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Search Results: 1 - 10 of 52932 matches for " David Faeh "
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End-digits preference for self-reported height depends on language
Matthias Bopp, David Faeh
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-342
Abstract: We analysed reports of height of 47,192 individuals (aged 15 years or older) living in Switzerland and participating in one of the three population-based Swiss Health Surveys carried out in 1992/93, 1997 and 2002 respectively. Digit preferences were analysed by sex, age group, educational level, survey, smoking status, interview language (only for Swiss nationals) and nationality. Adjusted odds ratios (OR) with 95% confidence interval were calculated by using multivariate logistic regression.Italian and French nationals (44.1% and 40.6%) and Italian and French Swiss (39.6% and 35.3%) more strongly preferred zero and five than Germans and German Swiss (29.2% and 30.3%). Two, four, six and eight were more popular in Germans and German Swiss (both 44.4%). Compared to German Swiss (OR = 1), for the end-digits zero and five, the OR were 1.50 (1.38–1.63) for Italian Swiss and 1.24 (1.18–1.30) for French Swiss; 1.73 (1.58–1.89) for Italian nationals and 1.61 (1.33–1.95) for French nationals. The end-digits two, four, six and eight showed an opposite pattern.Different preferences for end-digits depending on language and nationality could be observed consistently in all three national health surveys. The patterns were strikingly similar in Swiss and foreign nationals speaking the same language, suggesting that preferences were specific to language rather than to nationality. Taking into account rounding preferences could allow more valid comparisons in analyses of self-reported data originating from different cultures.Body stature has an influence on various aspects of life including income, health related quality of life and on success in career and in mate selection [1-4]. Size is also inversely related with unintentional injury and mortality from cardiovascular disease and cancer [5-7]. Size can even decide on life and death on the battlefield [8]. Mostly, persons tend to overestimate their height when they report it [9,10]. Misreporting height varies by sex, age, educati
Blood glucose may be an alternative to cholesterol in CVD risk prediction charts
Julia Braun, Matthias Bopp, David Faeh
Cardiovascular Diabetology , 2013, DOI: 10.1186/1475-2840-12-24
Abstract: We followed-up 6,095 men and women aged >=16 years who participated 1977--79 in a community based health study and were anonymously linked with the Swiss National Cohort until the end of 2008. During follow-up, 727 participants died of CVD. Based on the ESC SCORE methodology (Weibull regression), we used age, sex, blood pressure, smoking, and fasting glucose or total cholesterol. The mean Brier score (BS), area under the receiver-operating characteristic curve (AUC) and integrated discrimination improvement (IDI) were used for model comparison. We validated our models internally using cross-validation and externally using another data set.In our models, the p-value of total cholesterol was 0.046, that of glucose was p < 0.001. The model with glucose had a slightly better predictive capacity (BS: 2216x10-5 vs. 2232x10-5; AUC: 0.9181 vs. 0.9169, IDI: 0.009 with p-value 0.026) and could well discriminate the overall risk of persons with high and low concentrations. The external validation confirmed these findings.Our study suggests that instead of total cholesterol glucose can be used in models predicting overall CVD mortality risk.
Prevalence, awareness and control of diabetes in the Seychelles and relationship with excess body weight
David Faeh, Julita William, Luc Tappy, Eric Ravussin, Pascal Bovet
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-163
Abstract: Examination survey in a sample representative of the entire population aged 25–64 of the Seychelles, attended by 1255 persons (participation rate of 80.2%). An oral glucose tolerance test (OGTT) was performed in individuals with fasting blood glucose between 5.6 and 6.9 mmol/l. Diabetes mellitus (DM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were defined along criteria of the ADA. Prevalence estimates were standardized for age.The prevalence of DM was 11.5% and 54% of persons with DM were aware of having DM. Less than a quarter of all diabetic persons under treatment were well controlled for glycemia (HbA1c), blood pressure or LDL-cholesterol. The prevalence of IGT and IFG were respectively 10.4% and 24.2%. The prevalence of excess weight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) was respectively 60.1% and 25.0%. Half of all DM cases in the population could be attributed to excess weight.We found a high prevalence of DM and pre-diabetes in a rapidly developing country in the African region. The strong association between overweight and DM emphasizes the importance of weight control measures to reduce the incidence of DM in the population. High rates of diabetic persons not aware of having DM in the population and insufficient cardiometabolic control among persons treated for DM stress the need for intensifying health care for diabetes.It is estimated that diabetes mellitus (DM) accounts currently for 5.2% of all deaths worldwide [1]. The number of people with DM is expected to double from 175 million in 2000 to 353 million in 2030 [2]. The largest increase is expected to occur in developing countries, with 305 million individuals likely to have DM by 2030 [2].The prevalence of DM in adults varies markedly between different populations, e.g. 2.6% in Nigeria [3], 18% in Mauritius [4], and more than 50% in Pima Indians in the U.S. [5]. These differences have been related to unfavorable trends in factors such as overweight and sedentary ha
Clustering of smoking, alcohol drinking and cannabis use in adolescents in a rapidly developing country
David Faeh, Bharathi Viswanathan, Arnaud Chiolero, Wick Warren, Pascal Bovet
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-169
Abstract: Cross-sectional survey in a representative sample of secondary school students using an anonymous self-administered questionnaire (Global Youth Tobacco Survey). The questionnaire was completed by 1,321 (92%) of 1,442 eligible students aged 11 to 17 years. Main variables of interest included smoking cigarettes on ≥1 day in the past 30 days; drinking any alcohol beverage on ≥1 day in the past 30 days and using cannabis at least once in the past 12 months.In boys and girls, respectively, prevalence (95% CI) was 30% (26–34)/21% (18–25) for smoking, 49% (45–54)/48% (43–52) for drinking, and 17% (15–20)/8% (6–10) for cannabis use. The prevalence of all these behaviors increased with age. Smokers were two times more likely than non-smokers to drink and nine times more likely to use cannabis. Drinkers were three times more likely than non-drinkers to smoke or to use cannabis. Comparison of observed versus expected frequencies of combination categories demonstrated clustering of these risk behaviors in students (P < 0.001).Smoking, drinking and cannabis use were common and clustered among adolescents of a rapidly developing country. These findings stress the need for early and integrated prevention programs.In addition to the increased risk of chronic diseases at an older age, smoking, drinking and use of illegal substances in adolescents are associated with more immediate health hazards such as depression, interpersonal violence, motor vehicle crashes and drowning, risky sexual behaviors, and suicidal behavior [1-3]. Furthermore, behaviors initiated during adolescence tend to track into adulthood [4]. Early experience with smoking and drinking increases the risk of subsequent tobacco [5] and alcohol [6] dependences. In addition, cross-sectional [7-9] and longitudinal [10-12] studies in western countries have shown that these behaviors tended to cluster in adolescence and perhaps even at an earlier age [13]. Also of importance, these behaviors increase the likelihood to adop
Educational inequalities in mortality and associated risk factors: German- versus French-speaking Switzerland
David Faeh, Matthias Bopp, Swiss National Cohort Study Group
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-567
Abstract: The Swiss National Cohort, a longitudinal census-based record linkage study, provided mortality and survival time data (3.5 million individuals, 40-79 years, 261,314 deaths, 1990-2000). The Swiss Health Survey 1992/93 provided cross-sectional data on risk factors. Inequalities were calculated as percentage of change in mortality rate (survival time, hazard ratio) or risk factor prevalence (odds ratio) per year of additional education using multivariable Cox and logistic regression.Significant inequalities in mortality were found for all causes of death in men and for most causes in women. Inequalities were largest in men for causes related to smoking and alcohol use and in women for circulatory diseases. Gradients in all-cause mortality were more pronounced in younger and middle-aged men, especially in German-speaking Switzerland. Mortality inequalities tended to be larger in German-speaking Switzerland whereas inequalities in associated risk factors were generally more pronounced in French-speaking Switzerland.With respect to inequalities in mortality and associated risk factors, we found characteristic differences between German- and French-speaking Switzerland, some of which followed gradients described in Europe. These differences only partially reflected inequalities in associated risk factors.Social inequalities in all-cause and cause-specific mortality have been reported for many European countries, including Switzerland [1,2]. However, in general there is a serious lack of comparable data [3]. Comparisons between countries are also hampered by the prevailing use of aggregated instead of individual data. Even when adequate data are available, it can still be difficult to assess inequalities because of nationally different definitions of socio-economic status (SES) and substantial variation regarding assignment of causes of death or assessment of risk factors (including self-rated health) between countries [4-6]. The coarse definition and classification of SES
Diabetes and pre-diabetes are associated with cardiovascular risk factors and carotid/femoral intima-media thickness independently of markers of insulin resistance and adiposity
David Faeh, Julita William, Patrick Yerly, Fred Paccaud, Pascal Bovet
Cardiovascular Diabetology , 2007, DOI: 10.1186/1475-2840-6-32
Abstract: Major CVD risk factors (systolic blood pressure, smoking, LDL-cholesterol, HDL-cholesterol,) were measured in a random sample of adults aged 25–64 in the Seychelles (n = 1255, participation rate: 80.2%).According to the criteria of the American Diabetes Association, IGR was divided in four ordered categories: 1) normal fasting glucose (NFG), 2) impaired fasting glucose (IFG) and normal glucose tolerance (IFG/NGT), 3) IFG and impaired glucose tolerance (IFG/IGT), and 4) diabetes mellitus (DM). Carotid and femoral IMT was assessed by ultrasound (n = 496).Age-adjusted levels of the major CVD risk factors worsened gradually across IGR categories (NFG < IFG/NGT < IFG/IGT < DM), particularly HDL-cholesterol and blood pressure (p for trend < 0.001). These relationships were marginally attenuated upon further adjustment for waist, BMI or insulin (whether considered alone or combined) and most of these relationships remained significant. With regards to IMT, the association was null with IFG/NGT, weak with IFG/IGT and stronger with DM (all more markedly at femoral than carotid levels). The associations between IMT and IFG/IGT or DM (adjusted by age and major CVD risk factors) decreased only marginally upon further adjustment for BMI, waist or insulin. Further adjustment for family history of diabetes did not alter the results.We found graded relationships between IGR categories and both major CVD risk factors and carotid/femoral IMT. These relationships were only partly accounted for by BMI, waist and insulin. This suggests that increased CVD-risk associated with IGR is also mediated by factors other than the considered markers of adiposity and insulin resistance. The results also imply that IGR and associated major CVD risk factors should be systematically screened and appropriately managed.Worldwide, the number of persons with diabetes mellitus (DM) is expected to double in the next 25 years and to affect more than 350 million individuals by 2030 [1]. Accordingly, there is
Pharmaceutical information: Does the Directive 2001/83/EC protect such a right for the end user?
Andrea Faeh
Amsterdam Law Forum , 2011,
Abstract: The right to information is of crucial importance for the end-user of pharmaceuticals to exercise their right of self-determination. In the Directive 2001/83/EC relating to pharmaceuticals for human use all the particulars that have to be on the labelling or in the package leaflet are stipulated and need to be transposed into national law. This contribution scrutinises first the implications that a correct implementation of the information rules entails for the legal position of the individual. Second, the conditions and consequences of a failed implementation will be equally assessed in order to evaluate the legal impact when the right to information is violated by the state or the marketing authorisation holder.
Health Risk or Resource? Gradual and Independent Association between Self-Rated Health and Mortality Persists Over 30 Years
Matthias Bopp, Julia Braun, Felix Gutzwiller, David Faeh, for the Swiss National Cohort Study Group
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0030795
Abstract: Background Poor self-rated health (SRH) is associated with increased mortality. However, most studies only adjust for few health risk factors and/or do not analyse whether this association is consistent also for intermediate categories of SRH and for follow-up periods exceeding 5–10 years. This study examined whether the SRH-mortality association remained significant 30 years after assessment when adjusting for a wide range of known clinical, behavioural and socio-demographic risk factors. Methods We followed-up 8,251 men and women aged ≥16 years who participated 1977–79 in a community based health study and were anonymously linked with the Swiss National Cohort (SNC) until the end of 2008. Covariates were measured at baseline and included education, marital status, smoking, medical history, medication, blood glucose and pressure. Results 92.8% of the original study participants could be linked to a census, mortality or emigration record of the SNC. Loss to follow-up 1980–2000 was 5.8%. Even after 30 years of follow-up and after adjustment for all covariates, the association between SRH and all-cause mortality remained strong and estimates almost linearly increased from “excellent” (reference: hazard ratio, HR 1) to “good” (men: HR 1.07 95% confidence interval 0.92–1.24, women: 1.22, 1.01–1.46) to “fair” (1.41, 1.18–1.68; 1.39, 1.14–1.70) to “poor”(1.61, 1.15–2.25; 1.49, 1.07–2.06) to “very poor” (2.85, 1.25–6.51; 1.30, 0.18–9.35). Persons answering the SRH question with “don't know” (1.87, 1.21–2.88; 1.26, 0.87–1.83) had also an increased mortality risk; this was pronounced in men and in the first years of follow-up. Conclusions SRH is a strong and “dose-dependent” predictor of mortality. The association was largely independent from covariates and remained significant after decades. This suggests that SRH provides relevant and sustained health information beyond classical risk factors or medical history and reflects salutogenetic rather than pathogenetic pathways.
Establishing a follow-up of the Swiss MONICA participants (1984-1993): record linkage with census and mortality data
Matthias Bopp, Julia Braun, David Faeh, Felix Gutzwiller, Swiss National Cohort Study Group
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-562
Abstract: Record linkage procedures were used in a multi-step approach. Kaplan-Meier curves from our data were contrasted with the survival probabilities expected from life tables for the general population, age-standardized mortality rates from our data with those derived from official cross-sectional mortality data. Cox regression models were fit to investigate the influence of covariates on survival.97.8% of the eligible 10,160 participants (25-74y at baseline) could be linked to a census (1990: 9,737; 2000: 8,749), mortality (1,526, 1984-2008) and/or emigration record (320, 1990-2008). Linkage success did not differ by any key study characteristic. Results of survival analyses were robust to linkage step or certainty of a correct link. Loss to follow-up between 1990 and 2000 amounted to 4.7%. MONICA participants had lower mortality than the general population, but similar mortality patterns, (e.g. variation by educational level, marital status or region).Using anonymized census and death records allowed an almost complete mortality follow-up of MONICA study participants of up to 25 years. Lower mortality compared to the general population was in line with a presumable ?healthy participant' selection in the original MONICA study. Apart from that, the derived data set reproduced known mortality patterns and showed only negligible potential for selection bias introduced by the linkage process. Anonymous record linkage was feasible and provided robust results. It can thus provide valuable information, when no cohort study is available.Surveys that assess clinical and lifestyle properties have been conducted in many countries. However, only few of these surveys provide a mortality follow-up. This substantially limits their potential to evaluate the significance of risk factors in the population. An exception are countries with national health data registers [1] or with an established system for ascertaining vital status, e.g. the National Death Index in the U.S. [2], the Canad
Population Specific and Up to Date Cardiovascular Risk Charts Can Be Efficiently Obtained with Record Linkage of Routine and Observational Data
David Faeh, Julia Braun, Kaspar Rufibach, Milo A. Puhan, Pedro Marques-Vidal, Matthias Bopp, Swiss National Cohort (SNC)
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0056149
Abstract: Background Only few countries have cohorts enabling specific and up-to-date cardiovascular disease (CVD) risk estimation. Individual risk assessment based on study samples that differ too much from the target population could jeopardize the benefit of risk charts in general practice. Our aim was to provide up-to-date and valid CVD risk estimation for a Swiss population using a novel record linkage approach. Methods Anonymous record linkage was used to follow-up (for mortality, until 2008) 9,853 men and women aged 25–74 years who participated in the Swiss MONICA (MONItoring of trends and determinants in CVD) study of 1983–92. The linkage success was 97.8%, loss to follow-up 1990–2000 was 4.7%. Based on the ESC SCORE methodology (Weibull regression), we used age, sex, blood pressure, smoking, and cholesterol to generate three models. We compared the 1) original SCORE model with a 2) recalibrated and a 3) new model using the Brier score (BS) and cross-validation. Results Based on the cross-validated BS, the new model (BS = 14107×10?6) was somewhat more appropriate for risk estimation than the original (BS = 14190×10?6) and the recalibrated (BS = 14172×10?6) model. Particularly at younger age, derived absolute risks were consistently lower than those from the original and the recalibrated model which was mainly due to a smaller impact of total cholesterol. Conclusion Using record linkage of observational and routine data is an efficient procedure to obtain valid and up-to-date CVD risk estimates for a specific population.
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