Background and Objectives: Little is known about the impact of nicotine replacement therapy (NRT) use duration on smoking cessation in the general population. This study determines whether duration of NRT use is associated with smoking cessation. Methods: Data were from the Ontario Tobacco Survey longitudinal study of a population-based cohort of baseline smokers who made serious quit attempts during 18 months of follow-up. The association between NRT (any NRT, patches, or gum) use duration and smoking cessation outcomes (short-term abstinence ≥1 month and long-term abstinence ≥12 months) was estimated by Poisson regression, adjusting for all confounding variables. Results: Among the 1,590 eligible smokers, 933 (59%) did not use any NRT, 535 (34%) used NRT <8 weeks, and 112 (8%) used NRT ≥8 weeks at follow-up. The median duration of NRT use was 14 days. A consistent “J” shape of associations between quit aid use duration and smoking cessation outcomes (quit rates) was found. Using any NRT, patches, or gum <8 weeks was generally associated with a lower likelihood of quitting, but using them ≥8 weeks was generally associated with a higher likelihood of quitting, compared to not using them. Only using patches for the recommended duration (≥8 weeks) was associated with a higher likelihood of short-term (relative risk, RR 1.74, 95% confidence interval, CI 1.21-2.50) and long-term (RR 2.62, 95% CI 1.25-5.50) abstinence at the end of 18 months of follow-up, compared to not using patches. Using gum ≥8 weeks was not associated with short- or long-term abstinence at the end of 18 months of follow-up. Conclusions: Using nicotine patches for the recommended duration is associated with successful short- and long-term abstinence in the general population. More efforts are needed to encourage smokers to use nicotine patches for eight or more weeks when attempting to quit.

Background and Objectives: Little is known about the impact of nicotine replacement therapy (NRT) use duration on smoking cessation in the general population. This study determines whether duration of NRT use is associated with smoking cessation. Methods: Data were from the Ontario Tobacco Survey longitudinal study of a population-based cohort of baseline smokers who made serious quit attempts during 18 months of follow-up. The association between NRT (any NRT, patches, or gum) use duration and smoking cessation outcomes (short-term abstinence ≥1 month and long-term abstinence ≥12 months) was estimated by Poisson regression, adjusting for all confounding variables. Results: Among the 1,590 eligible smokers, 933 (59%) did not use any NRT, 535 (34%) used NRT <8 weeks, and 112 (8%) used NRT ≥8 weeks at follow-up. The median duration of NRT use was 14 days. A consistent “J” shape of associations between quit aid use duration and smoking cessation outcomes (quit rates) was found. Using any NRT, patches, or gum <8 weeks was generally associated with a lower likelihood of quitting, but using them ≥8 weeks was generally associated with a higher likelihood of quitting, compared to not using them. Only using patches for the recommended duration (≥8 weeks) was associated with a higher likelihood of short-term (relative risk, RR 1.74, 95% confidence interval, CI 1.21-2.50) and long-term (RR 2.62, 95% CI 1.25-5.50) abstinence at the end of 18 months of follow-up, compared to not using patches. Using gum ≥8 weeks was not associated with short- or long-term abstinence at the end of 18 months of follow-up. Conclusions: Using nicotine patches for the recommended duration is associated with successful short- and long-term abstinence in the general population. More efforts are needed to encourage smokers to use nicotine patches for eight or more weeks when attempting to quit.

Olfactory function is affected by demographic, cognitive, and genetic factors. In the present thesis, three empirical studies investigated individual differences in olfactory ability. Study I explored demographic and cognitive correlates in common olfactory tasks; odor detection, odor discrimination, and odor identification. The results indicated that old age influenced performance negatively in all tasks, and that semantic memory proficiency and executive functioning were related to odor discrimination and odor identification performance. No cognitive influence was observed for measurements of olfactory threshold. Using population-based data, Study II investigated a potential influence of the ApoE gene on olfactory identification after controlling for health status, semantic memory, and preclinical and clinical dementia. The main finding was that the ApoE- ɛ4 allele interacted with age, such that older ɛ4-carriers had an impaired odor identification performance relative to older non-carriers. Importantly, the negative ApoE- ɛ4 effect on olfactory proficiency was independent of clinical dementia conversion within five years. Study III investigated the effects of the BDNF val66met polymorphism on olfactory change over a five-year interval, in a community dwelling sample of young and old age cohorts. The results showed that age-related decline in olfactory identification was influenced by the BDNF val66met. In middle-aged subjects, no effect of BDNF val66met was observed although older val homozygote carriers showed a selectively larger olfactory decline than the older met carriers. Overall, results suggest that the relative influence of demographic and cognitive factors vary across different olfactory tasks and that two genes (ApoE and BDNF) impact age-related deficits in odor identification. Potential theoretical and practical implications of the findings are discussed as well as potential limitations of association studies in genomics research.

In cases of forensic dental identification, a key factor in the comparison of the dental status of deceased persons with antemortem dental records is the matching of dental restorations in individual teeth. Many studies have been performed showing the prevalence of dental interventions. This has mostly been performed by counting the numbers of decayed, missing and filled teeth (DMFT) in each mouth without detailed data collection on a per-tooth basis. The purpose of this study was to investigate the research question: to what extent would data on the distribution and prevalence of restoration types in the human dentition facilitate forensic identification? A database program was developed to allow efficient collection and collation of dental trait information. Provision was made for storing information relating to a subject's individual teeth, such as restorative materials used and surfaces filled. Other data, such as missing teeth, caries status on a per-individual tooth basis and presence and details of types of prostheses may be stored. iii Data from patients attending a private group practice in Hobart was collected and a system was devised to enable the likelihood of dental trait occurrence to be calculated in cases of forensic dental identification. The capabilities of the system are demonstrated in a series of mock cases of dental identification. An opportunity to make use of the database for which it was designed arose in relation to the analysis of person identification evidence in a murder trial at the Tasmanian Supreme Court. The use of this reference database in evidence invoked lengthy debate involving the judge, crown prosecutor and defence barristers. The resulting voire dire was resolved in favour of conclusions drawn from the use of the database being admitted in evidence. The legal precedent set in the Marlow trial may possibly offer encouragement for practising odontologists to further the concept of establishing and using reference databases of dental traits in population groups in other parts of Australia.

L’objectif de ces travaux est de connaître et évaluer les caractéristiques épidémiologiques des cancers de la cavité orale et de l’oropharynx. Ces deux localisations partagent des facteurs de risque en commun, et sont de fait souvent regroupées dans les études épidémiologiques. Cependant, la découverte de facteurs de risque spécifiques, telle l’infection par le virus du papillome humain pour les cancers de l’oropharynx, nous conduit à fournir des taux d’incidence spécifiques avec la classification anatomique de ces cancers. En réorganisant les données disponibles dans la base des données du Centre International de Recherche sur le Cancer, nous avons recherché les cas incidents au niveau mondial et recalculé les taux d’incidence dans les registres de 60 pays, pendant la période 1998-2002. La classification TNM n’est pas disponible dans les bases de données du CIRC. Nous avons identifié et contacté les registres du cancer qui ont déclaré son recueil. Cela nous a permis de créer et structurer une base des données innovante et inédite, dont les informations ont été analysées par rapport à la qualité. Finalement nous avons comparé la distribution de stades précoces et avancés dans 8 pays. Les résultats montrent que l’incidence des cancers de la cavité buccale et de l’oropharynx est très hétérogène au niveau mondial par rapport à la sous localisation des tumeurs, à l’âge d’incidence, au ratio homme/femme et au stade clinique. / Oral cavity and oropharynx cancers : International incidence and TNM classification in population-based cancer registries The aim of this work was to know and to evaluate the epidemiological patterns of oral cavity and ororpharynx cancers. These topographies share some common risk factors and they are often grouped in epidemiological studies. However, the implication of the human papilloma virus in oropharyngeal tumors lead us to provide incidence rates according to the anatomical classification of these tumors. We reorganized the incidence data available at the International Agency for Research on Cancer, for the period 1998-2002. Incidence rates were calculated for oral cavity and oropharynx cancers separately for 60 countries. As the TNM classification is not available on the IARC database we contacted the cancer registries that declared to abstract and collect it. Based on their data we created and structure a new, innovative and quality controlled. Finally, we compared the TNM stage distribution among 8 countries. The results show that the oral cavity and oropharynx cancers have a very heterogeneous distribution in the studied registries concerning tumor sub-sites, age of incidence, male to female ratio and clinical stage.

Introdução: O crescente aumento da população idosa faz aumentar a necessidade de recursos de saúde, entre eles o uso de medicamentos.Objetivo: Estudar os riscos de polifarmácia em idosos no município de São Paulo, Brasil. Métodos: Este estudo faz parte do projeto SABE – Saúde,Bem-estar e Envelhecimento – através de questionários por amostra em domicílios de 2143 idosos com 60 anos e mais composta por sorteio. Os dados finais foram ponderados e expandidos de modo que representem a população idosa no ano de 2000. A polifarmácia foi definida como o uso de quatro ou mais medicamentos, e utilizado o estudo de regressão logística por passos (IC 95%). Resultados: A média do número de medicamentos foi de 2,72 e a prevalência de polifarmácia de 31,5%. A polifarmácia foi mais prevalente em mulheres com 75 anos e mais (52,1%), religião espírita(51,2%), que declaram estado de saúde ruim (40,2%) e escolaridade acima de 12 anos (46,9%). Verificou-se que 71,1% adquirem medicamentos do próprio bolso, 15,95% se automedicam e a não adesão é devida ao custo (9,1%). Os riscos para polifarmácia foram mulheres (OR 2,2), idade acima de 75 anos (OR 1,5), consulta e internação em quatro meses (OR de 1,9 e 3,8) e problemas cardíacos (OR 3,8). Quanto ao medicamento impróprio a prevalência foi de 15,6%. Conclusão: Os riscos identificados na polifarmácia mostram uma necessidade de políticas públicas que visem promover o uso racional de medicamentos. / Introduction: The continuous growth of the elderly population increases the need for further health resources; amongst them is the use of drugs.Object: Study the risks’ Polypharmacy in the population of elderly people within the city of São Paulo, Brasil. Method: This study is part of the ‘SABE’ project – Health, Well-being and aging. This survey is carried out by using a sample questionnaire in the residence of 2143 people aged 60 and over. The final data are pondered and expanded to represent the population of elderly people in the year 2000. In order to analyze, polypharmacy was defined as four or more drugs, using the study of stepwise logistical regression (IC95%). Results: The average number of drug stays at 2,72, with a prevalence of polyfarmacy of 31,5%. Polyfarmacy is more prevalent amongst women aged 75 and over (52,1%); spiritualists (51,2%); those who claim poor self perceived health status (40,2%); those whose level of education is at least 12 years (46,9%). It has been observed that 71,1% use their own money to buy drugs; 15,9% practice self-medication; the cost of treatment being the cause of nonadherence (9,1%). Women are more at risk (OR 2,2), aged 75 and over (OR 1,5), visit to the physician and hospitalization within four months(OR from 1,9 to 3,8), cardiovascular conditions (OR 3,8). As for inappropriate use of medications, the prevalence is 15,6%. Conclusion: The identified risks in polypharmacy show a need for public policies that would promote a more rational use of medications.

Numerous organizations collect and distribute non-aggregate personal data for a variety of different purposes, including demographic and public health research. In these situations, the data distributor is responsible with the protection of the anonymity and personal information of individuals. Microaggregation is one of the most commonly used statistical disclosure control methods. In microaggregation, the set of original records is first partitioned into several groups. The records in the same group are similar to each other. The minimum number of records in each group is k. Each record is replaced by the mean value of the group (centroid). The confidentiality of records is protected by ensuring that each group has at least a minimum of k records and each record is indistinguishable from at least k-1 other records in the microaggregated dataset. The goal of this process is to keep the within-group homogeneity higher and the information loss lower, where information loss is the sum squared deviation between the actual records and the group centroids. Several heuristics have been proposed for the NP-hard minimum information loss microaggregation problem. Among the most promising methods is the multivariate Hansen-Mukherjee (MHM) algorithm that uses a shortest path algorithm to identify the best partition consistent with a specified ordering of records. Developing improved heuristics for ordering multivariate points for microaggregation remains an open research challenge. This dissertation adapts a version of the population-based ant colony optimization algorithm (PACO) to order records within which MHM algorithm is used iteratively to improve the quality of grouping. Results of computational experiments using benchmark test problems indicate that P-ACO/MHM based microaggregation algorithm yields comparable or improved information loss than those obtained by extant methods.

Association of education with mental illness in Czech population Abstract This master thesis aimed to study the association of education with mental disorders in the Czech population. Data were used from a nationally representative cross-sectional study - the CZEch Mental health Study (CZEMS). Mental disorders were assessed with Mini-International Neuropsychiatric Interview and divided into four groups - affective, anxiety, substance use and alcohol use. Information about the highest completed education was self-reported by participants during an interview. Binary logistic regresion examined the association of education with mental disorders, group-wise adjusting for sociodemographic, social and health-related characteristics. The analysis was conducted on 3 175 participants (54 % women, median age 49 years). Lower education (primary and vocational) was associated with higher occurrence of mental disorders, this association remained after adjustment for all characteristics. The association was strongest for alcohol use disorders and weakest for anxiety disorders and did not differ by sex. The relationship between education and alcohol use as well as substance use disorders was apparent in particular in younger individuals. The observed educational differences in the occurrence of mental disorders should be...

Background: Inflammation is proposed to play a role in the development of Alzheimer's disease, and may also be involved in the pathogenesis of mild cognitive impairment (MCI). This study examined the association of inflammatory markers in serum or plasma with prevalent MCI and MCI subtypes in a population-based sample. Methods: Olmsted County, MN, residents aged 70-89 years on October 1, 2004, were evaluated using the Clinical Dementia Rating Scale, a neurological evaluation, and neuropsychological testing. Information ascertained for each participant was reviewed by an expert panel of neuropsychologists, physicians, and nurses, and a diagnosis of normal cognition, MCI, or dementia was made by consensus. C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis alpha (TNFα), and adiponectin were measured at baseline. Results: Among 313 subjects with MCI and 1570 cognitively normal subjects, a CRP level in the upper quartile (>3.3 mg/L) was significantly associated with MCI (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.00-2.01) and with nonamnestic MCI (OR, 2.05; 95% CI, 1.12-3.78) after adjusting for age, sex, and years of education. However, there was no association with amnestic MCI (OR, 1.21; 95% CI, 0.81-1.82). No association was observed with the other inflammatory markers. Conclusions: Plasma CRP is associated with prevalent MCI and with nonamnestic MCI in elderly, nondemented persons in a population-based setting. These findings suggest the involvement of inflammation in the pathogenesis of MCI.

We carried out a population-based study on low-grade diffuse gliomas in the Canton of Zurich, Switzerland (population 1.16 million). From 1980 to 1994, 987 astrocytic and oligodendroglial tumors were diagnosed, of which 122 (12.4%) were low-grade (WHO grade II). The incidence rates adjusted to the World Standard Population, per million population per year, were 2.28 for low-grade diffuse astrocytomas, 0.89 for oligoastrocytomas, and 2.45 for oligodendrogliomas. The survival rate (mean follow-up 7.5±4.8 years) was highest for patients with oligodendroglioma (78% at 5 years, 51% at 10 years), followed by those with oligoastrocytoma (70% at 5 years, 49% at 10 years) and fibrillary astrocytoma (65% at 5 years, 31% at 10 years). Survival of patients with gemistocytic astrocytoma was poor, with survival rates of 16% at 5 years and 0% at 10 years. Younger patients (<50 years) survived significantly longer than older patients (>50 years; P=0.013). DNA sequencing, performed in 84% of cases, revealed that TP53 mutations were most frequent in gemistocytic astrocytomas (88%), followed by fibrillary astrocytomas (53%) and oligoastrocytomas (44%), but were infrequent (13%) in oligodendrogliomas. The presence of TP53 mutations was associated with shorter survival of patients with low-grade diffuse gliomas (log-rank test; P=0.047), but when each histological type was analyzed separately, an association was observed only for oligoastrocytoma (P=0.05). Loss on 1p and 19q were assessed by quantitative microsatellite analysis in 67% of cases. These alterations were frequent in oligodendrogliomas (1p, 57%; 19q, 69%), less common in oligoastrocytomas (lp, 27%; 19q, 45%), rare in fibrillary astrocytomas (lp, 7%; 19q, 7%), and absent in gemistocytic astrocytomas. None of these alterations were predictive of survival. These results establish the frequency of key genetic alterations in low-grade diffuse gliomas at a population-based level. Multi-variate Cox's regression analysis indicates that only age and histological type, but not genetic alterations, are significant predictive factors.