Child Behavior Checklists completed by parents of 1863 clinically referred American and Dutch boys aged 6-11 and 12-16 were subjected to principal components analyses with varimax rotations. For each age group, the construct validity of seven empirically derived syndromes was supported by cross-national correlations ranging from 0.80 to 0.98. These syndromes were designated as Aggressive, Delinquent, Depressed (ages 6-11 only), Hyperactive, Schizoid (ages 12-16 only), Somatic Complaints, Uncommunicative, and Withdrawal (Social Withdrawal for ages 6-11; Hostile Withdrawal for ages 12-16). Cross-national similarities in the distribution of scores for normative samples supported the use of the same syndrome scales by clinicians and researchers in the two countries. The cross-national construct validity of Obsessive-Compulsive and Immature syndromes did not receive adequate support.
The impact of residential dampness or mold on respiratory health is well established but few studies have focused on university students. This study aims to: (a) describe the prevalence of exposure to residential dampness or mold in university students according to socio-geographic factors and (b) identify associated housing characteristics. A web survey was conducted in 2014 among the 26,676 students registered at the Université de Sherbrooke (QC, Canada). Residential dampness and mold being closely intertwined, they were considered as a single exposure and assessed using a validated questionnaire. Exposure was compared according to socio-geographic and housing characteristics using chi-square tests and logistic regressions. Among the 2097 participants included in the study (response rate: 8.1%), over 80% were tenants. Residential exposure to dampness or mold was frequent (36.0%, 95% CI: 33.9–38.1). Marked differences for this exposure were noted according to home ownership (39.7% vs. 25.5% among tenants and owners respectively; OR = 1.92%, 95% CI: 1.54–2.38). Campus affiliation, household composition and the number of residents per building were associated with exposure to dampness or mold (p < 0.01), while sex and age were not. Exposure was also associated with older buildings, and buildings in need of renovations and lacking proper ventilation (p < 0.001). This study highlights the potential risk of university students suffering from mold-related health effects given their frequent exposure to this agent. Further research is needed to fully evaluate the mold-related health impact in this at risk group.
To evaluate the cost-effectiveness of a lottery on physicians' responses to a mail survey, a randomized controlled trial was conducted with a random sample of 1,000 members of the Quebec Federation of General Practitioners in 1997. For the first mailing of this survey, each respondent was randomly assigned to the control or experimental group, which was offered participation in a lottery upon return of the questionnaire. Response rate was 41.2% in the experimental group and 34.8% in the control group, a 6.4% difference (CI95%: 0.6%-12.6%). The additional cost of the lottery was about Can$500, giving an incremental cost of Can$16 per questionnaire returned. In conclusion, a lottery resulted in a small but statistically significant increase in the response rate of physicians to a mail survey. This method may be a cost-effective option when applied to large surveys.
Objective: To measure the association between primary healthcare (PHC) organizational types and patient coverage for clinical preventive services (CPs). Method: study conducted in quebec (2005), including a population-based survey of patients' experience of care (N=4,417) and a survey of PHC clinics. Outcome measures: Patient-reported CPs delivery rates and CPs coverage scores. multiple logistic regressions used to assess factors associated with higher probability of receiving CPs. Results: CPs delivery rates were higher among patients with a regular source of PHC. Higher CPs score was associated with having a public (OR 1.79; 95% CI 1.35-2.37) or mixed (OR 1.22; 95% CI 1.01-1.48) type of organization as source of PHC compared to a private one, and having had a high number of visits to the regular source of PHC in the past two years (≥6: OR 1.83; 95% CI 1.41-2.38) compared to a single visit. Conclusion: Public and mixed PHC organizations seem to perform better. CPs delivery is strongly associated with having a regular source of care.
RésuméObjectif : mesurer la relation entre le type d' organisation de services médicaux de première ligne et la prestation des pratiques cliniques préventives (PCP). Méthodologie : étude menée au québec (2005), comprenant une enquête auprès
Bone is continuously regenerated and remodeled as an adaptation to mechanical load. Bone mass and fracture resistance are maintained by a balanced equilibrium between bone formation and bone resorption. Regeneration and response to mechanical load are, however, impaired in osteoporosis and during aging. Bone resorption is enhanced by chronic inflammation while bone formation is altered by rising levels of inhibitors in the aging organism. Core molecular principles of the regulation of bone metabolism in health and disease have been characterized and developed as therapeutic targets. The receptor activator of nuclear factor kappaB ligand (RANKL) and osteoclast-derived protease cathepsin K are important regulators and effectors of osteoclast differentiation and bone resorption. Bone formation is stimulated by bone morphogenetic proteins (BMP) and via the parathyroid hormone receptor and the Wnt signaling pathway. The principles of osteoclast inhibition using bisphosphonates have now been known for almost three decades. Based on more recent knowledge RANKL and cathepsin K have been developed as new therapeutic targets to inhibit bone resorption. While denosumab, a RANKL antibody, has already been introduced into routine treatment strategies, the cathepsin K antagonist odanacatib is currently in the licensing process. Bone formation can also be stimulated by local administration of BMPs, by systemic treatment with the parathyroid hormone fragment teriparatide and by using antibodies targeting the Wnt inhibitor sclerostin. The latter are presently being tested in phase III clinical studies. In the near future a panel of traditional and novel treatment strategies will be available that will enable us to meet the individual clinical needs during aging and for the treatment of osteoporosis.
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