Sample records for adjusted prevalence ratio

  1. Prevalence odds ratio versus prevalence ratio: choice comes with consequences.

    PubMed

    Tamhane, Ashutosh R; Westfall, Andrew O; Burkholder, Greer A; Cutter, Gary R

    2016-12-30

    Odds ratio, risk ratio, and prevalence ratio are some of the measures of association which are often reported in research studies quantifying the relationship between an independent variable and the outcome of interest. There has been much debate on the issue of which measure is appropriate to report depending on the study design. However, the literature on selecting a particular category of the outcome to be modeled and/or change in reference group for categorical independent variables and the effect on statistical significance, although known, is scantly discussed nor published with examples. In this article, we provide an example of a cross-sectional study wherein prevalence ratio was chosen over (Prevalence) odds ratio and demonstrate the analytic implications of the choice of category to be modeled and choice of reference level for independent variables. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Hormone-mediated adjustment of sex ratio in vertebrates.

    PubMed

    Navara, Kristen J

    2013-12-01

    The ability to adjust sex ratios at the individual level exists among all vertebrate groups studied to date. In many cases, there is evidence for facultative adjustment of sex ratios in response to environmental and/or social cues. Because environmental and social information must be first transduced into a physiological signal to influence sex ratios, hormones likely play a role in the adjustment of sex ratio in vertebrates, because the endocrine system acts as a prime communicator that directs physiological activities in response to changing external conditions. This symposium was developed to bring together investigators whose work on adjustment of sex ratio represents a variety of vertebrate groups in an effort to draw comparisons between species in which the sex-determination process is well-established and those in which more work is needed to understand how adjustments in sex ratio are occurring. This review summarizes potential hormone targets that may underlie the mechanisms of adjustment of sex ratio in humans, non-human mammals, birds, reptiles, and fishes.

  3. Prevalence Odds Ratio versus Prevalence Ratio: Choice Comes with Consequences

    PubMed Central

    Tamhane, Ashutosh R; Westfall, Andrew O; Burkholder, Greer A; Cutter, Gary R

    2016-01-01

    Odds ratio (OR), risk ratio (RR), and prevalence ratio (PR) are some of the measures of association which are often reported in research studies quantifying the relationship between an independent variable and the outcome of interest. There has been much debate on the issue of which measure is appropriate to report depending on the study design. However, the literature on selecting a particular category of the outcome to be modeled and/or change in reference group for categorical independent variables and the effect on statistical significance, although known, is scantly discussed nor published with examples. In this article, we provide an example of a cross-sectional study wherein PR was chosen over (Prevalence) OR and demonstrate the analytic implications of the choice of category to be modeled and choice of reference level for independent variables. PMID:27460748

  4. Gender empowerment and female-to-male smoking prevalence ratios

    PubMed Central

    Fong, Geoffrey T

    2011-01-01

    Abstract Objective To determine whether in countries with high gender empowerment the female-to-male smoking prevalence ratio is also higher. Methods Bivariate and multiple regression analyses were performed to explore the relation between the United Nations Development Programme’s gender empowerment measure (GEM) and the female-to-male smoking prevalence ratio (calculated from the 2008 WHO global tobacco control report). Because a country’s progression through the various stages of the tobacco epidemic and its gender smoking ratio (GSR) are thought to be influenced by its level of development, we explored this correlation as well, with economic development defined in terms of gross national income (GNI) per capita and income inequality (Gini coefficient). Findings The GSR was significantly and positively correlated with the GEM (r = 0.680; P < 0.001). In addition, the GEM was the strongest predictor of the GSR (β, adjusted: 0.47; P < 0.0001) after controlling for GNI per capita and for Gini coefficient. Conclusion Whether progress towards gender empowerment can take place without a corresponding increase in smoking among women remains to be seen. Strong tobacco control measures are needed in countries where women are being increasingly empowered. PMID:21379415

  5. Triglyceride to high-density lipoprotein cholesterol ratio predicts cardiovascular outcomes in prevalent dialysis patients.

    PubMed

    Chen, Hung-Yuan; Tsai, Wan-Chuan; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Yang, Ju-Yeh; Peng, Yu-Sen

    2015-03-01

    Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, an indicator of atherogenic dyslipidemia, is a predictor of cardiovascular (CV) outcomes in the general population and has been correlated with atherosclerotic events. Whether the TG/HDL-C ratio can predict CV outcomes and survival in dialysis patients is unknown. We performed this prospective, observational cohort study and enrolled 602 dialysis patients (539 hemodialysis and 63 peritoneal dialysis) from a single center in Taiwan followed up for a median of 3.9 years. The outcomes were the occurrence of CV events, CV death, and all-cause mortality during follow-up. The association of baseline TG/HDL-C ratio with outcomes was explored with Cox regression models, which were adjusted for demographic parameters and inflammatory/nutritional markers. Overall, 203 of the patients experienced CV events and 169 patients died, of whom 104 died due to CV events. Two hundred fifty-four patients reached the composite CV outcome. Patients with higher TG/HDL-C levels (quintile 5) had a higher incidence of CV events (adjusted hazard ratio [HR] 2.03, 95% confidence interval [CI] 1.19-3.47), CV mortality (adjusted HR 1.91, 95% CI 1.07-3.99), composite CV outcome (adjusted HR 2.2, 95% CI 1.37-3.55), and all-cause mortality (adjusted HR 1.94, 95% CI 1.1-3.39) compared with the patients in quintile 1. However, in diabetic dialysis patients, the TG/HDL-C ratio did not predict the outcomes. The TG/HDL-C ratio is a reliable and easily accessible predictor to evaluate CV outcomes and survival in prevalent nondiabetic dialysis patients. ClinicalTrials.gov: NCT01457625.

  6. Triglyceride to High-Density Lipoprotein Cholesterol Ratio Predicts Cardiovascular Outcomes in Prevalent Dialysis Patients

    PubMed Central

    Chen, Hung-Yuan; Tsai, Wan-Chuan; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Yang, Ju-Yeh; Peng, Yu-Sen

    2015-01-01

    Abstract Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, an indicator of atherogenic dyslipidemia, is a predictor of cardiovascular (CV) outcomes in the general population and has been correlated with atherosclerotic events. Whether the TG/HDL-C ratio can predict CV outcomes and survival in dialysis patients is unknown. We performed this prospective, observational cohort study and enrolled 602 dialysis patients (539 hemodialysis and 63 peritoneal dialysis) from a single center in Taiwan followed up for a median of 3.9 years. The outcomes were the occurrence of CV events, CV death, and all-cause mortality during follow-up. The association of baseline TG/HDL-C ratio with outcomes was explored with Cox regression models, which were adjusted for demographic parameters and inflammatory/nutritional markers. Overall, 203 of the patients experienced CV events and 169 patients died, of whom 104 died due to CV events. Two hundred fifty-four patients reached the composite CV outcome. Patients with higher TG/HDL-C levels (quintile 5) had a higher incidence of CV events (adjusted hazard ratio [HR] 2.03, 95% confidence interval [CI] 1.19–3.47), CV mortality (adjusted HR 1.91, 95% CI 1.07–3.99), composite CV outcome (adjusted HR 2.2, 95% CI 1.37–3.55), and all-cause mortality (adjusted HR 1.94, 95% CI 1.1–3.39) compared with the patients in quintile 1. However, in diabetic dialysis patients, the TG/HDL-C ratio did not predict the outcomes. The TG/HDL-C ratio is a reliable and easily accessible predictor to evaluate CV outcomes and survival in prevalent nondiabetic dialysis patients. ClinicalTrials.gov: NCT01457625 PMID:25761189

  7. [Evaluation of estimation of prevalence ratio using bayesian log-binomial regression model].

    PubMed

    Gao, W L; Lin, H; Liu, X N; Ren, X W; Li, J S; Shen, X P; Zhu, S L

    2017-03-10

    To evaluate the estimation of prevalence ratio ( PR ) by using bayesian log-binomial regression model and its application, we estimated the PR of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea in their infants by using bayesian log-binomial regression model in Openbugs software. The results showed that caregivers' recognition of infant' s risk signs of diarrhea was associated significantly with a 13% increase of medical care-seeking. Meanwhile, we compared the differences in PR 's point estimation and its interval estimation of medical care-seeking prevalence to caregivers' recognition of risk signs of diarrhea and convergence of three models (model 1: not adjusting for the covariates; model 2: adjusting for duration of caregivers' education, model 3: adjusting for distance between village and township and child month-age based on model 2) between bayesian log-binomial regression model and conventional log-binomial regression model. The results showed that all three bayesian log-binomial regression models were convergence and the estimated PRs were 1.130(95 %CI : 1.005-1.265), 1.128(95 %CI : 1.001-1.264) and 1.132(95 %CI : 1.004-1.267), respectively. Conventional log-binomial regression model 1 and model 2 were convergence and their PRs were 1.130(95 % CI : 1.055-1.206) and 1.126(95 % CI : 1.051-1.203), respectively, but the model 3 was misconvergence, so COPY method was used to estimate PR , which was 1.125 (95 %CI : 1.051-1.200). In addition, the point estimation and interval estimation of PRs from three bayesian log-binomial regression models differed slightly from those of PRs from conventional log-binomial regression model, but they had a good consistency in estimating PR . Therefore, bayesian log-binomial regression model can effectively estimate PR with less misconvergence and have more advantages in application compared with conventional log-binomial regression model.

  8. Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.

    PubMed

    Pollmanns, Johannes; Romano, Patrick S; Weyermann, Maria; Geraedts, Max; Drösler, Saskia E

    2018-04-01

    To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used. A retrospective cross-sectional study using in- and outpatient secondary data was performed. Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care. Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28-37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition-specific control limits with prevalence adjustment. Unadjusted ACSH rates should be used with caution for high-stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH. © Health Research and Educational Trust.

  9. Trends in prevalence of patient case-mix adjusters used in the Medicare dialysis payment system.

    PubMed

    Hollenbeak, Christopher S; Rubin, Robert J; Tzivelekis, Spiros; Stephens, J Mark

    2015-06-01

    The Medicare End-Stage Renal Disease Prospective Payment System (PPS) used data from 2006-08 to set weights for each case-mix adjuster that is part of the bundled payment formula. The details of the population case-mix were not made public, and little is known about consistency of case-mix over time. This study estimated the prevalence of case-mix adjusters during 2006-2008 and analyzed changes in case-mix prevalence from 2000-2008. Cross-sectional cohort study using United States Renal Data System data for Medicare dialysis patients. Three 3-year cohorts (2000-02, 2003-05, 2006-08) were analyzed for changes over time in case-mix prevalence. Double-digit trends were observed in many case-mix categories between 2000-02 and 2006-08. Large declines were observed in prevalence of patients with low BMI, pericarditis, new to dialysis, and ages 18-44. Large increases were observed in chronic co-morbidities, pneumonia and age cohort 80+. Substantial changes in case-mix adjuster prevalence suggest the PPS payment formula should be regularly updated.

  10. Sex ratio adjustment by sex-specific maternal cannibalism in hamsters.

    PubMed

    Beery, Annaliese K; Zucker, Irving

    2012-10-10

    Mammalian offspring sex ratios can be biased via prenatal and postnatal mechanisms, including sperm selection, sex-specific embryo loss, and differential postnatal investment in males and females. Syrian hamsters routinely cannibalize some of their pups in the first days after birth. We present evidence that short day lengths, typically predictive of poor autumn and winter field conditions, are associated with male-biased sex ratios, achieved in part through selective perinatal maternal infanticide of female offspring. Higher peak litter sizes were associated with increased cannibalism rates, decreased final litter counts, and increased body mass of pups surviving to weaning. To our knowledge this is the first report of sex ratio adjustment by offspring cannibalism. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Compression Ratio Adjuster

    NASA Technical Reports Server (NTRS)

    Akkerman, J. W.

    1982-01-01

    New mechanism alters compression ratio of internal-combustion engine according to load so that engine operates at top fuel efficiency. Ordinary gasoline, diesel and gas engines with their fixed compression ratios are inefficient at partial load and at low-speed full load. Mechanism ensures engines operate as efficiently under these conditions as they do at highload and high speed.

  12. High dietary ratio of omega-6 to omega-3 polyunsaturated acids during pregnancy and prevalence of post-partum depression.

    PubMed

    da Rocha, Camilla M M; Kac, Gilberto

    2012-01-01

    Observational studies suggest association between low concentrations of omega-3 family fatty acids and greater risk for post-partum depression (PPD). The objective was to investigate the effect of unbalanced dietary intake of omega-6/omega-3 ratio >9:1 in the prevalence for PPD. The study comprises a prospective cohort with four waves of follow-up during pregnancy and one following delivery. PPD was evaluated according to the Edinburgh Post-partum Depression Scale (PPD ≥ 11) in 106 puerperae between 2005 and 2007, in Rio de Janeiro, Brazil. Independent variables included socio-demographic, obstetric, pre-pregnancy body mass index (BMI) and dietary intake data, which were obtained by means of a food frequency questionnaire in the first trimester of pregnancy. Statistical analysis involved calculation of PPD prevalence and multivariate Poisson regression with robust variance. PPD prevalence amounted to 26.4% [n = 28; confidence interval (CI) 95%: 18.0-34.8], and higher prevalences of PPD were observed in women who consumed an omega-6/omega-3 ratio >9:1 (60.0%) and in those with pre-pregnancy BMI <18.5 kg/m(2) (66.7%). These variables held as factors associated to PPD in the multivariate model, elevating the chances of occurrence of the outcome in 2.50 (CI 95%: 1.21-5.14) and 4.01 times (CI 95%: 1.96-8.20), respectively. Analyses were adjusted for age, schooling, pre-pregnancy BMI, lipids consumption and time elapsed since delivery. It verified an association between omega-6/omega-3 ratio above 9:1, the levels recommended by the Institute of Medicine, and the prevalence of PPD. These results add to the evidence regarding the importance of omega-6 and omega-3 fatty acids in the regulation of mental health mechanisms. © 2010 Blackwell Publishing Ltd.

  13. Adjusting Permittivity by Blending Varying Ratios of SWNTs

    NASA Technical Reports Server (NTRS)

    Tour, James M.; Stephenson, Jason J.; Higginbotham, Amanda

    2012-01-01

    A new composite material of singlewalled carbon nanotubes (SWNTs) displays radio frequency (0 to 1 GHz) permittivity properties that can be adjusted based upon the nanotube composition. When varying ratios of raw to functionalized SWNTs are blended into the silicone elastomer matrix at a total loading of 0.5 percent by weight, a target real permittivity value can be obtained between 70 and 3. This has particular use for designing materials for microwave lenses, microstrips, filters, resonators, high-strength/low-weight electromagnetic interference (EMI) shielding, antennas, waveguides, and low-loss magneto-dielectric products for applications like radome construction.

  14. Female starlings adjust primary sex ratio in response to aromatic plants in the nest.

    PubMed

    Polo, Vicente; Veiga, José P; Cordero, Pedro J; Viñuela, Javier; Monaghan, Pat

    2004-09-22

    Adjustment of offspring sex ratios should be favoured by natural selection when parents are capable of facultatively altering brood sex ratios and of recognizing the circumstances that predict the probable fitness benefit of producing sons and daughters. Although experimental studies have shown that female birds may adjust offspring sex ratios in response to changes in their own condition and in the external appearance of their mate, and male attributes other than his external morphology are also thought to act as signals of male quality, it is not known whether females will respond to changes in such signals, in the absence of any change in the appearance of the male himself. Here, we experimentally manipulated a male courtship display, the green plants carried to the nest by male spotless starlings (Sturnus unicolor), without changing any physical attributes of the male himself, and examined whether this influenced female decisions on offspring sex ratio. We found that in an environment in which female starlings were producing more daughters than sons, experimental enhancement of the green nesting material caused females to significantly increase the number of male eggs produced and thereby removed the female bias. This effect was consistent in 2 years and at two localities. This demonstrates that the green material, whose function has long puzzled biologists, conveys important information to the female and that she facultatively adjusts offspring production accordingly.

  15. Non-alcoholic fatty liver disease is associated with high prevalence of gastro-oesophageal reflux symptoms.

    PubMed

    Miele, Luca; Cammarota, Giovanni; Vero, Vittoria; Racco, Simona; Cefalo, Consuelo; Marrone, Giuseppe; Pompili, Maurizio; Rapaccini, Gianlodovico; Bianco, Alessandro; Landolfi, Raffaele; Gasbarrini, Antonio; Grieco, Antonio

    2012-12-01

    Gastro-oesophageal reflux symptoms are usually reported by patients with obesity and metabolic syndrome. Aim of this study was to assess the prevalence and clinical characteristics of gastro-oesophageal reflux symptoms in subjects with non-alcoholic fatty liver disease. Cross-sectional, case-control study of 185 consecutive patients with non-alcoholic fatty liver disease and an age- and sex-matched control group of 112 healthy volunteers. Participants were interviewed with the aid of a previously validated questionnaire to assess lifestyle and reflux symptoms in the 3 months preceding enrolment. Odds ratios were determined before and after adjustment for body mass index, increased waist circumference, physical activity, metabolic syndrome and proton pump inhibitors and/or antiacid medication. The prevalence of heartburn and/or regurgitation and of at least one of gastro-oesophageal reflux symptoms was significantly higher in the non-alcoholic fatty liver disease group. Non-alcoholic fatty liver disease subjects were associated to higher prevalence of heartburn (adjusted odds ratios: 2.17, 95% confidence intervals: 1.16-4.04), regurgitation (adjusted odds ratios: 2.61, 95% confidence intervals: 1.24-5.48) and belching (adjusted odds ratios: 2.01, 95% confidence intervals: 1.12-3.59) and had higher prevalence of at least one GER symptom (adjusted odds ratios: 3.34, 95% confidence intervals: 1.76-6.36). Non-alcoholic fatty liver disease is associated with a higher prevalence of gastro-oesophageal reflux symptoms. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  16. The Ratio of Dietary Branched-Chain Amino Acids is Associated with a Lower Prevalence of Obesity in Young Northern Chinese Adults: An Internet-Based Cross-Sectional Study

    PubMed Central

    Li, Yan-Chuan; Li, Ying; Liu, Li-Yan; Chen, Yang; Zi, Tian-Qi; Du, Shan-Shan; Jiang, Yong-Shuai; Feng, Ren-Nan; Sun, Chang-Hao

    2015-01-01

    This study aims to examine the association between the ratio of dietary branched chain amino acids (BCAA) and risk of obesity among young northern Chinese adults. A total of 948 randomly recruited participants were asked to finish our internet-based dietary questionnaire for the Chinese (IDQC). Associations between dietary BCAA ratio and prevalence of overweight/obesity and abdominal obesity were analyzed. Furthermore, 90 subjects were randomly selected to explore the possible mechanism. Dietary BCAA ratio in obese participants was significantly lower than non-obese participants. We found negative correlations between the ratio of dietary BCAA and body mass index (BMI) (r = −0.197, p < 0.001) or waist circumference (r = −0.187, p < 0.001). Compared with those in the first quartile, the multivariable-adjusted OR (95% CI) of the 3rd and 4th quartiles of dietary BCAA ratio for overweight/obesity were 0.508 (0.265–0.972) and 0.389 (0.193–0.783), respectively (all p < 0.05). After stratification by gender, the significance still existed in the 3rd and 4th quartile in males and the 4th quartile in females. For abdominal obesity, the multivariable-adjusted OR (95% CI) of the 3rd and 4th quartile of dietary BCAA ratio were 0.351 (0.145–0.845) and 0.376 (0.161–0.876), respectively (all p < 0.05). This significance was stronger in males. Further studies indicated that dietary BCAA ratio was inversely associated with 2-h postprandial glucose (2 h-PG) and status of inflammation. In conclusion, a higher ratio of dietary BCAA is inversely associated with prevalence of obesity, postprandial glucose and status of inflammation in young northern Chinese adults. PMID:26593945

  17. The Ratio of Dietary Branched-Chain Amino Acids is Associated with a Lower Prevalence of Obesity in Young Northern Chinese Adults: An Internet-Based Cross-Sectional Study.

    PubMed

    Li, Yan-Chuan; Li, Ying; Liu, Li-Yan; Chen, Yang; Zi, Tian-Qi; Du, Shan-Shan; Jiang, Yong-Shuai; Feng, Ren-Nan; Sun, Chang-Hao

    2015-11-18

    This study aims to examine the association between the ratio of dietary branched chain amino acids (BCAA) and risk of obesity among young northern Chinese adults. A total of 948 randomly recruited participants were asked to finish our internet-based dietary questionnaire for the Chinese (IDQC). Associations between dietary BCAA ratio and prevalence of overweight/obesity and abdominal obesity were analyzed. Furthermore, 90 subjects were randomly selected to explore the possible mechanism. Dietary BCAA ratio in obese participants was significantly lower than non-obese participants. We found negative correlations between the ratio of dietary BCAA and body mass index (BMI) (r = -0.197, p < 0.001) or waist circumference (r = -0.187, p < 0.001). Compared with those in the first quartile, the multivariable-adjusted OR (95% CI) of the 3rd and 4th quartiles of dietary BCAA ratio for overweight/obesity were 0.508 (0.265-0.972) and 0.389 (0.193-0.783), respectively (all p < 0.05). After stratification by gender, the significance still existed in the 3rd and 4th quartile in males and the 4th quartile in females. For abdominal obesity, the multivariable-adjusted OR (95% CI) of the 3rd and 4th quartile of dietary BCAA ratio were 0.351 (0.145-0.845) and 0.376 (0.161-0.876), respectively (all p < 0.05). This significance was stronger in males. Further studies indicated that dietary BCAA ratio was inversely associated with 2-h postprandial glucose (2 h-PG) and status of inflammation. In conclusion, a higher ratio of dietary BCAA is inversely associated with prevalence of obesity, postprandial glucose and status of inflammation in young northern Chinese adults.

  18. Association of triglyceride-to-high density lipoprotein cholesterol ratio to cardiorespiratory fitness in men.

    PubMed

    Vega, Gloria Lena; Grundy, Scott M; Barlow, Carolyn E; Leonard, David; Willis, Benjamin L; DeFina, Laura F; Farrell, Stephen W

    Both triglyceride-to-high density lipoprotein cholesterol (TG/HDL-C) and cardiorespiratory fitness (CRF) impart risk for all-cause morbidity and mortality independently of conventional risk factors. To determine prevalence and/or incidence of high TG/HDL-C ratio in men with low CRF. Clinical characteristics and CRF were used to determine prevalence of a TG/HDL-C ratio ≥ 3.5 (high ratio) in 13,954 men of the Cooper Center Longitudinal Study. High-ratio conversion was determined in 10,424 men with normal baseline TG/HDL-C ratio. Hazard ratio (HR) of incident high TG/HDL-C was adjusted for age and waist girth. Men with low CRF had the highest prevalence of a high TG/HDL-C ratio. In the population with normal TG/HDL-C, age-adjusted HR of incident high TG/HDL-C ratio was 2.77 times higher in men with lowest CRF than in those with highest CRF. Incidence of conversion of normal to high ratio was 5.5% per year in low CRF population, compared with 1.7% in high CRF subjects. Incidence HR was independent of waist girth. Men who converted from normal to high TG/HDL-C ratio during the follow-up period had increased number of metabolic risk factors and a higher prevalence of metabolic syndrome. Men who did not convert to a high TG/HDL-C ratio retained a low prevalence of metabolic syndrome risk factors. A high TG/HDL-C ratio is common in men with low CRF. Metabolic syndrome also is common among those with a high ratio. Copyright © 2016 National Lipid Association. All rights reserved.

  19. Prevalence of Irritable Bowel Syndrome and Chronic Fatigue 10 Years After Giardia Infection.

    PubMed

    Litleskare, Sverre; Rortveit, Guri; Eide, Geir Egil; Hanevik, Kurt; Langeland, Nina; Wensaas, Knut-Arne

    2018-03-06

    Irritable bowel syndrome (IBS) is a complication that can follow gastrointestinal infection, but it is not clear if patients also develop chronic fatigue. We investigated the prevalence and odds ratio of IBS and chronic fatigue 10 years after an outbreak of Giardia lamblia, compared with a control cohort, and changes in prevalence over time. We performed a prospective follow-up study of 1252 laboratory-confirmed cases of giardiasis (exposed), which developed in Bergen, Norway in 2004. Statistics Norway provided us with information from 2504 unexposed individuals from Bergen, matched by age and sex (controls). Questionnaires were mailed to participants 3, 6, and 10 years after the outbreak. Results from the 3- and 6-year follow-up analyses have been published previously. We report the 10-year data and changes in prevalence among time points, determined by logistic regression using generalized estimating equations. The prevalence of IBS 10 years after the outbreak was 43% (n = 248) among 576 exposed individuals and 14% (n = 94) among 685 controls (adjusted odds ratio for development of IBS in exposed individuals, 4.74; 95% CI, 3.61-6.23). At this time point, the prevalence of chronic fatigue was 26% (n = 153) among 587 exposed individuals and 11% (n = 73) among 692 controls (adjusted odds ratio, 3.01; 95% CI, 2.22-4.08). The prevalence of IBS among exposed persons did not change significantly from 6 years after infection (40%) to 10 years after infection (43%; adjusted odds ratio for the change 1.03; 95% CI, 0.87-1.22). However, the prevalence of chronic fatigue decreased from 31% at 6 years after infection to 26% at 10 years after infection (adjusted odds ratio for the change 0.74; 95% CI, 0.61-0.90). The prevalence of IBS did not change significantly from 6 years after an outbreak of Giardia lamblia infection in Norway to 10 years after. However, the prevalence of chronic fatigue decreased significantly from 6 to 10 years afterward. IBS and chronic fatigue were

  20. Incidence, prevalence, and hybrid approaches to calculating disability-adjusted life years

    PubMed Central

    2012-01-01

    When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don’t discount the value of future health, there is a sense in which the choice of calculation method is a mere question of accounting. Such questions can be important, but they don’t raise deep theoretical concerns. If we do discount, however, choice of calculation method can change the relative burden attributed to different conditions over time. I conclude by recommending that studies involving disability-adjusted life years be explicit in noting what calculation method is being employed and in explaining why that calculation method has been chosen. PMID:22967055

  1. Socioeconomic inequality and peripheral artery disease prevalence in US adults.

    PubMed

    Pande, Reena L; Creager, Mark A

    2014-07-01

    Lower socioeconomic status is associated with cardiovascular disease. We sought to determine whether there is a higher prevalence of peripheral artery disease (PAD) in individuals with lower socioeconomic status. We analyzed data from the National Health and Nutrition Examination Survey 1999 to 2004. PAD was defined based on an ankle.brachial index .0.90. Measures of socioeconomic status included poverty.income ratio,a ratio of self-reported income relative to the poverty line, and attained education level. Of 6791 eligible participants,overall weighted prevalence of PAD was 5.8% (SE, 0.3). PAD prevalence was significantly higher in individuals with low income and lower education. Individuals in the lowest of the 6 poverty.income ratio categories had more than a2-fold increased odds of PAD compared with those in the highest poverty-income ratio category (odds ratio, 2.69; 95%confidence interval, 1.80.4.03; P<0.0001). This association remained significant even after multivariable adjustment(odds ratio, 1.64; 95% confidence interval, 1.04.2.6; P=0.034). Lower attained education level also associated with higher PAD prevalence (odds ratio, 2.8; 95% confidence interval, 1.96.4.0; P<0.0001) but was no longer significant after multivariable adjustment. Low income and lower attained education level are associated with PAD in US adults. These data suggest that individuals of lower socioeconomic status remain at high risk and highlight the need for education and advocacy efforts focused on these at-risk populations.

  2. Sex- and Age-Adjusted Population Analysis of Prevalence Estimates for Hidradenitis Suppurativa in the United States.

    PubMed

    Garg, Amit; Kirby, Joslyn S; Lavian, Jonathan; Lin, Gloria; Strunk, Andrew

    2017-08-01

    The true prevalence of hidradenitis suppurativa (HS) is unknown. To establish standardized overall and group-specific prevalence estimates for HS in the United States. This retrospective analysis included a demographically heterogeneous population-based sample of more than 48 million unique patients across all US census regions. As of October 27, 2016, a total of 47 690 patients with HS were identified using electronic health record data. Standardized overall point prevalence for HS and sex-, age-, and race-specific prevalence estimates of HS in the general US population. Of the 47 690 patients with HS (26.2% men and 73.8% women), the overall HS prevalence in the US population sample was 0.10%, or 98 per 100 000 persons (95% CI, 97-99 per 100 000 persons). The adjusted prevalence in women was 137 per 100 000 (95% CI, 136-139 per 100 000), more than twice that of men (58 per 100 000; 95% CI, 57-59 per 100 000; P < .001). The prevalence of HS was highest among patients aged 30 to 39 years (172 per 100 000; 95% CI, 169-275 per 100 000) compared with all other age groups (range, 15-150 per 100 000; P < .001). Adjusted HS prevalences among African American (296 per 100 000; 95% CI, 291-300 per 100 000) and biracial (218 per 100 000; 95% CI, 202-235 per 100 000) patients were more than 3-fold and 2-fold greater, respectively, than that among white patients (95 per 100 000; 95% CI, 94-96 per 100 000; P < .001). Hidradenitis suppurativa is an uncommon, but not rare, disease in the United States that disproportionately affects female patients, young adults, and African American and biracial patients.

  3. Current and future worldwide prevalence of dependency, its relationship to total population, and dependency ratios.

    PubMed Central

    Harwood, Rowan H.; Sayer, Avan Aihie; Hirschfeld, Miriam

    2004-01-01

    OBJECTIVE: To estimate the number of people worldwide requiring daily assistance from another person in carrying out health, domestic or personal tasks. METHODS: Data from the Global Burden of Disease Study were used to calculate the prevalence of severe levels of disability, and consequently, to estimate dependency. Population projections were used to forecast changes over the next 50 years. FINDINGS: The greatest burden of dependency currently falls in sub-Saharan Africa, where the "dependency ratio" (ratio of dependent people to the population of working age) is about 10%, compared with 7-8% elsewhere. Large increases in prevalence are predicted in sub-Saharan Africa, the Middle East, Asia and Latin America of up to 5-fold or 6-fold in some cases. These increases will occur in the context of generally increasing populations, and dependency ratios will increase modestly to about 10%. The dependency ratio will increase more in China (14%) and India (12%) than in other areas with large prevalence increases. Established market economies, especially Europe and Japan, will experience modest increases in the prevalence of dependency (30%), and in the dependency ratio (up to 10%). Former Socialist economies of Europe will have static or declining numbers of dependent people, but will have large increases in the dependency ratio (up to 13%). CONCLUSION: Many countries will be greatly affected by the increasing number of dependent people and will need to identify the human and financial resources to support them. Much improved collection of data on disability and on the needs of caregivers is required. The prevention of disability and provision of support for caregivers needs greater priority. PMID:15259253

  4. Use of the Posterior/Anterior Corneal Curvature Radii Ratio to Improve the Accuracy of Intraocular Lens Power Calculation: Eom's Adjustment Method.

    PubMed

    Kim, Mingue; Eom, Youngsub; Lee, Hwa; Suh, Young-Woo; Song, Jong Suk; Kim, Hyo Myung

    2018-02-01

    To evaluate the accuracy of IOL power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio. Nine hundred twenty-eight eyes from 928 reference subjects and 158 eyes from 158 cataract patients who underwent phacoemulsification surgery were enrolled. Adjusted corneal power of cataract patients was calculated using the fictitious refractive index that was obtained from the geometric mean posterior/anterior corneal curvature radii ratio of reference subjects and adjusted anterior and predicted posterior corneal curvature radii from conventional keratometry (K) using the posterior/anterior corneal curvature radii ratio. The median absolute error (MedAE) based on the adjusted corneal power was compared with that based on conventional K in the Haigis and SRK/T formulae. The geometric mean posterior/anterior corneal curvature radii ratio was 0.808, and the fictitious refractive index of the cornea for a single Scheimpflug camera was 1.3275. The mean difference between adjusted corneal power and conventional K was 0.05 diopter (D). The MedAE based on adjusted corneal power (0.31 D in the Haigis formula and 0.32 D in the SRK/T formula) was significantly smaller than that based on conventional K (0.41 D and 0.40 D, respectively; P < 0.001 and P < 0.001, respectively). The percentage of eyes with refractive prediction error within ± 0.50 D calculated using adjusted corneal power (74.7%) was significantly greater than that obtained using conventional K (62.7%) in the Haigis formula (P = 0.029). IOL power calculation using adjusted corneal power according to the posterior/anterior corneal curvature radii ratio provided more accurate refractive outcomes than calculation using conventional K.

  5. Magnitude and Determinants of the Ratio between Prevalence of Low Vision and Blindness in Rapid Assessment of Avoidable Blindness Surveys.

    PubMed

    Kaphle, Dinesh; Lewallen, Susan

    2017-10-01

    To determine the magnitude and determinants of the ratio between prevalence of low vision and prevalence of blindness in rapid assessment of avoidable blindness (RAAB) surveys globally. Standard RAAB reports were downloaded from the repository or requested from principal investigators. Potential predictor variables included prevalence of uncorrected refractive error (URE) as well as gross domestic product (GDP) per capita, health expenditure per capita of the country across World Bank regions. Univariate and multivariate linear regression were used to investigate the correlation between potential predictor variables and the ratio. The results of 94 surveys from 43 countries showed that the ratio ranged from 1.35 in Mozambique to 11.03 in India with a median value of 3.90 (Interquartile range 3.06;5.38). Univariate regression analysis showed that prevalence of URE (p = 0.04), logarithm of GDP per capita (p = 0.01) and logarithm of health expenditure per capita (p = 0.03) were significantly associated with the higher ratio. However, only prevalence of URE was found to be significant in multivariate regression analysis (p = 0.03). There is a wide variation in the ratio of the prevalence of low vision to the prevalence of blindness. Eye care service utilization indicators such as the prevalence of URE may explain some of the variation across the regions.

  6. An Adjusted Likelihood Ratio Approach Analysing Distribution of Food Products to Assist the Investigation of Foodborne Outbreaks

    PubMed Central

    Norström, Madelaine; Kristoffersen, Anja Bråthen; Görlach, Franziska Sophie; Nygård, Karin; Hopp, Petter

    2015-01-01

    In order to facilitate foodborne outbreak investigations there is a need to improve the methods for identifying the food products that should be sampled for laboratory analysis. The aim of this study was to examine the applicability of a likelihood ratio approach previously developed on simulated data, to real outbreak data. We used human case and food product distribution data from the Norwegian enterohaemorrhagic Escherichia coli outbreak in 2006. The approach was adjusted to include time, space smoothing and to handle missing or misclassified information. The performance of the adjusted likelihood ratio approach on the data originating from the HUS outbreak and control data indicates that the adjusted approach is promising and indicates that the adjusted approach could be a useful tool to assist and facilitate the investigation of food borne outbreaks in the future if good traceability are available and implemented in the distribution chain. However, the approach needs to be further validated on other outbreak data and also including other food products than meat products in order to make a more general conclusion of the applicability of the developed approach. PMID:26237468

  7. Friendships with Co-Participants in Organized Activities: Prevalence, Quality, Friends' Characteristics, and Associations with Adolescents' Adjustment

    ERIC Educational Resources Information Center

    Poulin, Francois; Denault, Anne-Sophie

    2013-01-01

    The goal of this study was to provide an in-depth examination of friendships within organized activities. The prevalence of friendships with co-participants, their quality and characteristics, and their associations with adjustment were investigated. A sample of 281 (60% girls) 8th grade adolescents reported their friendships, activities, and…

  8. Three methods to construct predictive models using logistic regression and likelihood ratios to facilitate adjustment for pretest probability give similar results.

    PubMed

    Chan, Siew Foong; Deeks, Jonathan J; Macaskill, Petra; Irwig, Les

    2008-01-01

    To compare three predictive models based on logistic regression to estimate adjusted likelihood ratios allowing for interdependency between diagnostic variables (tests). This study was a review of the theoretical basis, assumptions, and limitations of published models; and a statistical extension of methods and application to a case study of the diagnosis of obstructive airways disease based on history and clinical examination. Albert's method includes an offset term to estimate an adjusted likelihood ratio for combinations of tests. Spiegelhalter and Knill-Jones method uses the unadjusted likelihood ratio for each test as a predictor and computes shrinkage factors to allow for interdependence. Knottnerus' method differs from the other methods because it requires sequencing of tests, which limits its application to situations where there are few tests and substantial data. Although parameter estimates differed between the models, predicted "posttest" probabilities were generally similar. Construction of predictive models using logistic regression is preferred to the independence Bayes' approach when it is important to adjust for dependency of tests errors. Methods to estimate adjusted likelihood ratios from predictive models should be considered in preference to a standard logistic regression model to facilitate ease of interpretation and application. Albert's method provides the most straightforward approach.

  9. Enhancing the Accuracy of Platelet to Lymphocyte Ratio after Adjustment for Large Platelet Count: A Pilot Study in Breast Cancer Patients

    PubMed Central

    Seretis, Charalampos; Seretis, Fotios; Lagoudianakis, Emmanuel; Politou, Marianna; Gemenetzis, George; Salemis, Nikolaos S.

    2012-01-01

    Background. The objective of our study is to investigate the potential effect of adjusting preoperative platelet to lymphocyte ratio, an emerging biomarker of survival in cancer patients, for the fraction of large platelets. Methods. A total of 79 patients with breast neoplasias, 44 with fibroadenomas, and 35 with invasive ductal carcinoma were included in the study. Both conventional platelet to lymphocyte ratio (PLR) and the adjusted marker, large platelet to lymphocyte ratio (LPLR), were correlated with laboratory and histopathological parameters of the study sample. Results. LPLR elevation was significantly correlated with the presence of malignancy, advanced tumor stage, metastatic spread in the axillary nodes and HER2/neu overexpression, while PLR was only correlated with the number of infiltrated lymph nodes. Conclusions. This is the first study evaluating the effect of adjustment for large platelet count on improving PLR accuracy, when correlated with the basic independent markers of survival in a sample of breast cancer patients. Further studies are needed in order to assess the possibility of applying our adjustment as standard in terms of predicting survival rates in cancer. PMID:23304480

  10. Enhancing the accuracy of platelet to lymphocyte ratio after adjustment for large platelet count: a pilot study in breast cancer patients.

    PubMed

    Seretis, Charalampos; Seretis, Fotios; Lagoudianakis, Emmanuel; Politou, Marianna; Gemenetzis, George; Salemis, Nikolaos S

    2012-01-01

    Background. The objective of our study is to investigate the potential effect of adjusting preoperative platelet to lymphocyte ratio, an emerging biomarker of survival in cancer patients, for the fraction of large platelets. Methods. A total of 79 patients with breast neoplasias, 44 with fibroadenomas, and 35 with invasive ductal carcinoma were included in the study. Both conventional platelet to lymphocyte ratio (PLR) and the adjusted marker, large platelet to lymphocyte ratio (LPLR), were correlated with laboratory and histopathological parameters of the study sample. Results. LPLR elevation was significantly correlated with the presence of malignancy, advanced tumor stage, metastatic spread in the axillary nodes and HER2/neu overexpression, while PLR was only correlated with the number of infiltrated lymph nodes. Conclusions. This is the first study evaluating the effect of adjustment for large platelet count on improving PLR accuracy, when correlated with the basic independent markers of survival in a sample of breast cancer patients. Further studies are needed in order to assess the possibility of applying our adjustment as standard in terms of predicting survival rates in cancer.

  11. Adjusting the HIV prevalence for non-respondents using mortality rates in an open cohort in northwest Tanzania.

    PubMed

    Tenu, Filemon; Isingo, Raphael; Zaba, Basia; Urassa, Mark; Todd, Jim

    2014-06-01

    To estimate HIV prevalence in adults who have not tested for HIV using age-specific mortality rates and to adjust the overall population HIV prevalence to include both tested and untested adults. An open cohort study was established since 1994 with demographic surveillance system (DSS) and five serological surveys conducted. Deaths from Kisesa DSS were used to estimate mortality rates and 95% confidence intervals by HIV status for 3- 5-year periods (1995-1999, 2000-2004, and 2005-2009). Assuming that mortality rates in individuals who did not test for HIV are similar to those in tested individuals, and dependent on age, sex and HIV status and HIV, prevalence was estimated. In 1995-1999, mortality rates (per 1000 person years) were 43.7 (95% CI 35.7-53.4) for HIV positive, 2.6 (95% CI 2.1-3.2) in HIV negative and 16.4 (95% CI 14.4-18.7) in untested. In 2000-2004, mortality rates were 43.3 (95% CI 36.2-51.9) in HIV positive, 3.3 (95% CI 2.8-4.0) in HIV negative and 11.9 (95% CI 10.5-13.6) in untested. In 2005-2009, mortality rates were 30.7 (95% CI 24.8-38.0) in HIV positive, 4.1 (95% CI 3.5-4.9) in HIV negative and 5.7 (95% CI 5.0-6.6) in untested residents. In the three survey periods (1995-1999, 2000-2004, 2005-2009), the adjusted period prevalences of HIV, including the untested, were 13.5%, 11.6% and 7.1%, compared with the observed prevalence in the tested of 6.0%, 6.8 and 8.0%. The estimated prevalence in the untested was 33.4%, 21.6% and 6.1% in the three survey periods. The simple model was able to estimate HIV prevalence where a DSS provided mortality data for untested residents. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  12. Standardized Prevalence Ratios for Atrial Fibrillation in Adult Dialysis Patients in Japan.

    PubMed

    Ohsawa, Masaki; Tanno, Kozo; Okamura, Tomonori; Yonekura, Yuki; Kato, Karen; Fujishima, Yosuke; Obara, Wataru; Abe, Takaya; Itai, Kazuyoshi; Ogasawara, Kuniaki; Omama, Shinichi; Turin, Tanvir Chowdhury; Miyamatsu, Naomi; Ishibashi, Yasuhiro; Morino, Yoshihiro; Itoh, Tomonori; Onoda, Toshiyuki; Kuribayashi, Toru; Makita, Shinji; Yoshida, Yuki; Nakamura, Motoyuki; Tanaka, Fumitaka; Ohta, Mutsuko; Sakata, Kiyomi; Okayama, Akira

    2016-05-05

    While it is assumed that dialysis patients in Japan have a higher prevalence of atrial fibrillation (AF) than the general population, the magnitude of this difference is not known. Standardized prevalence ratios (SPRs) for AF in dialysis patients (n = 1510) were calculated compared to data from the general population (n = 26 454) living in the same area. The prevalences of AF were 3.8% and 1.6% in dialysis patients and the general population, respectively. In male subjects, these respective values were 4.9% and 3.3%, and in female subjects they were 1.6% and 0.6%. The SPRs for AF were 2.53 (95% confidence interval [CI], 1.88-3.19) in all dialysis patients, 1.80 (95% CI, 1.30-2.29) in male dialysis patients, and 2.13 (95% CI, 0.66-3.61) in female dialysis patients. The prevalence of AF in dialysis patients was twice that in the population-based controls. Since AF strongly contributes to a higher risk of cardiovascular mortality and morbidity in the general population, further longitudinal studies should be conducted regarding the risk of several outcomes attributable to AF among Japanese dialysis patients.

  13. Prevalence ratio of HTLV-1 in nursing mothers from the state of Paraiba, Northeastern Brazil.

    PubMed

    Pimenta, Flávia C F; Kashima Haddad, Simone; de Medeiros Filho, João G; Costa, Maria José C; Diniz, Margareth F M; Fernandes, Melina P; de Araújo, Lenisio B; Pombo-de-Oliveira, Maria S

    2008-08-01

    The human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus known as a direct causal agent of a malignant disease. The vertical route of HTLV transmission is the most frequent pathway of the virus contamination. This study was performed to determine the prevalence ratio of HTLV-1 infection among nursing women. From January 2004 to January 2005, blood samples from 1033 nursing mothers from Paraíba, Brazil were evaluated for HTLV antibodies by ELISA and HTLV-1 viral particles confirmed by polymerase chain reaction (PCR). HTLV antibodies were detected in 7 women. The overall seroprevalence ratio was 0.68% and HTLV-1 viral sequences were confirmed by PCR in 2 women. These preliminary data suggest that HTLV screening should be introduced as a mandatory test before breastfeeding and breast milk donation in Paraíba, Brazil. Additionally, counseling programs would help reduce the prevalence ratio of HTLV-1 infected individuals in this Brazilian region.

  14. Prevalence and Losses in Quality-Adjusted Life Years of Child Health Conditions: A Burden of Disease Analysis.

    PubMed

    Craig, Benjamin M; Hartman, John D; Owens, Michelle A; Brown, Derek S

    2016-04-01

    To estimate the prevalence and losses in quality-adjusted life years (QALYs) associated with 20 child health conditions. Using data from the 2009-2010 National Survey of Children with Special Health Care Needs, preference weights were applied to 14 functional difficulties to summarize the quality of life burden of 20 health conditions. Among the 14 functional difficulties, "a little trouble with breathing" had the highest prevalence (37.1 %), but amounted to a loss of just 0.16 QALYs from the perspective of US adults. Though less prevalent, "a lot of behavioral problems" and "chronic pain" were associated with the greatest losses (1.86 and 3.43 QALYs). Among the 20 conditions, allergies and asthma were the most prevalent but were associated with the least burden. Muscular dystrophy and cerebral palsy were among the least prevalent and most burdensome. Furthermore, a scatterplot shows the association between condition prevalence and burden. In child health, condition prevalence is negatively associated with quality of life burden from the perspective of US adults. Both should be considered carefully when evaluating the appropriate role for public health prevention and interventions.

  15. Social disparities in the prevalence of multimorbidity - A register-based population study.

    PubMed

    Schiøtz, Michaela L; Stockmarr, Anders; Høst, Dorte; Glümer, Charlotte; Frølich, Anne

    2017-05-10

    Prevalences of multimorbidity vary between European studies and several methods and definitions are used. In this study we examine the prevalence of multimorbidity in relation to age, gender and educational attainment and the association between physical and mental health conditions and educational attainment in a Danish population. A cross-sectional design was used to study the prevalence of multimorbidity, defined as two or more chronic conditions, and of comorbid physical and mental health conditions across age groups and educational attainment levels among 1,397,173 individuals aged 16 years and older who lived in the Capital Region of Denmark on January 1st, 2012. After calculating prevalence, odds ratios for multimorbidity and mental health conditions were derived from logistic regression on gender, age, age squared, education and number of physical conditions (only for odds ratios for mental health conditions). Odds ratios for having multimorbidity and mental health conditions for each variable were adjusted for all other variables. Multimorbidity prevalence was 21.6%. Half of the population aged 65 and above had multimorbidity, and prevalence was inversely related to educational attainment: 26.9% (95% CI, 26.8-26.9) among those with lower secondary education versus 13.5% (95% CI, 13.5-13.6) among people with postgraduate education. Adjusted odds ratios for multimorbidity were 0.50 (95% CI, 0.49-0.51) for people with postgraduate education, compared to people with lower secondary education. Among all population members, 4.9% (95% CI, 4.9-4.9) had both a physical and a mental health condition, a proportion that increased to 22.6% of people with multimorbidity. Physical and mental health comorbidity was more prevalent in women (6.33%; 95% CI, 6.3-6.4) than men (3.34%; 95% CI, 3.3-3.4) and approximately 50 times more prevalent among older persons than younger ones. Physical and mental health comorbidity was also twice as prevalent among people with lower

  16. The Prevalence of Cyber Bullying Victimization and Its Relationship to Academic, Social, and Emotional Adjustment among College Students

    ERIC Educational Resources Information Center

    Beebe, Jennifer Elizabeth

    2010-01-01

    The current study investigated the prevalence and frequency of cyber bullying victimization and examined the impact of cyber bullying on academic, social, and emotional college adjustment. Participants were recruited from two universities in the United States. Participants completed the Revised Cyber Bullying Survey (Kowalski & Limber, 2007)…

  17. Friendships with co-participants in organized activities: prevalence, quality, friends' characteristics, and associations with adolescents' adjustment.

    PubMed

    Poulin, François; Denault, Anne-Sophie

    2013-01-01

    The goal of this study was to provide an in-depth examination of friendships within organized activities. The prevalence of friendships with co-participants, their quality and characteristics, and their associations with adjustment were investigated. A sample of 281 (60% girls) 8th grade adolescents reported their friendships, activities, and adjustment. The results showed that 70% of youths have friends who co-participate with them. Friends in individual sports are more academically oriented whereas friends in team sports are more supportive but display higher levels of problem behavior. Finally, having friends in activities is associated with lower problem behavior and better academic functioning. Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.

  18. Assessing and adjusting for differences between HIV prevalence estimates derived from national population-based surveys and antenatal care surveillance, with applications for Spectrum 2013

    PubMed Central

    Marsh, Kimberly; Mahy, Mary; Salomon, Joshua A.; Hogan, Daniel R.

    2014-01-01

    Objective(s): To assess differences between HIV prevalence estimates derived from national population surveys and antenatal care (ANC) surveillance sites and to improve the calibration of ANC-derived estimates in Spectrum 2013 to more appropriately account for differences between these data. Design: Retrospective analysis of national population survey and ANC surveillance data from 25 countries with generalized epidemics in sub-Saharan Africa and 8 countries with concentrated epidemics. Methods: Adult national population survey and ANC surveillance HIV prevalence estimates were compared for all available national population survey data points for the years 1999–2012. For sub-Saharan Africa, a mixed-effects linear regression model determined whether the relationship between national population and ANC estimates was constant across surveys. A new calibration method was developed to incorporate national population survey data directly into the likelihood for HIV prevalence in countries with generalized epidemics. Results were used to develop default rules for adjusting ANC data for countries with no national population surveys. Results: ANC surveillance data typically overestimate population prevalence, although a wide variation, particularly in rural areas, is observed across countries and survey years. The new calibration method yields similar point estimates to previous approaches, but leads to an average 44% increase in the width of 95% uncertainty intervals. Conclusion: Important biases remain in ANC surveillance data for HIV prevalence. The new approach to model-fitting in Spectrum 2013 more appropriately accounts for this bias when producing national estimates in countries with generalized epidemics. In countries with concentrated epidemics, local sex ratios should be used to calibrate ANC surveillance estimates. PMID:25203158

  19. Chronic migraine prevalence, disability, and sociodemographic factors: results from the American Migraine Prevalence and Prevention Study.

    PubMed

    Buse, Dawn C; Manack, Aubrey N; Fanning, Kristina M; Serrano, Daniel; Reed, Michael L; Turkel, Catherine C; Lipton, Richard B

    2012-01-01

    To estimate the prevalence and distribution of chronic migraine (CM) in the US population and compare the age- and sex-specific profiles of headache-related disability in persons with CM and episodic migraine. Global estimates of CM prevalence using various definitions typically range from 1.4% to 2.2%, but the influence of sociodemographic factors has not been completely characterized. The American Migraine Prevalence and Prevention Study mailed surveys to a sample of 120,000 US households selected to represent the US population. Data on headache frequency, symptoms, sociodemographics, and headache-related disability (using the Migraine Disability Assessment Scale) were obtained. Modified Silberstein-Lipton criteria were used to classify CM (meeting International Classification of Headache Disorders, second edition, criteria for migraine with a headache frequency of ≥15 days over the preceding 3 months). Surveys were returned by 162,756 individuals aged ≥12 years; 19,189 individuals (11.79%) met International Classification of Headache Disorders, second edition, criteria for migraine (17.27% of females; 5.72% of males), and 0.91% met criteria for CM (1.29% of females; 0.48% of males). Relative to 12 to 17 year olds, the age- and sex-specific prevalence for CM peaked in the 40s at 1.89% (prevalence ratio 4.57; 95% confidence interval 3.13-6.67) for females and 0.79% (prevalence ratio 3.35; 95% confidence interval 1.99-5.63) for males. In univariate and adjusted models, CM prevalence was inversely related to annual household income. Lower income groups had higher rates of CM. Individuals with CM had greater headache-related disability than those with episodic migraine and were more likely to be in the highest Migraine Disability Assessment Scale grade (37.96% vs. 9.50%, respectively). Headache-related disability was highest among females with CM compared with males. CM represented 7.68% of migraine cases overall, and the proportion generally increased with age

  20. Prevalence of orofacial clefts and risks for nonsyndromic cleft lip with or without cleft palate in newborns at a university hospital from West Mexico.

    PubMed

    Corona-Rivera, Jorge Román; Bobadilla-Morales, Lucina; Corona-Rivera, Alfredo; Peña-Padilla, Christian; Olvera-Molina, Sandra; Orozco-Martín, Miriam A; García-Cruz, Diana; Ríos-Flores, Izabel M; Gómez-Rodríguez, Brian Gabriel; Rivas-Soto, Gemma; Pérez-Molina, J Jesús

    2018-02-19

    We determined the overall prevalence of typical orofacial clefts and the potential risks for nonsyndromic cleft lip with or without cleft palate in a university hospital from West México. For the prevalence, 227 liveborn infants with typical orofacial clefts were included from a total of 81,193 births occurred during the period 2009-2016 at the "Dr. Juan I. Menchaca" Civil Hospital of Guadalajara (Guadalajara, Jalisco, Mexico). To evaluate potential risks, a case-control study was conducted among 420 newborns, including only those 105 patients with nonsyndromic cleft lip with or without cleft palate (cases), and 315 infants without birth defects (controls). Data were analyzed using multivariable logistic regression analysis expressed as adjusted odds ratio with 95% confidence intervals . The overall prevalence for typical orofacial clefts was 28 per 10,000 (95% confidence interval: 24.3-31.6), or 1 per 358 live births. The mean values for the prepregnancy weight, antepartum weight, and pre-pregnancy body mass index were statistically higher among the mothers of cases. Infants with nonsyndromic cleft lip with or without cleft palate had a significantly higher risk for previous history of any type of congenital anomaly (adjusted odds ratio: 2.7; 95% confidence interval: 1.4-5.1), history of a relative with cleft lip with or without cleft palate (adjusted odds ratio: 19.6; 95% confidence interval: 8.2-47.1), and first-trimester exposures to progestogens (adjusted odds ratio: 6.8; 95% CI 1.8-25.3), hyperthermia (adjusted odds ratio: 3.4; 95% confidence interval: 1.1-10.6), and common cold (adjusted odds ratio: 3.6; 95% confidence interval: 1.1-11.9). These risks could have contributed to explain the high prevalence of orofacial clefts in our region of Mexico, emphasizing that except for history of relatives with cleft lip with or without cleft palate, most are susceptible of modification. © 2018 Japanese Teratology Society.

  1. A low arm and leg muscle mass to total body weight ratio is associated with an increased prevalence of metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2010-2011.

    PubMed

    Kim, Yong Hwan; So, Wi-Young

    2016-09-14

    The aim of this study was to investigate the association between metabolic syndrome (MetS) and arm and leg muscle mass to total weight ratios in Korean adults. This was a randomized, controlled, cross-sectional study. Data from 2,383 adults (1,030 men and 1,353 women) were collected from the Korea National Health and Nutrition Examination Survey 2010-2011. Blood lipid profiles, blood pressure, and anthropometric characteristics, including weight, height, waist circumference, and muscle mass on dual energy X-ray absorptiometry (DXA), were evaluated in the participants. MetS was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III. The average mass of both arms and legs was determined using regional muscle analysis by DXA. Afterwards, the arm and leg muscle mass to total body weight ratio was determined and classified into 4 quartiles (i.e., quartile 1 [highest muscle ratio] to quartile 4 [lowest muscle ratio]). According to the arm muscle and leg muscle ratios, there was a higher prevalence of MetS in quartile 4 than in quartile 1 in both men and women. A low arm and leg muscle mass to body weight ratio was associated with a higher prevalence of MetS after adjusting for age, physical activity, frequency of smoking, and frequency of alcohol consumption. In conclusion, MetS patients demonstrated a lower arm and leg muscle mass to body weight ratio. Strength training for the lower and upper extremities is recommended because it can have a positive effect on MetS prevention.

  2. The Dietary Fructose:Vitamin C Intake Ratio Is Associated with Hyperuricemia in African-American Adults.

    PubMed

    Zheng, Zihe; Harman, Jane L; Coresh, Josef; Köttgen, Anna; McAdams-DeMarco, Mara A; Correa, Adolfo; Young, Bessie A; Katz, Ronit; Rebholz, Casey M

    2018-03-01

    A high fructose intake has been shown to be associated with increased serum urate concentration, whereas ascorbate (vitamin C) may lower serum urate by competing with urate for renal reabsorption. We assessed the combined association, as the fructose:vitamin C intake ratio, and the separate associations of dietary fructose and vitamin C intakes on prevalent hyperuricemia. We conducted cross-sectional analyses of dietary intakes of fructose and vitamin C and serum urate concentrations among Jackson Heart Study participants, a cohort of African Americans in Jackson, Mississippi, aged 21-91 y. In the analytic sample (n = 4576), multivariable logistic regression was used to examine the separate associations of dietary intakes of fructose and vitamin C and the fructose:vitamin C intake ratio with prevalent hyperuricemia (serum urate ≥7 mg/dL), after adjusting for age, sex, smoking, waist circumference, systolic blood pressure, estimated glomerular filtration rate, diuretic medication use, vitamin C supplement use, total energy intake, alcohol consumption, and dietary intake of animal protein. Analyses for individual dietary factors (vitamin C, fructose) were adjusted for the other dietary factor. In the fully adjusted model, there were 17% greater odds of hyperuricemia associated with a doubling of the fructose:vitamin C intake ratio (OR: 1.17; 95% CI: 1.08, 1.28), 20% greater odds associated with a doubling of fructose intake (OR: 1.20; 95% CI: 1.08, 1.34), and 13% lower odds associated with a doubling of vitamin C intake (OR: 0.87; 95% CI: 0.78, 0.97). Dietary fructose and the fructose:vitamin C intake ratio were more strongly associated with hyperuricemia among men than women (P-interaction ≤ 0.04). Dietary intakes of fructose and vitamin C are associated with prevalent hyperuricemia in a community-based population of African Americans.

  3. Adjustment of the ratio of Ca/P in the ceramic coating on Mg alloy by plasma electrolytic oxidation

    NASA Astrophysics Data System (ADS)

    Yao, Zhongping; Li, Liangliang; Jiang, Zhaohua

    2009-04-01

    The ceramic coatings containing Ca and P were prepared on AZ91D Mg alloy by plasma electrolytic oxidation technique in NaOH system and Na 2SiO 3 system, respectively. The phase composition, morphology and the element distribution of the coatings was studied by X-ray diffraction, scanning electron microscopy and energy dispersive spectroscopy. The corrosion resistance of the coatings was examined by polarizing curve methods in a 0.9% NaCl solution. In NaOH system, there were a large number of micro-holes distributing evenly on the surface of the coating, and the coating was mainly composed of Mg, Al, P and Ca. In Na 2SiO 3 system, the micro-holes in the coatings were reduced greatly in number and the distribution of the micro-holes was uneven, and the coating was mainly composed of Mg, Al, Si, P and Ca. The ratio of Ca/P in the coating can be controlled by the adjustment of the technique parameters to a certain extent. The adjustment of the concentration of Ca 2+ in the electrolyte was an effective method to change the ratio of Ca/P in the coating in both systems; the reaction time and the working voltage for the adjustment of the ratio of Ca/P in the coating was more suitable for the NaSi 2O 3 system than the NaOH system. The polarizing curve tests showed the coatings improved the corrosion resistance of the AZ91D Mg alloy in 0.9% NaCl solution by nearly two orders of magnitude.

  4. Diabetes Prevalence Among Racial-Ethnic Minority Group Members With Severe Mental Illness Taking Antipsychotics: Double Jeopardy?

    PubMed

    Mangurian, Christina; Keenan, Walker; Newcomer, John W; Vittinghoff, Eric; Creasman, Jennifer M; Schillinger, Dean

    2017-08-01

    This study assessed differences in diabetes prevalence based on race-ethnicity among people with severe mental illnesses. This retrospective cohort study examined diabetes prevalence in 2009 among California Medicaid enrollees with severe mental illness who were screened for diabetes (N=19,364). Poisson regression assessed differences in diabetes prevalence by race-ethnicity. The sample was standardized to the U.S. The overall prevalence of diabetes was 32.0%. The adjusted prevalence for all minority groups with severe mental illness, except for Asians, was significantly higher than for whites (1.21-1.28 adjusted prevalence ratios). With inverse probability weighting to reduce selection bias captured by measured factors, estimated prevalence of diabetes among screened participants was 27.3%. The prevalence of diabetes in minority groups with severe mental illness was significantly higher than among whites with severe mental illness. Mental health administrators should implement universal diabetes screening with specific outreach efforts targeting minority populations with severe mental illness.

  5. Inverse association between altitude and obesity: A prevalence study among Andean and low-altitude adult individuals of Peru

    PubMed Central

    Woolcott, Orison O.; Gutierrez, Cesar; Castillo, Oscar A.; Elashoff, Robert M.; Stefanovski, Darko; Bergman, Richard N.

    2015-01-01

    Objective To determine the association between altitude and obesity in a nationally representative sample of the Peruvian adult population. Design and Methods This is a cross-sectional analysis of publicly available data from the Food and Nutrition National Center (CENAN, Peru), period 2009-2010. Prevalence ratio of obesity and abdominal obesity was determined as a measure of association. Obesity and abdominal obesity were diagnosed based on direct anthropometric measurements. Results The final dataset consisted of 31,549 individuals ≥20 years old. The prevalence ratio of obesity was as follows: 1.00 between 0–499 m (reference category), 1.00 (95% confidence interval 0.87-1.16) between 500–1,499 m, 0.74 (0.63-0.86) between 1,500–2,999, and 0.54 (0.45-0.64) at ≥3,000 m, adjusting for age, sex, self-reported physical activity, out-migration rate, urbanization, poverty, education, and geographical latitude and longitude. In the same order, the adjusted prevalence ratio of abdominal obesity was 1.00, 1.01 (0.94-1.07), 0.93 (0.87-0.99), and 0.89 (0.82-0.95), respectively. We found an interaction between altitude and sex and between altitude and age (P<0.001, for both interactions) on the association with obesity and abdominal obesity. Conclusions Among Peruvian adult individuals, we found an inverse association between altitude and obesity, adjusting for multiple covariates. This adjusted association varied by sex and age. PMID:26935008

  6. Inverse association between altitude and obesity: A prevalence study among andean and low-altitude adult individuals of Peru.

    PubMed

    Woolcott, Orison O; Gutierrez, Cesar; Castillo, Oscar A; Elashoff, Robert M; Stefanovski, Darko; Bergman, Richard N

    2016-04-01

    To determine the association between altitude and obesity in a nationally representative sample of the Peruvian adult population. This is a cross-sectional analysis of publicly available data from the Food and Nutrition National Center (CENAN, Peru), period 2009-2010. The Prevalence ratio of obesity and abdominal obesity was determined as a measure of association. Obesity and abdominal obesity were diagnosed based on direct anthropometric measurements. The final data set consisted of 31,549 individuals ≥20 years old. The prevalence ratio of obesity was as follows: 1.00 between 0 and 499 m (reference category), 1.00 (95% confidence interval 0.87-1.16) between 500-1,499 m, 0.74 (0.63-0.86) between 1,500-2,999 m, and 0.54 (0.45-0.64) at ≥3,000 m, adjusting for age, sex, self-reported physical activity, out-migration rate, urbanization, poverty, education, and geographical latitude and longitude. In the same order, the adjusted prevalence ratio of abdominal obesity was 1.00, 1.01 (0.94-1.07), 0.93 (0.87-0.99), and 0.89 (0.82-0.95), respectively. We found an interaction between altitude and sex and between altitude and age (P < 0.001, for both interactions) on the association with obesity and abdominal obesity. Among Peruvian adult individuals, we found an inverse association between altitude and obesity, adjusting for multiple covariates. This adjusted association varied by sex and age. © 2016 The Obesity Society.

  7. Risk-adjusted sequential probability ratio tests: applications to Bristol, Shipman and adult cardiac surgery.

    PubMed

    Spiegelhalter, David; Grigg, Olivia; Kinsman, Robin; Treasure, Tom

    2003-02-01

    To investigate the use of the risk-adjusted sequential probability ratio test in monitoring the cumulative occurrence of adverse clinical outcomes. Retrospective analysis of three longitudinal datasets. Patients aged 65 years and over under the care of Harold Shipman between 1979 and 1997, patients under 1 year of age undergoing paediatric heart surgery in Bristol Royal Infirmary between 1984 and 1995, adult patients receiving cardiac surgery from a team of cardiac surgeons in London,UK. Annual and 30-day mortality rates. Using reasonable boundaries, the procedure could have indicated an 'alarm' in Bristol after publication of the 1991 Cardiac Surgical Register, and in 1985 or 1997 for Harold Shipman depending on the data source and the comparator. The cardiac surgeons showed no significant deviation from expected performance. The risk-adjusted sequential probability test is simple to implement, can be applied in a variety of contexts, and might have been useful to detect specific instances of past divergent performance. The use of this and related techniques deserves further attention in the context of prospectively monitoring adverse clinical outcomes.

  8. A review of terrorism and its reduction of the gender ratio at birth after seasonal adjustment.

    PubMed

    Grech, Victor; Zammit, Dorota

    2017-12-01

    Males are born in excess of females, a ratio expressed as M/T (males:total births). The ratio exhibits seasonal variation. Furthermore, acute stressful events may result in a transient dip in male births due to excess foetal losses, reducing M/T. This study was carried out in order to identify significant M/T dips after adjusting for seasonality. Live births by gender and month were sought for acute stressful events. After seasonal correction (where appropriate), M/T dips were sought. Live births. M/T dips. This paper studied 112,226,306 live births. The following events showed dips ≤5th percentile 3-5months after these acute episodes: the Brooklyn Bridge protests, Katrina Hurricane for all 4 states and for each individual state (Alabama, Florida, Louisiana, Mississippi), the Battle in Seattle, the London bombings, The Madrid bombings (for Madrid and for Spain), the Breivik shooting, the Oklahoma City bombing and the Sandy Hook Elementary School shooting. The Virginia Polytechnic Institute and State University shooting the Fukushima Daiichi nuclear disaster also showed dips albeit slightly later. Seasonal adjustments should be taken into consideration in order to avoid Type 1 or 2 error pitfalls. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Heterogeneity in Periodontitis Prevalence in the Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Sanders, Anne E.; Campbell, Steven M.; Beck, James D.; Mauriello, Sally M.; Jimenez, Monik C.; Kaste, Linda M.; Singer, Richard H.; Beaver, Shirley M.; Finlayson, Tracy L.; Badner, Victor M.

    2014-01-01

    Purpose To examine acculturation and established risk factors in explaining variation in periodontitis prevalence among Hispanic/Latino subgroups. Methods Participants were 12,730 dentate adults aged 18–74 years recruited into the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four U.S. field centers between 2008 and 2011. A standardized periodontal assessment measured probing pocket depth and gingival recession at six sites per tooth for up to 28 teeth. Periodontitis was defined according to the CDC/AAP case classifications developed for population surveillance. Covariates included acculturation indicators and established periodontitis risk factors. Survey estimation procedures took account of the complex sampling design. Adjusted multivariate binomial regression estimated prevalence ratios (PR) and 95% confidence limits (95% CL). Results Unadjusted prevalence of moderate/severe periodontitis was 38.5% and ranged from 24.7% among Dominicans to 52.1% among Cubans. Adjusted prevalence ratios for subgroups relative to Dominicans were: 1.34 (95% CL: 1.13, 1.58) among South Americans; 1.37 (95% CL: 1.17, 1.61) among Puerto Ricans; 1.43 (95% CL: 1.25, 1.64) among Mexicans; 1.53 (95% CL: 1.32, 1.76) among Cubans; and 1.55 (95% CL: 1.35, 1.78) among Central Americans. Conclusion Heterogeneity in prevalence of moderate/severe periodontitis among Hispanic/Latino subpopulations was not explained by acculturation or periodontitis risk factors. PMID:24731697

  10. Standardized Prevalence Ratios for Chronic Hepatitis C Virus Infection Among Adult Japanese Hemodialysis Patients

    PubMed Central

    Ohsawa, Masaki; Kato, Karen; Itai, Kazuyoshi; Tanno, Kozo; Fujishima, Yosuke; Konda, Ryuichiro; Okayama, Akira; Abe, Koichi; Suzuki, Kazuyuki; Nakamura, Motoyuki; Onoda, Toshiyuki; Kawamura, Kazuko; Sakata, Kiyomi; Akiba, Takashi; Fujioka, Tomoaki

    2010-01-01

    Background Many studies have estimated the prevalence of anti-hepatitis C virus (HCV) antibody among hemodialysis (HD) patients; however, the prevalence of HCV core antigen—which indicates the presence of chronic HCV infection—is not known. Methods Standardized prevalence ratios (SPRs) for anti-HCV antibody and HCV core antigen among HD patients (n = 1214) were calculated on the basis of data from the general population (n = 22 472) living in the same area. Results The prevalences of anti-HCV antibody and HCV core antigen were 12.5% and 7.8%, respectively, in male hemodialysis patients, and 8.5% and 4.1% in female hemodialysis patients. The SPRs (95% confidence interval) for anti-HCV antibody and HCV core antigen were 8.39 (6.72–10.1) and 12.9 (9.66–16.1), respectively, in males, and 5.42 (3.67–7.17) and 8.77 (4.72–12.8) in females. Conclusions The prevalences of chronic HCV infection among male and female HD patients were 13-fold and 9-fold, respectively, those of the population-based controls. Further studies should therefore be conducted to determine the extent of chronic HCV infection among HD patients in other populations and to determine whether chronic HCV infection contributes to increased mortality in HD patients. PMID:19881229

  11. The prevalence and determinants of hypothyroidism in hospitalized patients with type 2 diabetes mellitus.

    PubMed

    Song, Fei; Bao, Cuiping; Deng, Meiyu; Xu, Hui; Fan, Meijuan; Paillard-Borg, Stéphanie; Xu, Weili; Qi, Xiuying

    2017-01-01

    The purpose of this study was to investigate the prevalence of hypothyroidism among hospitalized patients with type 2 diabetes mellitus and its related factors, and to assess the prevalence of macrovascular and microvascular diseases among type 2 diabetes mellitus inpatients with hypothyroidism and euthyroidism. A total of 1662 type 2 diabetes mellitus inpatients hospitalized at the Metabolic Diseases Hospital, Tianjin Medical University from 1 January 2008 to 1 March 2013 were included in this study. Information on demographic and anthropometric factors and additional variables related to hypothyroidism were collected from medical records. Prevalence rates were calculated and standardized using direct method based on the age-specific and sex-specific structure of all participants. Data were analyzed using binary logistic regression with adjustment for potential confounders. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and 77.0 % of the patients with hypothyroidism had subclinical hypothyroidism. The prevalence of hypothyroidism increased with age, and was higher in women (10.8 %) than in men (3.4 %). Older age (odds ratio, 1.74; 95 % confidence interval, 1. 05 to 2.89), female gender (odds ratio, 2.02; 95 % confidence interval, 1.05 to 3.87), and positive thyroid peroxidase antibody (odds ratio, 4.99; 95 % confidence interval, 2.83 to 8.79) were associated with higher odds of hypothyroidism among type 2 diabetes mellitus inpatients. The type 2 diabetes mellitus inpatients with hypothyroidism had higher prevalence of cerebrovascular diseases than those with euthyroidism after adjustment for age and gender. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and most patients had subclinical hypothyroidism. Older age, female gender, and positive thyroid peroxidase antibody could be indicators for detecting hypothyroidism in type 2 diabetes mellitus inpatients.

  12. Asian Americans: diabetes prevalence across U.S. and World Health Organization weight classifications.

    PubMed

    Oza-Frank, Reena; Ali, Mohammed K; Vaccarino, Viola; Narayan, K M Venkat

    2009-09-01

    To compare diabetes prevalence among Asian Americans by World Health Organization and U.S. BMI classifications. Data on Asian American adults (n = 7,414) from the National Health Interview Survey for 1997-2005 were analyzed. Diabetes prevalence was estimated across weight and ethnic group strata. Regardless of BMI classification, Asian Indians and Filipinos had the highest prevalence of overweight (34-47 and 35-47%, respectively, compared with 20-38% in Chinese; P < 0.05). Asian Indians also had the highest ethnic-specific diabetes prevalence (ranging from 6-7% among the normal weight to 19-33% among the obese) compared with non-Hispanic whites: odds ratio (95% CI) for Asian Indians 2.0 (1.5-2.6), adjusted for age and sex, and 3.1 (2.4-4.0) with additional adjustment for BMI. Asian Indian ethnicity, but not other Asian ethnicities, was strongly associated with diabetes. Weight classification as a marker of diabetes risk may need to accommodate differences across Asian subgroups.

  13. Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand.

    PubMed

    Becerra-Fernández, Antonio; Rodríguez-Molina, José Miguel; Asenjo-Araque, Nuria; Lucio-Pérez, María Jesús; Cuchí-Alfaro, Miguel; García-Camba, Eduardo; Pérez-López, Gilberto; Menacho-Román, Miriam; Berrocal-Sertucha, María Carmen; Ly-Pen, Domingo; Aguilar-Vilas, María Victorina

    2017-07-01

    In recent years, different studies have provided estimates of the prevalence of transsexualism with very diverse results. The purpose of this study was to ascertain the prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain). A total of 1234 patients who attended from 2007 to the end of 2015 in the only Gender Identity Unit (GIU) in Madrid were analyzed. Sixty-three patients were excluded for various reasons; thus, 1171 could be included: 803 male-to-female (MtF) and 368 female-to-male (FtM) transsexual patients. Transsexualism was diagnosed based on the ICD-10, World Health Organization, 1992, and/or gender identity disorder based on the DSM-IV-TR, American Psychiatric Association, 2000. The demographic statistics were calculated on the basis of the population over 15 years old of Madrid. Based on healthcare demand, the prevalence of transsexualism was 22.1 in 100,000 inhabitants: 31.2 for MtF and 12.9 for FtM, making the MtF/FtM ratio approximately 2.2:1. The incidence rate was 2.5 in 100,000 inhabitants, representing an annual average of 130 demands. Although transsexualism occurs in all countries with different rates of prevalence, in our area, this prevalence was higher than reported from other European countries. We believe that two main circumstances might influence this high prevalence: the easy accessibility and the absence of a waiting list to the GIU, and the permissive social and legal climate and openness of Spain, especially in Madrid.

  14. Applied Prevalence Ratio estimation with different Regression models: An example from a cross-national study on substance use research.

    PubMed

    Espelt, Albert; Marí-Dell'Olmo, Marc; Penelo, Eva; Bosque-Prous, Marina

    2016-06-14

    To examine the differences between Prevalence Ratio (PR) and Odds Ratio (OR) in a cross-sectional study and to provide tools to calculate PR using two statistical packages widely used in substance use research (STATA and R). We used cross-sectional data from 41,263 participants of 16 European countries participating in the Survey on Health, Ageing and Retirement in Europe (SHARE). The dependent variable, hazardous drinking, was calculated using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C). The main independent variable was gender. Other variables used were: age, educational level and country of residence. PR of hazardous drinking in men with relation to women was estimated using Mantel-Haenszel method, log-binomial regression models and poisson regression models with robust variance. These estimations were compared to the OR calculated using logistic regression models. Prevalence of hazardous drinkers varied among countries. Generally, men have higher prevalence of hazardous drinking than women [PR=1.43 (1.38-1.47)]. Estimated PR was identical independently of the method and the statistical package used. However, OR overestimated PR, depending on the prevalence of hazardous drinking in the country. In cross-sectional studies, where comparisons between countries with differences in the prevalence of the disease or condition are made, it is advisable to use PR instead of OR.

  15. Rheumatoid arthritis prevalence in Quebec.

    PubMed

    Bernatsky, Sasha; Dekis, Alaa; Hudson, Marie; Pineau, Christian A; Boire, Gilles; Fortin, Paul R; Bessette, Louis; Jean, Sonia; Chetaille, Ann L; Belisle, Patrick; Bergeron, Louise; Feldman, Debbie Ehrmann; Joseph, Lawrence

    2014-12-19

    To estimate rheumatoid arthritis (RA) prevalence in Quebec using administrative health data, comparing across regions. Cases of RA were ascertained from physician billing and hospitalization data, 1992-2008. We used three case definitions: 1) ≥ 2 billing diagnoses, submitted by any physician, ≥ 2 months apart, but within 2 years; 2) ≥ 1 diagnosis, by a rheumatologist; 3) ≥1 hospitalization diagnosis (all based on ICD-9 code 714, and ICD-10 code M05). We combined data across these three case definitions, using Bayesian hierarchical latent class models to estimate RA prevalence, adjusting for the imperfect sensitivity and specificity of the data. We compared urban versus rural regions. Using our case definitions and no adjustment for error, we defined 75,760 cases for an over-all RA prevalence of 9.9 per thousand residents. After adjusting for the imperfect sensitivity and specificity of our case definition algorithms, we estimated Quebec RA prevalence at 5.6 per 1000 females and 4.1 per 1000 males. The adjusted RA prevalence estimates for older females were the highest for any demographic group (9.9 cases per 1,000), and were similar in rural and urban regions. In younger males and females, and in older males, RA prevalence estimates were lower in rural versus urban areas. Without adjustment for error inherent in administrative databases, RA prevalence in Quebec was approximately 1%, while adjusted estimates are approximately half that. The lower prevalence in rural areas, seen for most demographic groups, may suggest either true regional variations in RA risk, or under-ascertainment of cases in rural Quebec.

  16. Prevalence of chronic diseases according to socioeconomic status measured by wealth index: health survey in Serbia.

    PubMed

    Vuković, Dejana; Bjegović, Vesna; Vuković, Goran

    2008-12-01

    To examine socioeconomic inequalities in the prevalence of chronic diseases in Serbia, using the data from 2006 national health survey. A stratified sample of 7673 households was selected and 14522 household members older than 20 years were interviewed (response rate 80.5%). Wealth index was used as a measure of socioeconomic status. Standardized morbidity prevalence ratios were computed using the poorest category as reference. Odds ratios for the prevalence of the selected chronic diseases and their 95% confidence intervals were calculated by multivariate logistic analysis adjusted for age, education, smoking status, and body mass index. Hypertension was the most prevalent disease in all socioeconomic categories; standardized morbidity prevalence ratios were higher in richer men (151.3 in the richest) and lower in richer women (86.1 in the richest). Rheumatism/arthritis was the second most prevalent disease in both sexes, with the highest prevalence in the poorest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 86.4 in men and 74.0 in women). The prevalence of hyperlipidemia was associated with wealth index in both men and women and was highest in the richest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 275.9 in men and 138.4 in women). Logistic regression models showed that higher wealth index was associated with higher prevalence of hypertension, hyperlipidemia, and allergy, while lower wealth index was associated with higher prevalence of rheumatism/arthritis. There were considerable socioeconomic inequalities in the prevalence of chronic diseases in Serbia. These results indicate an opportunity to reduce inequalities and show a need for further investigation on the determinants of chronic diseases.

  17. Correlation of MRI-derived adipose tissue measurements and anthropometric markers with prevalent hypertension in the community.

    PubMed

    Lorbeer, Roberto; Rospleszcz, Susanne; Schlett, Christopher L; Heber, Sophia D; Machann, Jürgen; Thorand, Barbara; Meisinger, Christa; Heier, Margit; Peters, Annette; Bamberg, Fabian; Lieb, Wolfgang

    2018-07-01

    To compare the correlations of MRI-derived adipose tissue measurements and anthropometric markers, respectively, with prevalent hypertension in a community-based sample, free of clinical cardiovascular disease. MRI-derived adipose tissue measurements were obtained in 345 participants (143 women; age 39-73 years) of the KORA FF4 survey from Southern Germany using a 3-Tesla machine and included total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SCAT), hepatic fat fraction (HFF), pancreatic fat fraction (PFF) as well as pericardial adipose tissue (PAT). In addition, the anthropometric markers body mass index, waist circumference, hip circumference, waist-hip ratio (WHR) and waist-height ratio (WHtR) as well as blood pressure measurements were obtained. The prevalence of hypertension was 33.6% (women: 28%, men: 38%). VAT and PAT had the highest area under the curve (AUC) values for identifying individuals with prevalent hypertension (AUC: 0.75; 0.73, respectively), whereas WHtR and waist circumference were best performing anthropometric markers (AUC: 0.72; 0.70, respectively). A 1SD increment of TAT was associated with the highest odd for hypertension in the age-adjusted and sex-adjusted model (OR = 2.20, 95% CI 1.67-2.91, P < 0.001) and in the fully adjusted model (OR = 1.97, 95% CI 1.45-2.66, P < 0.001). TAT was the only MRI-derived adipose tissue measurement that was associated with hypertension independently of the best performing anthropometric marker waist circumference in the fully adjusted model (OR = 1.93, 95% CI 1.00-3.72, P = 0.049). MRI-derived adipose tissue measurements perform similarly in identifying prevalent hypertension compared with anthropometric markers. Especially, TAT, VAT and PAT as well as WHtR and waist circumference were highly correlated with prevalent hypertension.

  18. Gender ratios of administrative prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) across the lifespan: A nationwide population-based study in Taiwan.

    PubMed

    Huang, Charles Lung-Cheng; Weng, Shih-Feng; Ho, Chung-Han

    2016-10-30

    To verify the hypothesis that there is different gender ratio of attention-deficit/hyperactivity disorder (ADHD) among adults compared to children and adolescents in the clinical setting among Asian population. The nationwide population-based database containing data on enrollees in the National Health Insurance program in Taiwan during 2000-2007 was used in this study, and we investigated the lifetime gender ratios of administrative prevalence and incidence in healthcare-seeking ADHD patients (n=228,029). The male-to-female ratios of diagnosed incidence and prevalence of child/adolescent ADHD (age <20 years) ranged from 3.39 to 4.07 and 3.87-4.31, respectively. The male-to-female ratios of diagnosed incidence and prevalence of ADHD in the adult group (age 20-65 years) ranged from 0.24 to 0.76 and 0.35-0.98, respectively. In conclusion, there was substantially increased female-to-male ratio in adults ADHD compared to children and adolescents in the clinical setting. Further researches on the management and mechanism are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Adjustment of the MRSA Search and Destroy policy for outpatients in the Netherlands: a prospective cohort study with repeated prevalence measurements.

    PubMed

    van Rijen, Miranda Ml; Kluytmans, Jan Ajw

    2014-01-15

    In the Netherlands a successful MRSA Search and Destroy policy is applied in healthcare institutes. We determined the effect of an adjustment in the MRSA Search and Destroy policy for patients in the outpatient clinic on the MRSA transmission to health care workers (HCW). In June 2008 an adjustment in the policy for outpatients was introduced in a large teaching hospital. Following this adjustment MRSA positive patients and patients at risk could be seen and treated applying general precautions, without additional protective measures. Also, disinfection of the room after the patient had left was abandoned. To monitor the effect of this policy on the transmission of MRSA all physicians and health care workers of the outpatient clinic were screened for MRSA carriage repeatedly. Before the introduction of the adjusted policy all physicians and HCW of the outpatient clinic were screened (=0-measurement, n = 1,073). None of them was found to be MRSA positive. After introduction of the policy in June 2008 the screening was repeated in October 2008 (n = 1,170) and April 2009 (n = 1,128). In April 2009 one health care worker was MRSA positive resulting in a mean prevalence of 0.09%. This is lower than the known prevalence in HCW. The health care worker was colonized with the livestock-related Spa type t011. As far as we could verify, no patients with this Spa-type had been cared for by the health care worker. The adjusted MRSA policy did not lead to detectable transmission of MRSA to HCW and was associated with less disturbances in the work flow.

  20. Scalp seborrheic dermatitis: prevalence and associated factors in male adolescents.

    PubMed

    Breunig, Juliano de Avelar; de Almeida, Hiram Larangeira; Duquia, Rodrigo Pereira; Souza, Paulo Ricardo Martins; Staub, Henrique Luiz

    2012-01-01

    The prevalence of seborrheic dermatitis (SD) in the general population is variable in the literature. Factors associated with SD are not well understood. To verify the prevalence of scalp SD in a selected survey of male adolescents on mandatory military service and to find possible associated factors (skin color, socioeconomic level, triceps skin fold, acne, and tobacco consumption). This cross-sectional study included 18-year-old male adolescents on compulsory military service in a southern Brazilian city. Scalp SD was considered as erythema and scaling in any part of the scalp. Skin color, socioeconomic level, triceps skin fold, acne, and tabagism comprised the independent variables studied in our population. A total of 2201 adolescents entered the study. The global prevalence of scalp SD was 11%. White skin [adjusted prevalence ratio (PR) 1.42; 95% CI 1.06-1.92; P = 0.02] and triceps skin fold >19.5 mm (adjusted PR 1.56; 95% CI 1.12-2.18; P = 0.009) were significantly associated with scalp SD. The other variables were not associated with the outcome. Prevalence of scalp SD in our survey of male adolescents was 11%. The occurrence of scalp SD was associated with white skin and a higher body fat content. © 2012 The International Society of Dermatology.

  1. Socioeconomic inequalities in the incidence and prevalence of type 2 diabetes mellitus in Europe.

    PubMed

    Espelt, Albert; Borrell, Carme; Palència, Laia; Goday, Alberto; Spadea, Teresa; Gnavi, Roberto; Font-Ribera, Laia; Kunst, Anton E

    2013-01-01

    The aim of this study was to analyze socioeconomic position (SEP) inequalities in the prevalence and incidence of type 2 diabetes mellitus (T2DM) in people aged 50 years and over in Europe and to describe the contribution of body mass index (BMI) and other possible mediators. This was a cross-sectional and longitudinal study including men and women ≥ 50 years old in 11 European countries in 2004 and 2006 (n = 21,323). The prevalence and cumulative incidence of T2DM were calculated with self-reported T2DM or when the individual took drugs for diabetes. Prevalence ratio (PR) and relative risk (RR) of prevalent and incident T2DM were calculated according to educational level and adjusted by BMI and other possible mediators. The age-adjusted and country-adjusted prevalence of T2DM in 2004 was 10.2% in men and 8.5% in women. Compared to those with higher education, men and women with lower education had a PR [95% CI] of T2DM of 1.29 [1.12-1.50] and 1.61 [1.39-1.86], respectively. SEP-related inequalities in incidence (RR [95%CI]) were 1.88 [1.35-2.62] in women and 1.04 [0.78-1.40] in men. Adjusting for potential mediators reduced inequalities in the prevalence and incidence of T2DM among women by 26.2% and 21.6%, respectively, and inequalities in prevalence among men by 44.8%. We observed significant inequalities in the prevalence and incidence (women only) of T2DM as a function of socioeconomic position. These inequalities were mediated by BMI. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. [Association between waist circumference and the prevalence/control of hypertension by gender and different body mass index classification in an urban elderly population].

    PubMed

    Wu, Lei; He, Yao; Jiang, Bin; Liu, Miao; Yang, Shanshan; Zeng, Jing; Wang, Yiyan; Wang, Jianhua; Zhang, Di

    2015-12-01

    The aim of the present study was to evaluate the association between waist circumference and the prevalence/control of hypertension in an urban elderly population. From September 2009 to June 2010, a population-based cross-sectional study was conducted in Wanshoulu area of Beijing, China. A total of 2 035 elderly (828 male, 1 207 females) participants aged ≥60 years from a community were included in this study for data analysis. We found that the increased waist circumference could significantly increase the risk of prevalence and poor control of hypertension, with the adjusted odds ratios (95% CI) as 1.04 (1.01-1.08) and 0.96 (0.92-1.00) , respectively. Among those identified pure central obesity females (64.7%) , the prevalence of hypertension was significantly higher than those females with normal body mass index (BMI) or with normal waist circumference (52.2%). The adjusted odds ratio (95%CI) between the above said groups appeared as 1.58 (1.07-2.32). The control rate of hypertension among females (32.9%) with pure central obesity, was lower than that of the females with normal BMI and waist circumference (43.5%) , with an adjusted odds ratio (95%CI) as 0.62 (0.37-1.04, P=0.071). There appeared significant association between people with pure central obesity and the increased risk of prevalence or with poor control of hypertension. More attention should be paid to both the prevalence and control of hypertension programs among females with pure central obesity.

  3. Active epilepsy prevalence, the treatment gap, and treatment gap risk profile in eastern China: A population-based study.

    PubMed

    Ding, Xiaoyan; Zheng, Yang; Guo, Yi; Shen, Chunhong; Wang, Shan; Chen, Feng; Yan, Shengqiang; Ding, Meiping

    2018-01-01

    We measured the prevalence of active epilepsy and investigated the treatment gap and treatment gap risk profile in eastern China. This was a cross-sectional population-based survey conducted in Zhejiang, China, from October 2013 to March 2014. A total 54,976 people were selected using multi-stage cluster sampling. A two-stage questionnaire-based process was used to identify patients with active epilepsy and to record their demographic, socioeconomic, and epilepsy-related features. Logistic regression analysis was used to analyze risk factors of the treatment gap in eastern China, as adjusted for age and sex. We interviewed 50,035 people; 118 had active epilepsy (2.4‰), among which the treatment gap was 58.5%. In multivariate analysis, failure to receive appropriate antiepileptic treatment was associated with higher seizure frequency of 12-23 times per year (adjusted odds ratio=6.874; 95% confidence interval [CI]=2.372-19.918), >24 times per year (adjusted odds ratio=19.623; 95% CI=4.999-77.024), and a lack of health insurance (adjusted odds ratio=7.284; 95% CI=1.321-40.154). Eastern China has relatively lower prevalence of active epilepsy and smaller treatment gap. Interventions aimed at reducing seizure frequency, improving the health insurance system should be investigated as potential targets to further bridge the treatment gap. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Association of urinary sodium/creatinine ratio with bone mineral density in postmenopausal women: KNHANES 2008-2011.

    PubMed

    Kim, Sung-Woo; Jeon, Jae-Han; Choi, Yeon-Kyung; Lee, Won-Kee; Hwang, In-Ryang; Kim, Jung-Guk; Lee, In-Kyu; Park, Keun-Gyu

    2015-08-01

    Accumulating evidence shows that high sodium chloride intake increases urinary calcium excretion and may be a risk factor for osteoporosis. However, the effect of oral sodium chloride intake on bone mineral density (BMD) and risk of osteoporosis has been inadequately researched. The aim of the present study was to determine whether urinary sodium excretion (reflecting oral sodium chloride intake) associates with BMD and prevalence of osteoporosis in postmenopausal women. This cross-sectional study involved a nationally representative sample consisting of 2,779 postmenopausal women who participated in the Korea National Health and Nutritional Examination Surveys in 2008-2011. The association of urinary sodium/creatinine ratio with BMD and other osteoporosis risk factors was assessed. In addition, the prevalence of osteoporosis was assessed in four groups with different urinary sodium/creatinine ratios. Participants with osteoporosis had significantly higher urinary sodium/creatinine ratios than the participants without osteoporosis. After adjusting for multiple confounding factors, urinary sodium/creatinine ratio correlated inversely with lumbar spine BMD (P = 0.001). Similarly, when participants were divided into quartile groups according to urinary sodium/creatinine ratio, the average BMD dropped as the urinary sodium/creatinine ratio increased. Multiple logistic regression analysis revealed that compared to quartile 1, quartile 4 had a significantly increased prevalence of lumbar spine osteoporosis (odds ratios 1.346, P for trend = 0.044). High urinary sodium excretion was significantly associated with low BMD and high prevalence of osteoporosis in lumbar spine. These results suggest that high sodium chloride intake decreases lumbar spine BMD and increases the risk of osteoporosis in postmenopausal women.

  5. Speech perception at positive signal-to-noise ratios using adaptive adjustment of time compression.

    PubMed

    Schlueter, Anne; Brand, Thomas; Lemke, Ulrike; Nitzschner, Stefan; Kollmeier, Birger; Holube, Inga

    2015-11-01

    Positive signal-to-noise ratios (SNRs) characterize listening situations most relevant for hearing-impaired listeners in daily life and should therefore be considered when evaluating hearing aid algorithms. For this, a speech-in-noise test was developed and evaluated, in which the background noise is presented at fixed positive SNRs and the speech rate (i.e., the time compression of the speech material) is adaptively adjusted. In total, 29 younger and 12 older normal-hearing, as well as 24 older hearing-impaired listeners took part in repeated measurements. Younger normal-hearing and older hearing-impaired listeners conducted one of two adaptive methods which differed in adaptive procedure and step size. Analysis of the measurements with regard to list length and estimation strategy for thresholds resulted in a practical method measuring the time compression for 50% recognition. This method uses time-compression adjustment and step sizes according to Versfeld and Dreschler [(2002). J. Acoust. Soc. Am. 111, 401-408], with sentence scoring, lists of 30 sentences, and a maximum likelihood method for threshold estimation. Evaluation of the procedure showed that older participants obtained higher test-retest reliability compared to younger participants. Depending on the group of listeners, one or two lists are required for training prior to data collection.

  6. [Prevalence and user profile of electronic cigarettes in Spain (2014)].

    PubMed

    Lidón-Moyano, Cristina; Martínez-Sánchez, Jose M; Fu, Marcela; Ballbè, Montse; Martín-Sánchez, Juan Carlos; Fernández, Esteve

    To describe the prevalence and user profile of electronic cigarettes among Spanish adults and evaluate the potential dual use of these devices with combustible or conventional tobacco in 2014 in Spain. Cross-sectional study of a representative sample of the Spanish adult (16-75 years old) population (n=1,016). A computer-assisted telephone survey was conducted in 2014. The prevalence and 95% confidence intervals (95% CI) for the use of electronic cigarettes stratified by gender, age, tobacco consumption and social status were calculated. The sample was weighted and a logistic regression model adjusted to obtain the crude odds ratios (OR) adjusted by gender, age and social status. 10.3% (95% CI: 8.6-12.4) of the Spanish adult population stated being ever users of electronic cigarettes (2% current users, 3.2% past users and 5.1% experimental users). Among current electronic cigarette users, 57.2% also smoked combustible or conventional tobacco, 28% had never smoked and 14.8% were former smokers. The prevalence of electronic cigarette use was higher in the younger population (adjusted OR=23.8; 95% CI: 2.5-227.7) and smokers of combustible tobacco (adjusted OR=10.1; 95% CI: 5.8-17.5). The use of electronic cigarettes in Spain is scarce and is most prevalent among young people and tobacco smokers. Nevertheless, one out of four current electronic cigarette users have never smoked. Hence, the regulation of these devices should be reinforced to avoid a possible gateway to nicotine products among never smokers. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Prevalence of asthma in school children on the Arizona-Sonora Border

    PubMed Central

    Carr, Tara F; Beamer, Paloma I; Rothers, Janet; Stern, Debra A; Gerald, Lynn B; Rosales, Cecilia B.; Van Horne, Yoshira Ornelas; Pivniouk, Oksana N; Vercelli, Donata; Halonen, Marilyn; Gameros, Mercedes; Martinez, Fernando D; Wright, Anne L

    2016-01-01

    Background Mexican-born children living in the US have a lower prevalence of asthma than other US children. While children of Mexican descent near the Arizona-Sonora border are genetically similar, differences in environmental exposures might result in differences in asthma prevalence across this region. Objective To determine if the prevalence of asthma and wheeze in these children varies across the AZ-Sonora border. Methods The International Study of Asthma and Allergy in Children written and video questionnaires were administered to 1753 adolescents from five middle schools: Tucson (school A), Nogales, AZ (schools B, C), and Nogales, Sonora, Mexico (schools D, E). Prevalence of asthma and symptoms was compared, with analyses in the AZ schools limited to self-identified Mexican-American students. Results Compared with the Sonoran reference school E, the adjusted odds ratio for asthma was significantly higher in US schools A (OR 4.89, 95%CI 2.72-8.80), B (3.47, 1.88-6.42), and C (4.12, 1.78-9.60). The adjusted odds ratio for wheeze in the past year was significantly higher in schools A (2.19, 1.20-4.01) and B (2.67, 1.42-5.01) on the written questionnaire and significantly higher in A (2.13, 1.22-3.75), B (1.95, 1.07-3.53) and Sonoran school D (2.34, 1.28-4.30) on the video questionnaire compared with school E. Conclusion Asthma and wheeze prevalence differed significantly between schools and was higher in the US. Environmental factors that may account for these differences could provide insight into mechanisms of protection from asthma. PMID:27544711

  8. Association between Hypertension and the Prevalence of Low Back Pain and Osteoarthritis in Koreans: A Cross-Sectional Study

    PubMed Central

    Bae, Young-Hyeon; Shin, Joon-Shik; Lee, Jinho; Kim, Me-riong; Park, Ki Byung; Cho, Jae-Heung; Ha, In-Hyuk

    2015-01-01

    Background Hypertension and musculoskeletal disorders are highly prevalent in adult populations. The objective of this study was to investigate the association between hypertension and prevalence of low back pain (LBP) and osteoarthritis in Koreans. Methods A total 17,128 participants (age ≥20 years) who answered low back pain and osteoarthritis items in the 4th Korean National Health and Nutrition Examination Survey (2007–2009) were analyzed. Odds ratios were calculated using logistic regression and were adjusted for age, sex, income level, education, occupation, BMI, smoking status, alcohol consumption, and physical activity. Results Lifetime prevalence of LBP in hypertensive subjects was 34.4%, and that of osteoarthritis 26.2%. LBP prevalence was significantly lower in hypertensives (fully adjusted OR 0.79; 95% CI 0.70–0.90), and both LBP and osteoarthritis prevalence was significantly lower in participants with systolic blood pressure ≥140mmHg than those with <120mmHg (fully adjusted OR 0.81; 95% CI 0.70–0.94, and 0.81; 95% CI 0.68–0.96, respectively). Prevalence of LBP in subjects with diastolic blood pressure ≥90mmHg was also significantly lower than those with <80mmHg (fully adjusted OR 0.73; 95% CI 0.63–0.85). LBP and osteoarthritis prevalence did not differ by systolic or diastolic blood pressure interval in respondents taking antihypertensive medication. LBP and osteoarthritis prevalence increased with longer hypertension duration (fully adjusted p for trend 0.028, and 0.0008, respectively). Conclusions Hypertension showed an inverse relationship with LBP and osteoarthritis prevalence, which may be ascribed to hypertension-associated hypalgesia, and antihypertensive medication intake and longer hypertension duration attenuated this association. PMID:26393797

  9. Persistent sex-by-environment effects on offspring fitness and sex-ratio adjustment in a wild bird population.

    PubMed

    Bowers, E Keith; Thompson, Charles F; Sakaluk, Scott K

    2015-03-01

    A major component of sex-allocation theory, the Trivers-Willard model (TWM), posits that sons and daughters are differentially affected by variation in the rearing environment. In many species, the amount of parental care received is expected to have differing effects on the fitness of males and females. When this occurs, the TWM predicts that selection should favour adjustment of the offspring sex ratio in relation to the expected fitness return from offspring. However, evidence for sex-by-environment effects is mixed, and little is known about the adaptive significance of producing either sex. Here, we test whether offspring sex ratios vary according to predictions of the TWM in the house wren (Troglodytes aedon, Vieillot). We also test the assumption of a sex-by-environment effect on offspring using two experiments, one in which we manipulated age differences among nestlings within broods, and another in which we held nestling age constant but manipulated brood size. As predicted, females with high investment ability overproduced sons relative to those with lower ability. Males were also overproduced early within breeding seasons. In our experiments, the body mass of sons was more strongly affected by the sibling-competitive environment and resource availability than that of daughters: males grew heavier than females when reared in good conditions but were lighter than females when in poor conditions. Parents rearing broods with 1:1 sex ratios were more productive than parents rearing broods biased more strongly towards sons or daughters, suggesting that selection favours the production of mixed-sex broods. However, differences in the condition of offspring as neonates persisted to adulthood, and their reproductive success as adults varied with the body mass of sons, but not daughters, prior to independence from parental care. Thus, selection should favour slight but predictable variations in the sex ratio in relation to the quality of offspring that parents are

  10. COPD prevalence in a random population survey: a matter of definition.

    PubMed

    Shirtcliffe, P; Weatherall, M; Marsh, S; Travers, J; Hansell, A; McNaughton, A; Aldington, S; Muellerova, H; Beasley, R

    2007-08-01

    A recent American Thoracic Society and European Respiratory Society joint Task Force report recommends using a lower limit of normal (LLN) of forced expiratory volume in one second/forced vital capacity as opposed to a fixed ratio of <0.7 to diagnose airflow obstruction, in order to reduce false positive diagnoses of chronic obstructive pulmonary disease (COPD) as defined by the Global Initiative for Obstructive Lung Disease (GOLD). To date, there is no reliable spirometry-based prevalence data for COPD in New Zealand and the effect of different definitions of airflow obstruction based on post-bronchodilator spirometry is not known. Detailed written questionnaires, full pulmonary function tests (including pre- and post-bronchodilator flow-volume loops) and atopy testing were completed in 749 subjects recruited from a random population sample. The GOLD-defined, age-adjusted prevalence (95% confidence interval) for adults aged >or=40 yrs was 14.2 (11.0-17.0)% compared with an LLN-defined, age-adjusted, post-bronchodilator prevalence in the same group of 9.0 (6.7-11.3)%. The prevalence of chronic obstructive pulmonary disease varied markedly depending on the definition used. Further research using longitudinal rather than cross-sectional data will help decide the preferred approach in chronic obstructive pulmonary disease prevalence surveys.

  11. Does sitting height ratio affect estimates of obesity prevalence among Canadian Inuit? Results from the 2007-2008 Inuit Health Survey.

    PubMed

    Galloway, Tracey; Chateau-Degat, Marie-Ludivine; Egeland, Grace M; Young, T Kue

    2011-01-01

    High sitting height ratio (SHR) is a characteristic commonly associated with Inuit morphology. Inuit are described as having short leg lengths and high trunk-to-stature proportions such that cutoffs for obesity derived from European populations may not adequately describe thresholds of disease risk. Further, high SHR may help explain the reduced impact of BMI on metabolic risk factors among Inuit relative to comparison populations. This study investigates the relationship between SHR and body mass index (BMI) in Inuit. Subjects are 2,168 individuals (837 males and 1,331 females) from 36 Inuit communities in the Canadian Arctic. Mean age is 42.63 ± 14.86 years in males and 41.71 ± 14.83 years in females. We use linear regression to examine the association between age, sex, height, sitting height, SHR, waist circumference (WC), and BMI. We then evaluate the efficacy of the relative sitting height adjustment as a method of correcting observed BMI to a population-standardized SHR. Mean BMI is significantly higher than among non-Inuit Canadians. Obesity prevalence is high, particularly among Inuit women. In the regression, only age and WC are significant predictors of BMI. While SHR is significantly greater than that of the US population, there is substantial agreement between overweight and obesity prevalence using observed and corrected BMI. We find no consistent relationship between SHR and BMI and suggest the unique anthropometric and metabolic profile observed in Inuit arise from factors not yet delineated. More complex anthropometric and imaging studies in Inuit are needed. Copyright © 2011 Wiley-Liss, Inc.

  12. The Prevalence and Incidence of Epiretinal Membranes in Eyes With Inactive Extramacular CMV Retinitis

    PubMed Central

    Kozak, Igor; Vaidya, Vijay; Van Natta, Mark L.; Pak, Jeong W.; May, K. Patrick; Thorne, Jennifer E.

    2014-01-01

    Purpose. To determine the prevalence and incidence of epiretinal membranes (ERM) in eyes with inactive extramacular cytomegalovirus (CMV) retinitis in patients with acquired immune deficiency syndrome (AIDS). Methods. A case–control report from a longitudinal multicenter observational study by the Studies of the Ocular Complications of AIDS (SOCA) Research Group. A total of 357 eyes of 270 patients with inactive CMV retinitis and 1084 eyes of 552 patients with no ocular opportunistic infection (OOI) were studied. Stereoscopic views of the posterior pole from fundus photographs were assessed at baseline and year 5 visits for the presence of macular ERM. Generalized estimating equations (GEE) logistic regression was used to compare the prevalence and 5-year incidence of ERM in eyes with and without CMV retinitis at enrollment. Crude and adjusted logistic regression was performed adjusting for possible confounders. Main outcome measures included the prevalence, incidence, estimated prevalence, and incidence odds ratios. Results. The prevalence of ERM at enrollment was 14.8% (53/357) in eyes with CMV retinitis versus 1.8% (19/1084) in eyes with no OOI. The incidence of ERM at 5 years was 18.6% (16/86) in eyes with CMV retinitis versus 2.4% (6/253) in eyes with no OOI. The crude odds ratio (OR) (95% confidence interval, CI) for prevalence was 9.8 (5.5–17.5) (P < 0.01). The crude OR (95% CI) for incidence was 9.4 (3.2–27.9) (P < 0.01). Conclusions. A history of extramacular CMV retinitis is associated with increased prevalence and incidence of ERM formation compared to what is seen in eyes without ocular opportunistic infections in AIDS patients. PMID:24925880

  13. Low Estimated Glomerular Filtration Rate Is Prevalent among North Korean Refugees in South Korea

    PubMed Central

    Song, Young-Soo

    2018-01-01

    Background The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans. Methods Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database. Results The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m2) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02–7.89). Conclusion The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea. PMID:29788704

  14. Low Estimated Glomerular Filtration Rate Is Prevalent among North Korean Refugees in South Korea.

    PubMed

    Song, Young-Soo; Choi, Seong-Woo

    2018-05-01

    The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans. Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database. The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m 2 ) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02-7.89). The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea.

  15. Differences in the triglyceride to HDL-cholesterol ratio between Palestinian and Israeli adults.

    PubMed

    Weiss, Ram; Nassar, Hisham; Sinnreich, Ronit; Kark, Jeremy D

    2015-01-01

    To evaluate differences in the triglyceride to HDL-cholesterol ratio (TG/HDL), thought to be a proxy measure of insulin resistance, between Palestinian and Israeli adults in view of the greater incidence of coronary heart disease and high prevalence of diabetes in Palestinian Arabs. A population-based observational prevalence study of cardiovascular and diabetes risk factors in Jerusalem. Participants (968 Palestinians, 707 Israelis, sampled at ages 25-74 years) underwent fasting and 2 h post-75 g oral challenge plasma glucose determinations. Metabolic risk was assessed using the surrogate index TG/HDL. Sex-specific comparisons were stratified by categories of body mass index and sex-specific waist circumference quartiles, adjusted by regression for age, glucose tolerance status and use of statins. Prevalence of overweight and obesity was substantially larger in Palestinians (p = 0.005). Prevalence of diabetes was 2.4 and 4 fold higher among Palestinian men and women, respectively (p<0.001). Adjusted TG/HDL was higher in Palestinians than Israelis across BMI and waist circumference categories (p<0.001 for both). Higher TG/HDL in Palestinians persisted in analyses restricted to participants with normal glucose tolerance and off statins. Notably, higher TG/HDL among Palestinians prevailed at a young age (25-44 years) and in normal weight individuals of both sexes. Palestinians have a higher TG/HDL ratio than Israelis. Notably, this is evident also in young, healthy and normal weight participants. These findings indicate the need to study the determinants of this biomarker and other measures of insulin resistance in urban Arab populations and to focus research attention on earlier ages: childhood and prenatal stages of development.

  16. Differences in the Triglyceride to HDL-Cholesterol Ratio between Palestinian and Israeli Adults

    PubMed Central

    Weiss, Ram; Nassar, Hisham; Sinnreich, Ronit; Kark, Jeremy D.

    2015-01-01

    Aims To evaluate differences in the triglyceride to HDL-cholesterol ratio (TG/HDL), thought to be a proxy measure of insulin resistance, between Palestinian and Israeli adults in view of the greater incidence of coronary heart disease and high prevalence of diabetes in Palestinian Arabs. Research Methods A population-based observational prevalence study of cardiovascular and diabetes risk factors in Jerusalem. Participants (968 Palestinians, 707 Israelis, sampled at ages 25-74 years) underwent fasting and 2h post-75g oral challenge plasma glucose determinations. Metabolic risk was assessed using the surrogate index TG/HDL. Sex-specific comparisons were stratified by categories of body mass index and sex-specific waist circumference quartiles, adjusted by regression for age, glucose tolerance status and use of statins. Results Prevalence of overweight and obesity was substantially larger in Palestinians (p = 0.005). Prevalence of diabetes was 2.4 and 4 fold higher among Palestinian men and women, respectively (p<0.001). Adjusted TG/HDL was higher in Palestinians than Israelis across BMI and waist circumference categories (p<0.001 for both). Higher TG/HDL in Palestinians persisted in analyses restricted to participants with normal glucose tolerance and off statins. Notably, higher TG/HDL among Palestinians prevailed at a young age (25-44 years) and in normal weight individuals of both sexes. Conclusions Palestinians have a higher TG/HDL ratio than Israelis. Notably, this is evident also in young, healthy and normal weight participants. These findings indicate the need to study the determinants of this biomarker and other measures of insulin resistance in urban Arab populations and to focus research attention on earlier ages: childhood and prenatal stages of development. PMID:25635396

  17. Prevalence of depression, anxiety, and adjustment disorders in women with spontaneous abortion in Germany - A retrospective cohort study.

    PubMed

    Jacob, Louis; Polly, Ines; Kalder, Matthias; Kostev, Karel

    2017-12-01

    The aim of this study was to analyze the prevalence of depression, anxiety, and adjustment disorders in women within the year following miscarriage in Germany. This study included women between the ages of 16 and 45 with a first pregnancy terminated by spontaneous abortion between January 2007 and December 2015 (index date). These women were followed in 262 gynecological practices. Women with a spontaneous abortion were matched (1:1) with pregnant women without spontaneous abortion by age, index year, diagnosis of female infertility prior to the index date, procreative management prior to the index date, and physician. This retrospective cohort study included 12,158 women with a spontaneous abortion and 12,158 pregnant women without a spontaneous abortion. The mean age was 31.6 (SD: 5.5).years. One year after the index date, 8.9% of women with spontaneous abortion and 5.7% of controls were diagnosed with depression, anxiety, or adjustment disorder. Individuals who had previously undergone a spontaneous abortion were more likely to have one of these three psychiatric disorders compared to controls (OR = 1.53). Similar results were found in the age groups 21-30 and 31-40. Spontaneous abortion is associated with an increased prevalence of developing psychiatric diseases within the first year. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Periodontal Bacteria and Prediabetes Prevalence in ORIGINS

    PubMed Central

    Demmer, R.T.; Jacobs, D.R.; Singh, R.; Zuk, A.; Rosenbaum, M.; Papapanou, P.N.; Desvarieux, M.

    2015-01-01

    Periodontitis and type 2 diabetes mellitus are known to be associated. The relationship between periodontal microbiota and early diabetes risk has not been studied. We investigated the association between periodontal bacteria and prediabetes prevalence among diabetes-free adults. ORIGINS (the Oral Infections, Glucose Intolerance and Insulin Resistance Study) cross sectionally enrolled 300 diabetes-free adults aged 20 to 55 y (mean ± SD, 34 ± 10 y; 77% female). Prediabetes was defined as follows: 1) hemoglobin A1c values ranging from 5.7% to 6.4% or 2) fasting plasma glucose ranging from 100 to 125 mg/dL. In 1,188 subgingival plaque samples, 11 bacterial species were assessed at baseline, including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Actinomyces naeslundii. Full-mouth clinical periodontal examinations were performed, and participants were defined as having no/mild periodontitis vs. moderate/severe periodontitis per the definition of the Centers for Disease Control and Prevention / American Academy of Periodontology. Modified Poisson regression evaluated prediabetes prevalence across bacterial tertiles. Prevalence ratios and 95% confidence intervals for third vs. first tertiles are presented. All analyses were adjusted for cardiometabolic risk factors. All results presented currently arise from the baseline cross section. Prediabetes prevalence was 18%, and 58% of participants had moderate/severe periodontitis. Prevalence ratios (95% confidence intervals) summarizing associations between bacterial levels and prediabetes were as follows: A. actinomycetemcomitans, 2.48 (1.34, 4.58), P = 0.004; P. gingivalis, 3.41 (1.78, 6.58), P = 0.0003; T. denticola, 1.99 (0.992, 4.00), P = 0.052; T. forsythia, 1.95 (1.0, 3.84), P = 0.05; A. naeslundii, 0.46 (0.25, 0.85), P = 0.01. The prevalence ratio for prediabetes among participants with moderate/severe vs. no/mild periodontitis was 1.47 (0.78, 2.74), P

  19. The spatial distribution of gender differences in obesity prevalence differs from overall obesity prevalence among US adults.

    PubMed

    Gartner, Danielle R; Taber, Daniel R; Hirsch, Jana A; Robinson, Whitney R

    2016-04-01

    Although obesity disparities between racial and socioeconomic groups have been well characterized, those based on gender and geography have not been as thoroughly documented. This study describes obesity prevalence by state, gender, and race and/or ethnicity to (1) characterize obesity gender inequality, (2) determine if the geographic distribution of inequality is spatially clustered, and (3) contrast the spatial clustering patterns of obesity gender inequality with overall obesity prevalence. Data from the Centers for Disease Control and Prevention's 2013 Behavioral Risk Factor Surveillance System were used to calculate state-specific obesity prevalence and gender inequality measures. Global and local Moran's indices were calculated to determine spatial autocorrelation. Age-adjusted, state-specific obesity prevalence difference and ratio measures show spatial autocorrelation (z-score = 4.89, P-value < .001). Local Moran's indices indicate the spatial distributions of obesity prevalence and obesity gender inequalities are not the same. High and low values of obesity prevalence and gender inequalities cluster in different areas of the United States. Clustering of gender inequality suggests that spatial processes operating at the state level, such as occupational or physical activity policies or social norms, are involved in the etiology of the inequality and necessitate further attention to the determinates of obesity gender inequality. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. The spatial distribution of gender differences in obesity prevalence differs from overall obesity prevalence among US adults

    PubMed Central

    Gartner, Danielle R.; Taber, Daniel R.; Hirsch, Jana A.; Robinson, Whitney R.

    2016-01-01

    Purpose While obesity disparities between racial and socioeconomic groups have been well characterized, those based on gender and geography have not been as thoroughly documented. This study describes obesity prevalence by state, gender, and race/ethnicity to (1) characterize obesity gender inequality, (2) determine if the geographic distribution of inequality is spatially clustered and (3) contrast the spatial clustering patterns of obesity gender inequality with overall obesity prevalence. Methods Data from the Centers for Disease Control and Prevention’s 2013 Behavioral Risk Factor Surveillance System (BRFSS) were used to calculate state-specific obesity prevalence and gender inequality measures. Global and Local Moran’s Indices were calculated to determine spatial autocorrelation. Results Age-adjusted, state-specific obesity prevalence difference and ratio measures show spatial autocorrelation (z-score=4.89, p-value <0.001). Local Moran’s Indices indicate the spatial distributions of obesity prevalence and obesity gender inequalities are not the same. High and low values of obesity prevalence and gender inequalities cluster in different areas of the U.S. Conclusion Clustering of gender inequality suggests that spatial processes operating at the state level, such as occupational or physical activity policies or social norms, are involved in the etiology of the inequality and necessitate further attention to the determinates of obesity gender inequality. PMID:27039046

  1. Population-based prevalence, incidence, and disease burden of autoimmune hepatitis in South Korea

    PubMed Central

    Ki, Moran; Kim, Kyung-Ah; Jang, Eun Sun; Jeong, Sook-Hyang

    2017-01-01

    Background and aim Little is known about population-based epidemiology and disease burden of autoimmune hepatitis (AIH). The aim of this study was to investigate the prevalence, incidence, comorbidity and direct medical cost of AIH in South Korea. Methods The data was from the nationwide, population-based National Health Insurance Service claims database and the Rare Intractable Disease registration program. Age and gender-specific prevalence rates were calculated, and data on comorbidity, diagnostic tests, prescribed drugs, and medical costs were retrieved for patients registered under the disease code K75.4 (AIH) from 2009 to 2013. Results A total of 4,085 patients with AIH were identified between 2009 and 2013 with a female-to-male ratio of 6.4. The age-adjusted prevalence rate was 4.82/100,000 persons and gender adjusted prevalence rates were 8.35 in females and 1.30 in males. The age-adjusted calculated incidence rate was 1.07/100,000 persons (gender-adjusted 1.83 in females and 0.31 in males). Ascites, variceal bleeding, and hepatocellular carcinoma were found in 1.4%, 1.3%, and 2.2% of the patients, respectively. Forty-six patients (1.1%) underwent liver transplantation during the study period. Case-fatality was 2.18%. Corticosteroid and azathioprine were prescribed in 44.1% and 38.0% of prevalent patients with AIH in 2013, respectively. The nationwide total direct medical cost was less than 4.0 million USD, and the average cost for each patient was 1,174 USD in 2013. Conclusion This is the first report on the nationwide epidemiology of AIH in Korea, and it showed a lower prevalence than that of Western countries with considerable disease burden. PMID:28771543

  2. The geography of HIV/AIDS prevalence rates in Botswana.

    PubMed

    Kandala, Ngianga-Bakwin; Campbell, Eugene K; Rakgoasi, Serai Dan; Madi-Segwagwe, Banyana C; Fako, Thabo T

    2012-01-01

    Botswana has the second-highest human immunodeficiency virus (HIV) infection rate in the world, with one in three adults infected. However, there is significant geographic variation at the district level and HIV prevalence is heterogeneous with the highest prevalence recorded in Selebi-Phikwe and North East. There is a lack of age-and location-adjusted prevalence maps that could be used for targeting HIV educational programs and efficient allocation of resources to higher risk groups. We used a nationally representative household survey to investigate and explain district level inequalities in HIV rates. A Bayesian geoadditive mixed model based on Markov Chain Monte Carlo techniques was applied to map the geographic distribution of HIV prevalence in the 26 districts, accounting simultaneously for individual, household, and area factors using the 2008 Botswana HIV Impact Survey. Overall, HIV prevalence was 17.6%, which was higher among females (20.4%) than males (14.3%). HIV prevalence was higher in cities and towns (20.3%) than in urban villages and rural areas (16.6% and 16.9%, respectively). We also observed an inverse U-shape association between age and prevalence of HIV, which had a different pattern in males and females. HIV prevalence was lowest among those aged 24 years or less and HIV affected over a third of those aged 25-35 years, before reaching a peak among the 36-49-year age group, after which the rate of HIV infection decreased by more than half among those aged 50 years and over. In a multivariate analysis, there was a statistically significant higher likelihood of HIV among females compared with males, and in clerical workers compared with professionals. The district-specific net spatial effects of HIV indicated a significantly higher HIV rate of 66% (posterior odds ratio of 1.66) in the northeast districts (Selebi-Phikwe, Sowa, and Francistown) and a reduced rate of 27% (posterior odds ratio of 0.73) in Kgalagadi North and Kweneng West districts

  3. [Domestic water hardness and prevalence of atopic eczema in Castellon (Spain) school children].

    PubMed

    Arnedo-Pena, Alberto; Bellido-Blasco, Juan; Puig-Barbera, Joan; Artero-Civera, Adrián; Campos-Cruañes, Joan Baptista; Pac-Sa, M Rosario; Villamarín-Vázquez, Jose Luis; Felis-Dauder, Carlos

    2007-01-01

    Water hardness has been associated with atopic eczema (AE) prevalence in two epidemiologic studies carried out on schoolchildren in England and Japan. To estimate the association between the prevalence of AE and domestic water hardness. The prevalence of AE was obtained from The International Study of Asthma and Allergies in Childhood, carried out in six towns in the province of Castellón on schoolchildren 6-7 and 13-14 years of age, using a standard questionnaire in 2002. Three zones were defined according to domestic water hardness of the six study localities: <200 mg/l, 200-250 mg/l, and >300 mg/l. A logistic regression analysis was performed. The lifetime prevalence of AE in schoolchildren 6-7 years of age was higher with the increment of water hardness, 28.6, 30.5 and 36.5% respectively for each zone; between zone 1 and zone 3, the adjusted odds ratios (ORa) were 1.58 (95% Confidence Intervals [CI] 1.04-2.39) (adjusted tendency test p=0.034). Prevalence of symptoms of AE within the past year were 4.7, 4.5, and 10.4%, respectively by zone; between zone 1 and zone 3, the ORa was 2.29 (95% CI 1.19-4.42) (adjusted tendency test p=0,163). For 13-14 year-old schoolchildren, tendencies to lifetime prevalence of AE at any time or in the past year were not significant. This study suggests that in 6-7 year-old schoolchildren, water hardness in the area where they live has some relevance to the development of the disease.

  4. Cardiovascular Risks Associated with Incident and Prevalent Periodontal Disease

    PubMed Central

    Yu, Yau-Hua; Chasman, Daniel I; Buring, Julie E; Rose, Lynda; Ridker, Paul M

    2014-01-01

    Aim While prevalent periodontal disease associates with cardiovascular risk, little is known about how incident periodontal disease influences future vascular risk. We compared effects of incident versus prevalent periodontal disease in developing major cardiovascular diseases (CVD), myocardial infarction (MI), ischemic stroke and total CVD. Material and Methods In a prospective cohort of 39863 predominantly white women, age ≥ 45 years and free of cardiovascular disease at baseline were followed for an average of 15.7 years. Cox proportional hazard models with time-varying periodontal status (prevalent [18%], incident [7.3%] vs. never [74.7%]) were used to assess future cardiovascular risks. Results Incidence rates of all CVD outcomes were higher in women with prevalent or incident periodontal disease. For women with incident periodontal disease, risk factor adjusted hazard ratios (HRs) were 1.42 (95% CI, 1.14–1.77) for major CVD, 1.72 (1.25–2.38) for MI, 1.41(1.02–1.95) for ischemic stroke, and 1.27(1.06–1.52) for total CVD. For women with prevalent periodontal disease, adjusted HRs were 1.14 (1.00–1.31) for major CVD, 1.27 (1.04–1.56) for MI, 1.12(0.91–1.37) for ischemic stroke, and 1.15(1.03–1.28) for total CVD. Conclusion New cases of periodontal disease, not just those that are pre-existing, place women at significantly elevated risks for future cardiovascular events. PMID:25385537

  5. Anger toward God: social-cognitive predictors, prevalence, and links with adjustment to bereavement and cancer.

    PubMed

    Exline, Julie J; Park, Crystal L; Smyth, Joshua M; Carey, Michael P

    2011-01-01

    Many people see themselves as being in a relationship with God and see this bond as comforting. Yet, perceived relationships with God also carry the potential for experiencing anger toward God, as shown here in studies with the U.S. population (Study 1), undergraduates (Studies 2 and 3), bereaved individuals (Study 4), and cancer survivors (Study 5). These studies addressed 3 fundamental issues regarding anger toward God: perceptions and attributions that predict anger toward God, its prevalence, and its associations with adjustment. Social-cognitive predictors of anger toward God paralleled predictors of interpersonal anger and included holding God responsible for severe harm, attributions of cruelty, difficulty finding meaning, and seeing oneself as a victim. Anger toward God was frequently reported in response to negative events, although positive feelings predominated. Anger and positive feelings toward God showed moderate negative associations. Religiosity and age correlated negatively with anger toward God. Reports of anger toward God were slightly lower among Protestants and African Americans in comparison with other groups (Study 1). Some atheists and agnostics reported anger involving God, particularly on measures emphasizing past experiences (Study 2) and images of a hypothetical God (Study 3). Anger toward God was associated with poorer adjustment to bereavement (Study 4) and cancer (Study 5), particularly when anger remained unresolved over a 1-year period (Study 5). Taken together, these studies suggest that anger toward God is an important dimension of religious and spiritual experience, one that is measurable, widespread, and related to adjustment across various contexts and populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  6. Prevalence of self-rated visual impairment among adults with diabetes.

    PubMed

    Saaddine, J B; Narayan, K M; Engelgau, M M; Aubert, R E; Klein, R; Beckles, G L

    1999-08-01

    This study estimated the prevalence of self-rated visual impairment among US adults with diabetes and identified correlates of such impairment. Self-reported data from the 1995 Behavioral Risk Factor Surveillance System survey of adults 18 years and older with diabetes were analyzed. Correlates of visual impairment were examined by multiple logistic regression analysis. The prevalence of self-rated visual impairment was 24.8% (95% confidence interval [CI] = 22.3%, 27.3%). Among insulin users, multivariable-adjusted odds ratios were 4.9 (95% CI = 2.6, 9.2) for those who had not completed high school and 1.8 (95% CI = 1.0, 2.8) for those who had completed high school compared with those with higher levels of education. Comparable estimates of odds ratios for nonusers of insulin were 2.2 (95% CI = 1.4, 3.4) and 1.3 (95% CI = 0.9, 2.0), respectively. Among nonusers, the adjusted odds for minority adults were 2.4 (95% CI = 1.0, 3.7) times the odds for non-Hispanic Whites. By these data, 1.6 million US adults with diabetes reported having some degree of visual impairment. Future research on the specific causes of visual impairment may help in estimating the avoidable public health burden.

  7. Socio-economic gradients in prevalent tuberculosis in Zambia and the Western Cape of South Africa.

    PubMed

    Yates, Tom A; Ayles, Helen; Leacy, Finbarr P; Schaap, A; Boccia, Delia; Beyers, Nulda; Godfrey-Faussett, Peter; Floyd, Sian

    2018-04-01

    To describe the associations between socio-economic position and prevalent tuberculosis in the 2010 ZAMSTAR Tuberculosis Prevalence Survey, one of the first large tuberculosis prevalence surveys in Southern Africa in the HIV era. The main analyses used data on 34 446 individuals in Zambia and 30 017 individuals in South Africa with evaluable tuberculosis culture results. Logistic regression was used to estimate adjusted odds ratios for prevalent TB by two measures of socio-economic position: household wealth, derived from data on assets using principal components analysis, and individual educational attainment. Mediation analysis was used to evaluate potential mechanisms for the observed social gradients. The quartile with highest household wealth index in Zambia and South Africa had, respectively, 0.55 (95% CI 0.33-0.92) times and 0.70 (95% CI 0.54-0.93) times the adjusted odds of prevalent TB of the bottom quartile. College or university-educated individuals in Zambia and South Africa had, respectively, 0.25 (95% CI 0.12-0.54) and 0.42 (95% CI 0.25-0.70) times the adjusted odds of prevalent TB of individuals who had received only primary education. We found little evidence that these associations were mediated via several key proximal risk factors for TB, including HIV status. These data suggest that social determinants of TB remain important even in the context of generalised HIV epidemics. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  8. The prevalence and incidence of epiretinal membranes in eyes with inactive extramacular CMV retinitis.

    PubMed

    Kozak, Igor; Vaidya, Vijay; Van Natta, Mark L; Pak, Jeong W; May, K Patrick; Thorne, Jennifer E

    2014-06-12

    To determine the prevalence and incidence of epiretinal membranes (ERM) in eyes with inactive extramacular cytomegalovirus (CMV) retinitis in patients with acquired immune deficiency syndrome (AIDS). A case-control report from a longitudinal multicenter observational study by the Studies of the Ocular Complications of AIDS (SOCA) Research Group. A total of 357 eyes of 270 patients with inactive CMV retinitis and 1084 eyes of 552 patients with no ocular opportunistic infection (OOI) were studied. Stereoscopic views of the posterior pole from fundus photographs were assessed at baseline and year 5 visits for the presence of macular ERM. Generalized estimating equations (GEE) logistic regression was used to compare the prevalence and 5-year incidence of ERM in eyes with and without CMV retinitis at enrollment. Crude and adjusted logistic regression was performed adjusting for possible confounders. Main outcome measures included the prevalence, incidence, estimated prevalence, and incidence odds ratios. The prevalence of ERM at enrollment was 14.8% (53/357) in eyes with CMV retinitis versus 1.8% (19/1084) in eyes with no OOI. The incidence of ERM at 5 years was 18.6% (16/86) in eyes with CMV retinitis versus 2.4% (6/253) in eyes with no OOI. The crude odds ratio (OR) (95% confidence interval, CI) for prevalence was 9.8 (5.5-17.5) (P < 0.01). The crude OR (95% CI) for incidence was 9.4 (3.2-27.9) (P < 0.01). A history of extramacular CMV retinitis is associated with increased prevalence and incidence of ERM formation compared to what is seen in eyes without ocular opportunistic infections in AIDS patients. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  9. Prevalence of HBsAg/HBeAg amongst 1 936 801 couples preparing for pregnancy in rural China: An observational study.

    PubMed

    Liu, J; Zhang, S; Wang, Q; Shen, H; Zhang, M; Zhang, Y; Yan, D; Liu, M

    2017-08-01

    There are few extant studies on the prevalence of HBV infection in couples preparing for pregnancy. We assessed the prevalence of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) in couples preparing for pregnancy in rural China, and the association between HBV prevalence and the statuses of HBsAg/HBeAg and ALT in the spouses. We performed a nationwide cross-sectional study, using data from a health check-up program for 1 936 801 rural couples from 31 provinces preparing for pregnancy between 2010 and 2012. ELISA was used to test serologic samples, and we defined couples who were either discordant or both positive for HBsAg as "POSITIVE COUPLES" (PC). Amongst the 1 936 801 couples, 202 816 (10.47%; 95% CI, 10.43%-10.51%) were PC. HBeAg (high infectiousness) was detected in 56 474 (27.84%; 95% CI, 27.65%-28.04%) of 202 816 HBsAg-positive couples. Multivariate models showed that the prevalence of HBV infection in wives increased along with the positive statuses for HBsAg/HBeAg and alanine aminotransferase (ALT) of their husbands (adjusted odds ratio increased from 2.31 to 4.98), after adjustment for potential confounders. Similarly, the prevalence of HBV infection in husbands was associated with the positive statuses of HBsAg/HBeAg and ALT of their wives (adjusted odds ratio increased from 2.04 to 4.93). The prevalence of POSITIVE COUPLES in couples preparing for pregnancy in rural China was high, and the prevalence of HBV infection was independently associated with the positive statuses of HBsAg/HBeAg and ALT of the spouses. Instead of solely focussing on mothers prior to becoming pregnant, POSITIVE COUPLES should be taken as an important unit of care. © 2017 John Wiley & Sons Ltd.

  10. Using sightability-adjusted brood-pair ratios to estimate waterfowl productivity

    USGS Publications Warehouse

    Pagano, Anthony M.; Amundson, Courtney L.; Pieron, Matthew R.; Arnold, Todd W.; Kimmel, Timothy C.

    2014-01-01

    Historically, biologists used brood-pair ratios (BPRs) as an index to waterfowl productivity to help guide management decisions and evaluate conservation practices. However, BPRs are biased by imperfect detection probabilities, especially for broods. We conducted roadside surveys for breeding waterfowl pairs on 7–8 study sites in the springs of 2006–2008 in northeastern North Dakota, USA. Later each year, we conducted replicate counts of broods on the same wetlands and used mark–recapture methods to estimate sightability-adjusted BPRs (SA-BPRs). Traditional roadside brood surveys detected only 30–45% of the available broods, depending on species. We explored the potential for using SA-BPRs to measure hen success (i.e., the probability a female hatches ≥1 egg across all nesting attempts) for mallards (Anas platyrhynchos) and other upland-nesting dabbling ducks (Anas spp.). We found that SA-BPRs explained 40% of the variation in hen success over 5 species of dabbling ducks, and we were able to detect an effect of predator reduction on hen success in combined dabblers, but not in mallards alone. However, we found no relationship between SA-BPRs and mallard fledging rates (hen success × initial brood size × duckling survival). Our results suggest that SA-BPRs can provide a cost-effective alternative to traditional measures of productivity such as nesting success, but not to measures of duckling survival. Nevertheless, SA-BPRs may be useful in areas where traditional measures of waterfowl productivity are logistically or financially challenging.

  11. Increasing prevalence and incidence of multiple sclerosis in Poland.

    PubMed

    Brola, Waldemar; Sobolewski, Piotr; Flaga, Stanisław; Fudala, Małgorzata; Jantarski, Konrad

    Epidemiologic data on multiple sclerosis (MS) in Poland are limited. Our objectives were to assess a mean annual incidence rate, and MS prevalence on December 31, 2015 in the Swietokrzyskie province (central Poland). We analyzed data of 1525 patients, collected in the Polish Multiple Sclerosis Registry. On December 31, 2015, overall crude prevalence of MS was not less than 121.3/100,000 (95% CI, 114.6-128.4). Significantly higher prevalence was recorded in females (167.1; 95% CI, 155.6-179.1) than in males (73.2; 95% CI, 64.2-82.6; P<0.001). The age-adjusted prevalence standardized to the European standard population was 114.2/100,000 (95% CI, 106.2-121.5). The female-male ratio was 2.4:1. The mean annual incidence was 4.5/100,000 (95% CI, 3.8-5.2). Increased MS prevalence and incidence compared to 2010 and previous studies from Poland confirmed that central Poland is a high risk area for MS. Copyright © 2016. Published by Elsevier Urban & Partner Sp. z o.o.

  12. Adjustment disorder with anxiety in old age: comparing prevalence and clinical management in primary care and mental health care.

    PubMed

    Arbus, C; Hergueta, T; Duburcq, A; Saleh, A; Le Guern, M-E; Robert, P; Camus, V

    2014-05-01

    Adjustment disorder with anxiety (AjD-A) is a common cause of severe anxiety symptoms, but little is known about its prevalence in old age. This cross-sectional study examined the prevalence of AjD-A in outpatients over the age of 60 who consecutively consulted 34 general practitioners and 22 psychiatrists during a 2-week period. The diagnosis of AjD-A was obtained using the optional module for diagnostic of adjustment disorder of the Mini International Neuropsychiatric Interview (MINI). The study procedure also explored comorbid psychiatric conditions and documented recent past stressful life events, as well as social disability and current pharmacological and non-pharmacological management. Overall, 3651 consecutive subjects were screened (2937 in primary care and 714 in mental health care). The prevalence rate of AjD-A was 3.7% (n=136). Up to 39% (n=53) of AjD-A subjects had a comorbid psychiatric condition, mostly of the anxious type. The most frequently stressful life event reported to be associated with the onset of AjD-A was personal illness or health problem (29%). More than 50% of the AjD-A patients were markedly to extremely disabled by their symptoms. Compared to patients who consulted psychiatrists, patients who were seen by primary care physicians were older, had obtained lower scores at the Hamilton Anxiety Rating Scale, benefited less frequently from non-pharmacological management and received benzodiazepines more frequently. AjD-A appears to be a significantly disabling cause of anxiety symptoms in community dwelling elderly persons, in particular those presenting personal health related problems. Improvement of early diagnosis and non-pharmacological management of AjD-A would contribute to limit risks of benzodiazepine overuse, particularly in primary care settings. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  13. Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis.

    PubMed

    Schumann, Barbara; Seidler, Andreas; Kluttig, Alexander; Werdan, Karl; Haerting, Johannes; Greiser, Karin Halina

    2011-04-01

    Hypertension is one of the most relevant risk factors for cardiovascular disease; however, little is known about differences in hypertension by occupation. The aim of this study was to explore the association between occupational group and prevalent hypertension. Cross-sectional data of the CARLA study were used, a representative sample of an East German population aged 45-83. Job titles of the current or last held occupation of 967 men and 808 women were coded using the German classification of occupation. Hypertension was defined as blood pressure of ≥140 mmHg (systolic), ≥90 mmHg (diastolic) or use of antihypertensives. Sex-stratified, age-adjusted prevalence risk ratios (PR) with 95% confidence intervals (CI) were calculated for 31 occupational groups. Hypertension was prevalent in 79% of the population. In men, highest age-adjusted prevalence ratios were observed in metal-processing workers, carpenters/painters, and electricians with PRs of 1.31 (CI 1.04-1.65), 1.28 (CI 1.00-1.64), and 1.21 (0.95-1.53), respectively, compared to office clerks. In women, highest PRs were found in technicians/forewomen, scrutinisers/storekeepers, and food-processing occupations with PR 1.28 (1.09-1.49), 1.23 (0.99-1.51), and 1.22 (1.01-1.48), respectively. Adjustment for education, smoking, body mass index, and current work hours did not fully explain occupational differences. Excluding currently non-working subjects lead to decreased PRs in men and to increased PR in women. Differences in the prevalences of hypertension by occupational group were only partly explained by conventional risk factors and may require workplace interventions targeted at high-risk occupations. Longitudinal data with large cohorts and work-related exposure assessment are needed to confirm a temporal relationship between occupation and incident hypertension.

  14. The prevalence of self-reported chronic conditions among Arab, Chaldean, and African Americans in southeast Michigan.

    PubMed

    Jamil, Hikmet; Dallo, Florence; Fakhouri, Monty; Templin, Thomas; Khoury, Radwan; Fakhouri, Haifa

    2009-01-01

    While there is a plethora of research on the prevalence of individual chronic conditions, studies that examine the clustering of these conditions are lacking, especially among immigrant, minority groups. Cross-sectional, convenience sample. A self-administered survey was distributed at churches, mosques, and small businesses. Arabs (n = 1383), Chaldeans (n = 868), Blacks (n = 809) and Whites (n = 220) in southeast Michigan. We estimated the prevalence of hypertension, high cholesterol, heart disease, diabetes, asthma, and depression. Using a logistic regression model, we estimated odds ratios and 95% confidence intervals for the association between ethnicity and reporting one or more chronic conditions before and after adjusting for demographic, socioeconomic status, health care, chronic conditions, and health behavior variables. The overall age and sex-adjusted prevalence of having one or more chronic conditions was 44%. Estimates were lower for Chaldeans (32%) compared to Arabs (44%), Whites and Blacks (50% for each group). In the fully adjusted model, Chaldeans were less likely (OR = 0.62; 95% CI = 0.43-0.89) to report having one more chronic conditions compared to Whites. Future studies should employ probability samples, and should collect more detailed sociodemographic and acculturation data, which influence the relationship between race/ethnicity and the prevalence of chronic conditions.

  15. Prevalence and predictors of post-stroke mood disorders: A meta-analysis and meta-regression of depression, anxiety and adjustment disorder.

    PubMed

    Mitchell, Alex J; Sheth, Bhavisha; Gill, John; Yadegarfar, Motahare; Stubbs, Brendon; Yadegarfar, Mohammad; Meader, Nick

    2017-07-01

    To ascertain the prevalence and predictors of mood disorders, determined by structured clinical interviews (ICD or DSM criteria) in people after stroke. Major electronic databases were searched from inception to June 2016 for studies involving major depression (MDD), minor depression (MnD), dysthymia, adjustment disorder, any depressive disorder (any depressive disorder) and anxiety disorders. Studies were combined using both random and fixed effects meta-analysis and results were stratified as appropriate. Depression was examined on 147 occasions from 2days to 7years after stroke (mean 6.87months, N=33 in acute, N=43 in rehabilitation and N=69 in the community/outpatients). Across 128 analyses involving 15,573 patients assessed for major depressive disorder (MDD), the point prevalence of depression was 17.7% (95% CI=15.6% to 20.0%) 0.65 analyses involving 9720 patients determined MnD was present in 13.1% in all settings (95% CI=10.9% to 15.8%). Dysthymia was present in 3.1% (95% CI=2.1% to 5.3%), adjustment disorder in 6.9% (95% CI=4.6 to 9.7%) and anxiety in 9.8% (95% CI=5.9% to 14.8%). Any depressive disorder was present in 33.5% (95% CI=30.3% to 36.8%). The relative risk of any depressive disorder was higher following left (dominant) hemisphere stroke, aphasia, and among people with a family history and past history of mood disorders. Depression, adjustment disorder and anxiety are common after stroke. Risk factors are aphasia, dominant hemispheric lesions and past personal/family history of depression but not time since stroke. Copyright © 2017. Published by Elsevier Inc.

  16. Multicenter transversal two-phase study to determine a national prevalence of epilepsy in Algeria.

    PubMed

    Moualek, Dalila; Pacha, Lamia Ali; Abrouk, Samira; Kediha, Mohamed Islam; Nouioua, Sonia; Aissa, Leila Ait; Bellatache, Mounia; Belarbi, Soreya; Slimani, Saddek; Khennouf, Houria; Fellahi, Lynda; El Amine Hamimed, Mohamed; Benali, Nadia; Chekkour, Mohamed Chahine; Maamoun, Ramdane; Dameche, Rachida; Assami, Salima; Tazir, Meriem

    2012-01-01

    The prevalence of epilepsy in Algeria is unknown. The aims of this multicenter transversal study were to determine the national prevalence and clinical characteristics of epilepsy in the Algerian population. This two-phase study was conducted in 5 circumscriptions and included 8,046 subjects aged over 2 months who attended the randomly selected public and private primary care clinics. In the phase 1 study, a questionnaire was submitted to the sample of patients. In the phase 2 study, all potentially epileptic people were examined by neurologists and a second questionnaire was submitted, eventually assessed by appropriate investigations. Sixty-seven patients were identified as having active epilepsy, giving a crude prevalence ratio of 8.32 per 1,000 (95% CI, 6.34-10.3) and an age-adjusted prevalence ratio of 8.9 per 1,000. The highest age-specific ratio was found in patients aged 10-19 years (16.92 per 1,000). Generalized seizures (68.7%) were more common than partial seizures (29.8%). Perinatal injuries were the major leading putative causes (11.9%). The prevalence of epilepsy of 8.32 determined in this study is relatively high. These results provide new epidemiological data and suggest that epilepsy remains an important public health issue to consider in Algeria. Copyright © 2012 S. Karger AG, Basel.

  17. Leaky polarizing beam splitter with adjustable leak ratio for operation in the wavelength range of 440-690 nm.

    PubMed

    Cheng, L; Bartlett, C L; Erwin, J K; Mansuripur, M

    1997-07-01

    We discuss the optomechanical design and fabrication of a novel wideband (440-690-nm), leaky polarizing beam splitter with an adjustable leak ratio. This beam splitter is an important component of a multiwavelength dynamic testbed that we have constructed for testing optical disks. The multilayer thin-film structure of the beam splitter is essentially a stacked pair of narrow-band dielectric reflectors that have been fine tuned for optimal performance. The characteristics of the fabricated device are in good agreement with our theoretical calculations.

  18. Prevalence of hypertension in immigrants and Swedish-born individuals, a cross-sectional study of 60-year-old men and women in Sweden.

    PubMed

    Carlsson, Axel C; Wändell, Per E; de Faire, Ulf; Hellénius, Mai-Lis

    2008-12-01

    To estimate the prevalence of hypertension, defined as systolic or diastolic blood pressure or both of at least 140/90 mmHg measured on one occasion or being treated for hypertension or both, in 60-year-old men and women in groups of immigrants compared to Swedish-born. A population-based, cross-sectional study in Stockholm County including 4228 participants (77% participation rate), of whom 19% were immigrants. Outcome measures were prevalence of hypertension in immigrants compared to Swedish-born men and women with adjustments for various metabolic, lifestyle and socio-economic characteristics. The prevalence of hypertension among Swedish-born individuals (n = 3327) was 61% in men and 44% in women, among Finnish-born individuals (n = 327) it was 77% in men and 62% in women and among non-European immigrants (n = 123) it was 51% in men and 36% in women. The mean blood pressure in Finnish-born men was 149/90 (hypertensive). After adjustments for metabolic, lifestyle and socio-economic characteristics, the odds ratio for hypertension in immigrants from Finland was 2.02 (1.56-2.61) and the odds ratio in immigrants from non-European countries was 0.52 (0.34-0.80) using Swedish-born participants as reference. About half of all 60-year-olds in Sweden had high blood pressure. The high prevalence of hypertension found in Finnish-born immigrants remained after adjustments for many factors and needs a genetic or environmental explanation. The high prevalence of hypertension in Sweden, especially in Finnish-born immigrants, calls for preventive actions.

  19. [Prevalence and risk factors of dyslipidemia in a rural population of Henan Province, China].

    PubMed

    Zhou, J M; Luo, X P; Wang, S; Yin, L; Pang, C; Wang, G A; Shen, Y X; Wu, D T; Zhang, L; Ren, Y C; Wang, B Y; Yang, X Y; Zhang, H Y; Han, C Y; Zhao, Y; Li, L L; Wang, C J; Feng, T P; Zhao, J Z; Hu, D S; Zhang, M

    2016-09-06

    Objective: The purpose of this study was to investigate the prevalence and risk factors of dyslipidemia in a rural population of Henan Province, China. Methods: A total of 20 194 participants aged ≥18 years were selected randomly by cluster sampling from two townships(towns)in Henan Province from July to August 2007 and July to August 2008. Investigations included questionnaires, anthropometric measurements, fasting plasma glucose, and lipid profile examination at baseline. A total of 16 155 participants were followed up from July to August 2013 and July to October 2014. Overall, 13 869 participants were included in the study, after excluding 2 286 participants with incomplete dyslipidemia follow-up data. Distributions of the characteristics of dyslipidemia were determined, and prevalence was standardized by age according to data of the 2010 Sixth National Population Census. Risk factors for dyslipidemia were analyzed using a logistic regression model after adjusting for sex, age, education level, marital status, and income status. Results: The prevalence of dyslipidemia was 53.72%(7 450/13 869)for residents aged ≥22 years living in rural areas of Henan Province(59.32%(3 069/5 174)for men and 50.39%(4 381/8 695)for women). The adjusted prevalence of dyslipidemia was 50.50%(59.27% for men and 45.53% for women). The prevalence of hypercholesterolemia, hypertriglyceridemia, low HDL-C, and high LDL-C was 4.34%(602/13 868), 20.42%(2 826/13 837), 42.75%(5 927/13 865), and 3.14%(420/13 375), respectively, and the adjusted prevalence was 2.44%, 18.84%, 41.42%, and 1.86%, respectively. Logistic regression analyses showed that alcohol consumption( OR =1.27, 95% CI : 1.05-1.53), family history of hyperlipidemia( OR =1.29, 95% CI : 1.17-1.43), overweight( OR =1.40, 95% CI : 1.22-1.61), obesity( OR = 1.65, 95% CI : 1.39- 1.96), abnormal waist circumference( OR =1.22, 95% CI : 1.04- 1.43), and abnormal waist-height ratio( OR =1.21, 95% CI : 1.01-1.45)were significant

  20. Prevalence and Associated Factors of Peer Victimization (Bullying) among Grades 7 and 8 Middle School Students in Kuwait

    PubMed Central

    Al Daihani, Abdullah E.; Francis, Konstantinos

    2017-01-01

    Background. Peer victimization (bullying) is a universal phenomenon with detrimental effects. The aim of this study is to determine the prevalence and factors of bullying among grades 7 and 8 middle school students in Kuwait. Methods. The study is a cross-sectional study that includes a sample of 989 7th and 8th grade middle school students randomly selected from schools. The Revised Olweus Bully/Victim Questionnaire was used to measure different forms of bullying. After adjusting for confounding, logistic regression identified the significant associated factors related to bullying. Results. Prevalence of bullying was 30.2 with 95% CI 27.4 to 33.2% (3.5% bullies, 18.9% victims, 7.8% bully victims). Children with physical disabilities and one or both non-Kuwaiti parents or children with divorced/widowed parents were more prone to be victims. Most victims and bullies were found to be current smokers. Bullies were mostly in the fail/fair final school grade category, whereas victims performed better. The logistic regression showed that male gender (adjusted odds ration = 1.671, p = 0.004), grade 8 student (adjusted odds ratio = 1.650, p = 0.004), and student with physical disabilities (adjusted odds ratio = 1.675, p = 0.003), were independently associated with bullying behavior. Conclusions. There is a need for a school-wide professional intervention program and improvement in the students' adjustment to school environment to control bullying behavior. PMID:28348603

  1. Asthma prevalence, family size, and birth order.

    PubMed

    Goldberg, Shmuel; Israeli, Eran; Schwartz, Shepard; Shochat, Tzippora; Izbicki, Gabriel; Toker-Maimon, Ori; Klement, Eyal; Picard, Elie

    2007-06-01

    Asthma prevalence may be reduced in large families. The hygiene hypothesis suggests that older siblings protect their younger siblings from asthma through a modulating effect on the still-maturing immune system. If the hygiene hypothesis is correct, asthma prevalence should be inversely related to birth order. The objective of this study was to examine the relationship between asthma prevalence, and family size and birth order. The medical records of 531,116 Israeli military conscripts were reviewed. The association between number of children in the family and the prevalence of asthma, and between birth order and the prevalence of asthma was assessed. Odds ratios for asthma by birth order and family size, adjusted for each other, were calculated. Asthma was diagnosed in 26,833 male subjects (8.6%) and 15,079 female subjects (6.9%). Asthma prevalence was inversely related to the number of children in the family (p < 0.001). Among subjects who were the only child in the family, the prevalence of asthma was 7.3%. The prevalence increased to 8.95% among subjects from families with three siblings, and then progressively decreased as the number of siblings increased, and reached a trough of 0.58% in conscripts from families of 15 to 20 siblings. Asthma prevalence was similar for all birth orders. In families with four or more children, asthma prevalence is inversely related to the number of children in the family. Asthma prevalence is similar for all birth orders. The similar asthma prevalence for all birth orders challenges the hygiene hypothesis as the mechanism for the decreased asthma prevalence in large families.

  2. Prevalence of olfactory impairment in older adults.

    PubMed

    Murphy, Claire; Schubert, Carla R; Cruickshanks, Karen J; Klein, Barbara E K; Klein, Ronald; Nondahl, David M

    2002-11-13

    Older adults represent the fastest-growing segment of the US population, and prevalences of vision and hearing impairment have been extensively evaluated. However, despite the importance of sense of smell for nutrition and safety, the prevalence of olfactory impairment in older US adults has not been studied. To determine the prevalence of olfactory impairment in older adults. A total of 2491 Beaver Dam, Wis, residents aged 53 to 97 years participating in the 5-year follow-up examination (1998-2000) for the Epidemiology of Hearing Loss Study, a population-based, cross-sectional study. Olfactory impairment, assessed by the San Diego Odor Identification Test and self-report. The mean (SD) prevalence of impaired olfaction was 24.5% (1.7%). The prevalence increased with age; 62.5% (95% confidence interval [CI], 57.4%-67.7%) of 80- to 97-year-olds had olfactory impairment. Olfactory impairment was more prevalent among men (adjusted prevalence ratio, 1.92; 95% CI, 1.65-2.19). Current smoking, stroke, epilepsy, and nasal congestion or upper respiratory tract infection were also associated with increased prevalence of olfactory impairment. Self-reported olfactory impairment was low (9.5%) and this measure became less accurate with age. In the oldest group, aged 80 to 97 years, sensitivity of self-report was 12% for women and 18% for men. This study demonstrates that prevalence of olfactory impairment among older adults is high and increases with age. Self-report significantly underestimated prevalence rates obtained by olfaction testing. Physicians and caregivers should be particularly alert to the potential for olfactory impairment in the elderly population.

  3. The Effect of Improved Water Supply on Diarrhea Prevalence of Children under Five in the Volta Region of Ghana: A Cluster-Randomized Controlled Trial.

    PubMed

    Cha, Seungman; Kang, Douk; Tuffuor, Benedict; Lee, Gyuhong; Cho, Jungmyung; Chung, Jihye; Kim, Myongjin; Lee, Hoonsang; Lee, Jaeeun; Oh, Chunghyeon

    2015-09-25

    Although a number of studies have been conducted to explore the effect of water quality improvement, the majority of them have focused mainly on point-of-use water treatment, and the studies investigating the effect of improved water supply have been based on observational or inadequately randomized trials. We report the results of a matched cluster randomized trial investigating the effect of improved water supply on diarrheal prevalence of children under five living in rural areas of the Volta Region in Ghana. We compared the diarrheal prevalence of 305 children in 10 communities of intervention with 302 children in 10 matched communities with no intervention (October 2012 to February 2014). A modified Poisson regression was used to estimate the prevalence ratio. An intention-to-treat analysis was undertaken. The crude prevalence ratio of diarrhea in the intervention compared with the control communities was 0.85 (95% CI 0.74-0.97) for Krachi West, 0.96 (0.87-1.05) for Krachi East, and 0.91 (0.83-0.98) for both districts. Sanitation was adjusted for in the model to remove the bias due to residual imbalance since it was not balanced even after randomization. The adjusted prevalence ratio was 0.82 (95% CI 0.71-0.96) for Krachi West, 0.95 (0.86-1.04) for Krachi East, and 0.89 (0.82-0.97) for both districts. This study provides a basis for a better approach to water quality interventions.

  4. Group Sex and Prevalent Sexually Transmitted Infections Among Men Who Have Sex with Men.

    PubMed

    Rice, Cara E; Lynch, Courtney D; Norris, Alison H; Davis, John A; Fields, Karen S; Ervin, Melissa; Turner, Abigail Norris

    2016-08-01

    We evaluated the direct relation between group sex and prevalent sexually transmitted infections (STI) in a cross-sectional study of men who have sex with men (MSM) presenting at an urban STI clinic in the Midwestern US. Among 231 men who enrolled and reported that they have sex with men, we collected behavioral data using a combination of interviewer and self-administered surveys and extracted STI data from electronic health records. We used modified Poisson regression to examine the unadjusted and adjusted associations between group sex participation and prevalent STI. One-quarter of participants (n = 58) reported group sex participation in the last 3 months. Eighteen percent of participants (n = 42) had gonorrhea and 19 % (n = 45) had chlamydial infection. Men who reported recent group sex were more likely to be HIV-positive, to report recent drug use, and to report unprotected receptive anal intercourse in the past 3 months. After adjustment for age, race, and recent drug use, recent participation in group sex was associated with prevalent gonorrhea infection (prevalence ratio [PR] = 2.11, 95 % confidence interval [CI] = [1.13, 3.95]) but not chlamydia infection (PR = 1.03, 95 % CI = [0.58, 1.84]). We performed a sensitivity analysis in which we also adjusted for unprotected receptive anal intercourse and the results were not substantively changed. In summary, participation in group sex in the past 3 months was associated with a more than twofold increased prevalence of gonorrhea, but not with chlamydia. These findings support group sex participation as a potential contributor to increased STI prevalence.

  5. Overtime work and prevalence of diabetes in Japanese employees: Japan epidemiology collaboration on occupational health study.

    PubMed

    Kuwahara, Keisuke; Imai, Teppei; Nishihara, Akiko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Uehara, Akihiko; Kuroda, Reiko; Omoto, Daisuke; Kurotani, Kayo; Pham, Ngoc Minh; Nanri, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Kunugita, Naoki; Dohi, Seitaro

    2014-01-01

    Epidemiologic evidence on long working hour and diabetes has been conflicting. We examined the association between overtime work and prevalence of diabetes among Japanese workers. The subjects were 40,861 employees (35,170 men and 5,691 women), aged 16 to 83 years, of 4 companies in Japan. Hours of overtime were assessed using self-reported questionnaires. Diabetes was defined as a fasting plasma glucose ≥126 mg/dl (7.0 mmol/l), hemoglobin A1c ≥6.5% (48 mmol/mol), or current use of anti-diabetic drug. Multiple logistic regression analysis was used to calculate odds ratio of diabetes for each category of overtime. After adjustment for age, sex, company, smoking, and BMI, there was a suggestion of U-shaped relationship between overtime work and prevalence of diabetes (P for quadratic trend = 0.07). Compared with those who worked <45 hours of overtime per month, the adjusted odds ratios (95% confidence interval) of diabetes were 0.86 (0.77-0.94), 0.69 (0.53-0.89), and 1.03 (0.72-1.46) for those who worked 45-79, 80-99, and ≥100 hours of overtime per month, respectively. In one company (n = 33,807), where other potential confounders including shift work, job position, type of department, alcohol consumption, sleep duration, leisure time physical activity, and family history of diabetes was additionally adjusted for, similar result was obtained (P for quadratic trend = 0.05). Long hours of overtime work may not be associated with increased prevalence of diabetes among Japanese workers.

  6. Association between the prevalence of depression and age in a large representative German sample of people aged 53 to 80 years.

    PubMed

    Wild, Beate; Herzog, Wolfgang; Schellberg, Dieter; Lechner, Sabine; Niehoff, Doro; Brenner, Hermann; Rothenbacher, Dietrich; Stegmaier, Christa; Raum, Elke

    2012-04-01

    The aim of the study was to determine the association between the prevalence of clinically significant depression and age in a large representative sample of elderly German people. In the second follow-up (2005-2007) of the ESTHER cohort study, the 15-item geriatric depression scale (GDS-15) as well as a sociodemographic and clinical questionnaire were administered to a representative sample of 8270 people of ages 53 to 80 years. The prevalence of clinically significant depression was estimated using a GDS cut-off score of 5/6. Prevalence rates were estimated for the different age categories. Association between depression and age was analyzed using logistic regression, adjusted for gender, co-morbid medical disorders, education, marital status, physical activity, smoking, self-perceived cognitive impairment, and anti-depressive medication. Of the participants, 7878 (95.3%) completed more than twelve GDS items and were included in the study. The prevalence of clinically significant depression was 16.0% (95%CI = [15.2; 16.6]). The function of depression prevalence dependent on age group showed a U-shaped pattern (53-59: 21.0%, CI = [18.9; 23.3]; 60-64: 17.7%, CI = [15.7; 19.7]; 65-69: 12.6%, CI = [11.2; 14.0]; 70-74: 14.4%, CI = [12.6; 16.0]; 75-80: 17.1%, CI = [14.9; 19.4]). Adjusted odds ratios showed that the chances of being depressive decrease with the age category but remain relatively stable for people aged 65 and over. The prevalence of depression in the elderly seems to be associated with the age category. Adjusted odds ratios showed that people aged 60 and older had lower chances of being depressive than people aged 53 to 59 years. Copyright © 2011 John Wiley & Sons, Ltd.

  7. Prevalence of musculoskeletal disorders among immigrant Latino farmworkers and non-farmworkers in North Carolina.

    PubMed

    Mora, Dana C; Miles, Christopher M; Chen, Haiying; Quandt, Sara A; Summers, Phillip; Arcury, Thomas A

    2016-05-03

    This paper evaluates the variability in the prevalence of epicondylitis, rotator cuff syndrome, low back pain, and lower extremity pathology among immigrant Latino farmworkers and non-farmworkers. Data were collected from a study among 272 farmworkers and non-farmworkers. Participants were recruited in eastern and central North Carolina. A physical examination was conducted by trained physicians. Prevalence of musculoskeletal disorders (MSDs) among Latino manual workers is high compared with other workers in similar occupations. Non-farmworkers (49%) had a higher prevalence of MSDs than farmworkers (35%). Epicondylitis (20.2%) and rotator cuff syndrome (19.1%) were most prevalent. Age was found to be significant among those who had epicondylitis (adjusted odds ratio [AOR] = 1.04) and lower extremity pathology (AOR = 1.07). Latino immigrant manual workers have high prevalence of MSDs. Further studies are needed to identify possible factors that make these populations more vulnerable to MSDs.

  8. Standardized morbidity ratios of four chronic health conditions among World Trade Center responders: Comparison to the National Health Interview Survey.

    PubMed

    Kim, Hyun; Kriebel, David; Liu, Bian; Baron, Sherrry; Mongin, Steven; Baidwan, Navneet K; Moline, Jacqueline M

    2018-05-01

    We conducted external comparisons for the prevalence of asthma, hypertension, diabetes, and cancer among World Trade Center (WTC) general responders using the National Health Interview Survey (NHIS) as the reference, along with internal comparisons for the incidence of asthma. Standardized Morbidity Ratios (SMRs) were calculated for the prevalence of the health conditions, and risk ratios (RRs) for asthma incidence. Relative to the NHIS, asthma prevalence was in excess in responders over the study years (age-adjusted SMRs = 1.3-2.8). Hypertension prevalence began to exceed expected from 2006 while diabetes was lower than expected. An upward trend towards excess cancer prevalence was observed. Internal comparisons showed elevated asthma incidence among protective service and utility workers compared to construction workers; while those who arrived at the WTC site in the morning of 9/11 had a lower asthma risk than those who arrived in the afternoon. The use of NHIS data as a reference population demonstrates and reconfirms several important patterns of excess risk in WTC responders. External comparisons are an alternative for disaster cohorts without an established comparison group. © 2018 Wiley Periodicals, Inc.

  9. Elevated Prevalence of Suicide Attempts among Victims of Police Violence in the USA.

    PubMed

    DeVylder, Jordan E; Frey, Jodi J; Cogburn, Courtney D; Wilcox, Holly C; Sharpe, Tanya L; Oh, Hans Y; Nam, Boyoung; Link, Bruce G

    2017-10-01

    Recent evidence suggests that police victimization is widespread in the USA and psychologically impactful. We hypothesized that civilian-reported police victimization, particularly assaultive victimization (i.e., physical/sexual), would be associated with a greater prevalence of suicide attempts and suicidal ideation. Data were drawn from the Survey of Police-Public Encounters, a population-based survey of adults (N = 1615) residing in four US cities. Surveys assessed lifetime exposure to police victimization based on the World Health Organization domains of violence (i.e., physical, sexual, psychological, and neglect), using the Police Practices Inventory. Logistic regression models tested for associations between police victimization and (1) past 12-month suicide attempts and (2) past 12-month suicidal ideation, adjusted for demographic factors (i.e., gender, sexual orientation, race/ethnicity, income), crime involvement, past intimate partner and sexual victimization exposure, and lifetime mental illness. Police victimization was associated with suicide attempts but not suicidal ideation in adjusted analyses. Specifically, odds of attempts were greatly increased for respondents reporting assaultive forms of victimization, including physical victimization (odds ratio = 4.5), physical victimization with a weapon (odds ratio = 10.7), and sexual victimization (odds ratio = 10.2). Assessing for police victimization and other violence exposures may be a useful component of suicide risk screening in urban US settings. Further, community-based efforts should be made to reduce the prevalence of exposure to police victimization.

  10. The Effect of Improved Water Supply on Diarrhea Prevalence of Children under Five in the Volta Region of Ghana: A Cluster-Randomized Controlled Trial

    PubMed Central

    Cha, Seungman; Kang, Douk; Tuffuor, Benedict; Lee, Gyuhong; Cho, Jungmyung; Chung, Jihye; Kim, Myongjin; Lee, Hoonsang; Lee, Jaeeun; Oh, Chunghyeon

    2015-01-01

    Although a number of studies have been conducted to explore the effect of water quality improvement, the majority of them have focused mainly on point-of-use water treatment, and the studies investigating the effect of improved water supply have been based on observational or inadequately randomized trials. We report the results of a matched cluster randomized trial investigating the effect of improved water supply on diarrheal prevalence of children under five living in rural areas of the Volta Region in Ghana. We compared the diarrheal prevalence of 305 children in 10 communities of intervention with 302 children in 10 matched communities with no intervention (October 2012 to February 2014). A modified Poisson regression was used to estimate the prevalence ratio. An intention-to-treat analysis was undertaken. The crude prevalence ratio of diarrhea in the intervention compared with the control communities was 0.85 (95% CI 0.74–0.97) for Krachi West, 0.96 (0.87–1.05) for Krachi East, and 0.91 (0.83–0.98) for both districts. Sanitation was adjusted for in the model to remove the bias due to residual imbalance since it was not balanced even after randomization. The adjusted prevalence ratio was 0.82 (95% CI 0.71–0.96) for Krachi West, 0.95 (0.86–1.04) for Krachi East, and 0.89 (0.82–0.97) for both districts. This study provides a basis for a better approach to water quality interventions. PMID:26404337

  11. The prevalence of diagnosed tourette syndrome in Canada: A national population-based study.

    PubMed

    Yang, Jaeun; Hirsch, Lauren; Martino, Davide; Jette, Nathalie; Roberts, Jodie; Pringsheim, Tamara

    2016-11-01

    The objective of this study was to examine: (1) the prevalence of diagnosed Tourette syndrome in Canada by sex in youth (aged 12-17) and adults and (2) socioeconomic factors in this population. The majority of epidemiological studies of tics have focused on children and youth, with few studies describing the prevalence of tics in adult populations. Canadian data on Tourette syndrome prevalence were derived from the Canadian Community Health Survey 2010 and 2011 cycles, a Statistics Canada population-based cross-sectional survey that collects information related to health status. We determined the prevalence of diagnosed Tourette syndrome and examined sociodemographic factors, including age, sex, education, income, employment, and birthplace. Overall, 122,884 Canadians participated in the surveys, with 122 participants diagnosed with Tourette syndrome. The prevalence of Tourette syndrome was higher in males in youth: 6.03 per 1000 (95% confidence interval: 3.24-8.81) in males versus 0.48 per 1,000 (95% confidence interval: 0.05-0.91) in females, with a prevalence risk ratio of 5.31 (95% confidence interval: 2.38-11.81). In adults, the prevalence of Tourette syndrome was 0.89 per 1,000 (95% confidence interval: 0.48-1.29) in males versus 0.44 (95% confidence interval: 0.16.0-0.71) in females, with a prevalence risk ratio of 1.93 (95% confidence interval: 1.21-3.08). After adjusting for age and sex, adults with Tourette syndrome had lower odds of receiving postsecondary education or being employed and higher odds of having income lower than the median and receiving governmental support. Data on the prevalence of Tourette syndrome in adults are scarce because most studies focus on children. Our data demonstrate a decreasing prevalence risk ratio for sex in adults compared to children. A diagnosis of Tourette syndrome is associated with lower education, income, and employment in adulthood. © 2016 International Parkinson and Movement Disorder Society. © 2016

  12. Higher Prevalence of Frailty Among a Sample of HIV-Infected Middle-aged and Older Chinese Adults Is Associated With Neurocognitive Impairment and Depressive Symptoms.

    PubMed

    Ding, Yingying; Lin, Haijiang; Liu, Xing; Wong, Frank Y; Sun, Yan V; Marconi, Vincent C; He, Na

    2017-03-01

    We investigated the prevalence and correlates of prefrailty/frailty, determined on the basis of the Fried criteria, in Chinese patients with and those without human immunodeficiency virus (HIV) infection. HIV-infected patients were more likely to be frail or prefrail than controls, and this association remained significant after adjustment for potential confounders (odds ratio, 3.79). After additional adjustment for neurocognitive impairment and depressive and insomnia symptoms, this association remained significant but attenuated (odds ratio, 2.16). In the HIV-infected group, these 3 variables were independently associated with prefrailty/frailty. These findings suggest that neurocognitive impairment and depressive and/or insomnia symptoms may account for a higher prevalence of prefrailty/frailty in HIV-infected patients but require further longitudinal investigation. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  13. Prevalence of and factors associated with regular khat chewing among university students in Ethiopia.

    PubMed

    Astatkie, Ayalew; Demissie, Meaza; Berhane, Yemane; Worku, Alemayehu

    2015-01-01

    Khat (Catha edulis) is commonly chewed for its psychostimulant and euphorigenic effects in Africa and the Arabian Peninsula. Students use it to help them study for long hours especially during the period of examination. However, how regularly khat is chewed among university students and its associated factors are not well documented. In this article we report on the prevalence of and factors associated with regular khat chewing among university students in Ethiopia. We did a cross-sectional study from May 20, 2014 to June 23, 2014 on a sample of 1,255 regular students recruited from all campuses of Hawassa University, southern Ethiopia. The data were collected using self-administered questionnaires. We analyzed the data to identify factors associated with current regular khat chewing using complex sample adjusted logistic regression analysis. The prevalence of current regular khat chewing was 10.5% (95% confidence interval [CI]: 6.1%-14.9%). After controlling for sex, religion, year of study, having a father who chews khat, cigarette smoking and alcohol drinking in the adjusted logistic regression model, living off-campus in rented houses as compared to living in the university dormitory (adjusted odds ratio [95% CI] =8.09 [1.56-42.01]), and having friends who chew khat (adjusted odds ratio [95% CI] =4.62 [1.98-10.74]) were found to significantly increase the odds of current regular khat use. Students living outside the university campus in rented houses compared to those living in dormitory and those with khat chewing peers are more likely to use khat. A multipronged prevention approach involving students, the university officials, the surrounding community, and regulatory bodies is required.

  14. Overtime Work and Prevalence of Diabetes in Japanese Employees: Japan Epidemiology Collaboration on Occupational Health Study

    PubMed Central

    Nishihara, Akiko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Uehara, Akihiko; Kuroda, Reiko; Omoto, Daisuke; Kurotani, Kayo; Pham, Ngoc Minh; Nanri, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Kunugita, Naoki; Dohi, Seitaro

    2014-01-01

    Objective Epidemiologic evidence on long working hour and diabetes has been conflicting. We examined the association between overtime work and prevalence of diabetes among Japanese workers. Methods The subjects were 40,861 employees (35,170 men and 5,691 women), aged 16 to 83 years, of 4 companies in Japan. Hours of overtime were assessed using self-reported questionnaires. Diabetes was defined as a fasting plasma glucose ≥126 mg/dl (7.0 mmol/l), hemoglobin A1c ≥6.5% (48 mmol/mol), or current use of anti-diabetic drug. Multiple logistic regression analysis was used to calculate odds ratio of diabetes for each category of overtime. Results After adjustment for age, sex, company, smoking, and BMI, there was a suggestion of U-shaped relationship between overtime work and prevalence of diabetes (P for quadratic trend = 0.07). Compared with those who worked <45 hours of overtime per month, the adjusted odds ratios (95% confidence interval) of diabetes were 0.86 (0.77–0.94), 0.69 (0.53–0.89), and 1.03 (0.72–1.46) for those who worked 45–79, 80–99, and ≥100 hours of overtime per month, respectively. In one company (n = 33,807), where other potential confounders including shift work, job position, type of department, alcohol consumption, sleep duration, leisure time physical activity, and family history of diabetes was additionally adjusted for, similar result was obtained (P for quadratic trend = 0.05). Conclusions Long hours of overtime work may not be associated with increased prevalence of diabetes among Japanese workers. PMID:24787995

  15. Polyunsaturated fatty acid intake and prevalence of eczema and rhinoconjunctivitis in Japanese children: The Ryukyus Child Health Study

    PubMed Central

    2011-01-01

    Background The recent increase in the prevalence of allergic disorders might be a consequence of increased intake of n-6 polyunsaturated fatty acids (PUFAs) and reduced intake of n-3 PUFAs. The current cross-sectional study examined the association between intake levels and the prevalence of eczema and rhinoconjunctivitis in Japanese children. Methods Subjects were 23,388 schoolchildren aged 6-15 years residing in Okinawa. The presence of eczema and/or rhinoconjunctivitis was determined according to the criteria of the International Study of Asthma and Allergies in Childhood. A brief diet history questionnaire for children and adolescents was administered to acquire information on dietary factors. Adjustment was made for age, sex, residential municipality, number of siblings, smoking in the household, body mass index, paternal and maternal history of allergic diseases, and paternal and maternal educational level. Results The prevalences of eczema and rhinoconjunctivitis in the previous 12 months were 7.0% and 8.0%, respectively. Consumption of PUFAs, n-3 PUFAs, α-linolenic acid, n-6 PUFAs, and linoleic acid was positively associated with the prevalence of eczema: the adjusted odds ratios (ORs) between extreme quintiles (95% confidence intervals [CIs], P for trend) were 1.26 (1.07-1.48, 0.04), 1.31 (1.11-1.54, 0.009), 1.31 (1.12-1.55, 0.003), 1.26 (1.07-1.48, 0.01), and 1.27 (1.08-1.49, 0.01), respectively. Arachidonic acid intake was independently inversely related to eczema: the adjusted OR between extreme quintiles was 0.81 (0.69-0.95, 0.0008). Eczema was not associated with eicosapentaenoic or docosahexaenoic acid intake, or with the ratio of n-3 to n-6 PUFA intake. Only arachidonic acid intake was statistically significantly related to the prevalence of rhinoconjunctivitis, showing a clear inverse linear trend: the adjusted OR between extreme quintiles was 0.86 (0.74-0.997, 0.03). Conclusions Consumption of n-3 and n-6 PUFAs, especially α-linolenic acid and

  16. Chronic disease prevalence in women and air pollution--A 30-year longitudinal cohort study.

    PubMed

    To, Teresa; Zhu, Jingqin; Villeneuve, Paul J; Simatovic, Jacqueline; Feldman, Laura; Gao, Chenwei; Williams, Devon; Chen, Hong; Weichenthal, Scott; Wall, Claus; Miller, Anthony B

    2015-07-01

    Air pollution, such as fine particulate matter (PM2.5), can increase risk of adverse health events among people with heart disease, diabetes, asthma and chronic obstructive pulmonary disease (COPD) by aggravating these conditions. Identifying the influence of PM2.5 on prevalence of these conditions may help target interventions to reduce disease morbidity among high-risk populations. The objective of this study is to measure the association of exposure of PM2.5 with prevalence risk of various chronic diseases among a longitudinal cohort of women. Women from Ontario who enrolled in the Canadian National Breast Screening Study (CNBSS) from 1980 to 1985 (n = 29,549) were linked to provincial health administrative data from April 1, 1992 to March 31, 2013 to determine the prevalence of major chronic disease and conditions (heart disease, diabetes, asthma, COPD, acute myocardial infarction, angina, stroke and cancers). Exposure to PM2.5 was measured using satellite data collected from January 1, 1998 to December 31, 2006 and assigned to resident postal-code at time of entry into study. Poisson regression models were used to describe the relationship between exposure to ambient PM2.5 and chronic disease prevalence. Prevalence rate ratios (PRs) were estimated while adjusting for potential confounders: baseline age, smoking, BMI, marital status, education and occupation. Separate models were run for each chronic disease and condition. Congestive heart failure (PR = 1.31, 95% CI: 1.13, 1.51), diabetes (PR = 1.28, 95% CI: 1.16, 1.41), ischemic heart disease (PR = 1.22, 95% CI: 1.14, 1.30), and stroke (PR = 1.21, 95% CI: 1.09, 1.35) showed over a 20% increase in PRs per 10 μg/m(3) increase in PM2.5 after adjusting for risk factors. Risks were elevated in smokers and those with BMI greater than 30. This study estimated significant elevated prevalent rate ratios per unit increase in PM2.5 in nine of the ten chronic diseases studied. Copyright © 2015 Elsevier Ltd. All rights

  17. Intake of dairy products and the prevalence of dental caries in young children.

    PubMed

    Tanaka, Keiko; Miyake, Yoshihiro; Sasaki, Satoshi

    2010-07-01

    In vitro studies show that milk or milk components may have cariostatic properties. However, the results of epidemiological studies on the association between intake of dairy products and dental caries have been inconsistent. The purpose of this cross-sectional study was to examine the association between intake of dairy products and the prevalence of dental caries in young children. Study subjects were 2058 Japanese children aged 3 years. Information on diet was assessed with a self-administered brief diet history questionnaire for children. The consumption of dairy products was categorized into 3 levels in order to represent the tertiles as closely as possible. Dental caries was assessed by a visual examination. Adjustment was made for sex, toothbrushing frequency, use of fluoride, between-meal snack frequency, maternal smoking during pregnancy, environmental tobacco smoke exposure at home, and paternal and maternal educational levels. Compared with yogurt consumption at the lowest tertile (<1 time/week), its intake at the highest level (> or =4 times/week) was significantly associated with a lower prevalence of dental caries, showing a clear dose-response relationship (adjusted prevalence ratio=0.78, 95% confidence interval: 0.62-0.98, P for trend=0.04). There were no material associations between intake of cheese, bread and butter, or milk and the prevalence of dental caries. These data suggest that a high consumption of yogurt may be associated with a lower prevalence of dental caries in young children. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. The Problem of Rarity: Estimation of Prevalence in Rare Disease.

    PubMed

    Auvin, Stéphane; Irwin, John; Abi-Aad, Paul; Battersby, Alysia

    2018-05-01

    From a disease's first description to its wider recognition, factors such as changes over time in diagnostic criteria, available therapies, and subsequent mortality rates may influence diagnosed prevalence of rare diseases. To propose a novel methodology for estimating the true prevalence of rare diseases using current incidence adjusted to changing diagnostic practice over time. This article focuses on rare diseases whose diagnosis may have changed over time, and raises the hypothesis that prevalence calculated from current incidence may be higher than diagnosed prevalence, which may lag behind the current disease definition and diagnostic methods. A rare epileptic encephalopathy, Dravet syndrome (DS), is explored as an illustrative example. A targeted literature review was performed for DS to identify all reported incidence, prevalence, and mortality and depict how diagnostic practice has evolved over time. A conceptual model was developed to calculate prevalence derived from current incidence figures alone (incidence-derived prevalence) or incidence adjusted with factors that cause a diagnostic drag (diagnostic awareness-adjusted prevalence). We identified sufficient publications of incidence and prevalence to test the conceptual model. For pediatric patients with DS, diagnosed prevalence in the field (as reported in current literature) matches incidence-derived prevalence, whereas for adult patients, it is overestimated by incidence-derived prevalence, but not by diagnostic awareness-adjusted prevalence. Care should be taken with current incidence-derived prevalence figures to not overstate the prevalence in rare diseases, as methodological challenges in counting small populations, coupled with advances in rare disease discovery, may cause discrepancies. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Rural-Urban Differences in Alzheimer's Disease and Related Disorders Diagnostic Prevalence in Kentucky and West Virginia.

    PubMed

    Abner, Erin L; Jicha, Gregory A; Christian, W Jay; Schreurs, Bernard G

    2016-06-01

    Older adults living in rural areas may face barriers to obtaining a diagnosis of Alzheimer's disease and related disorders (ADRD). We sought to examine rural-urban differences in prevalence of ADRD among Medicare beneficiaries in Kentucky and West Virginia, 2 contiguous, geographically similar states with large rural areas and aged populations. We used Centers for Medicare and Medicaid Services Public Use Files data from 2007 to 2013 to assess prevalence of ADRD at the county level among all Medicare beneficiaries in each state. Rural-Urban Continuum Codes were used to classify counties as rural or urban. We used Poisson regression to estimate unadjusted and adjusted prevalence ratios. Primary analyses focused on 2013 data and were repeated for 2007 to 2012. This study was completely ecologic. After adjusting for state, average beneficiary age, percent of female beneficiaries, percent of beneficiaries eligible for Medicaid in each county, Central Appalachian county, percent of age-eligible residents enrolled in Medicare, and percent of residents under age 65 enrolled in Medicare in our adjusted models, we found that 2013 ADRD diagnostic prevalence was 11% lower in rural counties (95% CI: 9%-13%). Medicare beneficiaries in rural counties in Kentucky and West Virginia may be underdiagnosed with respect to ADRD. However, due to the ecologic design, and evidence of a younger, more heavily male beneficiary population in some rural areas, further studies using individual-level data are needed to confirm the results. © 2015 National Rural Health Association.

  20. [Estimation of prevalence, incidence and sex ratio of transsexualism in Catalonia according to health care demand].

    PubMed

    Gómez Gil, E; Trilla García, A; Godás Sieso, T; Halperin Rabinovich, I; Puig Domingo, M; Vidal Hagemeijer, A; Peri Nogués, J M

    2006-01-01

    To estimate the epidemiology of transsexualism in the autonomous community of Catalonia according to data gathered at the Hospital Clinic of Barcelona, the single public hospital providing specialized psychiatric and endocrinological care for transsexual patients in this community. Prevalence was calculated on the basis of the total number of patients diagnosed of transsexualism (ICD-10, F64.0) at the Hospital Clinic and living in Catalonia, and the incidence by counting all new cases of transsexuals for the last 5 years, based on the population census between 15 and 65 years of age. During the period from 1996 through 2004 a total of 201 subjects were referred to this hospital with complaints of gender dysphoria. Transsexualism was diagnosed in 182 patients, 161 of whom were living in Catalonia. This yields a prevalence rate in Catalonia of 1:21,031 males and 1:48,096 females. The sex ratio was 2.6. Annual incidence in the last five years was 0.73/100,000/year. The low prevalence compared with recently published data from European Union countries may be due to the relatively few years of data collection and to the low clinical demand because surgical procedures costs are not covered by the public health insurance. In contrast, the high incidence may be due to the increasing demand since 2000, when a more benevolent and tolerant social climate in Spain started.

  1. Prevalence of the Metabolic Syndrome among Korean Workers by Occupational Group: Fifth Korean National Health and Nutrition Examination Survey (KNHANES) 2010

    PubMed Central

    2013-01-01

    Objectives The prevalence of the metabolic syndrome has increased rapidly in South Korea over the past 10 years. However, the occurrence of the metabolic syndrome in workers grouped according to the specific type of work is not well understood in Korea. In this study, we assessed the differences in the prevalence of the metabolic syndrome by occupational group and evaluated the risk of the metabolic syndrome among occupational groups. Methods From the Fifth Korean National Health and Nutrition Examination Survey (2010), 3,303 employed participants were included in this study. The unadjusted and age-adjusted prevalences of the metabolic syndrome were estimated and multiple logistic regression analysis was conducted using the presence of the metabolic syndrome as a dependent variable, and adjusting for age, education level, household income, drinking behavior, smoking status, physical activity, work hours, and work scheduling pattern. Results Among male workers, non-manual workers had the greatest age-adjusted prevalence (26.4%, 95% CI: 22.3-30.5%) among the occupational groups. In a logistic regression analysis, male manual workers had a significantly lower odds ratio for the metabolic syndrome relative to non-manual workers (0.59, 95% CI: 0.41-0.85). Conclusion Our study demonstrated differences in the prevalence of the metabolic syndrome by occupational group and identified the greatest risk for the metabolic syndrome in male non-manual workers. PMID:24472422

  2. Prevalence of chronic kidney disease defined by using CKD-EPI equation and albumin-to-creatinine ratio in the Korean adult population.

    PubMed

    Ji, Eunhee; Kim, Yon Su

    2016-11-01

    An updated chronic kidney disease (CKD) definition and classification were proposed by Kidney Disease: Improving Global Outcomes (KDIGO), with adoption of a new equation to estimate glomerular filtration rate (GFR) and albuminuria to evaluate kidney structural damage. This study was performed to estimate the prevalence of CKD in the Korean adult population as defined and classified by the KDIGO guidelines. Cross-sectional samples of the fifth Korean National Health and Nutrition Examination Survey for 2011 to 2012 were examined for adults aged ≥ 19 years. CKD prevalence was determined based on decreased GFR and albuminuria. The GFR was estimated using the CKD Epidemiology Collaboration creatinine equation, and albuminuria was evaluated using the albumin-to-creatinine ratio (ACR) in spot urine. Of the 16,576 subjects participating in the survey, 10,636 (4,758 men, 5,878 women) were included in the present study. The prevalence of CKD was estimated as 7.9% (7.8% in 2011 and 8.0% in 2012, p = 0.770). The prevalence of low, moderately increased, high, and very high CKD risk prognosis was 92.0%, 6.3%, 1.1%, and 0.6%, respectively. The prevalence of albuminuria (ACR ≥ 30 mg/g) in individuals with GFR ≥ 60 mL/min/1.73 m 2 has reached 5.7%. The odds ratios of hypertension and diabetes to CKD were 3.4 and 3.1 in men, and 2.9 and 2.0 in women (all p < 0.001), respectively. A large percentage of CKD patients had albuminuria prior to a decrease in GFR. Regular laboratory tests for albuminuria for the high-risk group, and especially for hypertensive or diabetic patients, might improve detection of CKD at an early stage.

  3. Facultative adjustment of the offspring sex ratio and male attractiveness: a systematic review and meta-analysis.

    PubMed

    Booksmythe, Isobel; Mautz, Brian; Davis, Jacqueline; Nakagawa, Shinichi; Jennions, Michael D

    2017-02-01

    Females can benefit from mate choice for male traits (e.g. sexual ornaments or body condition) that reliably signal the effect that mating will have on mean offspring fitness. These male-derived benefits can be due to material and/or genetic effects. The latter include an increase in the attractiveness, hence likely mating success, of sons. Females can potentially enhance any sex-biased benefits of mating with certain males by adjusting the offspring sex ratio depending on their mate's phenotype. One hypothesis is that females should produce mainly sons when mating with more attractive or higher quality males. Here we perform a meta-analysis of the empirical literature that has accumulated to test this hypothesis. The mean effect size was small (r = 0.064-0.095; i.e. explaining <1% of variation in offspring sex ratios) but statistically significant in the predicted direction. It was, however, not robust to correction for an apparent publication bias towards significantly positive results. We also examined the strength of the relationship using different indices of male attractiveness/quality that have been invoked by researchers (ornaments, behavioural displays, female preference scores, body condition, male age, body size, and whether a male is a within-pair or extra-pair mate). Only ornamentation and body size significantly predicted the proportion of sons produced. We obtained similar results regardless of whether we ran a standard random-effects meta-analysis, or a multi-level, Bayesian model that included a correction for phylogenetic non-independence. A moderate proportion of the variance in effect sizes (51.6-56.2%) was due to variation that was not attributable to sampling error (i.e. sample size). Much of this non-sampling error variance was not attributable to phylogenetic effects or high repeatability of effect sizes among species. It was approximately equally attributable to differences (occurring for unknown reasons) in effect sizes among and within

  4. The Prevalence of Anosmia and Associated Factors Among U.S. Black and White Older Adults

    PubMed Central

    Pinto, Jayant M.; Guo, Xuguang; Alonso, Alvaro; Tranah, Gregory; Cauley, Jane A.; Garcia, Melissa; Satterfield, Suzanne; Huang, Xuemei; Harris, Tamara; Mosley, Thomas H.; Chen, Honglei

    2017-01-01

    Abstract Background: Olfactory impairment is common among older adults; however, data are largely limited to whites. Methods: We conducted pooled analyses of two community-based studies: the Atherosclerosis Risk in Communities study (ARIC, 1,398 blacks and 4,665 whites), and the Health, Aging, and Body Composition study (Health ABC, 958 blacks and 1,536 whites) to determine the prevalence of anosmia and associated factors for black and white older adults in the United States. Results: The overall prevalence of anosmia was 22.3% among blacks and 10.4% among whites. Blacks had a markedly higher odds of anosmia compared to whites in age and sex adjusted analyses (odds ratio [OR] 2.96, 95% confidence interval [CI] = 2.59–3.38). In both blacks and whites, higher anosmia prevalence was associated with older age and male sex. The highest prevalence was found in black men 85 years or older (58.3%), and the lowest in white women aged 65–69 years (2.4%). Higher education level, lower cognitive score, ApoE ε4, daytime sleepiness, poorer general health status, lower body mass index, and Parkinson disease were associated with higher prevalence of anosmia in one or both races. However, the racial difference in anosmia remained statistically significant after adjusting for these factors (fully adjusted OR = 1.76, 95%CI: 1.50–2.07). Results were comparable between the two cohorts. Discussion: Anosmia is common in older adults, particularly among blacks. Further studies are needed to identify risk factors for anosmia and to investigate racial disparities in this sensory deficit. PMID:28498937

  5. Prevalence of Enterobius vermicularis among preschool children in Gimhae-si, Gyeongsangnam-do, Korea.

    PubMed

    Lee, Sang-Eun; Lee, Jin-Hee; Ju, Jung-Won; Lee, Won-Ja; Cho, Shin-Hyeong

    2011-06-01

    The present study was performed to determine the prevalence of Enterobius vermicularis among preschool children in Gimhae-si, Korea. A total of 6,921 preschool children in 76 kindergartens were examined using the cellotape perianal swab method. The overall egg positive rate (EPR) was 10.5%. The EPR in boys was higher than that in girls (adjusted odds ratio [AOR]: 1.5, P<0.001), and it was higher in rural than in urban children (AOR: 1.2, P=0.022). The present study confirmed that the prevalence of E. vermicularis infection is fairly high among preschool children in Gimhae-si. Therefore, systematic control and preventive measures should be adopted to reduce morbidity associated with this nematode infection.

  6. Hepatitis C antibody prevalence among Mexico City prisoners injecting legal and illegal substances.

    PubMed

    Silverman-Retana, Omar; Serván-Mori, Edson; McCoy, Sandra I; Larney, Sarah; Bautista-Arredondo, Sergio

    2017-12-01

    Hepatitis C virus (HCV) infection is highly prevalent among prisoners and this prevalence estimates reach 64% among prisoners who inject illicit drugs. Prisons are important sites for HCV transmission in the absence of access to sterile injecting equipment; hence, it can be transmitted between prisoners who share contaminated needles and syringes. We aimed to estimate the prevalence of risk factors for anti-HCV prevalence, with particular interest on injecting behavior, and to assess correlates of anti-HCV positivity among Mexico City prisoners. Cross-sectional study based on information -collected in three male and two female prisons in Mexico City during 2010-2011- about sexually transmitted infections, socio-demographics, criminal history, substance use, vitamin injection, tattooing, among others (n=3,910). Weighted multivariable adjusted logistic regression models were estimated to assess the overall and differential odds for anti-HCV due to injecting behavior. Overall prevalence of anti-HCV was 3.3%. This figure rose to 43.1% among prisoners with a history of illicit drug injection. Prisoners with history of vitamin injection showed a similar prevalence of anti-HCV (43.8%). After stratifying by substance injected, the adjusted odds ratio was 9.8 (95% CI: 4.0, 23.8) for illicit drug injection and 11.9 (95% CI: 5.8, 23.8) for illicit drug and vitamin injection. Based on data from the most populous prisons in Mexico City, this study showed that anti-HCV is highly prevalent among prisoners with history of injecting behavior. In this sense, injecting behavior per-se, independent of the substance used, is associated with increased odds of anti-HCV positivity. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. [Prevalence of leisure-time physical activity and associated factors: a population-based study in São Paulo, Brazil, 2008-2009].

    PubMed

    Sousa, Clóvis Arlindo de; César, Chester Luiz Galvão; Barros, Marilisa Berti de Azevedo; Carandina, Luana; Goldbaum, Moisés; Marchioni, Dirce Maria Lobo; Fisberg, Regina Mara

    2013-02-01

    The purpose of this study was to ascertain the prevalence of self-reported leisure-time physical activity and related factors in the city of São Paulo, Brazil, 2008-2009. A population- based cross-sectional study interviewed 2,691 individuals of both sexes, 12 years or older. A two-stage cluster (census tract, household) random sample provided data using home interviews in 2008 and 2009. Leisure-time physical activity was measured with IPAQ, long version. Complex sample-adjusted descriptive statistics provided prevalence estimates, chi-square tests screened associations, and prevalence ratios (PR) expressed effects. Multiple Poisson regression was used to ascertain adjusted effects, and design effects were calculated. Of the interviewees, 16.4% (95%CI: 14.3-18.7) reported leisure-time physical activity. The findings indicate the importance of encouraging leisure-time physical activity, which was associated with male sex, higher income, younger age (12 to 29 years), not smoking, and not reporting frequent fatigue.

  8. Effort-Reward Imbalance at Work and the Prevalence of Unsuccessfully Treated Hypertension Among White-Collar Workers.

    PubMed

    Trudel, Xavier; Milot, Alain; Gilbert-Ouimet, Mahée; Duchaine, Caroline; Guénette, Line; Dalens, Violaine; Brisson, Chantal

    2017-08-15

    We examined the association between effort-reward imbalance (ERI) exposure at work and unsuccessfully treated hypertension among white-collar workers from a large cohort in Quebec City, Canada. The study used a repeated cross-sectional design involving 3 waves of data collection (2000-2009). The study sample was composed of 474 workers treated for hypertension, accounting for 739 observations. At each observation, ERI was measured using validated scales, and ambulatory blood pressure (BP) was measured every 15 minutes during the working day. Unsuccessfully treated hypertension was defined as daytime ambulatory BP of at least 135/85 mm Hg and was further divided into masked and sustained hypertension. Adjusted prevalence ratios and 95% confidence intervals were estimated. Participants in the highest tertile of ERI exposure had a higher prevalence of unsuccessfully treated hypertension (prevalence ratio = 1.45, 95% confidence interval: 1.16, 1.81) after adjustment for gender, age, education, family history of cardiovascular diseases, body mass index, diabetes, smoking, sedentary behaviors, and alcohol intake. The present study supports the effect of adverse psychosocial work factors from the ERI model on BP control in treated workers. Reducing these frequent exposures at work might lead to substantial benefits on BP control at the population level. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Prevalence of and factors associated with regular khat chewing among university students in Ethiopia

    PubMed Central

    Astatkie, Ayalew; Demissie, Meaza; Berhane, Yemane; Worku, Alemayehu

    2015-01-01

    Purpose Khat (Catha edulis) is commonly chewed for its psychostimulant and euphorigenic effects in Africa and the Arabian Peninsula. Students use it to help them study for long hours especially during the period of examination. However, how regularly khat is chewed among university students and its associated factors are not well documented. In this article we report on the prevalence of and factors associated with regular khat chewing among university students in Ethiopia. Methods We did a cross-sectional study from May 20, 2014 to June 23, 2014 on a sample of 1,255 regular students recruited from all campuses of Hawassa University, southern Ethiopia. The data were collected using self-administered questionnaires. We analyzed the data to identify factors associated with current regular khat chewing using complex sample adjusted logistic regression analysis. Results The prevalence of current regular khat chewing was 10.5% (95% confidence interval [CI]: 6.1%–14.9%). After controlling for sex, religion, year of study, having a father who chews khat, cigarette smoking and alcohol drinking in the adjusted logistic regression model, living off-campus in rented houses as compared to living in the university dormitory (adjusted odds ratio [95% CI] =8.09 [1.56–42.01]), and having friends who chew khat (adjusted odds ratio [95% CI] =4.62 [1.98–10.74]) were found to significantly increase the odds of current regular khat use. Conclusion Students living outside the university campus in rented houses compared to those living in dormitory and those with khat chewing peers are more likely to use khat. A multipronged prevention approach involving students, the university officials, the surrounding community, and regulatory bodies is required. PMID:25750551

  10. Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries.

    PubMed

    Lukasse, Mirjam; Schroll, Anne-Mette; Karro, Helle; Schei, Berit; Steingrimsdottir, Thora; Van Parys, An-Sofie; Ryding, Elsa Lena; Tabor, Ann

    2015-05-01

    To assess the prevalence and current suffering of experienced abuse in healthcare, to present the socio-demographic background for women with a history of abuse in healthcare and to assess the association between abuse in healthcare and selected obstetric characteristics. Cross-sectional study. Routine antenatal care in six European countries. In total 6923 pregnant women. Cross-tabulation and Pearson's chi-square was used to study prevalence and characteristics for women reporting abuse in healthcare. Associations with selected obstetric factors were estimated using multiple logistic regression analysis. Abuse in healthcare, fear of childbirth and preference for birth by cesarean section. One in five pregnant women attending routine antenatal care reported some lifetime abuse in healthcare. Prevalence varied significantly between the countries. Characteristics for women reporting abuse in healthcare included a significantly higher prevalence of other forms of abuse, economic hardship and negative life events as well as a lack of social support, symptoms of post-traumatic stress and depression. Among nulliparous women, abuse in healthcare was associated with fear of childbirth, adjusted odds ratio 2.25 (95% CI 1.23-4.12) for severe abuse in healthcare. For multiparous women only severe current suffering from abuse in healthcare was significantly associated with fear of childbirth, adjusted odds ratio 4.04 (95% CI 2.08-7.83). Current severe suffering from abuse in healthcare was significantly associated with the wish for cesarean section, and counselling for fear of childbirth for both nulli- and multiparous women. Abuse in healthcare among women attending routine antenatal care is common and for women with severe current suffering from abuse in healthcare, this is associated with fear of childbirth and a wish for cesarean section. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. Association of Kidney Function and Albuminuria With Prevalent and Incident Hypertension: The Atherosclerosis Risk in Communities (ARIC) Study

    PubMed Central

    Huang, Minxuan; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana H.; Astor, Brad C.; Coresh, Josef

    2014-01-01

    Background Decreased kidney function and kidney damage may predate hypertension, but only a few studies have investigated both types of markers simultaneously, and these studies have obtained conflicting results. Study Design Cross-sectional for prevalent and prospective observational study for incident hypertension. Setting & Participants 9,593 participants from the Atherosclerosis Risk in Communities (ARIC) Study, aged 53-75 years during 1996-1998. Predictors Several markers of kidney function (estimated glomerular filtration rate [eGFR] using serum creatinine and/or cystatin C and two novel markers [β-trace protein and β2-microglobulin]) and one marker of kidney damage (urinary albumin-creatinine ratio [ACR]). Every kidney marker was categorized by its quintiles (top quintile as a reference for eGFRs and bottom quintile for the rest). Outcomes Prevalent and incident hypertension. Measurements Prevalence and HRs of hypertension based on modified Poisson regression and Cox proportional hazards models, respectively. Results There were 4,378 participants (45.6%) with prevalent hypertension at baseline and 2,175 incident hypertension cases during a median follow-up of 9.8 years. While all five kidney function markers were significantly associated with prevalent hypertension, prevalent hypertension was most notably associated with higher ACR (adjusted prevalence ratio, 1.60 [95% CI, 1.50-1.71] for the highest vs lowest ACR quintile). Similarly, ACR was consistently associated with incident hypertension in all models tested (adjusted HR, 1.28 [95% CI, 1.10-1.49] for top quintile), while kidney function markers demonstrated significant associations in some, but not all, models. Even mildly increased ACR (9.14-14.0 mg/g) was significantly associated with incident hypertension. Limitations Self-reported use of antihypertensive medication for defining incident hypertension, single assessment of kidney markers, and relatively narrow age range. Conclusions Although all

  12. Prevalence of intermediate-stage age-related macular degeneration in patients with acquired immunodeficiency syndrome.

    PubMed

    Jabs, Douglas A; Van Natta, Mark L; Sezgin, Efe; Pak, Jeong Won; Danis, Ronald

    2015-06-01

    To evaluate the prevalence of intermediate-stage age-related macular degeneration (AMD) in patients with acquired immunodeficiency syndrome (AIDS). Cross-sectional study of patients with AIDS enrolled in the Longitudinal Study of the Ocular Complications of AIDS. Intermediate-stage AMD was determined from enrollment retinal photographs by graders at a centralized Reading Center, using the Age-Related Eye Disease Study grading system. Graders were masked as to clinical data. Of 1825 participants with AIDS and no ocular opportunistic infections, 9.9% had intermediate-stage AMD. Risk factors included age, with an odds ratio (OR) of 1.9 (95% confidence interval [CI] 1.6, 2.3, P < .001) for every decade of age; the prevalence of AMD ranged from 4.0% for participants 30-39 years old to 24.3% for participants ≥60 years old. Other risk factors included the human immunodeficiency virus (HIV) risk groups of injection drug use (OR = 2.4, 95% CI 1.5, 3.9, P < .001) or heterosexual contact (OR = 1.9, 95% CI 1.3, 2.8, P = .001). Compared with the HIV-uninfected population in the Beaver Dam Offspring Study, there was an approximate 4-fold increased age-adjusted prevalence of intermediate-stage AMD. Patients with AIDS have an increased age-adjusted prevalence of intermediate-stage AMD compared with that found in a non-HIV-infected cohort evaluated with similar methods. This increased prevalence is consistent with the increased prevalence of other age-related diseases in antiretroviral-treated, immune-restored, HIV-infected persons when compared to non-HIV-infected persons. Published by Elsevier Inc.

  13. Prevalence of renal stones in an Italian urban population: a general practice-based study.

    PubMed

    Croppi, Emanuele; Ferraro, Pietro Manuel; Taddei, Luca; Gambaro, Giovanni

    2012-10-01

    Kidney stones represent a common condition characterized by significant morbidity and economic costs. The epidemiology of kidney stones is not completely understood and may vary substantially based on geographic, socioeconomic and clinical factors; the present study aims at defining the prevalence and diagnostic patterns of kidney stones in a cohort representative of the general population in Florence, Italy. A sample of 1,543 adult subjects, all Caucasians, was randomly selected from a population of over 25,000 subjects followed by 22 general practitioners (GPs). Subjects were administered a questionnaire requesting the patient's age and sex, any history of kidney stones and/or colics and the prescription of kidney ultrasound (US) examination. GPs data-bases were also interrogated. Crude and adjusted prevalence proportions and ratios (PRs) with corresponding 95% confidence intervals (CIs) were computed. Furthermore, the association between the practice pattern of each physician with respect to US prescription and the prevalence of kidney stones was investigated. The overall prevalence of kidney stones was 7.5% (95% confidence interval 6.2, 8.9%), increasing with age until 55-60 years and then decreasing. About 50% reported recurrent disease. There were no significant differences in prevalence among males and females. GPs who tended to prescribe more US examinations were more likely to have more patients with kidney stones (adjusted PR 1.80, 95% CI 1.11, 2.94; p = 0.020). The present study confirms both the high prevalence and the regional variability of kidney stones. Practice patterns may be involved in such variability.

  14. Prevalence of Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Infections Among Transgender Persons Referred to an Italian Center for Total Sex Reassignment Surgery.

    PubMed

    Luzzati, Roberto; Zatta, Marta; Pavan, Nicola; Serafin, Maurizia; Maurel, Cristina; Trombetta, Carlo; Barbone, Fabio

    2016-07-01

    The burden of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in transgender population is an underestimated issue. We performed a study to evaluate the prevalence of such infections in transgender persons addressed our center for total sex reassignment surgery (SRS). All transgender persons undergoing SRS from 2000 to 2014 were evaluated retrospectively. Participant characteristics and results of HIV, HBV, and HCV testing were collected. Exact Fisher test, Cochran-Armitage tests for trend and correct prevalence ratios were estimated. Among 498 transgender persons, 243 had confirmed serological data. Of them, 25 were female-to-male and 218 male-to-female (MtF) subjects. The prevalence of HIV, HBV and HCV infections was 0%, 4.0%, and 8.0% in female-to-male, and 12.1%, 4.6%, and 3.7% in MtF. Among MtF, younger age and earlier year of SRS were associated with lower HIV prevalence. From the multivariate model, the mutually adjustment prevalence ratios were 1.9 (95% confidence interval [95% CI], 1.2-3.1) for SRS in 2005-2010 and 3.6 (95% CI, 1.3-9.4) in 2010-2014, as compared with SRS in 2000-2004; and 4.7 (95% CI, 2.4-9.4) for South Americans as compared with others. Among the HCV-positive MtF, 57.1% were also HIV-positive. Regarding HBV, the immunity was 38.5% and, after mutual adjustment, the prevalence ratios were 2.1 (95% CI, 1.3-3.4) for South Americans versus others and 2.2 (95% CI, 1.6-3.1) for year of birth ≥ 1980. The prevalence of HBV and HCV infections among our transgender persons overlaps that reported in the general population, but HCV prevalence was much higher in HIV-infected MtF. The high burden of HIV infection among MtF and its recent incremented prevalence points out that social and medical support should be strongly promoted in such population.

  15. [Adjusting Platelet Counts for Platelet Aggregation Tests].

    PubMed

    Ling, Li-Qin; Yang, Xin-Chun; Chen, Hao; Liu, Chao-Nan; Chen, Si; Jiang, Hong; Jin, Ya-Xiong; Zhou, Jing

    2018-03-01

    To explore a better method to adjust platelet counts for light transmission aggregometry (LTA). Blood samples from 36 healthy participants aged from 18 to 50 yr. were collected.Platelet-rich plasma (PRP) was diluted using platelet-poor plasma (PPP) and physiological saline (PS),respectively,in a ratio of 1.5,2,2.5 and 3 times. Platelet aggregation was induced by adenosine diphosphate (ADP),arachidonic acid (ARA),collagen (COL), epinephrine (EPI),or ristocetin (RIS). The maximal aggregation rates (MAs) of different approaches were compared. We also compared the MAs induced by RIS between PRP-obtained-PPP and whole blood-obtained-PPP (2 100× g, 5 min). Compared with the original PRP,the MAs induced by ADP,ARA,and EPI decreased in PPP-adjusted PRP (significant at 2-3 times dilution ratio, P <0.05),but not in PS-adjusted PRP ( P >0.05). The MA induced by RIS decreased in PS-adjusted PRP (significant at all dilution ratios, P <0.05),but not in PPP-adjusted PRP ( P >0.05). No changes in the MA induced by COL were found in PS-adjusted PRP and PPP-adjusted PRP ( P >0.05). Whole blood-obtained-PPP (2 100× g, 5 min) had the same MA induced by ristocetin compared with PRP-obtained-PPP ( P >0.05). PS is recommended for adjusting platelets counts for platelet aggregation induced by ADP,ARA,COL and EPI. Whole blood-obtained-PPP (2 100 × g, 5 min) is recommended for RIS-induced aggregation as a matter of convenience. Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).

  16. Prevalence of Cognitive Impairment and Dementia in Malays - Epidemiology of Dementia in Singapore Study.

    PubMed

    Hilal, Saima; Tan, Chuen S; Xin, Xu; Amin, Shaik M; Wong, Tien Y; Chen, Christopher; Venketasubramanian, Narayanaswamy; Ikram, Mohammad K

    2017-01-01

    To study the prevalence of cognitive impairment and dementia in communitydwelling Malays from Singapore; and to examine differences in prevalence among Chinese and Malays. Subjects (≥ 60 years) - drawn from the Malay component of the on-going multiethnic Epidemiology of Dementia in Singapore study - were screened using locally validated Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Subsequently, screen-positive participants underwent detailed neuropsychological assessments and neuroimaging. Cognitive impairment no dementia (CIND) and dementia were diagnosed based on accepted criteria. A total of 966 Malay subjects were included, of whom 102 had CIND-mild, 135 CINDmoderate, and 27 dementia. The overall age-standardized prevalence of any cognitive impairment was 25.5%, including 2% of dementia. The prevalence of any cognitive impairment increased with age from 14·9% in those aged 60-64 years to 40.2% in age ≥80 years. Women had a higher prevalence of CIND and dementia than men. Compared to previously published data from EDIS on Chinese, Malay were nearly twice more likely to have any cognitive impairment (Odds ratios adjusted for age, demographic and cardiovascular risk factors, and ApoEε4 carrier: 2.03, 95% confidence interval: 1.48-2.77). Among elderly Malays, the overall prevalence of any cognitive impairment was 25.5%. Even with a similar protocol of recruitment and assessment and adjusting for known risk factors, the prevalence of cognitive impairment was higher in Malays compared to Chinese. Further research is needed to unravel other factors that may underlie these ethnic differences in the occurrence of cognitive impairment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. Prevalence of sleep-disordered breathing in a multiethnic Asian population in Singapore: A community-based study.

    PubMed

    Tan, Adeline; Cheung, Yan Yi; Yin, Jason; Lim, Wei-Yen; Tan, Linda W L; Lee, Chi-Hang

    2016-07-01

    Limited data exist on the prevalence variation in sleep-disordered breathing (SDB) across different Asian ethnicities. This population study aimed to estimate the prevalence of SDB in Singapore, a multiethnic nation, and to quantify the prevalence variation among Chinese, Malays and Indians. The Singapore Health Study 2012 was a cross-sectional population study conducted on adults aged 21-79 years. Among 2329 participants who completed baseline examination, a sample of 242 subjects completed home-based sleep testing with an Embletta device (type 3 monitor). Moderate-to-severe SDB, defined as an apnoea-hypopnoea index (AHI) of ≥15 events/h, was used to estimate prevalence. The weighted estimates of the population prevalence of moderate-to-severe SDB and sleep apnoea syndrome were 30.5% and 18.1%, respectively. Of subjects with AHI ≥15, 91.0% were previously undiagnosed. Moderate-to-severe SDB prevalence varied across the Chinese (32.1%), Malays (33.8%) and Indians (16.5%). The mean body mass index (BMI) was lowest in Chinese (23.3 kg/m(2) ) and highest among Malays (26.0 kg/m(2) ) and Indians (25.4 kg/m(2) ). Compared with Chinese, Indians had lower odds of moderate-to-severe SDB after adjustment for age, sex and BMI (odds ratio 0.82, 95% CI: 0.70-0.96, P = 0.02). Sleep-disordered breathing is prevalent but mostly undiagnosed among Asians in Singapore. There was a lower prevalence of SDB among Indians compared with Chinese that remained after adjustment for age, sex and BMI. Strategies are needed to optimize diagnosis and recognize ethnic differences in SDB prevalence. © 2016 Asian Pacific Society of Respirology.

  18. Current cat ownership may be associated with the lower prevalence of atopic dermatitis, allergic rhinitis, and Japanese cedar pollinosis in schoolchildren in Himeji, Japan.

    PubMed

    Kurosaka, Fumitake; Nakatani, Yuji; Terada, Tadayuki; Tanaka, Akira; Ikeuchi, Haruki; Hayakawa, Akira; Konohana, Atsuo; Oota, Kenji; Nishio, Hisahide

    2006-02-01

    The aim of the study was to clarify the relationship between current pet ownership, passive smoking, and allergic diseases among the Japanese children. From 1995 to 2001, we distributed the Japanese edition of the questionnaire of the American Thoracic Society and the Division of Lung Diseases (ATS-DLD) to survey allergic diseases among 35,552 6-yr-old children at primary school in the city of Himeji, Japan. We analyzed the data by multiple logistic regression and calculated adjusted odds ratios for environmental factors, including passive smoking and pet (dog and/or cat) ownership. There were no significant relationships between the prevalence of asthma and current pet ownership and passive smoking. However, current cat ownership was related to a significantly lower prevalence of atopic dermatitis [adjusted odds ratio (aOR) 0.79, 95% confidence interval (CI) 0.67-0.93], allergic rhinitis (aOR: 0.71, 95% CI 0.57-0.89) and Japanese cedar pollinosis (aOR 0.57, 95% CI 0.44-0.75). Strikingly, passive smoking was also related to a significantly lower prevalence of allergic rhinitis (aOR 0.83, 95% CI 0.77-0.89) and Japanese cedar pollinosis (aOR 0.81, 95% CI 0.74-0.88). Current cat ownership was associated with a lower prevalence of atopic dermatitis, allergic rhinitis, and Japanese cedar pollinosis. In addition, passive smoking was also associated with a lower prevalence of allergic rhinitis and Japanese cedar pollinosis.

  19. Workplace policies and prevalence of knee osteoarthritis: the Johnston County Osteoarthritis Project

    PubMed Central

    Chen, J-C; Linnan, L; Callahan, L F; Yelin, E H; Renner, J B

    2007-01-01

    Objective Previous studies on work and knee osteoarthritis (KOA) have been primarily focused on physical demands; very little is known about work-related organisational policies and KOA risks and outcomes. We examined the associations between workplace policies and KOA in a community-based population in the USA. Methods The associations between employment offering accommodations (switch to physically less demanding jobs; part-time work for people needing reduced time) and benefits policies (paid sick leave; disability payment) with KOA outcomes (knee symptoms; symptomatic KOA [sKOA]; asymptomatic radiographic KOA [rKOA]) were analysed in participants (n = 1639) aged <65 years old and with completed employment histories and knee radiographs at baseline examination of the Johnston County Osteoarthritis Project. Multiple logistic regression models were used to estimate the prevalence odds ratios (ORs) of KOA associated with each workplace policy, adjusting for sociodemographic features, lifestyle factors, knee injuries, body mass index and other workplace characteristics. We used propensity score models to evaluate the differential selection in employment offering favourable policies and adjust for this potential bias accordingly. Results Individuals employed in workplaces offering better policies had significantly less knee symptoms. Lower sKOA prevalence was noted in workplaces offering job-switch accommodation (8% vs. 13%), paid sick leave (9% vs. 16%) and disability payment (8% vs. 16%) than their counterparts. In multivariable models, the difference in sKOA prevalence was statistically significant for paid sick leave (adjusted OR 0.58, 95% CI 0.37 to 0.91) and disability payment policies (adjusted OR 0.54, 95% CI 0.35 to 0.85). Even among those without overt knee-related symptoms, a similar pattern of negative association between workplace policies and rKOA was present and remained robust after propensity score adjustment. Conclusion The negative associations

  20. Workplace policies and prevalence of knee osteoarthritis: the Johnston County Osteoarthritis Project.

    PubMed

    Chen, J-C; Linnan, L; Callahan, L F; Yelin, E H; Renner, J B

    2007-12-01

    Previous studies on work and knee osteoarthritis (KOA) have been primarily focused on physical demands; very little is known about work-related organisational policies and KOA risks and outcomes. We examined the associations between workplace policies and KOA in a community-based population in the USA. The associations between employment offering accommodations (switch to physically less demanding jobs; part-time work for people needing reduced time) and benefits policies (paid sick leave; disability payment) with KOA outcomes (knee symptoms; symptomatic KOA [sKOA]; asymptomatic radiographic KOA [rKOA]) were analysed in participants (n = 1639) aged <65 years old and with completed employment histories and knee radiographs at baseline examination of the Johnston County Osteoarthritis Project. Multiple logistic regression models were used to estimate the prevalence odds ratios (ORs) of KOA associated with each workplace policy, adjusting for sociodemographic features, lifestyle factors, knee injuries, body mass index and other workplace characteristics. We used propensity score models to evaluate the differential selection in employment offering favourable policies and adjust for this potential bias accordingly. Individuals employed in workplaces offering better policies had significantly less knee symptoms. Lower sKOA prevalence was noted in workplaces offering job-switch accommodation (8% vs. 13%), paid sick leave (9% vs. 16%) and disability payment (8% vs. 16%) than their counterparts. In multivariable models, the difference in sKOA prevalence was statistically significant for paid sick leave (adjusted OR 0.58, 95% CI 0.37 to 0.91) and disability payment policies (adjusted OR 0.54, 95% CI 0.35 to 0.85). Even among those without overt knee-related symptoms, a similar pattern of negative association between workplace policies and rKOA was present and remained robust after propensity score adjustment. The negative associations between KOA and workplace policies

  1. Serum periostin is associated with prevalent knee osteoarthritis and disease incidence/progression in women: the OFELY study.

    PubMed

    Rousseau, J C; Sornay-Rendu, E; Bertholon, C; Garnero, P; Chapurlat, R

    2015-10-01

    Our aim was to investigate the relationships between serum periostin (POSTN) and both prevalence and incidence/progression of knee osteoarthritis (OA) in women. We investigated 594 women (62.7 ± 11.2 yr) from the OFELY cohort. Knee radiographs were scored according to the Kellgren & Lawrence (KL) grading system at baseline and 4 years later. Spine, hip and hand OA were assessed at baseline. Prevalent knee OA was defined by a KL score higher or equal in 2. Progression of KL was defined as an increase of the KL score ≥1 during the 4 years follow-up. Serum POSTN was measured at baseline by ELISA. By non-parametric tests, POSTN was significantly lower in 83 women with a KL score ≥2 at baseline, compared to those with a KL score <2 (n = 511; 1101 ± 300 vs 1181 ± 294 ng/ml, P = 0.002) after adjustment for age, body mass index (BMI), treatments and diseases, prevalent hand OA and prevalent lumbar spine OA. By logistic regression analyses, the odds-ratio of knee OA incidence/progression was significantly reduced by 21% (P = 0.043) for each quartile increase in serum POSTN at baseline, after adjustment for age, BMI, prevalent knee OA, prevalent hand OA and prevalent lumbar spine OA. We show for the first time that serum POSTN is associated with prevalence and the risk of development/progression of knee OA in women. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  2. Dynapenic Obesity and Prevalence of Type 2 Diabetes in Middle-Aged Japanese Men

    PubMed Central

    Kawakami, Ryoko; Sawada, Susumu S.; Lee, I-Min; Matsushita, Munehiro; Gando, Yuko; Okamoto, Takashi; Tsukamoto, Koji; Higuchi, Mitsuru; Miyachi, Motohiko; Blair, Steven N.

    2015-01-01

    Background The independent and combined associations of muscle strength and obesity on the prevalence of type 2 diabetes in Japanese men remain unclear. Methods Hand grip strength was cross-sectionally evaluated between 2011 and 2013 to assess muscle strength in 5039 male workers aged 40 to 64 years. Weight and height were measured, and overweight/obesity was defined as a body mass index ≥25 kg/m2. The prevalence of type 2 diabetes, defined as fasting plasma glucose ≥126 mg/dL and/or hemoglobin A1c ≥6.5% and/or self-reported physician-diagnosed diabetes, was evaluated. Odds ratios (OR) and 95% confidence intervals (95% CI) for the prevalence of type 2 diabetes were obtained using a logistic regression model. Results In total, 611 participants had type 2 diabetes, and 1763 participants were overweight/obese. After adjustment for covariates, we found an inverse association between muscle strength and the prevalence of type 2 diabetes (P for trend <0.01). In addition, when the analyses were stratified by obesity status, the multivariable-adjusted OR per 2-standard-deviation increase in muscle strength was 0.64 (95% CI, 0.49–0.83) in the overweight/obese group, compared to a weaker relationship in the normal-weight group (OR 0.79 per 2-standard-deviation increase; 95% CI, 0.60–1.06). Conclusions Dynapenia, an age-related decrease in muscle strength, is associated with increased prevalence of type 2 diabetes, and this relationship is stronger in overweight/obese middle-aged Japanese men than in normal-weight men. PMID:26256772

  3. The Prevalence of Type 2 Diabetes Mellitus in a Wisconsin Hmong Patient Population.

    PubMed

    Thao, Kevin K; Arndt, Brian; Tandias, Aman; Hanrahan, Lawrence

    2015-10-01

    Wisconsin's largest Asian population, the Hmong, may be at high risk for type 2 diabetes. However, there are few population-based studies investigating the prevalence of diabetes in this population. This study compared the prevalence of diabetes between Hmong and non-Hispanic white patients of the University of Wisconsin departments of family medicine, pediatrics, and internal medicine clinics. The study utilized data from the University of Wisconsin Electronic Health Record Public Health Information Exchange (UW eHealth--PHINEX). The proportion of Hmong patients diagnosed with diabetes was compared with the prevalence of diabetes in non-Hispanic white patients. Multivariate logistic regression was used to control for the differences in age, sex, body mass index (BMI), and health insurance between the two populations. The total prevalence of diabetes in the Hmong patient population was 11.3% compared to 6.0% in the non-Hispanic white patient population (P < 0.001). The prevalence of diabetes in Hmong adult patients was 19.1% compared to 7.8% in white adult patients (P =< 0.001). Compared with non-Hispanic whites, the odds ratio (95% CI) for diabetes, adjusted for age, sex, BMI, and insurance was 3.3 (2.6-4.1) for Hmong patients. Despite being one of Wisconsin's newest immigrant populations, who came from an area of the world with low rates of diabetes, the adjusted relative odds of diabetes in this clinic sample of Hmong patients is 3.3 times higher than its non-Hispanic white counterpart. The results support previous findings of significantly increased diabetes risk in the Hmong of Wisconsin.

  4. Prevalence of Injury in Occupation and Industry: Role of Obesity in the National Health Interview Survey 2004 to 2013.

    PubMed

    Gu, Ja K; Charles, Luenda E; Fekedulegn, Desta; Ma, Claudia C; Andrew, Michael E; Burchfiel, Cecil M

    2016-04-01

    The aim of this study was to estimate prevalence of injury by occupation and industry and obesity's role. Self-reported injuries were collected annually for US workers during 2004 to 2013. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were obtained from fitted logistic regression models. Overall weighted injury prevalence during the previous three months was 77 per 10,000 workers. Age-adjusted injury prevalence was greatest for Construction and Extraction workers (169.7/10,000) followed by Production (160.6) among occupations, while workers in the Construction industry sector (147.9) had the highest injury prevalence followed by the Agriculture/Forestry/Fishing/Mining/Utilities sector (122.1). Overweight and obese workers were 26% to 45% more likely to experience injuries than normal-weight workers. The prevalence of injury, highest for Construction workers, gradually increased as body mass index levels increased in most occupational and industry groups.

  5. [Adjustment disorder and DSM-5: A review].

    PubMed

    Appart, A; Lange, A-K; Sievert, I; Bihain, F; Tordeurs, D

    2017-02-01

    This paper exposes the complexity and discrete characteristic of the adjustment disorder with reference to its clinical and scientific diagnosis. Even though the disorder occurs in frequent clinical circumstances after important life events, such as mobbing, burn-out, unemployment, divorce or separation, pregnancy denial, surgical operation or cancer, the adjustment disorder is often not considered in the diagnosis since better known disorders with similar symptoms prevail, such as major depression and anxiety disorder. Ten years ago, Bottéro had already noticed that the adjustment disorder diagnosis remained rather uncommon with reference to patients he was working with while Langlois assimilated this disorder with an invisible diagnosis. In order to maximize the data collection, we used the article review below and challenged their surveys and results: National Center for Biotechnology Information (NBCI - Pubmed) for international articles and Cairn.info for French literature. Moreover, we targeted the following keywords on the search engine and used articles, which had been published from 1 February 1975 to 31 January 2015: "adjustment", "adjustment disorder" and the French translation "trouble de l'adaptation". One hundred and ninety-one articles matched our search criteria. However, after a closer analysis, solely 105 articles were selected as being of interest. Many articles were excluded since they were related to non-psychiatric fields induced by the term "adaptation". Indeed, the number of corresponding articles found for the adjustment disorder literally pointed-out the lack of existing literature on that topic in comparison to more known disorders such as anxiety disorder (2661 articles) or major depression (5481 articles). This represents up to 50 times more articles in comparison to the number of articles we found on adjustment disorder and up to 20 times more articles for the eating disorder (1994), although the prevalence is not significantly

  6. The Prevalence of Anosmia and Associated Factors Among U.S. Black and White Older Adults.

    PubMed

    Dong, Jing; Pinto, Jayant M; Guo, Xuguang; Alonso, Alvaro; Tranah, Gregory; Cauley, Jane A; Garcia, Melissa; Satterfield, Suzanne; Huang, Xuemei; Harris, Tamara; Mosley, Thomas H; Chen, Honglei

    2017-08-01

    Olfactory impairment is common among older adults; however, data are largely limited to whites. We conducted pooled analyses of two community-based studies: the Atherosclerosis Risk in Communities study (ARIC, 1,398 blacks and 4,665 whites), and the Health, Aging, and Body Composition study (Health ABC, 958 blacks and 1,536 whites) to determine the prevalence of anosmia and associated factors for black and white older adults in the United States. The overall prevalence of anosmia was 22.3% among blacks and 10.4% among whites. Blacks had a markedly higher odds of anosmia compared to whites in age and sex adjusted analyses (odds ratio [OR] 2.96, 95% confidence interval [CI] = 2.59-3.38). In both blacks and whites, higher anosmia prevalence was associated with older age and male sex. The highest prevalence was found in black men 85 years or older (58.3%), and the lowest in white women aged 65-69 years (2.4%). Higher education level, lower cognitive score, ApoE ε4, daytime sleepiness, poorer general health status, lower body mass index, and Parkinson disease were associated with higher prevalence of anosmia in one or both races. However, the racial difference in anosmia remained statistically significant after adjusting for these factors (fully adjusted OR = 1.76, 95%CI: 1.50-2.07). Results were comparable between the two cohorts. Anosmia is common in older adults, particularly among blacks. Further studies are needed to identify risk factors for anosmia and to investigate racial disparities in this sensory deficit. Published by Oxford University Press on behalf of The Gerontological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  7. Job strain and neck-shoulder symptoms: a prevalence study of women and men white-collar workers.

    PubMed

    Leroux, Isabelle; Brisson, Chantal; Montreuil, Sylvie

    2006-03-01

    Neck-shoulder symptoms are frequent among workers. Psychosocial factors at work have been associated with neck-shoulder symptoms, but few studies have examined job strain, the combined effect of high psychological demands (PD) and low decision latitude (DL). To examine the association between psychosocial factors at work and the prevalence of self-reported neck-shoulder symptoms among white-collar workers. In a cross-sectional study of 1543 white-collar workers, PD and DL at work were measured with Karasek's questionnaire. Prevalent cases were workers for whom neck-shoulder symptoms were present for >or=3 days during the previous 7 days and for whom pain intensity was greater than half the visual analogue scale. Gender and social support at work were evaluated as potential effect modifiers. Workers exposed to high job strain had a higher prevalence of neck-shoulder symptoms [adjusted prevalence ratio (PR): 1.54, 95% confidence interval (CI): 1.00-2.37]. No modifying effect of gender was observed in this association. The effect of job strain was stronger in workers with low social support (adjusted PR: 1.84, 95% CI: 0.92-3.68). These associations tended to be stronger and/or more precise when using alternative exposures and case definition. Namely, a stronger job strain effect was observed when a tertile cut-off was used to classify exposure (adjusted PR: 2.47, 95% CI: 1.15-5.32). These results suggest that primary prevention of neck-shoulder symptoms among white-collar workers should consider the exposure to job strain, especially when workers are exposed to low social support at work.

  8. Prevalence of Enterobius vermicularis among Preschool Children in Gimhae-si, Gyeongsangnam-do, Korea

    PubMed Central

    Lee, Sang-Eun; Lee, Jin-Hee; Ju, Jung-Won; Lee, Won-Ja

    2011-01-01

    The present study was performed to determine the prevalence of Enterobius vermicularis among preschool children in Gimhae-si, Korea. A total of 6,921 preschool children in 76 kindergartens were examined using the cellotape perianal swab method. The overall egg positive rate (EPR) was 10.5%. The EPR in boys was higher than that in girls (adjusted odds ratio [AOR]: 1.5, P<0.001), and it was higher in rural than in urban children (AOR: 1.2, P=0.022). The present study confirmed that the prevalence of E. vermicularis infection is fairly high among preschool children in Gimhae-si. Therefore, systematic control and preventive measures should be adopted to reduce morbidity associated with this nematode infection. PMID:21738277

  9. Association Between Prevalence of Chronic Obstructive Pulmonary Disease and Health-Related Quality of Life, South Carolina, 2011

    PubMed Central

    Steck, Susan E.; Heidari, Khosrow

    2013-01-01

    Introduction We investigated the prevalence of chronic obstructive pulmonary disease (COPD) in various population subgroups in South Carolina and examined associations between COPD and 4 core measures of health-related quality of life (HRQOL). Methods Data from 12,851 participants of the 2011 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. COPD prevalence rates were age-adjusted to the 2000 standard US population. Logistic regression models were used to estimate adjusted odds ratios (AOR’s) and 95% confidence intervals (CIs). Results The overall age-adjusted prevalence of self-reported diagnosis of COPD among community-dwelling adults in South Carolina in 2011 was 7.1% (standard error [SE] ±0.3). Prevalence of self-reported diagnosis of COPD was highest among women (8.9%; SE, ±0.5), those aged 65 years or older (12.9%; SE, ±0.5), current smokers (15.9%; SE, ±0.7), and those with low levels of education and income. Compared with community-dwelling adults without COPD, those with COPD were more likely to report fair or poor general health status (AOR, 3.97; 95% CI, 3.13–5.03), 14 or more physically unhealthy days (AOR, 2.10, 95% CI, 1.57–2.81), 14 or more mentally unhealthy days (AOR, 1.72; 95% CI, 1.21–2.43), and 14 or more days of activity limitation (AOR, 2.22; 95% CI, 1.53–3.22) within the previous 30 days. Conclusion COPD is a highly prevalent disease in South Carolina, especially among older people and smokers, and it is associated with poor HRQOL. Future work aimed at reducing risk factors may decrease the disease prevalence, and increasing early detection and improving access to appropriate medical treatments can improve HRQOL for those living with COPD. PMID:24370110

  10. Irritable bowel syndrome: prevalence, risk factors in an adult Lebanese population.

    PubMed

    Chatila, Rajaa; Merhi, Mahmoud; Hariri, Essa; Sabbah, Nada; Deeb, Mary E

    2017-12-02

    Very few studies report on the prevalence of irritable bowel syndrome (IBS) and its correlates in the Middle East. This study investigated Irritable Bowel Syndrome (IBS) prevalence in a sample of Lebanese adult individuals and associated demographic and behavioral lifestyle factors. This is an observational population-based study. The target population is working Lebanese adults, eighteen-to-sixty five years old. The sample was selected from a convenience population of bank employees in different geographical areas in Lebanon. The study participants completed an anonymous self-administered questionnaire, to collect data on their socio-demographic, behavioral and life style characteristics, and diagnostic questions following Rome III criteria to assess IBS occurrence. The difference in IBS prevalence by socio-demographic characteristics, smoking, alcohol consumption, and physical activity was assessed by using the Chi-square test. Logistic regression adjusted odds ratios were used to investigate the association between risk factors and IBS. Data was collected from 553 individuals and consisted of 52.8% females (mean age 35.9 years, SD = 11.9) and 47.2% males (mean age = 36.1 years, SD = 10.3). The prevalence of IBS in the study population according to Rome III criteria was 20.1%. The bivariate analysis indicated that being younger than 30 years old, a female, an ever water pipe smoker, an ever alcohol consumer are significantly associated with a higher prevalence of IBS. Educational level, cigarettes smoking and physical exercise were not significantly associated with IBS occurrence. The logistic regression adjusted odds ratio showed that females were 1.67 times more likely to have IBS than males (P˂ 0.05). The participants aged less than 30 years old were at a higher risk of having IBS (P˂ 0.01). Those who ever smoked waterpipe were 1.63 times more likely to have IBS than those who never smoked waterpipe (P˂ 0.05). Those who were ever alcohol

  11. Trends in silicosis prevalence and the healthy worker effect among gold miners in South Africa: a prevalence study with follow up of employment status.

    PubMed

    Knight, David; Ehrlich, Rodney; Fielding, Katherine; Jeffery, Hannah; Grant, Alison; Churchyard, Gavin

    2015-12-18

    Given the intimate association between silicosis and tuberculosis, understanding the epidemiology of the South African gold mining industry silicosis epidemic is essential to current initiatives to control both silicosis and tuberculosis in this population, one of the most heavily affected globally. The study's objectives were to compare the prevalence of silicosis among working black gold miners in South Africa during 2004-2009 to that of previous studies, including autopsy series, and to analyse the influence of silicosis and/or tuberculosis on exiting employment. Routine chest radiographs from a cohort of gold miners were read for silicosis by an experienced reader (I), and a subset re-read by a B-trained reader (II). Two methods of presenting the readings were used. Additionally, with baseline status of silicosis and previous or active tuberculosis as predictors, survival analysis examined the probability of exiting the workforce for any reason during 2006-2011. Reader I read 11 557 chest radiographs and reader II re-read 841. Overall, silicosis prevalence (ILO ≥ 1/0: 5.7 and 6.2% depending on reader method) was similar to the age adjusted prevalence found in a large study in 1984 (5.0%). When comparison was restricted to a single mine shaft previously studied in 2000, a decline in prevalence (ILO ≥ 1/1) was suggested for one of the reading methods (duration adjusted 20.5% vs. 13.0% in the current study). These findings are discordant with a long-term rising autopsy prevalence of silicosis over this period. Overall, relative to miners with neither disease, the adjusted hazard ratio for exiting employment during the follow-up period was 1.54 for baseline silicosis [95% confidence interval (CI) 1.17, 2.04], 1.71 for tuberculosis (95% CI 1.51, 1.94) and 1.53 for combined disease (95% CI 1.20, 1.96). This study found, a) there was no significant decline in overall silicosis prevalence among working black miners in the South African gold mining industry between

  12. Association of UV radiation with multiple sclerosis prevalence and sex ratio in France.

    PubMed

    Orton, S-M; Wald, L; Confavreux, C; Vukusic, S; Krohn, J P; Ramagopalan, S V; Herrera, B M; Sadovnick, A D; Ebers, G C

    2011-02-01

    French farmers and their families constitute an informative population to study multiple sclerosis (MS) prevalence and related epidemiology. We carried out an ecological study to evaluate the association of MS prevalence and ultraviolet (UV) radiation, a candidate climatologic risk factor. Mean annual and winter (December-March) UVB irradiation values were systematically compared to MS prevalence rates in corresponding regions of France. UVB data were obtained from the solar radiation database (SoDa) service and prevalence rates from previously published data on 2,667 MS cases registered with the national farmer health insurance system, Mutualité Sociale Agricole (MSA). Pearson correlation was used to examine the relationship of annual and winter UVB values with MS prevalence. Male and female prevalence were also analyzed separately. Linear regression was used to test for interaction of annual and winter UVB with sex in predicting MS prevalence. There was a strong association between MS prevalence and annual mean UVB irradiation (r = -0.80, p < 0.001) and average winter UVB (r = -0.87, p < 0.001). Both female (r = -0.76, p < 0.001) and male (r = -0.46, p = 0.032) prevalence rates were correlated with annual UVB. Regression modeling showed that the effect of UVB on prevalence rates differed by sex; the interaction effect was significant for both annual UVB (p = 0.003) and winter UVB (p = 0.002). The findings suggest that regional UVB radiation is predictive of corresponding MS prevalence rates and supports the hypothesis that sunlight exposure influences MS risk. The evidence also supports a potential role for gender-specific effects of UVB exposure.

  13. Association of UV radiation with multiple sclerosis prevalence and sex ratio in France

    PubMed Central

    Orton, S.-M.; Wald, L.; Confavreux, C.; Vukusic, S.; Krohn, J.P.; Ramagopalan, S.V.; Herrera, B.M.; Sadovnick, A.D.

    2011-01-01

    Background: French farmers and their families constitute an informative population to study multiple sclerosis (MS) prevalence and related epidemiology. We carried out an ecological study to evaluate the association of MS prevalence and ultraviolet (UV) radiation, a candidate climatologic risk factor. Methods: Mean annual and winter (December–March) UVB irradiation values were systematically compared to MS prevalence rates in corresponding regions of France. UVB data were obtained from the solar radiation database (SoDa) service and prevalence rates from previously published data on 2,667 MS cases registered with the national farmer health insurance system, Mutualité Sociale Agricole (MSA). Pearson correlation was used to examine the relationship of annual and winter UVB values with MS prevalence. Male and female prevalence were also analyzed separately. Linear regression was used to test for interaction of annual and winter UVB with sex in predicting MS prevalence. Results: There was a strong association between MS prevalence and annual mean UVB irradiation (r = −0.80, p < 0.001) and average winter UVB (r = −0.87, p < 0.001). Both female (r = −0.76, p < 0.001) and male (r = −0.46, p = 0.032) prevalence rates were correlated with annual UVB. Regression modeling showed that the effect of UVB on prevalence rates differed by sex; the interaction effect was significant for both annual UVB (p = 0.003) and winter UVB (p = 0.002). Conclusions: The findings suggest that regional UVB radiation is predictive of corresponding MS prevalence rates and supports the hypothesis that sunlight exposure influences MS risk. The evidence also supports a potential role for gender-specific effects of UVB exposure. PMID:21282589

  14. Prevalence of overweight and obesity in United Arab Emirates Expatriates: the UAE National Diabetes and Lifestyle Study.

    PubMed

    Sulaiman, Nabil; Elbadawi, Salah; Hussein, Amal; Abusnana, Salah; Madani, Abdulrazzag; Mairghani, Maisoon; Alawadi, Fatheya; Sulaiman, Ahmad; Zimmet, Paul; Huse, Oliver; Shaw, Jonathan; Peeters, Anna

    2017-01-01

    To describe current prevalence of obesity and related non-communicable diseases (NCDs) in expatriates living in the United Arab Emirates (UAE). We used data from the cross-sectional UAE National Diabetes and Lifestyle Study (UAEDIAB), which surveyed adult expatriates living in the UAE for at least 4 years. We report crude prevalence of overweight and obesity, indicated by gender and ethnicity-specific body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) cut-offs, by lifestyle and biomedical characteristics, as well as age and sex-adjusted odds ratios. Out of a total of 3064 recruited expatriates (response rate 68%), 2724 had completed all stages of the UAEDIAB study. Expatriates were; 81% men, mean age 38 years (range 18-80), 71% South East Asians, and 36% university graduates. In this sample, the prevalence of overweight and obesity, by BMI, were 43.0 and 32.3%, respectively. 52.4 and 56.5% of participants were at a substantially increased risk according to WC and WHR, respectively. The prevalence of diabetes, hypertension and hypercholesterolemia were 15.5, 31.8, and 51.7%, respectively, with the prevalence of each being higher in those with obesity. Prevalence of obesity and associated NCDs are extremely high in UAE expatriates. Without comprehensive prevention and management, levels of disease will continue to increase and productivity will fall.

  15. 45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

  16. 45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

  17. 45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

  18. 45 CFR 158.330 - Criteria for assessing request for adjustment to the medical loss ratio.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Potential Adjustment to the MLR for a State's Individual Market § 158.330 Criteria for assessing request for... individual market in a State that has requested an adjustment to the 80 percent MLR: (a) The number of... adjustment to the 80 percent MLR and the resulting impact on competition in the State. In making this...

  19. Prevalence of musculoskeletal disorders among school teachers from urban and rural areas in Chuquisaca, Bolivia: a cross-sectional study.

    PubMed

    Solis-Soto, María Teresa; Schön, Anabel; Solis-Soto, Angel; Parra, Manuel; Radon, Katja

    2017-10-27

    Musculoskeletal disorders (MSD) are important health problems in working populations. The study aimed to determine the prevalence of MSD among school teachers from urban and rural areas in Chuquisaca, Bolivia. A cross-sectional study was conducted in 60 randomly selected schools. In total, 1062 teachers were invited to participate (response 58%). The Spanish version of the Standardized Nordic questionnaire was used assessing the 12-months and 7-days prevalence of MSD as well as the 12-months prevalence of work limiting pain. Prevalence were calculated for the different parts of the body; as summary measures, MSD in any part of the body and in ≥3 parts of the body were assessed. Crude and adjusted odds ratios with 95% confidence intervals were calculated using logistic regression models adjusting for age, sex, teaching level and school type. Prevalence of MSD in any part of the body was 86% during the last 12 months, 63% during the last 7 days and 15% for work limiting pain. MSD was most common in the neck (12-months prevalence 47%) and least common in the wrist/hands (26%). In the adjusted model, teachers working in rural areas presented significantly higher odds than teachers from urban schools for work-limiting pain during the last 12-months considering any part of the body (aOR 2.2; 95% CI 1.1-4.1), and for ≥3 parts of the body (aOR 3.7; 95% CI 1.3-10.6). The prevalence of MSD is high in School teachers, even more in teachers working in rural areas. It is needed to identify risk factors for MSD in teachers in order to propose appropriate strategies to control and reduce it.

  20. The Prevalence of Carpal Tunnel Syndrome in Latino Poultry Processing Workers and Other Latino Manual Workers

    PubMed Central

    Cartwright, Michael S.; Walker, Francis O.; Blocker, Jill N.; Schulz, Mark R.; Arcury, Thomas A.; Grzywacz, Joseph G.; Mora, Dana; Chen, Haiying; Marín, Antonio J.; Quandt, Sara A.

    2011-01-01

    Objective To determine the prevalence of carpal tunnel syndrome (CTS) in Latino poultry processing workers. Methods Symptoms and nerve conduction studies were used to prospectively assess 287 Latino poultry processing workers and 226 Latinos in other manual labor occupations. Results The prevalence of CTS was higher in poultry processing (8.7%) compared to non-poultry manual workers (4.0%, p < 0.0001). The adjusted odds ratio for the prevalence of CTS in poultry workers was 2.51 (95% CI of 1.80 to 3.50) compared to non-poultry workers. Within the poultry workers, those who performed packing, sanitation, and chilling had a trend toward less CTS than those who performed tasks requiring more repetitive and strenuous hand movements. Discussion Latino poultry processing workers have a high prevalence of CTS, which likely results from the repetitive and strenuous nature of the work. PMID:22258161

  1. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study.

    PubMed

    Zhang, Lin; Zhang, Wei; Zhang, Lingling; Tian, Danping; Li, Li; Deng, Xin; Deng, Jing; Ning, Peishan; Hu, Guoqing

    2016-06-23

    Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Data came from the first health service household interview of Hunan province, China, in 2013. A Rao-Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45-64 years, 46%; 18-44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1-3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7-6.5) for young adults aged 18-44 years. The associations were not statistically significant for age groups 45-64 years and 65 years or older. The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

  2. Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke.

    PubMed

    Rajachandrakumar, Roshanth; Fraser, Julia E; Schinkel-Ivy, Alison; Inness, Elizabeth L; Biasin, Lou; Brunton, Karen; McIlroy, William E; Mansfield, Avril

    2017-02-01

    Anticipatory postural adjustments, executed prior to gait initiation, help preserve lateral stability when stepping. Atypical patterns of anticipatory activity prior to gait initiation may occur in individuals with unilateral impairment (e.g., stroke). This study aimed to determine the prevalence, correlates, and consequences of atypical anticipatory postural adjustment patterns prior to gait initiation in a sub-acute stroke population. Forty independently-ambulatory individuals with sub-acute stroke stood on two force plates and initiated gait at a self-selected speed. Medio-lateral centre of pressure displacement was calculated and used to define anticipatory postural adjustments (shift in medio-lateral centre of pressure >10mm from baseline). Stroke severity, motor recovery, and functional balance and mobility status were also obtained. Three patterns were identified: single (typical), absent (atypical), and multiple (atypical) anticipatory postural adjustments. Thirty-five percent of trials had atypical anticipatory postural adjustments (absent and multiple). Frequency of absent anticipatory postural adjustments was negatively correlated with walking speed. Multiple anticipatory postural adjustments were more prevalent when leading with the non-paretic than the paretic limb. Trials with multiple anticipatory postural adjustments had longer duration of anticipatory postural adjustment and time to foot-off, and shorter unloading time than trials with single anticipatory postural adjustments. A high prevalence of atypical anticipatory control prior to gait initiation was found in individuals with stroke. Temporal differences were identified with multiple anticipatory postural adjustments, indicating altered gait initiation. These findings provide insight into postural control during gait initiation in individuals with sub-acute stroke, and may inform interventions to improve ambulation in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Association between serum triglyceride to high-density lipoprotein cholesterol ratio and sarcopenia in elderly Korean males: The Korean National Health and Nutrition Examination Survey.

    PubMed

    Chung, Tae-Ha; Kwon, Yu-Jin; Shim, Jae-Yong; Lee, Yong-Jae

    2016-12-01

    We investigated the association between the triglycerides to high-density lipoprotein cholesterol (TG/HDL) ratio and sarcopenia in elderly Korean males. We examined the relationship between the TG/HDL ratio and sarcopenia in 879 elderly males ≥60years who participated in the 2010-2011 KNHANES. Sarcopenia was defined as an appendicular skeletal muscle mass (ASM) divided by the weight (%), which is >1 SD below the mean for young adults. The odds ratios (ORs) for sarcopenia were calculated using multiple logistic regression across the TG/HDL ratio quartiles (Q1: ≤1.4, Q2: 1.5-2.4, Q3: 2.5-3.8 and Q4: ≥3.9) after adjusting for confounding variables. The prevalence of sarcopenia significantly increased in accordance with TG/HDL ratio quartiles. Compared with the lowest quartile of the TG/HDL ratio, the corresponding OR (95% CI) of the highest quartile of the TG/HDL ratio for sarcopenia was 2.10 (1.12-3.91) after adjusting for age, body mass index (BMI), cigarette smoking, alcohol intake and physical activity. TG/HDL ratio was positively related with a higher risk of sarcopenia in elderly Korean males. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.

    PubMed Central

    Clements-Nolle, K; Marx, R; Guzman, R; Katz, M

    2001-01-01

    OBJECTIVES: This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. METHODS: We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. RESULTS: HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. CONCLUSIONS: High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services. PMID:11392934

  5. Prevalence of radiographic hip osteoarthritis is increased in high bone mass.

    PubMed

    Hardcastle, S A; Dieppe, P; Gregson, C L; Hunter, D; Thomas, G E R; Arden, N K; Spector, T D; Hart, D J; Laugharne, M J; Clague, G A; Edwards, M H; Dennison, E M; Cooper, C; Williams, M; Davey Smith, G; Tobias, J H

    2014-08-01

    Epidemiological studies have shown an association between increased bone mineral density (BMD) and osteoarthritis (OA), but whether this represents cause or effect remains unclear. In this study, we used a novel approach to investigate this question, determining whether individuals with High Bone Mass (HBM) have a higher prevalence of radiographic hip OA compared with controls. HBM cases came from the UK-based HBM study: HBM was defined by BMD Z-score. Unaffected relatives of index cases were recruited as family controls. Age-stratified random sampling was used to select further population controls from the Chingford and Hertfordshire cohort studies. Pelvic radiographs were pooled and assessed by a single observer blinded to case-control status. Analyses used logistic regression, adjusted for age, gender and body mass index (BMI). 530 HBM hips in 272 cases (mean age 62.9 years, 74% female) and 1702 control hips in 863 controls (mean age 64.8 years, 84% female) were analysed. The prevalence of radiographic OA, defined as Croft score ≥3, was higher in cases compared with controls (20.0% vs 13.6%), with adjusted odds ratio (OR) [95% CI] 1.52 [1.09, 2.11], P = 0.013. Osteophytes (OR 2.12 [1.61, 2.79], P < 0.001) and subchondral sclerosis (OR 2.78 [1.49, 5.18], P = 0.001) were more prevalent in cases. However, no difference in the prevalence of joint space narrowing (JSN) was seen (OR 0.97 [0.72, 1.33], P = 0.869). An increased prevalence of radiographic hip OA and osteophytosis was observed in HBM cases compared with controls, in keeping with a positive association between HBM and OA and suggesting that OA in HBM has a hypertrophic phenotype. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Lifetime Prevalence of Respiratory Diseases and Exposures Among Veterans of Operation Enduring Freedom and Operation Iraqi Freedom Veterans

    PubMed Central

    Barth, Shannon K.; Dursa, Erin K.; Bossarte, Robert; Schneiderman, Aaron

    2017-01-01

    Objective The objective of this study was to determine the prevalence of respiratory exposures and the association between respiratory exposures and respiratory disease among veterans deployed to Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) compared with nondeployed veterans of this era. Methods Data come from a national health survey of 20,563 deployed and nondeployed OEF/OIF era veterans. Prevalence estimates and adjusted odds ratios were calculated. Results were weighted to represent the population. Results Prevalence of at least one respiratory exposure was high among both deployed and nondeployed groups (95% and 70%, respectively). In both groups, those with any respiratory exposure were at an increased risk for reporting a respiratory disease. Conclusion Respiratory exposures are highly prevalent and are associated with increased odds of respiratory diseases among the OEF/OIF era population. PMID:27930474

  7. Prevalence of workers with shifts in hearing by industry: a comparison of OSHA and NIOSH Hearing Shift Criteria.

    PubMed

    Masterson, Elizabeth A; Sweeney, Marie Haring; Deddens, James A; Themann, Christa L; Wall, David K

    2014-04-01

    The purpose of this study was to compare the prevalence of workers with National Institute for Occupational Safety and Health significant threshold shifts (NSTS), Occupational Safety and Health Administration standard threshold shifts (OSTS), and with OSTS with age correction (OSTS-A), by industry using North American Industry Classification System codes. From 2001 to 2010, worker audiograms were examined. Prevalence and adjusted prevalence ratios for NSTS were estimated by industry. NSTS, OSTS, and OSTS-A prevalences were compared by industry. Twenty percent of workers had an NSTS, 14% had an OSTS, and 6% had an OSTS-A. For most industries, the OSTS and OSTS-A criteria identified 28% to 36% and 66% to 74% fewer workers than the NSTS criteria, respectively. Use of NSTS criteria allowing for earlier detection of shifts in hearing is recommended for improved prevention of occupational hearing loss.

  8. Prevalence of Workers with Shifts in Hearing by Industry: A Comparison of OSHA and NIOSH Hearing Shift Criteria

    PubMed Central

    Masterson, Elizabeth A.; Sweeney, Marie Haring; Deddens, James A.; Themann, Christa L.; Wall, David K.

    2015-01-01

    Objective The purpose of this study was to compare the prevalence of workers with National Institute for Occupational Safety and Health significant threshold shifts (NSTS), Occupational Safety and Health Administration standard threshold shifts (OSTS), and with OSTS with age correction (OSTS-A), by industry using North American Industry Classification System codes. Methods 2001-2010 worker audiograms were examined. Prevalence and adjusted prevalence ratios for NSTS were estimated by industry. NSTS, OSTS and OSTS-A prevalences were compared by industry. Results 20% of workers had an NSTS, 14% had an OSTS and 6% had an OSTS-A. For most industries, the OSTS and OSTS-A criteria identified 28-36% and 66-74% fewer workers than the NSTS criteria, respectively. Conclusions Use of NSTS criteria allowing for earlier detection of shifts in hearing is recommended for improved prevention of occupational hearing loss. PMID:24662953

  9. Blacks and whites in the Cuba have equal prevalence of hypertension: confirmation from a new population survey

    PubMed Central

    2013-01-01

    Background The excess burden of hypertension among blacks has been a prominent feature of the heath disparities literature, and many scientists presume it to be a stable and inevitable phenomenon. The underlying causes of this disparity can only be disentangled in a setting in which the population does not experience racial stratification of socioeconomic opportunities. While such conditions of racial equality remain uncommon, they may be approximated in Cuba, a country with a persistent policy of social inclusion over the last 5 decades. Methods We report on a 2010–2011 stratified probability sample of those aged 15–74 years from the urban population of Cienfuegos in central Cuba. A total of 1496 adults (880 women and 616 men) were recruited and assessed for blood pressure and anthropometrics according to standardized protocols, as well as medication use, educational attainment and observed skin tone (dichotomized into “black” and “white”). Weighted tabular and regression analyses were conducted to estimate adjusted prevalences of hypertension (> 140/90 mmHg) and adjusted prevalence odds ratios for contrasts between the two skin color groups. Results Mean pressures were higher for men than for women, but overall did not differ importantly between racial groups. About half of all diagnosed hypertensive men were on medication, a proportion that did not vary by racial group. For women, however, adjusted prevalence was somewhat higher among blacks, and treatment and control rates were also somewhat advantaged for white women. Conclusions Overall, skin color was unrelated to mean blood pressure or hypertensive status in this population, although among women specifically some racial advantage appears evident in adjusted prevalence and control, and should be investigated further. The overall null result suggests that Cuba may exemplify the social conditions in which racial excess in hypertension, characteristic of much of the western world, is not a

  10. Refusal bias in HIV prevalence estimates from nationally representative seroprevalence surveys.

    PubMed

    Reniers, Georges; Eaton, Jeffrey

    2009-03-13

    To assess the relationship between prior knowledge of one's HIV status and the likelihood to refuse HIV testing in populations-based surveys and explore its potential for producing bias in HIV prevalence estimates. Using longitudinal survey data from Malawi, we estimate the relationship between prior knowledge of HIV-positive status and subsequent refusal of an HIV test. We use that parameter to develop a heuristic model of refusal bias that is applied to six Demographic and Health Surveys, in which refusal by HIV status is not observed. The model only adjusts for refusal bias conditional on a completed interview. Ecologically, HIV prevalence, prior testing rates and refusal for HIV testing are highly correlated. Malawian data further suggest that amongst individuals who know their status, HIV-positive individuals are 4.62 (95% confidence interval, 2.60-8.21) times more likely to refuse testing than HIV-negative ones. On the basis of that parameter and other inputs from the Demographic and Health Surveys, our model predicts downward bias in national HIV prevalence estimates ranging from 1.5% (95% confidence interval, 0.7-2.9) for Senegal to 13.3% (95% confidence interval, 7.2-19.6) for Malawi. In absolute terms, bias in HIV prevalence estimates is negligible for Senegal but 1.6 (95% confidence interval, 0.8-2.3) percentage points for Malawi. Downward bias is more severe in urban populations. Because refusal rates are higher in men, seroprevalence surveys also tend to overestimate the female-to-male ratio of infections. Prior knowledge of HIV status informs decisions to participate in seroprevalence surveys. Informed refusals may produce bias in estimates of HIV prevalence and the sex ratio of infections.

  11. Prevalence of overweight, obesity and thinness in 9-10 year old children in Mauritius.

    PubMed

    Caleyachetty, Rishi; Rudnicka, Alicja R; Echouffo-Tcheugui, Justin B; Siegel, Karen R; Richards, Nigel; Whincup, Peter H

    2012-07-23

    To document the prevalence of overweight, obesity and thinness in 9-10 year old children in Mauritius. 412 boys and 429 girls aged 9-10 years from 23 primary schools were selected using stratified cluster random sampling. All data was cross-sectional and collected via anthropometry and self-administered questionnaire. Outcome measures were BMI (kg/m2), prevalence of overweight, obesity (International Obesity Task Force definitions) and thinness (low BMI for age). Linear and logistic regression analyses, accounting for clustering at the school level, were used to assess associations between gender, ethnicity, school location, and school's academic performance (average) to each outcome measure. The distribution of BMI was marginally skewed with a more pronounced positive tail in the girls. Median BMI was 15.6 kg/m2 in boys and 15.4 kg/m2 in girls, respectively. In boys, prevalence of overweight was 15.8% (95% CI: 12.6, 19.6), prevalence of obesity 4.9% (95% CI: 3.2, 7.4) and prevalence of thinness 12.4% (95% CI: 9.5, 15.9). Among girls, 18.9% (95% CI: 15.5, 22.9) were overweight, 5.1% (95% CI: 3.4, 7.7) were obese and 13.1% (95% CI: 10.2, 16.6) were thin. Urban children had a slightly higher mean BMI than rural children (0.5 kg/m2, 95% CI: 0.01, 1.00) and were nearly twice as likely to be obese (6.7% vs. 4.0%; adjusted odds ratio 1.6; 95% CI: 0.9, 3.5). Creole children were less likely to be classified as thin compared to Indian children (adjusted odds ratio 0.3, 95% CI: 0.2, 0.6). Mauritius is currently in the midst of nutritional transition with both a high prevalence of overweight and thinness in children aged 9-10 years. The coexistence of children representing opposite sides of the energy balance equation presents a unique challenge for policy and interventions. Further exploration is needed to understand the specific causes of the double burden of malnutrition and to make appropriate policy recommendations.

  12. 45 CFR 800.203 - Medical loss ratio.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Medical loss ratio. 800.203 Section 800.203 Public... PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment § 800.203 Medical loss ratio. (a) Required medical loss ratio. An MSPP issuer must attain: (1) The medical loss ratio (MLR...

  13. 45 CFR 800.203 - Medical loss ratio.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Medical loss ratio. 800.203 Section 800.203 Public... PROGRAM Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment § 800.203 Medical loss ratio. (a) Required medical loss ratio. An MSPP issuer must attain: (1) The medical loss ratio (MLR...

  14. Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases.

    PubMed

    Schwartz, Noah G; Rattner, Adi; Schwartz, Alan R; Mokhlesi, Babak; Gilman, Robert H; Bernabe-Ortiz, Antonio; Miranda, J Jaime; Checkley, William

    2015-09-01

    Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Cross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample. Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. There were 2,682 adults aged 35 to 92 y. Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5-32.0%), observed apneas (20.9%, 95% CI 19.4-22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1-20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18-5.84) was observed in those with all three versus no SDB symptoms. Sleep disordered breathing symptoms were highly prevalent, varied widely across four resource-limited settings in Peru, and exhibited strong

  15. Prevalence and likelihood ratio of symptoms in patients with good therapeutic response to Lycopodium clavatum. A retrospective study.

    PubMed

    Eizayaga, José Enrique; Pozzi, María Isabel; Canan, María Clara; Saravia, Laura

    2016-02-01

    Assessment of the likelihood ratio (LR) of symptoms has been proposed as a rational means for detecting indicators to homeopathic medicines. To investigate the prevalence and LR of symptoms commonly attributed to the homeopathic medicine Lycopodium clavatum (Lyc). Secondarily, to answer the question if experienced homeopaths could intuitively infer which the main symptoms of this medicine are. The presence of 35 selected symptoms, prescribed medicines and therapeutic response were assessed retrospectively. The symptoms' prevalence in the Lyc responding population and the LR of the symptoms compared to their prevalence in the remainder of the population were calculated. Two hundred and two Lyc and 550 non Lyc cases (total 752) were included for analysis. Twenty-two symptoms were confirmed as pertaining to Lyc's semiology (prevalence %; LR): contemptuous (3.3; 6.7), urinary stones history (2.7; 5.4), egotism (5.6; 3.6), dictatorial (33.3; 3.4), haughty (8.7; 3.3), sleeps on abdomen (3.3; 3.3), intolerance to clothing in abdomen (12.0; 3.1), reproaches (4.0; 3.0), helplessness (24.0; 2.7), fear of failure (10.7; 2.6), irritability on waking in the morning (16.7; 2.5), constipation alternating with diarrhea (8.7; 2.5), intolerant to contradiction (59.3; 2.3), want of self confidence (30.0; 2.4), abdominal distension after eating (23.3; 2.1); ailments from anticipation (32.0; 1.9), irritability before menses (23.3; 1.8), conscientious (26.0; 1.6), desire of sweets (52.0; 1.6), desire of chocolate (16.7; 1.6), lack of vital heat (41.3; 1.3), and flatterer (1.3; ∞). Surveyed homeopaths' intuitive inferences correlated well with symptoms' prevalence but not with their LR. Lycopodium's main symptoms are well known by homeopaths, but their knowledge correlates well with the symptoms' prevalence and not with their LR. Retrospective assessment of prevalence and LR of symptoms in good responders might be a means for better selection of symptoms for prospective studies

  16. Association of the TG/HDL-C and Non-HDL-C/HDL-C Ratios with Chronic Kidney Disease in an Adult Chinese Population.

    PubMed

    Wen, Jia; Chen, Yiyin; Huang, Yun; Lu, Yao; Liu, Xing; Zhou, Honghao; Yuan, Hong

    2017-01-01

    Evidence indicates a role for dyslipidemia in the development of chronic kidney disease (CKD). However, the association of lipid abnormalities and their ratios with kidney disease using the new CKD Epidemiology Collaboration (CKD-EPI) equation is not well understood. This cross-sectional study included 48,054 adult subjects. CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 or dipstick-positive proteinuria. Logistic regression models were used to examine the relationship between lipid variables and CKD. The prevalence of CKD in this study was 3.7%. When the participants exhibited higher serum triglyceride (TG), a higher TG/high-density lipoprotein cholesterol (TG/HDL-c) ratio or a higher non-HDL-c/HDL-c ratio or HDL-c in a lower quartile, the prevalence of CKD tended to be higher. The multivariate adjusted odds ratios for CKD per 1 standard deviation increase in lipid level were 1.17 (1.10-1.23) for TG, 0.86 (0.79-0.93) for HDL-c, 1.21 (1.13-1.31) for the TG/HDL-c ratio, and 1.14 (1.06-1.22) for the non-HDL-c/HDL-c ratio. No significant association was detected between CKD and total cholesterol (TC), non-HDL-c or the low-density lipoprotein cholesterol/HDL-c (LDL-c/HDL-c) ratio. In this relatively healthy adult Chinese population, the CKD-EPI equation determined that the TG/HDL-c and non-HDL-c/HDL-c ratios as well as TG and HDL-c correlate with the prevalence of CKD. © 2017 The Author(s). Published by S. Karger AG, Basel.

  17. Interhospital differences and case-mix in a nationwide prevalence survey.

    PubMed

    Kanerva, M; Ollgren, J; Lyytikäinen, O

    2010-10-01

    A prevalence survey is a time-saving and useful tool for obtaining an overview of healthcare-associated infection (HCAI) either in a single hospital or nationally. Direct comparison of prevalence rates is difficult. We evaluated the impact of case-mix adjustment on hospital-specific prevalences. All five tertiary care, all 15 secondary care and 10 (25% of 40) other acute care hospitals took part in the first national prevalence survey in Finland in 2005. US Centers for Disease Control and Prevention criteria served to define HCAI. The information collected included demographic characteristics, severity of the underlying disease, use of catheters and a respirator, and previous surgery. Patients with HCAI related to another hospital were excluded. Case-mix-adjusted HCAI prevalences were calculated by using a multivariate logistic regression model for HCAI risk and an indirect standardisation method. Altogether, 587 (7.2%) of 8118 adult patients had at least one infection; hospital-specific prevalences ranged between 1.9% and 12.6%. Risk factors for HCAI that were previously known or identified by univariate analysis (age, male gender, intensive care, high Charlson comorbidity and McCabe indices, respirator, central venous or urinary catheters, and surgery during stay) were included in the multivariate analysis for standardisation. Case-mix-adjusted prevalences varied between 2.6% and 17.0%, and ranked the hospitals differently from the observed rates. In 11 (38%) hospitals, the observed prevalence rank was lower than predicted by the case-mix-adjusted figure. Case-mix should be taken into consideration in the interhospital comparison of prevalence rates. Copyright 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Prevalence of Injury in Occupation and Industry: Role of Obesity in the National Health Interview Survey 2004 to 2013

    PubMed Central

    Gu, Ja K.; Charles, Luenda E.; Fekedulegn, Desta; Ma, Claudia C.; Andrew, Michael E.; Burchfiel, Cecil M.

    2016-01-01

    Objectives The aim of this study was to estimate prevalence of injury by occupation and industry and obesity’s role. Methods Self-reported injuries were collected annually for US workers during 2004 to 2013. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were obtained from fitted logistic regression models. Results Overall weighted injury prevalence during the previous three months was 77 per 10,000 workers. Age-adjusted injury prevalence was greatest for Construction and Extraction workers (169.7/10,000) followed by Production (160.6) among occupations, while workers in the Construction industry sector (147.9) had the highest injury prevalence followed by the Agriculture/Forestry/Fishing/Mining/Utilities sector (122.1). Overweight and obese workers were 26% to 45% more likely to experience injuries than normal-weight workers. Conclusion The prevalence of injury, highest for Construction workers, gradually increased as body mass index levels increased in most occupational and industry groups. PMID:27058472

  19. A Low Peripheral Blood CD4/CD8 Ratio Is Associated with Pulmonary Emphysema in HIV.

    PubMed

    Triplette, Matthew; Attia, Engi F; Akgün, Kathleen M; Soo Hoo, Guy W; Freiberg, Matthew S; Butt, Adeel A; Wongtrakool, Cherry; Goetz, Matthew Bidwell; Brown, Sheldon T; Graber, Christopher J; Huang, Laurence; Crothers, Kristina

    2017-01-01

    The prevalence of emphysema is higher among HIV-infected (HIV+) individuals compared to HIV-uninfected persons. While greater tobacco use contributes, HIV-related effects on immunity likely confer additional risk. Low peripheral blood CD4+ to CD8+ T-lymphocyte (CD4/CD8) ratio may reflect chronic inflammation in HIV and may be a marker of chronic lung disease in this population. Therefore, we sought to determine whether the CD4/CD8 ratio was associated with chronic obstructive pulmonary disease (COPD), particularly the emphysema subtype, in a cohort of HIV+ subjects. We performed a cross-sectional analysis of 190 HIV+ subjects enrolled in the Examinations of HIV Associated Lung Emphysema (EXHALE) study. Subjects underwent baseline laboratory assessments, pulmonary function testing and chest computed tomography (CT) analyzed for emphysema severity and distribution. We determined the association between CD4/CD8 ratio and emphysema, and the association between CD4/CD8 ratio and pulmonary function markers of COPD. Mild or greater emphysema (>10% lung involvement) was present in 31% of subjects. Low CD4/CD8 ratio was associated with >10% emphysema in multivariable models, adjusting for risk factors including smoking, current and nadir CD4 count and HIV RNA level. Those with CD4/CD8 ratio <0.4 had 6.3 (1.1-39) times the odds of >10% emphysema compared to those with a ratio >1.0 in fully adjusted models. A low CD4/CD8 ratio was also associated with reduced diffusion capacity (DLCO). A low CD4/CD8 ratio was associated with emphysema and low DLCO in HIV+ subjects, independent of other risk factors and clinical markers of HIV. The CD4/CD8 ratio may be a useful, clinically available, marker for risk of emphysema in HIV+ subjects in the antiretroviral therapy (ART) era.

  20. A Low Peripheral Blood CD4/CD8 Ratio Is Associated with Pulmonary Emphysema in HIV

    PubMed Central

    Attia, Engi F.; Akgün, Kathleen M.; Soo Hoo, Guy W.; Freiberg, Matthew S.; Butt, Adeel A.; Wongtrakool, Cherry; Goetz, Matthew Bidwell; Brown, Sheldon T.; Graber, Christopher J.; Huang, Laurence; Crothers, Kristina

    2017-01-01

    Objectives The prevalence of emphysema is higher among HIV-infected (HIV+) individuals compared to HIV-uninfected persons. While greater tobacco use contributes, HIV-related effects on immunity likely confer additional risk. Low peripheral blood CD4+ to CD8+ T-lymphocyte (CD4/CD8) ratio may reflect chronic inflammation in HIV and may be a marker of chronic lung disease in this population. Therefore, we sought to determine whether the CD4/CD8 ratio was associated with chronic obstructive pulmonary disease (COPD), particularly the emphysema subtype, in a cohort of HIV+ subjects. Methods We performed a cross-sectional analysis of 190 HIV+ subjects enrolled in the Examinations of HIV Associated Lung Emphysema (EXHALE) study. Subjects underwent baseline laboratory assessments, pulmonary function testing and chest computed tomography (CT) analyzed for emphysema severity and distribution. We determined the association between CD4/CD8 ratio and emphysema, and the association between CD4/CD8 ratio and pulmonary function markers of COPD. Results Mild or greater emphysema (>10% lung involvement) was present in 31% of subjects. Low CD4/CD8 ratio was associated with >10% emphysema in multivariable models, adjusting for risk factors including smoking, current and nadir CD4 count and HIV RNA level. Those with CD4/CD8 ratio <0.4 had 6.3 (1.1–39) times the odds of >10% emphysema compared to those with a ratio >1.0 in fully adjusted models. A low CD4/CD8 ratio was also associated with reduced diffusion capacity (DLCO). Conclusions A low CD4/CD8 ratio was associated with emphysema and low DLCO in HIV+ subjects, independent of other risk factors and clinical markers of HIV. The CD4/CD8 ratio may be a useful, clinically available, marker for risk of emphysema in HIV+ subjects in the antiretroviral therapy (ART) era. PMID:28122034

  1. Bias in Observational Studies of Prevalent Users: Lessons for Comparative Effectiveness Research From a Meta-Analysis of Statins

    PubMed Central

    Danaei, Goodarz; Tavakkoli, Mohammad; Hernán, Miguel A.

    2012-01-01

    Randomized clinical trials (RCTs) are usually the preferred strategy with which to generate evidence of comparative effectiveness, but conducting an RCT is not always feasible. Though observational studies and RCTs often provide comparable estimates, the questioning of observational analyses has recently intensified because of randomized-observational discrepancies regarding the effect of postmenopausal hormone replacement therapy on coronary heart disease. Reanalyses of observational data that excluded prevalent users of hormone replacement therapy led to attenuated discrepancies, which begs the question of whether exclusion of prevalent users should be generally recommended. In the current study, the authors evaluated the effect of excluding prevalent users of statins in a meta-analysis of observational studies of persons with cardiovascular disease. The pooled, multivariate-adjusted mortality hazard ratio for statin use was 0.77 (95% confidence interval (CI): 0.65, 0.91) in 4 studies that compared incident users with nonusers, 0.70 (95% CI: 0.64, 0.78) in 13 studies that compared a combination of prevalent and incident users with nonusers, and 0.54 (95% CI: 0.45, 0.66) in 13 studies that compared prevalent users with nonusers. The corresponding hazard ratio from 18 RCTs was 0.84 (95% CI: 0.77, 0.91). It appears that the greater the proportion of prevalent statin users in observational studies, the larger the discrepancy between observational and randomized estimates. PMID:22223710

  2. The Prevalence of Open-Angle Glaucoma by Age in Myopia: The Korea National Health and Nutrition Examination Survey.

    PubMed

    Shim, Seong Hee; Sung, Kyung Rim; Kim, Joon Mo; Kim, Hyun Tae; Jeong, Jinho; Kim, Chan Yun; Lee, Mi Yeon; Park, Ki Ho

    2017-01-01

    To investigate the prevalence of open-angle glaucoma (OAG) in myopia by age. A cross-sectional study using a stratified, multistage, probability cluster survey. Participants in the Korean National Health and Nutrition Examination Survey between 2010 and 2011 were included. A standardized protocol was used to interview every participant and perform comprehensive ophthalmic examinations. Glaucoma was diagnosed according to the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. After adjusting for age and sex, there was a positive correlation between OAG prevalence and increasing myopic refractive error except in participants with hyperopia. Younger participants with higher myopic refractive error had higher OAG prevalence than older participants with lower myopic refractive error. Participants with high myopia (OR 3.90, 95% confidence interval (CI) 2.30-6.59) had significantly greater age- and sex-adjusted odd ratios (ORs) than did those with emmetropia who were younger than 60 years. These data suggest that OAG develops earlier in participants with high myopia than in others. There was a high prevalence of OAG in participants with high myopia, even in those 19-29 years of age. Therefore, OAG screening should be performed earlier in participants with high myopia than is suggested by traditional guidelines.

  3. Environmental tobacco smoke exposure and periodontitis prevalence among nonsmokers in the hispanic community Health Study/Study of Latinos.

    PubMed

    Akinkugbe, Aderonke A; Sanders, Anne E; Preisser, John S; Cai, Jianwen; Salazar, Christian R; Beck, James D

    2017-04-01

    To describe self-reported exposure to environmental tobacco smoke (ETS) and its association with periodontitis prevalence in a diverse group of Hispanics/Latinos. Data came from 8675 lifetime nonsmokers in the 2008-2011 Hispanic Community Health Study/Study of Latinos. Exposure to ETS was self-reported, while periodontitis was defined using the Centers for Disease Control and Prevention-American Academy of Periodontology criteria and the proportion of sites affected by clinical attachment level of ≥3 mm or pocket depth of ≥4 mm. Survey logistic regression estimated prevalence odds ratios (POR) and 95% confidence intervals (CI). In addition, we assessed whether greater hours of exposure to ETS in the past year was associated with greater periodontitis prevalence, and lastly, we conducted a simple sensitivity analysis of ETS misclassification. Age-standardized prevalence estimates (95% CI) for ETS exposure and periodontitis were 57.6% (55.9, 59.4) and 39.8% (38.1, 41.4), respectively. After adjusting for confounders and periodontitis risk factors, we estimated an overall adjusted POR (95% CI) for the ETS-periodontitis association as 1.09 (0.95-1.26) with a confidence limit ratio (CLR) of 1.34. This association varied in magnitude by Hispanic/Latino background, ranging from 1.04 (0.75, 1.43 with a CLR = 1.91) among Central Americans to 1.76 (1.16, 2.66 with a CLR = 2.29) in Puerto Ricans. Previously reported associations between ETS and periodontitis appear weak in this study. However, the magnitude of the association differs according to Hispanic/Latino background. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study.

    PubMed

    Hasserius, R; Karlsson, M K; Nilsson, B E; Redlund-Johnell, I; Johnell, O

    2003-01-01

    The aim of this study was to evaluate whether a prevalent vertebral deformity predicts mortality and fractures in both men and women. In the city of Malmö, 598 individuals (298 men, 300 women; age 50-80 years) were selected from the city's population and were included in the Swedish part of the European Vertebral Osteoporosis Study (EVOS). At baseline the participants answered a questionnaire and lateral spine radiographs were performed. The prevalence of subjects with vertebral deformity was assessed using a morphometric method. The mortality during a 10-year follow-up period was determined through the register of the National Swedish Board of Health and Welfare. Eighty-five men and 43 women died during the study period. The subsequent fracture incidence during the follow-up period was ascertained by postal questionnaires, telephone interviews and by a survey of the archives of the Department of Radiology in the city hospital. Thirty-seven men and 69 women sustained a fracture during the study period. Data are presented as hazard ratios (HR) with 95% confidence interval (95% CI) within brackets. Prevalent vertebral deformity, defined as a reduction by more than 3 standard deviations (SD) in vertebral height ratio, predicted mortality during the forthcoming decade in both men [age-adjusted HR 2.4 (95% CI 1.6-3.9)] and women [age-adjusted HR 2.3 (95% CI 1.3-4.3)]. In men there was an increased mortality due to cardiovascular and pulmonary diseases and in women due to cancer. Prevalent vertebral deformity predicted an increased risk of any fracture during the forthcoming decade in both men [age-adjusted HR 2.7 (95% CI 1.4-5.3)] and women [age-adjusted HR 1.8 (95% CI 1.1-2.9)]. Prevalent vertebral deformity predicted an increased risk of any subsequent fragility fracture in women [age-adjusted HR 2.0 (95% CI 1.1-3.5)]; however, in men the increased risk was nonsignificant [age-adjusted HR 1.9 (95% CI 0.7-5.1)]. In summary, a prevalent vertebral deformity can predict

  5. Leptin to adiponectin ratio in preeclampsia.

    PubMed

    Khosrowbeygi, A; Ahmadvand, H

    2013-04-01

    The aim of the present study was to assess leptin/adiponectin ratio in preeclamptic patients compared with normal pregnant women. A cross-sectional study was designed. The study population consisted of 30 preeclamptic patients and 30 healthy pregnant women. Serum levels of total leptin and adiponectin were assessed using commercially available enzyme-linked immunosorbent assay methods. The one-way ANOVA and Student's t tests and Pearson's correlation analysis were used for statistical calculations. Levels of leptin and adiponectin were also adjusted for BMI. A p-value < 0.05 was considered statistically significant. The leptin/adiponectin ratio was increased significantly in preeclamptic patients. The leptin/adiponectin ratio was significantly higher in severe preeclamptic patient than in mild preeclampsia. Adjusted leptin/adiponectin ratio was also significantly increased in preeclamptic patients than in normal pregnant women. The findings of the present study suggest that the leptin/adiponectin ratio was increased in preeclamsia and imbalance between the adipocytokines could be involved in the pathogenesis of preeclampsia.

  6. The triglyceride-to-high density lipoprotein cholesterol ratio in overweight Korean children and adolescents.

    PubMed

    Yoo, Dong-Yoon; Kang, Yu Sun; Kwon, Eun Byul; Yoo, Eun-Gyong

    2017-09-01

    The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a biomarker of cardiometabolic risk in obese children and adolescents. The purpose of this study is to describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children and to evaluate whether the high TG/HDL-C ratio is associated with insulin resistance in overweight children and adolescents. Data from 255 overweight (aged 8.7±2.0 years) and 514 normal weight (aged 8.9±1.8 years) children and adolescents were evaluated. Glucose, insulin, total cholesterol (TC), HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non-HDL-C and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. The TG/HDL-C ratio was higher in overweight group compared to normal weight group (P<0.001). Among overweight children and adolescents, alanine aminotransferase (P=0.018), non-HDL-C (P<0.001), and HOMA-IR (P=0.004) were different between the TG/HDL-C ratio tertile groups. The prevalence of elevated HOMA-IR was increased with increasing TG/HDL-C ratio tertiles (P for trend=0.003). On regression analysis adjusted for age and sex, the BMI (β=0.402, P=0.001) and TG/HDL-C ratio (β=0.251, P=0.014) were independently associated with HOMA-IR (adjusted R2=0.324). The TG/HDL-C ratio of 2.0 or more showed higher sensitivity (55.6%) and specificity (72.9%), when compared to TC (≥200 mg/dL), non-HDL-C (≥145 mg/dL), and LDL-C (≥130 mg/dL) for identifying overweight children with elevated HOMA-IR. The TG/HDL-C ratio is independently associated with insulin resistance in overweight children and adolescents, and it can be useful in identifying those at higher cardiometabolic risk.

  7. The triglyceride-to-high density lipoprotein cholesterol ratio in overweight Korean children and adolescents

    PubMed Central

    Yoo, Dong-Yoon; Kang, Yu Sun; Kwon, Eun Byul

    2017-01-01

    Purpose The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio has recently been reported as a biomarker of cardiometabolic risk in obese children and adolescents. The purpose of this study is to describe the TG/HDL-C ratio and related factors in overweight and normal weight Korean children and to evaluate whether the high TG/HDL-C ratio is associated with insulin resistance in overweight children and adolescents. Methods Data from 255 overweight (aged 8.7±2.0 years) and 514 normal weight (aged 8.9±1.8 years) children and adolescents were evaluated. Glucose, insulin, total cholesterol (TC), HDL-C and TG levels were measured after overnight fasting, and the TG/HDL-C ratio, non–HDL-C and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Results The TG/HDL-C ratio was higher in overweight group compared to normal weight group (P<0.001). Among overweight children and adolescents, alanine aminotransferase (P=0.018), non–HDL-C (P<0.001), and HOMA-IR (P=0.004) were different between the TG/HDL-C ratio tertile groups. The prevalence of elevated HOMA-IR was increased with increasing TG/HDL-C ratio tertiles (P for trend=0.003). On regression analysis adjusted for age and sex, the BMI (β=0.402, P=0.001) and TG/HDL-C ratio (β=0.251, P=0.014) were independently associated with HOMA-IR (adjusted R2=0.324). The TG/HDL-C ratio of 2.0 or more showed higher sensitivity (55.6%) and specificity (72.9%), when compared to TC (≥200 mg/dL), non–HDL-C (≥145 mg/dL), and LDL-C (≥130 mg/dL) for identifying overweight children with elevated HOMA-IR. Conclusions The TG/HDL-C ratio is independently associated with insulin resistance in overweight children and adolescents, and it can be useful in identifying those at higher cardiometabolic risk. PMID:29025201

  8. Prevalence and Risk Factors of Chronic Otitis Media: The Korean National Health and Nutrition Examination Survey 2010–2012

    PubMed Central

    Park, Mina; Lee, Ji Sung; Lee, Jun Ho; Oh, Seung Ha; Park, Moo Kyun

    2015-01-01

    Background The performance of nationwide studies of chronic otitis media (COM) in adults has been insufficient in Korea. We evaluated the prevalence and risk factors of COM in Korea. Methods This study was conducted using data from the fifth Korean National Health and Nutrition Examination Survey (n = 23,621). After excluding the subjects under 20 year old and suffered from cancers, 16,063 patients were evaluated for COM. Participants underwent a medical interview, physical examination, endoscopic examination, and blood and urine test. COM was diagnosed by trained residents in the Department of Otorhinolaryngology using an ear, nose, and throat questionnaire and otoendoscopy findings. Data on the presence and absence of COM were collected. Multivariate logistic regression analyses were performed to identify its risk factors. Results Of the 16,063 participants aged above 20 year old, the weighted prevalence of COM was 3.8%. In the multivariate analyses, the following factors showed high odds ratios (ORs) for COM: pulmonary tuberculosis (adjusted OR, 1.78; 95% confidence interval [CI], 1.06-3.01), chronic rhinosinusitis (adjusted OR, 1.87; 95% CI, 1.17-2.98), mild hearing impairment (adjusted OR, 1.95; 95% CI, 1.34-2.85), moderate hearing impairment (adjusted OR, 4.00; 95% CI, 2.21-7.22), tinnitus (adjusted OR, 1.82; 95% CI, 1.34-2.49), increased hearing thresholds in pure tone audiometry in the right ear (adjusted OR, 1.02; 95% CI, 1.01-1.03), and left ear (adjusted OR, 1.03; 95% CI, 1.02-1.04). The following factors showed low odds ratios for COM: hepatitis B (adjusted OR, 0.28; 95% CI, 0.08-0.94) and rhinitis (adjusted OR, 0.60; 95% CI, 0.42-0.88). In addition, high levels of vitamin D, lead, and cadmium, EQ-5D index; and low red blood cell counts were associated with development of COM (Student’s t-test, P < 0.01). Conclusions Our population-based study showed that COM is not rare in Korea, and its development may be associated with various host and

  9. Environmental Tobacco Smoke Exposure and Periodontitis Prevalence among Non-smokers in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

    PubMed Central

    Akinkugbe, Aderonke A.; Sanders, Anne E.; Preisser, John S.; Cai, Jianwen; Salazar, Christian R.; Beck, James D.

    2016-01-01

    Objective To describe self-reported exposure to environmental tobacco smoke (ETS) and its association with periodontitis prevalence in a diverse group of Hispanics/Latinos. Methods Data came from 8,675 lifetime non-smokers in the 2008–2011 Hispanic Community Health Study/Study of Latinos. Exposure to ETS was self-reported while periodontitis was defined using the CDC/AAP criteria and the proportion of sites affected by clinical attachment level of ≥3mm or pocket depth of ≥4mm. Survey logistic regression estimated prevalence odds ratios (POR) and 95% confidence intervals (CI). In addition, we assessed whether greater hours of exposure to ETS in the past year was associated with greater periodontitis prevalence and lastly, we conducted a simple sensitivity analysis of ETS misclassification. Results Age-standardized prevalence estimates (95% CI) for ETS exposure and periodontitis were 57.6% (55.9, 59.4) and 39.8% (38.1, 41.4) respectively. After adjusting for confounders and periodontitis risk factors, we estimated an overall adjusted POR (95% CI) for the ETS-periodontitis association as 1.09 (0.95–1.26) with a confidence limit ratio (CLR) of 1.34. This association varied in magnitude by Hispanic/Latino background, ranging from 1.04 (0.75, 1.43 with a CLR=1.91) among Central-Americans to 1.76 (1.16, 2.66 with a CLR=2.29) in Puerto Ricans. Conclusions Previously reported associations between ETS and periodontitis appear weak in this study. However, the magnitude of the association differs according to Hispanic/Latino background. PMID:27978596

  10. The prevalence of co-morbid depression among employees with type 2 diabetes in a Japanese corporation: a descriptive study using an integrated health database.

    PubMed

    Arima, Hideaki; Miwa, Makiko; Kawahara, Kazuo

    2007-03-01

    To determine the prevalence of comorbid depression among people with type 2 diabetes using the integrated health database. A total of 6543 people aged 18-65 years were selected from the employees of a Japanese corporation. Using the corporation's integrated health database, which consisted of medical claims data and a self-reported questionnaire from the fiscal year 2000, this study was undertaken to identify the prevalence, the odds ratio and some related factors. The prevalence of co-morbid depression among people with type 2 diabetes was 2.6%. The crude odds ratio of co-morbid depression among those with type 2 diabetes was 2.20 (95% CI 0.88-5.50). After adjustment for covariates (gender, age, alcohol drinking, smoking, exercise, and dietary restriction), the odds ratio of co-morbid depression among those with type 2 diabetes was 2.33 (0.86-6.33). Using the integrated health database, it was suggested that patients with type 2 diabetes were more likely to suffer from depression and there was a relationship between depression and dietary restriction of portion control.

  11. 12 CFR 567.8 - Leverage ratio.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... a composite rating of 1, as defined in § 516.3 of this chapter, shall consist of a ratio of core... capital requirement shall consist of a ratio of core capital to adjusted total assets of 4 percent. Higher...

  12. Adjusting HIV prevalence estimates for non-participation: an application to demographic surveillance

    PubMed Central

    McGovern, Mark E.; Marra, Giampiero; Radice, Rosalba; Canning, David; Newell, Marie-Louise; Bärnighausen, Till

    2015-01-01

    Introduction HIV testing is a cornerstone of efforts to combat the HIV epidemic, and testing conducted as part of surveillance provides invaluable data on the spread of infection and the effectiveness of campaigns to reduce the transmission of HIV. However, participation in HIV testing can be low, and if respondents systematically select not to be tested because they know or suspect they are HIV positive (and fear disclosure), standard approaches to deal with missing data will fail to remove selection bias. We implemented Heckman-type selection models, which can be used to adjust for missing data that are not missing at random, and established the extent of selection bias in a population-based HIV survey in an HIV hyperendemic community in rural South Africa. Methods We used data from a population-based HIV survey carried out in 2009 in rural KwaZulu-Natal, South Africa. In this survey, 5565 women (35%) and 2567 men (27%) provided blood for an HIV test. We accounted for missing data using interviewer identity as a selection variable which predicted consent to HIV testing but was unlikely to be independently associated with HIV status. Our approach involved using this selection variable to examine the HIV status of residents who would ordinarily refuse to test, except that they were allocated a persuasive interviewer. Our copula model allows for flexibility when modelling the dependence structure between HIV survey participation and HIV status. Results For women, our selection model generated an HIV prevalence estimate of 33% (95% CI 27–40) for all people eligible to consent to HIV testing in the survey. This estimate is higher than the estimate of 24% generated when only information from respondents who participated in testing is used in the analysis, and the estimate of 27% when imputation analysis is used to predict missing data on HIV status. For men, we found an HIV prevalence of 25% (95% CI 15–35) using the selection model, compared to 16% among those who

  13. 30 CFR 36.44 - Maximum allowable fuel : air ratio.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Maximum allowable fuel : air ratio. 36.44...

  14. 30 CFR 36.44 - Maximum allowable fuel : air ratio.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Maximum allowable fuel : air ratio. 36.44...

  15. 30 CFR 36.44 - Maximum allowable fuel : air ratio.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Maximum allowable fuel : air ratio. 36.44...

  16. 30 CFR 36.44 - Maximum allowable fuel : air ratio.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel : air ratio determined from the... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Maximum allowable fuel : air ratio. 36.44...

  17. High Prevalence of Rectal Gonorrhea and Chlamydia Infection in Women Attending a Sexually Transmitted Disease Clinic

    PubMed Central

    Reese, Patricia Carr; Esber, Allahna; Lahey, Samantha; Ervin, Melissa; Davis, John A.; Fields, Karen; Turner, Abigail Norris

    2015-01-01

    Abstract Background: Testing women for urogenital Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is common in sexually transmitted disease (STD) clinics. However, women may not be routinely tested for rectal GC/CT. This may lead to missed infections in women reporting anal intercourse (AI). Methods: This was a retrospective review of all women who underwent rectal GC/CT testing from August 2012 to June 2013 at an STD clinic in Columbus, Ohio. All women who reported AI in the last year had a rectal swab collected for GC/CT nucleic acid amplification testing (n=331). Using log-binomial regression models, we computed unadjusted and adjusted associations for demographic and behavioral factors associated with rectal GC/CT infection. Results: Participants (n=331) were 47% African-American, with median age of 29 years. Prevalence of rectal GC was 6%, rectal CT was 13%, and either rectal infection was 19%. Prevalence of urogenital GC and CT was 7% and 13% respectively. Among women with rectal GC, 14% tested negative for urogenital GC. Similarly, 14% of women with rectal CT tested negative for urogenital CT. In unadjusted analyses, there was increased rectal GC prevalence among women reporting sex in the last year with an injection drug user, with a person exchanging sex for drugs or money, with anonymous partners, and while intoxicated/high on alcohol or illicit drugs. After multivariable adjustment, no significant associations persisted, but a trend of increased rectal GC prevalence was observed for women <26 years of age (p=0.06) and those reporting sex while intoxicated/high on alcohol or drugs (p=0.05). For rectal CT, only age <26 years was associated with prevalent infection in unadjusted models; this association strengthened after multivariable adjustment (prevalence ratio: 6.03; 95% confidence interval: 2.29–15.90). Conclusion: Nearly one in five women who reported AI in the last year had rectal GC or CT infection. Urogenital testing alone would have

  18. Cadmium Exposure is Associated with the Prevalence of Dyslipidemia.

    PubMed

    Zhou, Zhou; Lu, Yong-Hui; Pi, Hui-Feng; Gao, Peng; Li, Min; Zhang, Lei; Pei, Li-Ping; Mei, Xiang; Liu, Lin; Zhao, Qi; Qin, Qi-Zhong; Chen, Yu; Jiang, Yue-Ming; Zhang, Zhao-Hui; Yu, Zheng-Ping

    2016-01-01

    Cadmium is a widespread environmental and occupational pollutant that accumulates in human body with a biological half-life exceeding 10 years. Cadmium exposure has been demonstrated to increase rates of cardiovascular diseases. Whether occupational cadmium exposure is associated with the increase in the prevalence of dyslipidemia and hence contributes to the risk of cardiovascular diseases is still equivocal. To test the hypothesis that exposure to cadmium is related to the prevalence of dyslipidemia, we examined the associations between blood cadmium concentration and the prevalence of dyslipidemia in workers occupationally exposed to cadmium in China. A cross-sectional survey on demographic data, blood cadmium level and lipid profile in cadmium exposed workers from seven cadmium smelting factories in central and southwestern China was conducted. We measured blood cadmium concentration and lipid components of 1489 cadmium exposed workers. The prevalence of dyslipidemia was compared across blood cadmium quartiles. Associations between the blood cadmium concentrations and the prevalence of dyslipidemia were assessed using confounder adjusted linear and logistic regressions. The blood cadmium concentration was 3.61±0.84µg/L ( mean ±SD). The prevalence of dyslipidemia in this occupational population was 66.3%. Mean blood cadmium concentration of workers with dyslipedemia was significantly higher than that of workers without dyslipidemia (p <0.01). The prevalence of dyslipidemia increased dose-dependently with elevations in blood cadmium concentrations (p for trend <0.001). Elevated levels of blood cadmium were associated with BMI, education attainment, income, smoking status and duration of exposure (all p <0.01). Furthermore, the profile of blood lipid was obviously changed in this occupational population. The prevalence of high TC, high TG, Low HDL-C and high LDL-C rose with increases in blood cadmium levels dose-dependently (p for trend <0.001). The odds ratios

  19. Prevalence of self-medication in Brazil and associated factors

    PubMed Central

    Arrais, Paulo Sérgio Dourado; Fernandes, Maria Eneida Porto; Pizzol, Tatiane da Silva Dal; Ramos, Luiz Roberto; Mengue, Sotero Serrate; Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Farias, Mareni Rocha; Oliveira, Maria Auxiliadora; Bertoldi, Andréa Dâmaso

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil. METHODS This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified. RESULTS The self-medication prevalence in Brazil was 16.1% (95%CI 15.0–17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6–26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%). CONCLUSIONS Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks. PMID:27982373

  20. 30 CFR 36.44 - Maximum allowable fuel:air ratio.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... delivered to MSHA with the fuel-injection system adjusted by the applicant and tests of the exhaust-gas... adjustment of the fuel-injection system shall be accepted. The maximum fuel:air ratio determined from the... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Maximum allowable fuel:air ratio. 36.44 Section...

  1. Latitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis.

    PubMed

    Simpson, Steve; Blizzard, Leigh; Otahal, Petr; Van der Mei, Ingrid; Taylor, Bruce

    2011-10-01

    There is a striking latitudinal gradient in multiple sclerosis (MS) prevalence, but exceptions in Mediterranean Europe and northern Scandinavia, and some systematic reviews, have suggested that the gradient may be an artefact. The authors sought to evaluate the association between MS prevalence and latitude by meta-regression. Studies were sourced from online databases, reference mining and author referral. Prevalence estimates were age-standardised to the 2009 European population. Analyses were carried out by means of random-effects meta-regression, weighted with the inverse of within-study variance. The authors included 650 prevalence estimates from 321 peer-reviewed studies; 239 were age-standardised, and 159 provided sex-specific data. The authors found a significant positive association (change in prevalence per degree-latitude) between age-standardised prevalence (1.04, p<0.001) and latitude that diminished at high latitudes. Adjustment for prevalence year strengthened the association with latitude (2.60, p<0.001). An inverse gradient in the Italian region reversed on adjustment for MS-associated HLA-DRB1 allele distributions. Adjustment for HLA-DRB1 allele frequencies did not appreciably alter the gradient in Europe. Adjustment for some potential sources of bias did not affect the observed associations. This, the most comprehensive review of MS prevalence to date, has confirmed a statistically significant positive association between MS prevalence and latitude globally. Exceptions to the gradient in the Italian region and northern Scandinavia are likely a result of genetic and behavioural-cultural variations. The persistence of a positive gradient in Europe after adjustment for HLA-DRB1 allele frequencies strongly supports a role for environmental factors which vary with latitude, the most prominent candidates being ultraviolet radiation (UVR)/vitamin D.

  2. Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study.

    PubMed

    Djoussé, Luc; Hopkins, Paul N; North, Kari E; Pankow, James S; Arnett, Donna K; Ellison, R Curtis

    2011-04-01

    Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies have demonstrated blood pressure lowering effects of dark chocolate. However, limited data are available on the association of chocolate consumption and the risk of coronary heart disease (CHD). We sought to examine the association between chocolate consumption and prevalent CHD. We studied in a cross-sectional design 4970 participants aged 25-93 years who participated in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate intake was assessed through a semi-quantitative food frequency questionnaire. We used generalized estimating equations to estimate adjusted odds ratios. Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education, non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)]. These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general United States population. Published by Elsevier Ltd.

  3. Metabolic Syndrome Components After Pediatric Liver Transplantation: Prevalence and the Impact of Obesity and Immunosuppression.

    PubMed

    Perito, E R; Lustig, R H; Rosenthal, P

    2016-06-01

    Metabolic syndrome is associated with long-term morbidity and mortality after adult liver transplantation (LT). Whether pediatric LT recipients have a higher prevalence of metabolic syndrome remains controversial. In a cross-sectional study, we evaluated pediatric LT recipients aged 8-30 years using National Health and Nutrition Examination Survey (NHANES) protocols. LT recipients were matched by gender, race/ethnicity, and age with controls from NHANES. Pediatric LT recipients (n = 83), after adjusting for overweight/obesity and glucocorticoid use, had increased prevalence of prehypertension and hypertension, impaired glucose tolerance (IGT; 2-h glucose after oral glucose tolerance test ≥140 mg/dL), and low high-density lipoprotein compared to matched NHANES controls (n = 235) despite a lower prevalence of overweight/obesity. Among LT recipients, the adjusted odds of IGT doubled for every 7.5 years taking calcineurin inhibitors (odds ratio = 2.10, 95% confidence interval 1.06-4.17 per 7.5 years taking calcineurin inhibitors, p = 0.03). Among all subjects with IGT, LT recipients had a lower prevalence of overweight/obesity and less insulin resistance (homeostatic model assessment of insulin resistance) than did controls with IGT. Among normal weight subjects, LT recipients were significantly more likely than controls to have prehypertension/hypertension, IGT, low high-density lipoprotein, and metabolic syndrome. Pediatric LT recipients have unique metabolic syndrome profiles and risk factors and will require tailored screening and management protocols. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  4. Prevalence, Incidence, and Clearance of Anogenital Warts in Kenyan Men Reporting High-Risk Sexual Behavior, Including Men Who Have Sex With Men

    PubMed Central

    Neme, Santiago; Wahome, Elizabeth; Mwashigadi, Grace; Thiong'o, Alexander N.; Stekler, Joanne D.; Wald, Anna; Sanders, Eduard J.; Graham, Susan M.

    2015-01-01

    Background. Human papillomavirus (HPV) causes a spectrum of disease, ranging from warts to cancer. Prevalence, incidence, and factors associated with anogenital warts in East African men are unknown. Methods. Kenyan men reporting high-risk sexual behavior were inspected for anogenital warts at enrollment and follow-up visits. Logistic regression was performed to identify associations with anogenital warts at baseline. Cox regression was performed to analyze predictors of incident anogenital warts, and Kaplan–Meier curves were used to estimate clearance. Results. Baseline anogenital wart prevalence in 1137 men was 2.9% (95% confidence interval [CI], 2.0%–4.0%) overall, 2.0% in human immunodeficiency virus (HIV)-uninfected men, and 9.4% in HIV-1-infected men (adjusted odds ratio, 5.43; 95% CI, 2.03–11.29). Over a median of 1.4 years, anogenital wart incidence among 1104 men was 5.3 (95% CI, 4.3–6.5) per 100 person-years. Having HIV-1 infection at baseline (adjusted hazard ratio [aHR], 1.66; 95% CI, 1.01–2.72) or a genital syndrome during follow-up (aHR, 4.78; 95% CI, 3.03–7.56) was associated with increased wart incidence. Wart clearance was lower in HIV-1-infected men (log-rank P<.001). Conclusions. Anogenital wart prevalence and incidence were increased in HIV-1-infected men, and anogenital warts co-occurred with other genital syndromes. Quadrivalent HPV vaccination should be recommended for young men in settings with high HIV-1 prevalence. PMID:26110169

  5. Prevalence of respiratory symptoms in children and air quality by village in rural Indonesia.

    PubMed

    Hong, Ching-Ye; Chia, Sin-Eng; Widjaja, Daniel; Saw, Seang-Mei; Lee, Jeannette; Munoz, Canesio; Koh, David

    2004-11-01

    This study compared prevalence of respiratory symptoms in three Indonesian villages and related this to air quality. We interviewed caregivers of 382 children, using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and monitored air quality during the survey period. Respiratory symptom prevalence was highest in Kerinci (40.5%), followed by SP7 (33.3%) and Pelalawan (19.8%). Compared with Pelalawan, adjusted odds ratios were 3.17 (95% confidence interval, 1.43-7.07) for Kerinci, and 2.03 (1.04-3.96) for SP7. Ambient air quality levels were highest in Kerinci for PM10 and hydrocarbon (means: 102.9 microg/m3, 10.5 microg/m3), followed by SP7 (73.7 microg/m3, 6.3 microg/m3) and Pelalawan (26.1 microg/m3, 4.7 microg/m3). The higher prevalence of respiratory symptoms in Kerinci and SP7 could be the result of higher PM10 and hydrocarbon levels in these locations.

  6. Flood-Exposure Is Associated with Higher Prevalence of Child Undernutrition in Rural Eastern India

    PubMed Central

    Rodriguez-Llanes, Jose Manuel; Ranjan-Dash, Shishir; Mukhopadhyay, Alok; Guha-Sapir, Debarati

    2016-01-01

    Background: Child undernutrition and flooding are highly prevalent public health issues in Asia, yet epidemiological studies investigating this association are lacking. Methods: To investigate to what extent floods exacerbate poor nutritional status in children and identify most vulnerable groups, we conducted a population-based survey of children aged 6–59 months inhabiting flooded and non-flooded communities of the Jagatsinghpur district, Odisha (India), one year after large floods in 2008. Anthropometric measurements on 879 children and child, parental and household level variables were collected through face-to-face interviews in September 2009. The association between flooding and the prevalence of wasting, stunting and underweight was examined using weighted multivariate logistic regression for children inhabiting communities exposed solely to floods in 2008 and those communities repeatedly flooded (2006 and 2008) controlling for parental education and other relevant variables. We examined the influence of age on this association. Propensity score matching was conducted to test the robustness of our findings. Results: The prevalence of wasting among children flooded in 2006 and 2008 was 51.6%, 41.4% in those flooded only in 2008, and 21.2% in children inhabiting non-flooded communities. Adjusting by confounders, the increased prevalence relative to non-flooded children in the exposed groups were 2.30 (adjusted prevalence ratio (aPR); 95% CI: 1.86, 2.85) and 1.94 (95% CI: 1.43, 2.63), respectively. Among repeatedly flooded communities, cases of severe wasting in children were 3.37 times more prevalent than for children inhabiting in those non-flooded (95% CI: 2.34, 4.86) and nearly twice more prevalent relative to those flooded only once. Those children younger than one year during previous floods in 2006 showed the largest difference in prevalence of wasting compared to their non-flooded counterparts (aPR: 4.01; 95% CI: 1.51, 10.63). Results were robust to

  7. Flood-Exposure is Associated with Higher Prevalence of Child Undernutrition in Rural Eastern India.

    PubMed

    Rodriguez-Llanes, Jose Manuel; Ranjan-Dash, Shishir; Mukhopadhyay, Alok; Guha-Sapir, Debarati

    2016-02-06

    Child undernutrition and flooding are highly prevalent public health issues in Asia, yet epidemiological studies investigating this association are lacking. To investigate to what extent floods exacerbate poor nutritional status in children and identify most vulnerable groups, we conducted a population-based survey of children aged 6-59 months inhabiting flooded and non-flooded communities of the Jagatsinghpur district, Odisha (India), one year after large floods in 2008. Anthropometric measurements on 879 children and child, parental and household level variables were collected through face-to-face interviews in September 2009. The association between flooding and the prevalence of wasting, stunting and underweight was examined using weighted multivariate logistic regression for children inhabiting communities exposed solely to floods in 2008 and those communities repeatedly flooded (2006 and 2008) controlling for parental education and other relevant variables. We examined the influence of age on this association. Propensity score matching was conducted to test the robustness of our findings. The prevalence of wasting among children flooded in 2006 and 2008 was 51.6%, 41.4% in those flooded only in 2008, and 21.2% in children inhabiting non-flooded communities. Adjusting by confounders, the increased prevalence relative to non-flooded children in the exposed groups were 2.30 (adjusted prevalence ratio (aPR); 95% CI: 1.86, 2.85) and 1.94 (95% CI: 1.43, 2.63), respectively. Among repeatedly flooded communities, cases of severe wasting in children were 3.37 times more prevalent than for children inhabiting in those non-flooded (95% CI: 2.34, 4.86) and nearly twice more prevalent relative to those flooded only once. Those children younger than one year during previous floods in 2006 showed the largest difference in prevalence of wasting compared to their non-flooded counterparts (aPR: 4.01; 95% CI: 1.51, 10.63). RESULTS were robust to alternative adjusted models and

  8. Fish and fat intake and prevalence of allergic rhinitis in Japanese females: the Osaka Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Sasaki, Satoshi; Tanaka, Keiko; Ohya, Yukihiro; Miyamoto, Shoichi; Matsunaga, Ichiro; Yoshida, Toshiaki; Hirota, Yoshio; Oda, Hajime

    2007-06-01

    It remains uncertain whether intake of fish or n-3 polyunsaturated fatty acids is preventive against allergic disorders. This cross-sectional study investigated the association of intake of selected high-fat foods and specific types of fatty acids with the prevalence of allergic rhinitis in Japan where intake of fish is high. Study subjects were 1002 Japanese pregnant females. Allergic rhinitis (including cedar pollinosis) was defined as present if subjects had received drug treatment at some point during the previous 12 months. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, indoor domestic pets, family history of asthma, atopic eczema, and allergic rhinitis, family income, education, mite antigen level in house dust, changes in diet in the previous month, season when data were collected, and body mass index. There was a tendency for an inverse dose-response association between fish intake and allergic rhinitis although the adjusted odds ratio for comparison of the highest with the lowest quartile was not statistically significant (p for trend = 0.09). Intake of eicosapentaenoic and docosahexaenoic acids was independently associated with a decreased prevalence of allergic rhinitis: the multivariate odds ratio for the highest quartile was 0.56 (95% confidence interval: 0.32-0.96, p for trend = 0.03). Intake of n-6 polyunsaturated fatty acids in the third quartile but not the second and fourth quartiles showed a tendency for an inverse association with the prevalence of allergic rhinitis. No measurable relationship was found between consumption of meat, eggs, dairy products, total fat, saturated, monounsaturated, and n-3 polyunsaturated fatty acids, and cholesterol or the ratio of n-3 to n-6 polyunsaturated fatty acids and allergic rhinitis. Our findings suggest that the intake of eicosapentaenoic and

  9. Indian men's use of commercial sex workers: prevalence, condom use, and related gender attitudes.

    PubMed

    Decker, Michele R; Miller, Elizabeth; Raj, Anita; Saggurti, Niranjan; Donta, Balaiah; Silverman, Jay G

    2010-02-01

    Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past year CSW contact, condom nonuse therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. The nationally representative Indian National Family Health Survey-3 was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past year CSW contact, and inconsistent condom use. Approximately 1 in 100 Indian men (0.9%) reported past year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6%) and never married men (9.9%). Men's CSW contact related to higher levels of sexual entitlement (adjusted odds ratio = 1.64; 95% confidence interval 1.24 to 2.17) and justification of violence against wives (adjusted odds ratio = 1.41; 95% confidence interval: 1.03 to 1.93). Men's past year CSW contact was concentrated among young and unmarried Indian men; condom nonuse with CSWs was common. Traditional gender ideologies seemed to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk subpopulations and indicating that gender ideologies should be addressed.

  10. Prevalence and risk factors for Taenia solium cysticercosis in school-aged children: A school based study in western Sichuan, People's Republic of China.

    PubMed

    Openshaw, John J; Medina, Alexis; Felt, Stephen A; Li, Tiaoying; Huan, Zhou; Rozelle, Scott; Luby, Stephen P

    2018-05-08

    Taenia solium cysticercosis affects millions of impoverished people worldwide and can cause neurocysticercosis, an infection of the central nervous system which is potentially fatal. Children may represent an especially vulnerable population to neurocysticercosis, due to the risk of cognitive impairment during formative school years. While previous epidemiologic studies have suggested high prevalence in rural China, the prevalence in children as well as risk factors and impact of disease in low-resource areas remain poorly characterized. Utilizing school based sampling, we conducted a cross-sectional study, administering a questionnaire and collecting blood for T. solium cysticercosis antibodies in 2867 fifth and sixth grade students across 27 schools in west Sichuan. We used mixed-effects logistic regression models controlling for school-level clustering to study associations between risk factors and to characterize factors influencing the administration of deworming medication. Overall prevalence of cysticercosis antibodies was 6%, but prevalence was significantly higher in three schools which all had prevalences of 15% or higher. Students from households owning pigs (adjusted odds ratio [OR] 1.81, 95% CI 1.08-3.03), from households reporting feeding their pigs human feces (adjusted OR 1.49, 95% CI 1.03-2.16), and self-reporting worms in their feces (adjusted OR 1.85, 95% CI 1.18-2.91) were more likely to have cysticercosis IgG antibodies. Students attending high prevalence schools were more likely to come from households allowing pigs to freely forage for food (OR 2.26, 95% CI 1.72-2.98) and lacking a toilet (OR 1.84, 95% CI 1.38-2.46). Children who were boarding at school were less likely to have received treatment for gastrointestinal worms (adjusted OR 0.58, 95% CI 0.42-0.80). Our study indicates high prevalences of cysticercosis antibodies in young school aged children in rural China. While further studies to assess potential for school-based transmission

  11. Increased Prevalence of Chronic Lymphocytic Thyroiditis in Korean Patients with Papillary Thyroid Cancer

    PubMed Central

    Oh, Chang-Mo; Park, Sohee; Lee, Joo Young; Won, Young-Joo; Shin, Aesun; Kong, Hyun-Joo; Choi, Kui-Sun; Lee, You Jin; Chung, Ki- Wook; Jung, Kyu-Won

    2014-01-01

    Background In recent years, some reports have suggested that papillary thyroid cancers are more frequently associated with lymphocytic thyroiditis or Hashimoto's thyroiditis. This study investigated a potential increase in the prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients. Materials and Methods We used national epidemiological survey data on thyroid cancer patients diagnosed in 1999, 2005, and 2008. A retrospective medical record survey was conducted by representative sampling of a national cancer incidence database. The analysis included 5,378 papillary thyroid cancer patients aged 20–79 years. We calculated the age-standardized prevalence and age-adjusted prevalence ratios using a binomial regression model with a log link for the prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients by sex for each year. Results The prevalence of chronic lymphocytic thyroiditis among papillary thyroid cancer patients was 4.0% and 12.8% for men and women in 1999, 6.5% and 24.6% in 2005, and 10.7% and 27.6% in 2008, respectively. Between 1999 and 2008, the age-standardized prevalence of chronic lymphocytic thyroiditis increased 4.1-fold in male patients and 2.0-fold in female patients with papillary thyroid cancer. The prevalence of other thyroid diseases, however, did not increase in either gender. Conclusions Among Korean papillary thyroid cancer patients, the prevalence of chronic lymphocytic thyroiditis increased between 1999 and 2008, whereas the prevalence of other thyroid disorders did not change. PMID:24927027

  12. Twenty-year trends in the prevalence of disability in China

    PubMed Central

    Chen, Gong; Song, Xinming; Liu, Jufen; Yan, Lijing; Du, Wei; Pang, Lihua; Zhang, Lei; Wu, Jilei; Zhang, Bingzi; Zhang, Jun

    2011-01-01

    Abstract Objective To evaluate changes in the age-adjusted prevalence of disability in transitional China from 1987 to 2006. Methods Data from nationally representative surveys conducted in 1987 and 2006 were used to calculate age-adjusted disability prevalence rates by applying appropriate sample weights and directly adjusting to the age distribution of the 1990 Chinese population. Trends were assessed in terms of average annual percentage change. Findings The estimated number of disabled people in China in 1987 and 2006 was 52.7 and 84.6 million, respectively, corresponding to a weighted prevalence of 4.9% and 6.5%. The age-adjusted prevalence of disability decreased by an average of 0.5% per year (average annual percentage change, AAPC: −0.5%; 95% confidence interval, CI: −0.7 to −0.4) during 1987–2006. However, it increased by an average of 0.3% (AAPC: 0.3%; 95% CI: 0.1 to 0.5) per year in males and by an average of 1.0% (AAPC: 1.0%; 95% CI: 0.8 to 1.2) per year among rural residents, whereas among females it showed an average annual decrease of 1.5% (AAPC: −1.5%; 95% CI: −1.7 to −1.3) and among urban residents, an average annual decrease of 3.9% (AAPC: −3.9%; 95% CI: −4.3 to −3.5). Despite significant declining trends for hearing and speech, intellectual and visual disabilities, the annual age-adjusted prevalence of physical and mental disabilities increased by an average of 11.2% (AAPC: 11.2%; 95% CI: 10.5 to 11.9) and 13.3% (AAPC: 13.3%; 95% CI: 10.7 to 16.2), respectively. Conclusion In China, the age-adjusted prevalence of disability has declined since 1987, with inconsistencies dependent on the type of disability. These findings call for continuing and specific efforts to prevent disabilities in China. PMID:22084524

  13. Prevalence of overweight, obesity and thinness in 9–10 year old children in Mauritius

    PubMed Central

    2012-01-01

    Objective To document the prevalence of overweight, obesity and thinness in 9–10 year old children in Mauritius. Methods 412 boys and 429 girls aged 9–10 years from 23 primary schools were selected using stratified cluster random sampling. All data was cross-sectional and collected via anthropometry and self-administered questionnaire. Outcome measures were BMI (kg/m2), prevalence of overweight, obesity (International Obesity Task Force definitions) and thinness (low BMI for age). Linear and logistic regression analyses, accounting for clustering at the school level, were used to assess associations between gender, ethnicity, school location, and school's academic performance (average) to each outcome measure. Results The distribution of BMI was marginally skewed with a more pronounced positive tail in the girls. Median BMI was 15.6 kg/m2 in boys and 15.4 kg/m2 in girls, respectively. In boys, prevalence of overweight was 15.8% (95% CI: 12.6, 19.6), prevalence of obesity 4.9% (95% CI: 3.2, 7.4) and prevalence of thinness 12.4% (95% CI: 9.5, 15.9). Among girls, 18.9% (95% CI: 15.5, 22.9) were overweight, 5.1% (95% CI: 3.4, 7.7) were obese and 13.1% (95% CI: 10.2, 16.6) were thin. Urban children had a slightly higher mean BMI than rural children (0.5 kg/m2, 95% CI: 0.01, 1.00) and were nearly twice as likely to be obese (6.7% vs. 4.0%; adjusted odds ratio 1.6; 95% CI: 0.9, 3.5). Creole children were less likely to be classified as thin compared to Indian children (adjusted odds ratio 0.3, 95% CI: 0.2, 0.6). Conclusion Mauritius is currently in the midst of nutritional transition with both a high prevalence of overweight and thinness in children aged 9–10 years. The coexistence of children representing opposite sides of the energy balance equation presents a unique challenge for policy and interventions. Further exploration is needed to understand the specific causes of the double burden of malnutrition and to make appropriate policy recommendations

  14. Are the new IADPSG criteria for gestational diabetes useful in a country with a very high prevalence?

    PubMed

    Minsart, Anne-Frederique; N'guyen, Thai-Son Pierre; Dimtsu, Hirut; Ratsimandresy, Rachel; Dada, Fouad; Ali Hadji, Rachid

    2014-09-01

    The International Association of Diabetes and Pregnancy Study Groups released new recommendations on screening methods and diagnostic criteria for gestational diabetes. The main objectives of the present study were to analyze characteristics of mothers who underwent the new screening test, and to assess the prevalence of gestational diabetes and related pregnancy complications such as the 5-minute Apgar score <7, in a urban maternity clinic in Djibouti. The effect of treating gestational diabetes was also evaluated. Totally, 231 mothers underwent the new screening test, and 106 were diagnosed as having gestational diabetes (45.9%). Mothers with gestational diabetes had an excess risk of low Apgar scores, even after adjustment for socio-economic and medical covariates, with an odds ratio of 6.34 (1.77-22.66), p value <0.005. Only 46.2% of mothers with gestational diabetes followed the recommendations regarding treatment. Among these patients, 18.6% of infants from untreated mothers had a 5-minute Apgar score <7, compared to 3.9% infants from treated mothers (p value = 0.017). After adjustment, untreated mothers still had a high excess risk of low Apgar scores, although non-significant, with an odds ratio of 4.67 (0.78-27.87), p value = 0.09. In conclusion, gestational diabetes is highly prevalent in Djibouti and is related to low Apgar scores.

  15. Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers

    PubMed Central

    Kerr, T; Strathdee, S A; Shoveller, J; Montaner, J S; Tyndall, M W

    2009-01-01

    Objective To examine the prevalence and structural correlates of gender based violence against female sex workers in an environment of criminalised prostitution. Design Prospective observational study. Setting Vancouver, Canada during 2006-8. Participants Female sex workers 14 years of age or older (inclusive of transgender women) who used illicit drugs (excluding marijuana) and engaged in street level sex work. Main outcome measure Self reported gender based violence. Results Of 267 female sex workers invited to participate, 251 women returned to the study office and consented to participate (response rate of 94%). Analyses were based on 237 female sex workers who completed a baseline visit and at least one follow-up visit. Of these 237 female sex workers, 57% experienced gender based violence over an 18 month follow-up period. In multivariate models adjusted for individual and interpersonal risk practices, the following structural factors were independently correlated with violence against female sex workers: homelessness (adjusted odds ratio for physical violence (aORphysicalviolence) 2.14, 95% confidence interval 1.34 to 3.43; adjusted odds ratio for rape (aORrape) 1.73, 1.09 to 3.12); inability to access drug treatment (adjusted odds ratio for client violence (aORclientviolence) 2.13, 1.26 to 3.62; aORphysicalviolence 1.96, 1.03 to 3.43); servicing clients in cars or public spaces (aORclientviolence 1.50, 1.08 to 2.57); prior assault by police (aORclientviolence 3.45, 1.98 to 6.02; aORrape 2.61, 1.32 to 5.16); confiscation of drug use paraphernalia by police without arrest (aORphysicalviolence 1.50, 1.02 to 2.41); and moving working areas away from main streets owing to policing (aORclientviolence 2.13, 1.26 to 3.62). Conclusions Our results demonstrate an alarming prevalence of gender based violence against female sex workers. The structural factors of criminalisation, homelessness, and poor availability of drug treatment independently correlated with gender

  16. Prevalence and structural correlates of gender based violence among a prospective cohort of female sex workers.

    PubMed

    Shannon, Kate; Kerr, T; Strathdee, S A; Shoveller, J; Montaner, J S; Tyndall, M W

    2009-08-11

    To examine the prevalence and structural correlates of gender based violence against female sex workers in an environment of criminalised prostitution. Prospective observational study. Vancouver, Canada during 2006-8. Female sex workers 14 years of age or older (inclusive of transgender women) who used illicit drugs (excluding marijuana) and engaged in street level sex work. Self reported gender based violence. Of 267 female sex workers invited to participate, 251 women returned to the study office and consented to participate (response rate of 94%). Analyses were based on 237 female sex workers who completed a baseline visit and at least one follow-up visit. Of these 237 female sex workers, 57% experienced gender based violence over an 18 month follow-up period. In multivariate models adjusted for individual and interpersonal risk practices, the following structural factors were independently correlated with violence against female sex workers: homelessness (adjusted odds ratio for physical violence (aOR(physicalviolence)) 2.14, 95% confidence interval 1.34 to 3.43; adjusted odds ratio for rape (aOR(rape)) 1.73, 1.09 to 3.12); inability to access drug treatment (adjusted odds ratio for client violence (aOR(clientviolence)) 2.13, 1.26 to 3.62; aOR(physicalviolence) 1.96, 1.03 to 3.43); servicing clients in cars or public spaces (aOR(clientviolence) 1.50, 1.08 to 2.57); prior assault by police (aOR(clientviolence) 3.45, 1.98 to 6.02; aOR(rape) 2.61, 1.32 to 5.16); confiscation of drug use paraphernalia by police without arrest (aOR(physicalviolence) 1.50, 1.02 to 2.41); and moving working areas away from main streets owing to policing (aOR(clientviolence) 2.13, 1.26 to 3.62). Our results demonstrate an alarming prevalence of gender based violence against female sex workers. The structural factors of criminalisation, homelessness, and poor availability of drug treatment independently correlated with gender based violence against street based female sex workers. Socio

  17. Demonization of Divorce: Prevalence Rates and Links to Postdivorce Adjustment

    ERIC Educational Resources Information Center

    Krumrei, Elizabeth J.; Mahoney, Annette; Pargament, Kenneth I.

    2011-01-01

    The meaning-making process can be crucial to individuals as they adjust to their divorce. Demonization is a negative coping response (also known as spiritual struggle) that involves appraising someone or something as related to demonic forces. Individuals may cognitively frame a divorce as the work of Satan in order to understand suffering while…

  18. Human papillomavirus prevalence, cervical abnormalities and risk factors among female sex workers in Lima, Peru

    PubMed Central

    Brown, B; Blas, M M; Cabral, A; Byraiah, G; Guerra-Giraldez, C; Sarabia-Vega, V; Carcamo, C; Gravitt, P E; Halsey, N A

    2015-01-01

    Summary Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infection. Questionnaires were administered to 200 FSWs aged 18–26 years in Lima, Peru, to gather risk behaviours, and cervical swab samples were collected for Pap smears and HPV DNA testing as part of a longitudinal study. Participants reported a median of 120 clients in the past month, and 99.2% reported using condoms with clients. The prevalence of any HPV in cervical samples was 66.8%; 34 (17.1%) participants had prevalent HPV 16 or 18, and 92 (46.2%) had one or more oncogenic types. Fifteen women had abnormal Pap smears, 13 of which were HPV DNA positive. Fewer years since first sex was associated with oncogenic HPV prevalence in a model adjusted for previous sexually transmitted infection (STI) status and condom use with partners (prevalence ratio = 0.77, 95% confidence interval [CI] = 0.60–0.97). Our data confirm the high rates of HPV transmission among FSWs in Peru, highlighting the need for early and effective strategies to prevent cervical cancer. PMID:22581946

  19. Human papillomavirus prevalence, cervical abnormalities and risk factors among female sex workers in Lima, Peru.

    PubMed

    Brown, B; Blas, M M; Cabral, A; Byraiah, G; Guerra-Giraldez, C; Sarabia-Vega, V; Carcamo, C; Gravitt, P E; Halsey, N A

    2012-04-01

    Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infection. Questionnaires were administered to 200 FSWs aged 18-26 years in Lima, Peru, to gather risk behaviours, and cervical swab samples were collected for Pap smears and HPV DNA testing as part of a longitudinal study. Participants reported a median of 120 clients in the past month, and 99.2% reported using condoms with clients. The prevalence of any HPV in cervical samples was 66.8%; 34 (17.1%) participants had prevalent HPV 16 or 18, and 92 (46.2%) had one or more oncogenic types. Fifteen women had abnormal Pap smears, 13 of which were HPV DNA positive. Fewer years since first sex was associated with oncogenic HPV prevalence in a model adjusted for previous sexually transmitted infection (STI) status and condom use with partners (prevalence ratio = 0.77, 95% confidence interval [CI] = 0.60-0.97). Our data confirm the high rates of HPV transmission among FSWs in Peru, highlighting the need for early and effective strategies to prevent cervical cancer.

  20. Implementation of the Brazilian Breastfeeding Network and prevalence of exclusive breastfeeding

    PubMed Central

    Passanha, Adriana; Benício, Maria Helena D'Aquino; Venâncio, Sônia Isoyama; dos Reis, Márcia Cristina Guerreiro

    2013-01-01

    OBJECTIVE To evaluate the association between the level of implementation of the Brazilian Breastfeeding Network and the prevalence of exclusive breastfeeding. METHODS Cross-sectional study of a representative sample of 916 infants < 6 months, in Ribeirao Preto, SP, Southeastern Brazil, in 2011. Data on breastfeeding, place of outpatient care and other characteristics were collected during the National Vaccination Campaign. The factor studied is where outpatient care took place: Private; Non-Network Public; Public with Network Workshop; and Public certified by Network. The individualized effect of the factor studied on the outcome was analyzed using Poisson regression with robust variance. RESULTS The comparison between private (reference category) and other outpatient care showed significant dose-response relationship with a progressive increase in the prevalence of exclusive breastfeeding in public non-Network, public with Network Workshop and public accredited by Network outpatient care (p = 0.047). As regards the Basic Health Units accredited by Network category, the Prevalence Ratio of exclusive breastfeeding was equal to 1.47 (95%CI 1.00;2.17), after adjustment for confounding variables. CONCLUSIONS The prevalence of exclusive breastfeeding for infants < 6 months was higher in places accredited by the Brazilian Breastfeeding Network, which evinces the importance of investing in accreditation of Basic Units of Health by this strategy. PMID:24626552

  1. Periodontal Bacteria and Prediabetes Prevalence in ORIGINS: The Oral Infections, Glucose Intolerance, and Insulin Resistance Study.

    PubMed

    Demmer, R T; Jacobs, D R; Singh, R; Zuk, A; Rosenbaum, M; Papapanou, P N; Desvarieux, M

    2015-09-01

    Periodontitis and type 2 diabetes mellitus are known to be associated. The relationship between periodontal microbiota and early diabetes risk has not been studied. We investigated the association between periodontal bacteria and prediabetes prevalence among diabetes-free adults. ORIGINS (the Oral Infections, Glucose Intolerance and Insulin Resistance Study) cross sectionally enrolled 300 diabetes-free adults aged 20 to 55 y (mean ± SD, 34 ± 10 y; 77% female). Prediabetes was defined as follows: 1) hemoglobin A1c values ranging from 5.7% to 6.4% or 2) fasting plasma glucose ranging from 100 to 125 mg/dL. In 1,188 subgingival plaque samples, 11 bacterial species were assessed at baseline, including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Actinomyces naeslundii. Full-mouth clinical periodontal examinations were performed, and participants were defined as having no/mild periodontitis vs. moderate/severe periodontitis per the definition of the Centers for Disease Control and Prevention / American Academy of Periodontology. Modified Poisson regression evaluated prediabetes prevalence across bacterial tertiles. Prevalence ratios and 95% confidence intervals for third vs. first tertiles are presented. All analyses were adjusted for cardiometabolic risk factors. All results presented currently arise from the baseline cross section. Prediabetes prevalence was 18%, and 58% of participants had moderate/severe periodontitis. Prevalence ratios (95% confidence intervals) summarizing associations between bacterial levels and prediabetes were as follows: A. actinomycetemcomitans, 2.48 (1.34, 4.58), P = 0.004; P. gingivalis, 3.41 (1.78, 6.58), P = 0.0003; T. denticola, 1.99 (0.992, 4.00), P = 0.052; T. forsythia, 1.95 (1.0, 3.84), P = 0.05; A. naeslundii, 0.46 (0.25, 0.85), P = 0.01. The prevalence ratio for prediabetes among participants with moderate/severe vs. no/mild periodontitis was 1.47 (0.78, 2.74), P

  2. Diabetes prevalence and income: Results of the Canadian Community Health Survey.

    PubMed

    Dinca-Panaitescu, Serban; Dinca-Panaitescu, Mihaela; Bryant, Toba; Daiski, Isolde; Pilkington, Beryl; Raphael, Dennis

    2011-02-01

    This paper contributes to a growing body of literature indicating the importance of income as a key socioeconomic status marker in accounting for the increased prevalence of type 2 diabetes (T2DM). We analyzed data from the Canadian Community Health Survey cycle 3.1 conducted by Statistics Canada. Descriptive statistics on the prevalence of self-reported diabetes were computed. Multiple logistic regression was used to examine the association between income and prevalence of T2DM. In 2005 an estimated 1.3 million Canadians (4.9%) reported having diabetes. The prevalence of T2DM in the lowest income group is 4.14 times higher than in the highest income group. Prevalence of diabetes decreases steadily as income goes up. The likelihood of diabetes was significantly higher for low-income groups even after adjusting for socio-demographic status, housing, BMI and physical activity. There is a graded association between income and diabetes with odds ratios almost double for men (OR 1.94, 95% CI 1.57-2.39) and almost triple for women (OR 2.75 95% CI 2.24-3.37) in the lowest income compared to those in highest income. These findings suggest that strategies for diabetes prevention should combine person-centered approaches generally recommended in the diabetes literature research with public policy approaches that acknowledge the role of socioeconomic position in shaping T2DM prevalence/incidence. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Preparation of hydrophilic interaction/ion-exchange mixed-mode chromatographic stationary phase with adjustable selectivity by controlling different ratios of the co-monomers.

    PubMed

    Bo, Chunmiao; Wang, Xiaomeng; Wang, Chaozhan; Wei, Yinmao

    2017-03-03

    Development of mixed-mode chromatography (MMC) stationary phase with adjustable selectivity is beneficial to meet the needs of complex samples. In this work, surface-initiated atom transfer radical polymerization (SI-ATRP) using the mixture of two functional monomers was proposed as a new preparation strategy for MMC stationary phase with adjustable selectivity. The mixture of sodium 4-styrenesulfonate (NASS) and dimethylaminoethyl methacrylate (DMAEMA) underwent SI-ATRP to bond poly(NASS-co-DMAEMA) on the surface of silica to prepare hydrophilic interaction/ion-exchange mixed-mode stationary phase. Various analytes (neutral, acidic, basic analytes and strong polar nucleosides) were employed to investigate the retention behaviors. The influences of water content and pH of the mobile phase on the retention validated the mixed-mode retention mechanisms of HILIC and ion-exchange. The charge and polarity of stationary phase as well as the separation selectivity were conveniently manipulated by the ratio of NASS to DMAEMA monomer, and the use of DMAEMA in the mixture additionally endowed the column with the temperature-responsive characteristics. Moreover, the application of the developed column was demonstrated by the successful separation of nucleosides, β-agonists and safflower injection. In a word, the proposed strategy can be potentially applied in the controllable preparation of MMC stationary phase with adjustable selectivity. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India.

    PubMed

    Wang, Hai-Yun; Leena, Kondarapassery Balakumaran; Plymoth, Amelie; Hergens, Maria-Pia; Yin, Li; Shenoy, Kotacherry Trivikrama; Ye, Weimin

    2016-03-15

    The prevalence of gastro-esophageal reflux disease (GERD) varies widely around the world. This study aimed to investigate the prevalence and risk factors of GERD in a general population of southern India. An interview-based observational study was carried out in southern India during 2010 and early 2011 using a GERD questionnaire (GerdQ). In total 1072 participants were enrolled using a multi-stage cluster sampling method. Presence of GERD was defined as a score of ≥ 8. Logistic regression models were used to derive odds ratios (ORs) with 95 % confidence intervals (CIs). The prevalence of GERD was 22.2 % (238/1072) in southern India, and was more common among older subjects and men. Overweight and obese subjects had a dose-dependent increased risk of GERD, compared to those with body mass index less than 25 (multivariate-adjusted OR = 1.4, 95 % CI 1.0-2.0; OR = 2.3, 95 % CI 1.3-4.1, respectively). People residing in urban community were more vulnerable to GERD than those in rural community (multivariate-adjusted OR = 1.8, 95 % CI 1.3-2.5). Similarly, those with a lower educational level appeared to have an increased risk of GERD. Further, those with a habit of pan masala chewing were more likely to develop GERD compared with those abstained from the habit (multivariate-adjusted OR = 2.0, 95 % CI 1.2-3.2). GERD is highly prevalent in southern India. Increasing age and BMI, an urban environment, lower educational level, and pan masala chewing appear to be risk factors of GERD symptoms for the studied population.

  5. Prevalence and risk factors associated with dry eye symptoms: a population based study in Indonesia

    PubMed Central

    Lee, A J; Lee, J; Saw, S-M; Gazzard, G; Koh, D; Widjaja, D; Tan, D T H

    2002-01-01

    Aim: To determine the prevalence and identify associated risk factors for dry eye syndrome in a population in Sumatra, Indonesia. Methods: A one stage cluster sampling procedure was conducted to randomly select 100 households in each of the five rural villages and one provincial town of the Riau province, Indonesia, from April to June 2001. Interviewers collected demographic, lifestyle, and medical data from 1058 participants aged 21 years or over. Symptoms of dry eye were assessed using a six item validated questionnaire. Presence of one or more of the six dry eye symptoms often or all the time was analysed. Presence of pterygium was documented. Results: Prevalence of one or more of the six dry eye symptoms often or all the time adjusted for age was 27.5% (95% confidence interval (CI) 24.8 to 30.2). After adjusting for all significant variables, independent risk factors for dry eye were pterygium (p<0.001, multivariate odds ratio (OR) 1.8; 95% CI 1.4 to 2.5) and a history of current cigarette smoking (p=0.05, multivariate OR 1.5; 95% CI 1.0 to 2.2). Conclusions: This population based study provides prevalence rates of dry eye symptoms in a tropical developing nation. From our findings, pterygium is a possible independent risk factor for dry eye symptoms. PMID:12446361

  6. Adjusting the Adjusted X[superscript 2]/df Ratio Statistic for Dichotomous Item Response Theory Analyses: Does the Model Fit?

    ERIC Educational Resources Information Center

    Tay, Louis; Drasgow, Fritz

    2012-01-01

    Two Monte Carlo simulation studies investigated the effectiveness of the mean adjusted X[superscript 2]/df statistic proposed by Drasgow and colleagues and, because of problems with the method, a new approach for assessing the goodness of fit of an item response theory model was developed. It has been previously recommended that mean adjusted…

  7. Occupations with an increased prevalence of self-reported asthma in Indian adults.

    PubMed

    Agrawal, Sutapa; Pearce, Neil; Millett, Christopher; Subramanian, S V; Ebrahim, Shah

    2014-10-01

    Occupational asthma remains relatively under-recognized in India with little or no information regarding preventable causes. We studied occupations with an increased prevalence of self-reported asthma among adult men and women in India. Analysis is based on 64,725 men aged 15-54 years and 52,994 women aged 15-49 years who participated in India's third National Family Health Survey, 2005-2006, and reported their current occupation. Prevalence odds ratios (ORs) for specific occupations and asthma were estimated using multivariate logistic regression, separately for men and women, adjusting for age, education, household wealth index, current tobacco smoking, cooking fuel use, rural/urban residence and access to healthcare. The prevalence of asthma among the working population was 1.9%. The highest odds ratios for asthma were found among men in the plant and machine operators and assemblers major occupation category (OR: 1.67; 95% CI: 1.14-2.45; p = 0.009). Men working in occupation subcategories of machine operators and assemblers (OR: 1.85; 95% CI: 1.24-2.76; p = 0.002) and mining, construction, manufacturing and transport (OR: 1.33; 95% CI: 1.00-1.77; p = 0.051) were at the highest risk of asthma. Reduced odds of asthma prevalence in men was observed among extraction and building trades workers (OR: 0.72; 95% CI: 0.53-0.97; p = 0.029). Among women none of the occupation categories or subcategories was found significant for asthma risk. Men and women employed in high-risk occupations were not at a higher risk of asthma when compared with those in low-risk occupations. This large population-based, nationally representative cross-sectional study has confirmed findings from high income countries showing high prevalence of asthma in men in a number of occupational categories and subcategories; however, with no evidence of increased risks for women in the same occupations.

  8. Prevalence and associated factors of myopia among primary and middle school-aged students: a school-based study in Guangzhou

    PubMed Central

    Guo, L; Yang, J; Mai, J; Du, X; Guo, Y; Li, P; Yue, Y; Tang, D; Lu, C; Zhang, W-H

    2016-01-01

    Purpose To estimate the prevalence of myopia among primary and middle school-aged students in Guangzhou and to explore the potentially contributing factors to myopia. Methods This cross-sectional study was based on a sample of students in grades 1–6 and grades 7–9. Data were collected from refractive error measurements and a structured questionnaire. Results A total of 3055 participants were involved in this analysis, and the overall prevalence of myopia was 47.4% (95% confidence interval (CI)= 45.6–49.2%). The prevalence of myopia in students increased along with the growth of grade level; the prevalence of myopia in students in grade 1 was only 0.2%, as it increased to 38.8% in students in grade 3, and the rate was the highest (68.4%) in students in grade 9. Girls were at a higher risk of myopia than boys (adjusted odds ratio=1.22, 95% CI=1.04–1.44). Both male and female students whose distance of reading was longer than 25 cm were less likely to have myopia and who have one or two myopic parents were at a higher risk of myopia. In addition, reading for pleasure more than 2 h per day (adjusted odds ratio=1.84, 95% CI=1.09–3.12) was only positively associated with myopia in boys and spending time watching television per week was only positively associated with myopia in girls. Conclusion Myopia in students is a significant public health problem in Guangzhou. Female gender, higher grade, longer time spent for near work, shorter distance of near work, and parental myopia were shown to be associated with the increasing risk of myopia in children. PMID:26965016

  9. The prevalence of colorectal adenomas in asymptomatic Korean men and women.

    PubMed

    Yang, Moon Hee; Rampal, Sanjay; Sung, Jidong; Choi, Yoon-Ho; Son, Hee Jung; Lee, Jun Haeng; Kim, Young-Ho; Chang, Dong Kyung; Rhee, Poong-Lyul; Rhee, Jong Chul; Guallar, Eliseo; Cho, Juhee

    2014-03-01

    Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significantly higher prevalence of adenomas compared with participants of average risk (36.9% vs. 26.9%; age- and sex-adjusted prevalence ratio = 1.16; 95% confidence interval, 1.09-1.22). The prevalence of adenomas increased annually in both men and women. In this large study of asymptomatic Korean men and women participating in a colonoscopy screening program, the prevalence of colorectal adenomas was comparable and possibly higher than previously reported in Western countries. Cost-effectiveness studies investigating the optimal age for starting colonoscopy screening and etiological studies to identify the reasons for the increasing trend in colorectal adenomas in Koreans are needed. ©2014 AACR.

  10. Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea

    PubMed Central

    Tickell, Kirkby D.; Pavlinac, Patricia B.; John-Stewart, Grace C.; Denno, Donna M.; Richardson, Barbra A.; Naulikha, Jaqueline M.; Kirera, Ronald K.; Swierczewski, Brett E.; Singa, Benson O.; Walson, Judd L.

    2017-01-01

    Abstract. Children with acute and chronic malnutrition are at increased risk of morbidity and mortality following a diarrheal episode. To compare diarrheal disease severity and pathogen prevalence among children with and without acute and chronic malnutrition, we conducted a cross-sectional study of human immunodeficiency virus-uninfected Kenyan children aged 6–59 months, who presented with acute diarrhea. Children underwent clinical and anthropometric assessments and provided stool for bacterial and protozoal pathogen detection. Clinical and microbiological features were compared using log binomial regression among children with and without wasting (mid-upper arm circumference ≤ 125 mm) or stunting (height-for-age z score ≤ −2). Among 1,363 children, 7.0% were wasted and 16.9% were stunted. After adjustment for potential confounders, children with wasting were more likely than nonwasted children to present with at least one Integrated Management of Childhood Illness danger sign (adjusted prevalence ratio [aPR]: 1.3, 95% confidence interval [CI]: 1.0 to 1.5, P = 0.05), severe dehydration (aPR: 2.4, 95% CI: 1.5 to 3.8, P < 0.01), and enteroaggregative Escherichia coli recovered from their stool (aPR: 1.8, 1.1–2.8, P = 0.02). There were no differences in the prevalence of other pathogens by wasting status after confounder adjustment. Stunting was not associated with clinical severity or the presence of specific pathogens. Wasted children with diarrhea presented with more severe disease than children without malnutrition which may be explained by a delay in care-seeking or diminished immune response to infection. Combating social determinants and host risk factors associated with severe disease, rather than specific pathogens, may reduce the disparities in poor diarrhea-associated outcomes experienced by malnourished children. PMID:29140236

  11. Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea.

    PubMed

    Tickell, Kirkby D; Pavlinac, Patricia B; John-Stewart, Grace C; Denno, Donna M; Richardson, Barbra A; Naulikha, Jaqueline M; Kirera, Ronald K; Swierczewski, Brett E; Singa, Benson O; Walson, Judd L

    2017-11-01

    Children with acute and chronic malnutrition are at increased risk of morbidity and mortality following a diarrheal episode. To compare diarrheal disease severity and pathogen prevalence among children with and without acute and chronic malnutrition, we conducted a cross-sectional study of human immunodeficiency virus-uninfected Kenyan children aged 6-59 months, who presented with acute diarrhea. Children underwent clinical and anthropometric assessments and provided stool for bacterial and protozoal pathogen detection. Clinical and microbiological features were compared using log binomial regression among children with and without wasting (mid-upper arm circumference ≤ 125 mm) or stunting (height-for-age z score ≤ -2). Among 1,363 children, 7.0% were wasted and 16.9% were stunted. After adjustment for potential confounders, children with wasting were more likely than nonwasted children to present with at least one Integrated Management of Childhood Illness danger sign (adjusted prevalence ratio [aPR]: 1.3, 95% confidence interval [CI]: 1.0 to 1.5, P = 0.05), severe dehydration (aPR: 2.4, 95% CI: 1.5 to 3.8, P < 0.01), and enteroaggregative Escherichia coli recovered from their stool (aPR: 1.8, 1.1-2.8, P = 0.02). There were no differences in the prevalence of other pathogens by wasting status after confounder adjustment. Stunting was not associated with clinical severity or the presence of specific pathogens. Wasted children with diarrhea presented with more severe disease than children without malnutrition which may be explained by a delay in care-seeking or diminished immune response to infection. Combating social determinants and host risk factors associated with severe disease, rather than specific pathogens, may reduce the disparities in poor diarrhea-associated outcomes experienced by malnourished children.

  12. Slapping and spanking in childhood and its association with lifetime prevalence of psychiatric disorders in a general population sample.

    PubMed

    MacMillan, H L; Boyle, M H; Wong, M Y; Duku, E K; Fleming, J E; Walsh, C A

    1999-10-05

    Little information is available in Canada about the prevalence of and outcomes associated with a history of slapping and spanking in childhood. The objectives of this study were to estimate the prevalence of a history of slapping or spanking in a general population sample and to assess the relation between such a history and the lifetime prevalence of psychiatric disorders. In this general population survey, a probability sample of 9953 residents of Ontario aged 15 years and older who participated in the Ontario Health Supplement was used to examine the prevalence of a history of slapping and spanking. A subgroup of this sample (n = 4888), which comprised people aged 15 to 64 years who did not report a history of physical or sexual abuse during childhood, was used to assess the relation between a history of slapping or spanking and the lifetime prevalence of 4 categories of psychiatric disorder. The measures included a self-administered questionnaire with a question about frequency of slapping and spanking during childhood, as well as an interviewer-administered questionnaire to measure psychiatric disorder. The majority of respondents indicated that they had been slapped or spanked, or both, by an adult during childhood "sometimes" (33.4%) or "rarely" (40.9%); 5.5% reported that this occurred "often." The remainder (20.2%) reported "never" experiencing these behaviours. Among the respondents without a history of physical or sexual abuse during childhood, those who reported being slapped or spanked "often" or "sometimes" had significantly higher lifetime rates of anxiety disorders (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.04-1.96), alcohol abuse or dependence (adjusted OR 2.02, 95% CI 1.27-3.21) and one or more externalizing problems (adjusted OR 2.08, 95% CI 1.36-3.16), compared with those who reported "never" being slapped or spanked. There was also an association between a history of slapping or spanking and major depression, but it was not

  13. Slapping and spanking in childhood and its association with lifetime prevalence of psychiatric disorders in a general population sample

    PubMed Central

    MacMillan, H L; Boyle, M H; Wong, M Y; Duku, E K; Fleming, J E; Walsh, C A

    1999-01-01

    BACKGROUND: Little information is available in Canada about the prevalence of and outcomes associated with a history of slapping and spanking in childhood. The objectives of this study were to estimate the prevalence of a history of slapping or spanking in a general population sample and to assess the relation between such a history and the lifetime prevalence of psychiatric disorders. METHODS: In this general population survey, a probability sample of 9953 residents of Ontario aged 15 years and older who participated in the Ontario Health Supplement was used to examine the prevalence of a history of slapping and spanking. A subgroup of this sample (n = 4888), which comprised people aged 15 to 64 years who did not report a history of physical or sexual abuse during childhood, was used to assess the relation between a history of slapping or spanking and the lifetime prevalence of 4 categories of psychiatric disorder. The measures included a self-administered questionnaire with a question about frequency of slapping and spanking during childhood, as well as an interviewer-administered questionnaire to measure psychiatric disorder. RESULTS: The majority of respondents indicated that they had been slapped or spanked, or both, by an adult during childhood "sometimes" (33.4%) or "rarely" (40.9%); 5.5% reported that this occurred "often." The remainder (20.2%) reported "never" experiencing these behaviours. Among the respondents without a history of physical or sexual abuse during childhood, those who reported being slapped or spanked "often" or "sometimes" had significantly higher lifetime rates of anxiety disorders (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.04-1.96), alcohol abuse or dependence (adjusted OR 2.02, 95% CI 1.27-3.21) and one or more externalizing problems (adjusted OR 2.08, 95% CI 1.36-3.16), compared with those who reported "never" being slapped or spanked. There was also an association between a history of slapping or spanking and

  14. Chocolate consumption and prevalence of metabolic syndrome in the NHLBI Family Heart Study.

    PubMed

    Tokede, Oluwabunmi A; Ellison, Curtis R; Pankow, James S; North, Kari E; Hunt, Steven C; Kraja, Aldi T; Arnett, Donna K; Djoussé, Luc

    2012-08-01

    Previous studies have suggested that cocoa products, which are rich sources of flavonoids, may lower blood pressure, serum cholesterol, fasting blood glucose and improve endothelial function. However, it is unclear whether consumption of cocoa products including chocolate influences the risk of metabolic syndrome (MetS). In a cross-sectional design, we sought to examine the association between chocolate consumption and the prevalence of MetS. We studied 4098 participants from the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study aged 25-93 years. Chocolate consumption was assessed using a semi-quantitative food-frequency questionnaire. MetS was defined using the NCEP III criteria. Generalized estimating equations were used to estimate prevalence odds ratios of MetS according to frequency of chocolate intake. Of the 4098 participants (mean age 51.7 y) included in the analyses, 2206 (53.8%) were female. The prevalence of metabolic syndrome in our population was 30.2%. Compared with those who did not consume any chocolate, multivariate adjusted odds ratios (95% CI) for MetS were 1.26 (0.94, 1.69), 1.15 (0.85, 1.55), and 0.99 (0.66, 1.51) among women who reported chocolate consumption of 1-3 times/ month, 1-4 times/week, and 5+ times/week, respectively. Corresponding values for men were: 1.13 (0.82, 1.57), 1.02 (0.74, 1.39), and 1.21 (0.79, 1.85). These data do not support an association between chocolate intake and the prevalence of MetS in US adult men and women.

  15. Transmission Behaviors and Prevalence of Chlamydia and Gonorrhea Among Adult Film Performers.

    PubMed

    Javanbakht, Marjan; Dillavou, M Claire; Rigg, Robert W; Kerndt, Peter R; Gorbach, Pamina M

    2017-03-01

    Adult film work involves multiple sex partners, unprotected intercourse and frequent oral/rectal contact. Data on sexual networks and sexual behaviors of adult film performers (AFP) are limited. From August 2012 to May 2013, AFPs in Los Angeles, CA, seeking care at 2 clinics that provide sexually transmitted infections (STIs) testing to performers were offered urogenital, pharyngeal, and rectal chlamydia/gonorrhea testing. Participants were 18 years or older and performed in at least 1 adult film scene within the past year. A Web-based survey was used to collect sexual behavior information. A total of 360 AFPs were enrolled; 75% (n = 271) were women, and the median age was 25 years (interquartile range, 22-31 years). Most reported a main partner (73%), 23% reported non-film transactional partners, and only 6% reported always using condoms on-set. Overall, 24% (n = 86) tested positive for chlamydia or gonorrhea; 15% for chlamydia (n = 54) and 11% for gonorrhea (n = 41). Prevalence of chlamydia/gonorrhea varied by time as a performer (median, year 2 vs year 3; P = 0.06), and days of adult film-work in the past 30 days (median, 6 days vs 4 days; P = 0.02). In multivariable analyses, age (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) and type of scene (adjusted odds ratio for double vaginal = 2.89; 95% confidence interval, 1.29-6.48) were associated with chlamydia/gonorrhea positivity. Adult film performers had a high prevalence of STIs and reported low levels of condom use in the context of most sexual partnerships. Targeted intervention strategies-both in and outside the workplace-are needed to limit the spread of STIs.

  16. Radiofrequency electromagnetic fields; male infertility and sex ratio of offspring.

    PubMed

    Baste, Valborg; Riise, Trond; Moen, Bente E

    2008-01-01

    Concern is growing about exposure to electromagnetic fields and male reproductive health. The authors performed a cross-sectional study among military men employed in the Royal Norwegian Navy, including information about work close to equipment emitting radiofrequency electromagnetic fields, one-year infertility, children and sex of the offspring. Among 10,497 respondents, 22% had worked close to high-frequency aerials to a "high" or "very high" degree. Infertility increased significantly along with increasing self-reported exposure to radiofrequency electromagnetic fields. In a logistic regression, odds ratio (OR) for infertility among those who had worked closer than 10 m from high-frequency aerials to a "very high" degree relative to those who reported no work near high-frequency aerials was 1.86 (95% confidence interval (CI): 1.46-2.37), adjusted for age, smoking habits, alcohol consumption and exposure to organic solvents, welding and lead. Similar adjusted OR for those exposed to a "high", "some" and "low" degree were 1.93 (95% CI: 1.55-2.40), 1.52 (95% CI: 1.25-1.84), and 1.39 (95% CI: 1.15-1.68), respectively. In all age groups there were significant linear trends with higher prevalence of involuntary childlessness with higher self-reported exposure to radiofrequency fields. However, the degree of exposure to radiofrequency radiation and the number of children were not associated. For self-reported exposure both to high-frequency aerials and communication equipment there were significant linear trends with lower ratio of boys to girls at birth when the father reported a higher degree of radiofrequency electromagnetic exposure.

  17. Prevalence of Asthma in School Children on the Arizona-Sonora Border.

    PubMed

    Carr, Tara F; Beamer, Paloma I; Rothers, Janet; Stern, Debra A; Gerald, Lynn B; Rosales, Cecilia B; Van Horne, Yoshira Ornelas; Pivniouk, Oksana N; Vercelli, Donata; Halonen, Marilyn; Gameros, Mercedes; Martinez, Fernando D; Wright, Anne L

    Mexican-born children living in the United States have a lower prevalence of asthma than other US children. Although children of Mexican descent near the Arizona (AZ)-Sonora border are genetically similar, differences in environmental exposures might result in differences in asthma prevalence across this region. The objective of this study was to determine if the prevalence of asthma and wheeze in these children varies across the AZ-Sonora border. The International Study of Asthma and Allergy in Children written and video questionnaires were administered to 1753 adolescents from 5 middle schools: Tucson (school A), Nogales, AZ (schools B, C), and Nogales, Sonora, Mexico (schools D, E). The prevalence of asthma and symptoms was compared, with analyses in the AZ schools limited to self-identified Mexican American students. Compared with the Sonoran reference school E, the adjusted odds ratio (OR) for asthma was significantly higher in US schools A (OR 4.89, 95% confidence interval [CI] 2.72-8.80), B (OR 3.47, 95% CI 1.88-6.42), and C (OR 4.12, 95% CI 1.78-9.60). The adjusted OR for wheeze in the past year was significantly higher in schools A (OR 2.19, 95% CI 1.20-4.01) and B (OR 2.67, 95% CI 1.42-5.01) on the written questionnaire and significantly higher in A (OR 2.13, 95% CI 1.22-3.75), B (OR 1.95, 95% CI 1.07-3.53), and Sonoran school D (OR 2.34, 95% CI 1.28-4.30) on the video questionnaire compared with school E. Asthma and wheeze prevalence differed significantly between schools and was higher in the United States. Environmental factors that may account for these differences could provide insight into mechanisms of protection from asthma. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  18. Prevalence of abdominal obesity among Chinese adults in 2011.

    PubMed

    Du, Pei; Wang, Hui-Jun; Zhang, Bing; Qi, Su-Fen; Mi, Ying-Jun; Liu, Dian-Wu; Tian, Qing-Bao

    2017-06-01

    The prevalence of abdominal obesity is increasing dramatically worldwide. This study aimed to estimate the current prevalence of abdominal obesity from the 2011 China Health and Nutrition Survey (CHNS) and compare the data with other countries. Waist circumference (WC) of 12,326 Chinese adults (aged 20 years or older) from the 2011 CHNS were analyzed by age group and region. Abdominal obesity was defined as a WC ≥90 cm for men and WC ≥80 cm for women based on World Health Organization (WHO) recommendations for Asians. In 2011, the age-adjusted mean WC was 85.9 cm (95% confidence interval [CI], 85.6-86.2 cm) for men and 80.7 cm (95% CI, 80.4-80.9 cm) for women. Based on the WHO recommendations, the age-adjusted prevalence of abdominal obesity was 44.0% (95% CI, 43.1%-44.8%) overall, 35.3% (95% CI, 34.1%-36.6%) in men, and 51.7% (95% CI, 50.5%-52.9%) in women. Moreover, the age-adjusted prevalence was 44.0% (95% CI, 42.7%-45.2%) in rural populations, 42.5% (95% CI, 40.7%-44.2%) in urban populations, and 45.2% (95% CI, 43.5%-46.9%) in megacity populations. The prevalence in China (35.3% for men and 51.7% for women) was lower than in Japan (50.8% for men) and the United States (43.5% for men and 64.7% for women). Similar results were observed when applying the criteria suggested by the Working Group on Obesity in China. In 2011, the age-adjusted prevalence of abdominal obesity in China was 35.3% in men and 51.7% in women. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  19. Soy, isoflavones, and prevalence of allergic rhinitis in Japanese women: the Osaka Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Sasaki, Satoshi; Ohya, Yukihiro; Miyamoto, Shoichi; Matsunaga, Ichiro; Yoshida, Toshiaki; Hirota, Yoshio; Oda, Hajime

    2005-06-01

    It has been hypothesized that isoflavones reduce the risk of many chronic diseases, but there are no data on the effects of dietary soy and isoflavone consumption on allergic disorders. This cross-sectional study examined the relationship between dietary soy products and isoflavone intake and the prevalence of allergic rhinitis. Study subjects were 1002 Japanese pregnant women. Allergic rhinitis (including cedar pollinosis) was defined as present if subjects had received drug treatment at some point during the previous 12 months. Adjustment was made for age; gestation; parity; cigarette smoking; passive smoking at home and at work; indoor domestic pets; family history of asthma, atopic eczema, and allergic rhinitis; family income; education; mite allergen level in house dust; changes in diet in the previous month; season when data were collected; and body mass index. Compared with dietary intake of total soy product, soy protein, daidzein, and genistein in the first quartile, consumption of these substances in the fourth quartile was independently associated with a reduced prevalence of allergic rhinitis, although no significant dose-response relationships were observed. A clear inverse linear trend for miso intake across quartiles was found, whereas the adjusted odds ratio for comparison of the highest with the lowest quartile was not statistically significant. Consumption of tofu, tofu products, fermented soybeans, boiled soybeans, and miso soup was not related to the prevalence of allergic rhinitis. A high intake of soy and isoflavones may be associated with a reduced prevalence of allergic rhinitis.

  20. Estimated daily quercetin intake and association with the prevalence of type 2 diabetes mellitus in Chinese adults.

    PubMed

    Yao, Zhanxin; Gu, Yeqing; Zhang, Qing; Liu, Li; Meng, Ge; Wu, Hongmei; Xia, Yang; Bao, Xue; Shi, Hongbin; Sun, Shaomei; Wang, Xing; Zhou, Ming; Jia, Qiyu; Wu, Yuntang; Song, Kun; Gao, Weina; Guo, Changjiang; Niu, Kaijun

    2018-05-12

    Quercetin is one of potential antidiabetic substances because of its powerful antioxidant and anti-inflammatory actions. The purpose of this study is to estimate daily quercetin intake and assess the relationship between dietary quercetin intake and the prevalence of type 2 diabetes mellitus (T2DM) in a Chinese population. Dietary intake was investigated by a validated 100-item food frequency questionnaire. Daily intakes of quercetin and nutrients were calculated accordingly. T2DM was diagnosed based on the criteria of the American Diabetes Association. Adjusted logistic regression models were used to analyze the relationship between the quartiles of quercetin intake and the prevalence of T2DM. The prevalences of T2DM were 8.35% in men and 4.68% in women. The main food sources of quercetin were apple, orange, and green tea. Daily intake of quercetin was 20.9 ± 2.32 mg/day (mean ± SD). After adjusting for potentially confounding factors, the odds ratios (95% CI) for T2DM across the ascending quartiles of quercetin intake were: 1.00 (reference), 0.75 (0.60-0.95), 0.76 (0.59-0.99), and 0.63 (0.51-0.94). The results of the present study showed that quercetin intake was inversely related to the prevalence of T2DM in the Chinese population, suggesting a protective effect of quercetin in the development of T2DM.

  1. Incidence and prevalence of systemic lupus erythematosus among the native Arab population in UAE.

    PubMed

    Al Dhanhani, A M; Agarwal, M; Othman, Y S; Bakoush, O

    2017-05-01

    Background and objectives There is a paucity of information about the epidemiology of systemic lupus erythematosus (SLE) amongst Arabs. The objective of this study was to determine the incidence and prevalence of SLE among the native Arab population of United Arab Emirates (UAE). Methods Patients with SLE were identified from three sources: medical records of two local tertiary hospitals (four years; 2009 to 2012), laboratory requests for serum double stranded deoxyribonucleic acid and serum anti-nuclear antibody and confirmed histopathologic diagnosis of SLE (skin and kidney biopsy specimens). All the patients identified with SLE met the criteria of the American College of Rheumatology. Incidence and prevalence were calculated using the state records of the UAE native population as the denominator. The age-adjusted incidence was calculated by direct standardization using the World Health Organization world standard population 2000-2025. Results Sixteen new cases (13 females and three males) fulfilled the American College of Rheumatology SLE criteria. The mean (±SD) age at time of diagnosis was 28.6 ± 12.4 years. The crude incidence ratio (per 100,000 population) was 3.5, 1.1, 2.1 and 2.1 in years 2009, 2010, 2011, 2012, respectively. The age-standardized incidence per 100,000 population for the four years was 8.6 (95% confidence interval 4.2-15.9). The age-standardized prevalence of SLE among the native population according to the 2012 population consensus was 103/100,000 population (95% confidence interval 84.5-124.4). Conclusion The age-adjusted incidence and prevalence among UAE Arabs is higher than has been reported among most other Caucasian populations. Furthermore, the prevalence of SLE in UAE seems much higher than other similar Arab countries in the Gulf region.

  2. Chocolate Consumption is Inversely Associated with Prevalent Coronary Heart Disease: The National Heart, Lung, and Blood Institute Family Heart Study

    PubMed Central

    Djoussé, Luc; Hopkins, Paul N.; North, Kari E.; Pankow, James S.; Arnett, Donna K.; Ellison, R. Curtis

    2010-01-01

    Background and Aims Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies have demonstrated blood pressure lowering effects of dark chocolate. However, limited data are available on the association of chocolate consumption and the risk of coronary heart disease (CHD). We sought to examine the association between chocolate consumption and prevalent CHD. Methods We studied in a cross-sectional design 4,970 participants aged 25 to 93 years who participated in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate intake was assessed through a semi-quantitative food frequency questionnaire. We used generalized estimating equations to estimate adjusted odds ratios. Results Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education, non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR=1.49 (0.96-2.32)]. Conclusions These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general population. PMID:20858571

  3. Prevalence of microalbuminuria in the general population of Seychelles and strong association with diabetes and hypertension independent of renal markers.

    PubMed

    Pruijm, Menno T; Madeleine, George; Riesen, Walter F; Burnier, Michel; Bovet, Pascal

    2008-05-01

    Few studies have examined microalbuminuria (MAU) in non-western populations. We assessed the prevalence of MAU in the general population of a middle-income country in the African region and relationships between MAU and selected cardiovascular risk factors. An examination survey was conducted in a sample representative of the entire population aged 25-64 years in the Seychelles. MAU adjusted for urine creatinine concentration was measured on the second morning urine using a semiquantitative point-of-care analyzer. A total of 1255 persons attended the survey (participation rate of 80.2%). The age-adjusted prevalence of MAU was 11.4%. At age 25-64 years, the prevalence of MAU was 5% in persons without diabetes and hypertension, 20% in persons with either condition and 41% in persons with both conditions. The overall prevalence of stages 3-4 chronic kidney disease was low at 3.2%. In multivariate analysis, MAU was associated with age [odds ratio (OR) 1.24 for a 10-year increase; 95% confidence interval (CI): 1.02-1.52], hypertension stage I (2.0; 1.1-3.8) and stage II (4.5; 2.3-8.6), obesity (1.7; 1.0-2.8) and diabetes (3.0; 1.9-4.9). These associations were virtually unchanged upon further adjustment for markers of renal function such as serum creatinine, serum cystatin C and calculated renal function. The prevalence of MAU was high in this population, and MAU was strongly associated with several cardiovascular risk factors independently of renal function markers. These findings suggest that MAU could be a useful marker of cardiovascular risk in this population and help identify persons in need of a specific cardiovascular risk management.

  4. Prevalence and risk factors of Coxiella burnetii seropositivity in Danish beef and dairy cattle at slaughter adjusted for test uncertainty.

    PubMed

    Paul, Suman; Agger, Jens F; Agerholm, Jørgen S; Markussen, Bo

    2014-03-01

    Antibodies to Coxiella burnetii have been found in the Danish dairy cattle population with high levels of herd and within herd seroprevalences. However, the prevalence of antibodies to C. burnetii in Danish beef cattle remains unknown. The objectives of this study were to (1) estimate the prevalence and (2) identify risk factors associated with C. burnetii seropositivity in Danish beef and dairy cattle based on sampling at slaughter. Eight hundred blood samples from slaughtered cattle were collected from six Danish slaughter houses from August to October 2012 following a random sampling procedure. Blood samples were tested by a commercially available C. burnetii antibody ELISA kit. A sample was defined positive if the sample-to-positive ratio was greater than or equal to 40. Animal and herd information were extracted from the Danish Cattle Database. Apparent (AP) and true prevalences (TPs) specific for breed, breed groups, gender and herd type; and breed-specific true prevalences with a random effect of breed was estimated in a Bayesian framework. A Bayesian logistic regression model was used to identify risk factors of C. burnetii seropositivity. Test sensitivity and specificity estimates from a previous study involving Danish dairy cattle were used to generate prior information. The prevalence was significantly higher in dairy breeds (AP=9.11%; TP=9.45%) than in beef breeds (AP=4.32%; TP=3.54%), in females (AP=9.10%; TP=9.40%) than in males (AP=3.62%; TP=2.61%) and in dairy herds (AP=15.10%; TP=16.67%) compared to beef herds (AP=4.54%; TP=3.66%). The Bayesian logistic regression model identified breed group along with age, and number of movements as contributors for C. burnetii seropositivity. The risk of seropositivity increased with age and increasing number of movements between herds. Results indicate that seroprevalence of C. burnetii is lower in cattle sent for slaughter than in Danish dairy cows in production units. A greater proportion of this prevalence

  5. Temperature-dependent sex determination in fish revisited: prevalence, a single sex ratio response pattern, and possible effects of climate change.

    PubMed

    Ospina-Alvarez, Natalia; Piferrer, Francesc

    2008-07-30

    In gonochoristic vertebrates, sex determination mechanisms can be classified as genotypic (GSD) or temperature-dependent (TSD). Some cases of TSD in fish have been questioned, but the prevalent view is that TSD is very common in this group of animals, with three different response patterns to temperature. We analyzed field and laboratory data for the 59 fish species where TSD has been explicitly or implicitly claimed so far. For each species, we compiled data on the presence or absence of sex chromosomes and determined if the sex ratio response was obtained within temperatures that the species experiences in the wild. If so, we studied whether this response was statistically significant. We found evidence that many cases of observed sex ratio shifts in response to temperature reveal thermal alterations of an otherwise predominately GSD mechanism rather than the presence of TSD. We also show that in those fish species that actually have TSD, sex ratio response to increasing temperatures invariably results in highly male-biased sex ratios, and that even small changes of just 1-2 degrees C can significantly alter the sex ratio from 1:1 (males:females) up to 3:1 in both freshwater and marine species. We demonstrate that TSD in fish is far less widespread than currently believed, suggesting that TSD is clearly the exception in fish sex determination. Further, species with TSD exhibit only one general sex ratio response pattern to temperature. However, the viability of some fish populations with TSD can be compromised through alterations in their sex ratios as a response to temperature fluctuations of the magnitude predicted by climate change.

  6. High fructose corn syrup and diabetes prevalence: a global perspective.

    PubMed

    Goran, Michael I; Ulijaszek, Stanley J; Ventura, Emily E

    2013-01-01

    The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearson's correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%, p=0.03; fasting plasma glucose=5.34 vs. 5.22 mmol/L, p=0.03) despite similarities in obesity and total sugar and calorie availability. These results suggest that countries with higher availability of HFCS have a higher prevalence of type 2 diabetes independent of obesity.

  7. Variation of adenoma prevalence by age, sex, race, and colon location in a large population: implications for screening and quality programs.

    PubMed

    Corley, Douglas A; Jensen, Christopher D; Marks, Amy R; Zhao, Wei K; de Boer, Jolanda; Levin, Theodore R; Doubeni, Chyke; Fireman, Bruce H; Quesenberry, Charles P

    2013-02-01

    Reliable community-based colorectal adenoma prevalence estimates are needed to inform colonoscopy quality standards and to estimate patient colorectal cancer risks; however, minimal data exist from populations with large numbers of diverse patients and examiners. We evaluated the prevalence of adenomas detected by sex, age, race/ethnicity, and colon location among 20,792 Kaiser Permanente Northern California members ≥50 years of age who received a screening colonoscopy examination (102 gastroenterologists, 2006-2008). Prevalence of detected adenomas increased more rapidly with age in the proximal colon (adjusted odds ratio [OR], 2.39; 95% confidence interval [CI], 2.05-2.80; 70-74 vs 50-54 years) than in the distal colon (OR, 1.89; 95% CI, 1.63-2.19). Prevalence was higher among men vs women at all ages (OR, 1.77; 95% CI, 1.66-1.89), increasing in men from 25% to 39% at ≥70 years and in women from 15% at 50-54 years to 26% (P < .001). Proximal adenoma prevalence was higher among blacks than whites (OR, 1.26; 95% CI, 1.04-1.54), although total prevalence was similar, including persons <60 years old (OR, 1.17; 95% CI, 0.91-1.50). Prevalence of detected adenomas increases substantially with age and is much higher in men; proximal adenomas are more common among blacks than whites, although the total prevalence and the prevalence for ages <60 years were similar by race. These demographic differences are such that current adenoma detection guidelines may not be valid, without adjustment, for comparing providers serving different populations. The variation in prevalence and location may also have implications for the effectiveness of screening methods in different demographic groups. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  8. Variations in Diabetes Prevalence in Low-, Middle-, and High-Income Countries: Results From the Prospective Urban and Rural Epidemiological Study.

    PubMed

    Dagenais, Gilles R; Gerstein, Hertzel C; Zhang, Xiaohe; McQueen, Matthew; Lear, Scott; Lopez-Jaramillo, Patricio; Mohan, Viswanathan; Mony, Prem; Gupta, Rajeev; Kutty, V Raman; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Zatonska, Katarzyna; Oguz, Aytekin; Rosengren, Annika; Kelishadi, Roya; Yusufali, Afzalhussein; Diaz, Rafael; Avezum, Alvaro; Lanas, Fernando; Kruger, Annamarie; Peer, Nasheeta; Chifamba, Jephat; Iqbal, Romaina; Ismail, Noorhassim; Xiulin, Bai; Jiankang, Liu; Wenqing, Deng; Gejie, Yue; Rangarajan, Sumathy; Teo, Koon; Yusuf, Salim

    2016-05-01

    The goal of this study was to assess whether diabetes prevalence varies by countries at different economic levels and whether this can be explained by known risk factors. The prevalence of diabetes, defined as self-reported or fasting glycemia ≥7 mmol/L, was documented in 119,666 adults from three high-income (HIC), seven upper-middle-income (UMIC), four lower-middle-income (LMIC), and four low-income (LIC) countries. Relationships between diabetes and its risk factors within these country groupings were assessed using multivariable analyses. Age- and sex-adjusted diabetes prevalences were highest in the poorer countries and lowest in the wealthiest countries (LIC 12.3%, UMIC 11.1%, LMIC 8.7%, and HIC 6.6%; P < 0.0001). In the overall population, diabetes risk was higher with a 5-year increase in age (odds ratio 1.29 [95% CI 1.28-1.31]), male sex (1.19 [1.13-1.25]), urban residency (1.24 [1.11-1.38]), low versus high education level (1.10 [1.02-1.19]), low versus high physical activity (1.28 [1.20-1.38]), family history of diabetes (3.15 [3.00-3.31]), higher waist-to-hip ratio (highest vs. lowest quartile; 3.63 [3.33-3.96]), and BMI (≥35 vs. <25 kg/m(2); 2.76 [2.52-3.03]). The relationship between diabetes prevalence and both BMI and family history of diabetes differed in higher- versus lower-income country groups (P for interaction < 0.0001). After adjustment for all risk factors and ethnicity, diabetes prevalences continued to show a gradient (LIC 14.0%, LMIC 10.1%, UMIC 10.9%, and HIC 5.6%). Conventional risk factors do not fully account for the higher prevalence of diabetes in LIC countries. These findings suggest that other factors are responsible for the higher prevalence of diabetes in LIC countries. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  9. Clustering of Helicobacter pylori infection in couples: differences between high- and low-prevalence population groups.

    PubMed

    Brenner, Hermann; Weyermann, Maria; Rothenbacher, Dietrich

    2006-07-01

    Several mostly small-scale studies reported clustering of Helicobacter pylori infections as a possible indicator of conjugal transmission, but results have been inconsistent. We assessed clustering of H pylori infections in a large community-based study from Germany that included both high-prevalence and low-prevalence population subgroups. Current H pylori infection was determined among 670 couples by means of carbon-13-urea breath test ((13)C-UBT) breath test and a monoclonal antigen immunoassay for H pylori in stool. Prevalences of infection among women were 34.9% (51 of 146 women) if the partner was infected and 14.5% (76 of 524 women) if the partner was not infected. Stratification by nationality showed a strong association of infection for partners with other than German nationality (adjusted odds ratio [OR], 6.05; 95% confidence interval [CI], 1.31-17.96), for whom prevalence of infection was greater than 50%, whereas no association was seen for German partners born in Germany (OR, 1.10; 95% CI, 0.47-2.61), for whom infection prevalence was approximately 10% (p for interaction = 0.048). Conjugal transmission of infection caused by H pylori is unlikely to be of relevance in low-prevalence population groups. Our results are consistent with the hypothesis of a potential role of conjugal transmission of H pylori infection in high-prevalence population groups.

  10. Dental arch dimensions, form and tooth size ratio among a Saudi sample.

    PubMed

    Omar, Haidi; Alhajrasi, Manar; Felemban, Nayef; Hassan, Ali

    2018-01-01

    To determine the dental arch dimensions and arch forms in a sample of Saudi orthodontic patients, to investigate the prevalence of Bolton anterior and overall tooth size discrepancies, and to compare the effect of gender on the measured parameters. Methods: This study is a biometric analysis of dental casts of 149 young adults recruited from different orthodontic centers in Jeddah, Saudi Arabia. The dental arch dimensions were measured. The measured parameters were arch length, arch width, Bolton's ratio, and arch form. The data were analyzed using IBM SPSS software version 22.0 (IBM Corporation, New York, USA); this cross-sectional study was conducted between April 2015 and May 2016. Results: Dental arch measurements, including inter-canine and inter-molar distance, were found to be significantly greater in males than females (p less than 0.05). The most prevalent dental arch forms were narrow tapered (50.3%) and narrow ovoid (34.2%), respectively. The prevalence of tooth size discrepancy in all cases was 43.6% for anterior ratio and 24.8% for overall ratio. The mean Bolton's anterior ratio in all malocclusion classes was 79.81%, whereas the mean Bolton's overall ratio was 92.21%. There was no significant difference between males and females regarding Bolton's ratio. Conclusion: The most prevalent arch form was narrow tapered, followed by narrow ovoid. Males generally had larger dental arch measurements than females, and the prevalence of tooth size discrepancy was more in Bolton's anterior teeth ratio than in overall ratio.

  11. Dental arch dimensions, form and tooth size ratio among a Saudi sample

    PubMed Central

    Omar, Haidi; Alhajrasi, Manar; Felemban, Nayef; Hassan, Ali

    2018-01-01

    Objectives: To determine the dental arch dimensions and arch forms in a sample of Saudi orthodontic patients, to investigate the prevalence of Bolton anterior and overall tooth size discrepancies, and to compare the effect of gender on the measured parameters. Methods: This study is a biometric analysis of dental casts of 149 young adults recruited from different orthodontic centers in Jeddah, Saudi Arabia. The dental arch dimensions were measured. The measured parameters were arch length, arch width, Bolton’s ratio, and arch form. The data were analyzed using IBM SPSS software version 22.0 (IBM Corporation, New York, USA); this cross-sectional study was conducted between April 2015 and May 2016. Results: Dental arch measurements, including inter-canine and inter-molar distance, were found to be significantly greater in males than females (p<0.05). The most prevalent dental arch forms were narrow tapered (50.3%) and narrow ovoid (34.2%), respectively. The prevalence of tooth size discrepancy in all cases was 43.6% for anterior ratio and 24.8% for overall ratio. The mean Bolton’s anterior ratio in all malocclusion classes was 79.81%, whereas the mean Bolton’s overall ratio was 92.21%. There was no significant difference between males and females regarding Bolton’s ratio. Conclusion: The most prevalent arch form was narrow tapered, followed by narrow ovoid. Males generally had larger dental arch measurements than females, and the prevalence of tooth size discrepancy was more in Bolton’s anterior teeth ratio than in overall ratio. PMID:29332114

  12. Early Age at First Sexual Intercourse is Associated with Higher Prevalence of High-grade Squamous Intraepithelial Lesions (HSIL).

    PubMed

    Xavier-Júnior, José Cândido Caldeira; Dufloth, Rozany Mucha; Vale, Diama Bhadra; Lima, Marcelo Tavares de; Zeferino, Luiz Carlos

    2017-02-01

    Objective  To evaluate the association of age at first sexual intercourse with the results of the cervicovaginal cytology. Study Design  Observational analytical study about the prevalence of altered cervicovaginal cytology results in women aged between 18 and 34 years from a densely populated area in Brazil, during 10 years. The patients were stratified into 2 categories according to their age at first sexual intercourse (13-16 years and 17-24 years). Results  From the total of 2,505,154 exams, 898,921 tests were in accordance with the inclusion criteria. Considering women with 4 years or less from the first sexual intercourse as a reference, those with 5 to 9 years and 10 years or more showed a higher prevalence of high-grade squamous intraepithelial lesions (HSILs). Women with an earlier onset of sexual intercourse (13-16 years) showed higher prevalence ratios for atypical squamous cells (ASC), low-grade squamous intraepithelial lesion (LSIL) and HSIL. The prevalence ratio for HSIL adjusted by age at diagnosis and by age at first sexual intercourse was higher only for women with an earlier onset of sexual intercourse. Conclusions  The age of first sexual intercourse could be a variable that might qualify the selection among young women who are really at a higher risk for HSIL. Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil.

  13. Racial and Ethnic Subgroup Disparities in Hypertension Prevalence, New York City Health and Nutrition Examination Survey, 2013-2014.

    PubMed

    Fei, Kezhen; Rodriguez-Lopez, Jesica S; Ramos, Marcel; Islam, Nadia; Trinh-Shevrin, Chau; Yi, Stella S; Chernov, Claudia; Perlman, Sharon E; Thorpe, Lorna E

    2017-04-20

    Racial/ethnic minority adults have higher rates of hypertension than non-Hispanic white adults. We examined the prevalence of hypertension among Hispanic and Asian subgroups in New York City. Data from the 2013-2014 New York City Health and Nutrition Examination Survey were used to assess hypertension prevalence among adults (aged ≥20) in New York City (n = 1,476). Hypertension was measured (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or self-reported hypertension and use of blood pressure medication). Participants self-reported race/ethnicity and country of origin. Multivariable logistic regression models assessed differences in prevalence by race/ethnicity and sociodemographic and health-related characteristics. Overall hypertension prevalence among adults in New York City was 33.9% (43.5% for non-Hispanic blacks, 38.0% for Asians, 33.0% for Hispanics, and 27.5% for non-Hispanic whites). Among Hispanic adults, prevalence was 39.4% for Dominican, 34.2% for Puerto Rican, and 27.5% for Central/South American adults. Among Asian adults, prevalence was 43.0% for South Asian and 39.9% for East/Southeast Asian adults. Adjusting for age, sex, education, and body mass index, 2 major racial/ethnic minority groups had higher odds of hypertension than non-Hispanic whites: non-Hispanic black (AOR [adjusted odds ratio], 2.6; 95% confidence interval [CI], 1.7-3.9) and Asian (AOR, 2.0; 95% CI, 1.2-3.4) adults. Two subgroups had greater odds of hypertension than the non-Hispanic white group: East/Southeast Asian adults (AOR, 2.8; 95% CI, 1.6-4.9) and Dominican adults (AOR, 1.9; 95% CI, 1.1-3.5). Racial/ethnic minority subgroups vary in hypertension prevalence, suggesting the need for targeted interventions.

  14. Recent trends in the prevalence of overweight and obesity among Canadian children

    PubMed Central

    Rodd, Celia; Sharma, Atul K.

    2016-01-01

    Background: Previous studies have shown an increase in the prevalence of overweight and obesity among Canadian children from 23.3% to 34.7% during 1978–2004. We examined the most recent trends by applying current definitions of overweight and obesity based on World Health Organization (WHO) body mass index (BMI) thresholds and recently validated norms for waist circumference and waist:height ratio. Methods: We examined directly measured height and weight data from the Canadian Community Health Survey (2004–2005) and the Canadian Health Measures Survey (2009–2013). We calculated z scores for BMI, height and weight based on the 2014 WHO growth charts for Canada, including the new extension of weight-for-age beyond 10 years. To calculate z scores for waist circumference and waist:height ratios, we used new charts from the reference population in the US NHANES III (National Health and Nutrition Examination Survey, 1988–1994). Results: Data were available for 14 014 children aged 3–19 years for the period 2004–2013. We observed a decline in the prevalence of overweight or obesity, from 30.7% (95% confidence interval [CI] 29.7% to 31.6%) to 27.0% (95% CI 25.3% to 28.7%) (p < 0.001) and stabilization in the prevalence of obesity at about 13%. These trends persisted after we adjusted for age, sex and race/ethnicity. Although they declined, the median z scores for BMI, weight and height were positive and higher than those in the WHO reference population. The z scores for waist circumference and waist:height ratio were negative, which indicated that the Canadian children had less central adiposity than American children in historic or contemporary NHANES cohorts. Interpretation: After a period of dramatic growth, BMI z scores and the prevalence of overweight or obesity among Canadian children decreased from 2004 to 2013, which attests to progress against this important public health challenge. PMID:27160875

  15. Recent trends in the prevalence of overweight and obesity among Canadian children.

    PubMed

    Rodd, Celia; Sharma, Atul K

    2016-09-20

    Previous studies have shown an increase in the prevalence of overweight and obesity among Canadian children from 23.3% to 34.7% during 1978-2004. We examined the most recent trends by applying current definitions of overweight and obesity based on World Health Organization (WHO) body mass index (BMI) thresholds and recently validated norms for waist circumference and waist:height ratio. We examined directly measured height and weight data from the Canadian Community Health Survey (2004-2005) and the Canadian Health Measures Survey (2009-2013). We calculated z scores for BMI, height and weight based on the 2014 WHO growth charts for Canada, including the new extension of weight-for-age beyond 10 years. To calculate z scores for waist circumference and waist:height ratios, we used new charts from the reference population in the US NHANES III (National Health and Nutrition Examination Survey, 1988-1994). Data were available for 14 014 children aged 3-19 years for the period 2004-2013. We observed a decline in the prevalence of overweight or obesity, from 30.7% (95% confidence interval [CI] 29.7% to 31.6%) to 27.0% (95% CI 25.3% to 28.7%) (p < 0.001) and stabilization in the prevalence of obesity at about 13%. These trends persisted after we adjusted for age, sex and race/ethnicity. Although they declined, the median z scores for BMI, weight and height were positive and higher than those in the WHO reference population. The z scores for waist circumference and waist:height ratio were negative, which indicated that the Canadian children had less central adiposity than American children in historic or contemporary NHANES cohorts. After a period of dramatic growth, BMI z scores and the prevalence of overweight or obesity among Canadian children decreased from 2004 to 2013, which attests to progress against this important public health challenge. © 2016 Canadian Medical Association or its licensors.

  16. CKD Prevalence Varies across the European General Population

    PubMed Central

    Stel, Vianda S.; Gambaro, Giovanni; Hallan, Stein; Völzke, Henry; Ärnlöv, Johan; Kastarinen, Mika; Guessous, Idris; Vinhas, José; Stengel, Bénédicte; Brenner, Hermann; Chudek, Jerzy; Romundstad, Solfrid; Tomson, Charles; Gonzalez, Alfonso Otero; Bello, Aminu K.; Ferrieres, Jean; Palmieri, Luigi; Browne, Gemma; Capuano, Vincenzo; Van Biesen, Wim; Zoccali, Carmine; Gansevoort, Ron; Navis, Gerjan; Rothenbacher, Dietrich; Ferraro, Pietro Manuel; Nitsch, Dorothea; Wanner, Christoph; Jager, Kitty J.

    2016-01-01

    CKD prevalence estimation is central to CKD management and prevention planning at the population level. This study estimated CKD prevalence in the European adult general population and investigated international variation in CKD prevalence by age, sex, and presence of diabetes, hypertension, and obesity. We collected data from 19 general-population studies from 13 European countries. CKD stages 1–5 was defined as eGFR<60 ml/min per 1.73 m2, as calculated by the CKD-Epidemiology Collaboration equation, or albuminuria >30 mg/g, and CKD stages 3–5 was defined as eGFR<60 ml/min per 1.73 m2. CKD prevalence was age- and sex-standardized to the population of the 27 Member States of the European Union (EU27). We found considerable differences in both CKD stages 1–5 and CKD stages 3–5 prevalence across European study populations. The adjusted CKD stages 1–5 prevalence varied between 3.31% (95% confidence interval [95% CI], 3.30% to 3.33%) in Norway and 17.3% (95% CI, 16.5% to 18.1%) in northeast Germany. The adjusted CKD stages 3–5 prevalence varied between 1.0% (95% CI, 0.7% to 1.3%) in central Italy and 5.9% (95% CI, 5.2% to 6.6%) in northeast Germany. The variation in CKD prevalence stratified by diabetes, hypertension, and obesity status followed the same pattern as the overall prevalence. In conclusion, this large-scale attempt to carefully characterize CKD prevalence in Europe identified substantial variation in CKD prevalence that appears to be due to factors other than the prevalence of diabetes, hypertension, and obesity. PMID:26701975

  17. Sex difference in the prevalence of metabolic syndrome and cardiovascular-related risk factors in urban adults from 33 communities of China: The CHPSNE study.

    PubMed

    Song, Qing-Bin; Zhao, Yang; Liu, Yu-Qin; Zhang, Jian; Xin, Shi-Jie; Dong, Guang-Hui

    2015-05-01

    Little is known about the epidemiology of metabolic syndrome in urban areas of China. To estimate the prevalence of MetS and identify its cardiovascular-related factors in men and women, a representative sample of 15,477 urban adults aged 18-74 years in Northeast China was selected from 2009 to 2010. The diagnosis of metabolic syndrome was based on criteria set by the National Cholesterol Education Program/Adult Treatment Panel. The overall prevalence of metabolic syndrome was 27.4% (men 27.9% and women 26.8%). Multivariable logistic regression analysis revealed that a higher education level and a higher family income were associated with a higher prevalence of metabolic syndrome in men, but associated with lower prevalence of metabolic syndrome among women. Higher physical activity was associated with a decreased prevalence of metabolic syndrome in men (adjusted odds ratios (aORs) = 0.88, 95% confidence interval (CI): 0.79-0.99), but associated with an increased prevalence of metabolic syndrome in women (aOR = 1.14, 95% CI: 1.00-1.29). Compared with rice as the major staple food, cooked wheaten foods were associated with lower adjusted odds for metabolic syndrome both in men (aOR = 0.72, 95% CI: 0.58-0.90) and in women (aOR = 0.72, 95% CI: 0.56-0.92). In conclusion, metabolic syndrome is highly prevalent in urban areas of China, and there is heterogeneity by sex in the relationships between risk factors and metabolic syndrome prevalence. © The Author(s) 2015.

  18. Small-for-gestational age prevalence risk factors in central Appalachian states with mountain-top mining.

    PubMed

    Ferdosi, Hamid; Lamm, Steve H; Afari-Dwamena, Nana Ama; Dissen, Elisabeth; Chen, Rusan; Li, Ji; Feinleib, Manning

    2018-01-01

    To identify risk factors for small-for-gestational age (SGA) for counties in central Appalachian states (Kentucky (KY), Tennessee (TN), Virginia (VA), and West Virginia (WV)) with varied coal mining activities. Live birth certificate files (1990-2002) were used for obtaining SGA prevalence rates for mothers based on the coal mining activities of their counties of residence, mountain-top mining (MTM) activities, underground mining activities but no mountain-top mining activity (non-MTM), or having no mining activities (non-mining). Co-variable information, including maternal tobacco use, was also obtained from the live birth certificate. Adjusted odds ratios were obtained using multivariable logistic regression comparing SGA prevalence rates for counties with coal mining activities to those without coal mining activities and comparing SGA prevalence rates for counties with coal mining activities for those with and without mountain-top mining activities. Comparisons were also made among those who had reported tobacco use and those who had not. Both tobacco use prevalence and SGA prevalence were significantly greater for mining counties than for non-mining counties and for MTM counties than for non-MTM counties. Adjustment for tobacco use alone explained 50% of the increased SGA risk for mining counties and 75% of the risk for MTM counties, including demographic pre-natal care co-variables that explained 75% of the increased SGA risk for mining counties and 100% of the risk for MTM. The increased risk of SGA was limited to the third trimester births among tobacco users and independent of the mining activities of their counties of residence. This study demonstrates that the increased prevalence of SGA among residents of counties with mining activity was primarily explained by the differences in maternal tobacco use prevalence, an effect that itself was gestational-age dependent. Self-reported tobacco use marked the population at the increased risk for SGA in central

  19. Sleep Disordered Breathing in Four Resource-Limited Settings in Peru: Prevalence, Risk Factors, and Association with Chronic Diseases

    PubMed Central

    Schwartz, Noah G.; Rattner, Adi; Schwartz, Alan R.; Mokhlesi, Babak; Gilman, Robert H.; Bernabe-Ortiz, Antonio; Miranda, J. Jaime; Checkley, William

    2015-01-01

    Study Objectives: Sleep disordered breathing (SDB) is a highly prevalent condition in high-income countries, with major consequences for cardiopulmonary health, public safety, healthcare utilization, and mortality. However, its prevalence and effect in low- and middle-income countries are less well known. We sought to determine the prevalence, risk factors, and comorbidities of SDB symptoms in four resource-limited settings. Design: Cross-sectional analysis of the CRONICAS Cohort, a population-based age- and sex-stratified sample. Setting: Four resource-limited settings in Peru varying in altitude, urbanization, and air pollution. Participants: There were 2,682 adults aged 35 to 92 y. Measurements and Results: Self-reported SDB symptoms (habitual snoring, observed apneas, Epworth Sleepiness Scale), sociodemographics, medical history, anthropometrics, spirometry, blood biomarkers were reported. We found a high prevalence of habitual snoring (30.2%, 95% confidence interval [CI] 28.5–32.0%), observed apneas (20.9%, 95% CI 19.4–22.5%) and excessive daytime sleepiness (18.6%, 95% CI 17.1–20.1%). SDB symptoms varied across sites; prevalence and adjusted odds for habitual snoring were greatest at sea level, whereas those for observed apneas were greatest at high altitude. In multivariable analysis, habitual snoring was associated with older age, male sex, body mass index (BMI), and higher socioeconomic status; observed apneas were associated with BMI; and excessive daytime sleepiness was associated with older age, female sex, and medium socioeconomic status. Adjusted odds of cardiovascular disease, depression, and hypertension and total chronic disease burden increased progressively with the number of SDB symptoms. A threefold increase in the odds of having an additional chronic comorbid disease (adjusted odds ratio 3.57, 95% CI 2.18–5.84) was observed in those with all three versus no SDB symptoms. Conclusions: Sleep disordered breathing symptoms were highly

  20. Prevalence and correlates of fatigue among persons with HIV infection.

    PubMed

    Sullivan, Patrick S; Dworkin, Mark S

    2003-04-01

    To describe prevalence of fatigue and its correlates among persons with HIV infection, we abstracted medical records of 13,768 persons in care for HIV in >100 US clinics. The prevalence of fatigue (defined as fatigue, malaise, or weakness that was the primary reason for a medical visit, was persistent, or was severe enough to preclude work) was 37%. Fatigue was more common among persons with clinical AIDS (adjusted odds ratio [AOR] 1.3, CI 1.1-1.5); depression (AOR 2.4, CI 2.1-2.7); and hemoglobin concentrations <8, 8-10, and 10-12 g/dL (AORs 3.3 [CI 2.4-4.6], 2.7 [CI 2.2-3.2], and 1.5 [CI 1.3-1.7], respectively). Fatigue was not associated with viral load or CD4 cell count <200/microl. Fatigue cannot be viewed solely as a constitutional symptom of progressive HIV disease. Physicians should seek underlying, treatable causes for fatigue such as depression and anemia and treat these conditions when they are found.

  1. The effects of household income distribution on stroke prevalence and its risk factors of high blood pressure and smoking: a cross-sectional study in Saskatchewan, Canada.

    PubMed

    Bird, Yelena; Lemstra, Mark; Rogers, Marla

    2017-03-01

    Stroke is a major chronic disease and a common cause of adult disability and mortality. Although there are many known risk factors for stroke, lower income is not one that is often discussed. To determine the unadjusted and adjusted association of income distribution on the prevalence of stroke in Saskatchewan, Canada. Information was collected from the Canadian Community Health Survey conducted by Statistics Canada for 2000-2008. In total, 178 variables were analysed for their association with stroke. Prior to statistical adjustment, stroke was seven times more common for lower income residents than higher income residents. After statistical adjustment, only four covariates were independently associated with stroke prevalence, including having high blood pressure (odds ratio (OR) = 2.62; 95% confidence interval (CI) = 2.12-3.24), having a household income below CAD$30,000 per year (OR = 2.49; 95% CI = 1.88-3.29), being a daily smoker (OR = 1.36; 95% CI = 1.16-1.58) and being physically inactive (OR = 1.27; 95% CI = 1.13-1.43). After statistical adjustment, there were five covariates independently associated with high blood pressure prevalence, including having a household income below CAD$30,000 per year (OR = 1.52; 95% CI = 1.41-1.63). After statistical adjustment, there were five covariates independently associated with daily smoking prevalence, including having a household income below CAD$30,000 per year (OR = 1.29; 95% CI = 1.25-1.33). Knowledge of disparities in the prevalence, severity, disability and mortality of stroke is critically important to medical and public health professionals. Our study found that income distribution was strongly associated with stroke, its main disease intermediary - high blood pressure - and its main risk factor - smoking. As such, income is an important variable worthy of public debate as a modifiable risk factor for stroke.

  2. E-cigarettes, Cigarettes, and the Prevalence of Adolescent Tobacco Use

    PubMed Central

    Urman, Robert; Leventhal, Adam M.; Gauderman, W. James; Cruz, Tess Boley; Gilreath, Tamika D.; Howland, Steve; Unger, Jennifer B.; Berhane, Kiros; Samet, Jonathan M.; McConnell, Rob

    2016-01-01

    BACKGROUND: Adolescent e-cigarette use has increased rapidly in recent years, but it is unclear whether e-cigarettes are merely substituting for cigarettes or whether e-cigarettes are being used by those who would not otherwise have smoked. To understand the role of e-cigarettes in overall tobacco product use, we examine prevalence rates from Southern California adolescents over 2 decades. METHODS: The Children’s Health Study is a longitudinal study of cohorts reaching 12th grade in 1995, 1998, 2001, 2004, and 2014. Cohorts were enrolled from entire classrooms in schools in selected communities and followed prospectively through completion of secondary school. Analyses used data from grades 11 and 12 of each cohort (N = 5490). RESULTS: Among 12th-grade students, the combined adjusted prevalence of current cigarette or e-cigarette use in 2014 was 13.7%. This was substantially greater than the 9.0% adjusted prevalence of current cigarette use in 2004, before e-cigarettes were available (P = .003) and only slightly less than the 14.7% adjusted prevalence of smoking in 2001 (P = .54). Similar patterns were observed for prevalence rates in 11th grade, for rates of ever use, and among both male and female adolescents and both Hispanic and Non-Hispanic White adolescents. CONCLUSIONS: Smoking prevalence among Southern California adolescents has declined over 2 decades, but the high prevalence of combined e-cigarette or cigarette use in 2014, compared with historical Southern California smoking prevalence, suggests that e-cigarettes are not merely substituting for cigarettes and indicates that e-cigarette use is occurring in adolescents who would not otherwise have used tobacco products. PMID:27401102

  3. Rural-urban differences in the prevalence of cognitive impairment in independent community-dwelling elderly residents of Ojiya city, Niigata Prefecture, Japan.

    PubMed

    Nakamura, Kazutoshi; Kitamura, Kaori; Watanabe, Yumi; Shinoda, Hiroko; Sato, Hisami; Someya, Toshiyuki

    2016-11-01

    This study aimed to examine rural-urban differences in the prevalence of cognitive impairment in Japan. We targeted 592 residents aged 65 years and older who did not use long-term care insurance services in one rural and two urban areas in Ojiya City, Japan. Of these, 537 (90.7 %) participated in the study. The revised Hasegawa's dementia scale (HDS-R) was used to assess cognitive function, and cognitive impairment was defined as a HDS-R score ≤20. Lifestyle information was obtained through interviews. The prevalence of cognitive impairment was compared according to the levels of predictor variables by odds ratios (ORs) calculated by a logistic regression analysis. Mean age of participants was 75.7 years (SD 7.0). The prevalence of cognitive impairment was 20/239 (8.4 %) in the rural area and 6/298 (2.0 %) in the urban areas, for a total of 26/537 (4.8 %) overall. Men tended to have a higher prevalence of cognitive impairment (P = 0.0628), and age was associated with cognitive impairment (P for trend <0.0001). The rural area had a significantly higher prevalence of cognitive impairment (age- and sex-adjusted OR = 4.04, 95 % CI: 1.54-10.62) than urban areas. This difference was significant after adjusting for other lifestyle factors. The prevalence of cognitive impairment was higher in the rural area relative to urban areas in Ojiya city. This regional difference suggests the existence of potentially modifiable factors other than lifestyle in relation to cognitive impairment.

  4. Prevalence and incidence of multiple sclerosis in central Poland, 2010-2014.

    PubMed

    Brola, Waldemar; Sobolewski, Piotr; Flaga, Stanisław; Fudala, Małgorzata; Szczuchniak, Wiktor; Stoiński, Jan; Rosołowska, Anita; Wójcik, Jacek; Kapica-Topczewska, Katarzyna; Ryglewicz, Danuta

    2016-08-11

    Comprehensive epidemiologic data for multiple sclerosis (MS) in Poland are limited. The aim of this cross-sectional population-based study was to determine the incidence and prevalence of MS in the Swietokrzyskie Region (central Poland). This study identified MS cases every year between 1 January 2010 and 31 December 2014. The study area population on the prevalence day (December 31, 2014) was 1,263,176 (646,506 women and 616,670 men). A total of 1462 patients with a clinically definite diagnosis of MS according to McDonald's criteria (2005), recorded in the Polish Multiple Sclerosis Registry, were considered for estimation of crude, age- and sex-specific prevalence, and incidence. The overall crude prevalence rate of confirmed MS patients was 115.7/100,000 (95 % confidence interval (CI), 111.2-121.4). A significantly higher prevalence was recorded in females (159.6/100,000; 95 % CI, 151.1-165.3) than in males (69.7/100,000; 95 % CI, 62.4-77.3) (P < 0.001). Age-adjusted rates for the Polish and European Standard Population were 109.8/100,000 (95 % CI, 105.4-114.8) and 106.6/100,000 (95 % CI, 101.1-111.2), respectively. The female/male ratio was 2.4. The mean annual incidence was 4.2/100,000 (95 % CI. 3.7-4.4). The incidence and prevalence of MS in the Swietokrzyskie region confirm that central Poland is a high risk area for MS. Compared with previous epidemiologic studies from Poland, the prevalence of MS has increased during recent years.

  5. Ratio of Trunk to Leg Volume as a New Body Shape Metric for Diabetes and Mortality

    PubMed Central

    Wilson, Joseph P.; Kanaya, Alka M.; Fan, Bo; Shepherd, John A.

    2013-01-01

    Background Body shape is a known risk factor for diabetes and mortality, but the methods estimating body shape, BMI and waist circumference are crude. We determined whether a novel body shape measure, trunk to leg volume ratio, was independently associated with diabetes and mortality. Methods Data from the National Health and Nutritional Examination Survey 1999–2004, a study representative of the US population, were used to generate dual-energy X-ray absorptiometry-derived trunk to leg volume ratio and determine its associations to diabetes, metabolic covariates, and mortality by BMI category, gender, and race/ethnicity group. Results The prevalence of pre-diabetes and diabetes increased with age, BMI, triglycerides, blood pressure, and decreased HDL level. After adjusting for covariates, the corresponding fourth to first quartile trunk to leg volume ratio odds ratios (OR) were 6.8 (95% confidence interval [CI], 4.9–9.6) for diabetes, 3.9 (95% CI, 3.0–5.2) for high triglycerides, 1.8 (95% CI, 1.6–2.1) for high blood pressure, 3.0 (95% CI, 2.4–3.8) for low HDL, 3.6 (95% CI, 2.8–4.7) for metabolic syndrome, and 1.76 (95% CI, 1.20–2.60) for mortality. Additionally, trunk to leg volume ratio was the strongest independent measure associated with diabetes (P<0.001), even after adjusting for BMI and waist circumference. Even among those with normal BMI, those in the highest quartile of trunk to leg volume ratio had a higher likelihood of death (5.5%) than those in the lowest quartile (0.2%). Overall, trunk to leg volume ratio is driven by competing mechanisms of changing adiposity and lean mass. Conclusions A high ratio of trunk to leg volume showed a strong association to diabetes and mortality that was independent of total and regional fat distributions. This novel body shape measure provides additional information regarding central adiposity and appendicular wasting to better stratify individuals at risk for diabetes and mortality, even among those with

  6. Mapping the Prevalence of Physical Inactivity in U.S. States, 1984-2015.

    PubMed

    An, Ruopeng; Xiang, Xiaoling; Yang, Yan; Yan, Hai

    2016-01-01

    Physical inactivity is a leading cause of morbidity, disability and premature mortality in the U.S. and worldwide. This study aimed to map the prevalence of physical inactivity across U.S. states over the past three decades, and estimate the over-time adjusted changes in the prevalence of physical inactivity in each state. Individual-level data (N = 6,701,954) were taken from the 1984-2015 Behavioral Risk Factor Surveillance System (BRFSS), an annually repeated cross-sectional survey of state-representative adult population. Prevalence of self-reported leisure-time physical inactivity was estimated by state and survey year, accounting for the BRFSS sampling design. Logistic regressions were performed to estimate the changes in the prevalence of physical inactivity over the study period for each state, adjusting for individual characteristics including sex, age, race/ethnicity, education, marital status, and employment status. The prevalence of leisure-time physical inactivity varied substantially across states and survey years. In general, the adjusted prevalence of physical inactivity gradually declined over the past three decades in a majority of states. However, a substantial proportion of American adults remain physically inactive. Among the 50 states and District of Columbia, 45 had over a fifth of their adult population without any leisure-time physical activity, and 8 had over 30% without physical activity in 2015. Moreover, the adjusted prevalence of physical inactivity in several states (Arizona, North Carolina, North Dakota, Utah, West Virginia, and Wyoming) remained largely unchanged or even increased (Minnesota and Ohio) over the study period. Although the prevalence of physical inactivity declined over the past three decades in a majority of states, the rates remain substantially high and vary considerably across states. Closely monitoring and tracking physical activity level using the state physical activity maps can help guide policy and program

  7. Prevalence and sociodemographic correlates of primary headache disorders: results of a population-based survey from Bangalore, India.

    PubMed

    Gururaj, Gopalakrishna; Kulkarni, Girish B; Rao, Girish N; Subbakrishna, D K; Stovner, Lars J; Steiner, Timothy J

    2014-01-01

    Headache disorders are common and burdensome throughout the world, placing high demand on health care services. Good information on their prevalence and distribution through sectors of the population are a prerequisite for planning interventions and organizing services, but unavailable for India. To find out the prevalence of headache disorders in Karnataka State and establish important sociodemographic associations. Using a door to door survey technique, amongst 2997 households, 2329 individuals were interviewed with a validated structured questionnaire by randomly sampling one adult member (aged 18-65 years) from eligible households in urban (n = 1226) and rural (n = 1103) areas of Bangalore, during the period April 2009 and January 2010. Chi-square, odds ratio (OR), and logistic regression. The 1-year prevalence of headache was 63.9% (62.0% when adjusted for age, gender and habitation) and 1-day prevalence (headache on the day prior to the survey) was 5.9%. Prevalence was higher in the age groups of 18-45 years, among females (OR = 2.3; 95% confidence interval: 1.9-2.7) and those in rural areas. Prevalence was higher in rural (71.2 [68.4-73.8]) than in urban areas (57.3 [54.5-60.1]) even after adjusting for gender. The proportion of days lost to headache from paid work was 1.1%, while overall productivity loss (from both paid and household work) was 2.8%. Headache disorders are a major health problem in India with significant burden. It requires systematic efforts to organize effective services to be able to reach a large number of people in urban and rural India. Education of physicians and other health-care workers, and the public should be a pillar of such efforts.

  8. Prevalence of visual impairment in El Salvador: inequalities in educational level and occupational status.

    PubMed

    Rius, Anna; Guisasola, Laura; Sabidó, Meritxell; Leasher, Janet L; Moriña, David; Villalobos, Astrid; Lansingh, Van C; Mujica, Oscar J; Rivera-Handal, José Eduardo; Silva, Juan Casrlos

    2014-11-01

    To examine the prevalence of blindness, visual impairment, and related eye diseases and conditions among adults in El Salvador, and to explore socioeconomic inequalities in their prevalence by education level and occupational status, stratified by sex. Based upon the Rapid Assessment of Avoidable Blindness (RAAB) methodology, this nationwide sample comprised 3 800 participants (3 399 examined) ≥ 50 years old from 76 randomly selected clusters of 50 persons each. The prevalence of blindness, visual impairment and related eye diseases and conditions, including uncorrected refractive error (URE), was calculated for categories of education level and occupational status. Multiple logistic regression models were fitted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) and stratified by sex. Age-adjusted prevalence was 2.4% (95% CI: 2.2-2.6) for blindness (men: 2.8% (95% CI: 2.5-3.1); women: 2.2% (95% CI: 1.9-2.5)) and 11.8% (95% CI: 11.6-12.0) for moderate visual impairment (men: 10.8% (95% CI: 10.5-11.1); women: 12.6% (95% CI: 12.4-12.8)). The proportion of visual impairment due to cataract was 43.8% in men and 33.5% in women. Inverse gradients of socioeconomic inequalities were observed in the prevalence of visual impairment. For example, the age-adjusted OR (AOR) was 3.4 (95% CI: 2.0-6.4) for visual impairment and 4.3 (95% CI: 2.1-10.4) for related URE in illiterate women compared to those with secondary education, and 1.9 (95% CI: 1.1-3.1) in cataract in unemployed men. Blindness and visual impairment prevalence is high in the El Salvador adult population. The main associated conditions are cataract and URE, two treatable conditions. As socioeconomic and gender inequalities in ocular health may herald discrimination and important barriers to accessing affordable, good-quality, and timely health care services, prioritization of public eye health care and disability policies should be put in place, particularly among women, the unemployed, and

  9. High prevalence of sarcopenia among binge drinking elderly women: a nationwide population-based study.

    PubMed

    Yoo, Jun-Il; Ha, Yong-Chan; Lee, Young-Kyun; Hana-Choi; Yoo, Moon-Jib; Koo, Kyung-Hoi

    2017-05-30

    Alcohol consumption is considered a risk factor for sarcopenia, but the association between alcohol consumption and the prevalence of sarcopenia has not been evaluated in detail. This study was to identify the relationship between alcohol drinking patterns and the prevalence of sarcopenia in the elderly Korean population. The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Participants were excluded if they were under the age of 65, or if data was not available regarding skeletal muscle mass or dietary intake. After these exclusions, a total of 4020 participants (men: 1698; women: 2322) were analyzed in the present study. Sarcopenia is defined according to the criteria for the Asia Working Group for Sarcopenia (AWGS). Binge drinking was defined as consuming ≥5 standard alcoholic drinks (≥4 drinks for women) consecutively on one occasion. This data was subcategorized into two groups based on presence of binge drinking: Social drinking (≤1 time/month) and binge drinking (>1 time/month). Women binge drinkers with weekly or daily consumption had 2.8 times higher prevalence of sarcopenia than social drinkers (Odds Ratio [OR] = 2.84; 95% Confidence Interval [CI] = 1.12-7.29). However, there were no associations between binge drinkers and sarcopenia in men. After adjusting for age, body mass index (BMI), energy intake, moderate physical activity, and energy intake, women binge drinkers with weekly or daily alcohol consumption had 3.9 times higher prevalence of sarcopenia than social drinkers (OR = 3.88; 95% CI = 1.33-11.36). The prevalence of sarcopenia in elderly women was related to binge drinking frequency and amounts of drinking after adjusting for covariates. Elderly Korean women who binge drink once or more per week may be associated with sarcopenia, as seen with the observed 3.9 times higher prevalence compared to social drinkers.

  10. Racial and ethnic differences in the prevalence of metabolic syndrome and its components of metabolic syndrome in women with polycystic ovary syndrome: a regional cross-sectional study.

    PubMed

    Chan, Jessica L; Kar, Sujata; Vanky, Eszter; Morin-Papunen, Laure; Piltonen, Terhi; Puurunen, Johanna; Tapanainen, Juha S; Maciel, Gustavo Arantes Rosa; Hayashida, Sylvia Asaka Yamashita; Soares, Jose Maria; Baracat, Edmund Chada; Mellembakken, Jan Roar; Dokras, Anuja

    2017-08-01

    Polycystic ovary syndrome is a heterogeneous disorder and its presentation varies with race and ethnicity. Reproductive-age women with polycystic ovary syndrome are at increased risk of metabolic syndrome; however, it is not clear if prevalence of metabolic syndrome and clustering of its components differs based on race and ethnicity. Moreover, the majority of these women do not undergo routine screening for metabolic syndrome. We sought to compare the prevalence of metabolic syndrome and clustering of its components in women with polycystic ovary syndrome in the United States with women in India, Brazil, Finland, and Norway. This is a cross-sectional study performed in 1089 women with polycystic ovary syndrome from 1999 through 2016 in 5 outpatient clinics in the United States, India, Brazil, Finland, and Norway. Polycystic ovary syndrome was defined by the Rotterdam criteria. Main outcome measures were: metabolic syndrome prevalence, blood pressure, body mass index, fasting high-density lipoprotein cholesterol, fasting triglycerides, and fasting glucose. Data from all sites were reevaluated for appropriate application of diagnostic criteria for polycystic ovary syndrome, identification of polycystic ovary syndrome phenotype, and complete metabolic workup. The US White women with polycystic ovary syndrome were used as the referent group. Logistic regression models were used to evaluate associations between race and metabolic syndrome prevalence and its components and to adjust for potential confounders, including age and body mass index. The median age of the entire cohort was 28 years. Women from India had the highest mean Ferriman-Gallwey score for clinical hyperandrogenism (15.6 ± 6.5, P < .001). The age-adjusted odds ratio for metabolic syndrome was highest in US Black women at 4.52 (95% confidence interval, 2.46-8.35) compared with US White women. When adjusted for age and body mass index, the prevalence was similar in the 2 groups. Significantly more Black

  11. Contact angle adjustment in equation-of-state-based pseudopotential model

    NASA Astrophysics Data System (ADS)

    Hu, Anjie; Li, Longjian; Uddin, Rizwan; Liu, Dong

    2016-05-01

    The single component pseudopotential lattice Boltzmann model has been widely applied in multiphase simulation due to its simplicity and stability. In many studies, it has been claimed that this model can be stable for density ratios larger than 1000. However, the application of the model is still limited to small density ratios when the contact angle is considered. The reason is that the original contact angle adjustment method influences the stability of the model. Moreover, simulation results in the present work show that, by applying the original contact angle adjustment method, the density distribution near the wall is artificially changed, and the contact angle is dependent on the surface tension. Hence, it is very inconvenient to apply this method with a fixed contact angle, and the accuracy of the model cannot be guaranteed. To solve these problems, a contact angle adjustment method based on the geometry analysis is proposed and numerically compared with the original method. Simulation results show that, with our contact angle adjustment method, the stability of the model is highly improved when the density ratio is relatively large, and it is independent of the surface tension.

  12. Contact angle adjustment in equation-of-state-based pseudopotential model.

    PubMed

    Hu, Anjie; Li, Longjian; Uddin, Rizwan; Liu, Dong

    2016-05-01

    The single component pseudopotential lattice Boltzmann model has been widely applied in multiphase simulation due to its simplicity and stability. In many studies, it has been claimed that this model can be stable for density ratios larger than 1000. However, the application of the model is still limited to small density ratios when the contact angle is considered. The reason is that the original contact angle adjustment method influences the stability of the model. Moreover, simulation results in the present work show that, by applying the original contact angle adjustment method, the density distribution near the wall is artificially changed, and the contact angle is dependent on the surface tension. Hence, it is very inconvenient to apply this method with a fixed contact angle, and the accuracy of the model cannot be guaranteed. To solve these problems, a contact angle adjustment method based on the geometry analysis is proposed and numerically compared with the original method. Simulation results show that, with our contact angle adjustment method, the stability of the model is highly improved when the density ratio is relatively large, and it is independent of the surface tension.

  13. Body mass index, waist circumference, waist-hip ratio, and glucose intolerance in Chinese and Europid adults in Newcastle, UK.

    PubMed Central

    Unwin, N; Harland, J; White, M; Bhopal, R; Winocour, P; Stephenson, P; Watson, W; Turner, C; Alberti, K G

    1997-01-01

    OBJECTIVE: To compare the prevalence of glucose intolerance (impaired glucose tolerance and diabetes), and its relationship to body mass index (BMI) and waist-hip ratio in Chinese and Europid adults. DESIGN: This was a cross sectional study. SETTING: Newcastle upon Tyne. SUBJECTS: These comprised Chinese and Europid men and women, aged 25-64 years, and resident in Newcastle upon Tyne, UK. MAIN OUTCOME MEASURES: Two hour post load plasma glucose concentration, BMI, waist circumference, and waist-hip ratio. METHODS: Population based samples of Chinese and European adults were recruited. Each subject had a standard WHO oral glucose tolerance test. RESULTS: Complete data were available for 375 Chinese and 610 Europid subjects. The age adjusted prevalences of glucose intolerance in Chinese and Europid men were 13.0% (p = 0.04). Mean BMIs were lower in Chinese men (23.8 v 26.1) and women (23.5 v 26.1) than in the Europids (p values < 0.001), as were waist circumferences (men, 83.3 cm v 90.8, p < 0.001; women, 77.3 cm v 79.2, p < 0.05). Mean waist-hip ratios were lower in Chinese men (0.90 v 0.91, p = 0.02) but higher in Chinese women (0.84 v 0.78, p < 0.001) compared with Europids. In both Chinese and Europid adults, higher BMI, waist circumference, and waist-hip ratio were associated with glucose intolerance. CONCLUSIONS: The prevalence of glucose intolerance in Chinese men and women, despite lower BMIs, is similar to or higher than that in local Europid men and women and intermediate between levels found in China and those in Mauritius. It is suggested that an increase in mean BMI to the levels in the Europid population will be associated with a substantial increase in glucose intolerance in Chinese people. PMID:9196645

  14. Skeletal muscle mass adjusted by height correlated better with muscular functions than that adjusted by body weight in defining sarcopenia.

    PubMed

    Han, Der-Sheng; Chang, Ke-Vin; Li, Chia-Ming; Lin, Yu-Hong; Kao, Tung-Wei; Tsai, Keh-Sung; Wang, Tyng-Grey; Yang, Wei-Shiung

    2016-01-20

    Sarcopenia, characterized by low muscle mass and function, results in frailty, comorbidities and mortality. However, its prevalence varies according to the different criteria used in its diagnosis. This cross-sectional study investigated the difference in the number of sarcopenia cases recorded by two different measurement methods of low muscle mass to determine which measurement was better. We recruited 878 (54.2% female) individuals aged over 65 years and obtained their body composition and functional parameters. Low muscle mass was defined as two standard deviations below either the mean height-adjusted (hSMI) or weight-adjusted (wSMI) muscle mass of a young reference group. The prevalence of sarcopenia was 6.7% vs. 0.4% (male/female) by hSMI, and 4.0% vs. 10.7% (male/female) by wSMI. The κ coefficients for these two criteria were 0.39 vs. 0.03 (male/female), and 0.17 in all subjects. Serum myostatin levels correlated positively with gait speed (r = 0.142, p = 0.007) after adjustment for gender. hSMI correlated with grip strength, cardiopulmonary endurance, leg endurance, gait speed, and flexibility. wSMI correlated with grip strength, leg endurance, gait speed, and flexibility. Since hSMI correlated more closely with grip strength and more muscular functions, we recommend hSMI in the diagnosis of low muscle mass.

  15. Dietary meat and fat intake and prevalence of rhinoconjunctivitis in pregnant Japanese women: baseline data from the Kyushu Okinawa Maternal and Child Health Study

    PubMed Central

    2012-01-01

    Background Dietary fat exerts numerous complex effects on proinflammatory and immunologic pathways. Several epidemiological studies have examined the relationships between intake of fatty acids and/or foods high in fat and allergic rhinitis, but have provided conflicting findings. The current cross-sectional study investigated such relationships in Japan. Methods Study subjects were 1745 pregnant women. The definition of rhinoconjunctivitis was based on criteria from the International Study of Asthma and Allergies in Childhood. Information on dietary factors was collected using a validated self-administered diet history questionnaire. Adjustment was made for age; gestation; region of residence; number of older siblings; number of children; smoking; secondhand smoke exposure at home and at work; family history of asthma, atopic eczema, and allergic rhinitis; household income; education; and body mass index. Results The prevalence of rhinoconjunctivitis in the past 12 months was 25.9%. Higher meat intake was significantly associated with an increased prevalence of rhinoconjunctivitis: the adjusted odds ratio between extreme quartiles was 1.71 (95% confidence interval: 1.25-2.35, P for trend = 0.002). No measurable association was found between fish intake and rhinoconjunctivitis. Intake of total fat, saturated fatty acids, monounsaturated fatty acids, n-3 polyunsaturated fatty acids, α-linolenic acid, eicosapentaenoic acid, docosahexaenoic acid, n-6 polyunsaturated fatty acids, linoleic acid, arachidonic acid, and cholesterol and the ratio of n-3 to n-6 polyunsaturated fatty acid intake were not evidently related to the prevalence of rhinoconjunctivitis. Conclusions The current results suggest that meat intake may be positively associated with the prevalence of rhinoconjunctivitis in young adult Japanese women. PMID:22449171

  16. Chocolate consumption and prevalence of metabolic syndrome in the NHLBI Family Heart Study

    PubMed Central

    Tokede, Oluwabunmi A.; Ellison, Curtis R.; Pankow, James S.; North, Kari E.; Hunt, Steven C.; Kraja, Aldi T.; Arnett, Donna K.; Djoussé, Luc

    2014-01-01

    SUMMARY Background & aims Previous studies have suggested that cocoa products, which are rich sources of flavonoids, may lower blood pressure, serum cholesterol, fasting blood glucose and improve endothelial function. However, it is unclear whether consumption of cocoa products including chocolate influences the risk of metabolic syndrome (MetS). In a cross-sectional design, we sought to examine the association between chocolate consumption and the prevalence of MetS. Methods We studied 4098 participants from the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study aged 25–93 years. Chocolate consumption was assessed using a semi-quantitative food-frequency questionnaire. MetS was defined using the NCEP III criteria. Generalized estimating equations were used to estimate prevalence odds ratios of MetS according to frequency of chocolate intake. Results Of the 4098 participants (mean age 51.7 y) included in the analyses, 2206 (53.8%) were female. The prevalence of metabolic syndrome in our population was 30.2%. Compared with those who did not consume any chocolate, multivariate adjusted odds ratios (95% CI) for MetS were 1.26 (0.94, 1.69), 1.15 (0.85, 1.55), and 0.99 (0.66, 1.51) among women who reported chocolate consumption of 1–3 times/ month, 1–4 times/week, and 5+ times/week, respectively. Corresponding values for men were: 1.13 (0.82, 1.57), 1.02 (0.74, 1.39), and 1.21 (0.79, 1.85). Conclusion These data do not support an association between chocolate intake and the prevalence of MetS in US adult men and women. PMID:25126517

  17. Racial and Ethnic Subgroup Disparities in Hypertension Prevalence, New York City Health and Nutrition Examination Survey, 2013–2014

    PubMed Central

    Rodriguez-Lopez, Jesica S.; Ramos, Marcel; Islam, Nadia; Trinh-Shevrin, Chau; Yi, Stella S.; Chernov, Claudia; Perlman, Sharon E.; Thorpe, Lorna E.

    2017-01-01

    Introduction Racial/ethnic minority adults have higher rates of hypertension than non-Hispanic white adults. We examined the prevalence of hypertension among Hispanic and Asian subgroups in New York City. Methods Data from the 2013–2014 New York City Health and Nutrition Examination Survey were used to assess hypertension prevalence among adults (aged ≥20) in New York City (n = 1,476). Hypertension was measured (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or self-reported hypertension and use of blood pressure medication). Participants self-reported race/ethnicity and country of origin. Multivariable logistic regression models assessed differences in prevalence by race/ethnicity and sociodemographic and health-related characteristics. Results Overall hypertension prevalence among adults in New York City was 33.9% (43.5% for non-Hispanic blacks, 38.0% for Asians, 33.0% for Hispanics, and 27.5% for non-Hispanic whites). Among Hispanic adults, prevalence was 39.4% for Dominican, 34.2% for Puerto Rican, and 27.5% for Central/South American adults. Among Asian adults, prevalence was 43.0% for South Asian and 39.9% for East/Southeast Asian adults. Adjusting for age, sex, education, and body mass index, 2 major racial/ethnic minority groups had higher odds of hypertension than non-Hispanic whites: non-Hispanic black (AOR [adjusted odds ratio], 2.6; 95% confidence interval [CI], 1.7–3.9) and Asian (AOR, 2.0; 95% CI, 1.2–3.4) adults. Two subgroups had greater odds of hypertension than the non-Hispanic white group: East/Southeast Asian adults (AOR, 2.8; 95% CI, 1.6–4.9) and Dominican adults (AOR, 1.9; 95% CI, 1.1–3.5). Conclusion Racial/ethnic minority subgroups vary in hypertension prevalence, suggesting the need for targeted interventions. PMID:28427484

  18. Impact of statistical adjustment for frequency of venue attendance in a venue-based survey of men who have sex with men.

    PubMed

    Gustafson, Paul; Gilbert, Mark; Xia, Michelle; Michelow, Warren; Robert, Wayne; Trussler, Terry; McGuire, Marissa; Paquette, Dana; Moore, David M; Gustafson, Reka

    2013-05-15

    Venue sampling is a common sampling method for populations of men who have sex with men (MSM); however, men who visit venues frequently are more likely to be recruited. While statistical adjustment methods are recommended, these have received scant attention in the literature. We developed a novel approach to adjust for frequency of venue attendance (FVA) and assess the impact of associated bias in the ManCount Study, a venue-based survey of MSM conducted in Vancouver, British Columbia, Canada, in 2008-2009 to measure the prevalence of human immunodeficiency virus and other infections and associated behaviors. Sampling weights were determined from an abbreviated list of questions on venue attendance and were used to adjust estimates of prevalence for health and behavioral indicators using a Bayesian, model-based approach. We found little effect of FVA adjustment on biological or sexual behavior indicators (primary outcomes); however, adjustment for FVA did result in differences in the prevalence of demographic indicators, testing behaviors, and a small number of additional variables. While these findings are reassuring and lend credence to unadjusted prevalence estimates from this venue-based survey, adjustment for FVA did shed important insights on MSM subpopulations that were not well represented in the sample.

  19. Prevalence and individual risk factors associated with clinical lumbar instability in rice farmers with low back pain

    PubMed Central

    Puntumetakul, Rungthip; Yodchaisarn, Wantanee; Emasithi, Alongkot; Keawduangdee, Petcharat; Chatchawan, Uraiwan; Yamauchi, Junichiro

    2015-01-01

    Introduction Clinical lumbar instability (CLI) is one of the subgroups of chronic non-specific low back pain. Thai rice farmers often have poor sustained postures during a rice planting process and start their farming at an early age. However, individual associated factors of CLI are not known and have rarely been diagnosed in low back pain. This study aimed to determine the prevalence and individual associated factors of CLI in Thai rice farmers. Methods A cross-sectional survey was conducted among 323 Thai rice farmers in a rural area of Khon Kaen province, Thailand. Face-to-face interviews were conducted using the 13-item Delphi criteria questionnaire, after which an objective examination was performed using aberrant movement sign, painful catch sign, and prone instability test to obtain information. Individual factors such as sex, body mass index, waist-hip ratio, smoking, and number of years of farming experience, were recorded during the face-to-face interview. Results The prevalence of CLI in Thai rice farmers calculated by the method described in this study was 13% (age 44±10 years). Number of years of farming experience was found to be significantly correlated with the prevalence of CLI (adjusted odds ratio =2.02, 95% confidence interval =1.03–3.98, P<0.05). Conclusion This study provides prevalence of CLI in Thai rice farmers. Those with long-term farming experience of at least 30 years have a greater risk of CLI. PMID:25565778

  20. Low prevalence of obstructive lung disease in a suburban population of Malaysia: A BOLD collaborative study.

    PubMed

    Loh, Li Cher; Rashid, Abdul; Sholehah, Siti; Gnatiuc, Louisa; Patel, Jaymini H; Burney, Peter

    2016-08-01

    As a Burden of Obstructive Lung Disease (BOLD) collaboration, we studied the prevalence of chronic obstructive pulmonary disease (COPD) and its associated risk factors in a suburban population in Malaysia. Nonhospitalized men or women of age ≥ 40 years from a Penang district were recruited by stratified simple random sampling. Participants completed detailed questionnaires on respiratory symptoms and exposure to COPD risk factors. Prebronchodilator and post-bronchodilator spirometry conducted was standardized across all international BOLD sites in device and data quality control. Of the 1218 individuals recruited for the study, 663 (340 men and 323 women) had complete questionnaire data and acceptable post-bronchodilator spirometry. The estimated population prevalence of Global Initiative for Chronic Obstructive Lung Disease (GOLD) ≥ stage I was 6.5% or 3.4% based on either fixed forced expiratory volume in 1 s/forced vital capacity ratio of <0.7 or National Health and Nutritional Examination Survey-derived lower limit of normal ratio while the prevalence of GOLD ≥ stage II was either 4.6% or 3.1%, respectively. Multivariate logistic regression analysis showed independent association between all stages of COPD with cigarette smoking pack years (adjusted odds ratio per 10-year increase: 1.73; 95% confidence interval: 1.09-2.75), use of biomass fuel for cooking (1.61; 1.10-2.36) and exposure to dusty job (1.50; 1.09-2.06). This study represented the first robust population-based epidemiology data on COPD for Malaysia. Compared with other sites globally, our estimated population prevalence was relatively low. In addition to cigarette smoking, use of biomass fuel and exposure to dusty job represented significant risk to the development of COPD. © 2016 Asian Pacific Society of Respirology.

  1. Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing.

    PubMed

    Matheny, Michael E; Normand, Sharon-Lise T; Gross, Thomas P; Marinac-Dabic, Danica; Loyo-Berrios, Nilsa; Vidi, Venkatesan D; Donnelly, Sharon; Resnic, Frederic S

    2011-12-14

    Automated adverse outcome surveillance tools and methods have potential utility in quality improvement and medical product surveillance activities. Their use for assessing hospital performance on the basis of patient outcomes has received little attention. We compared risk-adjusted sequential probability ratio testing (RA-SPRT) implemented in an automated tool to Massachusetts public reports of 30-day mortality after isolated coronary artery bypass graft surgery. A total of 23,020 isolated adult coronary artery bypass surgery admissions performed in Massachusetts hospitals between January 1, 2002 and September 30, 2007 were retrospectively re-evaluated. The RA-SPRT method was implemented within an automated surveillance tool to identify hospital outliers in yearly increments. We used an overall type I error rate of 0.05, an overall type II error rate of 0.10, and a threshold that signaled if the odds of dying 30-days after surgery was at least twice than expected. Annual hospital outlier status, based on the state-reported classification, was considered the gold standard. An event was defined as at least one occurrence of a higher-than-expected hospital mortality rate during a given year. We examined a total of 83 hospital-year observations. The RA-SPRT method alerted 6 events among three hospitals for 30-day mortality compared with 5 events among two hospitals using the state public reports, yielding a sensitivity of 100% (5/5) and specificity of 98.8% (79/80). The automated RA-SPRT method performed well, detecting all of the true institutional outliers with a small false positive alerting rate. Such a system could provide confidential automated notification to local institutions in advance of public reporting providing opportunities for earlier quality improvement interventions.

  2. 10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population.

    PubMed

    Kim, Daehoon; Yang, Pil-Sung; Jang, Eunsun; Yu, Hee Tae; Kim, Tae-Hoon; Uhm, Jae-Sun; Kim, Jong-Youn; Pak, Hui-Nam; Lee, Moon-Hyoung; Joung, Boyoung; Lip, Gregory Yh

    2018-05-01

    Most data on the clinical epidemiology of atrial fibrillation (AF) are reported from Western populations, and data for Asians are limited. We aimed to investigate the 10-year trends of the prevalence and incidence of non-valvular AF and provide prevalence projections till 2060 in Korea. We also investigated the annual risks of adverse outcomes among patients with AF. Using the Korean National Health Insurance Service database involving the entire Korean population, a total of 679,416 adults with newly diagnosed AF were identified from 2006 to 2015. The incidence and prevalence of AF and risk of adverse outcomes following AF onset were assessed. The prevalence of AF progressively increased by 2.10-fold from 0.73% in 2006 to 1.53% in 2015. The trend of its incidence was flat with a 10-year overall incidence of 1.77 per 1,000 person-years. The prevalence of AF is expected to reach 5.81% (2,290,591 patients with AF) in 2060. For a decade, the risk of all-cause mortality following AF declined by 30% (adjusted hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.68-0.72), heart failure by 52% (adjusted HR: 0.48, 95% CI: 0.44-0.51), and ischemic stroke by 9% (adjusted HR: 0.91, 95% CI: 0.88-0.93). The burden of AF among Asian patients is increasing. Although the overall risks of cardiovascular events and death following AF onset have decreased over a decade, the event rates are still high. Optimized management of any associated comorbidities should be part of the holistic management approach for patients with AF. Copyright © 2018. Published by Elsevier Inc.

  3. Mothers adjust offspring sex to match the quality of the rearing environment

    PubMed Central

    Pryke, Sarah R.; Rollins, Lee A.

    2012-01-01

    Theory predicts that mothers should adjust offspring sex ratios when the expected fitness gains or rearing costs differ between sons and daughters. Recent empirical work has linked biased offspring sex ratios to environmental quality via changes in relative maternal condition. It is unclear, however, whether females can manipulate offspring sex ratios in response to environmental quality alone (i.e. independent of maternal condition). We used a balanced within-female experimental design (i.e. females bred on both low- and high-quality diets) to show that female parrot finches (Erythrura trichroa) manipulate primary offspring sex ratios to the quality of the rearing environment, and not to their own body condition and health. Individual females produced an unbiased sex ratio on high-quality diets, but over-produced sons in poor dietary conditions, even though they maintained similar condition between diet treatments. Despite the lack of sexual size dimorphism, such sex ratio adjustment is in line with predictions from sex allocation theory because nutritionally stressed foster sons were healthier, grew faster and were more likely to survive than daughters. These findings suggest that mothers may adaptively adjust offspring sex ratios to optimally match their offspring to the expected quality of the rearing environment. PMID:22859597

  4. Mothers adjust offspring sex to match the quality of the rearing environment.

    PubMed

    Pryke, Sarah R; Rollins, Lee A

    2012-10-07

    Theory predicts that mothers should adjust offspring sex ratios when the expected fitness gains or rearing costs differ between sons and daughters. Recent empirical work has linked biased offspring sex ratios to environmental quality via changes in relative maternal condition. It is unclear, however, whether females can manipulate offspring sex ratios in response to environmental quality alone (i.e. independent of maternal condition). We used a balanced within-female experimental design (i.e. females bred on both low- and high-quality diets) to show that female parrot finches (Erythrura trichroa) manipulate primary offspring sex ratios to the quality of the rearing environment, and not to their own body condition and health. Individual females produced an unbiased sex ratio on high-quality diets, but over-produced sons in poor dietary conditions, even though they maintained similar condition between diet treatments. Despite the lack of sexual size dimorphism, such sex ratio adjustment is in line with predictions from sex allocation theory because nutritionally stressed foster sons were healthier, grew faster and were more likely to survive than daughters. These findings suggest that mothers may adaptively adjust offspring sex ratios to optimally match their offspring to the expected quality of the rearing environment.

  5. Public Housing Relocations and Partnership Dynamics in Areas With High Prevalences of Sexually Transmitted Infections

    PubMed Central

    Cooper, Hannah L.F.; Bonney, Loida; Luo, Ruiyan; Haley, Danielle F.; Linton, Sabriya; Hunter-Jones, Josalin; Ross, Zev; Wingood, Gina M.; Adimora, Adaora A.; Rothenberg, Richard

    2017-01-01

    Background We investigated the implications of one structural intervention—public housing relocations—for partnership dynamics among individuals living areas with high sexually transmitted infection (STI) prevalence. High-prevalence areas fuel STI endemicity and are perpetuated by spatially assortative partnerships. Methods We analyzed 7 waves of data from a cohort of black adults (n = 172) relocating from 7 public housing complexes in Atlanta, Georgia. At each wave, data on whether participants’ sexual partners lived in the neighborhood were gathered via survey. Participant addresses were geocoded to census tracts, and measures of tract-level STI prevalence, socioeconomic conditions, and other attributes were created for each wave. “High-prevalence tracts” were tracts in the highest quartile of STI prevalence in Georgia. Descriptive statistics and hierarchical generalized linear models examined trajectories of spatially assortative partnerships and identified predictors of assortativity among participants in high-prevalence tracts. Results All 7 tracts containing public housing complexes at baseline were high-prevalence tracts; most participants relocated to high-prevalence tracts. Spatially assortative partnerships had a U-shaped distribution: the mean percent of partners living in participants’ neighborhoods at baseline was 54%; this mean declined to 28% at wave 2 and was 45% at wave 7. Participants who experienced greater postrelocation improvements in tract-level socioeconomic conditions had a lower odds of having spatially assortative partnerships (adjusted odds ratio, 1.55; 95% confidence interval [95% CI], 1.06–2.26). Conclusions Public housing relocation initiatives may disrupt high-prevalence areas if residents experience significant postrelocation gains in tract-level socioeconomic conditions. PMID:26967298

  6. Visceral fat and prevalence of hypertension among African Americans and Hispanic Americans: findings from the IRAS family study.

    PubMed

    Foy, Capri G; Hsu, Fang-Chi; Haffner, Steven M; Norris, Jill M; Rotter, Jerome I; Henkin, Leora F; Bryer-Ash, Michael; Chen, Yii-Der I; Wagenknecht, Lynne E

    2008-08-01

    We examined the relationship between visceral adipose tissue (VAT), independent of overall adiposity, and prevalent hypertension among adults enrolled in the Insulin Resistance Atherosclerosis (IRAS) Family Study. We also examined the role of insulin sensitivity (S(I)) upon hypertension. This was a cross-sectional epidemiological study in which African-American and Hispanic-American families were recruited from three clinical sites. The main outcome measure was prevalent hypertension, as defined by standardized protocol. The relationship between VAT and prevalent hypertension was examined in adjusted marginal models among 1,582 participants. All continuous variables were standardized. A significant VAT by gender interaction prompted separate analyses for VAT according to gender. Further adjustment for S(I) was performed to determine its potential roles in the VAT-hypertension relationship. The mean age (s.d.) of the sample was 41.3 (13.8) years, with a mean body mass index (BMI) (s.d.) of 28.7 (6.0) kg/m2. Women comprised 58.5% of the sample (N = 925), and Hispanic Americans comprised 69.2% of the sample (N = 1,095). One in five participants (21.2%) had prevalent hypertension. In women, VAT was significantly associated with hypertension, independent of BMI (odds ratio (OR) = 1.49, P = 0.006). African-American women demonstrated increased odds of prevalent hypertension compared to Hispanic-American women (OR = 3.08, P < 0.001). Among men, VAT was not associated with hypertension independent of BMI, and BMI explained a significant amount of the variation in hypertension. A significant relationship may exist between VAT and hypertension among women, but not among men. The relationship between VAT and hypertension in women was not associated with insulin resistance.

  7. Prevalence and Risk Factors for Chagas Disease in Pregnant Women in Casanare, Colombia

    PubMed Central

    Cucunubá, Zulma M.; Flórez, Astrid C.; Cárdenas, Ángela; Pavía, Paula; Montilla, Marleny; Aldana, Rodrigo; Villamizar, Katherine; Ríos, Lyda C.; Nicholls, Rubén S.; Puerta, Concepción J.

    2012-01-01

    Knowledge of the prevalence and risk factors associated with maternal infection is the first step to develop a surveillance system for congenital transmission of Chagas disease. We conducted a cross-sectional study in Casanare, a disease-endemic area in Colombia. A total of 982 patients were enrolled in the study. A global prevalence of Trypanosoma cruzi infection of 4.0% (95% confidence interval [CI] = 2.8–5.3%) was found. Multivariate analysis showed that the most important risk-associated factors were age > 29 years (adjusted odds ratio [aOR] = 3.4, 95% CI = 0.9–12.4), rural residency (aOR = 2.2, 95% CI = 1.0–4.6), low education level (aOR = 10.2, 95% CI = 1.6–82.7), and previous knowledge of the vector (aOR = 2.2, 95% CI = 1.0–4.9). Relatives and siblings of infected mothers showed a prevalence of 9.3%. These findings may help physicians to investigate congenital cases, screen Chagas disease in siblings and relatives, and provide early treatment to prevent the chronic complications of Chagas disease. PMID:23033397

  8. Disparities in current cigarette smoking prevalence by type of disability, 2009-2011.

    PubMed

    Courtney-Long, Elizabeth; Stevens, Alissa; Caraballo, Ralph; Ramon, Ismaila; Armour, Brian S

    2014-05-01

    Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report smoking, little is known about the prevalence of smoking by type of disability, particularly for adults younger than 50 years of age. We used data from the 2009-2011 National Health Interview Survey to estimate the prevalence of smoking by type of disability and to examine the association of functional disability type and smoking among adults aged 18-49 years. Adults with a disability were more likely than adults without a disability to be current smokers (38.8% vs. 20.7%, p<0.001). Among adults with disabilities, the prevalence of smoking ranged from 32.4% (self-care difficulty) to 43.8% (cognitive limitation). When controlling for sociodemographic characteristics, having a disability was associated with statistically significantly higher odds of current smoking (adjusted odds ratio = 1.57, 95% confidence interval 1.40, 1.77). The prevalence of current smoking for adults was higher for every functional disability type than for adults without a disability. By understanding the association between smoking and disability type among adults younger than 50 years of age, resources for cessation services can be better targeted during the ages when increased time for health improvement can occur.

  9. Normotension, prehypertension, and hypertension in urban middle-class subjects in India: prevalence, awareness, treatment, and control.

    PubMed

    Gupta, Rajeev; Deedwania, Prakash C; Achari, Vijay; Bhansali, Anil; Gupta, Bal Kishan; Gupta, Arvind; Mahanta, Tulika G; Asirvatham, Arthur J; Gupta, Sunil; Maheshwari, Anuj; Saboo, Banshi; Jali, Mallikarjuna V; Singh, Jitendra; Guptha, Soneil; Sharma, Krishna Kumar

    2013-01-01

    We conducted a multisite study to determine the prevalence and determinants of normotension, prehypertension, and hypertension, and awareness, treatment, and control of hypertension among urban middle-class subjects in India. We evaluated 6,106 middle-class urban subjects (men 3,371; women, 2,735; response rate, 62%) in 11 cities for sociodemographic and biological factors. The subjects were classified as having normotension (BP < 120/80), prehypertension (BP 120-139/80-89), and hypertension (documented or BP ≥ 140/90). The prevalence of other cardiovascular risk factors was determined and associations evaluated through logistic regression analysis. The age-adjusted prevalences in men and women of normotension were 26.7% and 39.1%, of prehypertension 40.2% and 30.1%, and of hypertension 32.5% and 30.4%, respectively. The prevalence of normotension declined with age whereas that of hypertension increased (P-trend < 0.01). A significant association of normotension was found with younger age, low dietary fat intake, lower use of tobacco, and low obesity (P < 0.05). The prevalence of hypercholesterolemia, diabetes, and metabolic syndrome was higher in the groups with prehypertension and hypertension than in the group with normotension (age-adjusted odds ratios (ORs) 2.0-5.0, P < 0.001). The prevalences in men and women, respectively, of two or more risk factors were 11.1% and 6.4% in the group with normotension, 25.1% and 23.3% in the group with prehypertension, and 38.3% and 39.1% in the group with hypertension (P < 0.01). Awareness of hypertension in the study population was in 55.3%; 36.5% of the hypertensive group were receiving treatment for hypertension, and 28.2% of this group had a controlled BP (< 140/90 mm Hg). The study found a low prevalence of normotension and high prevalence of hypertension in middle-class urban Asian Indians. Significant associations of hypertension were found with age, dietary fat, consumption of fruits and vegetables, smoking, and

  10. Asthma prevalence among Hispanic adults in Puerto Rico and Hispanic adults of Puerto Rican descent in the United States - results from two national surveys.

    PubMed

    El Burai Félix, Suad; Bailey, Cathy M; Zahran, Hatice S

    2015-02-01

    Abstract Objective: To assess whether asthma prevalence differs between Hispanic adults living in Puerto Rico and Hispanic adults of Puerto Rican descent living in the United States. We used 2008-2010 Behavioral Risk Factor Surveillance System data, administered in Puerto Rico for Hispanic adults living in Puerto Rico (Hispanics in Puerto Rico), and 2008-2010 National Health Interview Survey data for Hispanic adults of Puerto Rican descent living in the United States (Puerto Rican Americans). We used 95% confidence intervals (CIs) to compare asthma prevalence between corresponding subgroups; non-overlapping CIs indicate statistical significance. Chi-square test and multivariate logistic regression were used to assess the association between current asthma status and socio-demographic factors and health risk behaviors within each Puerto Rican population. Current asthma prevalence among Hispanics in Puerto Rico (7.0% [6.4%-7.7%]) was significantly lower than the prevalence among Puerto Rican Americans (15.6% [13.0%-18.1%]). The prevalence among almost all socio-demographic and health risk subgroups of Hispanics in Puerto Rico was significantly lower than the prevalence among the corresponding subgroups of Puerto Rican Americans. Adjusting for potential confounders did not alter the results. Asthma prevalence was significantly associated with obesity among Puerto Rican Americans (adjusted prevalence ratios [aPR]=1.5 [1.1-2.0]), and among Hispanics in Puerto Rico was associated with obesity (aPR=1.6 [1.3-1.9]), smoking (aPR=1.4 [1.1-1.9]) and being female (aPR=1.9 [1.5-2.4]). Asthma was more prevalent among Puerto Rican Americans than Hispanics in Puerto Rico. Although the observed associations did not explain all variations in asthma prevalence between these two populations, they may lay the foundation for future research.

  11. Prevalence and incidence of epilepsy in a well-defined population of Northern Italy.

    PubMed

    Giussani, Giorgia; Franchi, Carlotta; Messina, Paolo; Nobili, Alessandro; Beghi, Ettore

    2014-10-01

    To calculate prevalence and incidence of epilepsy using administrative records. Claim records from the administrative district of Lecco, Northern Italy (population 311,637; 2001 census), collected during the years 2000-2008, were the data source. Patients of all ages were included. Based on previous findings from our group, the most accurate algorithm to detect epilepsy was the combination of electroencephalography (EEG) (ad hoc code) (at least one during the study period) and antiepileptic drugs (AEDs) (ATC code) (taken in 2008). Using this algorithm, the prevalence of epilepsy for the year 2008 was calculated. The reference population for prevalence was the population residing in the study area during the year 2008. Incident epilepsy cases were a subset of prevalent cases among patients not traced in the years 2000 through 2003. Average annual incidence rates were calculated for 2004 through 2008, taking for reference the person-years of exposure in the resident population. We calculated crude, adjusted (using positive and negative predictive values), and standardized (to the Italian and World population) prevalence and incidence. In 2008, 1,504 patients met the inclusion criteria, giving a prevalence of 4.57 per 1,000 (women 4.26; men 4.89). Prevalence tended to rise slightly with age. There were 864 incident cases, giving an average annual incidence of 53.41 per 100,000 (women 50.98; men 55.95). Incidence rates peaked in the elderly. The adjusted prevalence was 4.42 and the adjusted incidence 47.05. Standardized prevalence and incidence were, respectively, 4.30 per 1,000 and 48.35 per 100,000 (Italian population) and 3.79 per 1,000 and 44.74 per 100,000 (World population). The prevalence of epilepsy in the Lecco district was comparable to other studies, whereas the incidence was among the highest. With adjustments, administrative records are a cost-effective instrument to monitor epilepsy frequency. Wiley Periodicals, Inc. © 2014 International League Against

  12. Analysis of the prevalence of and risk factors for tinnitus in a young population.

    PubMed

    Park, Bumjung; Choi, Hyo Geun; Lee, Hyo-Jeong; An, Soo-Youn; Kim, Si Whan; Lee, Joong Seob; Hong, Sung Kwang; Kim, Hyung-Jong

    2014-08-01

    Tinnitus in children and adolescents is known to be as common as in adults. However, tinnitus in this young population is often overlooked, and a large population-based study designed to adjust for various risk factors for tinnitus is lacking. A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey, with 3047 participants aged 12 to 19 years, from 2008 through 2011. We investigated the tinnitus prevalence by questionnaire and analyzed risk factors for tinnitus of three types: personal, otologic, and parental factors. The prevalence of tinnitus in the young population was 17.7%, although only 0.3% of subjects reported severe discomfort caused by tinnitus. The tinnitus prevalence increased with age (adjusted odds ratio [AOR], 1.087). Female gender (AOR, 1.401), sleeping less than 9 hours (sleep 7 or 8 h: AOR, 1.437; sleep 6 h or less: AOR, 1.737), noise exposure in other places (AOR, 6.395), and momentary noise exposure (AOR, 5.504) increased the risk of tinnitus. Participants whose mother had a history of tinnitus showed higher AORs. However, high body mass index, alcohol consumption, stress, monthly household income, having an abnormal tympanic membrane, unilateral or bilateral hearing loss, noise exposure caused by earphone, and noise exposure in the workplace, all reported risk factors for tinnitus, showed no statistically significant difference. A tinnitus history in the father was also not associated with tinnitus in children. We believe that understanding the influences of these factors will help in preventing tinnitus.

  13. Comparison of the prevalence of metabolic syndrome and its association with diabetes and cardiovascular disease in the rural population of Bangladesh using the modified National Cholesterol Education Program Expert Panel Adult Treatment Panel III and International Diabetes Federation definitions

    PubMed Central

    Bhowmik, Bishwajit; Afsana, Faria; Siddiquee, Tasnima; Munir, Sanjida B; Sheikh, Fareeha; Wright, Erica; Bhuiyan, Farjana R; Ashrafuzzaman, Sheikh Mohammad; Mahtab, Hajera; Azad Khan, Abul Kalam; Hussain, Akhtar

    2015-01-01

    Aims/Introduction To compare the prevalence of metabolic syndrome (MS) using the modified National Cholesterol Education Program Adult Treatment Plan III (NCEP) and the International Diabetes Federation (IDF) definitions and, using both definitions, determine and compare the association of MS, prediabetes, type 2 diabetes, hypertension (HTN) and cardiovascular disease risk (CVD). Materials and Methods A total of 2,293 randomly selected participants (aged ≥20 years) in a rural community in Bangladesh were investigated in a population-based cross-sectional study. Sociodemographic and anthropometric characteristics, blood pressure, blood glucose, and lipid profiles were studied. Age-adjusted data for MS and cardiometabolic risk factors were assessed, and their relationships were examined. Results The age-adjusted prevalence of MS was 30.7% (males 30.5%; females 30.5%) using the NCEP definition, and 24.5% (males 19.2%, females 27.5%) using the IDF definition. The prevalence of MS using the NCEP definition was also higher in study participants with prediabetes, type 2 diabetes, HTN and CVD risk. The agreement rate between both definitions was 92% (k = 0.80). The NCEP definition had a stronger association with type 2 diabetes and HTN (odds ratio 12.4 vs 5.2; odds ratio 7.0 vs 4.7, respectively) than the IDF definition. However, the odds ratios for prediabetes and CVD risk were not significantly different. Conclusions The prevalence of MS was higher using the NCEP definition, and was more strongly associated with prediabetes, type 2 diabetes, HTN and CVD in this Bangladeshi population. PMID:25969712

  14. Economic abuse between intimate partners in Australia: prevalence, health status, disability and financial stress.

    PubMed

    Kutin, Jozica; Russell, Roslyn; Reid, Mike

    2017-06-01

    Economic abuse is a form of domestic violence that has a significant impact on the health and financial wellbeing of victims, but is understudied. This study determined the lifetime prevalence of economic abuse in Australia by age and gender, and the associated risk factors. The 2012 ABS Personal Safety Survey was used, involving a cross-sectional population survey of 17,050 randomly selected adults using face-to-face interviews. The survey-weighted prevalence of economic abuse was calculated and analysed by age and gender. Logistic regression was used to adjust odds ratios for possible confounding between variables. The lifetime prevalence of economic abuse in the whole sample was 11.5%. Women in all age groups were more likely to experience economic abuse (15.7%) compared to men (7.1%). Disability, health and financial stress status were significant markers of economic abuse. For women, financial stress and disability were important markers of economic abuse. However, prevalence rates were influenced by the measures used and victims' awareness of the abuse, which presents a challenge for screening and monitoring. Implications for public health: Social, health and financial services need to be aware of and screen for the warning signs of this largely hidden form of domestic violence. © 2017 The Authors.

  15. Gender differences in the age-stratified prevalence of risk factors in Korean ischemic stroke patients: a nationwide stroke registry-based cross-sectional study.

    PubMed

    Park, Tai Hwan; Ko, Youngchai; Lee, Soo Joo; Lee, Kyung Bok; Lee, Jun; Han, Moon-Ku; Park, Jong-Moo; Kim, Dong-Eog; Cho, Yong-Jin; Hong, Keun-Sik; Kim, Joon-Tae; Cho, Ki-Hyun; Kim, Dae-Hyun; Cha, Jae-Kwan; Yu, Kyung-Ho; Lee, Byung-Chul; Yoon, Byung-Woo; Lee, Ji Sung; Lee, Juneyoung; Gorelick, Philip B; Bae, Hee-Joon

    2014-08-01

    Although ethnic or cultural differences affect prevalence of cardiovascular risk factors, limited information is available about the age- and gender-stratified prevalence of the risk factors in Asian stroke population. We assessed gender- and age-stratified prevalences of major risk factors in Korean stroke patients, and assumed that the gender differences are attenuated by adjustment with lifestyle factors. Using the nationwide hospital-based stroke registry, we identified 9417 ischemic stroke patients admitted between April 2008 and January 2011. Prevalence of hypertension, diabetes, hyperlipidemia, atrial fibrillation, prior stroke, and coronary heart disease was assessed in both genders by age groups. We analyzed gender differences of the prevalence among the age groups by calculating prevalence ratio, and further explored the influence of lifestyle factors on the gender difference in multivariable analyses. Hypertension and hyperlipidemia were more common in men until middle age, but after that more common in women, whereas diabetes was more common in women after 65 years of age. Atrial fibrillation increased steadily with age in both genders but was more common in women through all age groups. Prior stroke and coronary heart disease showed inconsistent gender differences. Gender differences in hypertension and diabetes among the age groups were attenuated by adjustment with accompanying risk factors including lifestyle factors. Korean women with stroke had more hypertension and hyperlipidemia after middle age, more diabetes after 65 years, and more atrial fibrillation throughout all ages. Strategies to control risk factors in women at risk for stroke are eagerly needed. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

  16. Using risk-adjustment models to identify high-cost risks.

    PubMed

    Meenan, Richard T; Goodman, Michael J; Fishman, Paul A; Hornbrook, Mark C; O'Keeffe-Rosetti, Maureen C; Bachman, Donald J

    2003-11-01

    We examine the ability of various publicly available risk models to identify high-cost individuals and enrollee groups using multi-HMO administrative data. Five risk-adjustment models (the Global Risk-Adjustment Model [GRAM], Diagnostic Cost Groups [DCGs], Adjusted Clinical Groups [ACGs], RxRisk, and Prior-expense) were estimated on a multi-HMO administrative data set of 1.5 million individual-level observations for 1995-1996. Models produced distributions of individual-level annual expense forecasts for comparison to actual values. Prespecified "high-cost" thresholds were set within each distribution. The area under the receiver operating characteristic curve (AUC) for "high-cost" prevalences of 1% and 0.5% was calculated, as was the proportion of "high-cost" dollars correctly identified. Results are based on a separate 106,000-observation validation dataset. For "high-cost" prevalence targets of 1% and 0.5%, ACGs, DCGs, GRAM, and Prior-expense are very comparable in overall discrimination (AUCs, 0.83-0.86). Given a 0.5% prevalence target and a 0.5% prediction threshold, DCGs, GRAM, and Prior-expense captured $963,000 (approximately 3%) more "high-cost" sample dollars than other models. DCGs captured the most "high-cost" dollars among enrollees with asthma, diabetes, and depression; predictive performance among demographic groups (Medicaid members, members over 64, and children under 13) varied across models. Risk models can efficiently identify enrollees who are likely to generate future high costs and who could benefit from case management. The dollar value of improved prediction performance of the most accurate risk models should be meaningful to decision-makers and encourage their broader use for identifying high costs.

  17. Global population-level association between herpes simplex virus 2 prevalence and HIV prevalence.

    PubMed

    Kouyoumjian, Silva P; Heijnen, Marieke; Chaabna, Karima; Mumtaz, Ghina R; Omori, Ryosuke; Vickerman, Peter; Abu-Raddad, Laith J

    2018-06-19

    Our objective was to assess the population-level association between herpes simplex virus 2 (HSV-2) and HIV prevalence. Reports of HSV-2 and HIV prevalence were systematically reviewed and synthesized following PRISMA guidelines. Spearman rank correlation ((Equation is included in full-text article.)) was used to assess correlations. Risk ratios (RRHSV-2/HIV) and odds ratios (ORHSV-2/HIV) were used to assess HSV-2/HIV epidemiologic overlap. DerSimonian-Laird random-effects meta-analyses were conducted. In total, 939 matched HSV-2/HIV prevalence measures were identified from 77 countries. HSV-2 prevalence was consistently higher than HIV prevalence. Strong HSV-2/HIV prevalence association was found for all data ((Equation is included in full-text article.) = 0.6, P < 0.001), all data excluding people who inject drugs (PWID) and children ((Equation is included in full-text article.) = 0.7, P < 0.001), female sex workers ((Equation is included in full-text article.) = 0.5, P < 0.001), and MSM ((Equation is included in full-text article.) = 0.7, P < 0.001). No association was found for PWID ((Equation is included in full-text article.) = 0.2, P = 0.222) and children ((Equation is included in full-text article.) = 0.3, P = 0.082). A threshold effect was apparent where HIV prevalence was limited at HSV-2 prevalence less than 20%, but grew steadily with HSV-2 prevalence for HSV-2 prevalence greater than 20%. The overall pooled mean RRHSV-2/HIV was 5.0 (95% CI 4.7-5.3) and ORHSV-2/HIV was 9.0 (95% CI 8.4-9.7). The RRHSV-2/HIV and ORHSV-2/HIV showed similar patterns that conveyed inferences about HSV-2 and HIV epidemiology. HSV-2 and HIV prevalence are strongly associated. HSV-2 prevalence can be used as a proxy 'biomarker' of HIV epidemic potential, acting as a 'temperature scale' of the intensity of sexual risk behavior that drive HIV transmission. HSV-2 prevalence can be used to identify populations and/or sexual networks

  18. Occupations with an increased prevalence of self-reported asthma in Indian adults

    PubMed Central

    Pearce, Neil; Millett, Christopher; Subramanian, S.V.; Ebrahim, Shah

    2014-01-01

    Objectives Occupational asthma remains relatively under-recognized in India with little or no information regarding preventable causes. We studied occupations with an increased prevalence of self-reported asthma among adult men and women in India. Methods Analysis is based on 64 725 men aged 15–54 years and 52 994 women aged 15–49 years who participated in India’s third National Family Health Survey, 2005–2006, and reported their current occupation. Prevalence odds ratios (ORs) for specific occupations and asthma were estimated using multivariate logistic regression, separately for men and women, adjusting for age, education, household wealth index, current tobacco smoking, cooking fuel use, rural/urban residence and access to healthcare. Results The prevalence of asthma among the working population was 1.9%. The highest odds ratios for asthma were found among men in the plant and machine operators and assemblers major occupation category (OR: 1.67; 95% CI: 1.14–2.45; p = 0.009). Men working in occupation subcategories of machine operators and assemblers (OR: 1.85; 95% CI: 1.24–2.76; p = 0.002) and mining, construction, manufacturing and transport (OR: 1.33; 95% CI: 1.00–1.77; p = 0.051) were at the highest risk of asthma. Reduced odds of asthma prevalence in men was observed among extraction and building trades workers (OR: 0.72; 95% CI: 0.53–0.97; p = 0.029). Among women none of the occupation categories or subcategories was found significant for asthma risk. Men and women employed in high-risk occupations were not at a higher risk of asthma when compared with those in low-risk occupations. Conclusions This large population-based, nationally representative cross-sectional study has confirmed findings from high income countries showing high prevalence of asthma in men in a number of occupational categories and subcategories; however, with no evidence of increased risks for women in the same occupations. PMID:24712498

  19. Assessment of the value of repeated point-prevalence surveys for analyzing the trend in nosocomial infections.

    PubMed

    Sartor, Catherine; Delchambre, Anne; Pascal, Laurence; Drancourt, Michel; De Micco, Philippe; Sambuc, Roland

    2005-04-01

    To assess the value of repeated point-prevalence surveys in measuring the trend in nosocomial infections after adjustment for case mix. A 3,500-bed teaching facility composed of 4 acute care hospitals. From May 1992 to June 1996, eight point-prevalence surveys of nosocomial infections were performed in the hospitals using a sampling process. The trend of adjusted nosocomial infection rates was studied for the four surveys that collected data on indwelling catheters. Adjusted rates were calculated using a logistic regression model and a direct standardization method. From 1992 to 1996, a total of 20,238 patients were included in the 8 point-prevalence surveys. The nosocomial infection rate decreased from 8.6% in 1992 to 5% in 1996 (P < .001). The analysis of adjusted nosocomial infection rates included 9,600 patients. Four independent risk factors were identified: length of stay greater than 12 days, hospitalization in an intensive care unit, presence of an indwelling urinary catheter, and history of a surgical procedure. After adjustment for case mix, the nosocomial infection rate still showed a downward trend (from 7.2% in 1993 to 5.1% in 1996; P = .02). Adjusted prevalence rates of nosocomial infections showed a significant downward trend during the period of this study.

  20. Prevalence of obesity and its associated risk factors among Chinese adults in a Malaysian suburban village

    PubMed Central

    Chew, Wai Fong; Masyita, Mamot; Leong, Pooi Pooi; Boo, Nem Yun; Zin, Thaw; Choo, Kong Bung; Yap, Sook Fan

    2014-01-01

    INTRODUCTION Obesity is a major modifiable risk factor associated with most chronic diseases. The aim of this study was to determine the prevalence of obesity, and its associated risk factors, among apparently healthy Chinese adults in a Malaysian suburban village. METHODS This was a cross-sectional study conducted among the Chinese residents in Seri Kembangan New Village, Klang Valley, Selangor, Malaysia. Convenience sampling was used for the selection of participants. Body weight, height, waist and hip circumferences, and blood pressure were measured. Fasting venous plasma was drawn for the measurement of fasting glucose level and lipid profile. Data on sociodemographic factors, dietary habits, physical activity, perceived stress level and sleep duration were collected using interviewer-administered, pretested and validated questionnaires. RESULTS Among the 258 Chinese residents (mean age 41.4 ± 10.0 years) recruited, the prevalence of obesity was 40%. The obese participants had significantly higher mean blood pressure, and triglyceride and fasting plasma glucose levels than the non-obese participants (p < 0.05). The obese participants also had a significantly lower high-density lipoprotein cholesterol level than the non-obese participants. Logistic regression analysis showed that drinking soy milk (adjusted odds ratio [OR] 0.447; 95% confidence interval [CI] 0.253–0.787; p < 0.05) and the perception that a balanced diet consists mainly of vegetables (adjusted OR 0.440; 95% CI 0.215–0.900; p < 0.05) were associated with a reduced risk of obesity. The risk of obesity was higher in younger participants (adjusted OR 2.714; 95% CI 1.225–6.011; p < 0.05). CONCLUSION The prevalence of obesity was high among the apparently healthy suburban Chinese. Our findings suggest that soy milk consumption and the perception that a balanced diet consists mainly of vegetables are associated with a lower risk of developing obesity in this population. PMID:24570317

  1. Prevalence of obesity and its associated risk factors among Chinese adults in a Malaysian suburban village.

    PubMed

    Chew, Wai Fong; Masyita, Mamot; Leong, Pooi Pooi; Boo, Nem Yun; Zin, Thaw; Choo, Kong Bung; Yap, Sook Fan

    2014-02-01

    Obesity is a major modifiable risk factor associated with most chronic diseases. The aim of this study was to determine the prevalence of obesity, and its associated risk factors, among apparently healthy Chinese adults in a Malaysian suburban village. This was a cross-sectional study conducted among the Chinese residents in Seri Kembangan New Village, Klang Valley, Selangor, Malaysia. Convenience sampling was used for the selection of participants. Body weight, height, waist and hip circumferences, and blood pressure were measured. Fasting venous plasma was drawn for the measurement of fasting glucose level and lipid profile. Data on sociodemographic factors, dietary habits, physical activity, perceived stress level and sleep duration were collected using interviewer-administered, pretested and validated questionnaires. Among the 258 Chinese residents (mean age 41.4 ± 10.0 years) recruited, the prevalence of obesity was 40%. The obese participants had significantly higher mean blood pressure, and triglyceride and fasting plasma glucose levels than the non-obese participants (p < 0.05). The obese participants also had a significantly lower high-density lipoprotein cholesterol level than the non-obese participants. Logistic regression analysis showed that drinking soy milk (adjusted odds ratio [OR] 0.447; 95% confidence interval [CI] 0.253-0.787; p < 0.05) and the perception that a balanced diet consists mainly of vegetables (adjusted OR 0.440; 95% CI 0.215-0.900; p < 0.05) were associated with a reduced risk of obesity. The risk of obesity was higher in younger participants (adjusted OR 2.714; 95% CI 1.225-6.011; p < 0.05). The prevalence of obesity was high among the apparently healthy suburban Chinese. Our findings suggest that soy milk consumption and the perception that a balanced diet consists mainly of vegetables are associated with a lower risk of developing obesity in this population.

  2. Custodial grandmothers' psychological distress, dysfunctional parenting, and grandchildren's adjustment.

    PubMed

    Smith, Gregory C; Palmieri, Patrick A; Hancock, Gregory R; Richardson, Rhonda A

    2008-01-01

    An adaptation of the Family Stress Model (FSM) with hypothesized linkages between family contextual factors, custodial grandmothers' psychological distress, parenting practices, and grandchildren's adjustment was tested with structural equation modeling. Interview data from 733 custodial grandmothers of grandchildren between ages 4-17 revealed that the effect of grandmothers' distress on grandchildren's adjustment was mediated by dysfunctional parenting, especially regarding externalizing problems. The effects of contextual factors on grandchildren's adjustment were also indirect. The model's measurement and structural components were largely invariant across grandmothers' race and age, as well as grandchildren's gender and age. Group differences were more prevalent regarding the magnitude of latent means for model constructs. We conclude that parenting models like the FSM are useful for investigating custodial grandfamilies.

  3. The prevalence of the metabolic syndrome in Portugal: the PORMETS study.

    PubMed

    Raposo, Luís; Severo, Milton; Barros, Henrique; Santos, Ana Cristina

    2017-06-08

    The PORMETS study was designed to estimate the prevalence of metabolic syndrome and its determinants in the overall and administrative regions of the Portuguese mainland. A cross-sectional study of a representative sample of non-institutionalized Portuguese adults selected from primary health care centres lists including 1695 men and 2309 women was conducted from February 2007 to July 2009. A structured questionnaire was administered, collecting information on personal medical history and socio-demographic and behavioural characteristics. Anthropometrics, blood pressure, and venous blood samples were obtained. Metabolic syndrome was defined according to three operational definitions. The prevalence ratios and their respective 95% confidence intervals were calculated using binomial generalized linear regression, with the log link function. The prevalence rates of metabolic syndrome in this sample of Portuguese adults were 36.5%, 49.6%, and 43.1%, using the Adult Treatment Panel III, International Diabetes Federation and Joint Interim Statement definitions, respectively. The most prevalent feature of metabolic syndrome in this sample was high blood pressure (64.3%) and the lowest was high fasting glucose (24.9%). After adjustment for age and gender, significant differences were observed for the 18 districts of the Portugal mainland. Additionally, metabolic syndrome was significantly more frequent in non-urban areas than in urban ones (p = 0.001). The prevalence of metabolic syndrome was significantly higher in women (p˂0.001) and older participants (p˂0.001), as well as in those who reported being housewives (p = 0.010), retired (p = 0.046) or unemployed (p = 0.024). This study showed that metabolic syndrome is highly prevalent in the Portuguese adult population. Regional differences in the prevalence of this syndrome were observed, and this condition was more common in non-urban areas and less favoured socio-economic categories.

  4. 12 CFR 615.5330 - Minimum surplus ratios.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) and weighted on the basis of risk in accordance with § 615.5210. (b) Core surplus. (1) Each institution shall achieve and at all times maintain a ratio of core surplus to the risk-adjusted asset base of... otherwise includible pursuant to § 615.5301(b). (2) Each association shall compute its core surplus ratio by...

  5. Increasing atrial fibrillation prevalence in acute ischemic stroke and TIA.

    PubMed

    Otite, Fadar Oliver; Khandelwal, Priyank; Chaturvedi, Seemant; Romano, Jose G; Sacco, Ralph L; Malik, Amer M

    2016-11-08

    To evaluate trends in atrial fibrillation (AF) prevalence in acute ischemic stroke (AIS) and TIA in the United States. We used the Nationwide Inpatient Sample to retrospectively compute weighted prevalence of AF in AIS (n = 4,355,140) and TIA (n = 1,816,459) patients admitted to US hospitals from 2004 to 2013. Multivariate-adjusted models were used to evaluate the association of AF with clinical factors, mortality, length of stay, and cost. From 2004 to 2013, AF prevalence increased by 22% in AIS (20%-24%) and by 38% in TIA (12%-17%). AF prevalence varied by age (AIS: 6% in 50-59 vs 37% in ≥80 years; TIA: 4% in 50-59 vs 24% in ≥80 years), sex (AIS: male 19% vs female 25%; TIA: male 15% vs female 14%), race (AIS: white 26% vs black 12%), and region (AIS: Northeast 25% vs South 20%). Advancing age, female sex, white race, high income, and large hospital size were associated with increased odds of AF in AIS. AF in AIS was a risk factor for in-hospital death (odds ratio 1.93, 95% confidence interval 1.89-1.98) but mortality in AIS with AF decreased from 11.6% to 8.3% (p < 0.001). Compared to no AF, AF was associated with increased cost of $2,310 and length of stay 1.1 days in AIS. AF prevalence in AIS and TIA has continued to increase. Disparity in AF prevalence in AIS and TIA exists by patient and hospital factors. AF is associated with increased mortality in AIS. Innovative AIS preventive strategies are needed in patients with AF, especially in the elderly. © 2016 American Academy of Neurology.

  6. Estimating prevalence of osteoporosis: examples from industrialized countries.

    PubMed

    Wade, S W; Strader, C; Fitzpatrick, L A; Anthony, M S; O'Malley, C D

    2014-01-01

    In nine industrialized countries in North America, Europe, Japan, and Australia, country-specific osteoporosis prevalence (estimated from published data) at the total hip or hip/spine ranged from 9 to 38 % for women and 1 to 8 % for men. In these countries, osteoporosis affects up to 49 million individuals. Standardized country-specific prevalence estimates are scarce, limiting our ability to anticipate the potential global impact of osteoporosis. This study estimated the prevalence of osteoporosis in several industrialized countries (USA, Canada, five European countries, Australia, and Japan) using the World Health Organization (WHO) bone mineral density (BMD)-based definition of osteoporosis: BMD T-score assessed by dual-energy x-ray absorptiometry ≤-2.5. Osteoporosis prevalence was estimated for males and females aged 50 years and above using total hip BMD and then either total hip or spine BMD. We compiled published location-specific data, using the National Health and Nutrition Examination Survey (NHANES) III age and BMD reference groups, and adjusted for differences in disease definitions across sources. Relevant NHANES III ratios (e.g., male to female osteoporosis at the total hip) were applied where data were missing for countries outside the USA. Data were extrapolated from geographically similar countries as needed. Population counts for 2010 were used to estimate the number of individuals with osteoporosis in each country. For females, osteoporosis prevalence ranged from 9 % (UK) to 15 % (France and Germany) based on total hip BMD and from 16 % (USA) to 38 % (Japan) when spine BMD data were included. For males, prevalence ranged from 1 % (UK) to 4 % (Japan) based on total hip BMD and from 3 % (Canada) to 8 % (France, Germany, Italy, and Spain) when spine BMD data were included. Up to 49 million individuals met the WHO osteoporosis criteria in a number of industrialized countries in North America, Europe, Japan, and Australia.

  7. Projecting School Psychology Staffing Needs Using a Risk-Adjusted Model.

    ERIC Educational Resources Information Center

    Stellwagen, Kurt

    A model is proposed to project optimal school psychology service ratios based upon the percentages of at risk students enrolled within a given school population. Using the standard 1:1,000 service ratio advocated by The National Association of School Psychologists (NASP) as a starting point, ratios are then adjusted based upon the size of three…

  8. Socioeconomic Condition and Prevalence of Malaria Fever in Pakistani Children: Findings from a Community Health Survey.

    PubMed

    Asif, Atta Muhammad; Tahir, Muhammad Ramzan; Arshad, Irshad Ahmad

    2018-06-01

    We assessed the prevalence of malarial fever and its association with demographic and socioeconomic factors in children <5 years of age. Using the data of Pakistan Demographic and Health Survey (PDHS), the socioeconomic condition (SEC) was assessed by using a household wealth index as a proxy indicator, generated through principal component analysis. Two-stage sampling was used for selection of households, and multilevel logistic regression analysis was performed. The PDHS contains 10 935 children <5 years of age with valid information about malaria fever. In total, 36% (3930) children have malaria 2 weeks before the survey. A decreasing trend in prevalence of malaria fever was found with increasing SEC. Compared with SEC Quintile V, children of SEC Quintile I were more likely to get fever [adjusted odds ratio (AOR)=1.40 (1.15-1.69)] and of SEC Quintile II [AOR = 1.23 (1.03-1.45)]. SEC has a significant impact on the prevalence of malaria fever in the context of different regions in Pakistan.

  9. Approaches of aroma extraction dilution analysis (AEDA) for headspace solid phase microextraction and gas chromatography-olfactometry (HS-SPME-GC-O): Altering sample amount, diluting the sample or adjusting split ratio?

    PubMed

    Feng, Yunzi; Cai, Yu; Sun-Waterhouse, Dongxiao; Cui, Chun; Su, Guowan; Lin, Lianzhu; Zhao, Mouming

    2015-11-15

    Aroma extract dilution analysis (AEDA) is widely used for the screening of aroma-active compounds in gas chromatography-olfactometry (GC-O). In this study, three aroma dilution methods, (I) using different test sample volumes, (II) diluting samples, and (III) adjusting the GC injector split ratio, were compared for the analysis of volatiles by using HS-SPME-AEDA. Results showed that adjusting the GC injector split ratio (III) was the most desirable approach, based on the linearity relationships between Ln (normalised peak area) and Ln (normalised flavour dilution factors). Thereafter this dilution method was applied in the analysis of aroma-active compounds in Japanese soy sauce and 36 key odorants were found in this study. The most intense aroma-active components in Japanese soy sauce were: ethyl 2-methylpropanoate, ethyl 2-methylbutanoate, ethyl 3-methylbutanoate, ethyl 4-methylpentanoate, 3-(methylthio)propanal, 1-octen-3-ol, 2-methoxyphenol, 4-ethyl-2-methoxyphenol, 2-methoxy-4-vinylphenol, 2-phenylethanol, and 4-hydroxy-5-ethyl-2-methyl-3(2H)-furanone. Copyright © 2015. Published by Elsevier Ltd.

  10. Mapping the Prevalence of Physical Inactivity in U.S. States, 1984-2015

    PubMed Central

    Xiang, Xiaoling; Yang, Yan; Yan, Hai

    2016-01-01

    Background Physical inactivity is a leading cause of morbidity, disability and premature mortality in the U.S. and worldwide. This study aimed to map the prevalence of physical inactivity across U.S. states over the past three decades, and estimate the over-time adjusted changes in the prevalence of physical inactivity in each state. Methods Individual-level data (N = 6,701,954) were taken from the 1984–2015 Behavioral Risk Factor Surveillance System (BRFSS), an annually repeated cross-sectional survey of state-representative adult population. Prevalence of self-reported leisure-time physical inactivity was estimated by state and survey year, accounting for the BRFSS sampling design. Logistic regressions were performed to estimate the changes in the prevalence of physical inactivity over the study period for each state, adjusting for individual characteristics including sex, age, race/ethnicity, education, marital status, and employment status. Results The prevalence of leisure-time physical inactivity varied substantially across states and survey years. In general, the adjusted prevalence of physical inactivity gradually declined over the past three decades in a majority of states. However, a substantial proportion of American adults remain physically inactive. Among the 50 states and District of Columbia, 45 had over a fifth of their adult population without any leisure-time physical activity, and 8 had over 30% without physical activity in 2015. Moreover, the adjusted prevalence of physical inactivity in several states (Arizona, North Carolina, North Dakota, Utah, West Virginia, and Wyoming) remained largely unchanged or even increased (Minnesota and Ohio) over the study period. Conclusions Although the prevalence of physical inactivity declined over the past three decades in a majority of states, the rates remain substantially high and vary considerably across states. Closely monitoring and tracking physical activity level using the state physical activity

  11. Trends of obesity prevalence among Spanish adults with diabetes, 1987-2012.

    PubMed

    Basterra-Gortari, Francisco Javier; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; Gea, Alfredo; Sayón-Orea, Carmen; Martínez-González, Miguel Ángel

    2018-04-24

    Our aim was to examine the secular trends in obesity prevalence among Spanish adults with diabetes. Data were collected from 8 waves (from 1987 to 2012) of the National Health Surveys (NHS). NHS are cross-sectional studies conducted in representative samples of the Spanish adult population. Data of 7378 adults (≥16 years) who reported having been diagnosed of diabetes were analyzed. Previously validated self-reported weight and height were used to estimate body mass index (BMI). Obesity was defined as a BMI of 30kg/m 2 or greater. Age-adjusted obesity prevalence for each wave was calculated by the direct standardization method. From 1987 to 2012 age-adjusted prevalence of obesity among persons with diabetes increased from 18.2% (95% confidence interval [CI]: 14.2-22.2%) to 39.8% (95% CI: 36.8-42.8%). Age-adjusted prevalence of obesity in males with diabetes increased from 13.2% (95% CI: 7.3-19.1%) to 38.0% (95% CI: 33.8-42.1%) and in females from 23.0% (95% CI: 17.6-28.4%) to 42.3% (95% CI: 38.0-46.6%). Between 1987 and 2012 the prevalence of obesity markedly increased in Spain among adults with diabetes. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  12. Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend.

    PubMed

    Mainous, Arch G; Tanner, Rebecca J; Jo, Ara; Anton, Stephen D

    2016-07-01

    Trends in sedentary lifestyle may have influenced adult body composition and metabolic health among individuals at presumably healthy weights. This study examines the nationally representative prevalence of prediabetes and abdominal obesity among healthy-weight adults in 1988 through 2012. We analyzed the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES for the years 1999 to 2012, focusing on adults aged 20 years and older who have a body mass index (BMI) of 18.5 to 24.99 and do not have diabetes, either diagnosed or undiagnosed. We defined prediabetes using glycated hemoglobin (HbA1c) level ranges from 5.7% to 6.4%, as specified by the American Diabetes Association. Abdominal obesity was measured by waist circumference and waist-to-height ratio. The prevalence of prediabetes among healthy-weight adults, aged 20 years and older and without diagnosed or undiagnosed diabetes, increased from 10.2% in 1988-1994 to 18.5% in 2012. Among individuals aged 45 years and older, the prevalence of prediabetes increased from 22.0% to 33.1%. The percentage of adults aged 20 years and older with an unhealthy waist circumference increased from 5.6% in 1988-1994 to 7.6% in 2012. The percentage of individuals with an unhealthy waist-to-height ratio increased from 27.2% in 1988-1994 to 33.7% in 2012. Adjusted models found that measures of abdominal obesity were not independent predictors of prediabetes among adults with a healthy BMI. Among individuals within a healthy BMI range, the prevalence of prediabetes and abdominal obesity has substantially increased. Abdominal obesity does not appear to be the primary cause of the increase. © 2016 Annals of Family Medicine, Inc.

  13. Prevalence of Prediabetes and Abdominal Obesity Among Healthy-Weight Adults: 18-Year Trend

    PubMed Central

    Mainous, Arch G.; Tanner, Rebecca J.; Jo, Ara; Anton, Stephen D.

    2016-01-01

    PURPOSE Trends in sedentary lifestyle may have influenced adult body composition and metabolic health among individuals at presumably healthy weights. This study examines the nationally representative prevalence of prediabetes and abdominal obesity among healthy-weight adults in 1988 through 2012. METHODS We analyzed the National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and NHANES for the years 1999 to 2012, focusing on adults aged 20 years and older who have a body mass index (BMI) of 18.5 to 24.99 and do not have diabetes, either diagnosed or undiagnosed. We defined prediabetes using glycated hemoglobin (HbA1c) level ranges from 5.7% to 6.4%, as specified by the American Diabetes Association. Abdominal obesity was measured by waist circumference and waist-to-height ratio. RESULTS The prevalence of prediabetes among healthy-weight adults, aged 20 years and older and without diagnosed or undiagnosed diabetes, increased from 10.2% in 1988–1994 to 18.5% in 2012. Among individuals aged 45 years and older, the prevalence of prediabetes increased from 22.0% to 33.1%. The percentage of adults aged 20 years and older with an unhealthy waist circumference increased from 5.6% in 1988–1994 to 7.6% in 2012. The percentage of individuals with an unhealthy waist-to-height ratio increased from 27.2% in 1988–1994 to 33.7% in 2012. Adjusted models found that measures of abdominal obesity were not independent predictors of prediabetes among adults with a healthy BMI. CONCLUSIONS Among individuals within a healthy BMI range, the prevalence of prediabetes and abdominal obesity has substantially increased. Abdominal obesity does not appear to be the primary cause of the increase. PMID:27401417

  14. Using Relative Statistics and Approximate Disease Prevalence to Compare Screening Tests.

    PubMed

    Samuelson, Frank; Abbey, Craig

    2016-11-01

    Schatzkin et al. and other authors demonstrated that the ratios of some conditional statistics such as the true positive fraction are equal to the ratios of unconditional statistics, such as disease detection rates, and therefore we can calculate these ratios between two screening tests on the same population even if negative test patients are not followed with a reference procedure and the true and false negative rates are unknown. We demonstrate that this same property applies to an expected utility metric. We also demonstrate that while simple estimates of relative specificities and relative areas under ROC curves (AUC) do depend on the unknown negative rates, we can write these ratios in terms of disease prevalence, and the dependence of these ratios on a posited prevalence is often weak particularly if that prevalence is small or the performance of the two screening tests is similar. Therefore we can estimate relative specificity or AUC with little loss of accuracy, if we use an approximate value of disease prevalence.

  15. Prevalence of and disparities in HIV-related sexual risk behaviours among Chinese youth in relation to sexual orientation: a cross-sectional study.

    PubMed

    Guo, Chao; Zhang, Lei; Wang, Zhenjie; Chen, Gong; Zheng, Xiaoying

    2016-06-02

    Background: The aim of this study was to calculate the prevalence rate of HIV-related sexual risk behaviours (HSRB) among Chinese youth and determine whether there was an association between sexual orientation and HSRB. Methods: This study used a nationally representative survey of youth aged 15-24 years in China. Population numbers, prevalence, and proportions were calculated where appropriate. χ2 tests were used to determine the difference within categorical variables. Multivariate logistic regression was used to calculate the adjusted odd ratios (AOR) and 95% confidence interval (CI). Results: The rate of any HSRB among sexually active youth was 79.43%, and the most common HSRB was lack of condom use during the first sexual experience (66.02%). After adjusting for demographic and socioeconomic variables (sex, age, residence, living with parents or not, father's education and annual family income), non-heterosexual orientation was found to significantly increase the odds of HSRB (AOR = 2.42, 95% CI: 1.16-5.05). Conclusions: Non-heterosexual youth are at a higher risk of partaking in HSRB. The high prevalence of HSRB indicates the insufficiency of sex education for Chinese youth, especially for non-heterosexual youth. Greater efforts should be made to increase reproductive and sexual health services for Chinese youth.

  16. Association between family history risk categories and prevalence of diabetes in Chinese population.

    PubMed

    Zhang, Jinping; Yang, Zhaojun; Xiao, Jianzhong; Xing, Xiaoyan; Lu, Juming; Weng, Jianping; Jia, Weiping; Ji, Linong; Shan, Zhongyan; Liu, Jie; Tian, Haoming; Ji, Qiuhe; Zhu, Dalong; Ge, Jiapu; Chen, Li; Guo, Xiaohui; Zhao, Zhigang; Li, Qiang; Zhou, Zhiguang; Lin, Lixiang; Wang, Na; Yang, Wenying

    2015-01-01

    To investigate the association between different family history risk categories and prevalence of diabetes in the Chinese population. The family history of diabetes was obtained from each subject, and an oral glucose tolerance test was performed for measuring the fasting and postload glucose and insulin levels based on a national representative cross-sectional survey of 46,239 individuals (age ≥ 20 years) in the 2007-2008 China National Diabetes and Metabolism Disorders Study. The family history risk categories of diabetes were high, moderate, and average (FH2 and FH1: at least two generations and one generation of first-degree relatives with diabetes, respectively; FH0: no first-degree relatives with diabetes). The age- and gender-adjusted prevalence rates of diabetes were 32.7% (95% confidence interval (CI): 26.4-39.7%) in FH2, 20.1% (95% CI: 18.2-22.1%) in FH1, and 8.4% (95% CI: 7.9-8.9%) in FH0 (P < 0.0001). The calculated homeostatic model assessment-estimated insulin resistance (HOMA-IR), Matsuda insulin sensitivity index (ISI), and insulinogenic index (ΔI30/ΔG30) values showed significant trending changes among the three risk categories, with the most negative effects in FH2. Multivariate logistic regression analysis showed that the odds ratios of having diabetes were 6.16 (95% CI: 4.46-8.50) and 2.86 (95% CI: 2.41-3.39) times higher in FH2 and FH1, respectively, than in FH0 after adjustment for classical risk factors for diabetes. Family history risk categories of diabetes have a significant, independent, and graded association with the prevalence of this disease in the Chinese population.

  17. Ethnic differences in the prevalence of metabolic syndrome: results from a multi-ethnic population-based survey in Malaysia.

    PubMed

    Rampal, Sanjay; Mahadeva, Sanjiv; Guallar, Eliseo; Bulgiba, Awang; Mohamed, Rosmawati; Rahmat, Ramlee; Arif, Mohamad Taha; Rampal, Lekhraj

    2012-01-01

    The prevalence of metabolic syndrome is increasing disproportionately among the different ethnicities in Asia compared to the rest of the world. This study aims to determine the differences in the prevalence of metabolic syndrome across ethnicities in Malaysia, a multi-ethnic country. In 2004, we conducted a national cross-sectional population-based study using a stratified two-stage cluster sampling design (N = 17,211). Metabolic syndrome was defined according to the International Diabetes Federation/National Heart, Lung and Blood Institute/American Heart Association (IDF/NHLBI/AHA-2009) criteria. Multivariate models were used to study the independent association between ethnicity and the prevalence of the metabolic syndrome. The overall mean age was 36.9 years, and 50.0% participants were female. The ethnic distribution was 57.0% Malay, 28.5% Chinese, 8.9% Indian and 5.0% Indigenous Sarawakians. The overall prevalence of the metabolic syndrome was 27.5%, with a prevalence of central obesity, raised triglycerides, low high density lipoprotein cholesterol, raised blood pressure and raised fasting glucose of 36.9%, 29.3%, 37.2%, 38.0% and 29.1%, respectively. Among those <40 years, the adjusted prevalence ratios for metabolic syndrome for ethnic Chinese, Indians, and Indigenous Sarawakians compared to ethnic Malay were 0.81 (95% CI 0.67 to 0.96), 1.42 (95% CI 1.19 to 1.69) and 1.37 (95% CI 1.08 to 1.73), respectively. Among those aged ≥40 years, the corresponding prevalence ratios were 0.86 (95% CI 0.79 to 0.92), 1.25 (95% CI 1.15 to 1.36), and 0.94 (95% CI 0.80, 1.11). The P-value for the interaction of ethnicity by age was 0.001. The overall prevalence of metabolic syndrome in Malaysia was high, with marked differences across ethnicities. Ethnic Chinese had the lowest prevalence of metabolic syndrome, while ethnic Indians had the highest. Indigenous Sarawakians showed a marked increase in metabolic syndrome at young ages.

  18. Ethnic Differences in the Prevalence of Metabolic Syndrome: Results from a Multi-Ethnic Population-Based Survey in Malaysia

    PubMed Central

    Guallar, Eliseo; Bulgiba, Awang; Mohamed, Rosmawati; Rahmat, Ramlee; Arif, Mohamad Taha; Rampal, Lekhraj

    2012-01-01

    Introduction The prevalence of metabolic syndrome is increasing disproportionately among the different ethnicities in Asia compared to the rest of the world. This study aims to determine the differences in the prevalence of metabolic syndrome across ethnicities in Malaysia, a multi-ethnic country. Methods In 2004, we conducted a national cross-sectional population-based study using a stratified two-stage cluster sampling design (N = 17,211). Metabolic syndrome was defined according to the International Diabetes Federation/National Heart, Lung and Blood Institute/American Heart Association (IDF/NHLBI/AHA-2009) criteria. Multivariate models were used to study the independent association between ethnicity and the prevalence of the metabolic syndrome. Results The overall mean age was 36.9 years, and 50.0% participants were female. The ethnic distribution was 57.0% Malay, 28.5% Chinese, 8.9% Indian and 5.0% Indigenous Sarawakians. The overall prevalence of the metabolic syndrome was 27.5%, with a prevalence of central obesity, raised triglycerides, low high density lipoprotein cholesterol, raised blood pressure and raised fasting glucose of 36.9%, 29.3%, 37.2%, 38.0% and 29.1%, respectively. Among those <40 years, the adjusted prevalence ratios for metabolic syndrome for ethnic Chinese, Indians, and Indigenous Sarawakians compared to ethnic Malay were 0.81 (95% CI 0.67 to 0.96), 1.42 (95% CI 1.19 to 1.69) and 1.37 (95% CI 1.08 to 1.73), respectively. Among those aged ≥40 years, the corresponding prevalence ratios were 0.86 (95% CI 0.79 to 0.92), 1.25 (95% CI 1.15 to 1.36), and 0.94 (95% CI 0.80, 1.11). The P-value for the interaction of ethnicity by age was 0.001. Conclusions The overall prevalence of metabolic syndrome in Malaysia was high, with marked differences across ethnicities. Ethnic Chinese had the lowest prevalence of metabolic syndrome, while ethnic Indians had the highest. Indigenous Sarawakians showed a marked increase in metabolic syndrome at young

  19. Prevalence of obesity and diabetes in Spanish adults 1987-2012.

    PubMed

    Basterra-Gortari, Francisco Javier; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; Gea, Alfredo; Martinez-Gonzalez, Miguel Ángel

    2017-03-22

    The prevalence of obesity and diabetes mellitus (DM) has increased worldwide. Our objective was to examine trends in the prevalence of overweight, obesity, morbid obesity and DM in Spain from 1987 to 2012. Data were obtained from 8 waves of the national health surveys which are cross-sectional studies conducted in representative samples of the Spanish adult population. Self-reported data of 156,440 adults (≥16 years) from 1987 to 2012 were used. Body mass index (BMI) was calculated from self-reported weight and height. Overweight was defined as a BMI of 25.0 to 29.9kg/m 2 , obesity as a BMI≥30kg/m 2 and morbid obesity as a BMI≥40kg/m 2 . DM was considered present if the participant reported having been diagnosed. Age-adjusted prevalence was adjusted by the direct standardisation method to the 2003 survey population. From 1987 to 2012 age-adjusted prevalence of overweight increased from 34.0% (95% confidence interval [95% CI] 33.2-34.8) to 35.8% (95% CI 35.0-36.6), prevalence of obesity from 8.0% (95% CI 7.5-8.5) to 16.5% (95% CI 15.7-17.1%) and DM prevalence from 4.2% (95% CI 3.9-4.5) to 7.1% (95% CI 6.7-7.4%). Morbid obesity increased from 0.20% (95% CI 0.13-0.27) in 1993 to 0.88% (95% CI 0.70-1.05) in 2012. The growth rate was greater among males. An increasing trend of the prevalence of overweight, obesity, morbid obesity and DM was found in Spain from 1987 to 2012, particularly in males. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  20. A gigawatt level repetitive rate adjustable magnetic pulse compressor.

    PubMed

    Li, Song; Gao, Jing-Ming; Yang, Han-Wu; Qian, Bao-Liang; Li, Ze-Xin

    2015-08-01

    In this paper, a gigawatt level repetitive rate adjustable magnetic pulse compressor is investigated both numerically and experimentally. The device has advantages of high power level, high repetitive rate achievability, and long lifetime reliability. Importantly, dominate parameters including the saturation time, the peak voltage, and even the compression ratio can be potentially adjusted continuously and reliably, which significantly expands the applicable area of the device and generators based on it. Specifically, a two-stage adjustable magnetic pulse compressor, utilized for charging the pulse forming network of a high power pulse generator, is designed with different compression ratios of 25 and 18 through an optimized design process. Equivalent circuit analysis shows that the modification of compression ratio can be achieved by just changing the turn number of the winding. At the same time, increasing inductance of the grounded inductor will decrease the peak voltage and delay the charging process. Based on these analyses, an adjustable compressor was built and studied experimentally in both the single shot mode and repetitive rate mode. Pulses with peak voltage of 60 kV and energy per pulse of 360 J were obtained in the experiment. The rise times of the pulses were compressed from 25 μs to 1 μs and from 18 μs to 1 μs, respectively, at repetitive rate of 20 Hz with good repeatability. Experimental results show reasonable agreement with analyses.

  1. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students

    PubMed Central

    2016-01-01

    Background and Aims Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. Methods Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. Results The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06–2.06) and age group (odds ratio: 1.34, 95% CI: 1.01–1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08–2.17, P < 0.05). Conclusions Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among

  2. An evaluation of bias in propensity score-adjusted non-linear regression models.

    PubMed

    Wan, Fei; Mitra, Nandita

    2018-03-01

    Propensity score methods are commonly used to adjust for observed confounding when estimating the conditional treatment effect in observational studies. One popular method, covariate adjustment of the propensity score in a regression model, has been empirically shown to be biased in non-linear models. However, no compelling underlying theoretical reason has been presented. We propose a new framework to investigate bias and consistency of propensity score-adjusted treatment effects in non-linear models that uses a simple geometric approach to forge a link between the consistency of the propensity score estimator and the collapsibility of non-linear models. Under this framework, we demonstrate that adjustment of the propensity score in an outcome model results in the decomposition of observed covariates into the propensity score and a remainder term. Omission of this remainder term from a non-collapsible regression model leads to biased estimates of the conditional odds ratio and conditional hazard ratio, but not for the conditional rate ratio. We further show, via simulation studies, that the bias in these propensity score-adjusted estimators increases with larger treatment effect size, larger covariate effects, and increasing dissimilarity between the coefficients of the covariates in the treatment model versus the outcome model.

  3. Prevalence and Associated Factors of Subjective Halitosis in Korean Adolescents

    PubMed Central

    Kim, So Young; Sim, Songyong; Kim, Sung-Gyun; Park, Bumjung; Choi, Hyo Geun

    2015-01-01

    This study was conducted to estimate the prevalence and associated factors of subjective halitosis in adolescents. In total, 359,263 participants were selected from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2009 through 2013. Demographic data including age, sex, obesity and residency; psychosocial factors such as subjective health, stress, and economic levels; and dietary factors such as alcohol consumption; smoking; and fruit, soda, fast food, instant noodle, confection, and vegetable consumption were analyzed for correlations with halitosis using simple and multiple logistic regression analyses with complex sampling. In total, 23.6% of the participants reported the presence of halitosis. The following subjectively assessed factors were related to halitosis: poor health status (adjusted odds ratio [AOR] = 2.56), overweight or obese (AOR = 1.37), stress (AOR = 2.56), and lower economic levels (AOR = 1.85). The high intake of fast food (AOR = 1.15), instant noodles (AOR = 1.17), and confections (AOR = 1.17) and the low intake of fruits (AOR = 1.22) and vegetables (AOR = 1.19) were also related to halitosis. The prevalence of subjective halitosis in the studied adolescents was 23.6%. Specific psychosocial factors and dietary intake were related to halitosis. PMID:26461837

  4. Prevalence and Associated Factors of Subjective Halitosis in Korean Adolescents.

    PubMed

    Kim, So Young; Sim, Songyong; Kim, Sung-Gyun; Park, Bumjung; Choi, Hyo Geun

    2015-01-01

    This study was conducted to estimate the prevalence and associated factors of subjective halitosis in adolescents. In total, 359,263 participants were selected from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2009 through 2013. Demographic data including age, sex, obesity and residency; psychosocial factors such as subjective health, stress, and economic levels; and dietary factors such as alcohol consumption; smoking; and fruit, soda, fast food, instant noodle, confection, and vegetable consumption were analyzed for correlations with halitosis using simple and multiple logistic regression analyses with complex sampling. In total, 23.6% of the participants reported the presence of halitosis. The following subjectively assessed factors were related to halitosis: poor health status (adjusted odds ratio [AOR] = 2.56), overweight or obese (AOR = 1.37), stress (AOR = 2.56), and lower economic levels (AOR = 1.85). The high intake of fast food (AOR = 1.15), instant noodles (AOR = 1.17), and confections (AOR = 1.17) and the low intake of fruits (AOR = 1.22) and vegetables (AOR = 1.19) were also related to halitosis. The prevalence of subjective halitosis in the studied adolescents was 23.6%. Specific psychosocial factors and dietary intake were related to halitosis.

  5. Relationship Between Coffee Consumption and Prevalence of Metabolic Syndrome Among Japanese Civil Servants

    PubMed Central

    Matsuura, Hideo; Mure, Kanae; Nishio, Nobuhiro; Kitano, Naomi; Nagai, Naoko; Takeshita, Tatsuya

    2012-01-01

    Background Metabolic syndrome has become a major worldwide public health problem. We examined the relationship between coffee consumption and the prevalence of metabolic syndrome among Japanese civil servants. Methods The study participants were 3284 employees (2335 men and 948 women) aged 20 to 65 years. Using data from their 2008 health checkup records, we analyzed the relationship between coffee consumption and the prevalence of metabolic syndrome. Metabolic syndrome was defined according to the Japanese criteria. Results Metabolic syndrome was diagnosed in 374 of the 2335 men (16.0%) and 32 of the 948 women (3.4%). In univariate and multiple logistic regression analyses, the odds ratios (ORs) among men for the presence of metabolic syndrome were 0.79 (95% CI: 0.56–1.03) and 0.61 (0.39–0.95), respectively, among moderate (≥4 cups of coffee per day) coffee drinkers as compared with non-coffee drinkers. Among all components of metabolic syndrome, high blood pressure and high triglyceride level were inversely associated with moderate coffee consumption in men, after adjusting for age, body mass index, smoking status, drinking status, and exercise. However, in women, moderate coffee consumption was not significantly associated with the prevalence of metabolic syndrome or its components. Conclusions Moderate coffee consumption was significantly associated with lower prevalence of metabolic syndrome in Japanese male civil servants. PMID:22343325

  6. Prevalence of acute repetitive seizures (ARS) in the United Kingdom.

    PubMed

    Martinez, Carlos; Sullivan, Tim; Hauser, W Allen

    2009-12-01

    "Acute repetitive seizures" (ARS) is a term to describe a condition manifest by multiple seizures occurring over a relatively brief period of time -generally 24 hours- in patients with epilepsy. There is limited information regarding the epidemiology of ARS in the general population. We performed a historical cohort study using data from the United Kingdom General Practice Research Database (GPRD) to identify all incident and prevalent cases of active epilepsy in 2005. From among this group, we identified individuals at risk for ARS. This included those with "catastrophic epilepsy syndromes of childhood" (CE), and those with a history of seizure clustering in the context of other epilepsy syndromes. We identified 21,010 people with active epilepsy in the GPRD in 2005; prevalence 7.2/1000; age adjusted to the European Standard Population, 6.7; incidence 50/100,000 per year, age-adjusted 48/100,000. We identified 665 people at risk for ARS. The prevalence of CE in the general population was 1.2/10,000 and that of cluster seizures was 1.1/10,000. We estimated the crude prevalence of ARS in the general population to be 2.3/10,000; age adjusted 2.5 (CI, 2.3-2.7. The prevalence of ARS was highest in those 0-4 years of age (5.9/10,000) and fell with advancing age to 0.5/10,000 in those age 70 and older). This is the first population-based study to provide information on the prevalence of ARS. ARS affects about 3% of the population with epilepsy and 0.02% of the general population. More studies are needed to further evaluate this serious epilepsy phenomenon.

  7. Adherence to a Mediterranean diet is associated with lower prevalence of osteoarthritis: Data from the osteoarthritis initiative.

    PubMed

    Veronese, Nicola; Stubbs, Brendon; Noale, Marianna; Solmi, Marco; Luchini, Claudio; Smith, Toby O; Cooper, Cyrus; Guglielmi, Giuseppe; Reginster, Jean-Yves; Rizzoli, Renè; Maggi, Stefania

    2017-12-01

    The Mediterranean diet appears to be beneficial for several medical conditions, but data regarding osteoarthritis (OA) are not available. The aim of this study was to investigate if adherence to the Mediterranean diet is associated with a lower prevalence of OA of the knee in a large cohort from North America. 4358 community-dwelling participants (2527 females; mean age: 61.2 years) from the Osteoarthritis Initiative were included. Adherence to the Mediterranean diet was evaluated through a validated Mediterranean diet score (aMED) categorized into quartiles (Q). Knee OA was diagnosed both clinically and radiologically. The strength of the association between aMED (divided in quartiles) and knee OA was investigated through a logistic regression analysis and reported as odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for potential confounders. Participants with a higher adherence to Mediterranean diet had a significantly lower prevalence of knee OA compared to those with lower adherence (Q4: 25.2% vs. Q1: 33.8%; p < 0.0001). Using a logistic regression analysis, adjusting for 10 potential confounders with those in the lowest quartile of aMED as reference, participants with the highest aMED had a significant reduction in presence of knee OA (OR, 0.83; 95% CIs: 0.69-0.99, p = 0.04). Among the individual components of Mediterranean diet, only higher use of cereals was associated with lower odds of having knee OA (OR: 0.76; 95%CI: 0.60-0.98; p = 0.03). Higher adherence to a Mediterranean diet is associated with lower prevalence of knee OA. This remained when adjusting for potential confounders. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. Climatic factors are associated with childhood eczema prevalence in US

    PubMed Central

    Silverberg, Jonathan I.; Hanifin, Jon; Simpson, Eric L.

    2013-01-01

    Atopic dermatitis (AD, atopic eczema) is driven by a complex relationship between genetic predisposition and environmental exposures. We sought to determine the impact of specific climatic factors on the US prevalence of AD. We used a merged analysis of the 2007 National Survey of Children's Health from a representative sample of 91,642 children age 0–17 years and the 2006–2007 National Climate Data Center and Weather Service measurements of relative humidity (%), indoor heating degree days (HDD), clear sky UV indices ozone levels, and outdoor air temperature. As a proxy for AD, we used an affirmative response to the NSCH survey question asking whether the participant’s child has been given a doctor diagnosis of “eczema or any other kind of skin allergy” in the previous 12 months. In multivariate models controlling for sex, race/ethnicity, age and household income, eczema prevalence was significantly lower with highest-quartile mean annual relative humidity (logistic regression, adjusted odds ratio [95% confidence interval]=0.82 [0.71–0.96], P=0.01) and issued UV index (0.73 [0.64–0.84], P<0.0001), and with two other factors associated with increased UV exposure. Eczema prevalence was decreased with highest-quartile air temperature (0.80 [0.70–0.92], P=0.002), but increased with 3rd–quartile mean annual HDD (1.26 [1.11–1.43], P=0.0003). This study provides evidence of climate influences on the US prevalence of childhood eczema. PMID:23334343

  9. Prevalence of hepatitis E virus antibodies, Israel, 2009-2010.

    PubMed

    Mor, Orna; Bassal, Ravit; Michaeli, Michal; Wax, Marina; Ram, Daniela; Cohen-Ezra, Oranit; Cohen, Dani; Mendelson, Ella; Ben-Ari, Ziv; Shohat, Tamy

    2015-04-01

    We investigated prevalence of hepatitis E virus in a sample of the population of Israel. The overall seroprevalence of antibodies to the virus was 10.6% (95% CI 8.4%-13.0%); age-adjusted prevalence was 7.6%. Seropositivity was associated with age, Arab ethnicity, low socioeconomic status, and birth in Africa, Asia, or the former Soviet Union.

  10. Prevalence of musculoskeletal injuries sustained by students while attending a chiropractic college.

    PubMed

    Ndetan, Harrison T; Rupert, Ronald L; Bae, Sejong; Singh, Karan P

    2009-02-01

    The purpose of this study was to assess the prevalence, distribution, severity, risk factors of, and response to musculoskeletal injuries to the low back, hand/wrist, and neck/shoulder among chiropractic students while receiving and/or administering adjustments/manipulation while attending a chiropractic college. The study was an epidemiologic survey of chiropractic students at all levels of training (n = 890) at one chiropractic college. A self-administered anonymous 3-paged questionnaire was used. The questionnaire was divided into sections for collecting data separately on injuries associated with receiving or administering chiropractic adjustments. The response rate was 64.3% with 62.6% male respondents. The overall prevalence of injuries sustained in college was 31.5%, 44.4% of which was exacerbations of prior complaints. Injuries from receiving adjustments/manipulation were most prevalent to neck/shoulder (65.7%), whereas hand/wrist injuries were most common when administering adjustments (45.6%). The risk difference among students receiving adjustments was 81.6/1000 neck/shoulder injuries, and the etiologic fraction was 76.6%. The risk difference was 170/1000 hand/wrist injuries with etiologic fraction of 96.5% among students administering adjustments. Diversified, Gonstead, and upper cervical adjusting techniques were perceived to be the most injury-related. Some students enroll in a chiropractic college with preexisting injuries that can easily be exacerbated. Others sustain new injuries of moderate severity from receiving and administering adjustments. Potential risk factors may include height, body mass index, and nonexercising. The risk factors and mechanisms responsible for the high levels of hand/wrist injuries need further examination. This research identifies an important need to design a comprehensive and logical protocol to prevent injury to chiropractic students.

  11. [Individual and contextual determinants of the prevalence of untreated caries in Brazil].

    PubMed

    Frias, Antônio Carlos; Antunes, José Leopoldo Ferreira; Junqueira, Simone Rennó; Narvai, Paulo Capel

    2007-10-01

    To describe the prevalence of untreated caries among adolescents in Brazil and to analyze the association between caries and individual and contextual factors in the municipalities where these adolescents live. A Ministry of Health database (projeto SB-Brasil) provided health records on 16 833 adolescents from 15-19 years of age. The study variable used was the presence of at least one permanent tooth having been lost to caries. The individual variables considered were: sex, ethnic group, living in an urban versus a rural area, and being a student or not. Contextual variables related to the municipality were: municipal human development index (MHDI), proportion of households connected to the water system, and water fluoridation for 5 years or more. Multilevel logistic regression analysis was carried out to adjust the outcome to the individual and contextual variables. Individual determinants related to a higher probability of untreated caries were: the ethnic group described as "black or brown," (adjusted odds ratio, OR(adjust) = 1.79; 1.68 to 1.92); and living in a rural area (OR(adjust) = 1.31; 1.19 to 1.45). Being a student was identified as a protective factor (OR(adjust) = 0.67; 0.62 to 0.73). Secondary variables identified as contextual determinants of caries were MHDI (adjusted coefficient beta = -0.213), water fluoridation (beta = -0.201), and households connected to the water system (beta = -0.197). The results show inequalities in the distribution of health services in the various Brazilian regions, and suggest that inequalities may also be present in the effectiveness of the services provided. Policies to increase access to fluoride-treated water and school enrollment may contribute to preventing caries in adolescents.

  12. Prevalence and Evolution of Renal Impairment in People Living With HIV in Rural Tanzania.

    PubMed

    Mapesi, Herry; Kalinjuma, Aneth V; Ngerecha, Alphonce; Franzeck, Fabian; Hatz, Christoph; Tanner, Marcel; Mayr, Michael; Furrer, Hansjakob; Battegay, Manuel; Letang, Emilio; Weisser, Maja; Glass, Tracy R

    2018-04-01

    We assessed the prevalence, incidence, and predictors of renal impairment among people living with HIV (PLWHIV) in rural Tanzania. In a cohort of PLWHIV aged ≥15 years enrolled from January 2013 to June 2016, we assessed the association between renal impairment (estimated glomerural filtration rate < 90 mL/min/1.73 m 2 ) at enrollment and during follow-up with demographic and clinical characteristcis using logistic regression and Cox proportional hazards models. Of 1093 PLWHIV, 172 (15.7%) had renal impairment at enrollment. Of 921 patients with normal renal function at baseline, 117 (12.7%) developed renal impairment during a median follow-up (interquartile range) of 6.2 (0.4-14.7) months. The incidence of renal impairment was 110 cases per 1000 person-years (95% confidence interval [CI], 92-132). At enrollment, logistic regression identified older age (adjusted odds ratio [aOR], 1.79; 95% CI, 1.52-2.11), hypertension (aOR, 1.84; 95% CI, 1.08-3.15), CD4 count <200 cells/mm 3 (aOR, 1.80; 95% CI, 1.23-2.65), and World Health Organization (WHO) stage III/IV (aOR, 3.00; 95% CI, 1.96-4.58) as risk factors for renal impairment. Cox regression model confirmed older age (adjusted hazard ratio [aHR], 1.85; 95% CI, 1.56-2.20) and CD4 count <200 cells/mm 3 (aHR, 2.05; 95% CI, 1.36-3.09) to be associated with the development of renal impairment. Our study found a low prevalence of renal impairment among PLWHIV despite high usage of tenofovir and its association with age, hypertension, low CD4 count, and advanced WHO stage. These important and reassuring safety data stress the significance of noncommunicable disease surveillance in aging HIV populations in sub-Saharan Africa.

  13. Type of Vegetarian Diet, Body Weight, and Prevalence of Type 2 Diabetes

    PubMed Central

    Tonstad, Serena; Butler, Terry; Yan, Ru; Fraser, Gary E.

    2009-01-01

    OBJECTIVE We assessed the prevalence of type 2 diabetes in people following different types of vegetarian diets compared with that in nonvegetarians. RESEARCH DESIGN AND METHODS The study population comprised 22,434 men and 38,469 women who participated in the Adventist Health Study-2 conducted in 2002–2006. We collected self-reported demographic, anthropometric, medical history, and lifestyle data from Seventh-Day Adventist church members across North America. The type of vegetarian diet was categorized based on a food-frequency questionnaire. We calculated odds ratios (ORs) and 95% CIs using multivariate-adjusted logistic regression. RESULTS Mean BMI was lowest in vegans (23.6 kg/m2) and incrementally higher in lacto-ovo vegetarians (25.7 kg/m2), pesco-vegetarians (26.3 kg/m2), semi-vegetarians (27.3 kg/m2), and nonvegetarians (28.8 kg/m2). Prevalence of type 2 diabetes increased from 2.9% in vegans to 7.6% in nonvegetarians; the prevalence was intermediate in participants consuming lacto-ovo (3.2%), pesco (4.8%), or semi-vegetarian (6.1%) diets. After adjustment for age, sex, ethnicity, education, income, physical activity, television watching, sleep habits, alcohol use, and BMI, vegans (OR 0.51 [95% CI 0.40–0.66]), lacto-ovo vegetarians (0.54 [0.49–0.60]), pesco-vegetarians (0.70 [0.61–0.80]), and semi-vegetarians (0.76 [0.65–0.90]) had a lower risk of type 2 diabetes than nonvegetarians. CONCLUSIONS The 5-unit BMI difference between vegans and nonvegetarians indicates a substantial potential of vegetarianism to protect against obesity. Increased conformity to vegetarian diets protected against risk of type 2 diabetes after lifestyle characteristics and BMI were taken into account. Pesco- and semi-vegetarian diets afforded intermediate protection. PMID:19351712

  14. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.

    PubMed

    Tonstad, Serena; Butler, Terry; Yan, Ru; Fraser, Gary E

    2009-05-01

    We assessed the prevalence of type 2 diabetes in people following different types of vegetarian diets compared with that in nonvegetarians. The study population comprised 22,434 men and 38,469 women who participated in the Adventist Health Study-2 conducted in 2002-2006. We collected self-reported demographic, anthropometric, medical history, and lifestyle data from Seventh-Day Adventist church members across North America. The type of vegetarian diet was categorized based on a food-frequency questionnaire. We calculated odds ratios (ORs) and 95% CIs using multivariate-adjusted logistic regression. Mean BMI was lowest in vegans (23.6 kg/m(2)) and incrementally higher in lacto-ovo vegetarians (25.7 kg/m(2)), pesco-vegetarians (26.3 kg/m(2)), semi-vegetarians (27.3 kg/m(2)), and nonvegetarians (28.8 kg/m(2)). Prevalence of type 2 diabetes increased from 2.9% in vegans to 7.6% in nonvegetarians; the prevalence was intermediate in participants consuming lacto-ovo (3.2%), pesco (4.8%), or semi-vegetarian (6.1%) diets. After adjustment for age, sex, ethnicity, education, income, physical activity, television watching, sleep habits, alcohol use, and BMI, vegans (OR 0.51 [95% CI 0.40-0.66]), lacto-ovo vegetarians (0.54 [0.49-0.60]), pesco-vegetarians (0.70 [0.61-0.80]), and semi-vegetarians (0.76 [0.65-0.90]) had a lower risk of type 2 diabetes than nonvegetarians. The 5-unit BMI difference between vegans and nonvegetarians indicates a substantial potential of vegetarianism to protect against obesity. Increased conformity to vegetarian diets protected against risk of type 2 diabetes after lifestyle characteristics and BMI were taken into account. Pesco- and semi-vegetarian diets afforded intermediate protection.

  15. Higher cardiovascular disease prevalence and mortality among younger blacks compared to whites.

    PubMed

    Jolly, Stacey; Vittinghoff, Eric; Chattopadhyay, Arpita; Bibbins-Domingo, Kirsten

    2010-09-01

    Blacks have higher rates of cardiovascular disease than whites. The age at which these differential rates emerge has not been fully examined. We examined cardiovascular disease prevalence and mortality among black and white adults across the adult age spectrum and explored potential mediators of these differential disease prevalence rates. We conducted a cross-sectional analysis of National Health and Nutrition Examination Survey data from 1999-2006. We estimated age-adjusted and age-specific prevalence ratios (PR) for cardiovascular disease (heart failure, stroke, or myocardial infarction) for blacks versus whites in adults aged 35 years and older and examined potential explanatory factors. From the National Compressed Mortality File 5-year aggregate file of 1999-2003, we determined age-specific cardiovascular disease mortality rates. In young adulthood, cardiovascular disease prevalence was higher in blacks than whites (35-44 years PR 1.9; 95% confidence interval [CI], 1.1-3.4). The black-white PR decreased with each decade of advancing age (P for trend=.04), leading to a narrowing of the racial gap at older ages (65-74 years PR 1.2; 95% CI, 0.8-1.6; > or =75 years PR 1.0; 95% CI, 0.7-1.4). Clinical and socioeconomic factors mediated some, but not all, of the excess cardiovascular disease prevalence among young to middle-aged blacks. Over a quarter (28%) of all cardiovascular disease deaths among blacks occurred in those aged <65 years, compared with 13% among whites. Reducing black/white disparities in cardiovascular disease will require a focus on young and middle-aged blacks.

  16. Prevalence of type 2 diabetes and its association with measures of body composition among African residents in the Netherlands--The HELIUS study.

    PubMed

    Meeks, Karlijn A C; Stronks, Karien; Beune, Erik J A J; Adeyemo, Adebowale; Henneman, Peter; Mannens, Marcel M A M; Nicolaou, Mary; Peters, Ron J G; Rotimi, Charles N; Snijder, Marieke B; Agyemang, Charles

    2015-11-01

    To compare type 2 diabetes prevalence among three ethnic groups resident in the Netherlands: Ghanaians, African Surinamese and Dutch origin. Secondly, to determine the contribution of measures of body composition to ethnic differences in type 2 diabetes. Baseline data from Ghanaian (n=1873), African Surinamese (n=2189) and Dutch (n=2151) origin participants of the HELIUS study (aged 18-70 years) were analyzed. Type 2 diabetes was determined according to the WHO criteria. Logistic regression tested ethnic differences in type 2 diabetes and the contribution of body fat percentage and waist-to-hip ratio. Among men, type 2 diabetes prevalence was higher in Ghanaians (14.9%) than in African Surinamese (10.4%) and Dutch (5.0%). Among women, type 2 diabetes prevalence in Ghanaian (11.1%) was higher than in Dutch (2.3%), but similar to African Surinamese (11.5%). After adjusting for age, body fat percentage and waist-to-hip ratio, the odds ratios for having type 2 diabetes were 1.55 (95% CI: 1.12-2.15) for Ghanaian men compared with African Surinamese and 4.19 (95% CI: 2.86-6.12) compared with Dutch. Among women these odds ratios were 0.94 (95% CI: 0.70-1.26) and 4.78 (95% CI: 2.82-8.11). The higher prevalence of type 2 diabetes among Ghanaian compared with African Surinamese men suggests a need to distinguish between African descent populations when assessing their type 2 diabetes risk. The higher odds for type 2 diabetes among Ghanaians cannot be attributed to differences in body composition. Further research on the contribution of lifestyle factors as well as genetic and epigenetic factors is needed to identify the reasons for the observed disparities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. High Levels of Morbidity and Mortality Among Pediatric Hematopoietic Cell Transplant Recipients With Severe Sepsis: Insights From the Sepsis PRevalence, OUtcomes, and Therapies International Point Prevalence Study.

    PubMed

    Lindell, Robert B; Gertz, Shira J; Rowan, Courtney M; McArthur, Jennifer; Beske, Florian; Plunkett, Adrian; Weiss, Scott L; Thomas, Neal J; Nadkarni, Vinay M; Fitzgerald, Julie C

    2017-12-01

    Pediatric severe sepsis is a major cause of morbidity and mortality worldwide, and hematopoietic cell transplant patients represent a high-risk population. We assessed the epidemiology of severe sepsis in hematopoietic cell transplant patients, describing patient outcomes compared with children with no history of hematopoietic cell transplant. Secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study, comparing demographics, sepsis etiology, illness severity, organ dysfunction, and sepsis-related treatments in patients with and without hematopoietic cell transplant. The primary outcome was hospital mortality. Multivariable logistic regression models were used to determine adjusted differences in mortality. International; 128 PICUs in 26 countries. Pediatric patients with severe sepsis prospectively identified over a 1-year period. None. In patients with severe sepsis, 37/567 (6.5%) had a history of hematopoietic cell transplant. Compared with patients without hematopoietic cell transplant, hematopoietic cell transplant patients had significantly higher hospital mortality (68% vs 23%; p < 0.001). Hematopoietic cell transplant patients were more likely to have hospital acquired sepsis and had more preexisting renal and hepatic dysfunction than non-hematopoietic cell transplant patients with severe sepsis. History of hematopoietic cell transplant, renal replacement therapy, admission from inpatient floor, and number of organ dysfunctions at severe sepsis recognition were independently associated with hospital mortality in multivariable analysis; hematopoietic cell transplant conferred the highest odds of mortality (odds ratio, 4.00; 95% CI, 1.78-8.98). In secondary analysis of hematopoietic cell transplant patients compared with other immunocompromised patients with severe sepsis, history of hematopoietic cell transplant remained independently associated with hospital mortality (odds ratio, 3.03; 95% CI, 1.11-8.27). In an

  18. Atrial Fibrillation in Hypertrophic Cardiomyopathy: Prevalence, Clinical Correlations, and Mortality in a Large High‐Risk Population

    PubMed Central

    Siontis, Konstantinos C.; Geske, Jeffrey B.; Ong, Kevin; Nishimura, Rick A.; Ommen, Steve R.; Gersh, Bernard J.

    2014-01-01

    Background Atrial fibrillation (AF) is a common sequela of hypertrophic cardiomyopathy (HCM), but evidence on its prevalence, risk factors, and effect on mortality is sparse. We sought to evaluate the prevalence of AF, identify clinical and echocardiographic correlates, and assess its effect on mortality in a large high‐risk HCM population. Methods and Results We identified HCM patients who underwent evaluation at our institution from 1975 to 2012. AF was defined by known history (either chronic or paroxysmal), electrocardiogram, or Holter monitoring at index visit. We examined clinical and echocardiographic variables in association with AF. The effect of AF on overall and cause‐specific mortality was evaluated with multivariate Cox proportional hazards models. Of 3673 patients with HCM, 650 (18%) had AF. Patients with AF were older and more symptomatic (P<0.001). AF was less common among patients with obstructive HCM phenotype and was associated with larger left atria, higher E/e’ ratios, and worse cardiopulmonary exercise tolerance (all P values<0.001). During median (interquartile range) follow‐up of 4.1 (0.2 to 10) years, 1069 (29%) patients died. Patients with AF had worse survival compared to those without AF (P<0.001). In multivariate analysis adjusted for established risk factors of mortality in HCM, the hazard ratio (95% confidence interval) for the effect of AF on overall mortality was 1.48 (1.27 to 1.71). AF did not have an effect on sudden or nonsudden cardiac death. Conclusions In this large referral HCM population, approximately 1 in 5 patients had AF. AF was a strong predictor of mortality, even after adjustment for established risk factors. PMID:24965028

  19. Prevalence of mental disorders and related functioning and treatment engagement among people with diabetes.

    PubMed

    Boden, Matthew Tyler

    2018-03-01

    To examine prevalence, functioning and treatment associated with all DSM-5 12-month mood, anxiety, eating and substance use disorders among people with diabetes in data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Through multistage stratified randomized sampling a sample representative of the United States civilian population was obtained. Prevalence of diabetes (Type 1 and 2), DSM-5 disorders, physical and mental functioning, and treatment utilization were assessed via telephone interview. Analyses of weighted data (N=36,138) included calculation of descriptive statistics, and chi-square, logistic and linear regression analyses. Participants with (vs. without) diabetes (9.3% of weighted sample) had a significantly: (a) higher prevalence of any anxiety disorder and posttraumatic stress disorder (with and without adjustment for sociodemographic characteristics), and any mood disorder, major depressive disorder and specific phobia (with adjustment), (b) lower prevalence of any substance use disorder and alcohol and tobacco use disorders (with and without adjustment), and cannabis use disorder (without adjustment). Among participants with diabetes, mental disorder prevalence was consistently associated with sex and age, and to a lesser frequency, race/ethnicity. Lower levels of physical and mental functioning were found among participants with diabetes and a comorbid mental disorder. A minority of participants with diabetes and a comorbid mental disorder received treatment for mood and anxiety disorders, and few received treatment for eating and substance use disorders. Multiple types of mood, anxiety, eating and substance use disorders are prevalent, problematic, and often untreated among people with diabetes. Published by Elsevier Inc.

  20. Prevalence, Potential Predictors, and Genotype-Specific Prevalence of Human Papillomavirus Infection among Sexually Active Students in Japan.

    PubMed

    Imai, Hirohisa; Nakao, Hiroyuki; Shinohara, Hisae; Watarai, Mutsuko; Matsumoto, Noriko; Yamagishi, Takuya; Saito, Masuko; Kitamura, Tadaichi

    2015-01-01

    We conducted a community-based study to evaluate genotype-specific prevalence of high-risk HPV (HR-HPV) and potential predictors of its presence in young, asymptomatic, female college students. Self-administered surveys and vaginal swabs for self collection were distributed to students of participating schools. A sufficient cellular component in cervical samples was verified by examining for the presence of human β-globin DNA by PCR. A total of 1,118 valid cervical samples were subjected to screening for HR-HPV infection with the Digene Hybrid Capture 2 assay, followed by identification of HPV genotypes with GENOSEARCH HPV31 kit. Logistic regression was used to adjust for confounding factors associated with HR-HPV positivity and the adjusted odds ratio (AOR) was calculated. The median age of recruited students was 20 years. Of the 1,118 women who provided valid cervical samples for testing, 770 had sexual intercourse in the past, of which 125 (16.2%) were positive for HR-HPV. Logistic regression analysis revealed that HR-HPV infection was associated with smoking history (AOR 2.13; 95% confidence interval [CI] 1.98 to 5.05; p < 0.01), total number of partners (AOR 4.72; 95% CI 1.97 to 11.32 if > 5 partners; p < 0.001), number of partners in the past 6 months (AOR 3.12; 95% CI 1.42 to 6.87; p < 0.01), improper use of condoms (AOR 2.21; 95% CI 1.25 to 3.90; p < 0.01), and chlamydia infection (AOR 2.61; 95% CI 1.28 to 5.34; p < 0.01). The most common HR-HPV genotype was type 52 (6.4%), followed by 16 (3.1%), 56 (3.0%), and 58 (2.6%). Compared with previous reports in East Asian coutries, the prevalence of HR-HPV infection among young, asymptomatic, female students before the nationwide use of vaccination in Japan was in the intermediate range. The most common HR-HPV genotypes were HPV 52, 16, 56, and 58.

  1. Prevalence, Potential Predictors, and Genotype-Specific Prevalence of Human Papillomavirus Infection among Sexually Active Students in Japan

    PubMed Central

    Imai, Hirohisa; Nakao, Hiroyuki; Shinohara, Hisae; Watarai, Mutsuko; Matsumoto, Noriko; Yamagishi, Takuya; Saito, Masuko; Kitamura, Tadaichi

    2015-01-01

    Background and Methods We conducted a community-based study to evaluate genotype-specific prevalence of high-risk HPV (HR-HPV) and potential predictors of its presence in young, asymptomatic, female college students. Self-administered surveys and vaginal swabs for self collection were distributed to students of participating schools. A sufficient cellular component in cervical samples was verified by examining for the presence of human β-globin DNA by PCR. A total of 1,118 valid cervical samples were subjected to screening for HR-HPV infection with the Digene Hybrid Capture 2 assay, followed by identification of HPV genotypes with GENOSEARCH HPV31 kit. Logistic regression was used to adjust for confounding factors associated with HR-HPV positivity and the adjusted odds ratio (AOR) was calculated. Results The median age of recruited students was 20 years. Of the 1,118 women who provided valid cervical samples for testing, 770 had sexual intercourse in the past, of which 125 (16.2%) were positive for HR-HPV. Logistic regression analysis revealed that HR-HPV infection was associated with smoking history (AOR 2.13; 95% confidence interval [CI] 1.98 to 5.05; p < 0.01), total number of partners (AOR 4.72; 95% CI 1.97 to 11.32 if > 5 partners; p < 0.001), number of partners in the past 6 months (AOR 3.12; 95% CI 1.42 to 6.87; p < 0.01), improper use of condoms (AOR 2.21; 95% CI 1.25 to 3.90; p < 0.01), and chlamydia infection (AOR 2.61; 95% CI 1.28 to 5.34; p < 0.01). The most common HR-HPV genotype was type 52 (6.4%), followed by 16 (3.1%), 56 (3.0%), and 58 (2.6%). Conclusion Compared with previous reports in East Asian coutries, the prevalence of HR-HPV infection among young, asymptomatic, female students before the nationwide use of vaccination in Japan was in the intermediate range. The most common HR-HPV genotypes were HPV 52, 16, 56, and 58. PMID:26176861

  2. Prevalence of antibiotic prescription in southern Italian outpatients: real-world data analysis of socioeconomic and sociodemographic variables at a municipality level.

    PubMed

    Russo, Veronica; Monetti, Valeria Marina; Guerriero, Francesca; Trama, Ugo; Guida, Antonella; Menditto, Enrica; Orlando, Valentina

    2018-01-01

    The aim of this study was to analyze the geographic variation in systemic antibiotic prescription at a regional level and to explore the influence of socioeconomic and sociodemographic variables. This study was a retrospective analysis of reimbursement pharmacy records in the outpatient settings of Italy's Campania Region in 2016. Standardized antibiotic prescription rates were calculated at municipality and Local Health Unit (LHU) level. Antibiotic consumption was analyzed as defined daily doses (DDD)/1000 inhabitants per day (DID). Logistic regression was performed to evaluate the association between antibiotic prescription and sociodemographic and socioeconomic determinants at a municipality level. The average antibiotic prevalence rate was 46.8%. At LHU level, the age-adjusted prevalence rates ranged from 41.1% in Benevento to 51.0% in Naples2. Significant differences were found among municipalities, from 15.2% in Omignano (Salerno LHU [Sa-LHU]) to 61.9% in Moschiano (Avellino [Av-LHU]). The geographic distribution also showed significant differences in terms of antibiotic consumption, from 6.7 DID in Omignano to 41.6 in San Marcelino (Caserta [Ce-LHU]). Logistic regression showed that both municipality type and average annual income level were the main determinants of antibiotic prescription. Urban municipalities were more than eight times as likely to have antibiotic high prevalence rates compared to rural municipalities (adjusted odds ratio [OR]: 8.62; 95% confidence interval [CI]: 4.06-18.30, P <0.001). Low average annual income level municipalities were more than eight times as likely to have antibiotic high prevalence rates compared to high average annual income level municipalities (adjusted OR: 8.48; 95% CI: 3.45-20.81, P <0.001). We provide a snapshot of Campania's antibiotic consumption, evidencing the impact of both socioeconomic and sociodemographic factors on the prevalence of antibiotic prescription. The observed intraregional variability

  3. Levels and determinants of breast and cervical cancer screening uptake in HIV-infected women compared with the general population in France.

    PubMed

    Tron, L; Lert, F; Spire, B; Dray-Spira, R

    2017-03-01

    Cancer is a growing concern for HIV-infected people, and screening plays a major role in alleviating the burden it causes. We sought to investigate the levels and determinants of breast cancer screening (BCS) and cervical cancer screening (CCS) in HIV-infected women as compared with the general population. The Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS)-Vespa2 study was conducted in 2011 in a national representative sample of 3022 HIV-infected hospital out-patients in France. The rates and correlates of BCS and CCS among HIV-infected women were compared with those in the general population using multivariate Poisson regression models. The BCS rate during the 2 years preceding the survey interview was 80.7% among HIV-infected women vs. 89.1% in the general population (P = 0.146). The CCS rate during the preceding 3 years was 88.1% among HIV-infected women vs. 83.1% in the general population (P = 0.021). During the preceding year, the CCS rate among HIV-infected women was 76.5%. The barriers to BCS and CCS were a low educational level [BCS: adjusted prevalence rate ratio 0.88; 95% confidence interval (CI) 0.80-0.97; CCS: adjusted prevalence rate ratio 0.91; 95% CI 0.83-0.99], not having supplementary health insurance (CCS: adjusted prevalence rate ratio 0.92; 95% CI 0.86-0.98), an irregular gynaecological follow-up (BCS: adjusted prevalence rate ratio 0.77; 95% CI 0.64-0.92; CCS: adjusted prevalence rate ratio 0.72; 95% CI 0.64-0.81) and a low CD4 count (BCS: adjusted prevalence rate ratio 0.83; 95% CI 0.71-0.97; CCS: adjusted prevalence rate ratio 0.78; 95% CI 0.63-0.98). The disparities in CCS uptake in terms of age, employment and gynaecological follow-up were less pronounced among HIV-infected women than in the general population. BCS and CCS uptake was not lower among HIV-infected women than in the general population, but CCS was suboptimal. Specificities in the profile of barriers to screening emerged. © 2016 British HIV

  4. Seaweed consumption and prevalence of depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Tanaka, Keiko; Okubo, Hitomi; Sasaki, Satoshi; Arakawa, Masashi

    2014-09-03

    Seaweed is a popular traditional food in Japan and is a rich source of bioactive metabolites. The neuroprotective properties of seaweed have attracted attention; to date, however, there has been no epidemiological evidence regarding the relationship between seaweed consumption and depression. The current cross-sectional study investigated the association between seaweed consumption and depressive symptoms during pregnancy in Japan. Study subjects were 1745 pregnant women. Depressive symptoms were defined as present when subjects had a Center for Epidemiologic Studies Depression Scale score of 16 or higher. Dietary consumption during the preceding month was assessed using a self-administered diet history questionnaire. Adjustment was made for age; gestation; region of residence; number of children; family structure; history of depression; family history of depression; smoking; secondhand smoke exposure at home and at work; job type; household income; education; body mass index; and intake of fish and yogurt. The prevalence of depressive symptoms during pregnancy was 19.3%. After adjustment for possible dietary and non-dietary confounding factors, higher seaweed consumption was independently associated with a lower prevalence of depressive symptoms during pregnancy: the adjusted odds ratios (95% confidence intervals) for depressive symptoms during pregnancy in the first, second, third, and fourth quartiles of seaweed consumption were 1 (reference), 0.72 (0.51 - 1.004), 0.71 (0.50 - 1.01), and 0.68 (0.47 - 0.96), respectively (P for trend = 0.03). The present results suggest that seaweed consumption may be inversely associated with the prevalence of depressive symptoms during pregnancy in Japanese women.

  5. Sibling number and prevalence of allergic disorders in pregnant Japanese women: baseline data from the Kyushu Okinawa Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Tanaka, Keiko; Arakawa, Masashi

    2011-07-14

    Although an inverse relationship between number of siblings and likelihood of allergic disorders has been shown in many epidemiological studies, the biological mechanism underlying this phenomenon has not yet been identified. There is no epidemiological research regarding the sibling effect on allergic disorders in Japanese adults. The current cross-sectional study examined the relationship between number of siblings and prevalence of allergic disorders among adult women in Japan. Subjects were 1745 pregnant women. This study was based on questionnaire data. The definitions of wheeze and asthma were based on criteria from the European Community Respiratory Health Survey whereas those of eczema and rhinoconjunctivitis were based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age, region of residence, pack-years of smoking, secondhand smoke exposure at home and at work, family history of asthma, atopic eczema, and allergic rhinitis, household income, and education. The prevalence values of wheeze, asthma, eczema, and rhinoconjunctivitis in the past 12 months were 10.4%, 5.5%, 13.0%, and 25.9%, respectively. A significant inverse exposure-response relationship was observed between the number of older siblings and rhinoconjunctivitis, but not wheeze, asthma, or eczema (P for trend=0.03); however, the adjusted odds ratio (OR) for having 2 or more older siblings was not significant although the adjusted OR for having 1 older sibling was statistically significant (adjusted OR=0.71 [95% CI: 0.56-0.91]). Number of total siblings and number of younger siblings were not related to wheeze, asthma, eczema, or rhinoconjunctivitis. This study found a significant inverse relationship between the number of older siblings and the prevalence of rhinoconjunctivitis among pregnant Japanese women. Our findings are likely to support the intrauterine programming hypothesis; however, we could not rule out the hygiene hypothesis.

  6. Sibling number and prevalence of allergic disorders in pregnant Japanese women: baseline data from the Kyushu Okinawa Maternal and Child Health Study

    PubMed Central

    2011-01-01

    Background Although an inverse relationship between number of siblings and likelihood of allergic disorders has been shown in many epidemiological studies, the biological mechanism underlying this phenomenon has not yet been identified. There is no epidemiological research regarding the sibling effect on allergic disorders in Japanese adults. The current cross-sectional study examined the relationship between number of siblings and prevalence of allergic disorders among adult women in Japan. Methods Subjects were 1745 pregnant women. This study was based on questionnaire data. The definitions of wheeze and asthma were based on criteria from the European Community Respiratory Health Survey whereas those of eczema and rhinoconjunctivitis were based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age, region of residence, pack-years of smoking, secondhand smoke exposure at home and at work, family history of asthma, atopic eczema, and allergic rhinitis, household income, and education. Results The prevalence values of wheeze, asthma, eczema, and rhinoconjunctivitis in the past 12 months were 10.4%, 5.5%, 13.0%, and 25.9%, respectively. A significant inverse exposure-response relationship was observed between the number of older siblings and rhinoconjunctivitis, but not wheeze, asthma, or eczema (P for trend = 0.03); however, the adjusted odds ratio (OR) for having 2 or more older siblings was not significant although the adjusted OR for having 1 older sibling was statistically significant (adjusted OR = 0.71 [95% CI: 0.56-0.91]). Number of total siblings and number of younger siblings were not related to wheeze, asthma, eczema, or rhinoconjunctivitis. Conclusions This study found a significant inverse relationship between the number of older siblings and the prevalence of rhinoconjunctivitis among pregnant Japanese women. Our findings are likely to support the intrauterine programming hypothesis; however, we could

  7. Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica: Data from the Costa Rican Longevity and Healthy Aging Study

    PubMed Central

    Harhay, Meera N.; Harhay, Michael O.; Coto-Yglesias, Fernando; Bixby, Luis Rosero

    2015-01-01

    Summary Objectives Recent studies in Central America indicate that mortality attributable to chronic kidney disease (CKD) is rising rapidly. We sought to determine the prevalence and regional variation of CKD and the relationship of biologic and socioeconomic factors to CKD risk in the older-adult population of Costa Rica. Methods We used data from the Costa Rican Longevity and Health Aging Study (CRELES). The cohort was comprised of 2657 adults born before 1946 in Costa Rica, chosen through a sampling algorithm to represent the national population of Costa Ricans >60 years of age. Participants answered questionnaire data and completed laboratory testing. The primary outcome of this study was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2. Results The estimated prevalence of CKD for older Costa Ricans was 20% (95% CI 18.5 – 21.9%). In multivariable logistic regression, older age (adjusted odds ratio [aOR] 1.08 per year, 95%CI 1.07–1.10, p<0.001) was independently associated with CKD. For every 200 meters above sea level of residence, subjects’ odds of CKD increased 26% (aOR 1.26 95% CI 1.15–1.38, p<0.001). There was large regional variation in adjusted CKD prevalence, highest in Limon (40%, 95% CI 30%–50%) and Guanacaste (36%, 95% CI 26–46%) provinces. Regional and altitude effects remained robust after adjustment for socioeconomic status. Conclusions We observed large regional and altitude-related variations in CKD prevalence in Costa Rica, not explained by the distribution of traditional CKD risk factors. More studies are needed to explore the potential association of geographic and environmental exposures with the risk of CKD. PMID:26466575

  8. Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica: Data from the Costa Rican Longevity and Healthy Aging Study.

    PubMed

    Harhay, Meera N; Harhay, Michael O; Coto-Yglesias, Fernando; Rosero Bixby, Luis

    2016-01-01

    Recent studies in Central America indicate that mortality attributable to chronic kidney disease (CKD) is rising rapidly. We sought to determine the prevalence and regional variation of CKD and the relationship of biologic and socio-economic factors to CKD risk in the older-adult population of Costa Rica. We used data from the Costa Rican Longevity and Health Aging Study (CRELES). The cohort was comprised of 2657 adults born before 1946 in Costa Rica, chosen through a sampling algorithm to represent the national population of Costa Ricans >60 years of age. Participants answered questionnaire data and completed laboratory testing. The primary outcome of this study was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m 2 . The estimated prevalence of CKD for older Costa Ricans was 20% (95% CI 18.5-21.9%). In multivariable logistic regression, older age (adjusted odds ratio [aOR] 1.08 per year, 95% CI 1.07-1.10, P < 0.001) was independently associated with CKD. For every 200 m above sea level of residence, subjects' odds of CKD increased 26% (aOR 1.26 95% CI 1.15-1.38, P < 0.001). There was large regional variation in adjusted CKD prevalence, highest in Limon (40%, 95% CI 30-50%) and Guanacaste (36%, 95% CI 26-46%) provinces. Regional and altitude effects remained robust after adjustment for socio-economic status. We observed large regional and altitude-related variations in CKD prevalence in Costa Rica, not explained by the distribution of traditional CKD risk factors. More studies are needed to explore the potential association of geographic and environmental exposures with the risk of CKD. © 2015 John Wiley & Sons Ltd.

  9. Validation of Diagnostic Groups Based on Health Care Utilization Data Should Adjust for Sampling Strategy.

    PubMed

    Cadieux, Geneviève; Tamblyn, Robyn; Buckeridge, David L; Dendukuri, Nandini

    2017-08-01

    Valid measurement of outcomes such as disease prevalence using health care utilization data is fundamental to the implementation of a "learning health system." Definitions of such outcomes can be complex, based on multiple diagnostic codes. The literature on validating such data demonstrates a lack of awareness of the need for a stratified sampling design and corresponding statistical methods. We propose a method for validating the measurement of diagnostic groups that have: (1) different prevalences of diagnostic codes within the group; and (2) low prevalence. We describe an estimation method whereby: (1) low-prevalence diagnostic codes are oversampled, and the positive predictive value (PPV) of the diagnostic group is estimated as a weighted average of the PPV of each diagnostic code; and (2) claims that fall within a low-prevalence diagnostic group are oversampled relative to claims that are not, and bias-adjusted estimators of sensitivity and specificity are generated. We illustrate our proposed method using an example from population health surveillance in which diagnostic groups are applied to physician claims to identify cases of acute respiratory illness. Failure to account for the prevalence of each diagnostic code within a diagnostic group leads to the underestimation of the PPV, because low-prevalence diagnostic codes are more likely to be false positives. Failure to adjust for oversampling of claims that fall within the low-prevalence diagnostic group relative to those that do not leads to the overestimation of sensitivity and underestimation of specificity.

  10. Circulating levels of perfluoroalkyl substances and prevalent diabetes in the elderly.

    PubMed

    Lind, Lars; Zethelius, Björn; Salihovic, Samira; van Bavel, Bert; Lind, P Monica

    2014-03-01

    Several environmental contaminants, such as polychlorinated biphenyls, dioxins, bisphenol A and phthalates, have been linked to diabetes. We therefore investigated whether other kinds of contaminants, perfluoroalkyl substances (PFAS), also called perfluorinated compounds (PFCs), are also associated with diabetes. The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study investigated 1,016 men and women aged 70 years. Seven PFAS were detected in almost all participant sera by ultra-high performance liquid chromatograph/tandem mass spectrometry. Diabetes was defined as use of hypoglycaemic agents or fasting glucose >7.0 mmol/l. 114 people had diabetes. In the linear analysis, no significant relationships were seen between the seven PFAS and prevalent diabetes. However, inclusion of the quadratic terms of the PFAS revealed a significant non-linear relationship between perfluorononanoic acid (PFNA) and diabetes, even after adjusting for multiple confounders (OR 1.96, 95% CI 1.19, 3.22, p = 0.008 for the linear term and OR 1.25, 95% CI 1.08, 1.44, p = 0.002 for the quadratic term). Perfluorooctanoic acid (PFOA) also showed such a relationship (p = 0.01). PFOA was related to the proinsulin/insulin ratio (a marker of insulin secretion), but none of the PFAS was related to the HOMA-IR (a marker of insulin resistance) following adjustment for multiple confounders. PFNA was related to prevalent diabetes in a non-monotonic fashion in this cross-sectional study, supporting the view that this perfluoroalkyl substance might influence glucose metabolism in humans at the level of exposure seen in the general elderly population.

  11. Prevalence of obesity, diabetes and other cardiovascular risk factors in Andalusia (southern Spain). Comparison with national prevalence data. The Di@bet.es study.

    PubMed

    Valdés, Sergio; García-Torres, Francisca; Maldonado-Araque, Cristina; Goday, Albert; Calle-Pascual, Alfonso; Soriguer, Federico; Castaño, Luis; Catalá, Miguel; Gomis, Ramon; Rojo-Martínez, Gemma

    2014-06-01

    The aim of this study was to compare the prevalences of obesity, diabetes and other cardiovascular risk factors in the region of Andalusia with those in the rest of Spain. The Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifestyle. The sample consisted of 5103 participants ≥ 18 years. The variables analyzed were clinical, demographic and lifestyle survey, physical examination, and oral glucose tolerance test. The prevalence of cardiovascular risk factors in Andalusia (n=1517) was compared with that for the rest of Spain (n=3586). In data adjusted to the Spanish population, the prevalence of diabetes (World Health Organization, 1999), hypertension (blood pressure ≥ 140/90 mmHg), high-sensitivity CRP levels (≥ 3 mg/L) and obesity (body mass index ≥ 30 kg/m(2)) were 16.3%, 43.9%, 32.0%, and 37.0% in Andalusia compared with 12.5%, 39.9%, 28.3%, and 26.6% in the rest of Spain (P<.001 for differences except P=.01 for the difference in high-sensitivity CRP levels). The corresponding figures for the Andalusia data adjusted to the Andalusian population were 15.3%, 42.3%, 31.4%, and 34.0%, respectively. Differences in diabetes, hypertension and high-sensitivity CRP were not significant in models adjusted for age, sex, and adiposity measurements. Differences in obesity were not significant in models adjusted for age, sex, educational level, marital status, work status, and physical activity (P=.086) CONCLUSIONS: This study contributes information from a national study perspective and shows a higher prevalence of cardiovascular risk factors in southern Spain, in close relation to obesity, a sedentary lifestyle, and markers of socioeconomic disadvantage. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  12. Impact of body mass index on prevalence of multimorbidity in primary care: cohort study.

    PubMed

    Booth, Helen P; Prevost, A Toby; Gulliford, Martin C

    2014-02-01

    Multimorbidity is the co-occurrence of long-term conditions. Obesity is associated with an increased risk of long-term conditions including type 2 diabetes and depression. To quantify the association between body mass index (BMI) category and multimorbidity in a large cohort registered in primary care. The sample comprised primary care electronic health records of adults aged ≥30 years, sampled from the Clinical Practice Research Datalink between 2005 and 2011. Multimorbidity was defined as the co-occurrence of ≥2 of 11 conditions affecting seven organ systems. Age- and sex-standardized prevalence of multimorbidity was estimated by BMI category. Adjusted odds ratios associating BMI with additional morbidity were estimated adjusting for socioeconomic deprivation and smoking. The sample comprised 300 006 adults. After excluding participants with BMI never recorded, data were analysed for 223 089 (74%) contributing 1 374 109 person-years. In normal weight men, the standardized prevalence of multimorbidity was 23%, rising to 27% in overweight, 33% in category I obesity, 38% in category II and 44% in category III obesity. In women, the corresponding values were 28%, 34%, 41%, 45% and 51%. In category III obesity, the adjusted odds, relative to normal BMI, were 2.24 (2.13-2.36) for a first condition; 2.63 (2.51-2.76) for a second condition and 3.09 (2.92-3.28) for three or more conditions. In a cross-sectional analysis, 32% of multimorbidity was attributable to overweight and obesity. Multiple morbidity is highly associated with increasing BMI category and obesity, highlighting the potential for targeted primary and secondary prevention interventions in primary care.

  13. The relationship between the dietary inflammatory index and prevalence of radiographic symptomatic osteoarthritis: data from the Osteoarthritis Initiative.

    PubMed

    Veronese, Nicola; Shivappa, Nitin; Stubbs, Brendon; Smith, Toby; Hébert, James R; Cooper, Cyrus; Guglielmi, Giuseppe; Reginster, Jean-Yves; Rizzoli, Renè; Maggi, Stefania

    2017-12-05

    To investigate whether higher dietary inflammatory index (DII ® ) scores were associated with higher prevalence of radiographic symptomatic knee osteoarthritis in a large cohort of North American people from the Osteoarthritis Initiative database. A total of 4358 community-dwelling participants (2527 females; mean age 61.2 years) from the Osteoarthritis Initiative were identified. DII ® scores were calculated using the validated Block Brief 2000 Food-Frequency Questionnaire and scores were categorized into quartiles. Knee radiographic symptomatic osteoarthritis was diagnosed clinically and radiologically. The strength of association between divided into quartiles (DII ® ) and knee osteoarthritis was investigated through a logistic regression analysis, which adjusted for potential confounders, and results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Participants with a higher DII ® score, indicating a more pro-inflammatory diet, had a significantly higher prevalence of radiographic symptomatic knee osteoarthritis compared to those with lower DII ® score (quartile 4: 35.4% vs. quartile 1: 24.0%; p < 0.0001). Using a logistic regression analysis, adjusting for 11 potential confounders, participants with the highest DII ® score (quartile 4) had a significantly higher probability of experiencing radiographic symptomatic knee osteoarthritis (OR 1.40; 95% CI 1.14-1.72; p = 0.002) compared to participants with the lowest DII ® score (quartile 1). Higher DII ® values are associated with higher prevalence of radiographic symptomatic knee osteoarthritis.

  14. Incidence, prevalence, and survival of chronic pancreatitis: a population-based study.

    PubMed

    Yadav, Dhiraj; Timmons, Lawrence; Benson, Joanne T; Dierkhising, Ross A; Chari, Suresh T

    2011-12-01

    Population-based data on chronic pancreatitis (CP) in the United States are scarce. We determined incidence, prevalence, and survival of CP in Olmsted County, MN. Using Mayo Clinic Rochester's Medical Diagnostic Index followed by a detailed chart review, we identified 106 incident CP cases from 1977 to 2006 (89 clinical cases, 17 diagnosed only at autopsy); CP was defined by previously published Mayo Clinic criteria. We calculated age- and sex-adjusted incidence (for each decade) and prevalence rate (1 January 2006) per 100,000 population (adjusted to 2000 US White population). We compared the observed survival rate for patients with expected survival for age- and sex-matched Minnesota White population. Median age at diagnosis of CP was 58 years, 56% were male, and 51% had alcoholic CP. The overall (clinical cases or diagnosed only at autopsy) age- and sex-adjusted incidence was 4.05/100,000 person-years (95% confidence interval (CI) 3.27-4.83). The incidence rate for clinical cases increased significantly from 2.94/100,000 during 1977-1986 to 4.35/100,000 person-years during 1997-2006 (P<0.05) because of an increase in the incidence of alcoholic CP. There were 51 prevalent CP cases on 1 January 2006 (57% male, 53% alcoholic). The age- and sex-adjusted prevalence rate per 100,000 population was 41.76 (95% CI 30.21-53.32). At last follow-up, 50 patients were alive. Survival among CP patients was significantly lower than age- and sex-specific expected survival in Minnesota White population (P<0.001). Incidence and prevalence of CP are low, and ∼50% are alcohol related. The incidence of CP cases diagnosed during life is increasing. Survival of CP patients is lower than in the Minnesota White population.

  15. Prevalence of latent tuberculosis infection among tuberculosis laboratory workers in Iran.

    PubMed

    Nasehi, Mahshid; Hashemi-Shahraki, Abdolrazagh; Doosti-Irani, Amin; Sharafi, Saeed; Mostafavi, Ehsan

    2017-01-01

    The risk of transmission of Mycobacterium tuberculosis from patients to health care workers (HCWs) is a neglected problem in many countries, including Iran. The aim of this study was to estimate the prevalence of latent tuberculosis (TB) infection (LTBI) among TB laboratory staff in Iran, and to elucidate the risk factors associated with LTBI. All TB laboratory staff (689 individuals) employed in the TB laboratories of 50 Iranian universities of medical sciences and a random sample consisting of 317 low-risk HCWs were included in this cross-sectional study. Participants with tuberculin skin test indurations of 10 mm or more were considered to have an LTBI. The prevalence of LTBI among TB laboratory staff and low-risk HCWs was 24.83% (95% confidence interval [CI], 21.31 to 27.74%) and 14.82% (95% CI, 11.31 to 19.20%), respectively. No active TB cases were found in either group. After adjusting for potential confounders, TB laboratory staff were more likely to have an LTBI than low-risk HCWs (prevalence odds ratio, 2.06; 95% CI, 1.35 to 3.17). This study showed that LTBI are an occupational health problem among TB laboratory staff in Iran. This study reinforces the need to design and implement simple, effective, and affordable TB infection control programs in TB laboratories in Iran.

  16. Custodial Grandmothers' Psychological Distress, Dysfunctional Parenting, and Grandchildren's Adjustment

    PubMed Central

    Smith, Gregory C.; Palmieri, Patrick A.; Hancock, Gregory R.; Richardson, Rhonda A.

    2009-01-01

    An adaptation of the Family Stress Model (FSM) with hypothesized linkages between family contextual factors, custodial grandmothers' psychological distress, parenting practices, and grandchildren's adjustment was tested with structural equation modeling. Interview data from 733 custodial grandmothers of grandchildren between ages 4-17 revealed that the effect of grandmothers' distress on grandchildren's adjustment was mediated by dysfunctional parenting, especially regarding externalizing problems. The effects of contextual factors on grandchildren's adjustment were also indirect. The model's measurement and structural components were largely invariant across grandmothers' race and age, as well as grandchildren's gender and age. Group differences were more prevalent regarding the magnitude of latent means for model constructs. We conclude that parenting models like the FSM are useful for investigating custodial grandfamilies. PMID:19266869

  17. The prevalence, characteristics, and factors associated with purchasing Chinese herbal medicine among adults in Taiwan.

    PubMed

    Shih, Chun -Chuan; Huang, Lu-Hsiang; Yeh, Chun-Chieh; Lane, Hsin-Long; Hsieh, Chang-Ju; Tsai, Chin-Chuan; Lin, Li-Wei; Chen, Ta-Liang; Liao, Chien-Chang

    2017-03-27

    The objective of this study was to investigate the prevalence and factors associated with purchasing Chinese herbal medicine (CHM) without a physician's prescription among adults. Using data from the 2005 National Health Interview Survey and National Health Insurance, we identified 16,756 individuals aged 20 years and older. Socio-demographic factors, lifestyle, medical services utilization and health behaviors were compared between people with and without a history of purchasing CHM by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in a multiple logistic regression analysis. The one-month prevalence of purchasing CHM without a physician' prescription was 5.2% in Taiwan. People more likely to purchase CHM included people aged ≥70 years (OR 2.84, 95% CI 2.03-3.99), women (OR 1.28, 95% CI 1.11-1.48), non-indigenous people (OR 2.61, 95% CI 1.29-5.30), and people with an illness not receiving medical care (OR 2.69, 95% CI 2.19-3.31). The prevalence of purchasing CHM without a physician's prescription is high in Taiwan and is correlated with factors such as socio-demographics, disease history, and behaviors surrounding the utilization of medical care.

  18. Testing-adjusted chlamydia notification trends in New South Wales, Australia, 2000 to 2010.

    PubMed

    Cretikos, Michelle; Mayne, Darren; Reynolds, Roderick; Spokes, Paula; Madeddu, Daniel

    2014-01-01

    Between 2005 and 2010, Australian notification rates for chlamydia infection increased by 64% from 203 to 333 per 100 000 population. Interpreting this trend is difficult without examining rates and local patterns of testing. We examined the effect of adjusting for local testing rates on chlamydia notification trends in New South Wales (NSW), Australia from 2000 to 2010. We used testing data for NSW residents for Medicare Benefits Schedule items for chlamydia from 1 July 1999 to 30 June 2005 and 1 July 2007 to 30 June 2010. This data set excluded testing by public sector laboratories. We also obtained laboratory-confirmed genital chlamydia notifications in NSW residents for 1 July 1999 to 30 June 2010 and excluded notifications from public laboratories. We used negative binomial regression to assess trends in chlamydia notification rates by age and sex after adjusting for local government area (LGA)-level Medicare-funded testing rates, socioeconomic disadvantage, remoteness and Medicare provider density. Testing-adjusted rates of chlamydia notifications declined by 5.2% per annum (rate ratio [RR] = 0.95, 95% confidence interval (CI) = 0.93-0.96) for women overall, and 2.3% (RR = 0.98, 95% CI = 0.96-1.00) and 5.0% per annum (RR = 0.95, 95% CI = 0.93-0.98) for men in LGAs with moderate and high densities of Medicare providers, respectively. Notification rates remained stable for men in low Medicare provider density LGAs (RR = 1.01, 95% CI = 0.96-1.07). It is likely that increased testing for chlamydia has driven increases in chlamydia notification in NSW over the last decade. Notification data provide no evidence for a general increase in the prevalence of chlamydia in the NSW community for this period. Notification-based chlamydia surveillance should be routinely adjusted for local testing rates.

  19. Prevalence of colorectal neoplasm among patients with newly diagnosed coronary artery disease.

    PubMed

    Chan, Annie On On; Jim, Man Hong; Lam, Kwok Fai; Morris, Jeffrey S; Siu, David Chun Wah; Tong, Teresa; Ng, Fook Hong; Wong, Siu Yin; Hui, Wai Mo; Chan, Chi Kuen; Lai, Kam Chuen; Cheung, Ting Kin; Chan, Pierre; Wong, Grace; Yuen, Man Fung; Lau, Yuk Kong; Lee, Stephen; Szeto, Ming Leung; Wong, Benjamin C Y; Lam, Shiu Kum

    2007-09-26

    Colorectal neoplasm and coronary artery disease (CAD) share similar risk factors, and their co-occurrence may be associated. To investigate the prevalence of colorectal neoplasm in patients with CAD in a cross-sectional study and to identify the predisposing factors for the association of the 2 diseases. Patients in Hong Kong, China, were recruited for screening colonoscopy after undergoing coronary angiography for suspected CAD during November 2004 to June 2006. Presence of CAD (n = 206) was defined as at least 50% diameter stenosis in any 1 of the major coronary arteries; otherwise, patients were considered CAD-negative (n = 208). An age- and sex-matched control group was recruited from the general population (n = 207). Patients were excluded for use of aspirin or statins, personal history of colonic disease, or colonoscopy in the past 10 years. The prevalence of colorectal neoplasm in CAD-positive, CAD-negative, and general population participants was determined. Bivariate logistic regression was performed to study the association between colorectal neoplasm and CAD and to identify risk factors for the association of the 2 diseases after adjusting for age and sex. The prevalence of colorectal neoplasm in the CAD-positive, CAD-negative, and general population groups was 34.0%, 18.8%, and 20.8% (P < .001 by chi2 test), prevalence of advanced lesions was 18.4%, 8.7%, and 5.8% (P < .001), and prevalence of cancer was 4.4%, 0.5%, and 1.4% (P = .02), respectively. Fifty percent of the cancers in CAD-positive participants were early stage. After adjusting for age and sex, an association still existed between colorectal neoplasm and presence of CAD (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.25-2.70; P = .002) and between advanced lesions and presence of CAD (OR, 2.51; 95% CI, 1.43-4.35; P = .001). The metabolic syndrome (OR, 5.99; 95% CI, 1.43-27.94; P = .02) and history of smoking (OR, 4.74; 95% CI, 1.38-18.92; P = .02) were independent factors for the

  20. Racial disparities in the prevalence and control of hypertension among a cohort of HIV-infected patients in the southeastern United States.

    PubMed

    Burkholder, Greer A; Tamhane, Ashutosh R; Safford, Monika M; Muntner, Paul M; Willig, Amanda L; Willig, James H; Raper, James L; Saag, Michael S; Mugavero, Michael J

    2018-01-01

    African Americans are disproportionately affected by both HIV and hypertension. Failure to modify risk factors for cardiovascular disease and chronic kidney disease such as hypertension among HIV-infected patients may attenuate the benefits conferred by combination antiretroviral therapy. In the general population, African Americans with hypertension are less likely to have controlled blood pressure than whites. However, racial differences in blood pressure control among HIV-infected patients are not well studied. We conducted a cross-sectional study evaluating racial differences in hypertension prevalence, treatment, and control among 1,664 patients attending the University of Alabama at Birmingham HIV Clinic in 2013. Multivariable analyses were performed to calculate prevalence ratios (PR) with 95% confidence intervals (CI) as the measure of association between race and hypertension prevalence and control while adjusting for other covariates. The mean age of patients was 47 years, 77% were male and 54% African-American. The prevalence of hypertension was higher among African Americans compared with whites (49% vs. 43%; p = 0.02). Among those with hypertension, 91% of African Americans and 93% of whites were treated (p = 0.43). Among those treated, 50% of African Americans versus 60% of whites had controlled blood pressure (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg) (p = 0.007). After multivariable adjustment for potential confounders, prevalence of hypertension was higher among African Americans compared to whites (PR 1.25; 95% CI 1.12-1.39) and prevalence of BP control was lower (PR 0.80; 95% CI 0.69-0.93). Despite comparable levels of hypertension treatment, African Americans in our HIV cohort were less likely to achieve blood pressure control. This may place them at increased risk for adverse outcomes that disproportionately impact HIV-infected patients, such as cardiovascular disease and chronic kidney disease, and thus attenuate

  1. Maternal Anemia in Benin: Prevalence, Risk Factors, and Association with Low Birth Weight

    PubMed Central

    Bodeau-Livinec, Florence; Briand, Valerie; Berger, Jacques; Xiong, Xu; Massougbodji, Achille; Day, Karen P.; Cot, Michel

    2011-01-01

    We studied the prevalence of anemia during pregnancy and its relationship with low birth weight (LBW; birth weight < 2,500 g) in Benin. We analyzed 1,508 observations from a randomized controlled trial conducted from 2005 to 2008 showing equivalence on the risk of LBW between two drugs for Intermittent Preventive Treatment of malaria during pregnancy (IPTp). Despite IPTp, helminth prophylaxis, and iron and folic acid supplementations, the proportions of women with severe anemia (hemoglobin [Hb] concentration < 80 g/L) and anemia (Hb < 110 g/L) were high throughout pregnancy: 3.9% and 64.7% during the second and 3.7% and 64.1% during the third trimester, but 2.5% and 39.6% at the onset of labor, respectively. Compared with women without anemia (Hb ≥ 110 g/L) during the third trimester, women with severe anemia (Hb < 80 g/L) were at higher risk of LBW after adjustment for potential confounding factors (prevalence ratio [PR] = 2.8; 95% confidence interval [1.4–5.6]). PMID:21896797

  2. Prevalence of hypertension and noise-induced hearing loss in Chinese coal miners

    PubMed Central

    Liu, Jing; Xu, Ming; Ding, Lu; Zhang, Hengdong; Pan, Liping; Liu, Qingdong; Ding, Enming; Zhao, Qiuni; Wang, Boshen; Han, Lei

    2016-01-01

    Background Owing to inconsistent epidemiologic evidence and the presence of confounding factors, the relation between occupational noise exposure and hypertension still remained unclear. We aimed to assess whether Chinese coal miners were at risk of developing hypertension and noise induced hearing loss (NIHL), and whether occupational noise exposure was a risk factor of hypertension. Methods A questionnaire was designed to collect information from 738 study participants, all of whom were employees from the Datun Xuzhou Coal Company. The participants were divided into a noise-exposed group and a control group based on the noise level to which they were exposed in the workplace. The differences in the mean of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were compared between the noise-exposed and control groups. Also the prevalence and age-adjusted odds ratio (OR) [95% confidence intervals (CIs)] of audiometric deficit and hypertension was compared in the study. Binary logistic regression was used to assess the relation between occupational noise level and hypertension while controlling for potential confounding factors. Results Hypertension was more prevalent in noise-exposed group than the control group, 29.2% vs. 21.2% (P=0.012). The noise-exposed group faced an increased risk of hypertension (age-adjusted OR =1.52, 95% CI =1.07–2.15) when the control group was used as reference. The mean values of SBP and DBP of the noise-exposed groups were significantly higher than the control group (P=0.006 and P=0.002 respectively). Hearing loss at low frequencies was significantly more prevalent in the noise-exposed group than the control group, 12.8% vs. 7.4% (P=0.015), while the noise-exposed group faced the increased risk of hearing loss at low frequencies (age-adjusted OR =1.81, 95% CI =1.10–2.96). LEX, 8h (OR =1.036, 95% CI =1.012–1.060) was an independent risk of hypertension when controlling for potential confounding factors. Conclusions We

  3. Prevalence of human papillomavirus in cancer of the oropharynx by gender.

    PubMed

    Combes, Jean-Damien; Chen, Alyce A; Franceschi, Silvia

    2014-12-01

    Oropharyngeal cancer (OPC) is more frequent in men than women mainly due to the heavier and longer duration of smoking in men. Human papillomavirus (HPV) has a role in the rising incidence of OPC in the United States and other high-income countries. To determine whether there is a difference in the proportion of HPV-attributable OPC between men and women, we systematically retrieved HPV prevalence data from 63 studies reporting separately on OPC by gender. The male/female (M/F) ratios of HPV prevalence in OPC across different countries and the corresponding M/F ratios of cumulative lung cancer risk (a proxy for smoking) were compared. The United States had the highest M/F ratios of HPV prevalence in OPC (1.5). The lowest M/F ratios (≤0.7) were found in Asia and some European countries (e.g., France). The countries in which the M/F ratio of HPV prevalence in OPC was ≥1.0 had the most similar lung cancer risks for men and women. When HPV prevalence data were applied to age-standardized OPC incidence rates in the United States, Australia, the United Kingdom, and France, the M/F ratio for the HPV-positive OPC incidence rates was rather stable (around 4) in all countries. In contrast, the M/F ratio for the HPV-negative OPC incidence rates reached 10.2 in France versus <3 elsewhere. We showed that HPV prevalence in OPC differs by gender and country mainly as a consequence of the vast international variation in male smoking habits. Nevertheless, HPV-positive OPC may affect men more heavily than women in different populations for reasons that are unclear. ©2014 American Association for Cancer Research.

  4. The association between states' texting regulations and the prevalence of texting while driving among U.S. high school students.

    PubMed

    Rudisill, Toni M; Zhu, Motao

    2015-12-01

    To determine which distracted driving laws were associated with decreased texting while driving among U.S. teenage drivers. Data from the 2013 Youth Risk Behavior Surveillance System survey were merged with states' distracted driving legislation. The prevalence of texting while driving was assessed for different laws using log-binomial regression. Approximately 39.0% of students reported texting while driving at least once in the 30 days before survey. Compared to states with universal texting bans along with young driver all cellphone bans, the adjusted ratio of texting while driving was 0.94 (95% confidence interval [CI], 0.77-1.16) in states with no bans, 1.33 (95% CI, 1.11-1.58) for young driver bans only, 1.24 (95% CI, 1.00-1.52) in states with bans for young drivers but no young driver all cellphone bans, and 0.89 (95% CI, 0.66-1.19) in states with universal texting bans. The prevalence of texting was 28% less in states with delays of full licensure for texting offenses (prevalence ratio = 0.72; 95% CI, 0.59-0.88). Universal texting bans along with young driver all cellphone bans may be more effective in reducing texting while driving. Delays of full licensure may dissuade young drivers from texting and driving. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. The association between states’ texting regulations and the prevalence of texting while driving among U.S. high school students

    PubMed Central

    Rudisill, Toni M.; Zhu, Motao

    2015-01-01

    Purpose To determine which distracted driving laws were associated with decreased texting while driving among U.S. teenage drivers. Methods Data from the 2013 Youth Risk Behavior Surveillance System survey were merged with state’s distracted driving legislation. The prevalence of texting while driving was assessed for different laws using log-binomial regression. Results Approximately 39.0% of students reported texting while driving at least once in the 30 days before survey. Compared to states with universal texting bans along with young driver all cellphone bans, the adjusted ratio of texting while driving was 0.94 (95% confidence interval [CI], 0.77–1.16) in states with no bans, 1.33 (95% CI, 1.11–1.58) for young driver bans only, 1.24 (95% CI, 1.00–1.52) in states with bans for young drivers but no young driver all cellphone bans, and 0.89 (95% CI, 0.66–1.19) in states with universal texting bans. The prevalence of texting was 28% less in states with delays of full licensure for texting offenses (prevalence ratio = 0.72; 95% CI, 0.59–0.88). Conclusions Universal texting bans along with young driver all cellphone bans may be more effective in reducing texting while driving. Delays of full licensure may dissuade young drivers from texting and driving. PMID:26688117

  6. Direct comparison of risk-adjusted and non-risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes.

    PubMed

    Novick, Richard J; Fox, Stephanie A; Stitt, Larry W; Forbes, Thomas L; Steiner, Stefan

    2006-08-01

    We previously applied non-risk-adjusted cumulative sum methods to analyze coronary bypass outcomes. The objective of this study was to assess the incremental advantage of risk-adjusted cumulative sum methods in this setting. Prospective data were collected in 793 consecutive patients who underwent coronary bypass grafting performed by a single surgeon during a period of 5 years. The composite occurrence of an "adverse outcome" included mortality or any of 10 major complications. An institutional logistic regression model for adverse outcome was developed by using 2608 contemporaneous patients undergoing coronary bypass. The predicted risk of adverse outcome in each of the surgeon's 793 patients was then calculated. A risk-adjusted cumulative sum curve was then generated after specifying control limits and odds ratio. This risk-adjusted curve was compared with the non-risk-adjusted cumulative sum curve, and the clinical significance of this difference was assessed. The surgeon's adverse outcome rate was 96 of 793 (12.1%) versus 270 of 1815 (14.9%) for all the other institution's surgeons combined (P = .06). The non-risk-adjusted curve reached below the lower control limit, signifying excellent outcomes between cases 164 and 313, 323 and 407, and 667 and 793, but transgressed the upper limit between cases 461 and 478. The risk-adjusted cumulative sum curve never transgressed the upper control limit, signifying that cases preceding and including 461 to 478 were at an increased predicted risk. Furthermore, if the risk-adjusted cumulative sum curve was reset to zero whenever a control limit was reached, it still signaled a decrease in adverse outcome at 166, 653, and 782 cases. Risk-adjusted cumulative sum techniques provide incremental advantages over non-risk-adjusted methods by not signaling a decrement in performance when preoperative patient risk is high.

  7. Investigation of selection bias in the association of race with prevalent atrial fibrillation in a national cohort study: REasons for Geographic And Racial Differences in Stroke (REGARDS).

    PubMed

    Thacker, Evan L; Soliman, Elsayed Z; Pulley, LeaVonne; Safford, Monika M; Howard, George; Howard, Virginia J

    2016-08-01

    Atrial fibrillation (AF) is diagnosed more commonly in whites than blacks in the United States. In epidemiologic studies, selection bias could induce a noncausal positive association of white race with prevalent AF if voluntary enrollment was influenced by both race and AF status. We investigated whether nonrandom enrollment biased the association of race with prevalent self-reported AF in the US-based REasons for Geographic And Racial Differences in Stroke Study (REGARDS). REGARDS had a two-stage enrollment process, allowing us to compare 30,183 fully enrolled REGARDS participants with 12,828 people who completed the first-stage telephone survey but did not complete the second-stage in-home visit to finalize their REGARDS enrollment (telephone-only participants). REGARDS enrollment was higher among whites (77.1%) than among blacks (62.3%) but did not differ by self-reported AF status. The prevalence of AF was 8.45% in whites and 5.86% in blacks adjusted for age, sex, income, education, and perceived general health. The adjusted white/black prevalence ratio of self-reported AF was 1.43 (95% CI, 1.32-1.56) among REGARDS participants and 1.38 (1.22-1.55) among telephone-only participants. These findings suggest that selection bias is not a viable explanation for the higher prevalence of self-reported AF among whites in population studies such as REGARDS. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Prevalence and associated factors of DSM-V insomnia in Norway: the Nord-Trøndelag Health Study (HUNT 3).

    PubMed

    Uhlig, Benjamin Langsæter; Sand, Trond; Odegård, Siv Steinsmo; Hagen, Knut

    2014-06-01

    Many studies have assessed the prevalence of insomnia, but the influence of non-participants has largely been ignored. The objective of the present study was to estimate the prevalence and associated factors of insomnia in a large adult population using DSM-V (diagnostic and statistical manual of mental disorders, 5th ed.) criteria, also taking non-participants into account. This cross-sectional study used data from a questionnaire in The Nord-Trøndelag Health Study (HUNT 3) performed in 2006-2008, and a subsequent non-participant study. The total adult population (n=93,860 aged > or =20 years) of Nord-Trøndelag County, Norway, was invited. Of these, 40,535 responded to the insomnia questionnaire. Among 42,024 eligible non-participants, 6918 (17%) responded to two insomnia questions. Insomnia was diagnosed by applying modified DSM-V criteria. The age-adjusted insomnia prevalence was estimated using the age distribution of all adult inhabitants of Nord-Trøndelag. Supplementary prevalence data were estimated by extrapolating data from the non-participant study. Additionally, the association between insomnia and self-reported health was estimated, adjusting for known confounders. The total age-adjusted prevalence of insomnia was 7.1% (95% confidence interval [CI], 6.9-7.4) (8.6% for women, 5.5% for men). Adjusting for non-participants, the prevalence estimate changed to 7.9% (95% CI, 7.3-8.6) (9.4% for women, 6.4% for men). Insomnia was more than eight times more likely (OR, 8.3; 95% CI, 6.2-11.1) among individuals with very poor versus very good self-reported health, adjusting for age, gender, employment status, chronic musculoskeletal complaints, anxiety and depression. The adjusted insomnia prevalence estimate in Nord-Trøndelag was 7.9%. Insomnia was strongly associated with poor self-reported health. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Eszopiclone and Zolpidem Do Not Affect the Prevalence of the Low Arousal Threshold Phenotype

    PubMed Central

    Smith, Patrick R.; Sheikh, Karen L.; Costan-Toth, Camille; Forsthoefel, Derek; Bridges, Edward; Andrada, Teotimo F.; Holley, Aaron B.

    2017-01-01

    Study Objectives: We sought to determine whether non benzodiazepine sedative hypnotics (NBSH) reduce the occurrence of the low arousal threshold (LAT) phenotype. Methods: Consecutive patients with suspected obstructive sleep apnea (OSA) referred for polysomnography (PSG) had demographic and PSG data abstracted. LAT was estimated using PSG criteria. After adjusting for pretest probability (PTP) for OSA, we calculated the effect that premedication with NBSHs has on LAT prevalence. Results: Five hundred seventy-nine patients with a mean age and body mass index of 42.2 ± 10.1 y and 28.9 ± 4.5 kg/m2, respectively, had data available for analysis. Most patients (444, or 80.9%) had a LAT, and administering a NBSH (zolpidem or eszopiclone) on the same night as the PSG did not change LAT prevalence (NBSH: 339 (83.3%) versus no drug: 100 (80.6%); p = 0.50). Adjusting for PTP, neither administration of eszopiclone (odds ratio 0.80 (95% confidence interval: 0.33–2.0); 0.69) nor zolpidem (odds ratio 1.65 (95% confidence interval: 0.8–3.5); p = 0.19) reduced the odds that a patient had a LAT. NBSHs did not change the mean SpO2 nadir, percentage hypopneas, or apnea-hypopnea index. There was no association between zolpidem or eszopiclone dosing and SpO2 nadir (zolpidem: β = −0.69, p = 0.80; eszopiclone: β = −1.53, p = 0.68), percentage hypopneas (zolpidem: β = 2.2, p = 0.43; eszopiclone β = −6.2, p = 0.46), or apnea-hypopnea index (zolpidem: β = 3.1, p = 0.22; eszopiclone: β = 2.6, p = 0.39). Conclusions: The LAT is common in our population and NBSH premedication does not alter its occurrence. Further studies are needed to determine how the LAT can be optimally managed to improve OSA treatment. Citation: Smith PR, Sheikh KL, Costan-Toth C, Forsthoefel D, Bridges E, Andrada TF, Holley AB. Eszopiclone and zolpidem do not affect the prevalence of the low arousal threshold phenotype. J Clin Sleep Med. 2017;13(1):115–119. PMID:27784413

  10. Comparing the prevalence and the risk profile for antenatal depressive symptoms across cultures.

    PubMed

    Corbani, Irene E; Rucci, Paola; Iapichino, Elena; Quartieri Bollani, Marta; Cauli, Gilla; Ceruti, Mara R; Gala, Costanzo; Bassi, Mariano

    2017-11-01

    Although several studies have analyzed the risk factors of antenatal and post-partum depression, evidence on the prevalence and the risk profile for antenatal depressive symptoms (ADS) between native-born and different groups of non-native born women living in the same country is scant. The aim of this article is to compare the prevalence and the risk profile for ADS across geographical areas in women recruited from two large hospitals of North-western Italy. The presence of ADS was defined as an Edinburgh Post-natal Depression Scale (EPDS) score ≥12 or a Beck Depression Inventory, Short Form (BDI-SF) score ≥9 or the presence of suicidal ideation/behavior. Crude and adjusted odds ratios (ORs) of ADS were calculated using logistic regression models. The prevalence of ADS was 12.4% among Italian women and ranged from 11.4% in other European to 44.7% in North-African women. Crude ORs of ADS were OR = 3.3 (95% confidence interval (CI), 1.2-8.8) for Asian, 3.3 (95% CI, 1.9-5.6) for South-American and 5.7 (95% CI, 3.4-9.6) for North-African women. Marital problems, at-risk pregnancy, past psychiatric history, pharmacological treatment, psychological treatment, financial problems, change in residence and number of children were significantly associated with ADS in multivariate analyses, regardless of women's origin. After adjusting for these variables, the OR of ADS remained significant for South-American and North-African women. Our results demonstrate that the risk of ADS varies across geographical areas of origin and is highest among North-African women. The risk factors identified should be assessed in routine obstetric care to inform decisions about interventions to prevent post-partum depression and its consequences on the mothers and the newborns.

  11. Prevalence and correlates of internet cigarette purchasing among adult smokers in New Jersey.

    PubMed

    Hrywna, M; Delnevo, C D; Staniewska, D

    2004-09-01

    To examine the prevalence and correlates of internet cigarette purchasing among adult smokers. Analysis of internet purchasing in data from a population based telephone survey of New Jersey households. Logistic regression was used to determine factors associated with internet cigarette purchasing, adjusting for year, demographic, and smoking behaviour variables. 3447 current cigarette smokers pooled from three cross sectional surveys conducted in 2000, 2001, and 2002. Ever purchasing tobacco and usually buying cigarettes via the internet. Among all current cigarette smokers, ever having purchased tobacco via the internet increased from 1.1% in 2000 to 6.7% in 2002 and usually buying cigarettes via the internet increased from 0.8% in 2000 to 3.1% in 2002. Among current cigarette smokers with internet access, ever having purchased tobacco via the internet was higher among those who reported smoking 31 or more cigarettes per day (adjusted odds ratio (OR) 3.9, 95% confidence interval (CI) 1.5 to 10.2) and those without a past year quit attempt (adjusted OR 1.8, 95% CI 1.1 to 3.0). Usually purchasing cigarettes via the internet was higher among those aged 45-64 years (adjusted OR 4.4, 95% CI 1.1 to 17.1) and who reported having their first cigarette < or = 30 minutes after waking (adjusted OR 3.3, 95% CI 1.2 to 9.2). Although higher prices are known to reduce the demand for cigarettes, internet cigarette purchasing is likely to weaken this effect, particularly among heavy, more dependent smokers who are less interested in quitting.

  12. Prevalence of helminth infestation during pregnancy and its association with maternal anemia and low birth weight.

    PubMed

    Aderoba, Adeniyi K; Iribhogbe, Oseihie I; Olagbuji, Biodun N; Olokor, Oghenefegor E; Ojide, Chiedozie K; Ande, Adedapo B

    2015-06-01

    To determine the prevalence of helminth infestation during pregnancy and the associated risks of adverse maternal and infant outcomes. A cross-sectional study of women with a singleton pregnancy of at least 34 weeks was conducted at a teaching hospital in Benin City, Nigeria, between April 1 and September 30, 2010. Socioeconomic and clinical data were obtained. Stool samples were used to determine helminth infection. Birth weight was recorded at delivery. Multivariable analysis was used to assess the link between helminth infestation and maternal and perinatal outcomes. Among 178 women, 31 (17.4%) had a helminth infestation (15 [8.4%] had ascariasis, 8 [4.5%] trichuriasis, and 25 [14.0%] hookworm infestation). Multivariate analysis found that helminth infestations was associated with maternal anemia (adjusted odds ratio 12.4; 95% confidence interval 4.2-36.3) and low birth weight (adjusted odds ratio 6.8; 95% confidence interval 2.1-21.9). Approximately one in five women had a helminth infestation in the third trimester of pregnancy. Maternal helminth infestation significantly increased the risks of maternal anemia and low birth weight, indicating that routine administration of anthelminthic drugs during early pregnancy might improve perinatal outcomes. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Prevalence of Obesity Among Adults, by Household Income and Education - United States, 2011-2014.

    PubMed

    Ogden, Cynthia L; Fakhouri, Tala H; Carroll, Margaret D; Hales, Craig M; Fryar, Cheryl D; Li, Xianfen; Freedman, David S

    2017-12-22

    Studies have suggested that obesity prevalence varies by income and educational level, although patterns might differ between high-income and low-income countries (1-3). Previous analyses of U.S. data have shown that the prevalence of obesity varied by income and education, but results were not consistent by sex and race/Hispanic origin (4). Using data from the National Health and Nutrition Examination Survey (NHANES), CDC analyzed obesity prevalence among adults (aged ≥20 years) by three levels of household income, based on percentage (≤130%, >130% to ≤350%, and >350%) of the federal poverty level (FPL) and individual education level (high school graduate or less, some college, and college graduate). During 2011-2014, the age-adjusted prevalence of obesity among adults was lower in the highest income group (31.2%) than the other groups (40.8% [>130% to ≤350%] and 39.0% [≤130%]). The age-adjusted prevalence of obesity among college graduates was lower (27.8%) than among those with some college (40.6%) and those who were high school graduates or less (40.0%). The patterns were not consistent across all sex and racial/Hispanic origin subgroups. Continued progress is needed to achieve the Healthy People 2020 targets of reducing age-adjusted obesity prevalence to <30.5% and reducing disparities (5).

  14. Viruses are prevalent in non-ventilated hospital-acquired pneumonia.

    PubMed

    Shorr, Andrew F; Zilberberg, Marya D; Micek, Scott T; Kollef, Marin H

    2017-01-01

    Hospital-acquired pneumonia arising in non-ventilated patients (NVHAP) is traditionally thought to be caused by bacteria, and little is known about viral etiologies in this syndrome. We sought to describe the prevalence of viruses causing NVHAP and to determine factors independently associated with the isolation of a virus. We identified patients with NVHAP over one year and reviewed their cultures to determine etiologies. Patients with a viral process were compared to those with either negative cultures or a bacterial infection to determine variables independently associated with the recovery of a virus. Among 174 cases, cultures were positive in 46.0%, with viruses identified in 22.4%. Bacterial pathogens arose 23.6% of subjects. The most common viruses included rhinovirus, influenza, and parainfluenza. We noted no seasonality in the isolation of viral organisms, and most cases of viral NVHAP developed after more than a week length of stay (LOS). Outcomes in viral NVHAP were similar to those with bacterial NVHAP. Patients with viral and bacterial NVHAP were generally similar. Two variables were independently associated with isolation of a virus: a history of coronary artery disease (adjusted odds ratio: 5.16, 95% CI: 1.14-22.44) and a LOS of greater than 10 days prior to NVHAP diagnosis (adjusted odds ratio: 2.97, 95% CI: 1.35-6.51). As a screening test for a virus, neither had a good sensitivity or specificity. Viruses represent a common cause of NVHAP. Clinicians should consider viral diagnostic testing in NVHAP, as this may represent a means to enhance antimicrobial stewardship. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Age-Adjustment and Related Epidemiology Rates in Education and Research

    ERIC Educational Resources Information Center

    Baker, John D.; Kruckman, Laurence; George, Joyce

    2006-01-01

    A quick review of introductory textbooks reveals that while gerontology authors and instructors introduce some aspect of demography and epidemiology data, there is limited focus on age adjustment or other important epidemiology rates. The goal of this paper is to reintroduce a variety of basic epidemiology strategies such as incidence, prevalence,…

  16. Bullying Among South Korean Adolescents: Prevalence and Association With Psychological Adjustment.

    PubMed

    Yun, Ilhong; Kim, Seung-Gon

    2016-01-01

    This study assessed the prevalence rates of physical, verbal, relational, property, and cyber bullying among a sample of South Korean middle school students. Associations between bullying and a list of psychopathological symptoms were also examined. Finally, whether a link between bullying and psychopathological symptoms is modified by the level of parental attachment was examined. Results show that, contrary to Western studies, girls were more likely than boys to be involved in school bullying. Significant interaction effects between parental attachment and bully/victim status on depression were also discovered.

  17. Macrovascular Complications and Prevalence of Urgency Incontinence in Japanese Patients with Type 2 Diabetes Mellitus: The Dogo Study.

    PubMed

    Furukawa, Shinya; Sakai, Takenori; Niiya, Tetsuji; Miyaoka, Hiroaki; Miyake, Teruki; Yamamoto, Shin; Kanzaki, Sayaka; Maruyama, Koutatsu; Tanaka, Keiko; Ueda, Teruhisa; Senba, Hidenori; Torisu, Masamoto; Minami, Hisaka; Onji, Morikazu; Tanigawa, Takeshi; Matsuura, Bunzo; Hiasa, Yoichi; Miyake, Yoshihiro

    2017-01-01

    Objective Macrovascular diseases and urgency incontinence are common among Japanese patients with type 2 diabetes mellitus. However, little evidence exists regarding the association between stroke and urgency incontinence among patients with type 2 diabetes mellitus. We examined the associations between macrovascular complications and urgency incontinence among Japanese patients with type 2 diabetes mellitus. Methods The study subjects were 818 Japanese patients with type 2 diabetes mellitus. Urgency incontinence was defined as present when a subject answered "once a week or more" to the question: "Within one week, how often do you leak urine because you cannot defer the sudden desire to urinate?" We adjusted our analyses for sex, age, body mass index, duration of type 2 diabetes, current smoking, current drinking, hypertension, dyslipidemia, glycated hemoglobin, diabetic nephropathy, diabetic retinopathy, and diabetic peripheral neuropathy. Results The prevalence of urgency incontinence was 9.2%. Stroke was independently positively associated with urgency incontinence, with an adjusted odds ratio of 2.34 (95% confidence interval: 1.03-4.95). The associations between ischemic heart disease or peripheral artery disease and the prevalence of urgency incontinence were not significant. Conclusion In Japanese patients with type 2 diabetes mellitus, stroke, but not ischemic heart diseases or peripheral artery disease, was independently positively associated with urgency incontinence.

  18. Prevalence of major depressive disorder among spouses of men who use alcohol in a rural community in Central Sri Lanka.

    PubMed

    Ariyasinghe, Dewasmika; Abeysinghe, Ranil; Siriwardhana, Prabhash; Dassanayake, Tharaka

    2015-05-01

    To estimate the prevalence of major depressive disorder (MDD) among spouses of men who use alcohol in two rural areas in Sri Lanka, and to examine whether the severity of alcohol-related problems (ARPs) in men and presence of alcohol-related domestic violence are associated with MDD among these women. In a cross-sectional study, ARPs among men were assessed using Alcohol Use Disorders Identification Test (AUDIT) questionnaire filled in by men, and domestic violence and husbands' drinking pattern data obtained from the women. MDD among the women was ascertained using the Structured Clinical Interview for DSM-IV Disorders for major depression. Using logistic regression we examined whether age, past history of depression, different indices of ARPs and domestic violence were associated with current MDD among the women. Point prevalence of MDD in the sample was 33.3% (95% CI: 25.93, 40.73%). Once adjusted for other factors, morning drinking of the spouse (odds ratio = 4.11, 95% CI: 1.25, 13.47; P = 0.019) and increasing age (odds ratio = 1.05, 95% CI: 1.01, 1.09; P = 0.003) significantly increased the odds of MDD. Being subjected to domestic violence/arguments also had a trend to be associated with MDD among women, but was not significant (odds ratio = 2.29, 95% CI: 0.95, 5.48; P = 0.062). The prevalence of MDD among spouses of men who use alcohol is markedly higher than that has been observed among Sri Lankan women in previous studies. The prevalence of MDD in women seems to increase when their husbands are morning drinkers, and with increasing age. © The Author 2015. Medical Council on Alcohol and Oxford University Press.

  19. Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk?

    PubMed

    Silverstein, Barbara; Fan, Z Joyce; Smith, Caroline K; Bao, Stephen; Howard, Ninica; Spielholz, Peregrin; Bonauto, David; Viikari-Juntura, Eira

    2009-03-01

    The aim was to explore whether "adjustment" for gender masks important exposure differences between men and women in a study of rotator cuff syndrome (RCS) and carpal tunnel syndrome (CTS) and work exposures. This cross-sectional study of 733 subjects in 12 health care and manufacturing workplaces used detailed individual health and work exposure assessment methods. Multiple logistic regression analysis was used to compare gender stratified and adjusted models. Prevalence of RCS and CTS among women was 7.1% and 11.3% respectively, and among men 7.8% and 6.4%. In adjusted (gender, age, body mass index) multivariate analyses of RCS and CTS, gender was not statistically significantly different. For RCS, upper arm flexion >/=45 degrees and forceful pinch increased the odds in the gender-adjusted model (OR 2.66, 95% CI 1.26-5.59) but primarily among women in the stratified analysis (OR 6.68, 95% CI 1.81-24.66 versus OR 1.45, 95% CI 0.53-4.00). For CTS, wrist radial/ulnar deviation >/=4% time and lifting >/=4.5kg >3% time, the adjusted OR was higher for women (OR 4.85, 95% CI 2.12-11.11) and in the gender stratified analyses, the odds were increased for both genders (women OR 5.18, 95% CI 1.70-15.81 and men OR 3.63, 95% CI 1.08-12.18). Gender differences in response to physical work exposures may reflect gender segregation in work and potential differences in pinch and lifting capacity. Reduction in these exposures may reduce prevalence of upper extremity disorders for all workers.

  20. The Prevalence of Burning Mouth Syndrome: A Population-Based Study

    PubMed Central

    Kohorst, John J.; Bruce, Alison J.; Torgerson, Rochelle R.; Schenck, Louis A.; Davis, Mark D. P.

    2015-01-01

    Background Burning mouth syndrome (BMS) is defined as symptoms of persistent burning in the mouth without objective findings accounting for the symptoms. Objectives To calculate the point prevalence of BMS in Olmsted County, Minnesota, on December 31, 2010. Methods The Rochester Epidemiology Project (REP) medical records linkage system was used to identify BMS cases diagnosed or potentially diagnosed before December 31, 2009. Inclusion criteria were subjective oral discomfort, normal oral examination, and documented BMS diagnosis by a REP physician. Results In total, 149 BMS cases were confirmed, representing age- and sex-adjusted point prevalence of BMS in Olmsted County of 0.11%, or 105.6 (95% CI, 88.6–122.6) per 100,000 persons. Age-adjusted prevalence in women was significantly higher than men: 168.6 (95% CI, 139.0–198.2) vs 35.9 (95% CI, 21.4–50.3) per 100,000 persons (P<.001). The highest prevalence was in women aged 70 through 79 years (527.9 per 100,000 persons). Mean (SD) age at BMS diagnosis was 59.4 (15.1) years (range, 25–90 years). Conclusions To our knowledge, we provide the first report of population-based BMS prevalence. The data show that BMS most commonly affects women older than 50 years, and when defined through diagnostic criteria, it is less prevalent than described previously. PMID:25495557

  1. Differences in Obesity Prevalence by Demographic Characteristics and Urbanization Level Among Adults in the United States, 2013-2016.

    PubMed

    Hales, Craig M; Fryar, Cheryl D; Carroll, Margaret D; Freedman, David S; Aoki, Yutaka; Ogden, Cynthia L

    2018-06-19

    Differences in obesity by sex, age group, race and Hispanic origin among US adults have been reported, but differences by urbanization level have been less studied. To provide estimates of obesity by demographic characteristics and urbanization level and to examine trends in obesity prevalence by urbanization level. Serial cross-sectional analysis of measured height and weight among adults aged 20 years or older in the 2001-2016 National Health and Nutrition Examination Survey, a nationally representative survey of the civilian, noninstitutionalized US population. Sex, age group, race and Hispanic origin, education level, smoking status, and urbanization level as assessed by metropolitan statistical areas (MSAs; large: ≥1 million population). Prevalence of obesity (body mass index [BMI] ≥30) and severe obesity (BMI ≥40) by subgroups in 2013-2016 and trends by urbanization level between 2001-2004 and 2013-2016. Complete data on weight, height, and urbanization level were available for 10 792 adults (mean age, 48 years; 51% female [weighted]). During 2013-2016, 38.9% (95% CI, 37.0% to 40.7%) of US adults had obesity and 7.6% (95% CI, 6.8% to 8.6%) had severe obesity. Men living in medium or small MSAs had a higher age-adjusted prevalence of obesity compared with men living in large MSAs (42.4% vs 31.8%, respectively; adjusted difference, 9.8 percentage points [95% CI, 5.1 to 14.5 percentage points]); however, the age-adjusted prevalence among men living in non-MSAs was not significantly different compared with men living in large MSAs (38.9% vs 31.8%, respectively; adjusted difference, 4.8 percentage points [95% CI, -2.9 to 12.6 percentage points]). The age-adjusted prevalence of obesity was higher among women living in medium or small MSAs compared with women living in large MSAs (42.5% vs 38.1%, respectively; adjusted difference, 4.3 percentage points [95% CI, 0.2 to 8.5 percentage points]) and among women living in non-MSAs compared with women living in

  2. Prevalence of asthma, rhinitis and eczema symptoms in rural and urban school-aged children from Oropeza Province - Bolivia: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Asthma and allergies are world-wide common chronic diseases among children and young people. Little information is available about the prevalence of these diseases in rural areas of Latin America. This study assesses the prevalence of symptoms of asthma and allergies among children in urban and rural areas at Oropeza Province in Bolivia. Methods The Spanish version of the ISAAC standardized questionnaire and the ISAAC video questionnaire were implemented to 2584 children attending the fifth elementary grade in 36 schools in Oropeza province (response 91%). Lifetime, 12 months and severity prevalence were determined for asthma, rhinitis and eczema symptoms. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated adjusting for age using generalized linear mixed-effects models. Results Median age of children was 11 years, 74.8% attended public schools, and 52.1% were female. While children attending urban schools had lower prevalence of self-reported wheeze in the written questionnaire (adjusted OR 0.6; 95% CI 0.4-1.9), they were more likely than children attending rural schools to report wheeze in the video questionnaire (aOR 2.1; 95% CI 1.0-2.6). They also reported more frequently severe rhinoconjunctivitis (aOR 2.8; 95% CI 1.2-6.6) and severe eczema symptoms (aOR 3.3; 95% CI 1.0-11.0). Conclusion Overall in accordance with the hygiene hypothesis, children living in urban areas of Bolivia seem to have a higher prevalence of symptoms of asthma and allergies compared to children living in the country side. In order to develop primary prevention strategies, environmental factors need to be identified in future studies. PMID:24612913

  3. Prevalence of asthma, rhinitis and eczema symptoms in rural and urban school-aged children from Oropeza Province - Bolivia: a cross-sectional study.

    PubMed

    Solis Soto, María Teresa; Patiño, Armando; Nowak, Dennis; Radon, Katja

    2014-03-10

    Asthma and allergies are world-wide common chronic diseases among children and young people. Little information is available about the prevalence of these diseases in rural areas of Latin America. This study assesses the prevalence of symptoms of asthma and allergies among children in urban and rural areas at Oropeza Province in Bolivia. The Spanish version of the ISAAC standardized questionnaire and the ISAAC video questionnaire were implemented to 2584 children attending the fifth elementary grade in 36 schools in Oropeza province (response 91%). Lifetime, 12 months and severity prevalence were determined for asthma, rhinitis and eczema symptoms. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated adjusting for age using generalized linear mixed-effects models. Median age of children was 11 years, 74.8% attended public schools, and 52.1% were female. While children attending urban schools had lower prevalence of self-reported wheeze in the written questionnaire (adjusted OR 0.6; 95% CI 0.4-1.9), they were more likely than children attending rural schools to report wheeze in the video questionnaire (aOR 2.1; 95% CI 1.0-2.6). They also reported more frequently severe rhinoconjunctivitis (aOR 2.8; 95% CI 1.2-6.6) and severe eczema symptoms (aOR 3.3; 95% CI 1.0-11.0). Overall in accordance with the hygiene hypothesis, children living in urban areas of Bolivia seem to have a higher prevalence of symptoms of asthma and allergies compared to children living in the country side. In order to develop primary prevention strategies, environmental factors need to be identified in future studies.

  4. Metabolic syndrome prevalence in a multicultural population in Auckland, New Zealand.

    PubMed

    Gentles, Dudley; Metcalf, Patricia; Dyall, Lorna; Sundborn, Gerhard; Schaaf, David; Black, Peter; Scragg, Robert; Jackson, Rodney

    2007-01-26

    To estimate ethnic-specific metabolic syndrome prevalence in the Auckland region and to identify the main reasons for the differences. A cross-sectional survey of adults aged between 35-74 years within the Auckland area using a dual sampling frame with both cluster sampling and random selection from electoral rolls. Participants included 1006 Maori, 996 Pacific people, and 2020 of other ethnicity (mainly Europeans). The prevalence of metabolic syndrome (using the 2001 ATPIII definition, age and gender adjusted) were: Maori 32%, Pacific people 39%, and Others 16%. Maori were twice as likely as others (OR=2.01, 95% CI: 1.53 to 2.64) to have the metabolic syndrome while Pacific people were two and a half times as likely (OR=2.54, 95% CI: 1.93 to 3.35), after adjusting for multiple CVD risk factors other than the components of the syndrome. Adjusting these ethnic differences in prevalences for each of the components of the syndrome separately indicated that most of the differences could be accounted for by differences in obesity. In addition, more than a third of people with diabetes did not have the metabolic syndrome. The prevalences of metabolic syndrome were significantly higher in Pacific people and Maori compared to Others and measures of obesity accounted for most of the ethnic differences.

  5. Obesity Prevalence by Occupation in Washington State, Behavioral Risk Factor Surveillance System

    PubMed Central

    Lu, Dayu; Fan, Z. Joyce

    2014-01-01

    Introduction Data that estimate the prevalence of and risk factors for worker obesity by occupation are generally unavailable and could inform the prioritization of workplace wellness programs. The aims of this study were to estimate the prevalence of obesity by occupation, examine the association of occupational physical activity and a range of health behaviors with obesity, and identify occupations in which workers are at high risk of obesity in Washington State. Methods We conducted descriptive and multivariable analyses among 37,626 employed Washington State respondents using the Behavioral Risk Factor Surveillance System in odd numbered years, from 2003 through 2009. We estimated prevalence and prevalence ratios (PRs) by occupational groups adjusting for demographics, occupational physical activity level, smoking, fruit and vegetable consumption, and leisure-time physical activity (LPTA). Results Overall obesity prevalence was 24.6% (95% confidence interval [CI], 24.0–25.1). Workers in protective services were 2.46 (95% CI, 1.72–3.50) times as likely to be obese as workers in health diagnosing occupations. Compared with their counterparts, workers who consumed adequate amounts of fruits and vegetables and had adequate LTPA were significantly less likely to be obese (PR = 0.91; 95% CI, 0.86–0.97 and PR = 0.63; 95% CI, 0.60–0.67, respectively). Workers with physically demanding occupational physical activity had a lower PR of obesity (PR = 0.83; 95% CI, 0.78–0.88) than those with nonphysically demanding occupational physical activity. Conclusion Obesity prevalence and health risk behaviors vary substantially by occupation. Employers, policy makers, and health promotion practitioners can use our results to target and prioritize workplace obesity prevention and health behavior promotion programs. PMID:24406093

  6. Prevalence of asthma by industry in the US population: a study of 2001 NHIS data.

    PubMed

    Bang, Ki Moon; Hnizdo, Eva; Doney, Brent

    2005-06-01

    The estimated number of US workers potentially exposed to asthmagens ranges from 8 to 20 million. This study was undertaken to estimate the US prevalence of asthma in adults by industry of employment and to identify industries with elevated risk of asthma. Prevalence analysis was performed on 20,991 adults, 18 years of age and older who participated in the 2001 National Health Interview survey. We used SUDAAN software to estimate the prevalence of self-reported physician diagnosed asthma by industry, and odds ratios (ORs) for asthma and industry adjusted for age, sex, race, and smoking status. The overall prevalence of physician diagnosed asthma was 6.5% (95% CI 6.1-6.9); 4.7% (95% CI 4.1-5.3) for males and 8.5% (95% CI 7.9-9.1) for females. In whites, the prevalence and ORs were significantly elevated for printing, publishing, and allied industries (OR = 2.4, 95% CI 1.2-5.0) and health care (OR = 1.3, 95% CI 1.0-1.7). In blacks, ORs were elevated for furniture, lumber, and wood (OR = 5.9, 95% CI 1.4-25.4) and entertainment and recreation industries (OR = 4.1, 95% CI 1.1-15.9). Other industries with elevated ORs included automobile dealers and gasoline station; durable goods; elementary, secondary schools, and colleges; other personal services; eating and drinking places; entertainment and recreation services; and utility and sanitary. Industries with elevated prevalence of asthma are identified. This information helps to target workplaces where detailed investigations for prevention and control may be appropriate.

  7. Prevalence and Trends of Symptomatic Pelvic Floor Disorders in U.S. Women

    PubMed Central

    Wu, Jennifer M.; Vaughan, Camille P.; Goode, Patricia S.; Redden, David T.; Burgio, Kathryn L.; Richter, Holly E.; Markland, Alayne D.

    2014-01-01

    Objective To estimate the prevalence and trends of these pelvic floor disorders in U.S. women from 2005–2010. Methods We utilized the National Health and Nutritional Examination Survey (NHANES) from 2005–2006, 2007–2008, and 2009–2010. A total of 7,924 non-pregnant women (aged 20 years or older) were categorized as having: urinary incontinence – moderate to severe (3 or higher on a validated urinary incontinence (UI) severity index, range 0–12); fecal incontinence – at least monthly (solid, liquid, or mucus stool); and pelvic organ prolapse – seeing or feeling a bulge. Potential risk factors included age, race and ethnicity, parity, education, poverty income ratio, body mass index (BMI) (<25, 25–29, ≥30 kg/m2), co-morbidity count, and reproductive factors. Using appropriate sampling weights, weighted chi square analysis and multivariable logistic regression models with odds ratios (OR) and 95% confidence intervals (95% CI) were reported. Results The weighted prevalence rate of one or more pelvic floor disorder was 25.0% (95% CI 23.6, 26.3), including 17.1% (95% CI 15.8, 18.4) of women with moderate-to-severe urinary incontinence, 9.4% (95% CI 8.6, 10.2) with fecal incontinence, and 2.9% (95% CI 2.5, 3.4) with prolapse. From 2005 to 2010, no significant differences were found in the prevalence rates of any individual disorder or for all disorders combined (p>0.05). After adjusting for potential confounders, higher BMI, greater parity, and hysterectomy were associated with higher odds of one or more pelvic floor disorder. Conclusion Although rates of pelvic floor disorders did not change from 2005–2010, these condition remain common with one quarter of adult U.S. women reporting at least one disorder. PMID:24463674

  8. Disparities in Current Cigarette Smoking Prevalence by Type of Disability, 2009–2011

    PubMed Central

    Stevens, Alissa; Caraballo, Ralph; Ramon, Ismaila; Armour, Brian S.

    2014-01-01

    Objectives Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report smoking, little is known about the prevalence of smoking by type of disability, particularly for adults younger than 50 years of age. Methods We used data from the 2009–2011 National Health Interview Survey to estimate the prevalence of smoking by type of disability and to examine the association of functional disability type and smoking among adults aged 18–49 years. Results Adults with a disability were more likely than adults without a disability to be current smokers (38.8% vs. 20.7%, p<0.001). Among adults with disabilities, the prevalence of smoking ranged from 32.4% (self-care difficulty) to 43.8% (cognitive limitation). When controlling for sociodemographic characteristics, having a disability was associated with statistically significantly higher odds of current smoking (adjusted odds ratio = 1.57, 95% confidence interval 1.40, 1.77). Conclusions The prevalence of current smoking for adults was higher for every functional disability type than for adults without a disability. By understanding the association between smoking and disability type among adults younger than 50 years of age, resources for cessation services can be better targeted during the ages when increased time for health improvement can occur. PMID:24791023

  9. High prevalence of overweight and obesity among a representative sample of Puerto Rican children.

    PubMed

    Elías-Boneta, Augusto R; Toro, Milagros J; Garcia, Omar; Torres, Roxana; Palacios, Cristina

    2015-03-05

    The prevalence of childhood overweight and obesity has become a public health problem worldwide. The objectives of the study were: 1) to establish the BMI prevalence in 12-year olds residing in Puerto Rico, and 2) to determine BMI differences by sex, public-private school type, and geographic regions. Data was obtained from an island-wide probabilistic stratified sample of 1,582 twelve-year-olds (53% girls and 47% boys). The BMI was determined using the National Health and Nutrition Examination Survey procedures. Children were categorized as underweight, healthy weight, overweight or obese using the Center for Disease Control and Prevention's age and gender specific growth charts. A logistic regression model was used to estimate BMI category prevalence. Odds ratios were calculated using a multinomial regression. In this study, 18.8% of the children were overweight and 24.3% were obese. A higher prevalence of obesity was observed in boys as compared to girls, 28.2% vs. 20.2%, respectively. The estimated prevalence of overweight and obesity in children from public schools was lower than for those from private schools. After adjusting for type of school and region, boys had a significantly higher risk of being obese (64%) as compared to girls. In public schools, boys had a lower prevalence of being overweight while girls had a higher prevalence compared to children attending private schools. Girls attending private schools had a higher obesity prevalence (27.8%) compared to girls from public schools (19.8%). The prevalence of underweight (2.7%) is slightly lower than in the United States. The prevalence of overweight and obesity of 12-year-olds residing in PR was 18.8% and 24.3%, respectively; higher than in the U.S. (by groups). Boys were at higher risk of obesity than girls. There is an urgent need to implement public health policies/programs to reduce the prevalence of overweight and obesity in children in PR.

  10. The Prevalence of Trachoma in Tigray Region, Northern Ethiopia: Results of 11 Population-Based Prevalence Surveys Completed as Part of the Global Trachoma Mapping Project.

    PubMed

    Sherief, Sadik Taju; Macleod, Colin; Gigar, Goitum; Godefay, Hagos; Abraha, Atakelit; Dejene, Michael; Kello, Amir B; Belete, Aberash; Assefa, Yitbarek; Willis, Rebecca; Chu, Brian K; Solomon, Anthony W

    2016-01-01

    We aimed to estimate the prevalence of trachoma in each district ("woreda") of Tigray Region, Ethiopia. We conducted 11 cross-sectional community-based surveys in evaluation units covering 34 rural woredas from January to March 2013 using the standardized methodology developed for the Global Trachoma Mapping Project. Teams visited 8034 households in 275 villages. A total of 28,581 consenting individuals were examined, 16,163 (56.7%) of whom were female. The region-wide adjusted trichiasis prevalence was 1.7% in those aged 15 years and older. All evaluation units mapped had a trichiasis prevalence over the World Health Organization elimination threshold of 0.2% in people aged 15 years and older. The region-wide adjusted prevalence of the clinical sign trachomatous inflammation - follicular (TF) in children aged 1-9 years was 26.1%. A total 10 evaluation units, covering 31 woredas, with a combined rural population of 4.3 million inhabitants, had a prevalence of TF ≥10%, and require full implementation of the SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvement) for at least 3 years before impact surveys are undertaken. Of these, four evaluation units, covering 12 woredas, with a combined rural population of 1.7 million inhabitants, had a TF prevalence ≥30%. Both active trachoma and trichiasis are public health problems in Tigray, which needs urgent implementation of the full SAFE strategy.

  11. Cognitive impairment is independently associated with definitive and possible sarcopenia in hospitalized older adults: The prevalence and impact of comorbidities.

    PubMed

    Maeda, Keisuke; Akagi, Junji

    2017-07-01

    Older adults often present with several comorbidities, including sarcopenia. However, the prevalence of sarcopenia and its associations with other comorbidities in hospitalized older adults are unknown. The present study aimed to determine the prevalence of sarcopenia, and its associations with other comorbidities in hospitalized older adults. The present cross-sectional study included 619 patients admitted to a geriatric hospital. The prevalence of comorbidities in the presence and absence of sarcopenia, nutritional status (according to body mass index and the Mini-Nutritional Assessment-Short Form), and activities of daily living (according to the Barthel Index) were assessed. Sarcopenia was defined as skeletal muscle loss evaluated by both bioelectrical impedance and handgrip strength analyses. Of the 619 participants (mean age 83.0 ± 8.2 years), 417 (67.4%) and 87 (14.1%) had definitive and possible sarcopenia, respectively. The prevalence rates of cognitive impairment and stroke were significantly higher in patients with definitive sarcopenia and those with possible sarcopenia than in those without sarcopenia (cognitive impairment 54.4%, 70.1% and 20.9%, respectively, P < 0.001; stroke 31.2%, 48.3% and 19.1%, respectively, P < 0.001). Multivariate logistic regression analysis showed that cognitive impairment was independently associated with sarcopenia after adjusting for age, sex, the Mini-Nutritional Assessment-Short Form score, Barthel Index and primary disease (adjusted odds ratio 1.98, 95% confidence interval 1.06-3.71; P = 0.032). Sarcopenia might be highly prevalent among hospitalized older adults. Furthermore, cognitive impairment might be an independent explanatory variable of sarcopenia. Therefore, further studies on sarcopenia in patients with cognitive impairment are warranted. Geriatr Gerontol Int 2017; 17: 1048-1056. © 2016 Japan Geriatrics Society.

  12. Increasing Prevalence Rate of Nontuberculous Mycobacteria ...

    EPA Pesticide Factsheets

    Rationale: Many nontuberculous mycobacteria (NTM) are clinically significant pathogens that cause disease in a variety of different human organs and tissues. Objectives: A population-based study was undertaken to investigate the prevalence of patients with a positive specimen for NTM within five states of the United States. Methods: We determined the case and age distribution of patients with at least one specimen positive for NTM, using data submitted to the disease surveillance systems of five states (Maryland, Mississippi, Missouri, Ohio, and Wisconsin) between 2008 and 2013. Crude, age-specific, and age-adjusted prevalence rates per 100,000 persons were calculated for each state. Measurements and Main Results: From 2008 to 2013, a total of 24,226 NTM cases were reported to the disease surveillance systems of the five states. The overall average annual age-adjusted prevalence rate rose from 8.7 to 13.9 per 100,000 persons between the beginning and end of the surveillance period. The number of cases and case rate in the 50–80+-year age group was higher than in the 0–49-year age group. Prevalence by age category differed among the five states. The highest number of NTM cases was observed in Mississippi for the 80+-year age group, whereas Wisconsin observed the highest number of NTM cases in the 60- to 69-year age group. Conclusions: From 2008 to 2013, the number of patients with positive specimens for NTM rose. This trend is likely to continue in the co

  13. A preliminary survey on prevalence and knowledge about different aspects of somnambulism in Buner District of Khyber Pakhtunkhwa, Pakistan.

    PubMed

    Wajiha; Hasan, Zaigham; Afridi, Rabia; Rahman, Lubna; Qureshi, Naveeda Akhtar; Saeed, Kausar; Afridi, Humera

    2018-01-20

    Present study was aimed to investigate the prevalence and knowledge about different aspects of somnambulism in general population of Buner District, KP, Pakistan, during December 2015-November 2016. Data was collected through convenient sampling technique which was comprised of structured and detailed questionnaire. Collected data regarding different actions performed by sleepwalkers were adjusted through a weighted variable to generalize results. Univariate and multivariate logistic regression was used to evaluate association between variables related to somnambulism. Their odds ratios (ORs) were reported with their corresponding 95% CIs. In total, 11,881 individuals were surveyed, of which 448 (4%) suffered with sleep disorder. Females 256/448 (57%) were more prevalent as compared to males 192/448 (43%). Prevalence of somnambulism among children was 38% whereas 94% sufferers reported no effect on their growth. Majority of respondents reported that main cause of sleepwalking is stress and tension. Somnambulism was taken normal and mostly amusing disorder by sufferers and their families. Sleepwalking is not age specific and serious disorder. Sleepwalkers need special care during their episode due to unconsciousness.

  14. Domestic violence is associated with adult and childhood asthma prevalence in India.

    PubMed

    Subramanian, S V; Ackerson, Leland K; Subramanyam, Malavika A; Wright, Rosalind J

    2007-06-01

    Little is known on the influence of stressful psychosocial circumstances in predicting asthma. We examine the link between asthma prevalence and domestic violence (DV) in a nationally representative sample of adults and children in India. Analyses were based on the 1998-99 cross-sectional nationally representative Indian National Family Health Survey administered in 92 486 households. Individual-level prevalence of asthma was the primary outcome for this study. Exposure to DV was based on women's self-report of DV. In adjusted models, women who experienced DV either recently or in the past were at greater risk of being asthmatic [odds ratio (OR) range 1.26-1.37], compared with those who did not report any abuse. In households where women reported to have experienced DV, asthma risk was higher for all individuals in those households (OR range 1.15-1.19). The association between household DV and individual risk for asthma was also observed in gender-stratified analysis, and also in age-stratified analysis, with strong association observed in age groups of under-five, 5-14, 15-24 and 25-44 years. We find a consistent association between being exposed to, and having experienced, DV and asthma prevalence. Stress-induced mechanisms, partially captured through violence and social circumstances, may be a critical explanatory link in furthering our understanding of the social disparities in asthma.

  15. Prevalence and predictors of suicidality among medical students in a public university.

    PubMed

    Tan, S T; Sherina, M S; Rampal, L; Normala, I

    2015-02-01

    Undergraduate medical students have been the most distressed group among the student population. Depression and anxiety have been found to be more prevalent in this group of students compared to others. This study was conducted to determine the prevalence and predictors of suicidality among undergraduate medical students in a public university. This was an analytical cross-sectional study, conducted in a public university in Selangor, Malaysia. Data were collected using self-administered questionnaires from January to February 2013, and analysed using the Statistical Package for Social Sciences Software (version 21). Out of 625 undergraduate medical students, 537 (85.9%) participated in the study. The prevalence of the suicidality among undergraduate medical students was 7.0%. The significant predictors of suicidality based on multiple logistic regression were the respondent's lifetime suicide attempts (Adjusted Odds Ratio, AOR 10.4, 95% CI 2.7 to 40.9); depression (AOR 5.9, 95% CI 1.5 to 23.0); breaking off a steady love relationship (AOR 5.4, 95% CI 1.3 to 22.4); hopelessness (AOR 4.9, 95% CI 1.1 to 21.6); and something valued being lost or stolen (AOR 4.4, 95% CI 1.2 to 15.9). These findings indicate that mental health care services should be strengthened at university level. The results show a need for an intervention programme to reduce suicidality among the undergraduate medical students.

  16. Estimated prevalence of dementia based on analysis of drug databases in the Region of Madrid (Spain).

    PubMed

    de Hoyos-Alonso, M C; Bonis, J; Tapias-Merino, E; Castell, M V; Otero, A

    2016-01-01

    The progressive rise in dementia prevalence increases the need for rapid methods that complement population-based prevalence studies. To estimate the prevalence of dementia in the population aged 65 and older based on use of cholinesterase inhibitors and memantine. Descriptive study of use and prescription of cholinesterase inhibitors and/or memantine in 2011 according to 2 databases: Farm@drid (pharmacy billing records for the Region of Madrid) and BIFAP (database for pharmacoepidemiology research in primary care, with diagnosis and prescription records). We tested the comparability of drug use results from each database using the chi-square test and prevalence ratios. The prevalence of dementia in Madrid was estimated based on the dose per 100 inhabitants/day, adjusting the result for data obtained from BIFAP on combination treatment in the general population (0.37%) and the percentage of dementia patients undergoing treatment (41.13%). Cholinesterase inhibitors and memantine were taken by 2.08% and 0.72% of Madrid residents aged 65 and older was respectively. Both databases displayed similar results for use of these drugs. The estimated prevalence of dementia in individuals aged 65 and older is 5.91% (95% CI%, 5.85-5.95) (52 287 people), and it is higher in women (7.16%) than in men (4.00%). The estimated prevalence of dementia is similar to that found in population-based studies. Analysing consumption of specific dementia drugs can be a reliable and inexpensive means of updating prevalence data periodically and helping rationalise healthcare resources. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  17. The Prevalence of Syphilis from the Early HIV Period is Correlated With Peak HIV Prevalence at a Country Level.

    PubMed

    Osbak, Kara K; Rowley, Jane T; Kassebaum, Nicholas J; Kenyon, Chris Richard

    2016-04-01

    Could we have predicted national peak HIV based on syphilis prevalence in the 1990s? Earlier studies have shown positive correlations between various sexually transmitted infections at different population levels. In this article, we test the hypothesis that there was a residual variation in the national prevalence rates of syphilis and that these rates could predict subsequent peak HIV prevalence rates. This analysis uses linear regression to evaluate the country-level relationship between antenatal syphilis prevalence (1990-1999) and peak HIV prevalence. Antenatal syphilis data were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low-risk populations. Peak HIV prevalence was calculated based on data taken from the Global Health Observatory Data Repository of the World Health Organization. A moderately strong association is found for the 76 countries with data available (R = 0.53, P < 0.001). The association was weakened but remained significantly positive when we adjusted for the type of syphilis testing used. Syphilis prevalence in the 1990s predicted approximately 53% of the variation in peak HIV prevalence. Populations with generalized HIV epidemics had a higher prevalence of syphilis in the pre-HIV period. This finding provides additional rationale to carefully monitor sexual behavior, sexual networks, and sexually transmitted infection incidence in these populations.

  18. Prevalence of cholera risk factors between migrant Haitians and Dominicans in the Dominican Republic.

    PubMed

    Lund, Andrea J; Keys, Hunter M; Leventhal, Stephanie; Foster, Jennifer W; Freeman, Matthew C

    2015-03-01

    To determine whether cholera risk factor prevalence in the Dominican Republic can be explained by nationality, independent of other factors, given the vulnerability of many Haitians in the country and the need for targeted prevention. A cross-sectional, observational household survey (103 Haitian and 260 Dominican) was completed in 18 communities in July 2012. The survey included modules for demographics, knowledge, socioeconomic status, and access to adequate water, sanitation, and hygiene (WASH) infrastructure. Logistic regression assessed differential access to WASH infrastructure and Poisson regression assessed differences in cholera knowledge, controlling for potential confounders. Dominican and Haitian households differed on demographic characteristics. Haitians had lower educational attainment, socioeconomic status, and less knowledge of cholera than Dominicans (adjusted odds ratio [aOR] = 0.66; 95% confidence interval [95%CI] = 0.55-0.81). Access to improved drinking water was low for both groups, but particularly low among rural Haitians (aOR = 0.21; 95%CI: 0.04-1.01). No differences were found in access to sanitation after adjusting for sociodemographic confounders (aOR = 1.00; 95%CI: 0.57-1.76). Urban/rural geography and socioeconomic status play a larger role in cholera risk factor prevalence than nationality, indicating that Haitians' perceived vulnerability to cholera is confounded by contextual factors. Understanding the social dynamics that lead to cholera risk can inform control strategies, leading to better targeting and the possibility of eliminating cholera from the island.

  19. Active aging is associated with low prevalence of depressive symptoms among Brazilian older adults.

    PubMed

    Galli, Rosangela; Moriguchi, Emílio Hideyuki; Bruscato, Neide Maria; Horta, Rogerio Lessa; Pattussi, Marcos Pascoal

    2016-01-01

    Active aging is the process of optimizing opportunities for health, participation and security, aiming to improve quality of life as people age. A series of studies had demonstrated that a lower prevalence of depression is found among more active elderly. To evaluate the association between indicators of active aging and depressive symptoms among the elderly (aged 60 years or more). A population-based cross-sectional study was conducted with 1,006 elderly people (aged 60 years or over) from a small-sized Brazilian municipality. Depressive symptoms were assessed using the Geriatric Depression Scale - 15, with cutoff point ≥ 6 symptoms. Active aging was evaluated using indicators such as: active occupational situation, manual work, reading and physical activities. Data analyses used modified Poisson regression to obtain crude and adjusted prevalence ratios (PR). Most of the elderly people were: white, women and aged between 60 and 74 years. All the indicators of active aging were associated with the outcome. After controlling for socioeconomic, demographic and health variables, elderly people who worked, participated in groups, did manual work and maintained interests such as reading and talking to friends had lower prevalence of depressive symptoms compared to those not doing these activities. Active aging approaches may serve as a valuable mental health promotion strategy aimed at the elderly.

  20. Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030.

    PubMed

    Antonelli, Jodi A; Maalouf, Naim M; Pearle, Margaret S; Lotan, Yair

    2014-10-01

    The prevalence of urolithiasis and its risk factors such as obesity and diabetes have increased over time. Determine the future cost and prevalence of kidney stones using current and projected estimates for stones, obesity, diabetes, and population rates. The stone prevalence in 2000 was estimated from the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2007-2010. The cost per percentage prevalence of stones in 2000, calculated using Urologic Diseases in America Project data, was used to estimate the annual cost of stones in 2030, adjusting for inflation and increases in population, stone prevalence, obesity and diabetes rates. The primary outcome was prevalence and cost of stones in 2030. The secondary outcomes were the impact of obesity and diabetes on these values, calculated using odds ratios for stones by body mass index and diabetes status. The annual cost of stone disease in 2000, adjusted for inflation to 2014 US dollars, was approximately $2.81 billion. After accounting for increases in population and stone prevalence from 2000, the estimated cost of stones in 2007 in 2014 US dollars was $3.79 billion. Future population growth alone would increase the cost of stone disease by $780 million in 2030. Based on projected estimates for 2030, obesity will independently increase stone prevalence by 0.36%, with an annual cost increase of $157 million. Diabetes will independently increase stone prevalence by 0.72%, associated with a cost increase of $308 million annually by 2030. NHANES data, however, capture patient self-assessment rather than medical diagnosis, which is a potential bias. The rising prevalence of obesity and diabetes, together with population growth, is projected to contribute to dramatic increases in the cost of urolithiasis, with an additional $1.24 billion/yr estimated by 2030. Obesity, diabetes, and population rates will contribute to an estimated $1.24 billion/yr increase in the cost of kidney stones by 2030. Copyright

  1. Prevalence of Hepatitis E Virus Antibodies, Israel, 2009–2010

    PubMed Central

    Bassal, Ravit; Michaeli, Michal; Wax, Marina; Ram, Daniela; Cohen-Ezra, Oranit; Cohen, Dani; Mendelson, Ella; Ben-Ari, Ziv; Shohat, Tamy

    2015-01-01

    We investigated prevalence of hepatitis E virus in a sample of the population of Israel. The overall seroprevalence of antibodies to the virus was 10.6% (95% CI 8.4%–13.0%); age-adjusted prevalence was 7.6%. Seropositivity was associated with age, Arab ethnicity, low socioeconomic status, and birth in Africa, Asia, or the former Soviet Union. PMID:25811302

  2. Interaction of Sleep Duration and Sleep Quality on Hypertension Prevalence in Adult Chinese Males.

    PubMed

    Lu, Kai; Chen, Jia; Wu, Shouling; Chen, Ji; Hu, Dayi

    2015-01-01

    Previous studies demonstrated conflicting results about the association of sleep duration and hypertension. Given the potential relationship between sleep quality and hypertension, this study aimed to investigate the interaction of self-reported sleep duration and sleep quality on hypertension prevalence in adult Chinese males. We undertook a cross-sectional analysis of 4144 male subjects. Sleep duration were measured by self-reported average sleep time during the past month. Sleep quality was evaluated using the standard Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure level ≥140/90 mm Hg or current antihypertensive treatment. The association between hypertension prevalence, sleep duration, and sleep quality was analyzed using logistic regression after adjusting for basic cardiovascular characteristics. Sleep duration shorter than 8 hours was found to be associated with increased hypertension, with odds ratios and 95% confidence intervals (CIs) of 1.25 (95% CI, 1.03-1.52) for 7 hours, 1.41 (95% CI, 1.14-1.73) for 6 hours, and 2.38 (95% CI, 1.81-3.11) for <6 hours. Using very good sleep quality as the reference, good, poor, and very poor sleep quality were associated with hypertension, with odds ratios of 1.20 (95% CI, 1.01-1.42), 1.67 (95% CI, 1.32-2.11), and 2.32 (95% CI, 1.67-3.21), respectively. More importantly, further investigation of the association of different combinations of sleep duration and quality in relation to hypertension indicated an additive interaction. There is an additive interaction of poor sleep quality and short sleep duration on hypertension prevalence. More comprehensive measurement of sleep should be performed in future studies.

  3. Factors attributable for the prevalence of dental caries in Queensland children.

    PubMed

    Do, Loc Giang; Ha, Diep Hong; Spencer, A John

    2015-10-01

    Dental caries is a multifactorial condition, prevention of which requires comprehensive understanding of both contextual and compositional determinants and their population impact. To investigate contextual and compositional factors associated with the prevalence of dental caries in children and to estimate the population impact of those factors. Children in one Australian state were selected through stratified random sampling selection in 2010-2011. Oral epidemiological examinations provided individual-level outcomes: prevalence of dental caries in the primary (among 5- to 8-year-olds) and permanent dentitions (9- to 14-year-olds). Socioeconomic status, oral health behaviours and practices and dietary patterns were explanatory factors at the individual-level, school-level and area-level fluoridation status. Three-level multilevel multivariable models were sequentially specified for the prevalence of dental caries to estimate prevalence ratios (PR) associated with explanatory factors, adjusting for covariates and between- and within-group variances. Population attributable fraction (PAF) was estimated as the population impact of the statistically significant explanatory factors. Data from 2214 5- to 8-year-olds and 3186 9- to 14-year-olds from 207 schools in 16 areas were analysed. The prevalence of dental caries in the primary and the permanent dentitions was 47.1% (43.9-50.4) and 38.8% (36.1-41.6), respectively. The highest prevalence of dental caries was observed in the nonfluoridated areas. In bivariate associations, factors at three levels were associated with prevalence of dental caries. In the full models, children in the nonfluoridated areas had significantly higher prevalence of dental caries [PR for the primary: 1.29 (1.11-1.50); PR for the permanent 1.49 (1.01-2.21)] compared with children in fluoridated areas, controlling for other factors. PAF estimates indicated that lack of water fluoridation attributed to 21% and 31% of primary and permanent dental

  4. Prevalence of normal weight central obesity among Thai healthcare providers and their association with CVD risk: a cross-sectional study.

    PubMed

    Thaikruea, Lakkana; Thammasarot, Jiraporn

    2016-11-16

    This study aims to determine the prevalence of health personnel with normal weight central obesity and to investigate whether this group had higher cardiovascular disease (CVD) risk factors than those of the people with normal weight and without central obesity. A waist-to-height ratio was calculated as waist circumference (at umbilical level) in cm divided by height in cm. The central obesity cut-off level was 0.5. The body mass index was calculated as weight in kg divided by height in meters squared. The obesity cut-off level was 25 kg/m 2 . The prevalence of health personnel with normal weight central obesity was 15.4% (499 out of 3235). When compare this group to 1787 health personnel who had normal weight and without central obesity, they were 2.03 times (95% CI of adjusted OR; 1.62 to 2.54) more likely to have at least one CVD factor. The waist-to-height ratio cut-off value of 0.5 can be used as a self-assessment tool for central obesity without the need for a standard measuring tape. It is feasible to be implemented in screening or self-monitoring for the general population.

  5. Simple and cost-effective fabrication of solid biodegradable polymer microneedle arrays with adjustable aspect ratio for transdermal drug delivery using acupuncture microneedles

    NASA Astrophysics Data System (ADS)

    Cha, Kyoung Je; Kim, Taewan; Jea Park, Sung; Kim, Dong Sung

    2014-11-01

    Polymer microneedle arrays (MNAs) have received much attention for their use in transdermal drug delivery and microneedle therapy systems due to the advantages they offer, such as low cost, good mechanical properties, and a versatile choice of materials. Here, we present a simple and cost-effective method for the fabrication of a biodegradable polymer MNA in which the aspect ratio of each microneedle is adjustable using commercially available acupuncture microneedles. In our process, a master template with acupuncture microneedles, whose shape will be the final MNA, was carefully prepared by fixing them onto a plastic substrate with selectively drilled holes which, in turn, determine the aspect ratios of the microneedles. A polylactic acid (PLA; a biodegradable polymer) MNA was fabricated by a micromolding process with a polydimethylsiloxane (PDMS) mold containing the cavity of the microneedles, which was obtained by the PDMS replica molding against the master template. The mechanical force and degradation behavior of the replicated PLA MNA were characterized with the help of a compression test and an accelerated degradation test, respectively. Finally, the transdermal drug delivery performance of the PLA MNA was successfully simulated by two different methods of penetration and staining, using the skin of a pig cadaver. These results indicated that the proposed method can be effectively used for the fabrication of polymer MNAs which can be used in various microneedle applications.

  6. Minimum Marriage Age Laws and the Prevalence of Child Marriage and Adolescent Birth: Evidence from Sub-Saharan Africa.

    PubMed

    Maswikwa, Belinda; Richter, Linda; Kaufman, Jay; Nandi, Arijit

    2015-06-01

    The relationship of national laws that prohibit child marriage with the prevalence of child marriage and adolescent birth is not well understood. Data from Demographic and Health Surveys and from the Child Marriage Database created by the MACHEquity program at McGill University were used to examine the relationship between laws that consistently set the age for marriage for girls at 18 or older and the prevalence of child marriage and teenage childbearing in 12 Sub-Saharan African countries. Countries were considered to have consistent laws against child marriage if they required females to be 18 or older to marry, to marry with parental consent and to consent to sex. Associations between consistent laws and the two outcomes were identified using multivariate regression models. Four of the 12 countries had laws that consistently set the minimum age for marriage at 18 or older. After adjustment for covariates, the prevalence of child marriage was 40% lower in countries with consistent laws against child marriage than in countries without consistent laws against the practice (prevalence ratio, 0.6). The prevalence of teenage childbearing was 25% lower in countries with consistent minimum marriage age laws than in countries without consistent laws (0.8). Our results support the hypothesis that consistent minimum marriage age laws protect against the exploitation of girls.

  7. Prevalence and correlates for diarrhoea in the mountainous informal settlements of Huye town, Rwanda.

    PubMed

    Uwizeye, Dieudonné; Sokoni, Cosmas H; Kabiru, Caroline W

    2014-01-01

    Dwellers of urban informal settlements in developing countries are consistently reported to be victims of high diarrhoea prevalence. Studies have frequently reported the association between high diarrhoea prevalence and other factors, such as poor living conditions, inadequate hygiene, and sanitation in these settings. However, little is known about the dynamics of diarrhoea prevalence in mountainous urban informal settlements similar to the Rwandan context. This study was conducted in the Matyazo cell of Huye town to review the prevalence and correlates of diarrhoea. A survey of 214 households and transect walks in the neighbourhoods were conducted during the rainy and dry seasons. Logistic regression was used to analyse the survey data while the thematic analysis technique was used to analyse qualitative data. Results indicated a substantial reduction of diarrhoea prevalence from the rainy to the dry season. It was also found that the prevalence was unequally distributed in the neighbourhoods according to household location. After controlling for other household characteristics and sanitation conditions of around homes, the study indicated that households established at 1800 metres or more above sea level were protected against diarrhoea during both rainy seasons (Adjusted Odds Ratio_ AOR: .42, 95% Confidence Interval_ CI: .13-.81) and dry seasons (AOR: .58, CI: .12-.90) while households found further from the road were likely to suffer from diarrhoea during rainy seasons (AOR: 3.32, CI: 1.47-7.48) as well as in dry seasons (AOR: 1.60, CI: 1.26-4.10). Poor sanitation within and around homes was also found to be associated with the increase of diarrhoea in either season. However, the evidence was not sufficient enough to confirm a significant association between diarrhoea prevalence and other household characteristics. We believe this is due to the strength of environmental factors in mountainous settings.

  8. Effective classification of the prevalence of Schistosoma mansoni.

    PubMed

    Mitchell, Shira A; Pagano, Marcello

    2012-12-01

    To present an effective classification method based on the prevalence of Schistosoma mansoni in the community. We created decision rules (defined by cut-offs for number of positive slides), which account for imperfect sensitivity, both with a simple adjustment of fixed sensitivity and with a more complex adjustment of changing sensitivity with prevalence. To reduce screening costs while maintaining accuracy, we propose a pooled classification method. To estimate sensitivity, we use the De Vlas model for worm and egg distributions. We compare the proposed method with the standard method to investigate differences in efficiency, measured by number of slides read, and accuracy, measured by probability of correct classification. Modelling varying sensitivity lowers the lower cut-off more significantly than the upper cut-off, correctly classifying regions as moderate rather than lower, thus receiving life-saving treatment. The classification method goes directly to classification on the basis of positive pools, avoiding having to know sensitivity to estimate prevalence. For model parameter values describing worm and egg distributions among children, the pooled method with 25 slides achieves an expected 89.9% probability of correct classification, whereas the standard method with 50 slides achieves 88.7%. Among children, it is more efficient and more accurate to use the pooled method for classification of S. mansoni prevalence than the current standard method. © 2012 Blackwell Publishing Ltd.

  9. General Population Job Exposure Matrix Applied to a Pooled Study of Prevalent Carpal Tunnel Syndrome

    PubMed Central

    Dale, Ann Marie; Zeringue, Angelique; Harris-Adamson, Carisa; Rempel, David; Bao, Stephen; Thiese, Matthew S.; Merlino, Linda; Burt, Susan; Kapellusch, Jay; Garg, Arun; Gerr, Fred; Hegmann, Kurt T.; Eisen, Ellen A.; Evanoff, Bradley

    2015-01-01

    A job exposure matrix may be useful for the study of biomechanical workplace risk factors when individual-level exposure data are unavailable. We used job title–based exposure data from a public data source to construct a job exposure matrix and test exposure-response relationships with prevalent carpal tunnel syndrome (CTS). Exposures of repetitive motion and force from the Occupational Information Network were assigned to 3,452 active workers from several industries, enrolled between 2001 and 2008 from 6 studies. Repetitive motion and force exposures were combined into high/high, high/low, and low/low exposure groupings in each of 4 multivariable logistic regression models, adjusted for personal factors. Although force measures alone were not independent predictors of CTS in these data, strong associations between combined physical exposures of force and repetition and CTS were observed in all models. Consistent with previous literature, this report shows that workers with high force/high repetition jobs had the highest prevalence of CTS (odds ratio = 2.14–2.95) followed by intermediate values (odds ratio = 1.09–2.27) in mixed exposed jobs relative to the lowest exposed workers. This study supports the use of a general population job exposure matrix to estimate workplace physical exposures in epidemiologic studies of musculoskeletal disorders when measures of individual exposures are unavailable. PMID:25700886

  10. Prevalence and Predictors of Overweight and Obesity Among a Multiethnic Population of Pediatric Acute Lymphoblastic Leukemia Survivors: A Cross-Sectional Assessment.

    PubMed

    Brown, Austin L; Lupo, Philip J; Danysh, Heather E; Okcu, Mehmet F; Scheurer, Michael E; Kamdar, Kala Y

    2016-08-01

    As previous studies of obesity in survivors of pediatric acute lymphoblastic leukemia (ALL) have primarily been conducted among non-Hispanic white survivors or children treated on older protocols, our objective was to describe the prevalence and correlates of overweight status among an ethnically diverse population of pediatric ALL survivors, largely treated with more contemporary therapies. We evaluated the overweight/obesity status of pediatric ALL survivors (n=406) followed in the Texas Children's Cancer Center between 2004 and 2014. Survivors were classified as underweight, normal weight, overweight, or obese on the basis of their body mass index at their most current follow-up visit. Our results showed that Hispanic ethnicity (39% of the subjects) was associated with being overweight (adjusted odds ratio=1.88; 95% confidence interval, 1.13-3.14) or obese (adjusted odds ratio=2.84; 95% confidence interval, 1.59-5.06) at follow-up, even after adjusting for cranial radiotherapy (CRT) exposure. Body mass index z-score at diagnosis was also associated with overweight/obesity at follow-up. In addition, there was a statistically significant interaction between younger age at diagnosis and CRT, indicating that younger age at diagnosis was associated with obesity among patients who received CRT. These findings may help identify pediatric ALL patients that are at increased risk of being overweight or obese after treatment.

  11. Fifty-Year Trends in Atrial Fibrillation Prevalence, Incidence, Risk Factors, and Mortality in the Community

    PubMed Central

    Schnabel, Renate B.; Yin, Xiaoyan; PhilimonGona; Larson, Martin G.; Beiser, Alexa S.; McManus, David D.; Newton-Cheh, Christopher; Lubitz, Steven A.; Magnani, Jared W.; Ellinor, Patrick T.; SudhaSeshadri; Wolf, Philip A; Vasan, Ramachandran S.; Benjamin, Emelia J.; Levy, Daniel

    2015-01-01

    Summary Background Comprehensive long-term data on atrial fibrillation trends in men and women are scant. Methods We investigated trends in atrial fibrillation incidence, prevalence, and risk factors, and in stroke and mortality following its onset in Framingham Heart Study participants (n=9511) from 1958 to 2007. To accommodate sex differences in atrial fibrillation risk factors and disease manifestations, sex-stratified analyses were performed. Findings During 50 years of observation (202,417 person-years), there were 1,544 new-onset atrial fibrillation cases (46.8% women). We observed about a fourfold increase in the age-adjusted prevalence and more than a tripling in age-adjusted incidence of atrial fibrillation (prevalence 20.4 versus 96.2 per 1000 person-years in men; 13.7 versus 49.4 in women; incidence rates in first versus last decade 3.7 versus 13.4 per 1000 person-years in men; 2.5 versus 8.6 in women, ptrend<0.0001). For atrial fibrillation diagnosed by ECG during routine Framingham examinations, age-adjusted prevalence increased (12.6versus 25.7 per 1000 person-years in men; 8.1 versus 11.8 in women, ptrend<0.0001). The age-adjusted incidence increased, but did not achieve statistical significance. Although the prevalence of most risk factors changed over time, their associated hazards for atrial fibrillation changed little. Multivariable-adjusted proportional hazards models revealed a 73.5% decline in stroke and a 25.4% decline in mortality following atrial fibrillation onset (ptrend=0.0001, ptrend=0.003, respectively). Interpretation Our data suggest that observed trends of increased incidence of atrial fibrillation in the community were partially due to enhanced surveillance. Stroke occurrence and mortality following atrial fibrillation onset declined over the decades, and prevalence increased approximately fourfold. The hazards for atrial fibrillation risk factors remained fairly constant. Our data indicate a need for measures to enhance early

  12. Smoking prevalence differs by location of residence among Ghanaians in Africa and Europe: The RODAM study

    PubMed Central

    Brathwaite, Rachel; Addo, Juliet; Kunst, Anton E.; Agyemang, Charles; Owusu-Dabo, Ellis; de-Graft Aikins, Ama; Beune, Erik; Meeks, Karlijn; Klipstein-Grobusch, Kerstin; Bahendeka, Silver; Mockenhaupt, Frank P.; Amoah, Stephen; Galbete, Cecilia; Schulze, Matthias B.; Danquah, Ina; Smeeth, Liam

    2017-01-01

    Background Although the prevalence of smoking is low in Ghana, little is known about the effect of migration on smoking. Comparing Ghanaians living in their country of origin to those living in Europe offers an opportunity to investigate smoking by location of residence and the associations between smoking behaviours and migration-related factors. Methods Data on a relatively homogenous group of Ghanaians living in London (n = 949), Amsterdam (n = 1400), Berlin (n = 543), rural Ghana (n = 973) and urban Ghana (n = 1400) from the cross-sectional RODAM (Research on Obesity & Diabetes in African Migrants) study were used. Age-standardized prevalence rates of smoking by location of residence and factors associated with smoking among Ghanaian men were estimated using prevalence ratios (PR: 95% CIs). Results Current smoking was non-existent among women in rural and urban Ghana and London but was 3.2% and 3.3% in women in Amsterdam and Berlin, respectively. Smoking prevalence was higher in men in Europe (7.8%) than in both rural and urban Ghana (4.8%): PR 1.91: 95% CI 1.27, 2.88, adjusted for age, marital status, education and employment. Factors associated with a higher prevalence of smoking among Ghanaian men included European residence, being divorced or widowed, living alone, Islam religion, infrequent attendance at religious services, assimilation (cultural orientation), and low education. Conclusion Ghanaians living in Europe are more likely to smoke than their counterparts in Ghana, suggesting convergence to European populations, although prevalence rates are still far below those in the host populations. PMID:28475620

  13. Social support, marital adjustment, and psychological distress among women with primary infertility in Pakistan.

    PubMed

    Qadir, Farah; Khalid, Amna; Medhin, Girmay

    2015-01-01

    This study aimed to identify prevalence rates of psychological distress among Pakistani women seeking help for primary infertility. The associations of social support, marital adjustment, and sociodemographic factors with psychological distress were also examined. A total of 177 women with primary infertility were interviewed from one hospital in Islamabad using a Self-Reporting Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Locke-Wallace Marital Adjustment Test. The data were collected between November 2012 and March 2013. The prevalence of psychological distress was 37.3 percent. The results of the logistic regression suggested that marital adjustment and social support were significantly negatively associated with psychological distress in this sample. These associations were not confounded by any of the demographic variables controlled in the multivariable regression models. The role of perceived social support and adjustment in marriage among women experiencing primary infertility are important factors in understanding their psychological distress. The results of this small-scale effort highlight the need for social and familial awareness to help tackle the psychological distress related to infertility. Future research needs to focus on the way the experience of infertility is conditioned by social structural realities. New ways need to be developed to better take into account the process and nature of the infertility experience.

  14. Thyroid function modifies the association between ratio of triglyceride to high-density lipoprotein cholesterol and renal function: a multicenter cross-sectional study

    PubMed Central

    Yuan, Zhongshang; Zhao, Meng; Zhang, Bingchang; Zhang, Haiqing; Zhang, Xu; Guan, Qingbo; Ning, Guang; Gao, Ling; Xue, Fuzhong; Zhao, Jiajun

    2015-01-01

    Hypothyroidism was confirmed to be associated with both dyslipidemia and renal dysfunction. However, the impact of thyroid function on the relationship between serum lipid levels and renal function has never been given sufficient attention. In this large-scale multicenter cross-sectional study, the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL) and the prevalence of hypothyroidism in CKD subjects were significantly higher than those in non-CKD ones (P < 0.001). After adjustment for potential confounding factors, TG/HDL was shown to be significantly associated with serum Cr levels (β = 0.551; 95%CI, 0.394–0.708), and eGFR (β = −0.481; 95%CI, −0.731–−0.230). The risk for CKD was significantly increased as TG/HDL ratio was elevated (adjusted odds ratio = 1.20; 95%CI, 1.11–1.27). These significant associations were found among subjects with euthyroidism and hypothyroidism rather than hyperthyroidism. Furthermore, the associations between TG/HDL and Cr or CKD status were significantly greater in hypothyroidism than those in euthyroidism (P < 0.05). These results suggested that elevated TG/HDL ratio was associated with renal dysfunction; it exhibited a significantly stronger association with Cr and CKD in hypothyroidism than in euthyroidism. Therefore, more attention should be paid on lipid profile to prevent or delay the occurrence and progression of renal dysfunction, especially for those with hypothyroidism. PMID:26179571

  15. Thyroid function modifies the association between ratio of triglyceride to high-density lipoprotein cholesterol and renal function: a multicenter cross-sectional study.

    PubMed

    Yuan, Zhongshang; Zhao, Meng; Zhang, Bingchang; Zhang, Haiqing; Zhang, Xu; Guan, Qingbo; Ning, Guang; Gao, Ling; Xue, Fuzhong; Zhao, Jiajun

    2015-07-16

    Hypothyroidism was confirmed to be associated with both dyslipidemia and renal dysfunction. However, the impact of thyroid function on the relationship between serum lipid levels and renal function has never been given sufficient attention. In this large-scale multicenter cross-sectional study, the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL) and the prevalence of hypothyroidism in CKD subjects were significantly higher than those in non-CKD ones (P < 0.001). After adjustment for potential confounding factors, TG/HDL was shown to be significantly associated with serum Cr levels (β = 0.551; 95%CI, 0.394-0.708), and eGFR (β = -0.481; 95%CI, -0.731--0.230). The risk for CKD was significantly increased as TG/HDL ratio was elevated (adjusted odds ratio = 1.20; 95%CI, 1.11-1.27). These significant associations were found among subjects with euthyroidism and hypothyroidism rather than hyperthyroidism. Furthermore, the associations between TG/HDL and Cr or CKD status were significantly greater in hypothyroidism than those in euthyroidism (P < 0.05). These results suggested that elevated TG/HDL ratio was associated with renal dysfunction; it exhibited a significantly stronger association with Cr and CKD in hypothyroidism than in euthyroidism. Therefore, more attention should be paid on lipid profile to prevent or delay the occurrence and progression of renal dysfunction, especially for those with hypothyroidism.

  16. High HIV prevalence and associated risk factors among female sex workers in Rwanda.

    PubMed

    Mutagoma, Mwumvaneza; Samuel, Malamba S; Kayitesi, Catherine; Gasasira, Antoine R; Chitou, Bassirou; Boer, Kimberly; Hedt-Gauthier, Bethany; Gupta, Neil; Ntaganira, Joseph; Nsanzimana, Sabin

    2017-10-01

    Human immunodeficiency virus (HIV) prevalence is often high among female sex workers (FSWs) in sub-Saharan Africa. Understanding the dynamics of HIV infection in this key population is critical to developing appropriate prevention strategies. We aimed to describe the prevalence and associated risk factors among a sample of FSWs in Rwanda from a survey conducted in 2010. A cross-sectional biological and behavioral survey was conducted among FSWs in Rwanda. Time-location sampling was used for participant recruitment from 4 to 18 February 2010. HIV testing was done using HIV rapid diagnostic tests (RDT) as per Rwandan national guidelines at the time of the survey. Elisa tests were simultaneously done on all samples tested HIV-positive on RDT. Proportions were used for sample description; multivariable logistic regression model was performed to analyze factors associated with HIV infection. Of 1338 women included in the study, 1112 consented to HIV testing, and the overall HIV prevalence was 51.0%. Sixty percent had been engaged in sex work for less than five years and 80% were street based. In multivariable logistic regression, HIV prevalence was higher in FSWs 25 years or older (adjusted odds ratio [aOR] = 1.83, 95% [confidence interval (CI): 1.42-2.37]), FSWs with consistent condom use in the last 30 days (aOR = 1.39, [95% CI: 1.05-1.82]), and FSWs experiencing at least one STI symptom in the last 12 months (aOR = 1.74 [95% CI: 1.34-2.26]). There was an inverse relationship between HIV prevalence and comprehensive HIV knowledge (aOR = 0.65, [95% CI: 0.48-0.88]). HIV prevalence was high among a sample of FSWs in Rwanda, and successful prevention strategies should focus on HIV education, treatment of sexually transmitted infections, and proper and consistent condom use using an outreach approach.

  17. Long-term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study.

    PubMed

    Phelan, Suzanne; Kanaya, Alka M; Ma, Yong; Vittinghoff, Eric; Barrett-Connor, Elizabeth; Wing, Rena; Kusek, John W; Orchard, Trevor J; Crandall, Jill P; Montez, Maria G; Brown, Jeanette S

    2015-02-01

    To examine the long-term prevalence and predictors of weekly urinary incontinence in the Diabetes Prevention Program Outcomes Study, a follow-up study of the Diabetes Prevention Program randomized clinical trial of overweight adults with impaired glucose tolerance. This analysis included 1778 female participants of the Diabetes Prevention Program Outcomes Study who had been randomly assigned during the Diabetes Prevention Program to intensive lifestyle intervention (n = 582), metformin (n = 589) or placebo (n = 607). The study participants completed semi-annual assessments after the final Diabetes Prevention Program visit and for 6 years until October 2008. At the study entry, the prevalence of weekly urinary incontinence was lower in the intensive lifestyle intervention group compared with the metformin and placebo groups (44.2% vs 51.8%, 48.0% urinary incontinence/week, P = 0.04); during the 6-year follow-up period, these lower rates in intensive lifestyle intervention were maintained (46.7%, 53.1%, 49.9% urinary incontinence/week; P = 0.03). Statistically adjusting for urinary incontinence prevalence at the end of the Diabetes Prevention Program, the treatment arm no longer had a significant impact on urinary incontinence during the Diabetes Prevention Program Outcomes Study. Independent predictors of lower urinary incontinence during the Diabetes Prevention Program Outcomes Study included lower body mass index (odds ratio 0.988, 95% confidence interval 0.982-0.994) and greater physical activity (odds ratio 0.999, 95% confidence interval 0.998-1.000) at the Diabetes Prevention Program Outcomes Study entry, and greater reductions in body mass index (odds ratio 0.75, 95% confidence interval 0.60-0.94) and waist circumference (odds ratio 0.998, 95% confidence interval 0.996-1.0) during the Diabetes Prevention Program Outcomes Study. Diabetes was not significantly related to urinary incontinence. Intensive lifestyle intervention has a modest

  18. The effect of alcohol, tobacco and caffeine consumption and vegetarian diet on gallstone prevalence.

    PubMed

    Walcher, Thomas; Haenle, Mark Martin; Mason, Richard Andrew; Koenig, Wolfgang; Imhof, Armin; Kratzer, Wolfgang

    2010-11-01

    To investigate the effects of alcohol, tobacco and caffeine consumption and of vegetarian diet on gallstone prevalence in an urban population sample. A total of 2417 individuals underwent ultrasound examination and completed a standardized questionnaire as part of the EMIL study. Statistical analysis of the data considered the known risk factors of age, female sex, BMI, positive family history and potential confounders, such as alcohol, caffeine and tobacco consumption and vegetarian diet using multiple logistic regression with variable selection. The prevalence of gallstones in the population sample was 8% (171 out of 2147). Findings of the study confirmed the classic risk factors of age, female sex, obesity and positive family history. After the variable selection of potential risk factors in a logistic regression that was adjusted for age, female sex, BMI and positive family history, the factors like tobacco [odds ratio (OR) 1.09, 95% confidence interval (CI): 0.76-1.56, P=0.64] and caffeine consumption (OR: 0.77, 95% CI: 0.42-1.42, P=0.40) as well as vegetarian diet (OR: 1.14, 95% CI: 0.39-3.35, P=0.81) had no effect on gallstone prevalence. A protective effect against development of gallstones was shown for alcohol consumption (OR: 0.67, 95% CI: 0.46-0.99, P=0.04). The factors like tobacco and caffeine consumption as well as vegetarian diet exerted no measurable effect on the prevalence of gallstones. A protective effect was found for alcohol consumption.

  19. Being Bullied and Psychosocial Adjustment among Middle School Students in China

    ERIC Educational Resources Information Center

    Cheng, Yulan; Newman, Ian M.; Qu, Ming; Mbulo, Lazarous; Chai, Yan; Chen, Yan; Shell, Duane F.

    2010-01-01

    Background: Using the Chinese version of the Global School-based Health Survey (GSHS), this article describes the prevalence of being bullied among a nationally representative sample of Chinese students in grades 6-10 and explores the relationships between being bullied and selected indicators of psychosocial adjustment. Methods: A total of 9015…

  20. Prevalence and predictors of headache in patients referred to polysomnography.

    PubMed

    Beiske, Kornelia Katalin; Russell, Michael Bjørn; Stavem, Knut

    2013-11-18

    The objectives of this study were; (1) to assess the prevalence and frequency of headache in patients referred to polysomnography (PSG) due to a clinical suspicion of obstructive sleep apnea (OSA) or another sleep disturbance and compare with a reference population, and (2) to assess the association of OSA severity with headache and headache frequency. A total of 784 participants filled in a headache questionnaire between 2003 and 2009 at the Department of Clinical Neurophysiology, Akershus University Hospital. Of these patients 477 were suspected to have OSA, and 307 had other sleep complaints. We assessed the prevalence of headache and monthly headache frequencies, as well as sleep apnea severity using an apnea-hypopnea index (AHI). The association of headache and monthly headache frequencies with PSG subgroups was assessed using multivariate logistic and ordered logistic regression analysis. The frequency of headache was not associated with the severity of OSA. Patients referred to a sleep study for any reason had higher odds ratio (OR) for having experienced headache during the past year than population controls after adjustment for age, gender and education, i.e. patients with normal AHI had OR of 3.56, patients with OSA had OR of 3.51, and patients with other sleep disturbances had OR of 3.33. Similarly, the adjusted OR of being in a higher category of monthly headache frequency compared to controls was higher in those with normal AHI (OR 3.42), OSA (OR 3.29), and other sleep disturbances (OR 3.00). The odds of headache and headache frequency were higher in subjects referred to a PSG for any sleep disturbance independently of OSA, compared to general population controls. However, there was no association between experiencing headache during the past year or headache frequency with OSA severity.

  1. Prevalence and early determinants of common mental disorders in the 1982 birth cohort, Pelotas, Southern Brazil

    PubMed Central

    Anselmi, Luciana; Barros, Fernando C; Minten, Gicele C; Gigante, Denise P; Horta, Bernardo L; Victora, Cesar G

    2009-01-01

    OBJECTIVE To estimate the prevalence of common mental disorders and assess its association with risk factors in a cohort of young adults. METHODS Cross-sectional study nested in a 1982 birth cohort study conducted in Pelotas, Southern Brazil. In 2004-5, 4,297 subjects were interviewed during home visits. Common mental disorders were assessed using the Self-Report Questionnaire. Risk factors included socioeconomic, demographic, perinatal, and environmental variables. The analysis was stratified by gender and crude and adjusted prevalence ratios were estimated by Poisson regression. RESULTS The overall prevalence of common mental disorders was 28.0%; 32.8% and 23.5% in women and men, respectively. Men and women who were poor in 2004-5, regardless of their poor status in 1982, had nearly 1.5-fold increased risk for common mental disorders (p≤0.001) when compared to those who have never been poor. Among women, being poor during childhood (p≤0.001) and black/mixed skin color (p=0.002) increased the risk for mental disorders. Low birth weight and duration of breastfeeding were not associated to the risk of these disorders. CONCLUSIONS Higher prevalence of common mental disorders among low-income groups and race-ethnic minorities suggests that social inequalities present at birth have a major impact on mental health, especially common mental disorders. PMID:19142342

  2. Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome.

    PubMed

    Christian, Rose C; Dumesic, Daniel A; Behrenbeck, Thomas; Oberg, Ann L; Sheedy, Patrick F; Fitzpatrick, Lorraine A

    2003-06-01

    Polycystic ovary syndrome (PCOS), a common endocrine disorder of reproductive-aged women, is associated with multiple risk factors for coronary heart disease (CHD), such as diabetes mellitus, dyslipidemia, visceral obesity, and hypertension. However, premature coronary atherosclerosis has not been demonstrated in PCOS women. Electron beam computed tomography (EBCT) noninvasively measures coronary artery calcium (CAC), a marker for coronary atherosclerosis. We measured CAC by EBCT in 30- to 45-yr-old premenopausal PCOS women and compared the results to CAC in 1) recruited normal ovulatory volunteers matched for age and weight to the PCOS cohort, and 2) community-dwelling women of similar age in an extant coronary calcium database. Healthy, community-dwelling, ovulatory controls (n = 71) were matched by age and body mass index (BMI) to PCOS women (n = 36). Women with diabetes or known CHD were excluded. Subjects underwent EBCT scanning, oral glucose tolerance testing, and CHD risk factor assessment. PCOS women had significantly higher levels of serum total and low density lipoprotein cholesterol and testosterone levels than matched controls. PCOS and control women were obese and had a greater mean BMI than community-dwelling women (33 kg/m(2) for PCOS vs. 31 kg/m(2) for control; P < 0.001). CAC was more prevalent in PCOS women (39%) than in matched controls (21%; odds ratio, 2.4; P = 0.05) or community-dwelling women (9.9%; odds ratio, 5.9; P < 0.001). BMI, waist circumference, and total and low density lipoprotein cholesterol levels predicted CAC prevalence after adjustment for BMI. CAC is more prevalent in PCOS women than in obese or nonobese women of similar age. PCOS women are at increased risk for atherosclerosis and should be targeted for primary prevention of CHD.

  3. Diabetes prevalence based on health insurance claims: large differences between companies.

    PubMed

    Hoffmann, F; Icks, A

    2011-08-01

    We investigated if there are substantial differences in the prevalence of diabetes between members of different health insurance funds in Germany and, if so, which variables might explain these differences. Ten representative surveys (conducted between 2004 and 2008) of the Bertelsmann Healthcare Monitor, comprising 15 089 participants aged 18-79 years, were analysed. Our main independent variable was membership in one of eight health insurance funds. We first estimated the crude prevalence of diabetes stratified by these funds. We further fitted logistic regression models and stepwise adjusted for age and sex, further co-morbidities and anthropometric measures and factors influencing health awareness and lifestyle. The overall prevalence of diabetes was 6.9%. Stratified by health insurance funds, prevalences ranged between 3.9% within the Innungskrankenkassen to 11.4% within the Allgemeine Ortskrankenkassen. Adjusting for age and sex only led to minor changes. After controlling for all mentioned variables, these differences remained. Compared with those who were privately insured, persons within the Allgemeine Ortskrankenkassen (OR 1.73; 95% CI 1.30-2.29), the Betriebskrankenkassen (OR 1.54; 95% CI 1.15-2.07) and the Barmer (OR 1.39; 95% CI 1.01-1.91) had a higher prevalence. We found considerable differences in diabetes prevalence between German health insurance funds that remained after controlling for several relevant variables. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  4. Association Between Alcohol Outlets and HIV Prevalence in U.S. Counties.

    PubMed

    Rossheim, Matthew E; Thombs, Dennis L; Suzuki, Sumihiro

    2016-11-01

    The current study examines associations between on- and off-premise alcohol retail outlets and HIV prevalence in counties across the United States during a 3-year period. Health department and U.S. Census Bureau surveillance data were analyzed from 1,523 counties in 47 states, representing more than 86% of the U.S. population. Multilevel Poisson regression models were used to examine the association between the number of on- and off-premise alcohol outlets in a county and HIV prevalence in the same county, adjusting for the between-year correlation of HIV prevalence within each county. When we adjusted for potential confounders, number of on-premise alcohol outlets within a county was positively associated with HIV prevalence, whereas off-premise alcohol outlets were negatively associated with HIV prevalence. The relations observed in this study are consistent with the niche theory of assortative drinking, which maintains that drinkers who are prone to risk taking may be attracted to alcohol outlets where they can expand their social networks to include similarly high-risk individuals who engage in both heavy drinking and sexual risk taking. This is the largest study conducted to date to examine the association between alcohol retail outlet types and HIV prevalence. Natural experiments are needed to examine specific policy changes that reduce outlet density and its association with HIV incidence.

  5. Prevalence and correlates of internet cigarette purchasing among adult smokers in New Jersey

    PubMed Central

    Hrywna, M; Delnevo, C; Staniewska, D

    2004-01-01

    Objective: To examine the prevalence and correlates of internet cigarette purchasing among adult smokers. Design: Analysis of internet purchasing in data from a population based telephone survey of New Jersey households. Logistic regression was used to determine factors associated with internet cigarette purchasing, adjusting for year, demographic, and smoking behaviour variables. Participants: 3447 current cigarette smokers pooled from three cross sectional surveys conducted in 2000, 2001, and 2002. Main outcome measures: Ever purchasing tobacco and usually buying cigarettes via the internet. Results: Among all current cigarette smokers, ever having purchased tobacco via the internet increased from 1.1% in 2000 to 6.7% in 2002 and usually buying cigarettes via the internet increased from 0.8% in 2000 to 3.1% in 2002. Among current cigarette smokers with internet access, ever having purchased tobacco via the internet was higher among those who reported smoking 31 or more cigarettes per day (adjusted odds ratio (OR) 3.9, 95% confidence interval (CI) 1.5 to 10.2) and those without a past year quit attempt (adjusted OR 1.8, 95% CI 1.1 to 3.0). Usually purchasing cigarettes via the internet was higher among those aged 45–64 years (adjusted OR 4.4, 95% CI 1.1 to 17.1) and who reported having their first cigarette ⩽ 30 minutes after waking (adjusted OR 3.3, 95% CI 1.2 to 9.2). Conclusions: Although higher prices are known to reduce the demand for cigarettes, internet cigarette purchasing is likely to weaken this effect, particularly among heavy, more dependent smokers who are less interested in quitting. PMID:15333887

  6. Smoking prevalence in Medicaid has been declining at a negligible rate.

    PubMed

    Zhu, Shu-Hong; Anderson, Christopher M; Zhuang, Yue-Lin; Gamst, Anthony C; Kohatsu, Neal D

    2017-01-01

    In recent decades the overall smoking prevalence in the US has fallen steadily. This study examines whether the same trend is seen in the Medicaid population. National Health Interview Survey (NHIS) data from 17 consecutive annual surveys from 1997 to 2013 (combined N = 514,043) were used to compare smoking trends for 4 insurance groups: Medicaid, the Uninsured, Private Insurance, and Other Coverage. Rates of chronic disease and psychological distress were also compared. Adjusted smoking prevalence showed no detectable decline in the Medicaid population (from 33.8% in 1997 to 31.8% in 2013, trend test P = 0.13), while prevalence in the other insurance groups showed significant declines (38.6%-34.7% for the Uninsured, 21.3%-15.8% for Private Insurance, and 22.6%-16.8% for Other Coverage; all P's<0.005). Among individuals who have ever smoked, Medicaid recipients were less likely to have quit (38.8%) than those in Private Insurance (62.3%) or Other Coverage (69.8%; both P's<0.001). Smokers in Medicaid were more likely than those in Private Insurance and the Uninsured to have chronic disease (55.0% vs 37.3% and 32.4%, respectively; both P's<0.01). Smokers in Medicaid were also more likely to experience severe psychological distress (16.2% for Medicaid vs 3.2% for Private Insurance and 7.6% for the Uninsured; both P's<0.001). The high and relatively unchanging smoking prevalence in the Medicaid population, low quit ratio, and high rates of chronic disease and severe psychological distress highlight the need to focus on this population. A targeted and sustained campaign to help Medicaid recipients quit smoking is urgently needed.

  7. What is common becomes normal: the effect of obesity prevalence on maternal perception.

    PubMed

    Binkin, N; Spinelli, A; Baglio, G; Lamberti, A

    2013-05-01

    This analysis investigates the poorly-known effect of local prevalence of childhood obesity on mothers' perception of their children's weight status. In 2008, a national nutritional survey of children attending the third grade of elementary school was conducted in Italy. Children were measured and classified as underweight, normal weight, overweight and obese, using the International Obesity Task Force cut-offs for body mass index (BMI). A parental questionnaire included parental perception of their child's weight status (underweight, normal, a little overweight and a lot overweight). Regions were classified by childhood obesity prevalence (<8%, 8-12%, ≥13%). The association between incorrect maternal perception and regional obesity prevalence, and maternal and child characteristics were examined using bivariate and logistic regression analyses. Complete data were available for 37 590 children, of whom 24% were overweight and 12% obese. Mothers correctly identified the status of 84% of normal weight, 52% of overweight and 14% of obese children. Among overweight children, factors associated with underestimation of the child's weight included lower maternal education (adjusted odds ratio, aOR, 1.9; 95% confidence interval (CI) 1.6-2.4), residence in a high-obesity region (aOR 2.2; 95% CI 1.9-2.6), male gender (aOR 1.4; 95% CI 1.2-1.6) and child's BMI. Higher regional obesity prevalence is associated with lower maternal perception, suggesting that what is common has a greater likelihood of being perceived as normal. As perception is a first step to change, it may be harder to intervene in areas with high-obesity prevalence where intervention is most urgent. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. A simple signaling rule for variable life-adjusted display derived from an equivalent risk-adjusted CUSUM chart.

    PubMed

    Wittenberg, Philipp; Gan, Fah Fatt; Knoth, Sven

    2018-04-17

    The variable life-adjusted display (VLAD) is the first risk-adjusted graphical procedure proposed in the literature for monitoring the performance of a surgeon. It displays the cumulative sum of expected minus observed deaths. It has since become highly popular because the statistic plotted is easy to understand. But it is also easy to misinterpret a surgeon's performance by utilizing the VLAD, potentially leading to grave consequences. The problem of misinterpretation is essentially caused by the variance of the VLAD's statistic that increases with sample size. In order for the VLAD to be truly useful, a simple signaling rule is desperately needed. Various forms of signaling rules have been developed, but they are usually quite complicated. Without signaling rules, making inferences using the VLAD alone is difficult if not misleading. In this paper, we establish an equivalence between a VLAD with V-mask and a risk-adjusted cumulative sum (RA-CUSUM) chart based on the difference between the estimated probability of death and surgical outcome. Average run length analysis based on simulation shows that this particular RA-CUSUM chart has similar performance as compared to the established RA-CUSUM chart based on the log-likelihood ratio statistic obtained by testing the odds ratio of death. We provide a simple design procedure for determining the V-mask parameters based on a resampling approach. Resampling from a real data set ensures that these parameters can be estimated appropriately. Finally, we illustrate the monitoring of a real surgeon's performance using VLAD with V-mask. Copyright © 2018 John Wiley & Sons, Ltd.

  9. Benchmarking antibiotic use in Finnish acute care hospitals using patient case-mix adjustment.

    PubMed

    Kanerva, Mari; Ollgren, Jukka; Lyytikäinen, Outi

    2011-11-01

    It is difficult to draw conclusions about the prudence of antibiotic use in different hospitals by directly comparing usage figures. We present a patient case-mix adjustment model of antibiotic use to rank hospitals while taking patient characteristics into account. Data on antibiotic use were collected during the national healthcare-associated infection (HAI) prevalence survey in 2005 in Finland in all 5 tertiary care, all 15 secondary care and 10 (25% of 40) other acute care hospitals. The use of antibiotics was measured using use-days/100 patient-days during a 7day period and the prevalence of patients receiving at least two antimicrobials during the study day. Case-mix-adjusted antibiotic use was calculated by using multivariate models and an indirect standardization method. Parameters in the model included age, sex, severity of underlying diseases, intensive care, haematology, preceding surgery, respirator, central venous and urinary catheters, community-associated infection, HAI and contact isolation due to methicillin-resistant Staphylococcus aureus. The ranking order changed one position in 12 (40%) hospitals and more than two positions in 13 (43%) hospitals when the case-mix-adjusted figures were compared with those observed. In 24 hospitals (80%), the antibiotic use density observed was lower than expected by the case-mix-adjusted use density. The patient case-mix adjustment of antibiotic use ranked the hospitals differently from the ranking according to observed use, and may be a useful tool for benchmarking hospital antibiotic use. However, the best set of easily and widely available parameters that would describe both patient material and hospital activities remains to be determined.

  10. Are sex ratio distorting endosymbionts responsible for mating system variation among dance flies (Diptera: Empidinae)?

    PubMed

    Murray, Rosalind L; Herridge, Elizabeth J; Ness, Rob W; Bussière, Luc F

    2017-01-01

    Maternally inherited bacterial endosymbionts are common in many arthropod species. Some endosymbionts cause female-biased sex ratio distortion in their hosts that can result in profound changes to a host's mating behaviour and reproductive biology. Dance flies (Diptera: Empidinae) are well known for their unusual reproductive biology, including species with female-specific ornamentation and female-biased lek-like swarming behaviour. The cause of the repeated evolution of female ornaments in these flies remains unknown, but is probably associated with female-biased sex ratios in individual species. In this study we assessed whether dance flies harbour sex ratio distorting endosymbionts that might have driven these mating system evolutionary changes. We measured the incidence and prevalence of infection by three endosymbionts that are known to cause female-biased sex ratios in other insect hosts (Wolbachia, Rickettsia and Spiroplasma) across 20 species of dance flies. We found evidence of widespread infection by all three symbionts and variation in sex-specific prevalence across the taxa sampled. However, there was no relationship between infection prevalence and adult sex ratio measures and no evidence that female ornaments are associated with high prevalences of sex-biased symbiont infections. We conclude that the current distribution of endosymbiont infections is unlikely to explain the diversity in mating systems among dance fly species.

  11. Prevalent and Incident Tuberculosis Are Independent Risk Factors for Mortality among Patients Accessing Antiretroviral Therapy in South Africa

    PubMed Central

    Gupta, Ankur; Wood, Robin; Kaplan, Richard; Bekker, Linda-Gail; Lawn, Stephen D.

    2013-01-01

    Background Patients with prevalent or incident tuberculosis (TB) in antiretroviral treatment (ART) programmes in sub-Saharan Africa have high mortality risk. However, published data are contradictory as to whether TB is a risk factor for mortality that is independent of CD4 cell counts and other patient characteristics. Methods/Findings This observational ART cohort study was based in Cape Town, South Africa. Deaths from all causes were ascertained among patients receiving ART for up to 8 years. TB diagnoses and 4-monthly CD4 cell counts were recorded. Mortality rates were calculated and Poisson regression models were used to calculate incidence rate ratios (IRR) and identify risk factors for mortality. Of 1544 patients starting ART, 464 patients had prevalent TB at baseline and 424 developed incident TB during a median of 5.0 years follow-up. Most TB diagnoses (73.6%) were culture-confirmed. A total of 208 (13.5%) patients died during ART and mortality rates were 8.84 deaths/100 person-years during the first year of ART and decreased to 1.14 deaths/100 person-years after 5 years. In multivariate analyses adjusted for baseline and time-updated risk factors, both prevalent and incident TB were independent risk factors for mortality (IRR 1.7 [95% CI, 1.2–2.3] and 2.7 [95% CI, 1.9–3.8], respectively). Adjusted mortality risks were higher in the first 6 months of ART for those with prevalent TB at baseline (IRR 2.33; 95% CI, 1.5–3.5) and within the 6 months following diagnoses of incident TB (IRR 3.8; 95% CI, 2.6–5.7). Conclusions Prevalent TB at baseline and incident TB during ART were strongly associated with increased mortality risk. This effect was time-dependent, suggesting that TB and mortality are likely to be causally related and that TB is not simply an epiphenomenon among highly immunocompromised patients. Strategies to rapidly diagnose, treat and prevent TB prior to and during ART urgently need to be implemented. PMID:23418463

  12. Secular trends in cholesterol lipoproteins and triglycerides and prevalence of dyslipidemias in an urban Indian population

    PubMed Central

    Gupta, Rajeev; Guptha, Soneil; Agrawal, Aachu; Kaul, Vijay; Gaur, Kiran; Gupta, Vijay P

    2008-01-01

    Background Coronary heart disease is increasing in urban Indian subjects and lipid abnormalities are important risk factors. To determine secular trends in prevalence of various lipid abnormalities we performed studies in an urban Indian population. Methods Successive epidemiological Jaipur Heart Watch (JHW) studies were performed in Western India in urban locations. The studies evaluated adults ≥ 20 years for multiple coronary risk factors using standardized methodology (JHW-1, 1993–94, n = 2212; JHW-2, 1999–2001, n = 1123; JHW-3, 2002–03, n = 458, and JHW-4 2004–2005, n = 1127). For the present analyses data of subjects 20–59 years (n = 4136, men 2341, women 1795) have been included. In successive studies, fasting measurements for cholesterol lipoproteins (total cholesterol, LDL cholesterol, HDL cholesterol) and triglycerides were performed in 193, 454, 179 and 252 men (n = 1078) and 83, 472, 195, 248 women (n = 998) respectively (total 2076). Age-group specific levels of various cholesterol lipoproteins, triglycerides and their ratios were determined. Prevalence of various dyslipidemias (total cholesterol ≥ 200 mg/dl, LDL cholesterol ≥ 130 mg/dl, non-HDL cholesterol ≥ 160 mg/dl, triglycerides ≥ 150 mg/dl, low HDL cholesterol <40 mg/dl, high cholesterol remnants ≥ 25 mg/dl, and high total:HDL cholesterol ratio ≥ 5.0, and ≥ 4.0 were also determined. Significance of secular trends in prevalence of dyslipidemias was determined using linear-curve estimation regression. Association of changing trends in prevalence of dyslipidemias with trends in educational status, obesity and truncal obesity (high waist:hip ratio) were determined using two-line regression analysis. Results Mean levels of various lipoproteins increased sharply from JHW-1 to JHW-2 and then gradually in JHW-3 and JHW-4. Age-adjusted mean values (mg/dl) in JHW-1, JHW-2, JHW-3 and JHW-4 studies respectively showed a significant increase in total cholesterol (174.9 ± 45, 196.0

  13. Prevalence of birth defects among American-Indian births in California, 1983-2010.

    PubMed

    Aggarwal, Deepa; Warmerdam, Barbara; Wyatt, Katrina; Ahmad, Shabbir; Shaw, Gary M

    2015-02-01

    Approximately 6.3 million live births and fetal deaths occurred during the ascertainment period in the California Birth Defects Monitoring Program registry. American-Indian and non-Hispanic white women delivered 40,268 and 2,044,118 births, respectively. While much information has been published about non-Hispanic white infants, little is known regarding the risks of birth defects among infants born to American-Indian women. This study used data from the California Birth Defects Monitoring Program to explore risks of selected birth defects in offspring of American-Indian relative to non-Hispanic white women in California. The study population included all live births and fetal deaths 20 weeks or greater from 1983 to 2010. Prevalence ratios and corresponding 95% confidence intervals (CI) were computed using Poisson regression for 51 groupings of birth defects. Prevalence ratios were estimated for 51 groupings of birth defects. Of the 51, nine had statistically precise results ranging from 0.78 to 1.85. The eight groups with elevated risks for American-Indian births were reduction deformities of brain, anomalies of anterior segments, specified anomalies of ear, ostium secundum type atrial septal defect, specified anomalies of heart, anomalies of the aorta, anomalies of great veins, and cleft lip with cleft palate. Our results suggest that American-Indian women having babies in California may be at higher risk for eight birth defect phenotypes compared with non-Hispanic whites. Further research is needed to determine whether these risks are observed among other populations of American-Indian women or when adjusted for potential covariates. © 2015 Wiley Periodicals, Inc.

  14. Stroke Prevalence, Mortality and Disability-Adjusted Life Years in Children and Youth Aged 0-19 Years: Data from the Global and Regional Burden of Stroke 2013.

    PubMed

    Krishnamurthi, Rita V; deVeber, Gabrielle; Feigin, Valery L; Barker-Collo, Suzanne; Fullerton, Heather; Mackay, Mark T; O'Callahan, Finbar; Lindsay, M Patrice; Kolk, Anneli; Lo, Warren; Shah, Priyanka; Linds, Alexandra; Jones, Kelly; Parmar, Priya; Taylor, Steve; Norrving, Bo; Mensah, George A; Moran, Andrew E; Naghavi, Mohsen; Forouzanfar, Mohammed H; Nguyen, Grant; Johnson, Catherine O; Vos, Theo; Murray, Christopher J L; Roth, Gregory A

    2015-01-01

    There is increasing recognition of stroke as an important contributor to childhood morbidity and mortality. Current estimates of global childhood stroke burden and its temporal trends are sparse. Accurate and up-to-date estimates of childhood stroke burden are important for planning research and the resulting evidence-based strategies for stroke prevention and management. To estimate the prevalence, mortality and disability-adjusted life years (DALYs) for ischemic stroke (IS), hemorrhagic stroke (HS) and all stroke types combined globally from 1990 to 2013. Stroke prevalence, mortality and DALYs were estimated using the Global Burden of Disease 2013 methods. All available data on stroke-related incidence, prevalence, excess mortality and deaths were collected. Statistical models and country-level covariates were employed to produce comprehensive and consistent estimates of prevalence and mortality. Stroke-specific disability weights were used to estimate years lived with disability and DALYs. Means and 95% uncertainty intervals (UIs) were calculated for prevalence, mortality and DALYs. The median of the percent change and 95% UI were determined for the period from 1990 to 2013. In 2013, there were 97,792 (95% UI 90,564-106,016) prevalent cases of childhood IS and 67,621 (95% UI 62,899-72,214) prevalent cases of childhood HS, reflecting an increase of approximately 35% in the absolute numbers of prevalent childhood strokes since 1990. There were 33,069 (95% UI 28,627-38,998) deaths and 2,615,118 (95% UI 2,265,801-3,090,822) DALYs due to childhood stroke in 2013 globally, reflecting an approximately 200% decrease in the absolute numbers of death and DALYs in childhood stroke since 1990. Between 1990 and 2013, there were significant increases in the global prevalence rates of childhood IS, as well as significant decreases in the global death rate and DALYs rate of all strokes in those of age 0-19 years. While prevalence rates for childhood IS and HS decreased

  15. Increased dietary sodium is independently associated with greater mortality among prevalent hemodialysis patients.

    PubMed

    Mc Causland, Finnian R; Waikar, Sushrut S; Brunelli, Steven M

    2012-07-01

    Dietary sodium is thought to play a major role in the pathogenesis of hypertension, hypervolemia, and mortality in hemodialysis patients; hence, sodium restriction is almost universally recommended. Since the evidence upon which to base these assumptions is limited, we undertook a post-hoc analysis of 1770 patients in the Hemodialysis Study with available dietary, clinical, and laboratory information. Within this cohort, 772 were men, 1113 black, and 786 diabetic, with a mean age of 58 years and a median dietary sodium intake of 2080 mg/day. After case-mix adjustment, linear regression modeling found that higher dietary sodium was associated with a greater ultrafiltration requirement, caloric and protein intake; sodium to calorie intake ratio was associated with a greater ultrafiltration requirement; and sodium to potassium ratio was associated with higher serum sodium. No indices were associated with the pre-dialysis systolic blood pressure. Cox regression modeling found that higher baseline dietary sodium and the ratio of sodium to calorie or potassium were each independently associated with greater all-cause mortality. No association between a prescribed dietary sodium restriction and mortality were found. Thus, higher reported dietary sodium intake is independently associated with greater mortality among prevalent hemodialysis patients. Randomized trials will be necessary to determine whether dietary sodium restriction improves survival.

  16. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units.

    PubMed

    Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

    To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR) by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p≤0.05). 7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR=7.06), receiving information on breast milk expression by the primary health care unit (APR=3.65), and receiving help from the unit professionals to breastfeed (APR=2.24) were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR=0.09). Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation. Copyright © 2017. Published by Elsevier Editora Ltda.

  17. C-reactive Protein Is Associated With Prevalence of the Metabolic Syndrome, Hypertension, and Diabetes Mellitus in US Adults.

    PubMed

    Mazidi, Mohsen; Toth, Peter P; Banach, Maciej

    2018-05-01

    The prevalence of metabolic syndrome (MetS) has increased globally and is associated with an increased risk of cardiovascular diseases that may be related to its association with inflammation. We have assessed whether the prevalence of the MetS correlates with a serum high-sensitivity C-reactive protein (hsCRP) concentration in a population-based sample of US men and women. Participants were selected from the US National Health and Nutrition Examination Survey from 2005 to 2010. Of the 17 689 participants analyzed, 8607 (48.3%) were men. The mean age was 45.8 years in the overall sample (between men and women P = .047). The prevalence of MetS, diabetes mellitus, and hypertension increased across quartiles for hsCRP (all P < .001). Moreover, we found that for the age-, race-, sex-, and smoking-adjusted logistic regression, with increasing hsCRP, the risk of having MetS increased with an odds ratio of 5.20 (95% confidence interval, 4.54-5.93, P < .001) when comparing the highest quartile of serum hsCRP with the lowest. This study provides further evidence for an association between MetS and subclinical inflammation.

  18. Estimating Wisconsin Asthma Prevalence Using Clinical Electronic Health Records and Public Health Data

    PubMed Central

    Tomasallo, Carrie D.; Hanrahan, Lawrence P.; Tandias, Aman; Chang, Timothy S.; Cowan, Kelly J.

    2014-01-01

    Objectives. We compared a statewide telephone health survey with electronic health record (EHR) data from a large Wisconsin health system to estimate asthma prevalence in Wisconsin. Methods. We developed frequency tables and logistic regression models using Wisconsin Behavioral Risk Factor Surveillance System and University of Wisconsin primary care clinic data. We compared adjusted odds ratios (AORs) from each model. Results. Between 2007 and 2009, the EHR database contained 376 000 patients (30 000 with asthma), and 23 000 (1850 with asthma) responded to the Behavioral Risk Factor Surveillance System telephone survey. AORs for asthma were similar in magnitude and direction for the majority of covariates, including gender, age, and race/ethnicity, between survey and EHR models. The EHR data had greater statistical power to detect associations than did survey data, especially in pediatric and ethnic populations, because of larger sample sizes. Conclusions. EHRs can be used to estimate asthma prevalence in Wisconsin adults and children. EHR data may improve public health chronic disease surveillance using high-quality data at the local level to better identify areas of disparity and risk factors and guide education and health care interventions. PMID:24228643

  19. Estimating Wisconsin asthma prevalence using clinical electronic health records and public health data.

    PubMed

    Tomasallo, Carrie D; Hanrahan, Lawrence P; Tandias, Aman; Chang, Timothy S; Cowan, Kelly J; Guilbert, Theresa W

    2014-01-01

    We compared a statewide telephone health survey with electronic health record (EHR) data from a large Wisconsin health system to estimate asthma prevalence in Wisconsin. We developed frequency tables and logistic regression models using Wisconsin Behavioral Risk Factor Surveillance System and University of Wisconsin primary care clinic data. We compared adjusted odds ratios (AORs) from each model. Between 2007 and 2009, the EHR database contained 376,000 patients (30,000 with asthma), and 23,000 (1850 with asthma) responded to the Behavioral Risk Factor Surveillance System telephone survey. AORs for asthma were similar in magnitude and direction for the majority of covariates, including gender, age, and race/ethnicity, between survey and EHR models. The EHR data had greater statistical power to detect associations than did survey data, especially in pediatric and ethnic populations, because of larger sample sizes. EHRs can be used to estimate asthma prevalence in Wisconsin adults and children. EHR data may improve public health chronic disease surveillance using high-quality data at the local level to better identify areas of disparity and risk factors and guide education and health care interventions.

  20. Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas.

    PubMed

    Agustina, Rina; Sari, Tirta P; Satroamidjojo, Soemilah; Bovee-Oudenhoven, Ingeborg M J; Feskens, Edith J M; Kok, Frans J

    2013-10-19

    Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian children. A cross-sectional study was conducted among 274 randomly selected children aged 12-59 months in selected low socioeconomic urban areas of East Jakarta. The prevalence of diarrhea was assessed from 7-day records on frequency and consistency of the child's defecation pattern. Food-hygiene practices including mother's and child's hand washing, food preparation, cleanliness of utensils, water source and safe drinking water, habits of buying cooked food, child's bottle feeding hygiene, and housing and environmental condition were collected through home visit interviews and observations by fieldworkers. Thirty-six practices were scored and classified into poor (median and below) and better (above median) food-hygiene practices. Nutritional status of children, defined anthropometrically, was measured through height and weight. Among the individual food-hygiene practices, children living in a house with less dirty sewage had a significantly lower diarrhea prevalence compared to those who did not [adjusted odds ratio (OR) 0.16, 95% confidence interval (CI) = 0.03-0.73]. The overall food-hygiene practice score was not significantly associated with diarrhea in the total group, but it was in children aged < 2 years (adjusted OR 4.55, 95% CI = 1.08-19.1). Overall poor mother's food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. However, among children < 2 years from low socioeconomic urban areas they were associated with more diarrhea.

  1. Prevalence and associated factors of hepatitis C virus infection among renal disease patients on maintenance hemodialysis in three health centers in Aden, Yemen: a cross sectional study.

    PubMed

    Aman, Khadija; Al-Dubai, Sami AbdoRadman; Aman, Reema; Hawash, Aamenah; Alshagga, Mustafa; Kassim, Saba

    2015-03-01

    We aimed to assess the prevalence and factors associated with positive anti-hepatitis C virus (HCV) antibodies among patients on maintenance hemodialysis (HD) in three centers in Aden, Yemen. The data from 219 patients and their records over the period between 2000-2013, was extracted and analyzed. The mean ± SD age of the patients was 47.08 ± 13.9 years; 74.4% of them were married and 14.6% were employed. The prevalence of validated anti-HCV-positive cases was 40.2% (95%CI 33.64%-46.73%). The mean ± SD duration on HD of all the patients was 35.09 ± 38 months. On bivariate analysis, the duration on HD and attending more than one center for HD associated significantly with anti-HCV positivity (P <0.05). On multivariate fully adjusted Poisson regression modelling, controlled for age, Patients attending more than one center and those who underwent HD for longer durations were more likely to be positive for anti- HCV antibodies [P = 0.004, adjusted prevalence rate ratio (APRR) = 1.87, 95% confidence interval (CI): 1.22-2.88; P = 0.0005, APRR = 1.01, 95% CI: 1.00-1.02. In this study sample, the prevalence of HCV was significant. Patients attending more than one center and those who underwent HD for longer durations were found to be more likely to contract HCV. Enhancing existing infection control measures and allocating more resources to HD centers therefore warrants consideration.

  2. Projecting future smoking prevalence to 2025 and beyond in New Zealand using smoking prevalence data from the 2013 Census.

    PubMed

    van der Deen, Frederieke S; Ikeda, Takayoshi; Cobiac, Linda; Wilson, Nick; Blakely, Tony

    2014-11-28

    We have previously published a forecasting model of future smoking prevalence in New Zealand (NZ). Under business-as-usual (BAU) assumptions NZ's smokefree 2025 goal was not attained by any demographic group. However, the 2013 Census (which included a question on smoking) showed a greater than expected fall in prevalence, especially for Maori. We therefore aimed to provide upgraded projections to inform policy around tobacco endgame planning. The previously developed dynamic forecasting model was re-specified using smoking prevalence data from the 2006 and 2013 censuses from NZ. Calculations included changes in initiation by age 20 years, and net annual cessation rates, by sex, age, and ethnicity (Maori vs non-Maori). Projections under 2006-2013 trends (adjusted for no tax rises since 2010), by sex and ethnicity were made out to 2025 and beyond. Between the 2006 and 2013 censuses (adjusted for no tax rises since 2010), initiation of daily smoking by age 20 years decreased annually by 3.4% (95% uncertainty interval 3.2% to 3.6%) and 2.7% (2.5% to 2.8%) for non-Maori men and women, and by 2.9% (2.6% to 3.2%) and 3.2% (2.9% to 3.5%) for Maori respectively. Annual net smoking cessation rates ranged from 3.7% to 7.7% across demographic groups. The revised projected smoking prevalence in 2025 (allowing for tax increases that have occurred from 2010 to 2014) was 8.3% and 6.4% for non-Maori, and 18.7% and 19.3% for Maori men and women, respectively. The upgraded smoking prevalence projections still suggests that the NZ Government's smokefree 2025 goal would not be attained by any demographic group. It is likely that more intensive existing interventions, or entirely novel ones, will be needed to achieve the 2025 endgame goal.

  3. Occupation-related differences in the prevalence of metabolic syndrome.

    PubMed

    Sánchez-Chaparro, Miguel-Angel; Calvo-Bonacho, Eva; González-Quintela, Arturo; Fernández-Labandera, Carlos; Cabrera, Martha; Sáinz, Juan-Carlos; Fernández-Meseguer, Ana; Banegas, José R; Ruilope, Luis-Miguel; Valdivielso, Pedro; Román-García, Javier

    2008-09-01

    To investigate the prevalence of metabolic syndrome in the Spanish working population and determine how the prevalence varies according to occupation and sex. This was a cross-sectional study of 259,014 workers (mean age 36.4 years, range [16-74]; 72.9% male) who underwent a routine medical checkup. The Adult Treatment Panel III (2001) definition for metabolic syndrome was used. The prevalence of metabolic syndrome was 11.6% (95% CI 11.5-11.7) in male subjects and 4.1% (4.0-4.2) in female subjects and increased with age. The prevalence of metabolic syndrome varied in the different categories of occupational activity depending on the sex considered. Among female subjects, the age-adjusted prevalence of metabolic syndrome was higher in blue-collar than in white-collar workers, but this difference was not evident among male workers. The prevalence of metabolic syndrome varies in the different categories of occupational activity in the Spanish working population. This variation also depends on sex.

  4. Increased childhood morbidity after measles is short-term in urban Bangladesh.

    PubMed

    Akramuzzaman, S M; Cutts, F T; Wheeler, J G; Hossain, M J

    2000-04-01

    In a 1995-1996 cohort study in the city of Dhaka, Bangladesh, morbidity in 117 hospitalized and 137 acute measles cases compared with age-matched children without measles (unexposed) was determined by weekly interview for 6 months. Compared with unexposed children, there were higher incidences of hospitalization (adjusted rate ratio (RR) = 3.1, 95% confidence interval (CI): 1.3, 7.6) and bloody diarrhea (adjusted RR = 2.7, 95% CI: 1.4, 5.1) in hospital measles cases during the 6 weeks after recruitment. Among community cohorts, there were higher incidences of bloody diarrhea (adjusted RR = 4.1, 95% CI: 1.1, 14.6), watery diarrhea (adjusted RR = 1.6, 95% CI: 0.9, 2.7), fast breathing (adjusted RR = 3.8, 95% CI: 2.1, 6.9), and the weekly point prevalence of pneumonia (adjusted prevalence ratio = 3.1, 95% CI: 1.0, 9.8) in measles cases during the same period. All measles cases regained lost weight within about 6 weeks. The prevalence of anergy to seven recall antigens 6 weeks after recruitment was higher in both hospital (adjusted odds ratio = 2.8, 95% CI: 1.2, 6.4) and community (adjusted odds ratio = 3.1, 95% CI: 1.1, 8.9) measles cases. Morbidity increased during the first 6-8 weeks after measles, but the authors found no consistent evidence of longer-term morbidity or wasting. The results support recent findings that measles is not associated with increased delayed mortality.

  5. Husbands’ and Wives’ Alcohol Use Disorders and Marital Interactions as Longitudinal Predictors of Marital Adjustment

    PubMed Central

    Cranford, James A.; Floyd, Frank J.; Schulenberg, John E.; Zucker, Robert A.

    2011-01-01

    This longitudinal study tested the hypothesis that marital interactions mediate the associations between wives’ and husbands’ lifetime alcoholism status and their subsequent marital adjustment. Participants were 105 couples from the Michigan Longitudinal Study (MLS), an ongoing multimethod investigation of substance use in a community-based sample of alcoholics, nonalcoholics, and their families. At baseline (T1), husbands and wives completed a series of diagnostic measures and lifetime DSM-IV diagnosis of alcohol use disorder (AUD) was assessed. Couples completed a problem-solving marital interaction task 3 years later at T2, which was coded for the ratio of positive to negative behaviors (P/N) was calculated. Couples also completed the Dyadic Adjustment Scale (DAS; Spanier, 1976) at T4 (9 years after T1 and 6 years after T2). Moderate to strong positive correlations were observed between husbands’ and wives’ lifetime AUD, P/N ratio, and dyadic adjustment. Based on an Actor-Partner Independence Model (APIM) framework, results from structural equation modeling showed that husbands’ lifetime AUD was negatively associated with wives’ P/N ratio at the 3 year point, but was not related to their own or their wives’ marital adjustment 9 years from baseline. However, wives’ lifetime AUD had direct negative associations with their own and their husband’s marital satisfaction 9 years later, and wives’ P/N ratio was positively related to their own and their husband’s marital satisfaction 6 years later. Results indicate that marital adjustment in alcoholic couples may be driven more by the wives’ than the husbands’ AUD and marital behavior. PMID:21133510

  6. Analysis of the prevalence and associated risk factors of tinnitus in adults.

    PubMed

    Kim, Hyung-Jong; Lee, Hyo-Jeong; An, Soo-Youn; Sim, Songyong; Park, Bumjung; Kim, Si Whan; Lee, Joong Seob; Hong, Sung Kwang; Choi, Hyo Geun

    2015-01-01

    Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study was to analyze the prevalence and associated risk factors of tinnitus. We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling. The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR) of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h), those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss. Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history.

  7. The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries.

    PubMed

    Manyanga, Taru; El-Sayed, Hesham; Doku, David Teye; Randall, Jason R

    2014-08-28

    The burden caused by the coexistence of obesity and underweight in Low and Middle Income Countries is a challenge to public health. While prevalence of underweight among youth has been well documented in these countries, overweight, obesity and their associated risk factors are not well understood unlike in high income countries. Cross-sectional data from the Global School-based Student Health Survey (GSHS) conducted in seven African countries were used for this study. The survey used a clustered design to obtain a representative sample (n = 23496) from randomly selected schools. 53.6% of the sample was male, and participants ranged in age from 11-17 years old. Body Mass Index (BMI) was calculated using age and sex adjusted self-reported heights and weights. Classification of weight status was based on the 2007 World Health Organization growth charts (BMI-for-age and sex). Multivariable Logistic Regression reporting Odds Ratios was used to assess potential risk factors on BMI, adjusting for age, sex, and country. Statistical analyses were performed with Stata with an alpha of 0.05 and reporting 95% confidence intervals. Unadjusted rates of being underweight varied from 12.6% (Egypt) to 31.9% (Djibouti), while being overweight ranged from 8.7% (Ghana) to 31.4% (Egypt). Obesity rates ranged from 0.6% (Benin) to 9.3% (Egypt). Females had a higher overweight prevalence for every age group in five of the countries, exceptions being Egypt and Malawi. Overall, being overweight was more prevalent among younger (≤12) adolescents and decreased with age. Males had a higher prevalence of being underweight than females for every country. There was a tendency for the prevalence of being underweight to increase starting in the early teens and decrease between ages 15 and 16. Most of the potential risk factors captured by the GSHS were not significantly associated with weight status. The prevalence of both overweight and underweight was relatively high, demonstrating the

  8. Prevalence of Body Mass Index Lower Than 16 Among Women in Low- and Middle-Income Countries.

    PubMed

    Razak, Fahad; Corsi, Daniel J; Slutsky, Arthur S; Kurpad, Anura; Berkman, Lisa; Laupacis, Andreas; Subramanian, S V

    2015-11-24

    Body mass index (BMI) lower than 16 is the most severe category of adult undernutrition and is associated with substantial morbidity, increased mortality, and poor maternal-fetal outcomes such as low-birth-weight newborns. Little is known about the prevalence and distribution of BMI lower than 16 in low- and middle-income countries (LMIC). To determine the prevalence and distribution of BMI lower than 16 and its change in prevalence over time in women in LMIC. Cross-sectional data analysis composed of nationally representative surveys from 1993 through 2012 from the Demographic and Health Surveys Program. Women aged 20 through 49 years from 60 LMIC (N = 500,761) and a subset of 40 countries with repeated surveys (N = 604,144) were examined. Wealth was measured using a validated asset index, age was categorized in deciles, education by highest completed level (none, primary, secondary, or greater), and place of residence as urban vs rural. The primary outcome was BMI lower than 16. Analyses assessed the prevalence of BMI lower than 16, its association with sociodemographic factors, and change in prevalence. Logistic regression models were used to calculate odds ratios (ORs), adjusting for survey design and age structure. Among countries examined, the pooled, weighted, and age-standardized prevalence of BMI lower than 16 was 1.8% (95% CI, 1.7% to 1.8%) with the highest prevalence in India (6.2% [95% CI, 5.9% to 6.5%]), followed by Bangladesh (3.9% [95% CI, 3.4% to 4.3%]), Madagascar (3.4% [95% CI, 2.8% to 4.0%], Timor-Leste (2.9% [95% CI, 2.4% to 3.2%]), Senegal (2.5% [95% CI, 1.9% to 3.2%]), and Sierra Leone (2.2% [95% CI, 1.3% to 3.0%]); and 6 countries had prevalences lower than 0.1% (Albania, Bolivia, Egypt, Peru, Swaziland, and Turkey). The prevalence of BMI lower than 16 in women with a secondary or higher education level was 0.51% (95% CI, 0.47% to 0.55%), and in mutually adjusted models, a less than primary education level was associated with an OR of

  9. Are sex ratio distorting endosymbionts responsible for mating system variation among dance flies (Diptera: Empidinae)?

    PubMed Central

    Herridge, Elizabeth J.; Ness, Rob W.; Bussière, Luc F.

    2017-01-01

    Maternally inherited bacterial endosymbionts are common in many arthropod species. Some endosymbionts cause female-biased sex ratio distortion in their hosts that can result in profound changes to a host’s mating behaviour and reproductive biology. Dance flies (Diptera: Empidinae) are well known for their unusual reproductive biology, including species with female-specific ornamentation and female-biased lek-like swarming behaviour. The cause of the repeated evolution of female ornaments in these flies remains unknown, but is probably associated with female-biased sex ratios in individual species. In this study we assessed whether dance flies harbour sex ratio distorting endosymbionts that might have driven these mating system evolutionary changes. We measured the incidence and prevalence of infection by three endosymbionts that are known to cause female-biased sex ratios in other insect hosts (Wolbachia, Rickettsia and Spiroplasma) across 20 species of dance flies. We found evidence of widespread infection by all three symbionts and variation in sex-specific prevalence across the taxa sampled. However, there was no relationship between infection prevalence and adult sex ratio measures and no evidence that female ornaments are associated with high prevalences of sex-biased symbiont infections. We conclude that the current distribution of endosymbiont infections is unlikely to explain the diversity in mating systems among dance fly species. PMID:28609446

  10. Prevalence and clinical profile of metabolic syndrome among type 1 diabetes mellitus patients in southern India.

    PubMed

    Billow, Amy; Anjana, Ranjit Mohan; Ngai, Michelle; Amutha, Anandakumar; Pradeepa, Rajendra; Jebarani, Saravanan; Unnikrishnan, Ranjit; Michael, Edwin; Mohan, Viswanathan

    2015-07-01

    To assess the prevalence of metabolic syndrome (MetS) among patients with type 1 diabetes mellitus(T1DM) and to look at prevalence of diabetes complications in T1DM with and without MetS. We studied 451 T1DM patients attending a tertiary diabetes centre in Chennai, South India. T1DM was diagnosed based on absence of beta cell reserve and requirement of insulin from the time of diagnosis. Data on clinical and biochemical characteristics as well as complications details to study the prevalence were also extracted from electronic records. T1DM patients were divided into those with and without MetS[diagnosed according to the harmonizing the metabolic syndrome criteria(IDF/NHLBI/AHA/WHF/IAS/IASO)]. The overall prevalence of MetS among T1DM was 22.2%(100/451). Patients with MetS were older, had longer diabetes duration, acanthosis nigricans, and increased serum cholesterol. In the unadjusted logistic regression analysis, retinopathy, nephropathy and neuropathy were associated with MetS. However after adjustment for age, gender, diabetes duration, HbA1C and BMI significant association was seen only between MetS and retinopathy [odds ratio (OR) 2.82, 95% CI 1.18-6.74, p = 0.020] and nephropathy [OR 4.92, 95% CI 2.59-9.33, p < 0.001]. Prevalence of MetS is high among Asian Indian T1DM patients, and its presence is associated with increased risk of diabetic retinopathy and nephropathy. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Prevalence of overweight and obesity and their cardiometabolic comorbidities in Hispanic adults living in Puerto Rico.

    PubMed

    Pérez, Cynthia M; Sánchez, Hesmy; Ortiz, Ana P

    2013-12-01

    This study characterized the prevalence of overweight and obesity and assessed their cardiometabolic comorbidities in the population aged 21-79 years living in the San Juan metropolitan area of Puerto Rico. We analyzed data from a household survey conducted in Puerto Rico between 2005 and 2007 that used a representative sample of 840 non-institutionalized adults living in the San Juan metropolitan area. Body mass index categories were classified as normal weight, overweight and obese. Poisson regression model with robust variance was used to estimate the prevalence ratio to assess the association of each cardiometabolic comorbidity (hypertension, dyslipidemia, diabetes, prediabetes, systemic inflammation, prothrombotic state, and coronary heart disease) with overweight and obesity. Age-standardized prevalence of overweight and obesity was 35.9 and 41.5%, respectively, figures higher than the combined prevalence for the U.S. adult population (68.8%) but similar to all mainland Hispanics (78.8%). Men were more likely to be overweight than women (40.4 vs. 33.4%), whereas more women than men were obese (43.7 vs. 37.6%). Prevalence of all cardiometabolic comorbidities was significantly (p < 0.05) higher among overweight and obese adults than those of normal weight after adjusting for age, sex, years of education, smoking status, alcohol consumption and physical activity. A considerable proportion of adults in this population are overweight or obese. In view of the wide-ranging effects that overweight and obesity have on health, preventive actions to avert the rise of excess body weight as well as the design of lifestyle interventions are largely needed in this population.

  12. Increasing prevalence of diagnosed diabetes--United States and Puerto Rico, 1995-2010.

    PubMed

    2012-11-16

    In 2010, an estimated 18.8 million persons in the United States had diagnosed diabetes mellitus and another 7.0 million had undiagnosed diabetes. Since 1990, the prevalence of diagnosed diabetes in the United States has risen sharply among all age groups, both sexes, and all racial/ethnic groups for which data are available. To learn whether the increase has been greater in some regions of the United States than in others, data on self-reported diabetes in adults collected during 1995-2010 by the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. The analysis showed that the age-adjusted prevalence of diagnosed diabetes increased during the interval in every state, the District of Columbia (DC), and Puerto Rico. In 1995, age-adjusted prevalence was ≥6% in only three states, DC, and Puerto Rico, but by 2010 it was ≥6% in every state, DC, and Puerto Rico, and ≥10.0% in six states and Puerto Rico. Strategies to prevent diabetes and its preventable risk factors are needed, especially for those at highest risk for diabetes, to slow the rise in diabetes prevalence across the United States. Continued surveillance of diabetes prevalence and incidence, its risk factors, and prevention efforts is important to measure progress of prevention efforts.

  13. Abnormal splenic artery diameter/hepatic artery diameter ratio in cirrhosis-induced portal hypertension

    PubMed Central

    Zeng, Dao-Bing; Dai, Chuan-Zhou; Lu, Shi-Chun; He, Ning; Wang, Wei; Li, Hong-Jun

    2013-01-01

    AIM: To determine an optimal cutoff value for abnormal splenic artery diameter/proper hepatic artery diameter (S/P) ratio in cirrhosis-induced portal hypertension. METHODS: Patients with cirrhosis and portal hypertension (n = 770) and healthy volunteers (n = 31) underwent volumetric computed tomography three-dimensional vascular reconstruction to measure the internal diameters of the splenic artery and proper hepatic artery to calculate the S/P ratio. The cutoff value for abnormal S/P ratio was determined using receiver operating characteristic curve analysis, and the prevalence of abnormal S/P ratio and associations between abnormal S/P ratio and major complications of portal hypertension were studied using logistic regression. RESULTS: The receiver operating characteristic analysis showed that the cutoff points for abnormal splenic artery internal diameter and S/P ratio were > 5.19 mm and > 1.40, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 74.2%, 45.2%, 97.1%, and 6.6%, respectively. The prevalence of an abnormal S/P ratio in the patients with cirrhosis and portal hypertension was 83.4%. Patients with a higher S/P ratio had a lower risk of developing ascites [odds ratio (OR) = 0.708, 95%CI: 0.508-0.986, P = 0.041] and a higher risk of developing esophageal and gastric varices (OR = 1.483, 95%CI: 1.010-2.175, P = 0.044) and forming collateral circulation (OR = 1.518, 95%CI: 1.033-2.230, P = 0.034). After splenectomy, the portal venous pressure and maximum and mean portal venous flow velocities were reduced, while the flow rate and maximum and minimum flow velocities of the hepatic artery were increased (P < 0.05). CONCLUSION: The prevalence of an abnormal S/P ratio is high in patients with cirrhosis and portal hypertension, and it can be used as an important marker of splanchnic hemodynamic disturbances. PMID:23483462

  14. Giardia and Cryptosporidium antibody prevalence and correlates of exposure among Alaska residents, 2007-2008.

    PubMed

    Mosites, E; Miernyk, K; Priest, J W; Bruden, D; Hurlburt, D; Parkinson, A; Klejka, J; Hennessy, T; Bruce, M G

    2018-05-01

    Giardia duodenalis and Cryptosporidium spp. are common intestinal protozoa that can cause diarrhoeal disease. Although cases of infection with Giardia and Cryptosporidium have been reported in Alaska, the seroprevalence and correlates of exposure to these parasites have not been characterised. We conducted a seroprevalence survey among 887 residents of Alaska, including sport hunters, wildlife biologists, subsistence bird hunters and their families and non-exposed persons. We tested serum using a multiplex bead assay to evaluate antibodies to the Giardia duodenalis variant-specific surface protein conserved structural regions and to the Cryptosporidium parvum 17- and 27-kDa antigens. Approximately one third of participants in each group had evidence of exposure to Cryptosporidium. Prevalence of Giardia antibody was highest among subsistence hunters and their families (30%), among whom positivity was associated with lack of community access to in-home running water (adjusted prevalence ratio [aPR] 1.15, 95% confidence interval (CI) 1.02-1.28) or collecting rain, ice, or snow to use as drinking water (aPR 1.09, 95% CI 1.01-1.18). Improving in-home water access for entire communities could decrease the risk of exposure to Giardia.

  15. Prevalence, comorbidities, and cofactors associated with alcohol consumption among school-going adolescents in Malaysia.

    PubMed

    Manickam, Mala A; Abdul Mutalip, Mohd Hatta B; Abdul Hamid, Hamizatul Akmal Bt; Kamaruddin, Rozanim Bt; Sabtu, Mohd Yusoff B

    2014-09-01

    Alcohol is deleterious to physical and mental health as well as social well-being. This study aims to examine the prevalence of alcohol consumption and factors associated with its use among school-going Malaysian adolescents. The Global School-Based Student Health Survey (GSHS) 2012 employed 2-stage clustering design to Malaysian secondary school respondents aged 12 to 17 years. The prevalence of current alcohol usage was 8.9% (95% confidence interval [CI]: 7.8-10.07) overall, 11.2% (95% CI: 9.80-12.80) among males, and 23.4 (95% CI: 21.40-25.50) among Chinese students. Multivariate logistic regression showed that adolescents who had used alcohol were more likely to have used substance (adjusted odds ratio [aOR] = 3.39; 95% CI: 2.33-4.99), experienced injury (aOR = 1.53; 95% CI: 1.20-1.95), and engaged in sexual behaviors (aOR = 1.42, 95% CI: 1.12-1.79), and fights (aOR = 1.23; 95% CI: 1.08-1.41). The current national policies on alcohol should be strengthened to curb alcohol consumption among adolescents. © 2014 APJPH.

  16. Prevalence and correlates of skin cancer risk behaviors in Madrid (Spain).

    PubMed

    Galán, Iñaki; Rodríguez-Laso, Angel; Díez-Gañán, Lucía; Cámara, Enrique

    2011-01-01

    To estimate the prevalence and correlates of skin cancer-related behaviors in a representative sample of the population of the region of Madrid (Spain). We performed a cross-sectional study based on a telephone survey. A total of 2,007 participants aged 18-64 years completed a questionnaire that included items on knowledge about the risk of skin cancer, sun exposure, the use of ultraviolet (UV) lamps and sunburn during the previous year. Logistic regression models were constructed, adjusted for gender, age, educational level and employment status. Sun exposure as a risk factor for skin cancer was identified by 92.3% of participants and artificial tanning by 73.6%. Knowledge of risk factors was greater among university graduates and women (P<.001). A total of 14.6% were usually exposed to the sun in the summer during the hours of maximum UV radiation, while 4.3% had used UV lamps during the previous year; the use of these lamps was more frequent among women (P<.001) and young people (P<.05). The prevalence of sunburn was 13.2% and was lower among women: odds ratio (OR) 0.68 (95% CI: 0.51-0.90); this prevalence declined with greater age (p linear trend <0.001) and was higher among students: OR 1.60 (95% CI: 1.07-2.40). Numerous sociodemographic factors are related to UV radiation exposure and sunburn, with young people at highest risk. UV exposure is more frequent among women, whereas sunburn is more common among men. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  17. Prevalence of alcohol-interactive prescription medication use among current drinkers: United States, 1999 to 2010.

    PubMed

    Breslow, Rosalind A; Dong, Chuanhui; White, Aaron

    2015-02-01

    The majority of Americans consume alcoholic beverages. Alcohol interacts negatively with numerous commonly prescribed medications. Yet, on a population level, little is known about use of alcohol-interactive (AI) prescription medications among drinkers. The purpose of our study was to determine the prevalence of AI prescription medication use among current drinkers in the U.S. population. Data were from the National Health and Nutrition Examination Survey (NHANES 1999 to 2010); 26,657 adults aged ≥20 years had data on past year alcohol consumption and past month prescription medication use. Analyses were adjusted for covariates: age, race/ethnicity, education, marital status, and smoking. Statistical procedures accounted for survey stratification, clustering, and nonresponse. Analyses were weighted to be nationally representative. The unadjusted total prevalence of AI medication use was 42.8% (95% confidence interval [CI] 41.5 to 44.0). Among current drinkers, adjusted prevalence was 41.5% (CI 40.3 to 42.7). Among participants aged ≥65 total prevalence of AI medication use was 78.6% (CI 77.3 to 79.9) and adjusted prevalence among current drinkers was 77.8% (CI 75.7 to 79.7). The AI medications most commonly used by current drinkers were cardiovascular agents, central nervous system agents, and metabolic agents. Our results suggest that there could be substantial simultaneous exposure to alcohol and AI prescription medications in the U.S. population. Given the adverse health risks of combining alcohol with AI prescription medications, future efforts are needed to collect data to determine actual simultaneous prevalence. Copyright © 2015 by the Research Society on Alcoholism.

  18. Poisson sampling - The adjusted and unadjusted estimator revisited

    Treesearch

    Michael S. Williams; Hans T. Schreuder; Gerardo H. Terrazas

    1998-01-01

    The prevailing assumption, that for Poisson sampling the adjusted estimator "Y-hat a" is always substantially more efficient than the unadjusted estimator "Y-hat u" , is shown to be incorrect. Some well known theoretical results are applicable since "Y-hat a" is a ratio-of-means estimator and "Y-hat u" a simple unbiased estimator...

  19. Variability in case-mix adjusted in-hospital cardiac arrest rates.

    PubMed

    Merchant, Raina M; Yang, Lin; Becker, Lance B; Berg, Robert A; Nadkarni, Vinay; Nichol, Graham; Carr, Brendan G; Mitra, Nandita; Bradley, Steven M; Abella, Benjamin S; Groeneveld, Peter W

    2012-02-01

    It is unknown how in-hospital cardiac arrest (IHCA) rates vary across hospitals and predictors of variability. Measure variability in IHCA across hospitals and determine if hospital-level factors predict differences in case-mix adjusted event rates. Get with the Guidelines Resuscitation (GWTG-R) (n=433 hospitals) was used to identify IHCA events between 2003 and 2007. The American Hospital Association survey, Medicare, and US Census were used to obtain detailed information about GWTG-R hospitals. Adult patients with IHCA. Case-mix-adjusted predicted IHCA rates were calculated for each hospital and variability across hospitals was compared. A regression model was used to predict case-mix adjusted event rates using hospital measures of volume, nurse-to-bed ratio, percent intensive care unit beds, palliative care services, urban designation, volume of black patients, income, trauma designation, academic designation, cardiac surgery capability, and a patient risk score. We evaluated 103,117 adult IHCAs at 433 US hospitals. The case-mix adjusted IHCA event rate was highly variable across hospitals, median 1/1000 bed days (interquartile range: 0.7 to 1.3 events/1000 bed days). In a multivariable regression model, case-mix adjusted IHCA event rates were highest in urban hospitals [rate ratio (RR), 1.1; 95% confidence interval (CI), 1.0-1.3; P=0.03] and hospitals with higher proportions of black patients (RR, 1.2; 95% CI, 1.0-1.3; P=0.01) and lower in larger hospitals (RR, 0.54; 95% CI, 0.45-0.66; P<0.0001). Case-mix adjusted IHCA event rates varied considerably across hospitals. Several hospital factors associated with higher IHCA event rates were consistent with factors often linked with lower hospital quality of care.

  20. Medicare spending by state: the border-crossing adjustment.

    PubMed

    Basu, J; Lazenby, H C; Levit, K R

    1995-01-01

    As the first step in a pioneering effort by the Health Care Financing Administration (HCFA) to measure interstate border crossing for services used by both Medicare and non-Medicare beneficiaries, the authors study the spending behavior of Medicare beneficiaries for 10 Medicare-covered services. Based on interstate flow-of-expenditure data developed for calendar year 1991, the authors analyze the spending patterns of State residents by studying the inflow and outflow rates and the netflow ratios of expenditures incurred by Medicare patients. The report also provides per capita expenditure estimates with residence-based adjustments and evaluates the impact of the border-crossing adjustment for individual services and States.

  1. Smoking prevalence in Medicaid has been declining at a negligible rate

    PubMed Central

    Anderson, Christopher M.; Zhuang, Yue-Lin; Gamst, Anthony C.; Kohatsu, Neal D.

    2017-01-01

    Background In recent decades the overall smoking prevalence in the US has fallen steadily. This study examines whether the same trend is seen in the Medicaid population. Methods and findings National Health Interview Survey (NHIS) data from 17 consecutive annual surveys from 1997 to 2013 (combined N = 514,043) were used to compare smoking trends for 4 insurance groups: Medicaid, the Uninsured, Private Insurance, and Other Coverage. Rates of chronic disease and psychological distress were also compared. Results Adjusted smoking prevalence showed no detectable decline in the Medicaid population (from 33.8% in 1997 to 31.8% in 2013, trend test P = 0.13), while prevalence in the other insurance groups showed significant declines (38.6%-34.7% for the Uninsured, 21.3%-15.8% for Private Insurance, and 22.6%-16.8% for Other Coverage; all P’s<0.005). Among individuals who have ever smoked, Medicaid recipients were less likely to have quit (38.8%) than those in Private Insurance (62.3%) or Other Coverage (69.8%; both P’s<0.001). Smokers in Medicaid were more likely than those in Private Insurance and the Uninsured to have chronic disease (55.0% vs 37.3% and 32.4%, respectively; both P’s<0.01). Smokers in Medicaid were also more likely to experience severe psychological distress (16.2% for Medicaid vs 3.2% for Private Insurance and 7.6% for the Uninsured; both P’s<0.001). Conclusions The high and relatively unchanging smoking prevalence in the Medicaid population, low quit ratio, and high rates of chronic disease and severe psychological distress highlight the need to focus on this population. A targeted and sustained campaign to help Medicaid recipients quit smoking is urgently needed. PMID:28542637

  2. Prevalence, incidence and correlates of low risk HPV infection and anogenital warts in a cohort of women living with HIV in Burkina Faso and South Africa

    PubMed Central

    2018-01-01

    Objective To report the prevalence and incidence of low-risk human papillomavirus infection (LR-HPV) and anogenital warts (AGW) among women living with HIV (WLHIV) in Burkina Faso (BF) and South Africa (SA), and to explore HIV-related factors associated with these outcomes. Methods We enrolled 1238 WLHIV (BF = 615; SA = 623) aged 25–50 years and followed them at three time points (6, 12 and 16 months) after enrolment. Presence of AGW was assessed during gynaecological examination. Cervico-vaginal swabs for enrolment and month 16 follow-up visits were tested for HPV infection by Inno-LiPA® genotyping. Logistic regression was used to assess risk factors for prevalent infection or AGW. Cox regression was used to assess risk factors for incident AGW. Results Women in SA were more likely than those in BF to have prevalent LR-HPV infection (BF: 27.1% vs. SA: 40.9%; p<0.001) and incident LR-HPV infection (BF: 25.8% vs. SA: 31.6%, p = 0.05). Prevalence of persistent LR-HPV was similar in the two countries (BF: 33.3% vs. SA: 30.4%; p = 0.54), as were prevalence and incidence of AGW (Prevalence: BF: 7.5% vs. SA: 5.7%; p = 0.21; Incidence: BF: 2.47 vs. SA: 2.33 per 100 person-years; p = 0.41). HPV6 was associated with incident AGW (BF: adjusted Hazard Ratio (aHR) = 4.88; 95%CI: 1.36–17.45; SA: aHR = 5.02; 95%CI: 1.40–17.99). Prevalent LR-HPV (BF: adjusted Odds Ratio [aOR = 1.86]; 95%CI: 1.01–3.41; SA: aOR = 1.75; 95%CI: 0.88–3.48); persistent LR-HPV (BF: aOR = 1.92; 95%CI: 0.44–8.44; SA: aOR = 2.81; 95%CI: 1.07–7.41) and prevalent AGW (BF: aOR = 1.53; 95%CI: 0.61–3.87; SA: aOR = 4.11; 95%CI: 1.20–14.10) were each associated with low CD4+ counts (i.e. <200 vs. >500 cells/μL). Duration of ART and HIV plasma viral load were not associated with any LR-HPV infection or AGW outcomes. Conclusion LR-HPV infection and AGW are common in WLHIV in sub-Saharan Africa. Type-specific HPV vaccines and effective ART with immunological reconstitution could reduce the burden

  3. Prevalence of generalized anxiety disorder and its related factors among infertile patients in Iran: a cross-sectional study.

    PubMed

    Omani-Samani, Reza; Ghaheri, Azadeh; Navid, Behnaz; Sepidarkish, Mahdi; Maroufizadeh, Saman

    2018-06-19

    Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders among infertile patients. This study aimed to determine the prevalence of GAD and its associated factors among infertile patients in Tehran, Iran. This cross-sectional study included 1146 infertile patients in a referral fertility center in Tehran, Iran between May and October 2017. GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. The associations between GAD and demographic/fertility characteristics were estimated using simple and multiple logistic regression with odds ratio (OR) and 95% confidence interval (CI). The mean total GAD-7 score was 6.61 (SD = 5.32). Using a cut-off value of 10, the prevalence of GAD was 28.3%. In adjusted analysis, female sex (OR = 2.54, 95% CI = 1.88-3.42, P < 0.001), low educational level (OR = 1.45, 95% CI = 1.08-1.94, P = 0.012), high infertility duration (OR = 1.05, 95% CI = 1.01-1.09, P = 0.013), and treatment failure (OR = 1.52, 95% CI = 1.13-2.04, P = 0.006) were associated with GAD. The prevalence of GAD is relatively high in infertile patients. We conclude that all infertile patients should be screened for symptoms of GAD and treated for this disorder as need arises.

  4. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... attributable to the proposed energy or water conservation measure. The denominator of the ratio is the present... proposed energy or water conservation measure. [61 FR 32651, June 25, 1996] ...

  5. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... attributable to the proposed energy or water conservation measure. The denominator of the ratio is the present... proposed energy or water conservation measure. [61 FR 32651, June 25, 1996] ...

  6. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... attributable to the proposed energy or water conservation measure. The denominator of the ratio is the present... proposed energy or water conservation measure. [61 FR 32651, June 25, 1996] ...

  7. 10 CFR 436.22 - Adjusted internal rate of return.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... adjusted internal rate of return is the overall rate of return on an energy or water conservation measure... attributable to the proposed energy or water conservation measure. The denominator of the ratio is the present... proposed energy or water conservation measure. [61 FR 32651, June 25, 1996] ...

  8. Nickel exposure is associated with the prevalence of type 2 diabetes in Chinese adults.

    PubMed

    Liu, Gang; Sun, Liang; Pan, An; Zhu, Mingjiang; Li, Zi; ZhenzhenWang, Zhenzhen; Liu, Xin; Ye, Xingwang; Li, Huaixing; Zheng, He; Ong, Choon Nam; Yin, Huiyong; Lin, Xu; Chen, Yan

    2015-02-01

    Nickel exposure can induce hyperglycaemia in rodents, but little is known about its association with abnormal glucose metabolism in humans. We aimed to investigate the association of nickel exposure with the prevalence of type 2 diabetes in Chinese adults. A total of 2115 non-institutionalized men and women aged 55 to 76 years from Beijing and Shanghai were included, and urinary nickel concentration was assessed by inductively coupled plasma mass spectroscopy. The prevalence of type 2 diabetes was compared across urinary nickel quartiles. Fasting plasma glucose, insulin, lipids, C-reactive protein and glycated haemoglobin A1c, as well as urinary albumin and creatinine were measured. The median concentration of urinary nickel was 3.63 mg/l (interquartile range: 2.29–5.89 mg/l), and the prevalence of diabetes was 35.3% (747 cases/2115 persons). Elevated levels of urinary nickel were associated with higher fasting glucose, glycated haemoglobin A1c, insulin and homeostatic model assessment of insulin resistance (all P<0.01). The odds ratios (95% confidence interval) for diabetes across the increasing urinary nickel quartiles were 1.27 (0.97–1.67), 1.78 (1.36–2.32) and 1.68 (1.29–2.20), respectively (referencing to 1.00), after multivariate adjustment including lifestyle factors, body mass index and family history of diabetes (P for trend <0.001). The association remained unchanged after further controlling for urinary creatinine and C-reactive protein (P for trend <0.001). Increased urinary nickel concentration is associated with elevated prevalence of type 2 diabetes in humans.

  9. Prevalence and Motivation: Pubic Hair Grooming Among Men in the United States

    PubMed Central

    Gaither, Thomas W.; Awad, Mohannad A.; Osterberg, E. Charles; Rowen, Tami S.; Shindel, Alan W.; Breyer, Benjamin N.

    2016-01-01

    Pubic hair grooming is a growing phenomenon and is associated with body image and sexual activity. A nationally representative survey of noninstitutionalized adults aged 18 to 65 years residing in the United States was conducted. Differences in demographic and sexual characteristics between groomers and nongroomers were explored. Four thousand one hundred and ninety-eight men completed the survey. Of these men, 2,120 (50.5%) reported regular pubic hair grooming. The prevalence of grooming decreases with age, odds ratio = 0.95 (95% confidence interval [0.94, 0.96]), p < .001. Adjusting for sexual frequency and sexual orientation, grooming is associated with performing and receiving oral sex. The majority of men report grooming in preparation for sexual activity with a peak prevalence of 73% among men aged 25 to 34 years, followed by hygiene (61%) and routine care (44%). The majority of men who remove their pubic hair groom the hair above the penis (87%), followed by the scrotum (66%) and the penile shaft (57%). Overall, pubic hair grooming is common among men aged 18 to 65 years in the United States. Younger ages are associated with greater rates of pubic hair grooming. Many men groom for sex, in particular oral sex, as well as for routine care and hygiene. PMID:27480727

  10. Prevalence and Motivation: Pubic Hair Grooming Among Men in the United States.

    PubMed

    Gaither, Thomas W; Awad, Mohannad A; Osterberg, E Charles; Rowen, Tami S; Shindel, Alan W; Breyer, Benjamin N

    2017-05-01

    Pubic hair grooming is a growing phenomenon and is associated with body image and sexual activity. A nationally representative survey of noninstitutionalized adults aged 18 to 65 years residing in the United States was conducted. Differences in demographic and sexual characteristics between groomers and nongroomers were explored. Four thousand one hundred and ninety-eight men completed the survey. Of these men, 2,120 (50.5%) reported regular pubic hair grooming. The prevalence of grooming decreases with age, odds ratio = 0.95 (95% confidence interval [0.94, 0.96]), p < .001. Adjusting for sexual frequency and sexual orientation, grooming is associated with performing and receiving oral sex. The majority of men report grooming in preparation for sexual activity with a peak prevalence of 73% among men aged 25 to 34 years, followed by hygiene (61%) and routine care (44%). The majority of men who remove their pubic hair groom the hair above the penis (87%), followed by the scrotum (66%) and the penile shaft (57%). Overall, pubic hair grooming is common among men aged 18 to 65 years in the United States. Younger ages are associated with greater rates of pubic hair grooming. Many men groom for sex, in particular oral sex, as well as for routine care and hygiene.

  11. COPD prevalence and hospital admissions in Galicia (Spain). An analysis using the potential of new health information systems.

    PubMed

    Barbosa-Lorenzo, R; Ruano-Ravina, A; Fernández-Villar, A; López-Pardo, E; Carballeira-Roca, C; Barros-Dios, J M

    2018-05-05

    Chronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whether such prevalence was positively or negatively associated with COPD admissions, using all the data of a regional health care system. We designed a descriptive cross-sectional study which included all subjects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPD prevalence and incidence of admissions were calculated. Poisson regression models were then used to analyse the association between cases with diagnosis of COPD and admissions due to COPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivity subanalyses were performed by reference to the respective municipal rurality indices. Median municipal prevalence of COPD was 5.29% in men and 2.19% in women. Among patients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission. The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI 0.34-0.41) for men and 0.39 (95% CI 0.34-0.45) for women. There is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lying furthest from hospitals. There is considerable municipal variability in terms of COPD prevalence and proportion of admissions. In-depth attention should be given to disease-management training programmes. Copyright © 2018 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

  12. Markers of adiposity in HIV/AIDS patients: Agreement between waist circumference, waist-to-hip ratio, waist-to-height ratio and body mass index

    PubMed Central

    Ngu, Roland Cheofor; Kadia, Benjamin Momo; Tianyi, Frank-Leonel; Choukem, Simeon Pierre

    2018-01-01

    Background Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are all independent predictors of cardio-metabolic risk and therefore important in HIV/AIDS patients on antiretroviral therapy at risk of increased visceral adiposity. This study aimed to assess the extent of agreement between these parameters and the body mass index (BMI), as anthropometric parameters and in classifying cardio-metabolic risk in HIV/AIDS patients. Methods A secondary analysis of data from a cross-sectional study involving 200 HIV/AIDS patients was done. Anthropometric parameters were measured from participants using standard guidelines and central obesity defined according to recommended criteria. Increased cardio-metabolic risk was defined according to the standard cut-off values for all four parameters. Data were analyzed using STATA version 14.1. Results The prevalence of WC-defined central obesity, WHR-defined central obesity and WHtR > 0.50 were 33.5%, 44.5% and 36.5%, respectively. The prevalence of BMI-defined overweight and obesity was 40.5%. After adjusting for gender and HAART status, there was a significant linear association and correlation between WC and BMI (regression equation: WC (cm) = 37.184 + 1.756 BMI (Kg/m2) + 0.825 Male + 1.002 HAART, (p < 0.001, r = 0.65)), and between WHtR and BMI (regression equation: WHtR = 0.223 + 0.011 BMI (Kg/m2)– 0.0153 Male + 0.003 HAART, (p < 0.001, r = 0.65)), but not between WHR and BMI (p = 0.097, r = 0.13). There was no agreement between the WC, WHtR and BMI, and minimal agreement between the WHR and BMI, in identifying patients with an increased cardio-metabolic risk. Conclusion Despite the observed linear association and correlation between these anthropometric parameters, the routine use of WC, WHR and WHtR as better predictors of cardio-metabolic risk should be encouraged in these patients, due to their minimal agreement with BMI in identifying HIV/AIDS patients with increased cardio

  13. Sleep Disturbances in Adults With Arthritis: Prevalence, Mediators, and Subgroups at Greatest Risk. Data From the 2007 National Health Interview Survey

    PubMed Central

    LOUIE, GRANT H.; TEKTONIDOU, MARIA G.; CABAN-MARTINEZ, ALBERTO J.; WARD, MICHAEL M.

    2012-01-01

    Objective To examine the prevalence of sleep disturbances in adults with arthritis in a nationally representative sample, mediators of sleep difficulties, and subgroups of individuals with arthritis at greatest risk. Methods Using data on US adults ages ≥18 years participating in the 2007 National Health Interview Survey, we computed the prevalence of 3 measures of sleep disturbance (insomnia, excessive daytime sleepiness, and sleep duration <6 hours) among persons with arthritis. We used logistic regression analysis to examine if the association of arthritis and sleep disturbances was independent of sociodemographic characteristics and comorbidities, and to identify potential mediators. We used classification trees to identify subgroups at higher risk. Results The adjusted prevalence of insomnia was higher among adults with arthritis than those without arthritis (23.1% versus 16.4%; P < 0.0001), but was similar to those with other chronic diseases. Adults with arthritis were more likely than those without arthritis to report insomnia (unadjusted odds ratio 2.92, 95% confidence interval 2.68 –3.17), but adjustment for sociodemographic characteristics and comorbidities attenuated this association. Joint pain and limitation due to pain mediated the association between arthritis and insomnia. Among adults with arthritis, those with depression and anxiety were at highest risk for sleep disturbance. Results for excessive daytime sleepiness and sleep duration <6 hours were similar. Conclusion Sleep disturbance affects up to 10.2 million US adults with arthritis, and is mediated by joint pain and limitation due to pain. Among individuals with arthritis, those with depression and anxiety are at greatest risk. PMID:20890980

  14. Prevalence of adherence to fluid restriction in kidney patients in haemodialysis: objective indicator and perceived compliance.

    PubMed

    Iborra-Moltó, Carmelo; López-Roig, Sofía; Pastor-Mira, M de Los Ángeles

    2012-07-17

    Studies of adherence to fluid restriction show high variability in prevalence data, as different methods of measuring IWG (interdialysis weight gain) and cut-off criteria are used. To describe the prevalence of adherence to fluid restriction using daily IWG (criterion: ≤1 Kg) and daily IWG adjusted for dry weight (DW) (cut-off point adjusted criterion: DW<70 kg, IWG=1 kg/day; DW>70 kg and ≤80 kg, IWG=1.1 kg/day; DW>80 kg and ≤90 kg, IWG=1.2 kg/day; DW>90 kg, IWG=1.3 kg/day) and to study the association between this objective indicator and adherence behaviour as reported by patient. Our study included a total of 146 patients with a mean age of 66 years (SD: 13.6 years; range: 25-88 years), 66% of which were male. Ours was a longitudinal study with one month of follow-up. We collected both sociodemographic and clinical variables and mean daily IWG. Patient-reported adherence behaviour was assessed through an interview by a trained staff member from outside the department who asked the following question: "In order to avoid complications between haemodialysis sessions: during the last month, how many days did you ingest less than 1 litre of fluid per day?" (0= no days; 10= every day). A score ≤5 led to categorisation of patients as compliant with treatment. Statistical analysis included descriptive analysis, correlation test, chi-square and Crosstabs, ROC curve and logistic regression procedures. Prevalence of "objective" adherence to fluid restriction was 61% (mean daily IWG≤1kg) and 73% (mean daily IWG adjusted for dry weight). Reported adherence (prevalence: 56.2%) was associated with IWG adjusted for weight (chi-square =31.34; P=.000). In patients with objective adherence adjusted for weight, the prevalence of reported adherence was 1.65 times that of non-adherence (PR=1.65; 95% CI: 1.29-2.11). The final model for estimating the association between reported adherence behaviour and daily adjusted IWG included: age (higher), dry weight (lower), potassium

  15. Comparison of self-reported and observed prevalence of safety belt and helmet use in Florence.

    PubMed

    Lorini, C; Pieralli, F; Mersi, A; Cecconi, R; Garofalo, G; Santini, M G; Bonaccorsi, G

    2014-01-01

    Safety belt and helmet use was estimated from PASSI data and measured through Ulisse observations. Between 2008 and 2012 a total of 2,081 cars and motorcycle users were interviewed in the LHU of Florence and a total of 59,787 drivers (11,870 front passengers, 1,129 rear passengers and 16,816 motorcyclists) were observed. The comparison between self-reported and observed prevalences was performed by calculating the over-reporting factor (ORF), defined as the ratio of the self-reported to the observed prevalence of seat belt or helmet use. The time trend of the prevalence (both from self-reported and observed data) and of the ORF was assessed by using linear regression and Poisson's regression, respectively. The correlation between self-reported and observed prevalence is high, with a Pearson's correlation coefficient of 0.95 (p <0.05). Regarding front seat belt use rates, the difference between self-reported and observed data increases over time and the ORF range varies from 1.12 to 1.32. Rear seat belt data show a great variability, and the ORF varies from 0.67 to 1.37. In 2011 and 2012, the observed prevalence was higher than the self-reported one (ORF <1). Helmet use rates are very high, close to 100% with both methods; ORF has very small oscillations and ranges from 0.98 to 1, showing a good correlation between self-reported and observational data. There are no significant temporal variations both for the prevalences of use and for the ORF. The reasonable accuracy of self-reported data makes this method fit in the routinary assessment of safety belts and helmet usage, in order to limit the observations of the Ulisse system at predetermined time intervals. However, self-reported estimates need to be adjusted using an appropriate over-reporting factor.

  16. Increased dietary sodium is independently associated with greater mortality among prevalent hemodialysis patients

    PubMed Central

    Mc Causland, Finnian R.; Waikar, Sushrut S.; Brunelli, Steven M.

    2013-01-01

    Dietary sodium is thought to play a major role in the pathogenesis of hypertension, hypervolemia and mortality in hemodialysis patients. Thus, restriction is almost universally recommended. However, the evidence on which these assumptions are based is limited. We undertook a post-hoc analysis of the Hemodialysis Study with available dietary, clinical and laboratory information. Linear regression models were fit to estimate associations of dietary sodium with ultrafiltration requirement, blood pressure and nutritional indices. Cox regression models were fit to estimate the association of dietary sodium intake, sodium:calorie intake, sodium:potassium intake and prescribed sodium restriction with all-cause mortality. Complete data were available in 1770 subjects, of whom 44% were male, 63% were black and 44% were diabetic. Mean age was 58 (±14) years; median dietary sodium intake was 2080 (IQR: 1490-2850) mg/day. After case-mix adjustment, higher reported dietary sodium was associated with greater ultrafiltration requirement, caloric and protein intake; sodium:calorie intake ratio associated with greater UF requirement; sodium:potassium ratio associated with higher serum sodium. None were associated with pre-dialysis systolic blood pressure. Higher baseline reported dietary sodium, sodium:calorie ratio and sodium:potassium ratio were independently associated with greater all-cause mortality. No associations between prescribed dietary sodium restriction and mortality were observed. Higher reported dietary sodium intake is independently associated with greater mortality among prevalent hemodialysis subjects. Randomized trials are warranted to determine whether dietary sodium restriction improves survival. PMID:22418981

  17. Estimating diabetes prevalence by small area in England.

    PubMed

    Congdon, Peter

    2006-03-01

    Diabetes risk is linked to both deprivation and ethnicity, and so prevalence will vary considerably between areas. Prevalence differences may partly account for geographic variation in health performance indicators for diabetes, which are based on age standardized hospitalization or operation rates. A positive correlation between prevalence and health outcomes indicates that the latter are not measuring only performance. A regression analysis of prevalence rates according to age, sex and ethnicity from the Health Survey for England (HSE) is undertaken and used (together with census data) to estimate diabetes prevalence for 354 English local authorities and 8000 smaller areas (electoral wards). An adjustment for social factors is based on a prevalence gradient over area-deprivation quintiles. A Bayesian estimation approach is used allowing simple inclusion of evidence on prevalence from other or historical sources. The estimated prevalent population in England is 1.5 million (188 000 type 1 and 1.341 million type 2). At strategic health authority (StHA) level, prevalence varies from 2.4 (Thames Valley) to 4 per cent (North East London). The prevalence estimates are used to assess variations between local authorities in adverse hospitalization indicators for diabetics and to assess the relationship between diabetes-related mortality and prevalence. In particular, rates of diabetic ketoacidosis (DKA) and coma are positively correlated with prevalence, while diabetic amputation rates are not. The methodology developed is applicable to developing small-area-prevalence estimates for a range of chronic diseases, when health surveys assess prevalence by demographic categories. In the application to diabetes prevalence, there is evidence that performance indicators as currently calculated are not corrected for prevalence.

  18. Comparison of DNA testing strategies in monitoring human papillomavirus infection prevalence through simulation.

    PubMed

    Lin, Carol Y; Li, Ling

    2016-11-07

    HPV DNA diagnostic tests for epidemiology monitoring (research purpose) or cervical cancer screening (clinical purpose) have often been considered separately. Women with positive Linear Array (LA) polymerase chain reaction (PCR) research test results typically are neither informed nor referred for colposcopy. Recently, a sequential testing by using Hybrid Capture 2 (HC2) HPV clinical test as a triage before genotype by LA has been adopted for monitoring HPV infections. Also, HC2 has been reported as a more feasible screening approach for cervical cancer in low-resource countries. Thus, knowing the performance of testing strategies incorporating HPV clinical test (i.e., HC2-only or using HC2 as a triage before genotype by LA) compared with LA-only testing in measuring HPV prevalence will be informative for public health practice. We conducted a Monte Carlo simulation study. Data were generated using mathematical algorithms. We designated the reported HPV infection prevalence in the U.S. and Latin America as the "true" underlying type-specific HPV prevalence. Analytical sensitivity of HC2 for detecting 14 high-risk (oncogenic) types was considered to be less than LA. Estimated-to-true prevalence ratios and percentage reductions were calculated. When the "true" HPV prevalence was designated as the reported prevalence in the U.S., with LA genotyping sensitivity and specificity of (0.95, 0.95), estimated-to-true prevalence ratios of 14 high-risk types were 2.132, 1.056, 0.958 for LA-only, HC2-only, and sequential testing, respectively. Estimated-to-true prevalence ratios of two vaccine-associated high-risk types were 2.359 and 1.063 for LA-only and sequential testing, respectively. When designated type-specific prevalence of HPV16 and 18 were reduced by 50 %, using either LA-only or sequential testing, prevalence estimates were reduced by 18 %. Estimated-to-true HPV infection prevalence ratios using LA-only testing strategy are generally higher than using HC2-only or

  19. The prevalence and risk factors for pterygium in South Korea: the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010.

    PubMed

    Pyo, Eun-Young; Mun, Gui Hyeong; Yoon, Kyung Chul

    2016-01-01

    To determine the prevalence and risk factors for pterygium in the adult Korean population of South Korea. Data were analyzed from 9,193 participants who were 40 years of age or older from the Korea National Health and Nutrition Examination Survey (KNHANES), conducted from 2009 to 2010. Standardized slit-lamp examinations were performed by study ophthalmologists to examine the anterior segment for evidence of pterygium. Pterygium was graded clinically as T1 (atrophic), T2 (intermediate), or T3 (opaque). Every participant underwent ocular and systemic examinations, as well as interviewer-administered questionnaires. Any evidence of pterygium and observed association between the risk factors were recorded. The mean age of the subjects was 55.7 (±0.2) years. Of the 9,193 eligible subjects, 935 had pterygium in at least one eye. In a multivariate logistic regression analysis adjusted for age and sex, pterygium was significantly associated with rural vs. urban residence (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.4 to 2.0), lower level of education (OR, 4.5; 95% CI, 3.1 to 6.6), low income (OR, 1.3; 95% CI, 1.0 to 1.8), smoking (OR, 0.7; 95% CI, 0.5 to 1.0), and more hours of sun exposure (OR, 1.5; 95% CI, 1.2 to 1.8). After adjusting for all variables, the prevalence of pterygium was significantly associated with age, sex, residence, education level, and smoking. This is a nationwide epidemiologic study in South Korea to assess the prevalence of and risk factors for pterygium. The overall prevalence of pterygium was 8.8% among Koreans aged 40 years or older. Older age, male gender, rural residence, lower level of education, and non-smoking were associated with the development of pterygium.

  20. Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Background The prevalence of autism spectrum conditions (ASC) is 1% in developed countries, but little data are available from mainland China, Hong Kong and Taiwan. This study synthesizes evidence relating to the prevalence of ASC in these areas and assesses the effects of research methodology on prevalence estimates. Methods Systematic literature searches were conducted in PubMed, Web of Knowledge, China Web of Knowledge and Weipu databases, as well as relevant papers published from 1987 to 2011, reporting prevalence estimates of ASC or childhood autism in mainland China, Hong Kong and Taiwan. Summary estimates of prevalence were calculated with a random effects model. The effects of research methodology on the prevalence estimates were assessed using a meta-regression model. Results There were 25 studies eligible for review, 18 of which were suitable for inclusion in a meta-analysis. Pooled prevalence of childhood autism was 11.8 per 10,000 individuals (95% confidence interval (CI): 8.2, 15.3) in mainland China. Pooled prevalence of ASC was 26.6 per 10,000 (95% CI: 18.5, 34.6) in three areas. Substantial heterogeneity was identified between studies (I2>75%). The prevalence estimate of childhood autism was most strongly associated with the choice of screening instrument. After adjustment for age group, the odds ratio for prevalence estimates when using the Autism Behavior Checklist (ABC) as the screening instrument compared with those using the Clancy Autism Behavior Scale (CABS) was 0.29 (95% CI: 0.12, 0.69), and 1.79 (95% CI: 0.70, 4.55; P= 0.20) when using the Checklist for Autism in Toddlers (CHAT) compared to the CABS. Conclusions The available studies investigating the prevalence of ASC in China, Hong Kong and Taiwan have focused mainly on childhood autism rather than the whole spectrum. The prevalence estimates are lower than estimates from developed countries. Studies using more recently developed screening instruments reported higher prevalence than older

  1. Prevalence of dementia and major dementia subtypes in Spanish populations: A reanalysis of dementia prevalence surveys, 1990-2008

    PubMed Central

    de Pedro-Cuesta, Jesús; Virués-Ortega, Javier; Vega, Saturio; Seijo-Martínez, Manuel; Saz, Pedro; Rodríguez, Fernanda; Rodríguez-Laso, Angel; Reñé, Ramón; de las Heras, Susana Pérez; Mateos, Raimundo; Martínez-Martín, Pablo; Manubens, José María; Mahillo-Fernandez, Ignacio; López-Pousa, Secundino; Lobo, Antonio; Reglà, Jordi Llinàs; Gascón, Jordi; García, Francisco José; Fernández-Martínez, Manuel; Boix, Raquel; Bermejo-Pareja, Félix; Bergareche, Alberto; Benito-León, Julián; de Arce, Ana; del Barrio, José Luis

    2009-01-01

    Background This study describes the prevalence of dementia and major dementia subtypes in Spanish elderly. Methods We identified screening surveys, both published and unpublished, in Spanish populations, which fulfilled specific quality criteria and targeted prevalence of dementia in populations aged 70 years and above. Surveys covering 13 geographically different populations were selected (prevalence period: 1990-2008). Authors of original surveys provided methodological details of their studies through a systematic questionnaire and also raw age-specific data. Prevalence data were compared using direct adjustment and logistic regression. Results The reanalyzed study population (aged 70 year and above) was composed of Central and North-Eastern Spanish sub-populations obtained from 9 surveys and totaled 12,232 persons and 1,194 cases of dementia (707 of Alzheimer's disease, 238 of vascular dementia). Results showed high variation in age- and sex-specific prevalence across studies. The reanalyzed prevalence of dementia was significantly higher in women; increased with age, particularly for Alzheimer's disease; and displayed a significant geographical variation among men. Prevalence was lowest in surveys reporting participation below 85%, studies referred to urban-mixed populations and populations diagnosed by psychiatrists. Conclusion Prevalence of dementia and Alzheimer's disease in Central and North-Eastern Spain is higher in females, increases with age, and displays considerable geographic variation that may be method-related. People suffering from dementia and Alzheimer's disease in Spain may approach 600,000 and 400,000 respectively. However, existing studies may not be completely appropriate to infer prevalence of dementia and its subtypes in Spain until surveys in Southern Spain are conducted. PMID:19840375

  2. Prevalence and correlates of depression among adolescents in Malaysia.

    PubMed

    Kaur, Jasvindar; Cheong, Siew Man; Mahadir Naidu, Balkish; Kaur, Gurpreet; Manickam, Mala A; Mat Noor, Malisa; Ibrahim, Nurashikin; Rosman, Azriman

    2014-09-01

    Depression among adolescents has been recognized as a major public health issue. The objective of this study was to determine the prevalence and correlates of depression among school-going adolescents in Malaysia. Data from the Malaysia Global School-based Health Survey (GSHS) 2012 were analyzed with additional data from the validated DASS21 (Depression, Anxiety, and Stress) questionnaire. The study revealed that 17.7% of respondents had depressive symptoms. Multivariate analysis further showed that feeling lonely (adjusted odds ratio [aOR] = 2.99; 95% CI = 2.57-3.47), Indian ethnicity (aOR = 2.00; 95% CI = 1.63-2.44), using drugs (aOR = 1.85; 95% CI = 1.21-2.82), and being bullied (aOR = 1.79; 95% CI = 1.60-1.99) were significantly associated with depressive symptoms. Lack of parental supervision, alcohol use, and tobacco use were also significant risk factors. Addressing depressive symptoms among adolescents may have implications for managing their risks of being bullied and substance use. This study also highlights the need to further investigate depressive symptoms among adolescents of Indian ethnicity. © 2014 APJPH.

  3. Too old to test? Prevalence and correlates of HIV testing among sexually active older adults.

    PubMed

    Oraka, Emeka; Mason, Stacey; Xia, Mingjing

    2018-01-01

    Older adults account for 17% of new HIV diagnoses in the US and are more likely to be diagnosed with HIV later in the course of the disease compared to younger people. We calculated the prevalence and associated factors of having ever been tested for HIV among sexually active older adults. We analyzed data from the 2008-2016 General Social Survey Limited to respondents ≥65 years of age who reported more than one sex partner(s) in past 12 months (n = 757). HIV testing prevalence, prevalence ratios, and 95% confidence intervals were calculated by demographic variables and HIV-related risk behaviors. An estimated 16.3% of sexually active older adults have tested for HIV, and 15.9% were at increased risk for HIV infection (reported injection drug and/or crack-cocaine use, exchanging money for sex, more than three sex partners in the past year, or men who reported having sex with another man). In the adjusted model, adults aged 65-70, not married, self-identified as gay/bisexual, and at increased risk for HIV infection were more likely to have tested for HIV. An estimated 83.7% of sexually active older adults never tested for HIV. Strategies are needed to increase HIV awareness and testing among potentially high-risk older adults.

  4. Prevalence of and factors associated with sarcopenia in elderly patients with end-stage renal disease.

    PubMed

    Kim, Jwa-Kyung; Choi, Sun Ryoung; Choi, Myung Jin; Kim, Sung Gyun; Lee, Young Ki; Noh, Jung Woo; Kim, Hyung Jik; Song, Young Rim

    2014-02-01

    We investigated the prevalence of sarcopenia in elderly patients with end-stage renal disease (ESRD) and its relationship with various markers of nutrition, cognitive function, depressive symptoms, inflammation and β2-microglobulin. A cross-sectional study was conducted with 95 patients having ESRD aged over 50 years. Sarcopenia was defined as a decline in both muscle mass and strength. The mean age was 63.9 ± 10.0 years; 56.8% were men and 52.6% had diabetes. Sarcopenia was highly prevalent in elderly patients with ESRD (37.0% in men and 29.3% in women). Subjective Global Assessment (SGA), inflammatory markers and β2-microglobulin levels were significantly associated with sarcopenia, even after adjustment for age, gender, diabetes, and body mass index. Additionally, patients with depressive symptoms showed a higher risk of sarcopenia relative to those without depressive symptoms (odds ratio, OR = 6.87, 95% confidence interval, CI = 2.06-22.96) and sarcopenia was more likely to be present in patients with mild cognitive dysfunction (OR = 6.35, 95% CI = 1.62-34.96). Sarcopenia is highly prevalent in elderly patients with ESRD and is closely associated with SGA, inflammatory markers, β2-microglobulin, depression and cognitive dysfunction. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  5. [Influence of the self-reported skin color on the prevalence of metabolic syndrome in an urban Brazilian population].

    PubMed

    Barbosa, Paulo José Bastos; Lessa, Ines; Almeida Filho, Naomar de; Magalhães, Lucélia Batista N Cunha; Araújo, Jenny

    2010-01-01

    The metabolic syndrome (MS) has a high prevalence in different parts of the world, with variations between different ethnic groups. This study aims at exploring the influence of the self-reported skin color on the prevalence of MS Methods: Cross-sectional study, carried out in a population subgroup (n=1,439 adults) in Salvador, Brazil. The self-reported skin color (white, mulatto or black) was used as well as the MS criterion of ATP-III. The Chi-square test for tendency was used to analyze the prevalence gradient between the groups and logistic regression, for association analysis. The general prevalence of MS, adjusted for potentially confounder variables, did not differ among whites (23.3%), mulattos (23.3%) and blacks (23.4%). The analysis by sex showed, among men, a reduction in the MS prevalence of whites (26.2%, 95%CI: 20.7-31.7), in comparison to blacks (17.5%, 95%CI: 12.3-22.8) and an intermediate prevalence among mulattos, 21.9%, 95%CI: 18.6-25.1, p tend. = 0.002. Among the women, the tendency was the opposite, being higher among the blacks, 27.0%, 95%CI: 22.2-31.8, and lower among the whites, 20.5%, 95%CI: 15.6-25.4, p tend. = 0.02. The multivariate analysis of the association between skin color and MS (white = group of reference) showed that the black color of the skin was a protective factor among black men, with a prevalence ratio (PR) = 0.60 (0.36-0.97), whereas it tended to be a risk factor among black women, with a PR = 1.33 (0.94-1.78). The prevalence of MA presented an inverse variation according to the color of skin between men and women. To be black was a protective factor among men and a risk factor among women.

  6. Increased Prevalence of Cerebrovascular Disease in Hospitalized Patients with Marfan Syndrome.

    PubMed

    Kim, Sarasa T; Cloft, Harry; Flemming, Kelly D; Kallmes, David F; Lanzino, Giuseppe; Brinjikji, Waleed

    2018-02-01

    Small studies have suggested that Marfan syndrome is associated with a number of cerebrovascular complications. We sought to determine whether a clinical diagnosis of Marfan syndrome is associated with a higher prevalence of cerebrovascular diseases than the general population by performing a case-control study of hospitalized patients in the Nationwide Inpatient Sample (NIS). Using the 2000-2012 NIS, we performed a case-control study matching cases of Marfan syndrome to controls without such a diagnosis. The prevalence of various cerebrovascular diseases between the 2 groups were compared, and multivariate logistic regression was used to adjust for suspected comorbidities. Between 2000 and 2012, there were a total of 13,883 discharges carrying a diagnosis of Marfan syndrome. On univariate analysis, patients with Marfan syndrome were more likely to have a primary or secondary diagnosis of hemorrhagic stroke (0.5% versus 0.3%, odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.06-2.29, P = 0.02) as well as intracranial hemorrhage (subarachnoid hemorrhage [SAH] and hemorrhagic stroke) (0.3% versus 0.2%, OR = 1.72, 95% CI = 1.05-2.82, P = 0.03). Patients hospitalized with Marfan syndrome were significantly more likely to have carotid dissection (0.3% versus 0.0%, OR = 11.69, 95% CI = 3.60-38.08, P <. 0001) and cerebral aneurysms (0.2% versus 0.1%, OR = 3.67, 95% CI = 1.76-7.68, P = 0.0002). On multivariate analysis adjusted for age, race, and comorbidities, patients with Marfan syndrome had significantly higher odds of ischemic stroke (OR = 1.20, 95% CI = 1.02-1.43, P = 0.03), hemorrhagic stroke (OR = 1.75, 95% CI = 1.18-2.63, P = 0.005), carotid artery dissection (OR = 11.94, 95% CI = 4.23-50.03, P < 0.0001), and cerebral aneurysm (OR = 3.95, 95% CI = 1.95-8.90, P <0.0001). There is a modestly increased prevalence of ischemic stroke, hemorrhagic stroke, and cerebral

  7. Shifting prevalence of gallbladder polyps in Korea.

    PubMed

    Lee, Yoo Jin; Park, Kyung Sik; Cho, Kwang Bum; Kim, Eun Soo; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

    2014-09-01

    Only a few studies have evaluated the population-adjusted prevalence of gallbladder polyps (GBP). This study aimed to evaluate the changes in GBP prevalence and risk factors at a single health screening center in Korea from 2002 to 2012. Of 48,591 adults who underwent health screening between 2002 and 2012, 14,250 age- and gender-matched subjects were randomly selected to evaluate prevalence. Risk factors were analyzed between the GBP-positive and GBP-negative groups during 2002-2004 (Period A) and 2010-2012 (Period B). The annual prevalence of GBP over the 11-yr period was 5.4%. Annual prevalence increased from 3.8% in Period A to 7.1% in Period B. Male gender and obesity were independent risk factors for GBP in both periods. Hepatitis B virus surface antigen (HBsAg) positivity was a risk factor for GBP in Period A but not in Period B. The risk factors for GBP changed from HBsAg positivity to lipid profile abnormalities. Other variables including age, hypertension, diabetes, impaired fasting glucose, chronic hepatitis C virus infection, and liver function tests did not correlate with GBP. In conclusion, GBP prevalence is increasing and risk factors for GBP have changed in Korea. More attention should be paid to this issue in the future.

  8. Shifting Prevalence of Gallbladder Polyps in Korea

    PubMed Central

    2014-01-01

    Only a few studies have evaluated the population-adjusted prevalence of gallbladder polyps (GBP). This study aimed to evaluate the changes in GBP prevalence and risk factors at a single health screening center in Korea from 2002 to 2012. Of 48,591 adults who underwent health screening between 2002 and 2012, 14,250 age- and gender-matched subjects were randomly selected to evaluate prevalence. Risk factors were analyzed between the GBP-positive and GBP-negative groups during 2002-2004 (Period A) and 2010-2012 (Period B). The annual prevalence of GBP over the 11-yr period was 5.4%. Annual prevalence increased from 3.8% in Period A to 7.1% in Period B. Male gender and obesity were independent risk factors for GBP in both periods. Hepatitis B virus surface antigen (HBsAg) positivity was a risk factor for GBP in Period A but not in Period B. The risk factors for GBP changed from HBsAg positivity to lipid profile abnormalities. Other variables including age, hypertension, diabetes, impaired fasting glucose, chronic hepatitis C virus infection, and liver function tests did not correlate with GBP. In conclusion, GBP prevalence is increasing and risk factors for GBP have changed in Korea. More attention should be paid to this issue in the future. PMID:25246743

  9. Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas

    PubMed Central

    2013-01-01

    Background Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian children. Methods A cross-sectional study was conducted among 274 randomly selected children aged 12–59 months in selected low socioeconomic urban areas of East Jakarta. The prevalence of diarrhea was assessed from 7-day records on frequency and consistency of the child’s defecation pattern. Food-hygiene practices including mother’s and child’s hand washing, food preparation, cleanliness of utensils, water source and safe drinking water, habits of buying cooked food, child’s bottle feeding hygiene, and housing and environmental condition were collected through home visit interviews and observations by fieldworkers. Thirty-six practices were scored and classified into poor (median and below) and better (above median) food-hygiene practices. Nutritional status of children, defined anthropometrically, was measured through height and weight. Results Among the individual food-hygiene practices, children living in a house with less dirty sewage had a significantly lower diarrhea prevalence compared to those who did not [adjusted odds ratio (OR) 0.16, 95% confidence interval (CI) = 0.03-0.73]. The overall food-hygiene practice score was not significantly associated with diarrhea in the total group, but it was in children aged < 2 years (adjusted OR 4.55, 95% CI = 1.08-19.1). Conclusions Overall poor mother’s food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. However, among children < 2 years from low socioeconomic urban areas they were associated with more diarrhea. PMID:24138899

  10. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study.

    PubMed

    Tu, Karen; Chen, Zhongliang; Lipscombe, Lorraine L

    2008-05-20

    Researchers have predicted that there will be a relative increase of 24% in the prevalence of hypertension in developed countries from 2000 to 2025. Hypertension is a leading risk factor for death, stroke, cardiovascular disease and renal disease. Thus, accurate estimates of the prevalence of hypertension in a population have important implications for public policy. We sought to assess whether the estimated increase in the prevalence of hypertension has been underestimated. We performed a population-based cohort study using linked administrative data for adults aged 20 years and older in Ontario, Canada's most populous province with more than 12 million residents. Using a validated case-definition algorithm for hypertension, we examined trends in prevalence from 1995 to 2005 and in incidence from 1997 to 2004. The number of adults with hypertension more than doubled from 1995 to 2005. The age- and sex-adjusted prevalence increased from 153.1 per 1000 adults in 1995 to 244.8 per 1000 in 2005, which was a relative increase of 60.0% (p < 0.001). The age- and sex-adjusted incidence of hypertension increased from 25.5 per 1000 adults in 1997 to 32.1 per 1000 in 2004, which was a relative increase of 25.7% (p < 0.001). Our findings indicate that the rise in hypertension prevalence will likely far exceed the predicted prevalence for 2025. Public health strategies to prevent and manage hypertension and its sequelae are urgently needed.

  11. Prevalence and incidence of hypertension from 1995 to 2005: a population-based study

    PubMed Central

    Tu, Karen; Chen, Zhongliang; Lipscombe, Lorraine L.

    2008-01-01

    Background Researchers have predicted that there will be a relative increase of 24% in the prevalence of hypertension in developed countries from 2000 to 2025. Hypertension is a leading risk factor for death, stroke, cardiovascular disease and renal disease. Thus, accurate estimates of the prevalence of hypertension in a population have important implications for public policy. We sought to assess whether the estimated increase in the prevalence of hypertension has been underestimated. Methods We performed a population-based cohort study using linked administrative data for adults aged 20 years and older in Ontario, Canada's most populous province with more than 12 million residents. Using a validated case-definition algorithm for hypertension, we examined trends in prevalence from 1995 to 2005 and in incidence from 1997 to 2004. Results The number of adults with hypertension more than doubled from 1995 to 2005. The age-and sex-adjusted prevalence increased from 153.1 per 1000 adults in 1995 to 244.8 per 1000 in 2005, which was a relative increase of 60.0% (p < 0.001). The age-and sex-adjusted incidence of hypertension increased from 25.5 per 1000 adults in 1997 to 32.1 per 1000 in 2004, which was a relative increase of 25.7% (p < 0.001). Interpretation Our findings indicate that the rise in hypertension prevalence will likely far exceed the predicted prevalence for 2025. Public health strategies to prevent and manage hypertension and its sequelae are urgently needed. PMID:18490638

  12. Neighborhood stressors and race/ethnic differences in hypertension prevalence (the Multi-Ethnic Study of Atherosclerosis).

    PubMed

    Mujahid, Mahasin S; Diez Roux, Ana V; Cooper, Richard C; Shea, Steven; Williams, David R

    2011-02-01

    The reasons for racial/ethnic disparities in hypertension (HTN) prevalence in the United States are poorly understood. Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we investigated whether individual- and neighborhood-level chronic stressors contribute to these disparities in cross-sectional analyses. The sample consisted of 2,679 MESA participants (45-84 years) residing in Baltimore, New York, and North Carolina. HTN was defined as systolic or diastolic blood pressure ≥140 or 90 mm Hg, or taking antihypertensive medications. Individual-level chronic stress was measured by self-reported chronic burden and perceived major and everyday discrimination. A measure of neighborhood (census tract) chronic stressors (i.e., physical disorder, violence) was developed using data from a telephone survey conducted with other residents of MESA neighborhoods. Binomial regression was used to estimate associations between HTN and race/ethnicity before and after adjustment for individual and neighborhood stressors. The prevalence of HTN was 59.5% in African Americans (AAs), 43.9% in Hispanics, and 42.0% in whites. Age- and sex-adjusted relative prevalences of HTN (compared to whites) were 1.30 (95% confidence interval (CI): 1.22-1.38) for AA and 1.16 (95% CI: 1.04-1.31) for Hispanics. Adjustment for neighborhood stressors reduced these to 1.17 (95% CI: 1.11-1.22) and 1.09 (95% CI: 1.00-1.18), respectively. Additional adjustment for individual-level stressors, acculturation, income, education, and other neighborhood features only slightly reduced these associations. Neighborhood chronic stressors may contribute to race/ethnic differences in HTN prevalence in the United States.

  13. Genetic value of herd life adjusted for milk production.

    PubMed

    Allaire, F R; Gibson, J P

    1992-05-01

    Cow herd life adjusted for lactational milk production was investigated as a genetic trait in the breeding objective. Under a simple model, the relative economic weight of milk to adjusted herd life on a per genetic standard deviation basis was equal to CVY/dCVL where CVY and CVL are the genetic coefficients of variation of milk production and adjusted herd life, respectively, and d is the depreciation per year per cow divided by the total fixed costs per year per cow. The relative economic value of milk to adjusted herd life at the prices and parameters for North America was about 3.2. An increase of 100-kg milk was equivalent to 2.2 mo of adjusted herd life. Three to 7% lower economic gain is expected when only improved milk production is sought compared with a breeding objective that included both production and adjusted herd life for relative value changed +/- 20%. A favorable economic gain to cost ratio probably exists for herd life used as a genetic trait to supplement milk in the breeding objective. Cow survival records are inexpensive, and herd life evaluations from such records may not extend the generation interval when such an evaluation is used in bull sire selection.

  14. Negative Control Outcomes and the Analysis of Standardized Mortality Ratios

    PubMed Central

    Richardson, DB; Keil, A; Tchetgen, Tchetgen E; Cooper, GS

    2016-01-01

    In occupational cohort mortality studies, epidemiologists often compare the observed number of deaths in the cohort to the expected number obtained by multiplying person-time accrued in the study cohort by the mortality rate in an external reference population. Interpretation of the result may be difficult due to non-comparability of the occupational cohort and reference population. We describe an approach to estimate an adjusted standardized mortality ratio (aSMR) to control for bias due to unmeasured differences between the occupational cohort and the reference population. The approach draws on methods developed for the use of negative control outcomes. Conditions necessary for unbiased estimation are described, as well as looser conditions necessary for bias reduction. The approach is illustrated using data on bladder cancer mortality among male Oak Ridge National Laboratory workers. The SMR for bladder cancer was elevated among hourly-paid males (SMR=1.90; 1.27, 2.72) but not among monthly-paid males (SMR=0.96; 0.67, 1.33). After indirect adjustment using the proposed approach, the mortality ratios were similar in magnitude among hourly- and monthly-paid men (aSMR=2.22; 1.52, 3.24; and, aSMR=1.99; 1.43, 2.76, respectively). The proposed adjusted SMR offers a complement to typical standardized mortality ratio analyses. PMID:26172862

  15. Incidence and Prevalence of Rheumatoid Arthritis in a Health Management Organization in Argentina: A 15-year Study.

    PubMed

    Di, Wai Tan; Vergara, Facundo; Bertiller, Emmanuel; Gallardo, Maria de Los Angeles; Gandino, Ignacio; Scolnik, Marina; Martinez, Maximiliano J; Schpilberg, Mónica G; Rosa, Javier; Soriano, Enrique R

    2016-07-01

    To estimate incidence and prevalence rates of rheumatoid arthritis (RA) in the city of Buenos Aires (CABA), Argentina, using data from a university hospital-based health management organization. Global, age-specific, and sex-specific incidence and prevalence rates were calculated for members of the Hospital Italiano Medical Care Program (HIMCP), age ≥ 18 years. Incidence study followed members with continuous affiliation ≥ 1 year from January 2000 to January 2015 until he/she voluntarily left the HIMCP, RA was diagnosed, death, or study finalization. Cases from the Rheumatology Section database, electronic medical records, laboratory database, and pharmacy database were filtered with the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Prevalence was calculated on January 1, 2015, and standardized for CABA. Capture-recapture (C-RC) analysis estimated true population sizes. In the study period, incidence rates (cases per 100,000 person-yrs) were 18.5 (95% CI 16.7-20.4) overall, 25.2 (95% CI 22.4-28.0) for women, and 8.8 (95% CI 6.8-10.8) for men. Prevalence rates (percentage of RA cases in the sample population) were 0.329 (95% CI 0.298-0.359) overall, 0.464 (95% CI 0.417-0.510) for women, and 0.123 (95% CI 0.093-0.152) for men. Standardized CABA prevalence rate was 0.300 (95% CI 0.292-0.307). C-RC adjusted rates were almost the same as unadjusted rates. This study's incidence and prevalence rates are in the lower range of the rates found around the world. Our female to male prevalence ratio was 4:1. Our peak incidence age was in the sixth and seventh decades for both sexes.

  16. Psychosocial and demographic determinants of regional differences in the prevalence of obesity.

    PubMed

    Halkjaer, Jytte; Sørensen, Thorkild I A

    2004-03-01

    Differences in the prevalence of obesity between adjacent regions are quite common, but usually unexplained. This study examined whether birth place, selective migration, intelligence or education--which are both inversely and possibly causally related to obesity--are determinants of such differences. This population-based case-control study (case-cohort design) took place in the greater Copenhagen area (region 1) and surrounding provincial areas of Zealand (region 2), Denmark. A total of 2948 men with a median age of 19 years from two draft board regions during 1966-1977 were examined. The odds ratio (OR) for being obese (defined as body mass index > or = 31 kg/m2) was investigated using multiple logistic regression analyses. The OR for being obese in region 2 compared with region 1 was 1.74 (1.50-2.03). Adjustment for birth place, intelligence test score and educational level reduced the OR to 1.42 (1.10-1.82). The OR for being obese for those born in region 2 compared with region 1 was 1.71 (1.46-2.01). Adjustments for intelligence test score, educational level and examination region reduced this OR to 1.13 (0.87-1.46). Irrespective of birth place, men examined in region 2 had a higher OR for being obese than those examined in region 1; this effect was most pronounced for those born in region 2 and examined in either region 1 or 2, with an OR of 1.06 (0.71-1.57) and 1.87 (1.58-2.22) respectively. In conclusion, the regional differences in the prevalence of obesity could not be explained by birth place or later selective migration, but educational level and intelligence test score did explain some of the difference.

  17. Stroke prevalence among the Spanish elderly: an analysis based on screening surveys

    PubMed Central

    Boix, Raquel; del Barrio, José Luis; Saz, Pedro; Reñé, Ramón; Manubens, José María; Lobo, Antonio; Gascón, Jordi; de Arce, Ana; Díaz-Guzmán, Jaime; Bergareche, Alberto; Bermejo-Pareja, Félix; de Pedro-Cuesta, Jesús

    2006-01-01

    Background This study sought to describe stroke prevalence in Spanish elderly populations and compare it against that of other European countries. Methods We identified screening surveys -both published and unpublished- in Spanish populations, which fulfilled specific quality requirements and targeted prevalence of stroke in populations aged 70 years and over. Surveys covering seven geographically different populations with prevalence years in the period 1991–2002 were selected, and the respective authors were then asked to provide descriptions of the methodology and raw age-specific data by completing a questionnaire. In addition, five reported screening surveys in European populations furnished useful data for comparison purposes. Prevalence data were combined, using direct adjustment and logistic regression. Results The overall study population, resident in central and north-eastern Spain, totalled 10,647 persons and yielded 715 cases. Age-adjusted prevalences, using the European standard population, were 7.3% for men, 5.6% for women, and 6.4% for both sexes. Prevalence was significantly lower in women, OR 0.79 95% CI 0.68–0.93, increased with age, particularly among women, and displayed a threefold spatial variation with statistically significant differences. Prevalences were highest, 8.7%, in suburban, and lowest, 3.8%, in rural populations. Compared to pooled Spanish populations, statistically significant differences were seen in eight Italian populations, OR 1.39 95%CI (1.18–1.64), and in Kungsholmen, Sweden, OR 0.40 95%CI (0.27–0.58). Conclusion Prevalence in central and north-eastern Spain is higher in males and in suburban areas, and displays a threefold geographic variation, with women constituting the majority of elderly stroke sufferers. Compared to reported European data, stroke prevalence in Spain can be said to be medium and presents similar age- and sex-specific traits. PMID:17042941

  18. Sex prevalence of major congenital anomalies in the United Kingdom: a national population-based study and international comparison meta-analysis.

    PubMed

    Sokal, Rachel; Tata, Laila J; Fleming, Kate M

    2014-02-01

    The aim of this study was to assess sex differences in major congenital anomaly (CA) diagnoses within a national population sample; to examine the influence of sociodemographic and maternal factors on these risks; and to conduct a meta-analysis using estimates from other population-based studies. We conducted a population-based study in a United Kingdom research database of prospectively collected primary care data (The Health Improvement Network) including children born 1990 to 2009 (n = 794,169) and identified major CA diagnoses using EUROCAT (European Surveillance of Congenital Anomalies) classification. Prevalence ratios (PR) were used to estimate the risk of CA in males compared with females for any CA, system-specific subgroups and specific CA diagnoses. In a subpopulation of children whose medical records were linked to their mothers', we assessed the effect of adjusting for sociodemographic and maternal factors on sex odds ratios. PRs were pooled with measures from previously published studies. The prevalence of any CA was 307/10,000 in males (95% CI, 302-313) and 243/10,000 in females (95% CI, 238-248). Overall the risk of any CA was 26% greater in males (PR (male: female) 1.26, 95% CI, 1.23-1.30) however there was considerable variation across specific diagnoses. The magnitude and direction of risk did not change for any specific CA upon adjustment for sociodemographic and maternal factors. Our PRs were highly consistent with those from previous studies. The overall risk of CA is greater in males than females, although this masked substantial variation by specific diagnoses. Sociodemographic and maternal factors do not appear to affect these risks. Copyright © 2014 The Authors. Birth Defects Research (Part A) published by Wiley Periodicals, Inc.

  19. Occupation-Related Differences in the Prevalence of Metabolic Syndrome

    PubMed Central

    Sánchez-Chaparro, Miguel-Angel; Calvo-Bonacho, Eva; González-Quintela, Arturo; Fernández-Labandera, Carlos; Cabrera, Martha; Sáinz, Juan-Carlos; Fernández-Meseguer, Ana; Banegas, José R.; Ruilope, Luis-Miguel; Valdivielso, Pedro; Román-García, Javier

    2008-01-01

    OBJECTIVE—To investigate the prevalence of metabolic syndrome in the Spanish working population and determine how the prevalence varies according to occupation and sex. RESEARCH DESIGN AND METHODS—This was a cross-sectional study of 259,014 workers (mean age 36.4 years, range [16–74]; 72.9% male) who underwent a routine medical checkup. The Adult Treatment Panel III (2001) definition for metabolic syndrome was used. RESULTS—The prevalence of metabolic syndrome was 11.6% (95% CI 11.5–11.7) in male subjects and 4.1% (4.0–4.2) in female subjects and increased with age. The prevalence of metabolic syndrome varied in the different categories of occupational activity depending on the sex considered. Among female subjects, the age-adjusted prevalence of metabolic syndrome was higher in blue-collar than in white-collar workers, but this difference was not evident among male workers. CONCLUSIONS—The prevalence of metabolic syndrome varies in the different categories of occupational activity in the Spanish working population. This variation also depends on sex. PMID:18753667

  20. Prevalence of tuberculous infection and incidence of tuberculosis; a re-assessment of the Styblo rule

    PubMed Central

    van der Werf, MJ; Borgdorff, MW

    2008-01-01

    Abstract Objective To evaluate the validity of the fixed mathematical relationship between the annual risk of tuberculous infection (ARTI), the prevalence of smear-positive tuberculosis (TB) and the incidence of smear-positive TB specified as the Styblo rule, which TB control programmes use to estimate the incidence of TB disease at a population level and the case detection rate. Methods Population-based tuberculin surveys and surveys on prevalence of smear-positive TB since 1975 were identified through a literature search. For these surveys, the ratio between the number of tuberculous infections (based on ARTI estimates) and the number of smear-positive TB cases was calculated and compared to the ratio of 8 to 12 tuberculous infections per prevalent smear-positive TB case as part of the Styblo rule. Findings Three countries had national population-based data on both ARTI and prevalence of smear-positive TB for more than one point in time. In China the ratio ranged from 3.4 to 5.8, in the Philippines from 2.6 to 4.4, and in the Republic of Korea, from 3.2 to 4.7. All ratios were markedly lower than the ratio that is part of the Styblo rule. Conclusion According to recent country data, there are typically fewer than 8 to 12 tuberculous infections per prevalent smear-positive TB case, and it remains unclear whether this ratio varies significantly among countries. The decrease in the ratio compared to the Styblo rule probably relates to improvements in the prompt treatment of TB disease (by national TB programmes). A change in the number of tuberculous infections per prevalent smear-positive TB case in population-based surveys makes the assumed fixed mathematical relationship between ARTI and incidence of smear-positive TB no longer valid. PMID:18235886