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PubMed2006

ISAAC I and III in Georgia: time trends in prevalence of asthma and allergies.

ISAAC I and III surveys were carried out in schoolchildren aged 6-7 years from two centres of Georgia to estimate time trends and geographic variations in the prevalence of asthma, rhino-conjunctivitis and atopic eczema symptoms. A standard core questionnaire was used following the ISAAC methodology and was completed by the schoolchildren's parents. The prevalence of symptoms of allergic diseases in Phase I and Phase III was compared. The average prevalence of "current wheezing" almost not changed over 7 years, however there was some heterogeneity across the centres, particularly in Tbilisi centre the prevalence of current wheezing increased by 2.6% and in Kutaisi (it decreased by 2.4%. The symptoms of current rhino-conjunctivitis slightly decreased, but not statistically significant. More significant reduction was observed for symptoms atopic eczema, which was revealed in both centres. The results indicate that the epidemiological features of asthma and allergies in Georgia are changing, although the causes are still uncertain. Different patterns of time trends between centres suggested that there may be local differences in risk factors.

Asthma↗

PubMed1998

Socioeconomic differences in risk of myocardial infarction 1971-1994 in Sweden: time trends, relative risks and population attributable risks.

BACKGROUND: The general trend in incidence of myocardial infarction (MI) in the Stockholm area changed from increasing to decreasing around 1980. The objective of this study is to examine time trends in incidence in major socioeconomic strata, relative risk between socioeconomic groups and population risk attributable to socioeconomic differences during this period. METHODS: All cases of MI from 1971 to 1986 were identified from hospital discharge and cause-of-death registers. Person-years for each year of follow-up were calculated from the population register in the Stockholm region 1971-1986. Census registers were used for information on socioeconomic status. Register information was individually linked through the Swedish personal identification number. Supplementary information for 1992-1994 was taken from the case-control study SHEEP (Stockholm Heart Epidemiology Program). RESULTS: The decline in MI risk among male high- and middle-level employees started in 1976 and in male manual workers in 1981. For women incidence increased from 1971 to 1986 among manual workers and decreased among high- and middle-level employees. The increase over time of the relative risk from low socioeconomic position continued into the 1990s. Despite the reduction of the category of manual workers, the population attributable risk from socioeconomic differences also increased over time. The process of social change influencing the size of the socioeconomic groups contributes to the change in time trends of MI morbidity. CONCLUSIONS: The increase over time of relative and population attributable risks of MI from low socioeconomic status add to the public health importance of social inequity.

Adult↗

PubMed1985

Reye's syndrome: incidence and time trends in Olmsted County, MN, 1950-1981.

Incidence and time trends of Reye's syndrome have been determined in Olmsted County, MN, using the facilities of the Rochester Epidemiology Program Project at Mayo Clinic. Incidence rates in individuals under 18 years of age were 1.1 per 100,000 person-years in the 1970-75 time interval and 1.7 in the 1976-81 interval. Failure to identify any case in the earliest time interval yields a rate of zero, and an incidence higher than 0.6 per 100,000 can be excluded with 95% probability. This finding is consistent with an increasing incidence over time in this community and does not exclude the possibility that Reye's syndrome did not exist in Olmsted County before 1970.

Adolescent↗

PubMed1997

Prevalence and time trends of disabilities in school-age children.

BACKGROUND: Although the evolution of the prevalence of cerebral palsy is now well documented, much less is known about the evolution of the prevalence of other disabilities such as mental retardation, sensorial defects, autism and psychosis. The aim of this paper is to determine those trends. METHODS: A population-based survey was carried out in 1992-1993 in three French 'départments'. All disabled children born between 1976 and 1985 and receiving a special education and/or financial assistance were systematically registered. RESULTS: The comparison of three cohorts of children born in 1976-1978, 1979-1981 and 1982-1984 using the test for trend in proportion showed a significant decrease (P = 0.03) in the prevalence of severe mental retardation, after exclusion of Down syndrome. This decrease was significant for severe mental retardation associated with psychosis. The time trend prevalence for cerebral palsy increased (P = 0.03) but was irregular. The time trend prevalence of other disabilities (other motor defects, severe sensorial disabilities, autism and psychosis) did not change significantly. A detailed analysis of severe mental retardation and cerebral palsy was performed by geographical area, age at first registration and type of disability. CONCLUSION: The increase in prevalence of cerebral palsy is possibly due to earlier registration of disabled children. The decrease in prevalence of severe mental retardation does not seem to be due to recruitment bias, but there is a possibility of classification bias.

Adolescent↗

PubMed2001

Polychlorinated naphthalenes in U.K. soils: time trends, markers of source, and equilibrium status.

Polychlorinated naphthalenes (PCNs) have been analyzed in archived soil from the U.K. to investigate historical trends. Samples were obtained from the Broadbalk experiment plots (1944-1986) and Luddington experiment station (1968-1990). Luddington samples also include a set of soils that received a one-time sludge treatment in 1968, and duplicate samples of this archived sludge were also analyzed. Peak residues of sumPCN (sum of all PCN congeners quantified) were approximately 9000 pg g(-1) dry weight in 1956, declining to approximately 300 pg g(-1) in contemporary soils. The one-time sludge application resulted in elevated soil residues that were 1.5-6 times higher than the control plot over the time series. This increase is consistent with the known application rate and the amount of sumPCN in the applied sludge (approximately 250,000 pg g(-1) dry wt). Half-lives forthe Luddington control soil and the sludge-amended soil for the period 1972-1990 were 5.3 and 9.9 years, respectively. Investigation of time trends revealed differences between homologue groups with the higher molecular weight congeners peaking earlier in the time series (pre-1950) and the lower molecular weight congeners peaking later, ca. 1970. Time trends of individual congeners were investigated in terms of their relative mass percent contribution to the sum of their homologue group. Significant (p < 0.05) increasing trends were observed for several congeners associated with combustion sources (CN-29, -51, -52/60, -54, and -66/67) suggesting that combustion related sources are more important now than they were in the past. However, no decreasing trend was observed for congeners that were thought to be susceptible to degradation by photolysis suggesting that this may not be a key elimination pathway of PCNs in the environment. A simple calculation of the fugacity status of PCNs in air and soil showed that the tri-CNs are exhibiting net outgassing, while the penta-CNs are still being deposited to soil. Interestingly, the penta-CNs associated with combustion show the largest gradient for air-to-soil transfer, supporting the notion that combustion sources are important contributors to contemporary air burdens of these congeners.

Air Pollutants↗

PubMed1982

In-hospital maternal mortality in the United States: time trends and relation to method of delivery.

To study time trends in maternal mortality in the United States and to attempt to compare the risk of cesarean with vaginal delivery, information from the Professional Activities Study of the Commission on Professional and Hospital Activities for 3 years-1970, 1974, and 1978-was reviewed. For all deliveries, mortality per 100,000 deliveries declined from 25.7 in 1970 to 14.3 in 1978. For vaginal deliveries, mortality per 100,000 deliveries declined from 20.4 to 9.8. For cesarean deliveries, mortality per 100,000 births decreased more than for vaginal deliveries, from 113.8 to 40.9. Mortality for deliveries with no mention of complications, lacerations, or uterine rupture declined significantly from 1970 to 1978. Mortality for deliveries complicated by dystocia or malpresentation declined significantly from 1970 to 1974, but failed to decline thereafter. Mortality for deliveries complicated by a previous cesarean or by antepartum hemorrhage did not decline significantly from 1970 to 1978. For all complications with a sufficient number of vaginal and cesarean deliveries, except deliveries complicated by malpresentation or antepartum hemorrhage, mortality was at least twice as high in cesarean as in vaginal deliveries. Based on a comparison of mortality after a previous cesarean with mortality for all vaginal deliveries with no complication, the authors conclude that cesarean delivery is probably neither less than 2 nor more than 4 times more hazardous than vaginal delivery.

Adolescent↗

PubMed2002

Time trends in cancer incidence and mortality in central Italy.

Time trends in cancer incidence and mortality represent an essential tool for monitoring the changes in population lifestyle and in the environmental risks and the effectiveness of the health system on cancer control in a specific area. During 1985-1997 82 506 malignant tumours were diagnosed in the Tuscany Cancer Registry, central Italy (about 1 200 000 inhabitants) and 54 979 cancer deaths registered in the period 1985-1999 by the Regional Mortality Registry were analysed. A statistically significant decrease in incidence was evidenced for stomach and gallbladder in both sexes, and for oesophagus, larynx and lung among males. Significant increases were documented for melanomas of the skin, kidney and non-Hodgkin's lymphoma in both sexes for colon, prostate and Kaposi's sarcoma among males and for breast, thyroid and multiple myeloma among females. Mortality decreased significantly for stomach and thyroid in both sexes and for oral cavity and pharynx, oesophagus, rectum, larynx, lung, bone, prostate, testis and Hodgkin's disease among males and colon, gallbladder and breast among females. Mortality increased for soft tissue, brain and multiple myeloma. In conclusion, most of these data can be explained as the effect of the modifications that occurred in smoking habits between the sexes and as the consequence of the primary and secondary prevention activities that are ongoing in the area.

Adolescent↗

PubMed1999

Time trends in the mortality rates for tobacco- and alcohol-related cancers within the oral cavity and pharynx in Japan, 1950-94.

Mortality data of oral cancer over 40 years in Japan were analyzed to investigate time trends of the disease site-specifically and discuss the relation between these trends and the changing patterns of consumption of tobacco and alcohol beverages. Mortality rates were adjusted to the world standard population. In the males, overall oral cancer (ICD-9: 141-149) mortality rates have increased consistently from the lowest value of 1.25 (per 100,000 per year) in 1956 to 2.40 in 1992. The rates for females were constantly lower than those for males, and formed a modest peak of 0.96 in 1979. Regarding site-specific mortality rates, tongue cancer (141) presented a decreasing trend, while oro/hypopharyngeal (146, 148) and mouth (143-145) cancers showed increasing patterns, particularly in males. When the changing patterns of male truncated rates for ages 35-64 were compared with those of the annual consumption of cigarette and alcohol per capita, the time trend of oro/hypopharyngeal cancer mortality was analogous to cigarette consumption rather than to alcohol consumption, mouth cancer vice versa, and tongue cancer was not related to tobacco or alcohol consumption. The present findings suggest that tobacco and alcohol have different site-specific effects on the development of cancers within the oral cavity and pharynx.

Adult↗

PubMed2003

Combining cohort and period methods for retrospective time trend analyses of long-term cancer patient survival rates.

Assessing trends in long-term cancer patient survival is an essential component of monitoring progress against cancer by cancer registries. Traditional assessment of long-term survival ('cohort analysis') is very useful to disclose trends in long-term survival rates of patients diagnosed many years ago, but it does not allow the disclosure of recent trends in long-term survival rates. The latter can be achieved by an alternative method of survival analysis ('period analysis'), which has been proposed a few years ago. On the other hand, unlike cohort analysis, period analysis does not provide estimates of long-term survival rates for patients diagnosed in the early years after initiation of cancer registration. In this paper, a method of retrospective analysis of time trends in long-term survival rates is introduced, which combines the advantages of both cohort and period analysis ('mixed analysis'). This method thereby allows for a comprehensive monitoring of trends in long-term survival over an extended time span from the earliest to the most recent years of cancer registration. The use of the method is illustrated for retrospective time trend analyses of long-term survival of cancer patients in the United States with the 1973-1999 database of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.

Cohort Studies↗

PubMed1998

[Lead exposure in the ceramic tile industry: time trends and current exposure levels].

There is a high density of industries for the production of ceramic tiles in the District of Scandiano (province of Reggio Emilia, Emilia Romagna region). In this area, since the beginning of 1970s, the time trend of Pb exposure in ceramic tile plants has been evaluated by means of biological monitoring (BM) data collected at the Service of Prevention and Safety in the Work Environment and its associated Toxicology Laboratory. From these data, a clear decreasing time trend of exposure levels is documented, the reduction being more evident during the seventies and in 1985-88. During the seventies BM was introduced systematically in all ceramic tile plants with the determination of delta-aminolevulinic acid in urine (ALA-U). As a consequence of the BM programme, hygienic measures for the abatement of pollution inside the plants were implemented, and a reduction, from 20.6% to 2%, of ALA-U values exceeding 10 mg/l, was observed. In 1985, the determination of lead in blood (PbB) replaced that of ALA-U in the BM programmes and highlighted the persistence of high level of exposure to Pb, which could not be outlined by means of ALA-U because of its lower sensitivity. PbB levels were 36.1 micrograms/100 ml and 25.7 micrograms/100 ml in male and female workers, respectively. These results required the implementation, within the plants, of additional hygienic measures and a significant reduction of PbB was obtained in the following three years. In 1988 PbB levels were 26.0 +/- 10.7 and 21.6 +/- 10.3 micrograms/100 ml in male and female workers, respectively. In 1993-95 Pb levels were obtained from 1328 male and 771 female workers of 56 plants, accounting for about 40% of the total number of workers in the ceramic industry, in the zones of Sassuolo and Scandiano. Exposure levels are not different from those observed in the preceding years, with PbB levels of 25.3 +/- 11.1 and 19.1 +/- 9.2 micrograms/100 ml in male and female workers, respectively.

Adult↗

PubMed2000

Radical retropubic prostatectomy: time trends, morbidity and mortality in Japan.

OBJECTIVES: To assess the time trends, morbidity and mortality of contemporary anatomical radical retropubic prostatectomy (RRP) in a multi-institutional study in Japan, where RRP has become more popular in the last decade. PATIENTS AND METHODS: Between January 1991 and August 1998, 638 patients underwent RRP at seven urological centres in Japan. Major complications (within 30 days of surgery) and the 30-day mortality were reviewed retrospectively. Of the patients, 12.9% were < 60 years old, 56.3% were 60-69 years old and 30.9% were >/= 70 years old (median age 67). Results The number of RRPs increased markedly, by more than sevenfold, from 1991-92 to 1996-97, mainly because there were more patients undergoing RRP in their sixth decade. The contribution of T1c disease increased in absolute and relative terms, from 13.9% in 1991-92 to 37.9% in 1997-98. Over time, the mean blood loss and the allogeneic transfusion rate decreased steadily. There was a trend toward more favourable outcomes for pathological variables (an increased percentage of organ-confined disease, decreased margin positivity and a decreased incidence of positive lymph node metastasis). The most common complications were wound-related (7.5%), or anastomotic leakage (4.1%). Major cardiopulmonary complications occurred in only two patients (0.31%, both pulmonary embolisms). One patient died from cerebral haemorrhage within 30 days of surgery, giving a mortality rate of 0.16%. CONCLUSION: s This study indicates a trend towards selecting patients most likely to benefit from RRP. Although the procedure is technically demanding, it can have an acceptably low rate of early complications, little mortality and need for allogeneic transfusion. The assessment of morbidity suggests a lower incidence of catastrophic thrombo-embolic and cardiac complications in Japanese patients than in Western men. The present data may be useful in decision-analysis models evaluating the role of therapy for Asian men with early-stage prostate cancer.

Adult↗

PubMed1996

Time-trend of sleep disorder in relation to night work: a study of sequential 1-year prevalences within the GAZEL cohort.

We examined two longitudinal hypotheses: the 1-year prevalence for night workers is consistently higher than for others; the time trend is steeper for night workers than for others. Subjects were 12,779 men (age 40-50) working at Electricité de France-Gaz de France, and recruited in the GAZEL cohort. Five questionnaires were sent to all subjects on 1989 through 1993. Self-reported occurrence of sleep disorder in the previous year was regressed on night work status in 1989 and covariates to estimate prevalence rate differences (PRDs). The estimated PRD for regular night workers versus others was 6.1% (95% CI, 1.1-11.1%). There was a common time trend of 1.4% per year (1.0-1.9%), and evidence of excess trend for regular night workers: 1.1% (-0.7-2.9%). Findings indicate that the effect of night work on sleep complaints manifests itself during the first year of night work and is permanent.

Adult↗

PubMedDate not supplied

[Health system interventions assessment in Spain: an approach through the analysis of the time trends and the geographical variability of avoidable mortality between 1986 -2001].

BACKGROUND: Many studies have proposed Avoidable Mortality (ME) to monitor the performance of health services although its usefulness is limited by the multiplicity of the avoidable mortality lists being used. Time trends from 1986-2001 and the geographical distribution of avoidable mortality by provinces, are presented for Spain. METHODS: An Avoidable Mortality consensus list is being used. It includes avoidable mortality through the intervention of health services (ISAS in Spanish) and through health policy interventions (IPSI in Spanish). Time trends are analyzed adjusting Poisson or Joinpoint regression models and the annual percentages of change (APC) are estimated. Changes in geographical distribution between the first half of the analysed period and the second are tested by means of standard mortality ratios (SMR) and comparative mortality rates (CMR) for each province. RESULTS: Between 1986 and 2001 avoidable mortality decreased (APC: -1.68; CI: -1.99 and -1.38) slightly more than non-avoidable mortality (APC: -1.28; CI: -1.40 and -1.17). Higher reduction was observed for ISAS mortality (APC: -2.77; CI: -2.89 and -2.65) and an irregular trend for IPSI (between 1986-1990 increase APC: 4.86; CI: 3.32 and 6.41, between 1990-95 stabilization APC: -0.03; CI: -2.32 and 2.31 and finally 1995-2001 decrease APC: -3.57; CI: -4.72 and -2.40). CONCLUSIONS: Avoidable mortality decreased more than non avoidable mortality and important geographical variability can be observed among provinces which should be monitored in order to identify the health services weaknesses. The higher ISAS mortality was observed in southern provinces and the higher IPSI mortality in some areas on the coast. The pattern is somewhat similar for both analyzed periods.

Adolescent↗

PubMed2002

Rise in malaria incidence rates in South Africa: a small-area spatial analysis of variation in time trends.

Using Bayesian statistical models, the authors investigated spatial and temporal variations in small-area malaria incidence rates for the period mid-1986 to mid-1999 for two districts in northern KwaZulu Natal, South Africa. Maps of spatially smoothed incidence rates at different time points and spatially smoothed time trends in incidence gave a visual impression of the highest increase in incidence occurring where incidence rates previously had been lowest. This was confirmed by conditional autoregressive models, which showed that there was a significant negative association between time trends and smoothed baseline incidence before the steady rise in caseloads began. Growth rates also appeared to be higher in the areas close to the Mozambican border. The main findings of this analysis were that: 1) the spatial distribution of the rise in malaria incidence is uneven and strongly suggests a geographic expansion of high-malaria-risk areas; 2) there is evidence of a stabilization of incidence in areas that had the highest rates before the current escalation of rates began; and 3) areas immediately adjoining the Mozambican border appear to have undergone larger increases in incidence, in contrast to the general pattern of low growth in the more northern, high-baseline-incidence areas, but this was not confirmed by modeling. Smoothing of small-area maps of incidence and growth in incidence (trend) is important for interpretation of the spatial distribution of disease incidence and the spatial distribution of rapid changes in disease incidence.

Bayes Theorem↗

PubMed2000

Time trends in alcohol habits. Results from the Kirseberg project in Malmö, Sweden.

This paper reports on a pilot demonstration to implement an alcohol consumption reduction project in the community of Kirseberg, located in the city of Malmö, Sweden. The objective is to present data on time trends in alcohol use habits and alcohol-use-related problems in the Kirseberg population and to discuss potential effects of the alcohol prevention activities. It was possible to implement an alcohol consumption prevention community program successfully. The analysis of time trends in alcohol use habits and alcohol-use-related problems was, however, mainly inconclusive, but indicated a decrease in alcohol consumption and alcohol-use-related problems among young and middle-aged men.

Adult↗

PubMed2001

[Time trends in ovarian cancer incidence in Navarra (1973-1995): effect of age, birth cohort and period of diagnosis].

BACKGROUND: Ovarian cancer is the sixth most common malignancy and the first killer among gynaecologic cancers in women of the European Union. Five years after diagnosis relative survival rates were less than 35%. The aims of the present study are to describe the time trends in ovarian cancer incidence in Navarra over the period 1973-1995, and to identify the age, period-of-diagnosis and birth-cohort components underlying the trend's evolution. METHODS: Standard summary indexes of incidence were calculated. Log-linear Poisson models to quantify risks of ovarian cancer and the relative annual trend were used. Age-period-cohort models were adjusted in order to ascertain the effects on time trend exerted by the respective age, period-of-diagnosis and birth-cohort components. RESULTS: Ovarian cancer incidence has showed annual rises of 2.1% over the period 1973-1995, with stabilisation over the period 1988-1995. A 54% increase in the risk of ovarian cancer was shown for the period 1993-1995 vs.1973-1977. The more recent generations of women born in Navarra do not show significant changes in the risk of ovarian cancer. CONCLUSIONS: A considerable rise in ovarian cancer incidence in Navarra over the period 1973-1995 was found, less pronounced in the last decade. The risk of ovarian cancer shown in the more recent generations of women born in Navarra is stable.

English Abstract↗

PubMed1997

Esophageal and gastric carcinoma in Norway 1958-1992: incidence time trend variability according to morphological subtypes and organ subsites.

The occurrence of adenocarcinoma (AC) of the esophagus and gastric cardia has shown large increases in many but not all examined populations. This trend is in contrast with a decrease in distal gastric AC and a relative stability of esophageal squamous cell carcinoma. Our study aimed to describe esophageal and gastric carcinoma time trends in the Norwegian population between 1958 and 1992 based on data from the Cancer Registry of Norway. Estimated esophageal AC rates have accelerated over the study period, reaching average annual increases of 17% in men and 14% in women between 1983 and 1992. The occurrence of esophageal squamous cell carcinoma was relatively stable in both sexes. Proximal gastric cancer rates were stable in males and decreased somewhat in females. Distal gastric tumors showed decreases in both sexes, but were more pronounced in females. The strong increase in esophageal AC incidence parallels similar increases in the United States and some other countries. Although the observed increase may be explained to some extent by a shift in the classification of esophago-cardial adenocarcinomas, the figures are compatible with a real increase. AC of the esophagus, the proximal stomach and the distal stomach exhibit different epidemiological features, both in terms of sex ratios and time trends, suggesting risk factor differences between the subsites.

Adenocarcinoma↗

PubMed2002

Time trends in high blood pressure control and the use of antihypertensive medications in older adults: the Cardiovascular Health Study.

BACKGROUND: Control of high blood pressure (BP) in older adults is an important part of public health efforts at prevention. OBJECTIVE: To assess recent time trends in the awareness, treatment, and control of high BP and in the use of medications to treat high BP. METHODS: In the Cardiovascular Health Study, 5888 adults 65 years and older were recruited from 4 US centers. At baseline, participants underwent an extensive examination that included the measurement of BP, use of medications, and other risk factors. Participants were followed up with annual visits that assessed BP and medication use from baseline in 1989-1990 through the examination in 1998-1999. The primary outcome measures were control of BP to levels lower than than 140/90 mm Hg and the prevalence of use of various classes of antihypertensive medications. RESULTS: The awareness, treatment, and control of high BP improved during the 1990s. The proportions aware and treated were higher among blacks than whites, though control prevalences were similar. For both groups combined, the control of high BP to lower than 140/90 mm Hg increased from 37% at baseline to 49% in 1999. The 51% whose BP was not controlled generally had isolated mild to moderate elevations in systolic BP. Among treated persons, the improvement in control was achieved in part by a mean increase of 0.2 antihypertensive medications per person over the course of 9 years. Improved control was also achieved by increasing the proportion of the entire Cardiovascular Health Study population that was treated for hypertension, from 34.5% in 1990 to 51.1% in 1999. Time trends in antihypertensive drug use were pronounced. Among those without coronary disease, the use of low-dose diuretics and beta-blockers decreased, while the use of newer agents, such as calcium channel blockers, angiotensin-converting enzyme inhibitors, and alpha-blockers increased. CONCLUSIONS: While control of high BP improved in the 1990s, about half the participants with hypertension had uncontrolled BP, primarily mild to moderate elevations in systolic BP. Low-dose diuretics and beta-blockers--the preferred agents since 1993 according to the recommendations of the Joint National Committee on the Detection, Evaluation and Treatment of High Blood Pressure--remained underused. More widespread use of these agents will be an important intervention to prevent the devastating complications of hypertension, including stroke, myocardial infarction, and heart failure.

Age Factors↗