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Purpose To provide an up-to-date estimate on the changing prevalence of stroke survivors, and examines the geographic and socioeconomic variations in low and middle-income countries (LMICs). Methods We searched MEDLINE, EMBASE, SCOPUS and Web of Science databases and systematically reviewed articles reporting stroke prevalence and risk factors from inception to July 2015. Pooled prevalence estimates and secular trends based on random-effects models were conducted across LMICs, World Bank regions and income groups. Results Overall, 101 eligible community-based studies were included in the meta-analysis. The pooled crude prevalence of stroke survivors was highest in Latin America and Caribbean (21.2 per 1000, 95% CI 13.7 to 30.29) but lowest in sub-Saharan Africa (3.5 per 1000, 95% CI 1.9 to 5.7). Steepest increase in stroke prevalence occurred in low-income countries, increasing by 14.3% annually while the lowest increase occurred in lower-middle income countries (6% annually), and for every 10 years increase in participants' mean age, the prevalence of stroke survivors increases by 62% (95% CI 6% to 147%). Conclusion The prevalence estimates of stroke survivors are significantly different across LMICs in both magnitude and secular trend. Improved stroke surveillance and care, as well as better management of the underlying risk factors, primarily undetected or uncontrolled high blood pressure (HBP) are needed. [ABSTRACT FROM AUTHOR]

Background: Few studies on spatial patterns or secular trends in human leishmanias have been conducted in Morocco. This study aimed to examine spatial patterns and trends associated with the human leishmaniasis incidence rate (HLIR) at the province/prefecture level between 2003 and 2013 in Morocco. Methods: Only the available published country data on the HLIR between 2003 and 2013, from the open access files of the Ministry of Health, were used. Secular trends were examined using Kendall's rank correlation. An exploratory spatial data analysis was also conducted to examine the spatial autocorrelation (Global Moran's I and local indicator of spatial association [LISA]), and spatial diffusion at the province/prefecture level. The influence of various covariates (poverty rate, vulnerability rate, population density, and urbanization) on the HLIR was tested via spatial regression (ordinary least squares regression). Results: At the country level, no secular variation was observed. Poisson annual incidence rate estimates were 13 per 100 000 population (95 % CI = 12.9-13.1) for cutaneous leishmaniasis (CL) and 0.4 per 100 000 population (95 % CI = 0.4-0.5) for visceral leishmaniasis (VL). The available data on HLIR were based on combined CL and VL cases, however, as the CL cases totally outnumbered the VL ones, HLIR may be considered as CL incidence rate. At the provincial level, a secular increase in the incidence rate was observed in Al Hoceima (P = 0.008), Taounate (P = 0.04), Larache (P = 0.002), Tétouan (P = 0.0003), Khenifra (P = 0.008), Meknes (P = 0.03), and El Kelaa (P = 0.0007), whereas a secular decrease was observed only in the Chichaoua province (P=0.006). Even though increased or decreased rate was evident in these provinces, none of them showed clustering of leishmaniasis incidence. Significant spatial clusters of high leishmaniasis incidence were located in the northeastern part of Morocco, while spatial clusters of low leishmaniasis incidence were seen in some northwestern and southern parts of Morocco; there was spatial randomness in the remaining parts of the country. Significant clustering was seen from 2005 to 2013, during which time the Errachidia province was a permanent 'hot spot'. Global Moran's I increased from 0.2844 (P = 0.006) in 2005 to 0.5886 (P = 0.001) in 2011, and decreased to 0.2491 (P = 0.004) in 2013. It was found that only poverty had an effect on the HLIR (P = 0.0003), contributing only 23 % to this (Adjusted R-squared = 0.226). Conclusion: Localities showing either secular increase in human leishmaniasis or significant clustering have been identified, which may guide decision-making as to where to appropriately allocate funding and implement control measures. Researchers are also urged to undertake further studies focusing on these localities. [ABSTRACT FROM AUTHOR]

Background The incidence of childhood epilepsy has changed during the past decades, but it is unclear whether it increased or decreased. Methods Changes in drug-treated childhood epilepsy between 1968 and 2012 were evaluated using the Finnish nationwide register of all children, aged ≤ 15 years, on antiepileptic drugs (AEDs) prescribed for the treatment of epilepsy. The first registered entitlement to full-refundable AEDs was used as a proxy for newly diagnosed epilepsy. Incidence densities were calculated as ratios of annual new cases per 100,000 person-years in each calendar year during 1968 to 2012. Results The annual incidence density of newly treated childhood epilepsy increased from 35 in the 1960s to 87 per 100,000 person-years in the 1990s and decreased thereafter to 61 per 100,000 person-years. Since 1996, the incidence density decreased 1–2% per year in children aged < 1, 1–5, or 6–10 years (all 95% confidence intervals within 0.3%–3%), while no substantial change was seen in older children. Conclusion The incidence of drug-treated childhood epilepsy from the late 1960s to the early 1990s distinctly increased. The reasons for the increase are not fully understood but may include increasing ascertainment through improved diagnosis and a wider acceptance of AED treatment. Since the 1990s, a slight decline can be seen, probably reflecting the recent improvement in child health and safety. [ABSTRACT FROM AUTHOR]

Objectives To analyze the growth trends of children in Beijing from 1955 to 2010. Methods Data for the period 1955–1975 were derived from published records. Data for the period 1985–2010 were derived from the Chinese National Survey on Students’ Constitution and Health (CNSSCH). Since 1985, the overall sampling and measurement methods have been consistent. The mean, the standard deviation, and the variance (ANOVA) of height, weight, and BMI by age and sex of students aged 7–17 were calculated and analyzed. Results Between 1955 and 2010, the average height and weight of children in Beijing has increased. The average increments per decade for boys and girls were 2.45 cm and 2.03 cm in height and 2.68 kg and 1.68 kg in weight, respectively. The largest height increase per decade occurred between 1975 and 1985: 4.51 cm and 3.23 cm for boys and girls, respectively. The largest height increase for the entire 55-year period under study occurred among boys at age 13 (17.85 cm) and among girls at age 11 (15.90 cm.) Conclusions During the period 1955–2010, growth trends among children in Beijing were positive. The health and nutritional status of these children improved significantly. Since 2007, might be related to government intervention, childhood obesity has been curbed. [ABSTRACT FROM AUTHOR]

Purpose Engaging in prolonged screen-time behaviors (STBs) is detrimental for health. The objective of the present analyses was to examine temporal trends in TV viewing and computer use among adolescents across 30 countries. Methods Data were derived from the cross-national Health Behaviour in School-aged Children study. Data on TV viewing and computer use for gaming and nongaming purposes were collected in 2002 (n = 139,725 [51.4% girls]), 2006 (n = 149,251 [51.3% girls]), and 2010 (n = 154,845 [51.2% girls]). The temporal trends in TV viewing and computer use were each tested for all countries combined and for each individual country by sex-specific univariate analysis of variance. Results Between 2002 and 2010, TV viewing decreased slightly in most of the 30 countries among both boys and girls. This decrease was more than offset by a sharp increase in computer use, which was consistent across all countries. Overall, boys reported more hours of STBs. They also reported a slightly larger decrease in TV viewing and slightly larger increase in computer use. STBs were generally more frequent on weekend days. Conclusions The overall cross-national increases in STBs should be a call to action for public health practitioners, policy-makers, and researchers that interventions specifically focused on reducing STBs in youth are sorely needed. Because all countries experienced a trend in the same direction, it might be fruitful to learn more about the determinants of STBs among those countries in which hours of STBs are generally low as compared with other countries. [ABSTRACT FROM AUTHOR]

Background: Although fall-induced fractures of elderly persons are a major problem, epidemiologic knowledge on their time trends is limited. We assessed the trends in fall-induced fractures of the calcaneus and foot in older Finns between 1970 and 2013.Methods: The current trends in the number and incidence (per 100,000 persons) of fall-induced fractures of the calcaneus and foot of older Finns were determined by taking into account individuals 50-year-olds or older who were admitted to Finnish hospitals for primary treatment of such injury in 1970-2013.Results: The number and raw incidence of these fractures increased considerably between 1970 and 2013, from 64 (number) and 5.6 (incidence) in 1970, to 325 and 15.0, respectively, in 2013. The age-adjusted incidence of fracture was higher in men than women and showed a clear rise in both sexes in 1970-2013, from 7.2 to 15.2 in men (111% increase), and from 4.3 to 13.9 in women (223% increase). A similar rise was observed in the age-specific incidences. If trends in the age-specific fracture incidence continue at the same rate as were observed in 1970-2013, and the 50-year-old or older population increases as predicted (by 15% by the year 2030), the annual number of fall-induced fractures of the calcaneus and foot in this population will be 1.8 times higher in the year 2030 (580 fractures) than it was in 2013 (325 fractures).Conclusions: The number of fall-induced fractures of the calcaneus and foot among Finns 50 years of age or older has risen sharply between 1970 and 2013 with a rate that cannot be explained merely by demographic changes. Further studies should examine the reasons for the rise and possibilities for fracture prevention. [ABSTRACT FROM AUTHOR]

Estimates of the numbers and rates of acute decompensated heart failure (ADHF) hospitalization are central to understanding health-care utilization and efforts to improve patient care. We comprehensively estimated the frequency, rate, and trends of ADHF hospitalization in the United States. Based on Atherosclerosis Risk in Communities (ARIC) Study surveillance adjudicating 12,450 eligible hospitalizations during 2005-2010, we developed prediction models for ADHF separately for 3 International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 428 discharge diagnosis groups: 428 primary, 428 nonprimary, or 428 absent. We applied the models to data from the National Inpatient Sample (11.5 million hospitalizations of persons aged ≥55 years with eligible ICD-9-CM codes), an all-payer, 20% probability sample of US community hospitals. The average estimated number of ADHF hospitalizations per year was 1.76 million (428 primary, 0.80 million; 428 nonprimary, 0.83 million; 428 absent, 0.13 million). During 1998-2004, the rate of ADHF hospitalization increased by 2.0%/year (95% confidence interval (CI): 1.8, 2.5) versus a 1.4%/year (95% CI: 0.8, 2.1) increase in code 428 primary hospitalizations (P < 0.001). In contrast, during 2005-2011, numbers of ADHF hospitalizations were stable (-0.5%/year; 95% CI: -1.4, 0.3), while the numbers of 428-primary hospitalizations decreased by -1.5%/year (95% CI: -2.2, -0.8) (P for contrast = 0.03). In conclusion, the estimated number of hospitalizations with ADHF is approximately 2 times higher than the number of hospitalizations with ICD-9-CM code 428 in the primary position. The trend increased more steeply prior to 2005 and was relatively flat after 2005. [ABSTRACT FROM AUTHOR]

The care of premature infants in the 20th century is remarkable for technical advances that have dramatically improved survival, but little is known about temporal changes in the neuropathology of the premature infant over this time frame. We hypothesize that the autopsy rate of germinal matrix hemorrhage changed in the 20th century relative to combined influences of clinical interventions that were both harmful and helpful. We examined germinal matrix hemorrhage with intraventricular hemorrhage (GMH-IVH) in 345 premature infants (gestational age 25-36 weeks) autopsied at Boston Children's Hospital from 1914 to 2015. There was a median of 19 cases/decade (range 7-68). Over the course of the study median gestational age decreased from 33 to 27 gestational weeks (P < 0.001), and median postnatal survival increased from 2 to 26 days (P = 0.02). The incidence of GMH-IVH increased from 4.7% before 1960 to 50.0% from 1975 to 1980, and then decreased to 12.5% after 2005 (P < 0.001). The incidence of GMHIVH increased >3-fold around the time of the introduction of positive pressure ventilation into premature intensive care in the mid-1960s. The increased incidence of GMHIVH in the 1970s-1980s likely reflects respiratory and hemodynamic imbalances complicating mechanical ventilation. We speculate that the subsequent decreased incidence of GMH-IVH likely reflects stabilization of respiratory function with improvements in ventilators and in ventilator management beginning in the 1970s and the use of surfactant and antenatal steroids in the 1980s. [ABSTRACT FROM AUTHOR]

Background: Eating meals, particularly dinner, with family members has been found to be associated with improved dietary intake, lower prevalence of disordered eating behaviors, lower levels of substance abuse, and improved academic outcomes among adolescents. Limited research has examined how the frequency of family meals has changed over time. The objective of this study was to examine secular trends in family dinner frequency over a 12-year period using a large, nation-wide sample of adolescents. Methods: Using data from two cohorts of the Growing up Today study (GUTS; n = 18,075 observations for 14,79,714 and 15 year olds), we compared family dinner frequency among 14-15-year-olds in 1996 (GUTS1) through 2008 (GUTS2) and rate of change in family dinner frequency from 1996 to 1998 (GUTS1) and 2004-2008 (GUTS2). We it logistic models using generalized estimating equations with independence working correlation and empirical vari- ance to account for correlation within individual and between siblings. Results: From 1996 to 2008, the number of family dinners per week among males decreased from 5.3 to 4.6 (p = 0.04) and among females from 5.0 to 4.4 (p = 0.03). We found that the rate of decline in frequency of family meals was consistent in GUTS1 (1996-1998) and GUTS2 (2004-2008) among both males and females. Conclusions: From 1996 to 2008, frequency of family dinners decreased among adolescents. Future research should explore reasons for this decline as well as strategies to increase family meals among adolescents. [ABSTRACT FROM AUTHOR]

This study examines whether social inequality in tooth brushing frequency among adolescents changed from 1991 to 2014. The data material was seven comparable cross-sectional studies of nationally representative samples of 11- to 15-year-olds in Denmark with data about frequency of tooth brushing and occupation of parents. The total number of participants was 31,464, of whom 21.7% brushed their teeth less than the recommended 2 times a day. The absolute social inequality measured as prevalence difference between low and high social class increased from 7.7% in 1991 to 14.6% in 2014. The relative social inequality assessed by odds ratios for infrequent tooth brushing also increased from 1991 to 2014. [ABSTRACT FROM AUTHOR]

Background: The potential risks associated with hip resurfacing arthroplasty (HRA) are controversial and underestimated. The aim of this study was to explore intermediate-term trends for the levels of cobalt (Co), chromium (Cr), and molybdenum (Mo) ions after HRA. Methods: Forty patients who underwent HRA from October 2005 to December 2010 were recruited to this study. The serum levels of metal ions were examined preoperatively and 3, 12, 24, and 60 months after surgery. Trends and differences in levels of metal ions with respect to sex, operated side, and body mass index (BMI) were analyzed. Results: There were no significant differences in levels of Cr, Co, and Mo at each time point with respect to sex, operated side, and BMI (p > 0.05). The postoperative levels of Cr, Co, and Mo ions were significantly higher than the preoperative levels across sex, operated side, and BMI groups. Postoperative levels of Cr, Co, and Mo peaked at 12, 24, and 60 months, respectively. Cr levels peaked earlier (at 12 months) in the overweight (BMI ≥25 kg/m²) group compared to the normal-weight group (BMI <25 kg/m²), Co levels (at 12 months) peaked in women compared to men, and Mo levels (at 3 months) peaked in the bilateral HRA group compared to the unilateral HRA group. Conclusions: Serum levels of Cr, Co, and Mo increased significantly after HRA. Cr levels peaked earlier in the overweight patients, Co levels peaked in women, and Mo levels peaked in patients who underwent bilateral HRA. However, there were no significant differences with respect to sex, operated side, and BMI. [ABSTRACT FROM AUTHOR]

Low-trauma fractures of elderly persons are a major public health problem. However, epidemiologic knowledge on their fresh secular trends is scarce. Trends in the number and incidence (per 100,000 persons) of low-trauma fractures of the pelvic ring among older Finns were assessed by taking into account individuals 80-year-old or older who were admitted to Finnish hospitals for primary treatment of such injury in 1970-2013. The number and age-adjusted incidence of these fractures increased considerably between 1970 and 2013, from 33 (number) and 73 (incidence) in 1970 to 1055 and 364 in 2013. The age-specific incidence of fracture also increased in all age groups (80-84, 85-89, and 90-) of women and men during the entire study period. If the fracture incidence continues to rise at the same rates as in 1970-2013 and the size of the 80-year-old or older population of Finland increases as predicted (87 % by the year 2030), the number low-trauma pelvic fractures in this population will be 2.4 times higher in the year 2030 (2550 fractures) than it was in 2013 (1055 fractures). The number of low-trauma fractures of the pelvis among Finns 80 years of age or older has risen sharply between 1970 and 2013-with a rate that cannot be explained merely by demographic changes. Further studies are urgently needed to better assess the reasons for the rise and possibilities for fracture prevention. [ABSTRACT FROM AUTHOR]

Introduction: This study examined secular trends in reproductive outcome in women with inflammatory connective tissue disease compared with reference deliveries from the general population.Material and Methods: Historical cohort study based on data registered in the Medical Birth Register of Norway from 1967 to 2009. The study included singleton births in women recorded with connective tissue disease (n = 851) and reference deliveries from the general population (n = 2 437 110). Births were stratified in four periods, 1967-1979, 1980-1989, 1990-1999 and 2000-2009. Associations between connective tissue disease and maternal and perinatal outcomes by decade were assessed in logistic regression analyses and adjusted for maternal age at delivery and parity.Results: In the 1970s, around 2.7 deliveries/year were registered for women with connective tissue disease (0.004% of all deliveries). This increased to 42 deliveries/year (0.07% of all deliveries) after 2000. Adjusted odds ratios (aOR) for cesarean section were 5.0 (95% CI 2.1-11.9) in the first and 1.8 (95% CI 1.4-2.3) in the last period. For preterm delivery the aOR decreased from 4.9 (95% CI 2.1-11.4) to 3.1 (95% CI 2.3-4.2) and the aOR for birthweight <2500 g changed from 7.3 (95% CI 3.3-16.3) to 4.1 (95% CI 3.0-5.6).Conclusions: An increasing number of births were observed over time among women with connective tissue disease. Adverse pregnancy outcomes were more common among women with connective tissue disease but risks have decreased over time. [ABSTRACT FROM AUTHOR]

Background: In the context of concerns regarding the cardiorespiratory fitness (CRF) of youth populations, the aims of this study were: (1) to update reference values for the VO 2 max for school-aged Canadians and (2) to document secular trends in CRF after a 35-year interval., Methods: Between September 2014 and April 2017, the CRF of 3725 students (53.2% boys; 6.0 to 17.9 yrs) was determined using the 20-m shuttle run test. The sample was collected in 36 different schools from six cities of Québec (Canada)., Results: Median values of VO 2 max decreased with age in both sexes ( p ≤ 0.05). By the age of 10, more than 20% of boys showed VO 2 max values below the recommended value (42 ml·kg -1 ·min -1 ). At the age of 17, that proportion reached 56.8%. A similar proportion of 12 yrs girls (20%) were under the recommended minimal value (37 ml·kg -1 ·min -1 ) and that value reached 69.9% at the age of 17. Compared to 1982, the VO 2 max at age 17 has declined by 18% for boys and 12% for girls. The situation is worse in terms of functional capacity (number of stages completed) with an overall decrease of more than 30%., Conclusion: This study demonstrates that, compared to data obtained using the same methodology 35 years ago, the CRF and functional capacity of children and adolescents has declined to levels that should raise concerns from a public health perspective. Thus, the development of strategies to promote a physically active lifestyle in youth is more relevant than ever., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Leone, Levesque, Bourget-Gaudreault, Lemoyne, Kalinova, Comtois, Bui, Léger, Frémont and Allisse.)

OBJETIVO: Atualizar a tendência secular (1962-1988) da composição e da adequação nutricional da dieta familiar praticada nas áreas metropolitanas do Brasil, com base em nova pesquisa sobre orçamentos familiares realizada em meados da década de 90. MÉTODOS: Utilizaram-se como fontes de dados as pesquisas sobre orçamentos familiares (POF) da Fundação IBGE, realizadas entre março de 1987 e fevereiro de 1988 (13.611 domicílios) e entre outubro de 1995 e setembro de 1996 (16.014 domicílios), tendo ambas como universo de estudo as áreas metropolitanas do Brasil. Nas duas pesquisas chegou-se à disponibilidade domiciliar diária per capita de alimentos, dividindo-se o total de alimentos adquiridos no mês pelo número de pessoas residentes no domicílio e pelo número de dias do mês. O padrão alimentar foi caracterizado com base na participação relativa de grupos selecionados de alimentos e de nutrientes na disponibilidade calórica total. A comparação entre as duas pesquisas levou em conta o conjunto das áreas metropolitanas do País e estratos dessas áreas correspondentes às regiões menos desenvolvidas (Norte e Nordeste) e mais desenvolvidas (Centro-Oeste, Sudeste e Sul). RESULTADOS: Observou-se intensificação do consumo relativo de carnes, de leites e de seus derivados (exceto manteiga) em todas as áreas metropolitanas, enquanto o consumo de ovos passou a declinar, sobretudo no Centro-Sul do País. Leguminosas, raízes e tubérculos prosseguiram sua trajetória descendente, mas cereais e derivados tenderam a se estabilizar no Centro-Sul ou mesmo a se elevar ligeiramente no Norte-Nordeste. A participação relativa de açúcar refinado e refrigerantes cresceu em todas as áreas, sendo que a participação de óleos e gorduras vegetais manteve-se constante no Norte-Nordeste e declinou intensamente no Centro-Sul. CONCLUSÕES: A tendência ascendente da participação relativa de lipídios na dieta do Norte e do Nordeste, o aumento no consumo de ácidos graxos saturados em todas as áreas metropolitanas do País, ao lado da redução do consumo de carboidratos completos, da estagnação ou da redução do consumo de leguminosas, verduras, legumes e frutas e do aumento no consumo já excessivo de açúcar são os traços marcantes e negativos da evolução do padrão alimentar entre 1988 e 1996. Mudanças que podem indicar a adesão da população a dietas mais saudáveis -- declínio no consumo de ovos e recuo discreto da elevada proporção de calorias lipídicas -- foram registradas apenas no Centro-Sul do País.OBJECTIVE: A new family budget survey carried out in the mid-nineties in Brazil allows an update of the secular trends (1962-1988) of dietary patterns of Brazilian population living in metropolitan areas. METHODS: Data sources are IBGE Institute of Statistics family budget surveys carried out from March 1987 to February 1988 (13,611 households) and from October 1995 to September 1996 (16,014 households) in all metropolitan areas of Brazil. The daily food availability per capita for each household was calculated dividing the total food acquired in a month by the number of individuals living in a household and the month's number of days. Dietary patterns were characterized according to the amount of selected food groups and nutrients relative to the diet caloric input. Comparisons between the two surveys included the metropolitan area population as a whole and subgroups from less (North and Northeast) and more developed (Mid-west, Southeast and South) regions. RESULTS: It was observed an increase in consumption of meat and dairy products (except for butter) and a reduction in eggs consumption in both less and more developed regions. Beans, roots and tubers consumption showed a steady decline in the whole country while cereals consumption remained the same (higher in developed regions) or had a slight increase (in less developed regions). The proportional consumption of vegetal oils and margarine remained constant in the less developed regions but their consumption was greatly reduced in the more developed ones. CONCLUSIONS: An increase in the diet's lipid content in less developed regions and of saturated fat in the country as a whole, associated with a decrease or even no consumption of beans, vegetables, fruits and complex carbohydrates, and a further increase in the excessive sugar consumption are the negative aspects of the trend observed from 1988 to 1996. Changes that may indicate a growing awareness of the population toward a healthier diet, such as a decline in egg intake and a slight reduction in diets with a high total lipid content, were found only in more developed regions.

Puberty presents remarkable individual differences in timing reaching over 5 years in humans. We put emphasis on the two edges of the age distribution of pubertal signs in humans and point to an extended distribution towards earliness for initial pubertal stages and towards lateness for final pubertal stages. Such distortion of distribution is a recent phenomenon. This suggests changing environmental influences including the possible role of nutrition, stress and endocrine disruptors. Our ability to assess neuroendocrine effects and mechanisms is very limited in humans. Using the rodent as a model, we examine the impact of environmental factors on the individual variations in pubertal timing and the possible underlying mechanisms. The capacity of environmental factors to shape functioning of the neuroendocrine system is thought to be maximal during fetal and early postnatal life and possibly less important when approaching the time of onset of puberty. [ABSTRACT FROM AUTHOR]

Over the past 80 years (1925-2001/8) the physical development of children in the city of Minsk has undergone substantial changes. During the 20th century the developmental processes of growth acceleration were quite active and resulted in an increase in body length of more than 10 cm in both sexes: height in 18-year-old boys/girls increased on average by 1,61/1,37 cm/ per decade between 1925 and 2001/8. At the turn of the 20th- 21st centuries, a stabilization in growth processes was noted, as well as significant gracilization in the stature of girls, which can be partly explained by social factors. The growth processes of young boys and girls nowadays are more intense than those of previous generations. A faster pace of growth has revealed itself in the shift of growth curve crossing points. In 1925, the interval between the first and the second crossing was extended over time (it lasted for 5-7 years), however, in 2001/8 it had shrunk to 1-4 years. The changes witnessed in growth processes coincided with major changes in social, economic and political life - the fall of the Soviet Union, consolidation of Belarus' independence, World War II, and urbanization processes. [ABSTRACT FROM AUTHOR]

Results from a craniometrical study on a series of skulls from Slavic urban cemeteries are presented. The skulls date from the 11th-19th centuries. The earliest skulls (30 male and 15 female) examined in this study were from an urban cemetery in Novogrudok, in the Grodno region, in the west of Belarus, where they had been buried in soil in the late 11th- early 12th centuries. Other urban populations were represented by a series of skulls excavated from soil burial grounds in the following cities: Polotsk, the north of Belarus (45 male and 11 female skulls from the 17th-18th centuries); Gory (25 male and 18 female skulls from the 17th-18th centuries); and the central part of Minsk (19 male and 15 female skulls from the 17th-19th centuries). Comparisons revealed that the series from Novogrudok was the most dolichocranic. On the whole, with the exception of some slight differences, all the skulls in this series were fairly similar. Skulls from later periods, however, as opposed to those found at Novogrudo, were brachycranic. This would appear to correspond with a process of gradual gracilization and brahicefalization, which took place in most of Europe in the second millennium AD and has been observed in later groups of the population. [ABSTRACT FROM AUTHOR]

Background. A decline in prevalence of late-life disability in activities of daily living (ADLs) has been reported in Western countries. We investigate the time trend of disability in basic ADLs among Chinese older people in 1997–2006, and explore the potential contribution of cardiometabolic diseases to the trend. Methods. The study included 7,845 participants (age ≥ 60 years) in the China Health and Nutrition Survey who were examined in 1997, 2000, 2004, and 2006. Data on ADLs were collected through interviews. Disability in basic ADLs was defined as need of assistance or inability to perform at least one of the five self-care activities of bathing, dressing, toileting, feeding, and transferring. Generalized estimating equation models were used to test the time trend in ADL disability and its association with cardiometabolic diseases. Results. Prevalence of ADL disability decreased from 13.2% in 1997 to 9.9% in 2006; the trend was statistically evident among people aged 60–69 years, women, and rural residents (ptrend < .05). From 1997 to 2006, the prevalence of ADL disability decreased at a relative annual rate of 3.1% in total sample; the decline was statistically more evident in young-olds than older-olds, in men than women, and in rural than urban residents. The disabling effect decreased over time for stroke (ptrend = .032) and multiple cardiometabolic diseases (ptrend = .014). Conclusions. The prevalence of disability in basic ADLs among Chinese older adults decreased from 1997 to 2006. Stroke and multiple cardiometabolic diseases appear to become less disabling over time, which may partly contribute to the favorable trend in ADL disability. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective In this research study, we examine how both overweight and nonoverweight adolescent girls and boys fared from 1999 to 2010 in terms of disordered eating behaviors and psychosocial well-being. Method A repeated cross-sectional design was used. Participants were recruited from public schools in 1999 ( n = 3072, mean age = 14.6 ± 1.8) and 2010 ( n = 2793, mean age = 14.4 ± 2.0). Secular trends were examined by weight status and gender using inverse probability weighting to control for changes in socio-demographics. Results In general, the prevalence of disordered eating behaviors and markers of psychosocial well-being among overweight girls and boys remained the same from 1999 to 2010. In contrast, among nonoverweight girls, chronic dieting, unhealthy weight control behaviors, and extreme weight control behaviors decreased, and body satisfaction improved during this time period. Further, among non-overweight boys, the prevalence of unhealthy and extreme weight control behaviors decreased, as did mean depression scores. Discussion Overall, findings indicate a strong need to ensure that messages about the dangers of disordered eating behaviors are reaching overweight youth. Obesity prevention interventions should not overlook the comorbid nature of obesity, disordered eating and poor psychosocial health; prevention programming should address shared risk factors, including dieting, media use, body dissatisfaction, and weight-related teasing. © 2015 Wiley Periodicals, (Int J Eat Disord 2015; 48:323-327) [ABSTRACT FROM AUTHOR]

Background: High physical activity, low sedentary behavior and low consumption of sugar-sweetened beverages can be markers of a healthy lifestyle. We aim to observe longitudinal changes and secular trends in these lifestyle variables as well as in the prevalence of overweight and obesity in 7-to-9-year-old schoolchildren related to gender and socioeconomic position. Methods: Three cross-sectional surveys were carried out on schoolchildren in grades 1 and 2 (7-to-9-year-olds) in 2008 (n = 833), 2010 (n = 1085), and 2013 (n = 1135). Information on children's level of physical activity, sedentary behavior, diet, and parent's education level was collected through parental questionnaires. Children's height and weight were also measured. Longitudinal measurements were carried out on a subsample (n = 678) which was included both in 2008 (7-to-9-year-olds) and 2010 (9-to-11-year-olds). BMI was used to classify children into overweight (including obese) and obese based on the International Obesity Task Force reference. Questionnaire reported maternal education level was used as a proxy for socioeconomic position (SEP). Results: Longitudinally, consumption of sugar-sweetened beverages ⩾4 days/week increased from 7% to 16% in children with low SEP. Overall, sedentary behavior >4 hours/day doubled from 14% to 31% (p < 0.001) and sport participation ⩾3 days/week increased from 17% to 37% (p < 0.001). No longitudinal changes in overweight or obesity were detected. In the repeated cross-sectional observations sedentary behavior increased (p = 0.001) both in high and low SEP groups, and overweight increased from 13.8% to 20.9% in girls (p < 0.05). Overall, children with high SEP were less-often overweight (p < 0.001) and more physically active (p < 0.001) than children with low SEP. Conclusions: Children's lifestyles changed longitudinally in a relatively short period of two years. Secular trends were also observed, indicating that 7-9-year-olds could be susceptible to actions that promote a healthy lifestyle. Socioeconomic differences were consistent and even increasing when it came to sugar-sweetened beverage consumption. Decreasing the socioeconomic gap in weight status and related lifestyle variables should be prioritized. Primary school is an arena where most children could be reached and where their lifestyle could be influenced by health promoting activities. [ABSTRACT FROM AUTHOR]

ABSTRACT Recent reports on adult fracture epidemiology have focused mainly on the hip in the elderly, in whom increasing rates lately have changed to a decline. New reports of the preponderance of nonhip fractures in health expenditure call for a wider scope. We therefore examined current overall and site-specific fracture epidemiology in adults. We ascertained all fractures diagnosed in inpatient and outpatient care in all men and women aged 20 years or older in Skåne County, Sweden, from 1999 to 2010 (10 million person-years). For each fracture type, we estimated age-specific and sex-specific rates and evaluated potential time trends. We found 205,908 fractures yielding an overall fracture rate of 192 per 10,000 person-years. The age-standardized overall fracture rate increased by 1.2 per 10,000 and year (95% confidence interval, 0.8 to 1.5), but time trends were different for different fracture types, age strata, and for men and women. For example, in both women and men aged ≥50 years the rates of proximal humerus fracture increased (0.6 and 0.2 per 10,000 and year, respectively) while hip fracture rates declined (−1.0 and −0.3 per 10,000/year, respectively). Overall age-specific number of fractures increased with age in women but was stable in men. The increasing overall fracture rate is a major concern in the context of a growing and aging population. Effective and affordable preventive strategies and treatments should be an urgent priority to meet the challenges, especially in older women in whom most fractures occur. Comprehensive current detailed data, as provided in this study, may serve as reference for projections and for cost calculations of fracture care in other settings before results of similar examinations are available there. © 2014 American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

Background: Several studies showed that the waist circumference of US adults has increased over the past 25 y. However, because of the high correlation between waist circumference and body mass index (BMI; in kg/m²) (r ~ 0.9), it is uncertain if these trends in waist circumference exceed those expected on the basis of BMI changes over this time period. Objective: We assessed whether the recent trend in waist circumference was independent of changes in BMI, age, and race-ethnicity. Design: We analyzed data from the 1999-2000 through 2011-2012 cycles of the NHANES. Results: The mean waist circumference increased by ~2 cm (in men) and ~4 cm (in women) in adults in the United States over this 12-y period. In men, this increase was very close to what would be expected because of the 0.7 increase in mean BMI over this period. However, in women, most of the secular increase in waist circumference appeared to be independent of changes in BMI (mean: 0.6), age, and race-ethnicity over the 12-y period. We estimated that, independent of changes in these covariates, the mean waist circumference increased by 0.2 cm in men and 2.4 cm in women from 1999-2000 through 2011-2012; only the latter estimate was statistically significant. Conclusions: Our results indicate that, in women but not men, the recent secular trend in waist circumference is greater than what would be expected on the basis of changes in BMI. Possible reasons for this secular increase, along with sex differences, are uncertain. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate long-term trends in insomnia symptoms, tiredness and school performance among Finnish adolescents. A time-series from 1984 to 2011 was analysed from two large-scale survey studies, the Finnish School Health Promotion Study and the Health Behavior in School-Aged Children study. A total of 1 136 583 adolescents aged 11-18 years answered a standardized questionnaire assessing frequency of insomnia symptoms, tiredness and school performance. A clear approximately twofold increasing trend in insomnia symptoms and tiredness was found from the mid-1990s to the end of the 2000s. The increase was evident in all participating age groups and in both genders. After 2008, the increase seems to have stopped. Insomnia symptoms and tiredness were associated with lower school performance and they were more prevalent among girls (11.9 and 18.4%) compared to boys (6.9 and 9.0%, respectively). Unexpectedly, we also observed an increasingly widening gap in school performance between normally vigilant and chronically tired pupils. The underlying causes of these phenomena are unknown, but may concern changes in the broader society. The observed recent increasing trend in adolescents' sleep problems is worrisome: poor sleep quality has also been suggested to associate with clinical or subclinical mood or anxiety disorders and behavioural problems and predispose to sleep and psychiatric disorders later in life. Our results justify further studies and call for serious attention to be paid to adolescent's sleep in the Finnish educational system and society at large. [ABSTRACT FROM AUTHOR]

Purpose Hong Kong, in common with other Asian settings, has high rates of diabetes mellitus (DM) despite a relatively nonobese population. Given the rapid economic development in the region, most Asians grew up in limited living conditions. We examined the longitudinal mortality trends of DM. We assessed whether the first generation (birth cohorts in the 1930s) with late adolescence in a more economically developed environment had a lower risk of DM. Methods We used DM deaths and population figures in Hong Kong, 1976 to 2010. We fitted age–period–cohort models to decompose mortality rates into effects for age at mortality, calendar period of mortality, and birth cohort. Results The risk of death from DM fell for the first generation (births in the early 1930s) with late adolescence in Hong Kong, but possibly the risk rose again for the first generation (birth 1960s) affected by the obesity epidemic. Conclusions Adiposity might contribute to diabetes in Hong Kong, and similar Asian settings, however current vulnerability of many older Asians to DM in plentiful environments may be the result of limited living conditions until adulthood. Furthermore, our findings are more consistent with limited adolescent conditions than fetal undernutrition playing a role in vulnerability to DM. [ABSTRACT FROM AUTHOR]

The oldest old population (>85 years of age) represents the faster growing segment of the elderly in developed countries. Cardioembolic infarction (CI) accounts for 14%-30% of all cerebral infarcts and is the most severe ischemic stroke subtype with the highest in-hospital mortality. Also, CI is associated with a low frequency of symptom-free patients at hospital discharge and presents a non-negligible risk of early embolic recurrence. Moreover, cardioembolic stroke is the acute cerebrovascular event most commonly found in very old subjects. However, some clinical aspects of the natural course of the disease in very old patients are still poorly defined. The present report presents an updated review of relevant aspects of CI related to clinical manifestations, biological characteristics, prognostic implications, and treatment strategies, which may contribute to improving the quality of care and outcome of acute cardioembolic stroke in very old patients. The most relevant aspects of CI are discussed based on the data published in the literature and the authors' experience in the management of stroke patients, collected from the hospital-based "Sagrat Cor Hospital of Barcelona Stroke Registry". The following aspects are commented on: epidemiologic data and risk factors, clinical characteristics, cardiac workup studies, special cardioembolic clinical features, outcome, thrombolytic therapy, antithrombotic treatment, and indications for future research lines. Cardioembolic stroke is an important topic in the frontier between cardiology and vascular neurology. The impact of CI on the patients' health and quality of life, health care systems, and society in general merits an in-depth review of current clinical issues, advances, and controversies. [ABSTRACT FROM AUTHOR]

This paper studies the trends in height-by-age across socioeconomic groups of Chilean boys aged 5–18 born between 1880 and 1997, by performing a meta-analysis of 38 studies reporting height-by-age published since 1898. We estimate the trends using quantile regressions and by analyzing detailed height data from five selected studies. Both methods yield an average decennial increase in height of 1–1.1 cm, and 0.9 and 1.2–1.3 cm for boys of upper and lower socioeconomic status (SES), respectively. SES differences in heights of 9–11 cm are observed up to the late 1940s. However, boys born after the 1930s exhibit substantial convergence in height between socioeconomic groups, driven by an increase in height of middle and lower SES boys of 1.5 and 1.4–2 cm per decade, respectively. As a result, SES differences in height decreased to 5 cm in 1990s. Since these changes occurred in a context of moderate economic growth and persistent income inequality, we argue that our findings are associated with the emergence and expansion of social policies in Chile since the 1940s, which delivered steady improvements in health, nutrition and living conditions. [ABSTRACT FROM AUTHOR]

The oldest old population (>85 years of age) represents the faster growing segment of the elderly in developed countries. Cardioembolic infarction (CI) accounts for 14%-30% of all cerebral infarcts and is the most severe ischemic stroke subtype with the highest in-hospital mortality. Also, CI is associated with a low frequency of symptom-free patients at hospital discharge and presents a non-negligible risk of early embolic recurrence. Moreover, cardioembolic stroke is the acute cerebrovascular event most commonly found in very old subjects. However, some clinical aspects of the natural course of the disease in very old patients are still poorly defined. The present report presents an updated review of relevant aspects of CI related to clinical manifestations, biological characteristics, prognostic implications, and treatment strategies, which may contribute to improving the quality of care and outcome of acute cardioembolic stroke in very old patients. The most relevant aspects of CI are discussed based on the data published in the literature and the authors' experience in the management of stroke patients, collected from the hospital-based "Sagrat Cor Hospital of Barcelona Stroke Registry". The following aspects are commented on: epidemiologic data and risk factors, clinical characteristics, cardiac workup studies, special cardioembolic clinical features, outcome, thrombolytic therapy, antithrombotic treatment, and indications for future research lines. Cardioembolic stroke is an important topic in the frontier between cardiology and vascular neurology. The impact of CI on the patients' health and quality of life, health care systems, and society in general merits an in-depth review of current clinical issues, advances, and controversies. [ABSTRACT FROM AUTHOR]

Summary: The risk of a subsequent major or any fracture after a hip fracture and secular trends herein were examined. Within 1 year, 2.7 and 8.4 % of patients sustained a major or any (non-hip) fracture, which increased to 14.7 and 32.5 % after 5 years. Subsequent fracture rates increased during the study period both for major and any (non-hip) fracture. Introduction: Hip fractures are associated with subsequent fractures, particularly in the year following initial fracture. Age-adjusted hip fracture rates have stabilised in many developed countries, but secular trends in subsequent fracture remain poorly documented. We thus evaluated secular trends (2000-2010) and determinants for the risk of a subsequent major (humerus, vertebral, or forearm) and any (non-hip) fracture after hip fracture. Methods: Patients ≥50 years with a hip fracture between 2000 and 2010 were extracted from the UK Clinical Practice Research Datalink ( n = 30,516). Incidence rates, cumulative incidence probabilities, and adjusted hazard ratios (aHRs) were calculated. Results: Within 1 year following hip fracture, 2.7 and 8.4 % of patients sustained a major or any (non-hip) fracture, which increased to 14.7 and 32.5 % after 5 years, respectively. The most important risk factors for a subsequent major fracture within 1 year were the female gender [aHR 1.90, 95 % confidence interval (CI) 1.51-2.40] and a history of secondary osteoporosis (aHR 1.54, 95 % CI 1.17-2.02). The annual risk increased during the study period for both subsequent major (2009-2010 vs. 2000-2002: aHR 1.44, 95 % CI 1.12-1.83) and any (non-hip) facture (2009-2010 vs. 2000-2002: aHR 1.80, 95 % CI 1.58-2.06). Conclusion: The risk of sustaining a major or any (non-hip) fracture after hip fracture is small in the first year. However, given the recent rise in secondary fracture rates and the substantial risk of subsequent fracture in the longer term, fracture prevention is clearly indicated for patients who have sustained a hip fracture. [ABSTRACT FROM AUTHOR]

The current article examines changes over time in a commonly used measure of adult attachment style. A cross-temporal meta-analysis was conducted on 94 samples of American college students (total N = 25,243, between 1988 and 2011) who chose the most representative description of four possible attachment styles (Secure, Dismissing, Preoccupied, and Fearful) on the Relationship Questionnaire. The percentage of students with Secure attachment styles has decreased in recent years (1988: 48.98%; 2011: 41.62%), whereas the percentage of students with Insecure attachment styles (sum of Dismissing, Preoccupied, Fearful) has increased in recent years (1988: 51.02%; 2011: 58.38%). The percentage of students with Dismissing attachment styles has increased over time (1988: 11.93%; 2011: 18.62%), even after controlling for age, gender, race, and publication status. Positive views of others have declined across the same time period. We discuss possible implications and explanations for these changes. [ABSTRACT FROM AUTHOR]

Objective: Epidemiologic studies typically assess mental health using diagnostic measures or symptom severity measures. However, perceptions are also important. The objective of our study was to evaluate trends in perceived mental health in Canada during the past 20 years using data collected in a series of surveys. Methods: Perceived mental health status, the stressfulness of most days, and perceived general health, have been repeatedly measured in national surveys. In our study, the resulting frequencies and 95% confidence intervals were calculated. Distress was also assessed in the same surveys with the Kessler 6 Psychological Distress Scale, and analyzed using mean scores and frequencies based on cut-points. Data synthesis used forest plots. Time trends were assessed using random effects meta-regression models. Results: No detectable changes in distress were found. Similarly, self-rated general health remained stable. However, over time, Canadians became slightly more likely to report that their mental health was merely fair or poor. Conversely, they have been progressively less likely to perceive that their lives are quite a bit or extremely stressful. Conclusions: While these observations are ecological, the 2 trends may be related: distressing emotional experiences may increasingly be interpreted as evidence of a disturbance of mental health rather than a reaction to stressful circumstances. These changing perceptions should not be misinterpreted as an epidemic of poor mental health. [ABSTRACT FROM AUTHOR]

Background: The goal of the study was to identify secular trends in dental service delivery between dental therapists and dentists in the Yukon-Kuskokwim Delta region of Southwest Alaska, the first area of the United States to authorize dental therapy practice., Methods: Electronic health record transactions from the Yukon-Kuskokwim Health Corporation from 2006 through 2015 (n = 27,459) were analyzed. Five types of dental services were identified using Current Dental Terminology procedure codes: diagnostic, preventive, restorative, endodontic, and oral surgery. Main outcomes were percentages of services provided by dental therapists compared with dentists and population-level preventive oral health care., Results: The overall number of diagnostic, preventive, and restorative services in the Yukon-Kuskokwim Delta increased. For diagnostic services, there was a 3.5% annual decrease observed for dentists and a 4.1% annual increase for dental therapists (P < .001). Similar trends were observed for restorative services. For preventive services, there was no change for dentists (P = .89) and a 4.8% annual increase for dental therapists (P < .001). Dental therapists were more likely than dentists to provide preventive care at the population level., Conclusions: Dental therapists have made substantial contributions to the delivery of dental services in Alaska Native communities, particularly for population-based preventive care., Practical Implications: The study's findings indicate that there is a role for dental therapy practice in addressing poor access to oral health care in underserved communities., (Copyright © 2022 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Context: Sleep quality has been related to the risk of diabetes; however, little is known about the prevalence of diabetes in the United States according to the levels of sleep quality., Objective: To examine the joint secular trends of the overall sleep quality and diabetes among US adults from 2005-2006 to 2017-2018., Methods: Seven cycles of cross-sectional National Health and Nutrition Examination Survey (NHANES) data between 2005-2006 and 2017-2018 were included. Nonpregnant adults aged 20 years or older were eligible for the study. A healthy sleep score was calculated to represent overall sleep quality. The prevalence of diabetes was estimated and mean levels of fasting plasma glucose (FPG), glycated hemoglobin, and insulin resistance were calculated., Results: Both the estimated age-standardized prevalence of diabetes and changing trend in prevalence of diabetes varied by the overall sleep quality groups. The highest prevalence of diabetes was consistently observed in the low sleep quality group in each cycle, in which a significantly increasing trend was also noted across cycles (P for trend = .004). In contrast, the lowest prevalence of diabetes was consistently observed in the high sleep quality group in each cycle, in which no increasing trend over time was observed (P for trend = .346)., Conclusions: Overall sleep quality decreased significantly between 2005-2006 and 2017-2018 among US adults. The estimated prevalence of diabetes and related measures only increased in participants with low or medium overall sleep quality but remained stable in participants with high sleep quality., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Studies have shown that the prevalence of dementia in Latin America and the Caribbean (LAC) may be higher than in high-income countries. Thus, we sought to systematically analyse the prevalence of dementia and explore possible drivers that lead to this disparity in LAC countries., Method: We searched Pubmed, Web of Knowledge, Scopus, Lilacs, and SciELO for studies on dementia in LAC countries published in English, Spanish, and Portuguese. Random-effects model was applied., Results: Thirty-one studies from 17 LAC countries were included. Pooled prevalence of all-cause dementia was 10.66%. Further analyses with studies providing raw prevalence by sex, area, and educational level showed a higher prevalence for women (8.97%) than for men (7.26%). Also, dementia prevalence was higher for rural than urban residents (7.71% vs 8.68%, respectively). Participants without formal education presented more than double the prevalence of dementia (21.37%) compared to those with at least one year of formal education (9.88%). Studies with more recent data collection showed higher dementia prevalence., Conclusion: Our findings suggest a high global dementia prevalence in LAC countries and an unequal burden of dementia for women, lower-educated, and rural residents. Secular increases in dementia prevalence call for greater public health efforts for preventative actions., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)