BACKGROUND: To study mortality rate and causes of death among all hospitalized opioid addicts treated for self-poisoning or admitted for voluntary detoxification in Oslo between 1980 and 1981, and to compare their mortality to that of the general population. METHODS: A prospective cohort study was conducted on 185 opioid addicts from all medical departments in Oslo who were treated for either self-poisoning (n = 93, 1980), voluntary detoxification (n = 75, 1980/1981) or both (n = 17). Their median age was 24 years; with a range from 16 to 41, and 53% were males. All deaths that had occurred by the end of 2000 were identified from the Central Population Register. Causes of death were obtained from Statistics Norway. Standardized mortality ratios (SMRs) were computed for mortality, in general, and in particular, for different causes of death. RESULTS: During a period of 20 years, 70 opioid addicts died (37.8%), with a standardized mortality ratio (SMR) equal to 23.6 (95% CI, 18.7-29.9). The SMR remained high during the whole period, ranging from 32.4 in the first five-year period, to 13.4 in the last five-year period. There were no significant differences in SMR between self-poisonings and those admitted for voluntarily detoxification. The registered causes of death were accidents (11.4%), suicide (7.1%), cancer (4.3%), cardiovascular disease (2.9%), other violent deaths (2.9%), other diseases (71.4%). Among the 50 deaths classified as other diseases, the category "drug dependence" was listed in the vast majority of cases (37 deaths, 52.9% of the total). SMRs increased significantly for all causes of death, with the other diseases group having the highest SMR; 65.8 (95% CI, 49.9-86.9). The SMR was 5.4 (95% CI, 1.3-21.5) for cardiovascular diseases, and 4.3 (95% CI, 1.4-13.5) for cancer. The SMR was 13.2 (95% CI, 6.6-26.4) for accidents, 10.7 (95% CI, 4.5-25.8) for suicides, and 28.6 (95% CI, 7.1-114.4) for other violent deaths. CONCLUSION: The risk of death among opioid addicts was significantly higher for all causes of death compared with the general population, implying a poor prognosis over a 20-year period for this young patient group.
The study aimed to assess the effects of diabetes-related risk factors, especially severe hypoglycaemia,on the academic skills of children with early-onset type 1 diabetes mellitus (T1DM).
The study comprised 63 children with T1DM (31 females, 32 males; mean age 9 y 11 mo,SD 4 mo) and 92 comparison children without diabetes (40 females, 52 males;mean age 9 y 9 mo,SD 3 mo). Children were included if T1DM had been diagnosed before the age of 5 years and if they were aged between 9 and 10 years at the time of study. Children were not included if their native language was not Finnish and if they had a diagnosed neurological disorder that affected their cognitive development. Among the T1DM group, 37 had and 26 had not experienced severe hypoglycaemia and 26 had avoided severe hypoglycaemia. Severe hypoglycaemia, diabetic ketoacidosis(DKA), and glycaemic control were used as T1DM-related factors. Task performance in reading, spelling, and mathematics was compared among the three groups, and the effects of the T1DM-related factors were analysed with general linear models.
The groups with (p
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Comment In: Dev Med Child Neurol. 2012 May;54(5):393-422590722
The study is based on a sample of 965 children living in Oulu region (Finland), who were monitored for acute middle ear infections from birth to the age of two years. We introduce a nonparametrically defined intensity model for ear infections, which involves both fixed and time dependent covariates, such as calendar time, current age, length of breast-feeding time until present, or current type of day care. Unmeasured heterogeneity, which manifests itself in frequent infections in some children and rare in others and which cannot be explained in terms of the known covariates, is modelled by using individual frailty parameters. A Bayesian approach is proposed to solve the inferential problem. The numerical work is carried out by Monte Carlo integration (Metropolis-Hastings algorithm).
Although making explicit links between procedures and concepts during instruction in mathematics is important, it is still unclear the precise moments during instruction when such links are best made.
The objective was to test the effectiveness of a 3-week classroom intervention on the fractions knowledge of grade 5/6 students. The instruction was based on a theory that specifies three sites during the learning process where concepts and symbols can be connected (Hiebert, 1984): symbol interpretation, procedural execution, and solution evaluation. Sample. Seventy students from one grade 5/6 split and two grade 6 classrooms in two public elementary schools participated.
The students were randomly assigned to treatment and control. The treatment (Sites group) received instruction that incorporated specific connections between fractions concepts and procedures at each of the three sites specified by the Sites theory. Before and after the intervention, the students' knowledge of concepts and procedures was assessed, and a random subsample of 30 students from both conditions were individually interviewed to measure their ability to make specific connections between concepts and symbols at each of the three sites.
The health benefits of exercise participation and physical activity for mental health and psychosocial well-being (PSWB) have been shown in several studies. However, one important background factor, that is, motor skills (MSs), has largely been ignored. In addition, most of the existing research focuses on poor MSs, that is, poor MSs are often connected to poorer PSWB. The mechanism linking MSs and PSWB is unclear. However, a preliminary suggestion has been made that self-worth or self-perceptions might mediate the association between MSs and PSWB.
We investigated whether the self-concepts (SCs) of school-related physical education (SCPE), reading (SCR), and mathematics (SCM) mediate the relationship between MSs and PSWB in adolescence.
The study sample consisted of a second-grade female cohort (N = 327), ranging in age between 12 and 16 (years) in a municipality in Central Finland. PSWB was measured by the Strengths and Difficulties Questionnaire and the school-related SCs by the SC of ability scale adapted for use in Finland. MSs was assessed by a self-reported adolescent version of the Developmental Coordination Disorder Questionnaire. Structural mediator modelling was used to test the associations between MSs and PSWB with SC as a mediator.
First, MSs was strongly associated with school-related SCPE and SCM. However, a mediator role was observed only for SCPE, which weakly mediated peer problems. Second, MSs and PSWB, especially conduct problems, showed a very strong direct association.
The study suggests that MSs is connected to PSWB in adolescent girls. Enhancement of MSs could be a preventive strategy for supporting PSWB in adolescent girls.
We evaluated whether younger age in class is associated with poorer academic performance and an increased risk of being prescribed stimulants for attention-deficit/hyperactivity disorder (ADHD).
This was a nationwide population-based cohort study, linking data from national registries of prescribed drugs and standardized scholastic examinations. The study population comprised all children born in 1994-1996 who took standardized tests in Iceland at ages 9 and 12 (n = 11 785). We estimated risks of receiving low test scores (0-10th percentile) and being prescribed stimulants for ADHD. Comparisons were made according to children's relative age in class.
Mean test scores in mathematics and language arts were lowest among the youngest children in the fourth grade, although the gap attenuated in the seventh grade. Compared with the oldest third, those in the youngest third of class had an increased relative risk of receiving a low test score at age 9 for mathematics (1.9; 95% confidence interval [CI] 1.6-2.2) and language arts (1.8; 95% CI 1.6-2.1), whereas at age 12, the relative risk was 1.6 in both subjects. Children in the youngest third of class were 50% more likely (1.5; 95% CI 1.3-1.8) than those in the oldest third to be prescribed stimulants between ages 7 and 14.
Relative age among classmates affects children's academic performance into puberty, as well as their risk of being prescribed stimulants for ADHD. This should be taken into account when evaluating children's performance and behavior in school to prevent unnecessary stimulant treatment.
Age- and sex-related differences in vascular function and vascular response to mental stress. Longitudinal and cross-sectional studies in a cohort of healthy children and adolescents.
Department of Molecular and Clinical Medicine/Clinical Physiology, The Sahlgrenska Academy and University Hospital, University of Gothenburg, SE 41345 Gothenburg, Sweden. yun.chen@wlab.gu.se
Limited data, especially from longitudinal studies, are available regarding vascular health assessment in childhood. In this study, we performed longitudinal and cross-sectional studies in healthy children and adolescents to investigate age- and sex-related differences in vascular functions and vascular response to mental stress.
Pulse wave velocity (PWV) was measured by tonometry. Endothelial function and vascular response to mental arithmetic test were assessed using a peripheral artery tonometry device. Data were obtained in 162 adolescents (mean age of 17 years, 94 girls) in a 3-year follow-up study and 241 children (mean age of 10 years, 115 girls) in a first-time investigation. Physical activity was assessed in adolescents by a self-report questionnaire.
Our 3-year follow-up study revealed that the increased PWV was greater in male adolescents (0.79±0.79m/s) than in females (0.27±0.89m/s, p
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.
The authors demonstrate possible use of allometric equations to describe age-matched oncologic morbidity and mortality in stable population. Deviations from the allometric model (allometric signals) could be traced to changed technogenic load on the population. Examples show relationships between rank parameters of the models and the technogenic load levels.
