CanDRIVE(1): a Canadian Institutes of Health Research (CIHR) Institute of Aging funded New Emerging Team, Elisabeth-Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON, Canada K1N 5C8. email@example.com
Older drivers have one of the highest motor vehicle crash (MVC) rates per kilometer driven, largely due to the functional effects of the accumulation, and progression of age-associated medical conditions that eventually impact on fitness-to-drive. Consequently, physicians in many jurisdictions are legally mandated to report to licensing authorities patients who are judged to be medically at risk for MVCs. Unfortunately, physicians lack evidence-based tools to assess the fitness-to-drive of their older patients. This paper reports on a pilot study that examines the acceptability and association with MVC of components of a comprehensive clinical assessment battery.
To evaluate the acceptability to participants of components of a comprehensive assessment battery, and to explore potential predictors of MVC that can be employed in front-line clinical settings.
Case-control study of 10 older drivers presenting to a tertiary care hospital emergency department after involvement in an MVC and 20 age-matched controls.
The measures tested were generally found to be acceptable to participants. Positive associations (p
The objective of the study was to determine the prevalence and comorbidity of persisting attention-deficit hyperactivity disorder (ADHD) in adult psychiatric outpatients. Consecutive patients, first visits excluded, at a general psychiatric outpatient clinic were offered a screening for childhood ADHD with the Wender Utah Rating Scale (WURS). One hundred and forty-one patients out of 398 (35%) completed and returned the scale. Patients above or near cut-off for ADHD (n=57) were offered an extensive clinical evaluation with psychiatric as well as neuropsychological examination. The attrition was analysed regarding age, sex and clinical diagnoses. Out of the screened sample, 40% had scores indicating possible childhood ADHD. These 57 patients were invited to the clinical part of the study, but 10 declined assessment, leaving 47 (37 women and 10 men) who were actually examined. Thirty of these (21 women and nine men) met diagnostic criteria for ADHD at the time of examination. Among the patients with ADHD, affective disorders were the most common psychiatric diagnoses. The rate of alcohol and/or substance abuse, as noted in the medical records, was also high in the ADHD group. In the WURS-screened group, 22% (30 patients assessed as part of this study and one person with ADHD previously clinically diagnosed) were shown to have persisting ADHD. Therefore, it is clearly relevant for psychiatrists working in general adult psychiatry to have ADHD in mind as a diagnostic option, either as the patient's main problem or as a functional impairment predisposing for other psychiatric disorders.
Women living with HIV (WLWH) are at increased risk of invasive cervical cancer (ICC). International HIV guidelines suggest cervical screening twice the first year after HIV diagnosis and thereafter annually. Adherence to the HIV cervical screening program in Denmark is unknown.
We studied women from a population-based, nationwide HIV cohort in Denmark and a cohort of age-matched females from the general population. Screening behaviour was assessed from 1999-2010. Adjusted odds ratios (OR's) for screening attendance in the two cohorts and potential predictors of attendance to guidelines were estimated. Pathology specimens were identified from The Danish Pathology Data Bank.
We followed 1143 WLWH and 17,145 controls with no prior history of ICC for 9,509 and 157,362 person-years. The first year after HIV diagnosis 2.6% of WLWH obtained the recommended two cervical cytologies. During the different calendar intervals throughout the study period between 29-46% of WLWH followed the HIV cervical screening guidelines. Adjusted OR's of attendance to the general population screening program for WLWH aged 30, 40 and 50 years, compared to controls, were 0.69 (95% CI: 0.56-0.87), 0.67 (0.55-0.80) and 0.84 (0.61-1.15). Predictors of attendance to the HIV cervical screening program were a CD4 count?>?350 cells/µL and HIV RNA?
Cites: Int J STD AIDS. 2006 Sep;17(9):579-84; quiz 585-716942648
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):30-321775347
From a total population of 10,766 Swedish 50- to 59-year-old women, 6,917 (64.2%) participated in the Women's Health in Lund Area (WHILA) study, and among them 6,623 (95.7%) answered the questions on alcohol consumption. One out of 4 women (26.0%) consumed no alcohol in an ordinary week (non-drinkers), 57.4% consumed not more than 83 g alcohol, 12.5% consumed 84-167 g and 4.2% consumed 168 g or more. The weekly drinkers had a median consumption of 40.0 g alcohol (range 2.5-1,036.0) and the main sort of alcohol was wine. Comparing the four drinking groups, most differences occurred between the non-drinking and the weekly drinking women. The non-drinkers had lower socio-demographic status, poorer health and more symptoms, especially physical symptoms. In a multivariate logistic regression analysis, most associations between non-drinking and lower socio-demographic status remained.
BACKGROUND: This paper illustrates how data gathered from an existing screening programme against colorectal cancer can be used to produce new information on the natural history of colorectal cancer as well as the characteristics of the unhydrated Hemoccult II screening test. METHODS: A mathematical model is used, which on the basis of prevalence and interval incidence data from a randomized screening project initiated in Funen County, Denmark, estimates the sensitivity of the screening test and the sojourn time of the disease. RESULTS: The sensitivity of the Hemoccult is estimated at 62.1% and the mean sojourn time is estimated to be 2.1 years. CONCLUSIONS: The short sojourn time indicates that overall effectiveness of a Hemoccult II screening programme can be improved significantly by more frequent screening.
Despite various infant screening programmes, congenital hearing deficit is normally detected too late. However, the measurement of otoacoustic emissions (OAE) has now proved to be an effective means of assessing neonatal hearing. The article consists in an outline of both international and Swedish experience of universal neonatal screening programmes using OAE testing. Since universal OAE screening was introduced at University Hospital, LinkÃ¶ping, in September 1995, some 6,000 infants have been tested. During the first two years 98.5 per cent of the children participated. Satisfactory bilateral OAE test results were obtained in 97.1 per cent of cases. Where further investigation was necessary, it took the form of auditory brainstem response (ABR) testing during natural rest, or full diagnostic ABR testing under general anaesthesia.
Comment In: Lakartidningen. 1999 Jun 9;96(23):2835-610405529
OBJECTIVE: To investigate whether appointments for screening timed in proximity to annual milestones (birthdays, Christmas and New Year) may be used as a strategy to improve attendance for screening for colorectal cancer. DESIGN: Randomised controlled trial. SETTING: City of Oslo (urban) and Telemark county (urban and rural), Norway. PARTICIPANTS: 12,960 screened adults (64.7% of those invited). MAIN OUTCOME MEASURE: Attendance rates for each week and month of assigned appointment. RESULTS: Attendance rates were significantly higher in December than the rest of the year (72.3% v 64.6%, P
OBJECTIVE: To study the need for health screening among elderly people. SETTING, DESIGN AND SUBJECTS: A random sample of 605 people 75 years or older from the general population of Uppsala, Sweden received a postal questionnaire on health issues, and a random subsample of 101 persons were offered a health survey. MAIN OUTCOME MEASURES: Symptoms and signs of disease in questionnaire or at health examination. RESULTS: Thirty-nine people came to the health examination at the primary health care centre (PHCC), 15 were examined in their homes, and 11 were interviewed by telephone. Seventy-eight findings were made in the PHCC group, out of which 60 were known by the proband and 18 were new. In ten cases some action was taken. Of the 54 people examined, 50 persons had one or several findings. The most prevalent problems were hypertension, urinary incontinence, and hearing problems. However, few of these problems warranted referral to a general practitioner or hospital. CONCLUSIONS: It appears that a health survey of elderly people yielded little new information on the state of health among those surveyed at the time of the data collection. The bearing on the present-day situation is discussed.