Preventive medicine
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Preventive medicine · Nov 1991
Race and gender differences in serum lipoproteins of children, adolescents, and young adults--emergence of an adverse lipoprotein pattern in white males: the Bogalusa Heart Study.
Serum lipoprotein profiles in 4,231 individuals, ages 5-26 years, were studied cross-sectionally in a biracial community to describe the race- and gender-specific changes from adolescence into young adulthood. ⋯ These results underscore the desirability of early targeting for primary prevention.
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Preventive medicine · Nov 1991
The effects of a health education intervention program among Cretan adolescents.
An educational intervention program for the prevention of cardiovascular disease among 171 Cretan school students (13- and 14-year-olds) is assessed. Three schools from the province of Agios Vassilios acted as the intervention group while two schools from a neighboring province (Amari) formed the control group. ⋯ At the end of 1 academic year of intervention the results showed, after adjusting for age, sex, baseline value, height, and weight, an increase in total serum cholesterol of 0.70 mg/dl in the intervention group and 17.91 mg/dl in the control group (P less than 0.0001). Diastolic blood pressure (fourth phase) decreased by 2.95 mm Hg in the intervention group and by 0.48 mm Hg in the control group (P less than 0.05). Similar changes were observed in the body mass index (P less than 0.05). The proportion of school children starting smoking was significantly lower in the intervention group (6%) than in the control (20%) (P less than 0.01). The results indicate that this health education program in schools is effective in decreasing some of the major CVD risk factors. The long-term effect remains to be evaluated.
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Preventive medicine · Mar 1991
Mental health, stress, and poor health behaviors in two community samples.
The relationships of obesity, smoking, drinking, and lack of exercise to mental health and stress were evaluated in separate community samples of men and women. ⋯ These results emphasize the importance of considering gender-specific risk factors in the design of intervention programs.
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Preventive medicine · Jan 1991
Meta AnalysisEstrogen replacement therapy and coronary heart disease: a quantitative assessment of the epidemiologic evidence.
Considerable epidemiological evidence has accumulated regarding the effect of postmenopausal estrogens on coronary heart disease risk. Five hospital-based case-control studies yielded inconsistent but generally null results; however, these are difficult to interpret due to the problems in selecting appropriate controls. Six population-based case-control studies found decreased relative risks among estrogen users, though only 1 was statistically significant. ⋯ Overall, the bulk of the evidence strongly supports a protective effect of estrogens that is unlikely to be explained by confounding factors. This benefit is consistent with the effect of estrogens on lipoprotein subfractions (decreasing low-density lipoprotein levels and elevating high-density lipoprotein levels). A quantitative overview of all studies taken together yielded a relative risk of 0.56 (95% confidence interval 0.50-0.61), and taking only the internally controlled prospective and angiographic studies, the relative risk was 0.50 (95% confidence interval 0.43-0.56).
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The analysis of cancer prevention trials necessitates specialized procedures. Differences in the analysis plan between cancer prevention and therapy trials are emphasized. Discussion is focused upon (a) how trial conduct influences the analysis, (b) how noncompliance affects the analysis and the considerations this raises during the design and conduct of the trial, (c) how delays in the effect of the intervention impinges upon the analysis, and (d) statistical methods available to carry out the analysis. The analysis of a cancer prevention trial represents a final step in the evaluation of the study intervention and requires an adaptive planning procedure.