Objectives: To describe the development of the Oxford WebQ, a web-based 24 h dietary assessment tool developed for repeated administration in large prospective studies; and to report the preliminary assessment of its performance for estimating nutrient intakes. Design: We developed the Oxford WebQ by repeated testing until it was sufficiently comprehensive and easy to use. For the latest version, we compared nutrient intakes from volunteers who completed both the Oxford WebQ and an interviewer-administered 24 h dietary recall on the same day. Setting: Oxford, UK. Subjects: A total of 116 men and women. Results: The WebQ took a median of 12?5 (interquartile range: 10?8-16?3) min to self-complete and nutrient intakes were estimated automatically. By contrast, the interviewer-administered 24 h dietary recall took 30 min to complete and 30 min to code. Compared with the 24 h dietary recall, the mean Spearman's correlation for the 21 nutrients obtained from the WebQ was 0?6, with the majority between 0?5 and 0?9. The mean differences in intake were less than 610 % for all nutrients except for carotene and vitamins B 12 and D. On rare occasions a food item was reported in only one assessment method, but this was not more frequent or systematically different between the methods. Conclusions: Compared with an interviewer-based 24 h dietary recall, the WebQ captures similar food items and estimates similar nutrient intakes for a single day's dietary intake. The WebQ is self-administered and nutrients are estimated automatically, providing a low-cost method for measuring dietary intake in large-scale studies.
Previous studies have reported inconsistent results on the effect of anthropometric and lifestyle factors on the risk of developing glioma or meningioma tumours. A prospective cohort of 1.3 million middle-aged women was used to examine these relationships. During 7.7 million women-years of follow-up, a total of 1563 women were diagnosed with a primary incident central nervous system tumour: 646 tumours were classified as glioma and 390 as meningioma. Our results show that height is related to the incidence of all central nervous system tumours with a risk of about 20% per 10 cm increase in height (relative risk ¼ 1.19, 95% CI ¼ 1.10 -1.30 per 10 cm increase in height, Po0.001): the risks did not differ significantly between specified glioma and meningioma. Body mass index (BMI) was also related to central nervous system tumour incidence, with a risk of about 20% per 10 kg m À2 increase in BMI (relative risk ¼ 1.17, 95% CI ¼ 1.03 -1.34 per 10 kg m À2 increase in BMI, P ¼ 0.02). Smoking status, alcohol intake, socioeconomic level, parity, age at first birth, and oral contraceptive use were not associated with the risk of glioma or meningioma tumours. In conclusion, for women in the United Kingdom, the incidence of glioma or meningioma tumours increases with increasing height and increasing BMI. British Journal of Cancer (2008) Keywords: body mass index; glioma; height; meningioma; women Primary brain and central nervous system cancers are relatively rare and represent approximately 2% of all cancers diagnosed in the United Kingdom. However, due to a poor prognosis, they are responsible for 7% of the years of life lost from cancer before the age of 70 years (Cancer Research UK, 2007). Very little is known about the aetiology of central nervous system tumours, but environmental factors are thought to play a role (McKinney, 2004;Connelly and Malkin, 2007).The two most common types of central nervous system tumour are glioma and meningioma (Claus et al, 2005). Gliomas arise from glial cells, are found predominantly in the brain and to a lesser extent in the spinal cord or other parts of the central nervous system, and represent more than 70% of all brain tumours (Ohgaki and Kleihues, 2005). Gliomas are typically histologically malignant, can be either slow or fast growing, and are more frequently diagnosed in men than in women. Meningiomas arise from the arachnoidal cells of the leptomeninges (the pia mater and arachnoid mater of the meninges) (Sanson and Cornu, 2000), are also more frequently found in the brain than elsewhere in the central nervous system, and represent more than 20% of all brain tumours (Longstreth et al, 1993). Meningiomas are typically benign (490%) and slow growing. The risk of meningioma increases with age (Sanson and Cornu, 2000), and they are more frequently diagnosed in women (Sanson and Cornu, 2000;Perry et al, 2007).There are few well-established risk factors for glioma and meningioma tumours among adults; while exposure to ionizing radiation and rare inherited genetic conditions such as n...
Although in its infancy, organized screening for colorectal cancer (CRC) in the general population is increasing at regional and national levels. Documenting and describing these initiatives is critical to identifying, sharing and promoting best practice in the delivery of CRC screening. Subsequently, the International Colorectal Cancer Screening Network (ICRCSN) was established in 2003 to promote best practice in the delivery of organized screening programs. The initial aim was to identify and document organized screening initiatives that commenced before May 2004. Each identified initiative was sent 1 questionnaire per screening modality: fecal occult blood test, flexible sigmoidoscopy or total colonoscopy. Information was collected on screening methodology, testing details and initiative status. In total, 35 organized initiatives were identified in 17 countries, including 10 routine population-based screening programs, 9 pilots and 16 research projects. Fecal occult blood tests were the most frequently used screening modality, and total colonoscopy was seldom used as a primary screening test. The eligible age for screening ranged from 40 years old to no upper limit; most initiatives included participants aged 50 to 64. Recruitment was usually done by a mailed invitation or during a visit to a family physician. In conclusion, this is the first investigation describing the delivery of CRC screening protocols to various populations. The work of the ICRCSN is enabling valuable information to be shared and a common nomenclature to be established. ' 2007 Wiley-Liss, Inc.Key words: colonoscopy; colorectal cancer screening; fecal occult blood test; flexible sigmoidoscopy; geographic variation Worldwide each year, more than 940,000 new cases of colorectal cancer (CRC) are diagnosed and nearly 500,000 people die from the disease.1 CRC is the third most common cancer in both men and women worldwide, and the second most common cancer in the industrialized world. Early detection of CRC has been shown to improve outcomes through the detection of early-stage cancers and precursor lesions.3 Because early-stage disease frequently is asymptomatic, screening of the general population could decrease CRC incidence and mortality. There are 3 frequently used screening modalities: fecal occult blood test (FOBt), which reveals traces of blood in
Summary. Background: Current use of menopausal hormone therapy (HT) increases the risk of venous thromboembolism (VTE) and the formulations used may affect risk. Methods: A total of 1 058 259 postmenopausal UK women were followed by record linkage to routinely collected National Health Service hospital admission and death records. HT use and risk of VTE was examined using Cox regression to estimate relative risks (RRs) and 95% confidence intervals (CIs). Results: During 3.3 million years of follow-up, 2200 women had an incident VTE, diagnosed, on average, 1.5 years after last reporting HT use. RRs in current vs. never users at last reporting varied by HT formulation: the risk was significantly greater for oral estrogen-progestin than oral estrogen-only therapy (RR = 2. P heterogeneity = 0.0007). Current users of oral HT at last reporting had twice the risk of VTE in the first 2 years after starting HT than later (P heterogeneity = 0.0006). Associations were similar for deep vein thrombosis with and without pulmonary embolism. Over 5 years, 1 in 660 who had never used HT were admitted to hospital for (or died from) pulmonary embolism, compared with 1 in 475 current users of oral estrogen-only HT,1 in 390 users of estrogen-progestin HT containing norethisterone/norgestrel, and 1 in 250 users of estrogen-progestin HT containing medroxyprogesterone acetate. Conclusions: The risk of VTE varied considerably by HT formulation, being greatest in users of oral estrogen-progestin HT, especially formulations containing medroxyprogesterone acetate.
This paper describes the current wireless telecommunications infrastructure deployment regulations in Colombia. It also refers to the possible effects that this infrastructure could cause to the country`s health and environment. similarly, the results obtained show a comparison between the Argentina's current regulations, one of the most relevant researches carried out and the Colombian case. finally, some recommendations are proposed that can be considered in the project of regulations applicable in Colombia for the ensuring purpose that the non-ionizing radiation generated by wireless communications systems do not have effects on health and the environment. ResumenDescribe las actuales regulaciones colombianas para la instalación de infraestructuras de telecomunicaciones inalámbricas. También se refiere a los posibles efectos de esta infraestructura sobre la salud de la población y el medioambiente del país. Además, muestra los resultados de una comparación entre las actuales regulaciones de Argentina y el caso colombiano. Finalmente, se proponen algunas recomendaciones que pueden considerarse en A regulations' survey for the wireless telecommunications deployment in Colombia el proyecto regulatorio aplicable a Colombia, con el propósito de asegurar que la radiación no ionizada generada por los sistemas inalámbricos de comunicaciones no afecte la salud y el medioambiente.Palabras clave: Regulación de telecomunicaciones, Radiación no ionizante (RNI), Comunicaciones y salud, Polución visual, Instalación de infraestructura. ResumoDescreve as atuais regulamentações colombianas para a instalação de infraestruturas de telecomunicações sem fio. Também se refere aos possíveis efeitos desta infraestrutura sobre a saúde da população e o meio ambiente do país. Além disso, mostra os resultados de uma comparação entre as atuais regulamentações da Argentina e o caso colombiano. Finalmente, propõem-se algumas recomendações que podem considerar-se no projeto regulatório aplicável à Colômbia, com o propósito de assegurar que a radiação não ionizada gerada pelos sistemas sem fio de comunicações não afete a saúde e o meio ambiente.Palavras chave: Regulamentação de telecomunicações, Radiação não ionizante (RNI), Comunicações e saúde, Poluição visual, Instalação de infraestrutura.
The International Colorectal Cancer Screening Network was established in 2003 to promote best practice in the delivery of organized colorectal cancer screening programs. To facilitate evaluation of such programs, we defined a set of universally applicable colorectal cancer screening measures and indicators. To test the feasibility of data collection, we requested data on these variables and basic program characteristics from 26 organized full programs and 9 pilot programs in 24 countries. The size of the target population for each program varied considerably from a few thousand to 36 million. The majority of programs used fecal occult blood tests for primary screening, with more using guaiac than immunochemical tests. There was wide variation in the ability of screening programs to report the requested measures and in the values reported. In general, pilot programs were more likely to provide screening measure values than were full programs. As expected, detection rates for polyps and neoplasia were substantially higher in programs screening with endoscopy than in those using fecal occult blood tests. It is hoped that the screening measures and indicators, once revised in the light of this survey, will be adopted and used by existing programs and those in the early planning stages, allowing international comparison with the goal of improved colorectal cancer screening quality.
OBJECTIVETo investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders.RESEARCH DESIGN AND METHODSRelevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies.RESULTSData were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64–0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75–1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81–1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78–1.00). These associations were all subject to marked heterogeneity (I2 = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75–0.99), and heterogeneity was reduced (I2 = 0%). Adjustments for potential confounders altered these estimates very little.CONCLUSIONSThe pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies.
We examined the relation between the use of hormone replacement therapy (HRT) and the incidence of central nervous system (CNS) tumours in a large prospective study of 1,147,894 postmenopausal women. Women were aged 56.6 years on average at entry, and HRT use was recorded at recruitment and updated, where possible, about 3 years later. During a mean follow-up of 5.3 years per woman, 1,266 CNS tumours were diagnosed, including 557 gliomas, 311 meningiomas and 117 acoustic neuromas. Compared with never users of HRT, the relative risks (RRs) for all incident CNS tumours, gliomas, meningiomas and acoustic neuromas in current users of HRT were 1.20 (95% CI: 1.05-1.36), 1.09 (95% CI: 0.89-1.32), 1.34 (95% CI: 1.03-1.75) and 1.58 (95% CI: 1.02-2.45), respectively, and there was no significant difference in the relative risks by tumour type (heterogeneity p = 0.2). In past users of HRT the relative risk was 1.07 (95% CI: 0.93-1.24) for all CNS tumours. Among current users of HRT, there was significant heterogeneity by the type of HRT with the users of oestrogen-only HRT at higher risk of all CNS tumours than users of oestrogen-progestagen HRT (RR = 1.42, 95% CI: 1.21-1.67 versus RR = 0.97, 95% CI: 0.82-1.16) (heterogeneity p < 0.001). Among current users of oestrogen-only and oestrogen-progestagen HRT, there was no significant heterogeneity by duration of use, hormonal constituent or mode of administration of HRT.
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