Identifying and tracing a population at risk: the DESAD Project experience.

Nash, Scott D.; Tilley, Barbara C.; Kurland, Leonard T.; Gundersen, Jerome; Barnes, Ann B.; Donohew, P S; Kovacs, Laura

doi:10.2105/ajph.73.3.253

Cited by 19 publications

(8 citation statements)

References 18 publications

(3 reference statements)

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“…100 DES was used in medicine and agriculture, beginning in 1947 and 1950, respectively, and continuing through 1971 when the FDA encouraged the discontinuation of its use because of its association with vaginal and cervical cancer. 102 , 103 , 104 , 105 This usage corresponds with the increase in the incidence of anorexia nervosa in 14–20 year old females, but not other age groups, in the US and Switzerland beginning about 1965 and continuing through 1976. 106 , 107 In addition, women exposed to DES when fetuses are 5 times more likely to show inexplicable weight loss and to be diagnosed with an eating disorder such as anorexia nervosa or bulimia nervosa, compared to women who were not exposed to the drug.…”

Section: Anorexia Nervosa and Ctamentioning

confidence: 82%

Conditioned taste aversions

Chambers

2018

World j. otorhinolaryngol.-head neck surg.

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When one becomes ill after consuming a meal, there is a propensity to target a particular taste as the cause of the illness. The qualities of the taste most likely targeted include more novel, less preferred, and higher protein content. This association between a particular taste and illness is a form of learning that is termed conditioned taste aversion (CTA). A consequence of the learned association is that the taste will become aversive. When experiencing the taste again, individuals will show aversive reactions such as expressions of loathing, will experience mimicked illness sensations such as nausea, and subsequently, will avoid further exposure to the taste. The ability to acquire CTA occurs across species and across ages within a species. In the rat animal model, however, age differences exist in the capability of acquiring CTAs when increasingly longer intervals are imposed between consumption of a novel sweet solution and onset of illness. Pups have a decreased ability compared to young adults while aged rats have an increased ability. Evidence suggests that the failure of pups to acquire CTA at longer intervals is due to an immature retrieval mechanism and the facilitated ability of aged rats is due to a compromised clock mechanism that tracks the passage of time. Learned taste-illness association serves the critical function of informing individuals of the toxic nature of certain foods, thus preventing further illness and potentially death. Additionally, it contributes to the hypophagia observed during cancer chemotherapy and may contribute to the hypophagia found while suffering from bacterial infection, chronic medical conditions such as cancer, and restrictive food intake disorders such as anorexia nervosa.

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Section: Anorexia Nervosa and Ctamentioning

confidence: 82%

Conditioned taste aversions

Chambers

2018

World j. otorhinolaryngol.-head neck surg.

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“…Once again, this experience had many parallels with the experience and strategies used in the Diethylstilbestrol-Adenosis (DESAD) project conducted by Nash and colleagues [44]. The Tall Girls Study traced 87% of women identified as eligible from medical records [1], a great result given the limited information available and the duration of time to follow-up and similar to that traced by Nash et al (1983) [44].…”

Section: Methodsmentioning

confidence: 93%

“…The Tall Girls Study traced 87% of women identified as eligible from medical records [1], a great result given the limited information available and the duration of time to follow-up and similar to that traced by Nash et al (1983) [44]. The effectiveness of different strategies will vary greatly between countries; it is important to tailor strategies according to local circumstances to obtain optimal results.…”

Section: Methodsmentioning

confidence: 99%

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Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones

et al. 2011

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ObjectivePublic health research is an endeavour that often involves multiple relationships, far-reaching collaborations, divergent expectations and various outcomes. Using the Tall Girls Study as a case study, this paper will present and discuss a number of methodological, ethical and legal challenges that have implications for other public health research.ApproachThe Tall Girls Study was the first study to examine the long-term health and psychosocial effects of oestrogen treatment for tall stature.ResultsIn undertaking this study the research team overcame many hurdles: in maintaining collaboration with treating clinicians and with the women they had treated as girls - groups with opposing points of view and different expectations; using private practice medical records to trace women who had been patients up to forty years earlier; and exploring potential legal issues arising from the collection of data related to treatment.ConclusionWhile faced with complex challenges, the Tall Girls Study demonstrated that forward planning, ongoing dialogue between all stakeholders, transparency of processes, and the strict adherence to group-developed protocols were keys to maintaining rigour while undertaking pragmatic research.ImplicationsPublic health research often occurs within political and social contexts that need to be considered in the planning and conduct of studies. The quality and acceptability of research findings is enhanced when stakeholders are engaged in all aspects of the research process.

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“…As with Nash et d . , 8 local tracing activities prove to be the most productive, and depend on a dedicated and persistent field team. We were fortunate to recruit one field supervisor whose previous employment had provided substantial experience in these techniques, and who provided teams at other sites with practical consultation which augmented the methods cited in the m a n~a l .~~,~~ However, as Nash et al note,8 tracing beyond the local area increases expenses due to travel time and costs, suggesting the use of agencies with existing capacity to perform this task.…”

Section: Discussionmentioning

confidence: 99%

Cohort reconstruction: which infants can be restudied at school age?

McCormick

Baker

Brooks‐Gunn

et al. 1991

Paediatric Perinatal Epid

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Longer-term follow-up of infants with specific health concerns, such as low birthweight, is critical to assessing the effect of medical interventions. This report examines the approach of reconstructing previously studied cohorts in terms of the factors discriminating between respondents and non-respondents. Follow-up was attempted during 1987-1988 for 1875 children born during a 6-month period in 1978 in three geographically defined regions in the United States, for whom 1-year assessments of health and developmental status were obtained at 1 year of age as part of a previous study. For a 25% sample, participation involved a clinic visit for developmental assessments; for the remainder an interview by telephone or home visit. Follow-up was obtained for 72.5% of the cohort. Refusal rates were low (7%); most non-response was due to an inability to locate the families. Predictors of non-response reflected primarily low socio-economic status; completion rates were not influenced by mode of assessment. The role of a tracing agency is discussed. We conclude that cohort reconstruction is feasible with response rates comparable to some prospective studies with ongoing cohort maintenance.

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Identifying and tracing a population at risk: the DESAD Project experience.

Cited by 19 publications

References 18 publications

Conditioned taste aversions

Conditioned taste aversions

Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones

Cohort reconstruction: which infants can be restudied at school age?

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