics of smokers provide important data for the targeting and monitoring of smoking cessation programmes, and making international comparisons. Current information on this subject in Israel is very limited. During 1985-1987, the prevalence and correlates of cigarette smoking were examined in 5281 employees in Israeli industry, screened in the framework of the CORDIS study. The prevalence of smoking in men ranged from 44.7% in the age group 20-24 years to 28.0% in those aged 55-64. For women the prevalence ranged from 23.2% to 15.0% over the same age range. Ethnic differences were most marked in younger males with the highest prevalence in those of North African origin. Among females, the highest prevalence was among those of Western European origin. In most age groups, the highest proportion of exsmokers was found among those of Eastern European origin, except for older females where differences were not significant. Among males, educational differences were strong, with those of lower education smoking the most, whereas among females no significant differences were observed. For both sexes, past smokers were more prevalent in the highest education category. There was a cohort effect in declining age at starting smoking in both sexes and females tended to start smoking about 2 years older than males. Exsmokers tended to have been heavier smokers than current smokers, suggesting that heavy smokers may be more likely to quit than light smokers.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comportamentos Relacionados com a Saúde , Fumar/epidemiologia , Adulto , Fatores Etários , Estudos de Coortes , Escolaridade , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Abandono do Hábito de FumarRESUMO
Seasonal changes in blood pressure may be partially explained in thermoregulatory terms. We hypothesized that the seasonal variation in blood pressure is related to body mass index, due to the increased thermoregulatory requirements of leaner individuals. Ambulatory systolic and diastolic blood pressure were monitored once each in summer and winter in 101 healthy normotensive men aged 28 to 63 years. Environmental conditions and body mass index were measured. The population was divided according to quartiles of body mass index. The percentage of subjects with systolic blood pressure increases of more than 10 mm Hg from summer to winter was highest among subjects in the lowest body mass index category, and lowest among those in the highest body mass index category (35% and 8%, respectively, P < .0001). After adjusting for possible confounders, the change in mean systolic blood pressure from summer to winter was inversely associated with body mass index (beta = -0.26, P = .0149). There was no association between diastolic blood pressure change and body mass index. The increase in systolic blood pressure from summer to winter is inversely and independently associated with body mass index. Hypertension research and epidemiological blood pressure studies should take into account the interaction between season, body mass index, and blood pressure. It may also be important to assess hypertension and response to antihypertensive treatment in relation to season, particularly in lean hypertensives.
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Monitorização Ambulatorial da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Estações do Ano , Adulto , Regulação da Temperatura Corporal/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Many persons exhibit an elevation in blood pressure (BP) when examined in a medical setting. We examined whether individuals exhibiting an exaggerated pressure response (high responders) to BP determination would have an elevated baseline BP on follow-up, independent of the initial BP level. METHODS AND RESULTS: A total of 1217 employed men not on hypertensive medication, aged 20-64 years were examined over 2-4 years (mean 2.6 years) following the baseline measurements at entry. Pressure response was assessed at entry and defined as the difference between the first and fourth values in successive readings. Such a response was apparent for systolic BP (SBP) but was negligible for diastolic BP (DBP) and the former was negatively related to the baseline BP value. High responders were defined as persons showing a pressure response greater than the average for the respective subgroup with an initially similar baseline BP value. Logistic regression results indicated that those with high SBP responsivity had a 2.7 times greater chance of having an elevated SBP (> or = 140 mm Hg) on follow-up (95% CI 1.8-4.1, P < 0.001), independently of initial SBP, age, or body mass index. Other significant predictors were the initial baseline SBP value and age. In those with an initial SBP of 130-139 mm Hg, the baseline SBP was not predictive of future readings whereas high responders had a four times higher risk of having an elevated SBP on follow-up (OR = 4.0, 95% CI 2.0-8.0, P < 0.001). CONCLUSIONS: These findings suggest that SBP hyperresponsivity, to BP determination at the clinic independently predicts elevated SBP 2.6 years later. Further studies are warranted to determine the predictive value over a longer follow-up period.
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Pressão Sanguínea , Hipertensão/fisiopatologia , Adulto , Determinação da Pressão Arterial , Humanos , Hipertensão/epidemiologia , Hipertensão/psicologia , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estresse PsicológicoRESUMO
OBJECTIVES: (1) to compare dietary intake in summer and winter time; (2) to measure the change in body mass index (BMI), blood pressure and serum cholesterol between winter and summer; and (3) to determine the relationships between seasonal differences in dietary intake and BMI, blood pressure and serum cholesterol measurements. SUBJECTS AND METHODS: Ninety-four male industrial employees were screened twice in one year, in their work place, at winter and summer time. Workers were recruited from two factories and response rate was 95%. Health-related variables, including dietary intake, blood pressure and serum cholesterol were evaluated at each season and were compared. Correlation coefficients between seasonal differences in dietary intake and in BMI, blood pressure and serum cholesterol were calculated. RESULTS: From summer to winter the mean values of BMI increase from 26.1 kg/cm2 to 26.6 (P=0.038), systolic blood pressure from 119.6 to 121.6 (P=0.025), diastolic blood pressure from 75.2 to 77.2 mmHg (P=0.001), total cholesterol from 200.8 to 208.6 mg/dL (P=0.001), LDL cholesterol from 125.2 to 134.9 (P=0.001) and HDL cholesterol from 42.7 to 44.3 (P=0.0084). Triglycerides levels decrease from 174 to 145 in the winter (P=0.03). Mean dietary intake of fat increases from 99.1 to 106.0 (P=0.0016), saturated fat from 43.6 to 46.3 (P=0.0137), polyunsaturated fat from 25.1 to 28.3 (P=0.0002), cholesterol from 462.0 to 497.9 (P=0.0313), sodium from 5778.5 to 8208.2 (P=0.0035), zinc from 11.6 to 12.3 (P=0.0001), vitamin B1 from 1.4 to 1.5 (P=0.002), vitamin D from 4.3 to 4.9 (P=0.0323) and vitamin E from 11.2 to 12.7 (P=0.0073). Significant correlation was shown between the seasonal increase in saturated fat and the increase in BMI (r=0.37), total cholesterol (r=0.21) and LDL cholesterol (r=0.29). Seasonal change in dietary cholesterol intake was significantly and positively correlated with serum total cholesterol (r=0.24) and LDL cholesterol (r=0.24). Blood pressure was not associated with nutritional intake variables. CONCLUSIONS: Dietary intake in summer and winter is different as well as blood pressure, BMI and serum cholesterol. The seasonal increase in fat and cholesterol intake at winter time is associated with changes in BMI and serum cholesterol.
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Doenças Cardiovasculares/etiologia , Dieta , Estações do Ano , Adulto , Pressão Sanguínea , Índice de Massa Corporal , Colesterol/sangue , Colesterol na Dieta/administração & dosagem , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Laticínios , Gorduras na Dieta/administração & dosagem , Humanos , Masculino , Carne , Pessoa de Meia-Idade , Fatores de Risco , Triglicerídeos/sangueRESUMO
The seasonality of blood cholesterol is still not well established. Some have described a seasonal pattern with highest levels during autumn and lowest in summer, whereas others have reported no change. A number of studies showed circannual variations with maximum levels in winter and minimum in summer. The aim of this study was to examine the circannual variation of cholesterol in a large cohort in Israel. In the Israeli CORDIS study, employees of 21 factories were screened for cardiovascular disease risk factors during 1985-7. As part of the information gathered, serum cholesterol and blood counts were available for 3,726 men and 1,514 women. Serum cholesterol levels fit a circannual rhythm assessed by the cosinor analysis. Highest levels of serum cholesterol were found in spring and lowest in summer. We conclude that there is a circannual change of serum cholesterol, which could be partially associated with changes in environmental temperature. The circannual variation in serum cholesterol was considerable and should be taken into account when carrying out clinical evaluation of patients.
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Colesterol/sangue , Fenômenos Cronobiológicos/fisiologia , Estações do Ano , Adulto , Análise de Variância , Estudos de Coortes , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-IdadeRESUMO
We examined the prevalence of fatigue and its association with occupational conditions and health-related habits in 3785 industrial employees of six industrial sectors to define modifiable factors. The factors examined included complaints of fatigue during and after work, an ergonomic evaluation of employees' workstations, demographic characteristics, and health-related habits. Eighteen percent of the subjects complained of severe fatigue frequently or very frequently. We were able to identify two major modifiable variables that were independently associated with the presence of fatigue. Logistic regression showed that those workers who did not participate in physical activity at least once a week had a 1.7-fold increase in prevalence of severe fatigue (95% confidence interval = 1.3 to 2.3, P < 0.001). The other major modifiable factor was temperature control, with those workers who worked at non-temperature-controlled workstations having a 50% increase in the prevalence of fatigue (odds ratio = 1.5, 95% CI = 1.1 to 2.1; P = 0.01). Accidents were significantly more frequent in those workers with fatigue. Further studies should focus on intervention programs to modify the factors identified by this study.
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Fadiga/prevenção & controle , Doenças Profissionais/prevenção & controle , Adulto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/tratamento farmacológico , Exercício Físico , Fadiga/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Israel/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Doenças Profissionais/epidemiologia , Ocupações , Razão de Chances , Prevalência , Fatores de Risco , TemperaturaRESUMO
The objective of this study was to evaluate the association of physical activity at work with the risk of all-cause cardiovascular disease and cancer mortality. The cohort consisted of 3488 male, Israeli, industrial employees who participated in an 8-year follow-up study. During this period 129 deaths were recorded: 54 from cardiovascular disease, 47 from cancer, and 28 from other causes. Physical activity at work was assessed at entry on a 4-point scale (none, light, medium, and high). Potential confounding demographic, anthropometric, and socioeconomic variables, and health habits including leisure time physical activity were accounted for. We found that the hazard ratio of all-cause mortality in workers with a high physical workload was 1.82 (95% confidence interval, 1.18 to 2.81) compared with workers having a low workload. A similar trend was noted for cardiovascular disease and cancer mortality. We concluded that a high physical workload is associated with increased mortality rates. Future studies should differentiate between leisure time and work time physical activity.
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Doenças Cardiovasculares/mortalidade , Causas de Morte , Indústrias , Neoplasias/mortalidade , Doenças Profissionais/mortalidade , Carga de Trabalho , Adulto , Distribuição por Idade , Doenças Cardiovasculares/etiologia , Estudos de Coortes , Intervalos de Confiança , Inquéritos Epidemiológicos , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/etiologia , Doenças Profissionais/etiologia , Razão de Chances , Esforço Físico , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de RiscoRESUMO
OBJECTIVES: This quasi-experimental study tested the ambulatory blood pressure responsivity to daily variation in the work load of the same workers and examined whether this responsivity is moderated by perceived job control. METHODS: The subjects were 79 nonshift, normotensive men who reported nearly almost equal occurrences of low and high work load in a typical workday. Job control was assessed by questionnaire. The workers recorded their situational work load and other parameters at each recording of ambulatory blood pressure. RESULTS: An analysis of covariance showed the main effects of both situational work load and job control on systolic ambulatory blood pressure, as well as a significant work load by job control interaction, even after control for clinic blood pressure, age, and body mass index. A blood pressure response to increased work load was observed only for workers with low job control. These workers also had a higher average systolic ambulatory blood pressure than workers reporting high control. The difference was 6.2 mm Hg (0.82 kPa) during the low workload periods and 10.2 mm Hg (1.36 kPa) during the high workload periods. A further multiple regression analysis confirmed the interaction and the main effect of job control but not that of work load, after control for work-related activities, body position, and hour of examination. CONCLUSIONS: This study showed that ambulatory blood pressure at work can fluctuate with variations in work load but only for workers with low job control. Low job control is independently associated with higher systolic ambulatory blood pressure.
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Hipertensão/etiologia , Controle Interno-Externo , Doenças Profissionais/etiologia , Estresse Psicológico/complicações , Carga de Trabalho/psicologia , Adulto , Análise de Variância , Monitorização Ambulatorial da Pressão Arterial/psicologia , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estresse Psicológico/psicologia , Análise e Desempenho de TarefasRESUMO
Ultrasonography of the hip was performed sequentially by two different examiners in 75 infants. The ultrasound strips were reviewed twice by three paediatric orthopaedic surgeons and classified by the Graf method. The intraobserver and interobserver agreement between the interpretations was analysed using simple and weighted kappa coefficients calculated for agreement on the Graf classification and for grouping as normal (types 1A to 2A), and abnormal requiring treatment (types 2B to 4). When examining the same ultrasound strip, intraobserver agreement for the Graf classification was substantial (mean kappa 0.61), but interobserver agreement was only moderate (kappa 0.50). For the grouping into normal and abnormal, the mean kappa value for intraobserver agreement was 0.67 and for interobserver agreement 0.57. Because of the significant differences in agreement between normal and abnormal hips, we analysed a subgroup of those with at least one abnormal interpretation. Intraobserver agreement within this subgroup showed moderate reliability (kappa 0.41), but interobserver agreement was only fair (kappa 0.28). Interpretations of two different strips performed sequentially showed significantly lower agreement with an intraobserver kappa value of 0.29 and an interobserver value of 0.28. In the subgroup with at least one abnormal reading, the intraobserver kappa was 0.09 and the interobserver 0.1. Our findings suggest that both the technique of performing ultrasonography and the interpretation of the image may influence the result.
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Luxação Congênita de Quadril/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Feminino , Luxação Congênita de Quadril/classificação , Humanos , Lactente , Recém-Nascido , Masculino , Anamnese , Variações Dependentes do Observador , Ortopedia , Pediatria , Exame Físico , Reprodutibilidade dos Testes , Método Simples-Cego , UltrassonografiaRESUMO
The objectives of the study were to compare dietary intake by smoking levels in blue-collar Israeli workers occupationally exposed to lead and thus identify additional areas for health-enhancing intervention in addition to smoking cessation. One hundred and eighty-seven male industrial employees who were exposed to lead through their work were screened at the worksite to evaluate health status and dietary intake. Smokers had higher intakes of fat, cholesterol, calcium, riboflavin, and vitamin E per day. They were consuming more meat and high-fat dairy products. Dose-response relationships were shown for fat and energy intake by smoking level. Thus, smoking is associated with other adverse health behaviors. When conducting epidemiologic or occupational studies, analyses should include adjustment for the fact that the lifestyles of smokers may also be unhealthy in other ways.
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Dieta , Comportamentos Relacionados com a Saúde , Chumbo/sangue , Exposição Ocupacional/prevenção & controle , Fumar/epidemiologia , Adulto , Análise de Variância , Estudos de Casos e Controles , Gorduras na Dieta , Humanos , Israel , Estilo de Vida , Modelos Lineares , Masculino , Fumar/efeitos adversos , Fatores SocioeconômicosRESUMO
BACKGROUND: The degree to which serum total cholesterol predicts cardiovascular disease is uncertain. While most authors have placed TC among the most powerful risk indicators of CVD, some have claimed that it predicted CVD in women only, or even not at all. OBJECTIVE: To determine the predictive value of serum total cholesterol relative to diabetes, smoking, systolic blood pressure and body mass index (kg/m2), for cardiovascular disease mortality in 3,461 occupationally active Israeli males. METHODS: A prospective follow-up was carried out for the years 1987-1998 to determine the effect of age, smoking habits, a history of diabetes, SBP, BMI and TC, at entry, on CVD mortality. RESULTS: There were 84 CVD deaths during a total of 37,174 person-years follow up. The hazard ratios (95% confidence intervals) for CVD mortality with respect to variables at entry were: diabetes 5.2 (2.1-13.2), age 2.2 (1.7-2.9), smoking 1.3 (1.0-1.8), SBP 1.4 (1.1-2.0), TC 1.5 (1.0-2.1) and BMI 1.2 (0.7-2.2). Among non-obese, non-diabetic, normotensive subjects the hazard ratio of TC adjusted for age and smoking was 1.16 (1.09-1.22) per 10 mg/dl. In the remaining subjects it was 1.04 (0.98-1.12) only. There was a significant interaction between TC and diabetes, hypertension or obesity (P = 0.003). CONCLUSIONS: In this population of Israeli males we found an interaction between TC and other risk indicators for CVD. Confirmation is required for the unexpected finding that the predictive value of TC for CVD mortality among non-diabetic, non-obese and normotensive subjects exceeded that among subjects with either of these risk factors.
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Doenças Cardiovasculares/mortalidade , Colesterol/sangue , Adulto , Fatores Etários , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Intervalos de Confiança , Complicações do Diabetes , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Fumar/efeitos adversosRESUMO
BACKGROUND: Measuring postural changes is among the simplest methods to elicit basic cardiovascular responses from patients who should not be subjected to treadmill stress testing. We attempted to clarify the individual factors that may affect these changes in resting heart rate (HR). METHODS: In a cross-sectional study, 6016 employees in Israeli industries were screened during 1985-87 for cardiovascular disease risk factors (The CORDIS Study). Measures of resting HR (supine, sitting, and standing) were obtained from 5428 subjects. The association between the HR differences for different postures and age, sex, height, body mass index, blood pressure level, health related habits, environmental temperature, and time of the day was analyzed. RESULTS: The difference in HR between supine and standing position was found to be greater among women than men (12.7 vs. 11.6%, p < 0.03). It was independently positively associated with height (p < 0.0001), cigarette smoking (p < 0.0001), and coffee drinking (p < 0.001), and inversely associated with age (p < 0.002), blood pressure level (p < 0.0005), and physical activity at work (p < 0.0001). CONCLUSION: The interindividual variability in HR response to different postures is partially explained by individual variables such as age, sex, height, blood pressure level, and health-related habits.