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V Ajdacic-Gross

Publications and source records attributed to V Ajdacic-Gross.

12 recordsLinked to original sources
PubMed2006

Barriers to stroke thrombolysis in a geographically defined population.

OBJECTIVE: Barriers to thrombolysis are rather assessed for hospitalized stroke patients than among geographically defined populations. In a population-based approach, we assessed (1) the utilization rate of stroke thrombolysis in the community, and (2) the significance of the chosen stroke care provider as a potential barrier to thrombolysis. METHODS: We performed a databank-based post-hoc analysis, derived from data ascertained in a prospective, population-based stroke study among the permanent residents of the canton Basel-City, Switzerland. For the cohort with an onset assessment interval (OAI) < or =3 h, we compared thrombolyzed with non-thrombolyzed patients concerning demographic variables, the National Institutes of Health stroke scale (NIHSS) score, OAI, risk factors, and the type of stroke care provider. For patients without thrombolysis despite an OAI < or =3 h, barriers to thrombolysis were compiled. RESULTS: Among 269 patients, 49 had an OAI < or =3 h (18% of all patients and 38% of those 128 patients with exactly known time of onset). Fourteen patients received thrombolysis, amounting to a utilization rate of 5.2% (95% CI 2.9-8.6) for all patients and 29% (95% CI 17-43) for the OAI < or =3-hour cohort. For the latter, thrombolyzed differed from non-thrombolyzed patients in higher NIHSS score and type of stroke care provider, but not in demographic variables, OAI, or risk factors. Fourteen of 40 patients (35%) primarily admitted to the stroke unit received thrombolysis, compared with none of 9 patients primarily treated elsewhere (p < 0.04). In the OAI < or =3-hour cohort, mild or regressing stroke severity (48%), admission to hospitals not offering thrombolysis (20%), computed tomography or laboratory contraindications (17%) and severe comorbidity (14%) were barriers to thrombolysis. CONCLUSION: In this geographically defined population, every 20th stroke patient received thrombolysis. Only a minority of patients had an OAI < or =3 h, rendering late admission the most common barrier to thrombolysis. In the OAI < or =3-hour cohort, admission to hospitals not offering thrombolysis prompted exclusion from thrombolysis as often as established contraindications. Thus, acute stroke patients should solely be brought to hospitals providing thrombolysis.

Adult↗
PubMed2006

Use of army weapons and private firearms for suicide and homicide in the region of Basel, Switzerland.

OBJECTIVES: Switzerland has one of the highest rates of firearm suicides in the world. International studies show a positive correlation between the rate of households with guns and femicides with guns. Because its defense system requires a militia to keep personal firearms at home, Switzerland has a high rate of households with a gun. METHODS: Records of suicides in the region of Basel between 1992 and 1996 were reviewed. Suicides with either army weapons or private firearms and suicides by other means were compared. Methods and types of homicides that occurred in the region at the same time were also analyzed. FINDINGS: Firearm suicides were clearly the most frequent means of suicide. They were also used in 30.0% of domestic homicides, although other means were used at similar rates. Firearms for suicide were mainly used by men, especially army weapons. These men were younger, professionally better qualified, and fewer had ever been treated in one of the local state psychiatric services. DISCUSSION: The use of firearms for suicide, rather than homicide, and particularly of army weapons by young, well-educated men, requires more attention in debates and informed policy regarding access to firearms and suicide prevention in Switzerland.

Adult↗
PubMed2003

The Zurich Study: participation patterns and Symptom Checklist 90-R scores in six interviews, 1979-99.

OBJECTIVE: The Zurich study is a longitudinal study in psychiatric epidemiology that started in the late 1970s. The sixth interview in 1999 provides the basis to investigate and update the participation and drop-out patterns of the Zurich subjects. METHOD: Aside from descriptive analyses, particular attention was paid to the Symptom Checklist 90-R (SCL-90-R), used initially to stratify the Zurich sample. RESULTS: The initial proportions of high-scorers vs. low-scorers (two-thirds vs. one-third) have not changed significantly in the 367 subjects who participated in the 1999 interview. More detailed analyses indicate a selective and changing dependence of participation/drop-out on health status as measured by the SCL-90 R. In recent interviews drop-out has become more likely in subjects with extremely high SCL scores and in subjects with low SCL scores. CONCLUSION: Drop-out in the Zurich Study is associated with extreme SCL scores.

Adult↗
PubMed2003

Which individuals with affective symptoms seek help? Results from the Zurich epidemiological study.

OBJECTIVE: Several factors influence whether individuals with affective disorders seek help. The Zurich cohort study provides an opportunity to explore patient-based factors without confounding with problems of access. This study aims to identify features which predict help-seeking behaviour in symptomatic individuals and to explore failure of help seeking in those who did not. METHOD: Characteristics of currently symptomatic 40-year-old individuals in a stratified epidemiological sample were tested against help-seeking behaviour using bivariate statistics and logistic regression. Individual predictors were identified and interaction effects tested. RESULTS: Thirty-one per cent of the 364 subjects sought help in the preceding year. Past treatment and living alone were significantly associated with treatment. Total number of symptoms and several individual symptoms correlated with treatment in the bivariate analyses but regression analysis identified "unfounded self-reproach" and "hopelessness" interacting with social support to predict the best treatment. CONCLUSION: Social support is strongly protective against needing help in the presence of distressing affective symptoms unless these symptoms become elaborated into conclusions about their meaning and prognostic significance.

Adult↗
PubMed2002

[Depression among the elderly in Switzerland].

Data for this analysis came from a cross-sectional study on dementia, depression, and disability conducted in Zurich and Geneva in 1995/96. The random sample stratified by age and gender consisted of 921 subjects aged 65 and more. Based on the Canberra Interview for the Elderly, depression was assessed by means of psychogeriatric assessment scales (PAS) according to DSM-III-R criteria. The number of depressive symptoms (NDS) and the prevalence rate of depression (PRD) were computed for the whole sample as well as according to age and gender. To evaluate the independent effects of age as well as gender with regard to the risk of being depressed, multivariate analyses were conducted. On average, 13% of females vs 8% of males reported having at least one depressive symptom. The PAS yielded 298 (41.8%) subjects without depressive symptoms, 341 (50.2%) with 1-3 symptoms, and 60 (8.0%) with four or more. The average NDS was 1.27 (95% CI 1.16-1.39). For females, NDS values statistically significantly higher than those for males were calculated (1.53, 95% CI 1.35-1.70 vs 1.05, 95% CI 0.90-1.20). The NDS increased significantly with age. Subjects with low education levels and being divorced or widowed had statistically significantly higher NDS values than highly educated, married, or single persons. There were strong positive associations between NDS, dementia, and activities of daily living. Multivariate regression analysis revealed gender - however, not age - as a strong risk factor for NDS. Overall PRD amounted to 8.0% (95% CI 5.7-10.2%). Females had statistically significantly higher PRD values than males (10.4%, 95% CI 7.0-13.9% vs 3.9, 95% CI 2.0-5.9%). The PRD increased substantially with age. After adjustment for other risk factors, multivariate logistic regression analysis confirmed the positive statistically significant association between age, gender, and depression.

Activities of Daily Living↗
PubMed2001

[Dementia, depression and activity of daily living as risk factors for falls in elderly patients].

OBJECTIVES: Falls among elderly are a well-recognised public health problem. The purpose of the present study was to explore the relation between dementia, number of depressive symptoms, activities of daily living, setting, and risk of falling. METHODS: Data for the analysis came from a cross-sectional study about dementia, depression, and disabilities, carried out 1995/96 in Zurich and Geneva. The random sample stratified, by age and gender consisted of 921 subjects aged 65 and more. The interview was conducted by means of the Canberra interview for the Elderly, extended by short questionnaire. The subject was classified as a faller if the subject and/or the informant had reported a fall within the last 12 months prior to the interview. Logistic-regression analysis was used to determine the independent impact of dementia, depressive symptoms, and ADL-score on risk of falling. RESULTS: The stepwise logistic regression analysis has revealed a statistically significant association between dementia (OR 2.14, 95% CI 1.15-3.96), two resp. three depressive symptoms (OR 1.64, 95% CI 1.04-2.60) as well as four or more depressive symptoms (OR 2.64, 95% CI 1.39-5.02) and the risk of falling. There was no statistically significant relationship between studied risk factors and the risk of being one-time faller. However, we found a strong positive association between dementia (OR 3.92, 95% CI 1.75-8.79), four or more depressive symptoms (OR 3.90, 95% CI 1.55-9.83) and the risk of being recurrent faller. Moreover, residents of nursing homes (OR 8.50, 95% CI 2.18-33.22) and elderly aged 85 or more (OR 2.29, 95% CI 1.08-4.87) were under statistically significant higher risk of sustaining recurrent falls. CONCLUSIONS: The results of the present study confirm that dementia and depression substantially increase the risk of falling.

Accidental Falls↗
PubMed2001

How complete is AIDS surveillance in Europe? An eagle eye comparison with mortality data.

OBJECTIVES: Preliminary assessment of the adequacy of AIDS surveillance efforts in Europe by comparing data from two official sources-AIDS surveillance and mortality statistics. METHODS: The study used ENAADS (European Non-Aggregate AIDS Data Set) data compiled by the European Centre for the Epidemiological Monitoring of AIDS in St Maurice, France, and mortality statistics from WHO. As ENAADS provides information about AIDS incidence as well as AIDS mortality, both series were compared with WHO mortality data. Western European countries with more than 1000 adult AIDS cases as of July 1997 were included in the cross country comparative analyses. RESULTS: AIDS surveillance and mortality statistics in Europe depict four different patterns: (1) high overall concordance (Austria, Italy, Switzerland); (2) concordance between incidence by ENAADS and mortality by WHO, but a delay in mortality reporting in ENAADS (France, Spain); (3) more cases in WHO mortality data than in ENAADS data (Germany, Portugal); (4) more cases in ENAADS data than in WHO mortality data (Sweden, United Kingdom, Greece, Belgium). CONCLUSIONS: National AIDS surveillance systems in Europe exhibit important differences in terms of completeness and functionality. New challenges such as the introduction of effective but expensive and complex treatments will exert demands on surveillance efforts. Countries with discrepant AIDS and mortality data should try to improve and update their surveillance systems.

Acquired Immunodeficiency Syndrome↗
PubMed1999

[Epidemiological analysis of accidental falls by the elderly in Zurich and Geneva].

The purpose of the study was to determine the prevalence rate of fallers (PRF%) and fall-related consequences among the elderly according to age, gender and setting. Data derive from a cross-sectional study on dementia, depression and handicaps among the elderly, carried out between 1995 and 1996. Elderly people aged 65 and over living in Zurich or Geneva were considered eligible for the study. By means of the Canberra Interview for the Elderly, 921 subjects' and/or informants' interviews were completed. The subjects were classified as a faller if the subject and/or informant reported a fall in the year prior to the interview. Overall PRF% amounted to 27.8% and was higher to a statistically significant degree among females (30.9%) than males (22.5%). Gender difference in PRF was found only among the non-institutionalized elderly. Age-specific PRF increased significantly with the age of the elderly. However, this increase was observed only among male subjects. 143 subjects (PRF 17.1%) have fallen once and 101 (PRF 9.9%) two or more times. Females showed a substantially higher propensity to recurrent falls (age-adjusted OR 1.86; 95% confidence interval 1.11-3.10). While the risk of suffering two or more falls increased with age, it did not increase among one-time fallers. Residents of nursing homes had significantly higher risk of falling as compared with home-dwelling subjects (age-adjusted OR 2.46; 95% confidence interval 1.04-5.78). Every second fall caused fall-related consequences. 9.1% of all falls led to fall-related fracture. The risk of suffering fall-related consequences depended on neither age nor gender. One third of fallers reported fear of further falling. Falls among the elderly occur often and contribute substantially to morbidity.

Accidental Falls↗
PubMed1999

[Recording of multiple sclerosis in Swiss cause of death statistics. A 10-year mortality follow-up of the Bern prevalence study].

Based on data from a multiple sclerosis (MS) prevalence study which had been carried out in 1986 in the canton of Berne, Switzerland, a follow-up was performed 10 years later to gather information on mortality in the original study population. The authors used information on residency and death as gathered from municipal offices and, additionally, by record-linkage with the Swiss cause of death statistics. Slightly more than 80% of the cases were identified unequivocally as of January 1996. Among them, 21% of the cases died during the ten-year period; 70% of them have an MS entry in the cause of death statistics, mostly as the main cause of death. A large proportion of the non-identifiable cases appear to be related to mortality; thus, the findings here do not provide a promising basis for certain further analyses. In conclusion, continuous updating of personal data is the only way to avoid loss to follow-up in the carefully assembled prevalence database.

Cause of Death↗
PubMed1998

Season of birth in amyotrophic lateral sclerosis.

While studying birth cohort issues, the authors focused also on the seasons of birth in amyotrophic lateral sclerosis (ALS). The analyses were based on computerized death records of Swiss mortality statistics 1969-1993. The results confirm an excess of births in spring months. They suggest that risk factors in ALS can be acquired very early in life, thus introducing a long latency period.

Age of Onset↗
PubMed1994

Short and longterm fluctuations of generational MS risk.

According to the hypothesis that childhood is an important age stage in view of MS predisposition, alterations of MS risk may be expected in respect of generational succession. Age-period-cohort-analysis in the appropriate statistical analysis model in this connection. After having shown considerable fluctuations of generational MS risk in the long term view we have tried to derive additional informations from corresponding short term fluctuations: descriptive informations as well as results in relation to the short term fluctuations of infectious diseases' mortality. While applying again age-period-cohort-analysis the results are questioned by the fact that the underlying cohort estimates represent 5-years-moving-averages. Computerized individual death records of the Swiss mortality statistics available since 1969 will enable us to check the recent results.

Adolescent↗