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  1. Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study

    PubMed Central

    Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin

    2017-01-01

    Background To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. Methods A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. Results The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). Conclusions The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion. PMID:28746400

  2. Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study.

    PubMed

    Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin; Fu, Hua

    2017-01-01

    To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion.

  3. Studying Associations in Health Care Research.

    PubMed

    Flannelly, Kevin J; Flannelly, Laura T; Jankowski, Katherine R B

    2016-01-01

    This article discusses some of the types of relationships observed in healthcare research and depicts them in graphic form. The article begins by explaining two basic associations observed in chemistry and physics (Boyles' Law and Charles' Law), and illustrates how these associations are similar to curvilinear and linear associations, respectively, found in healthcare. Graphs of curvilinear associations include morbidity curves and survival and mortality curves. Several examples of linear relationships are given and methods of testing linear relationships with interval and ratio data are introduced (i.e., correlation and ordinary least-squares regression). In addition, 2 × 2 contingency tables for testing the association between categorical (or nominal) data are described. Finally, Sir Austin Bradford Hill's eight criteria for assessing causality from research on associations between variables are presented and explained. Three appendices provide interested readers with opportunities to practice interpreting selected curvilinear and linear relationships.

  4. Gene variants associated with ischemic stroke: the cardiovascular health study.

    PubMed

    Luke, May M; O'Meara, Ellen S; Rowland, Charles M; Shiffman, Dov; Bare, Lance A; Arellano, Andre R; Longstreth, W T; Lumley, Thomas; Rice, Kenneth; Tracy, Russell P; Devlin, James J; Psaty, Bruce M

    2009-02-01

    The purpose of this study was to determine whether 74 single nucleotide polymorphisms (SNPs), which had been associated with coronary heart disease, are associated with incident ischemic stroke. Based on antecedent studies of coronary heart disease, we prespecified the risk allele for each of the 74 SNPs. We used Cox proportional hazards models that adjusted for traditional risk factors to estimate the associations of these SNPs with incident ischemic stroke during 14 years of follow-up in a population-based study of older adults: the Cardiovascular Health Study (CHS). In white CHS participants, the prespecified risk alleles of 7 of the 74 SNPs (in HPS1, ITGAE, ABCG2, MYH15, FSTL4, CALM1, and BAT2) were nominally associated with increased risk of stroke (one-sided P<0.05, false discovery rate=0.42). In black participants, the prespecified risk alleles of 5 SNPs (in KRT4, LY6G5B, EDG1, DMXL2, and ABCG2) were nominally associated with stroke (one-sided P<0.05, false discovery rate=0.55). The Val12Met SNP in ABCG2 was associated with stroke in both white (hazard ratio, 1.46; 90% CI, 1.05 to 2.03) and black (hazard ratio, 3.59; 90% CI, 1.11 to 11.6) participants of CHS. Kaplan-Meier estimates of the 10-year cumulative incidence of stroke were greater among Val allele homozygotes than among Met allele carriers in both white (10% versus 6%) and black (12% versus 3%) participants of CHS. The Val12Met SNP in ABCG2 (encoding a transporter of sterols and xenobiotics) was associated with incident ischemic stroke in white and black participants of CHS.

  5. Factors associated with preferences for health system goals in Japan: a pilot study of the World Health Survey.

    PubMed

    Wada, Koji; Kakuma, Ritsuko; Hoshi, Keika; Sato, Yasuto; Hasegawa, Toshihiko; Satoh, Toshihiko

    2011-09-01

    Preferences among people for health system goals are important determinants in developing health policy. The aim of this study was to determine preferences for health system goals and their associations with sociodemographic characteristics in Japan. Participants were randomly selected from the general population in 5 prefectures and were asked to rank 5 health system goals in order of preference: health, health inequality, responsiveness, responsiveness inequality, and fair financing. Associations between sociodemographic characteristics and preferences for health system goals were examined using multinomial logistic regression analysis. A total of 4936 persons responded to this study. Health system goals in order of preference were health inequality (37.6%), responsiveness inequality (20.9%), health (18.4%), responsiveness (16.0%), and fair financing (7.1%). Sociodemographic characteristics such as gender, age, family status, education completed, and usage of health care services were associated with the preferred health system goal. Health policy makers should take these associations into account when developing prospective policy.

  6. Nutrition and health - the association between eating behavior and various health parameters: a matched sample study.

    PubMed

    Burkert, Nathalie T; Muckenhuber, Johanna; Großschädl, Franziska; Rásky, Eva; Freidl, Wolfgang

    2014-01-01

    Population-based studies have consistently shown that our diet has an influence on health. Therefore, the aim of our study was to analyze differences between different dietary habit groups in terms of health-related variables. The sample used for this cross-sectional study was taken from the Austrian Health Interview Survey AT-HIS 2006/07. In a first step, subjects were matched according to their age, sex, and socioeconomic status (SES). After matching, the total number of subjects included in the analysis was 1320 (N = 330 for each form of diet - vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat). Analyses of variance were conducted controlling for lifestyle factors in the following domains: health (self-assessed health, impairment, number of chronic conditions, vascular risk), health care (medical treatment, vaccinations, preventive check-ups), and quality of life. In addition, differences concerning the presence of 18 chronic conditions were analyzed by means of Chi-square tests. Overall, 76.4% of all subjects were female. 40.0% of the individuals were younger than 30 years, 35.4% between 30 and 49 years, and 24.0% older than 50 years. 30.3% of the subjects had a low SES, 48.8% a middle one, and 20.9% had a high SES. Our results revealed that a vegetarian diet is related to a lower BMI and less frequent alcohol consumption. Moreover, our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life. Therefore, public health programs are needed in order to reduce the health risk due to nutritional factors.

  7. Associations between health literacy and preventive health behaviors among older adults: findings from the health and retirement study.

    PubMed

    Fernandez, Dena M; Larson, Janet L; Zikmund-Fisher, Brian J

    2016-07-19

    While the association between inadequate health literacy and adverse health outcomes has been well documented, less is known about the impact of health literacy on health perceptions, such as perceptions of control over health, and preventive health behaviors. We identified a subsample of participants (N = 707) from the Health and Retirement Study (HRS), a nationally representative sample of older adults, who participated in health literacy testing. Self-reported health literacy was measured with a literacy screening question, and objective health literacy with a summed score of items from the Test of Functional Health Literacy. We compared answers on these items to those related to participation in health behaviors such as cancer screening, exercise, and tobacco use, as well as self-referencing health beliefs. In logistic regression models adjusted for gender, education, race, and age, participants with adequate self-reported health literacy (compared to poorer levels of health literacy) had greater odds of participation in mammography within the last 2 years (Odds ratio [OR] = 2.215, p = 0.01) and participation in moderate exercise two or more times per week (OR = 1.512, p = 0.03). Participants with adequate objective health literacy had reduced odds of participation in monthly breast self-exams (OR = 0.369, p = 0.004) and reduced odds of current tobacco use (OR = 0.456, p = 0.03). In adjusted linear regression analyses, self-reported health literacy made a small but significant contribution to explaining perceived control of health (β 0.151, p = <0.001) and perceived social standing (β 0.112, p = 0.002). In a subsample of older adult participants of the HRS, measures of health literacy were positively related to several health promoting behaviors and health-related beliefs and non-use of breast self-exams, a screening behavior of questionable benefit. These relationships varied however, between self-reported and

  8. Health characteristics associated with gaining and losing private and public health insurance: a national study.

    PubMed

    Jerant, Anthony; Fiscella, Kevin; Franks, Peter

    2012-02-01

    Millions of Americans lack or lose health insurance annually, yet how health characteristics predict insurance acquisition and loss remains unclear. To examine associations of health characteristics with acquisition and loss of private and public health insurance. Prospective observational analysis of 2000 to 2007 Medical Expenditure Panel Survey data for persons aged 18 to 63 on entry, enrolled for 2 years. We modeled year 2 private and public insurance gain and loss. year 2 insurance status [none (reference), any private insurance, or public insurance] among those uninsured in year 1 (N=13,022), and retaining or losing coverage in year 2 among those privately or publicly insured in year 1 (N=47,239). age, sex, race/ethnicity, education, income, region, urbanity, health status, health conditions, year 1 health expenditures, year 1 and 2 employment status, and (in secondary analyses) skepticism toward medical care and insurance. In adjusted analyses, lower income and education were associated with not gaining and with losing private insurance. Poorer health status was associated with public insurance gain. Smoking and being overweight were associated with not gaining private insurance, and smoking with losing private coverage. Secondary analyses adjusting for medical skepticism yielded similar findings. Social disadvantage and poorer health status are associated with gaining public insurance, whereas social advantage, not smoking, and not being overweight are associated with gaining private insurance, even when adjusting for attitudes toward medical care. Private insurers seem to benefit from relatively low health risk selection.

  9. Social capital, health behaviours and health: a population-based associational study

    PubMed Central

    2013-01-01

    Background Social capital is associated with health behaviours and health. Our objective was to explore how different dimensions of social capital and health-related behaviours are associated, and whether health behaviours mediate this association between social capital and self-rated health and psychological well-being. Methods We used data from the Health 2000 Survey (n=8028) of the adult population in Finland. The response rate varied between 87% (interview) and 77% (the last self-administered questionnaire). Due to item non-response, missing values were replaced using multiple imputation. The associations between three dimensions of social capital (social support, social participation and networks, trust and reciprocity) and five health behaviours (smoking, alcohol use, physical activity, vegetable consumption, sleep) were examined by using logistic regression and controlling for age, gender, education, income and living arrangements. The possible mediating role of health behaviours in the association between social capital and self-rated health and psychological well-being was also analysed with a logistic regression model. Results Social participation and networks were associated with all of the health behaviours. High levels of trust and reciprocity were associated with non-smoking and adequate duration of sleep, and high levels of social support with adequate duration of sleep and daily consumption of vegetables. Social support and trust and reciprocity were independently associated with self-rated health and psychological well-being. Part of the association between social participation and networks and health was explained by physical activity. Conclusions Irrespective of their social status, people with higher levels of social capital – especially in terms of social participation and networks – engage in healthier behaviours and feel healthier both physically and psychologically. PMID:23805881

  10. National Rural Health Association

    MedlinePlus

    ... Policy Responses Sequestration Impact Programs State Rural Health Associations Rural Medical Education Rural Health Fellows Rural Health ... Membership Categories Membership Application PROGRAMS State Rural Health Associations Rural Medical Education Rural Health Fellows Rural Health ...

  11. The association between team climate at work and mental health in the Finnish Health 2000 Study.

    PubMed

    Sinokki, M; Hinkka, K; Ahola, K; Koskinen, S; Klaukka, T; Kivimäki, M; Puukka, P; Lönnqvist, J; Virtanen, M

    2009-08-01

    Depression, anxiety and alcohol use disorders are common mental health problems in the working population. However, the team climate at work related to these disorders has not been studied using standardised interview methods and it is not known whether poor team climate predicts antidepressant use. This study investigated whether team climate at work was associated with DSM-IV depressive, anxiety and alcohol use disorders and subsequent antidepressant medication in a random sample of Finnish employees. The nationally representative sample comprised 3347 employees aged 30-64 years. Team climate was measured with a self-assessment scale. Diagnoses of depressive, anxiety and alcohol use disorders were based on the Composite International Diagnostic Interview. Data on the purchase of antidepressant medication in a 3-year follow-up period were collected from a nationwide pharmaceutical register of the Social Insurance Institution. In the risk factor adjusted models, poor team climate at work was significantly associated with depressive disorders (OR 1.61, 95% CI 1.10 to 2.36) but not with alcohol use disorders. The significance of the association between team climate and anxiety disorders disappeared when the model was adjusted for job control and job demands. Poor team climate also predicted antidepressant medication (OR 1.53, 95% CI 1.02 to 2.30). A poor team climate at work is associated with depressive disorders and subsequent antidepressant use.

  12. The Association between Membership in the Sandwich Generation and Health Behaviors: A Longitudinal Study

    ERIC Educational Resources Information Center

    Chassin, Laurie; Macy, Jon T.; Seo, Dong-Chul; Presson, Clark C.; Sherman, Steven J.

    2010-01-01

    The current study examined the association between membership in the sandwich generation, defined as providing care to both children and parents or in-laws, and five health behaviors: checking the food label for health value when buying foods, using a seat belt, choosing foods based on health value, exercising regularly, and cigarette smoking.…

  13. The Association between Membership in the Sandwich Generation and Health Behaviors: A Longitudinal Study

    ERIC Educational Resources Information Center

    Chassin, Laurie; Macy, Jon T.; Seo, Dong-Chul; Presson, Clark C.; Sherman, Steven J.

    2010-01-01

    The current study examined the association between membership in the sandwich generation, defined as providing care to both children and parents or in-laws, and five health behaviors: checking the food label for health value when buying foods, using a seat belt, choosing foods based on health value, exercising regularly, and cigarette smoking.…

  14. Chronic Periodontitis Genome-wide Association Study in the Hispanic Community Health Study / Study of Latinos.

    PubMed

    Sanders, A E; Sofer, T; Wong, Q; Kerr, K F; Agler, C; Shaffer, J R; Beck, J D; Offenbacher, S; Salazar, C R; North, K E; Marazita, M L; Laurie, C C; Singer, R H; Cai, J; Finlayson, T L; Divaris, K

    2017-01-01

    Chronic periodontitis (CP) has a genetic component, particularly its severe forms. Evidence from genome-wide association studies (GWASs) has highlighted several potential novel loci. Here, the authors report the first GWAS of CP among a large community-based sample of Hispanics/Latinos. The authors interrogated a quantitative trait of CP (mean interproximal clinical attachment level determined by full-mouth periodontal examinations) among 10,935 adult participants (mean age: 45 y, range: 18 to 76 y) from the Hispanic Community Health Study / Study of Latinos. Genotyping was done with a custom Illumina Omni2.5M array, and imputation to approximately 20 million single-nucleotide polymorphisms was based on the 1000 Genomes Project phase 1 reference panel. Analyses were based on linear mixed models adjusting for sex, age, study design features, ancestry, and kinship and employed a conventional P < 5 × 10(-8) statistical significance threshold. The authors identified a genome-wide significant association signal in the 1q42.2 locus ( TSNAX-DISC1 noncoding RNA, lead single-nucleotide polymorphism: rs149133391, minor allele [C] frequency = 0.01, P = 7.9 × 10(-9)) and 4 more loci with suggestive evidence of association ( P < 5 × 10(-6)): 1q22 (rs13373934), 5p15.33 (rs186066047), 6p22.3 (rs10456847), and 11p15.1 (rs75715012). We tested these loci for replication in independent samples of European-American ( n = 4,402) and African-American ( n = 908) participants of the Atherosclerosis Risk in Communities study. There was no replication among the European Americans; however, the TSNAX-DISC1 locus replicated in the African-American sample (rs149133391, minor allele frequency = 0.02, P = 9.1 × 10(-3)), while the 1q22 locus was directionally concordant and nominally significant (rs13373934, P = 4.0 × 10(-2)). This discovery GWAS of interproximal clinical attachment level-a measure of lifetime periodontal tissue destruction-was conducted in a large, community-based sample of

  15. Private prayer associations with depression, anxiety and other health conditions: an analytical review of clinical studies.

    PubMed

    Anderson, James W; Nunnelley, Paige A

    2016-09-01

    To critically analyze appropriate clinical studies to assess the relationship between health conditions and the frequency of private prayer. Private prayer is defined as individuals praying for themselves. Using PubMed and other search engines, we identified over 300 articles reporting relationships between prayer and health conditions. We identified 41 observational clinical studies that evaluated the relationship between private prayer and health conditions. Prayer scores of 5 to 1 were assigned to studies, with 5 being private prayer for health and 1 being prayer in combination with meditation or Bible study. Frequency scores ranged from 3 to 1 with 3 being twice daily or more and 0 when frequency was not assessed. Studies were ranked from 8 to 1 based on the sum of Prayer and Frequency Scores. Twenty-one studies had Prayer-Frequency scores of 5 to 8, indicating that they evaluated private prayer (praying for one's own health) of suitable frequency in association with health conditions. Nine of 11 studies indicated that private prayer was associated with a significantly lower prevalence of depression (P value, <0.01). Optimism as well as coping were significantly improved by prayer in four studies (P value, P < 0.01). In 10 studies of mental health conditions-including anxiety and confusion-there was a significant benefit associated with prayer (P < 0.01), In the reviewed studies, prayer did not have a significant effect on physical health or blood pressure. The reported observational studies suggest that frequent private prayer is associated with a significant benefit for depression, optimism, coping, and other mental health conditions such as anxiety. Controlled clinical trials are required to critically assess the associations of private prayer and health conditions.

  16. The association of patients' oral health literacy and dental school communication tools: a pilot study.

    PubMed

    Tam, Amy; Yue, Olivia; Atchison, Kathryn A; Richards, Jessica K; Holtzman, Jennifer S

    2015-05-01

    The aim of this pilot study was to assess adult patients' ability to read and understand two communication tools at the University of California, Los Angeles, School of Dentistry: the dental school clinic website and a patient education brochure pertaining to sedation in children that was written by dental school personnel. A convenience sample of 100 adults seeking treatment at the school's general dental clinic during 2012-13 completed a health literacy screening instrument. They were then asked to read clinic educational and informational materials and complete a survey. Analyses were conducted to determine the association between the subjects' oral health literacy and sociodemographics and their ability to locate and interpret information in written oral health information materials. SMOG and Flesch-Kincade formulas were used to assess the readability level of the electronic and written communication tools. The results demonstrated an association between these adults' oral health literacy and their dental knowledge and ability to navigate health information website resources and understand health education materials. Health literacy was not associated with age or gender, but was associated with education and race/ethnicity. The SMOG Readability Index determined that the website and the sedation form were written at a ninth grade reading level. These results suggest that dental schools and other health care organizations should incorporate a health-literate approach for their digital and written materials to enhance patients' ability to navigate and understand health information, regardless of their health literacy.

  17. The Association of Patients’ Oral Health Literacy and Dental School Communication Tools: A Pilot Study

    PubMed Central

    Tam, Amy; Yue, Olivia; Atchison, Kathryn A.; Richards, Jessica K.; Holtzman, Jennifer S.

    2016-01-01

    The aim of this pilot study was to assess adult patients’ ability to read and understand two communication tools at the University of California, Los Angeles, School of Dentistry: the dental school clinic website and a patient education brochure pertaining to sedation in children that was written by dental school personnel. A convenience sample of 100 adults seeking treatment at the school’s general dental clinic during 2012–13 completed a health literacy screening instrument. They were then asked to read clinic educational and informational materials and complete a survey. Analyses were conducted to determine the association between the subjects’ oral health literacy and sociodemographics and their ability to locate and interpret information in written oral health information materials. SMOG and Flesch-Kincade formulas were used to assess the readability level of the electronic and written communication tools. The results demonstrated an association between these adults’ oral health literacy and their dental knowledge and ability to navigate health information website resources and understand health education materials. Health literacy was not associated with age or gender, but was associated with education and race/ethnicity. The SMOG Readability Index determined that the website and the sedation form were written at a ninth grade reading level. These results suggest that dental schools and other health care organizations should incorporate a health-literate approach for their digital and written materials to enhance patients’ ability to navigate and understand health information, regardless of their health literacy. PMID:25941146

  18. Factors accounting for the association between anxiety and depression, and eczema: the Hordaland health study (HUSK)

    PubMed Central

    2010-01-01

    Background The association between anxiety and depression, and eczema is well known in the literature, but factors underlying this association remain unclear. Low levels of omega-3 fatty acids and female gender have been found to be associated with both depression and eczema. Somatization and health anxiety are known to be associated with anxiety and depression, further, somatization symptoms and health anxiety have also been found in several dermatological conditions. Accordingly, omega-3 fatty acid supplement, female gender, somatization and health anxiety are possible contributing factors in the association between anxiety and depression, and eczema. The aim of the study is to examine the relevance of proposed contributing factors for the association between anxiety and depression, and eczema, including, omega-3 fatty acid supplement, female gender, health anxiety and somatization. Methods Anxiety and depression was measured in the general population (n = 15715) employing the Hospital Anxiety and Depression Scale (HADS). Information on eczema, female gender, omega-3 fatty acid supplement, health anxiety and somatization was obtained by self-report. Results Somatization and health anxiety accounted for more than half of the association between anxiety/depression, and eczema, while the other factors examined were of minor relevance for the association of interest. Conclusions We found no support for female gender and omega-3 fatty acid supplement as contributing factors in the association between anxiety/depression, and eczema. Somatization and health anxiety accounted for about half of the association between anxiety/depression, and eczema, somatization contributed most. The association between anxiety/depression, and eczema was insignificant after adjustment for somatization and health anxiety. Biological mechanisms underlying the mediating effect of somatization are yet to be revealed. PMID:20412596

  19. Association of sedentary behavior time with ideal cardiovascular health: the ORISCAV-LUX study.

    PubMed

    Crichton, Georgina E; Alkerwi, Ala'a

    2014-01-01

    Recently attention has been drawn to the health impacts of time spent engaging in sedentary behaviors. No studies have examined sedentary behaviors in relation to the newly defined construct of ideal cardiovascular health, which incorporates three health factors (blood pressure, total cholesterol, fasting plasma glucose) and four behaviors (physical activity, smoking, body mass index, diet). The purpose of this study was to examine associations between sedentary behaviors, including sitting time, and time spent viewing television and in front of a computer, with cardiovascular health, in a representative sample of adults from Luxembourg. A cross-sectional analysis of 1262 participants in the Observation of Cardiovascular Risk Factors in Luxembourg study was conducted, who underwent objective cardiovascular health assessments and completed the International Physical Activity Questionnaire. A Cardiovascular Health Score was calculated based on the number of health factors and behaviors at ideal levels. Sitting time on a weekday, television time, and computer time (both on a workday and a day off), were related to the Cardiovascular Health Score. Higher weekday sitting time was significantly associated with a poorer Cardiovascular Health Score (p = 0.002 for linear trend), after full adjustment for age, gender, education, income and occupation. Television time was inversely associated with the Cardiovascular Health Score, on both a workday and a day off (p = 0.002 for both). A similar inverse relationship was observed between the Cardiovascular Health Score and computer time, only on a day off (p = 0.04). Higher time spent sitting, viewing television, and using a computer during a day off may be unfavorably associated with ideal cardiovascular health.

  20. A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study.

    PubMed

    Zhao, Di; Kim, Myung Hun; Pastor-Barriuso, Roberto; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Rampal, Sanjay; Shin, Hocheol; Kim, Joon Mo; Friedman, David S; Guallar, Eliseo; Cho, Juhee

    2016-01-01

    Intraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma. To examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults. Cohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits). BMI, waist circumference, and percent fat mass. At each visit, IOP was measured in both eyes with automated noncontact tonometers. In multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P < 0.001). The association was stronger in men compared to women (P < 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model. Increases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications.

  1. A Longitudinal Study of Association between Adiposity Markers and Intraocular Pressure: The Kangbuk Samsung Health Study

    PubMed Central

    Zhao, Di; Kim, Myung Hun; Pastor-Barriuso, Roberto; Chang, Yoosoo; Ryu, Seungho; Zhang, Yiyi; Rampal, Sanjay; Shin, Hocheol; Kim, Joon Mo; Friedman, David S.; Guallar, Eliseo; Cho, Juhee

    2016-01-01

    Importance Intraocular pressure (IOP) reduction or stabilization is the only proven method for glaucoma management. Identifying risk factors for IOP is crucial to understand the pathophysiology of glaucoma. Objective To examine the associations of change in body mass index (BMI), waist circumference, and percent fat mass with change in intraocular pressure (IOP) in a large sample of Korean adults. Design, setting and participants Cohort study of 274,064 young and middle age Korean adults with normal fundoscopic findings who attended annual or biennial health exams from January 1, 2002 to Feb 28, 2010 (577,981 screening visits). Exposures BMI, waist circumference, and percent fat mass. Main Outcome Measure(s) At each visit, IOP was measured in both eyes with automated noncontact tonometers. Results In multivariable-adjusted models, the average increase in IOP (95% confidence intervals) over time per interquartile increase in BMI (1.26 kg/m2), waist circumference (6.20 cm), and percent fat mass (3.40%) were 0.18 mmHg (0.17 to 0.19), 0.27 mmHg (0.26 to 0.29), and 0.10 mmHg (0.09 to 0.11), respectively (all P < 0.001). The association was stronger in men compared to women (P < 0.001) and it was only slightly attenuated after including diabetes and hypertension as potential mediators in the model. Conclusions and Relevance Increases in adiposity were significantly associated with an increase in IOP in a large cohort of Korean adults attending health screening visits, an association that was stronger for central obesity. Further research is needed to understand better the underlying mechanisms of this association, and to establish the role of weight gain in increasing IOP and the risk of glaucoma and its complications. PMID:26731527

  2. Genetic Loci Associated with Ideal Cardiovascular Health: A Meta-Analysis of Genome-wide Association Studies

    PubMed Central

    Allen, Norrina B.; Lloyd-Jones, Donald; Hwang, Shih-Jen; Rasmussen-Torvik, Laura; Fornage, Myriam; Morrison, Alanna C.; Baldridge, Abigail S.; Boerwinkle, Eric; Levy, Daniel; Cupples, L. Adrienne; Fox, Caroline S.; Thanassoulis, George; Dufresne, Line; Daviglus, Martha; Johnson, Andrew D.; Reis, Jared; Rotter, Jerome; Palmas, Walter; Allison, Mathew; Pankow, James S.; O’Donnell, Christopher J.

    2016-01-01

    Background Multiple genetic loci are associated with clinical cardiovascular (CV) disease and individual CV risk factors. Individuals with ideal levels of all major CV risk factors have very low risk for CVD morbidity or mortality. Ideal levels of risk factors can be attained by lifestyle modifications; however, little is known about gene variants associated with ideal CV health. Our objective was to carry out a genome-wide association study (GWAS) on the trait. Methods and Results We examined two dichotomous phenotypes of ideal CV health - Clinical (untreated cholesterol < 200 mg/dl; untreated blood pressure (BP) <120/<80; not diabetic) and Clinical+Behavioral (Clinical plus: not a current smoker; BMI <25 kg/m2) -among white participants aged 50 ± 5 years. We performed a meta-analysis of four GWAS (total n=11,708) from the MESA, CARDIA, ARIC and Framingham Heart Study cohorts. We identified a SNP (rs445925) in the APOC1/APOE region that was associated with Clinical ideal CV health at genome-wide level of significance (p<2.0×10−9). The significance of this region was validated using exome chip genotyping. The association with ideal CV health was attenuated after adjusting for LDL cholesterol. Conclusion A common SNP in the APOC1/APOE region, previously found to be associated with protective levels of cholesterol and lower cardiovascular risk, may be associated with ideal health. In future replication studies, larger sample sizes may be needed to detect loci with more modest effects on ideal CV health. In addition to the important impact of lifestyle modifications, we have identified evidence for gene variation that plays a role in ideal CV health. PMID:27179730

  3. Genetic Association Analysis under Complex Survey Sampling: The Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Lin, Dan-Yu; Tao, Ran; Kalsbeek, William D.; Zeng, Donglin; Gonzalez, Franklyn; Fernández-Rhodes, Lindsay; Graff, Mariaelisa; Koch, Gary G.; North, Kari E.; Heiss, Gerardo

    2014-01-01

    The cohort design allows investigators to explore the genetic basis of a variety of diseases and traits in a single study while avoiding major weaknesses of the case-control design. Most cohort studies employ multistage cluster sampling with unequal probabilities to conveniently select participants with desired characteristics, and participants from different clusters might be genetically related. Analysis that ignores the complex sampling design can yield biased estimation of the genetic association and inflation of the type I error. Herein, we develop weighted estimators that reflect unequal selection probabilities and differential nonresponse rates, and we derive variance estimators that properly account for the sampling design and the potential relatedness of participants in different sampling units. We compare, both analytically and numerically, the performance of the proposed weighted estimators with unweighted estimators that disregard the sampling design. We demonstrate the usefulness of the proposed methods through analysis of MetaboChip data in the Hispanic Community Health Study/Study of Latinos, which is the largest health study of the Hispanic/Latino population in the United States aimed at identifying risk factors for various diseases and determining the role of genes and environment in the occurrence of diseases. We provide guidelines on the use of weighted and unweighted estimators, as well as the relevant software. PMID:25480034

  4. Genetic association analysis under complex survey sampling: the Hispanic Community Health Study/Study of Latinos.

    PubMed

    Lin, Dan-Yu; Tao, Ran; Kalsbeek, William D; Zeng, Donglin; Gonzalez, Franklyn; Fernández-Rhodes, Lindsay; Graff, Mariaelisa; Koch, Gary G; North, Kari E; Heiss, Gerardo

    2014-12-04

    The cohort design allows investigators to explore the genetic basis of a variety of diseases and traits in a single study while avoiding major weaknesses of the case-control design. Most cohort studies employ multistage cluster sampling with unequal probabilities to conveniently select participants with desired characteristics, and participants from different clusters might be genetically related. Analysis that ignores the complex sampling design can yield biased estimation of the genetic association and inflation of the type I error. Herein, we develop weighted estimators that reflect unequal selection probabilities and differential nonresponse rates, and we derive variance estimators that properly account for the sampling design and the potential relatedness of participants in different sampling units. We compare, both analytically and numerically, the performance of the proposed weighted estimators with unweighted estimators that disregard the sampling design. We demonstrate the usefulness of the proposed methods through analysis of MetaboChip data in the Hispanic Community Health Study/Study of Latinos, which is the largest health study of the Hispanic/Latino population in the United States aimed at identifying risk factors for various diseases and determining the role of genes and environment in the occurrence of diseases. We provide guidelines on the use of weighted and unweighted estimators, as well as the relevant software. Copyright © 2014 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  5. Sleep Apnea Is Associated with Hearing Impairment: The Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Chopra, Amit; Jung, Molly; Kaplan, Robert C.; Appel, David W.; Dinces, Elizabeth A.; Dhar, Sumitrajit; Zee, Phyllis C.; Gonzalez, Franklyn; Lee, David J.; Ramos, Alberto R.; Hoffman, Howard J.; Redline, Susan; Cruickshanks, Karen J.; Shah, Neomi A.

    2016-01-01

    Study Objective: Sleep apnea (SA) may promote hearing impairment (HI) through ischemia and inflammation of the cochlea. Our objective was to assess an independent association between SA and HI in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants. Methods: We used data from the HCHS/SOL, a multicenter population-based study of self- identifying Hispanic/Latinos 18- to 74-y-old adults from four US urban communities. We performed home SA testing and in-clinic audiometry testing in all participants. SA was defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. HI was defined as a mean hearing threshold > 25 dB hearing level in either ear at the frequencies: 3,000 to 8,000 Hz for high-frequency HI (HF-HI) and 500 to 2,000 Hz for low-frequency HI (LF-HI). Combined-frequency HI (CF-HI) was defined as both conditions present, and Any-HI was considered as HI in either low or high frequencies. Results: Of 13,967 participants, 9.9% had SA and 32.3% had Any-HI. Adjusted for risk factors for HI, those with SA had a 30% higher odds of Any-HI (95% confidence interval [CI] = 8% to 57%), 26% higher odds of HF-HI (CI = 3% to 55%), 127% higher odds of LF-HI (CI = 21% to 326%), and 29% higher odds of CF-HI (CI = 0% to 65%). A dose-response association was observed between AHI severity and Any-HI (versus no SA, OR for AHI ≥ 15 and < 30 = 1.22, CI = 0.96 to 1.54, and OR for AHI ≥ 30 = 1.46, CI = 1.11 to 1.91, p = 0.002). Conclusion: SA is associated with HF-HI and LF-HI, independent of snoring and other confounders. Commentary: A commentary on this article appears in this issue on page 641. Citation: Chopra A, Jung M, Kaplan RC, Appel DW, Dinces EA, Dhar S, Zee PC, Gonzalez F, Lee DJ, Ramos AR, Hoffman HJ, Redline S, Cruickshanks KJ, Shah NA. Sleep apnea is associated with hearing impairment: the hispanic community health study/study of latinos. J Clin Sleep Med 2016;12(5):719–726. PMID:26951413

  6. The association between adolescents' health and disparities in school career: a longitudinal cohort study.

    PubMed

    Uiters, Ellen; Maurits, Erica; Droomers, Mariël; Zwaanswijk, Marieke; Verheij, Robert A; van der Lucht, Fons

    2014-10-25

    Literature suggests that children's educational achievement is associated with their health status and the socioeconomic position of their parents. Few studies have investigated this association in adolescence, while this is an important period affecting future life trajectories. Our study investigates the relationship between adolescents' health and their subsequent school career, taking into account their parents' socioeconomic position. Data of all Dutch adolescents who entered secondary education in 2003, according to the national education register, were linked to electronic health records from general practices and to data from the Dutch population register on a patient by patient basis. Secondary school career data of 2455 adolescents were available for several years, resulting in a longitudinal prospective cohort. School career was measured by the completion of secondary education within the research period. For most health problems, adolescents' health status at the moment of entering secondary education showed no association with the subsequent course of their school career. However, adolescents who had more frequent contact with their general practitioner for acute psychosocial problems (e.g. enuresis or overactive/hyperkinetic disorder), were less likely to complete their secondary education, also after adjustment for parental socioeconomic position. They were also less likely to complete their secondary education at the level of entry. Adolescents' secondary school career is negatively affected by the presence of acute psychosocial health problems, but not by the presence of physical health problems. This underlines the importance of adequately addressing mental health problems in adolescence.

  7. Associations between Dopamine and Serotonin Genes and Job Satisfaction: Preliminary Evidence from the Add Health Study

    ERIC Educational Resources Information Center

    Song, Zhaoli; Li, Wendong; Arvey, Richard D.

    2011-01-01

    Previous behavioral genetic studies have found that job satisfaction is partially heritable. We went a step further to examine particular genetic markers that may be associated with job satisfaction. Using an oversample from the National Adolescent Longitudinal Study (Add Health Study), we found 2 genetic markers, dopamine receptor gene DRD4 VNTR…

  8. Associations between Dopamine and Serotonin Genes and Job Satisfaction: Preliminary Evidence from the Add Health Study

    ERIC Educational Resources Information Center

    Song, Zhaoli; Li, Wendong; Arvey, Richard D.

    2011-01-01

    Previous behavioral genetic studies have found that job satisfaction is partially heritable. We went a step further to examine particular genetic markers that may be associated with job satisfaction. Using an oversample from the National Adolescent Longitudinal Study (Add Health Study), we found 2 genetic markers, dopamine receptor gene DRD4 VNTR…

  9. The association between earlier marijuana use and subsequent academic achievement and health problems: a longitudinal study.

    PubMed

    Brook, Judith S; Stimmel, Matthew A; Zhang, Chenshu; Brook, David W

    2008-01-01

    In this prospective longitudinal study, the authors investigated the association between marijuana use over a period of 13 years and subsequent health problems at age 27. A community sample of 749 participants from upstate New York was interviewed at mean ages of 14, 16, 22, and 27 years. Marijuana use over time was significantly associated with increased health problems by the late twenties, including respiratory problems, general malaise, neurocognitive problems, and lower academic achievement and functioning. Effective prevention and intervention programs should consider the wide range of adverse physiological and psychosocial outcomes associated with marijuana use over time.

  10. Positive Associations of Dispositional Mindfulness with Cardiovascular Health: the New England Family Study

    PubMed Central

    Loucks, Eric B.; Britton, Willoughby B.; Howe, Chanelle J.; Eaton, Charles B.; Buka, Stephen L.

    2015-01-01

    Background Mindfulness (the ability to attend nonjudgmentally to one’s own physical and mental processes) is receiving substantial interest as a potential determinant of health. However, little is known whether mindfulness is associated with cardiovascular health. Purpose The aim of this study is to evaluate whether dispositional mindfulness is associated with cardiovascular health. Method Study participants (n=382) were from the New England Family Study, born in Providence, RI, USA, with mean age 47 years. Dispositional mindfulness was assessed using the Mindful Attention Awareness Scale (MAAS). Cardiovascular health was assessed based on American Heart Association criteria. Cross-sectional multivariable-adjusted log binomial regression analyses were performed. Results Analyses demonstrated that those with high vs. low MAAS had prevalence ratio (PR) for good cardiovascular health of 1.83 (95 % confidence interval (CI) 1.07, 3.13), adjusted for age, gender, and race/ethnicity. There were significant associations of high vs. low mindfulness with non-smoking (PR=1.37, 95 % CI 1.06, 1.76), body mass index <25 kg/m2 (PR=2.17, 95 % CI 1.16, 4.07), fasting glucose <100 mg/dL (PR = 1.47, 95 % CI 1.06, 2.04), and high physical activity (PR = 1.56, 95 % CI 1.04, 2.35), but not blood pressure, total cholesterol, or fruit/vegetable consumption. Exploratory mediation analyses suggested that sense of control and depressive symptomatology may be mediators. Conclusion This study demonstrated preliminary cross-sectional evidence that dispositional mindfulness is positively associated with cardiovascular health, with the associations particularly driven by smoking, body mass index, fasting glucose, and physical activity. If in future research mindfulness-based practices are found to consistently improve cardio-vascular disease risk factors, such interventions may have potential to strengthen effects of cardiovascular health promotion programs. PMID:25339282

  11. Association between health literacy and hypertension management in a Chinese community: a retrospective cohort study.

    PubMed

    Shi, Di; Li, Jiangbo; Wang, Yong; Wang, Si; Liu, Kai; Shi, Rufeng; Zhang, Qiang; Chen, Xiaoping

    2017-03-16

    Low health literacy is associated with poor clinical outcomes. The relationship between literacy and blood pressure (BP) has been inconsistent. We investigated the determinants of health literacy and the potential relationship between health literacy and hypertension management. We conducted a retrospective cohort trial of 360 hypertensive patients. Scale measurements, physical examination, and laboratory tests were performed based on a standard protocol. To determine factors associated with health literacy, multiple logistic regression analysis was performed and the discriminatory power of the scale score for hypertension control was assessed by the area under the receiver operating curve. After adjusting for potential confounders, our findings show that the level of education, home blood pressure measurement, regular medication, and systolic blood pressure are significantly associated with health literacy. Moreover, patients with high health literacy have better hypertension control, a lower risk of ischemic cardiovascular disease (ICVD), lower brachial ankle pulse wave velocity values, and better health-related quality of life. In addition, our study also demonstrates that we can identify the health literacy level of hypertensive patients using the Chinese Health Literacy Scale for Hypertension. At a cut-off value of 13.5, we predict that patients will achieve long-term hypertension control. Adequate health literacy is a contributing factor to better blood pressure (BP) control and better perceived quality of life in hypertensive patients. Low health literacy increases the 10-year risk of ICVD and incidence of artery stiffness in hypertensive patients. Improving health literacy should be considered an important part of the management of hypertension.

  12. Association between maternal health literacy and child vaccination in India: a cross-sectional study

    PubMed Central

    Johri, Mira; Subramanian, S V; Sylvestre, Marie-Pierre; Dudeja, Sakshi; Chandra, Dinesh; Koné, Georges K; Sharma, Jitendar K; Pahwa, Smriti

    2015-01-01

    Background Education of mothers may improve child health. We investigated whether maternal health literacy, a rapidly modifiable factor related to mother's education, was associated with children's receipt of vaccines in two underserved Indian communities. Methods Cross-sectional surveys in an urban and a rural site. We assessed health literacy using Indian child health promotion materials. The outcome was receipt of three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. We used multivariate logistic regression to investigate the relationship between maternal health literacy and vaccination status independently in each site. For both sites, adjusted models considered maternal age, maternal and paternal education, child sex, birth order, household religion and wealth quintile. Rural analyses used multilevel models adjusted for service delivery characteristics. Urban analyses represented cluster characteristics through fixed effects. Results The rural analysis included 1170 women from 60 villages. The urban analysis included 670 women from nine slum clusters. In each site, crude and adjusted models revealed a positive association between maternal health literacy and DTP3. In the rural site, the adjusted OR was 1.57 (95% CI 1.11 to 2.21, p=0.010) for those with medium health literacy, and OR=1.30 (95% CI 0.89 to 1.91, p=0.172) for those with high health literacy. In the urban site, the adjusted OR was 1.10 (95% CI 0.65 to 1.88, p=0.705) for those with medium health literacy, and OR=2.06 (95% CI 1.06 to 3.99, p=0.032) for those with high health literacy. Conclusions In these study settings, maternal health literacy is independently associated with child vaccination. Initiatives targeting health literacy could improve vaccination coverage. PMID:25827469

  13. Association between parity and dentition status among Japanese women: Japan public health center-based oral health study.

    PubMed

    Ueno, Masayuki; Ohara, Satoko; Inoue, Manami; Tsugane, Shoichiro; Kawaguchi, Yoko

    2013-10-22

    Several studies have shown that parity is associated with oral health problems such as tooth loss and dental caries. In Japan, however, no studies have examined the association. The purpose of this study was to determine whether parity is related to dentition status, including the number of teeth present, dental caries and filled teeth, and the posterior occlusion, in a Japanese population by comparing women with men. A total of 1,211 subjects, who participated both in the Japan Public Health Center-Based (JPHC) Study Cohort I in 1990 and the dental survey in 2005, were used for the study. Information on parity or number of children was collected from a self-completed questionnaire administered in 1990 for the JPHC Study Cohort I, and health behaviors and clinical dentition status were obtained from the dental survey in 2005. The association between parity or number of children and dentition status was analyzed, by both unadjusted-for and adjusted-for socio-demographic and health behavioral factors, using a generalized linear regression model. Parity is significantly related to the number of teeth present and n-FTUs (Functional Tooth Units of natural teeth), regardless of socio-demographic and health behavioral factors, in female subjects. The values of these variables had a significantly decreasing trend with the rise of parity: numbers of teeth present (p for trend = 0.046) and n-FTUs (p for trend = 0.026). No relationships between the number of children and dentition status were found in male subjects. Higher-parity women are more likely to lose teeth, especially posterior occluding relations. These results suggest that measures to narrow the discrepancy by parity should be taken for promoting women's oral health. Delivery of appropriate information and messages to pregnant women as well as enlightenment of oral health professionals about dental management of pregnant women may be an effective strategy.

  14. The association between green space and mental health varies across the lifecourse. A longitudinal study.

    PubMed

    Astell-Burt, Thomas; Mitchell, Richard; Hartig, Terry

    2014-06-01

    Epidemiological studies on green space and health have relied almost exclusively on cross-sectional designs, restricting understanding on how this relationship could vary across the lifecourse. We used multilevel linear regression to analyse variation in minor psychiatric morbidity over nine annual waves of the British Household Panel Survey (1996-2004). The sample was restricted to residents of urban areas who remained within their neighbourhoods for at least 12 months. The 12-item General Health Questionnaire and confounders were reported for 29 626 male and 35 781 female observations (person-years). This individual-level dataset was linked to a measure of green space availability within each ward of residence. Regression models included age, gender, employment status, household tenure, marital status, education, smoking status and household income. When not considering age, green space was associated with better mental health among men, but not women. Interaction terms fitted between age and green space revealed variation in the association between green space and mental health across the lifecourse and by gender. For men, the benefit of more green space emerged in early to mid-adulthood. Among older women, a curvilinear association materialised wherein those with a moderate availability of green space had better mental health. These findings illustrate how the relationship between urban green space and health can vary across the lifecourse, and they highlight the need for longitudinal studies to answer why green space may be better for health at some points in the lifecourse than others.

  15. Association between BDNF-rs6265 and obesity in the Boston Puerto Rican Health Study

    USDA-ARS?s Scientific Manuscript database

    The objective of this study is to examine a functional variant (rs6265) in the BDNF gene interacting with dietary intake modulate obesity traits in the Boston Puerto Rican Health Study population. BDNF rs6265 was genotyped in 1147 Puerto Ricans (aged 45-75 years), and examined for association with o...

  16. Irregular Breakfast Eating and Associated Health Behaviors: A Pilot Study among College Students

    ERIC Educational Resources Information Center

    Thiagarajah, Krisha; Torabi, Mohammad R.

    2009-01-01

    The purpose of this study was to examine prevalence of eating breakfast and associated health compromising behaviors. This study utilized a cross-sectional survey methodology. A purposive cluster sampling technique was utilized to collect data from a representative sample of college students in a Midwestern university in the U.S. A total of 1,257…

  17. Nutrition and Health – The Association between Eating Behavior and Various Health Parameters: A Matched Sample Study

    PubMed Central

    Burkert, Nathalie T.; Muckenhuber, Johanna; Großschädl, Franziska; Rásky, Éva; Freidl, Wolfgang

    2014-01-01

    Population-based studies have consistently shown that our diet has an influence on health. Therefore, the aim of our study was to analyze differences between different dietary habit groups in terms of health-related variables. The sample used for this cross-sectional study was taken from the Austrian Health Interview Survey AT-HIS 2006/07. In a first step, subjects were matched according to their age, sex, and socioeconomic status (SES). After matching, the total number of subjects included in the analysis was 1320 (N = 330 for each form of diet – vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat). Analyses of variance were conducted controlling for lifestyle factors in the following domains: health (self-assessed health, impairment, number of chronic conditions, vascular risk), health care (medical treatment, vaccinations, preventive check-ups), and quality of life. In addition, differences concerning the presence of 18 chronic conditions were analyzed by means of Chi-square tests. Overall, 76.4% of all subjects were female. 40.0% of the individuals were younger than 30 years, 35.4% between 30 and 49 years, and 24.0% older than 50 years. 30.3% of the subjects had a low SES, 48.8% a middle one, and 20.9% had a high SES. Our results revealed that a vegetarian diet is related to a lower BMI and less frequent alcohol consumption. Moreover, our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life. Therefore, public health programs are needed in order to reduce the health risk due to nutritional factors. PMID:24516625

  18. Fish Health Studies Associated with the Kingston Fly Ash Spill, Spring 2009 - Fall 2010

    SciTech Connect

    Adams, Marshall; Fortner, Allison M

    2012-05-01

    On December 22, 2008, over 4 million cubic meters of fly ash slurry was released into the Emory River when a dike surrounding a solid waste containment area at the Tennessee Valley Authority's (TVA) Kingston Fossil Plant ruptured. One component of TVA's response to the spill is a biological monitoring program to assess short- and long-term ecological responses to the ash and associated chemicals, including studies on fish health and contaminant bioaccumulation. These studies were initiated in early Spring 2009 for the purposes of: (1) documenting the levels of fly ash-associated metals in various tissues of representative sentinel fish species in the area of the fly ash spill, (2) determining if exposure to fly ash-associated metals causes short, intermediate, or long-term health effects on these sentinel fish species, (3) assessing if there are causal relationships between exposure to metals and health effects on fish, (4) evaluating, along with information from other ecological and physicochemical studies, the nature and route of contaminant transfer though food chains into higher level consumers, (5) providing important information for the Ecological Risk Assessment (ERA) for the Kingston fly ash project, and (6) serving as an important technology information transfer or model study focused on how to best evaluate the environmental effects of fly ash (and related environmental stressors), not only at the Kingston site, but also at sites on other aquatic systems where coal-fired generating stations are located. This report presents the results of the first two years of the fish health study. To date, fish health and bioaccumulation studies have been conducted from Spring 2009 though Fall 2011 and includes 6 seasonal studies: Spring 2009, Fall 2009, Spring 2010, Fall 2010, Spring 2011, and Fall 2011. Both the Spring and Fall studies have focused on 3-4 sentinel fish species that represent different feeding habits, behaviors, and home ranges. In addition to fish

  19. Health burden associated with visual impairment in Singapore: the Singapore epidemiology of eye disease study.

    PubMed

    Wang, Xingzhi; Lamoureux, Ecosse; Zheng, Yingfeng; Ang, Marcus; Wong, Tien Yin; Luo, Nan

    2014-09-01

    To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore. Population-based cross-sectional study. We studied the 10 009 adults (3353 Chinese, 3397 Indians, and 3259 Malays) who underwent a comprehensive eye assessment and completed the European Quality of Life-5 Dimensions (EQ-5D) questionnaire in the Singapore Epidemiology of Eye Disease Study. We estimated the effects of VI, obesity, hypertension, diabetes, and hyperlipidemia on the EQ-5D index score using linear regression models and the association between VI and self-reported EQ-5D health problems using logistic regression models. We compared prevalence-based quality-adjusted life-year (QALY) loss associated with VI and other health conditions. For each condition, QALY loss was calculated for 100 000 persons in 1 year using associated reduction in EQ-5D index score estimated in regression analysis as disutility. The EQ-5D index score and annual QALY loss. The EQ-5D index score decreased with increasing VI severity in all 3 ethnicities. For example, after adjusting for sociodemographic characteristics, the difference in EQ-5D index score between adults with bilateral severe VI and those without VI was -0.044 (95% confidence interval [CI], -0.089 to 0.001) in Chinese, -0.127 (95% CI, -0.237 to -0.017) in Indians, and -0.085 (95% CI, -0.148 to -0.022) in Malays. In all 3 ethnicities, VI was associated with reporting of problems in mobility (e.g., odds ratio [OR], 3.69 for Chinese with bilateral severe VI; 95% CI, 1.21-12.13) and usual activities (e.g., OR, 6.51 for Chinese with bilateral severe VI; 95% CI, 1.59-26.58). In Indians, VI was also associated with anxiety or depression (e.g., OR, 2.68 for bilateral severe VI; 95% CI, 1.11-6.50). The annual QALY loss associated with VI was 511.8 in Chinese, 608.8 in Indians, and 706.7 in Malays, greater than that associated with other health conditions examined in

  20. Association of Health and Food Expenditures Inequality With Health Outcomes: A Case Study on Iranian Rural Households

    PubMed Central

    Naghdi, Seyran; Ghiasvand, Hesam; Shaarbafchi Zadeh, Nasrin; Azami, Saeidreza; Moradi, Tayebeh

    2014-01-01

    Background: Inequality in households’ and individuals' consumption expenditures is one of the most important aspects of health status difference among households and individuals. Objectives: We investigated the impact of some macro-economic factors specially inequality factors on the Iranian rural health status since 1986 through 2012. Patients and Methods: We conducted a longitudinal ecological and analytical study. The average sample size was 14602 households whom Iranian Statistics Center selected by a multi-stages clustering sampling approach. All required data has been collected from Iranian Statistics Centre and Deputy for Curial Affaires of Iranian Ministry of Health. We calculated the Gini coefficients for the rural food and health expenditures, then conducted a transloge autoregressive order one (AR1) to investigate the association between the Iranian rural households' key mortality rates and the food and health expenditure Gini coefficients, time trend, GDP per capita (PPP), and GDP per capita Gini coefficients. Results: The mean of Gini coefficients were 0.137 and 0.21 for the rural food expenditures inequality based on current and constant price, respectively. In addition, the mean of Gini coefficients were 0.26 and 0.31 for the rural health expenditures inequality based on current and constant price, respectively. The time trend, transloged form of Gini coefficients for health expenditures and GDP per capita Gini coefficients presented a significant negative correlation with transloged form of neonatal mortality rate. With regard to the transloged form of under five mortality we observed a significant negative correlation with time trend and transloged form of Gini coefficients for health expenditure and GDP per capita. Finally, there was a significant negative correlation between transloged forms of maternal mortality rate. Conclusions: Iranian policy makers should consider the rural health and food expenditures inequality and try to adopt more

  1. Association between serum uric acid and bone health in general population: a large and multicentre study

    PubMed Central

    Hong, Dun; Liu, Wenyue; Huang, Kangmao; Mo, Jian; Yu, Hejun; Wu, Shengjie; Fan, Shunwu

    2015-01-01

    Previous studies proposed that serum uric acid (UA), an endogenous antioxidant, could be a protective factor against bone loss. However, recently, a study with a population of US adults did not note the protective effects of serum UA. Therefore, the exact association between serum UA and bone health remains unclear. We performed a retrospective consecutive cohort study in a Chinese population to examine the association between serum UA and bone health. This cross-sectional study included 17,735 individuals who underwent lumbar spine bone mineral density (BMD) measurements as part of a health examination. In covariance analyses (multivariable-adjusted), a high serum UA level was associated with a high BMD, T-score, and Z-score. In binary logistic regression analyses (multivariable-adjusted), a high serum UA level was associated with low odds ratios (ORs) for at least osteopenia and osteoporosis in male (age ≥50 years) (OR = 0.72–0.60 and OR = 0.49–0.39, respectively) and postmenopausal female participants (OR = 0.61–0.51 and OR = 0.66–0.49, respectively). In conclusion, serum UA is associated with BMD, the T-score, and the Z-score, and has a strong protective effect against at least osteopenia and osteoporosis. PMID:26496032

  2. The Association between Physical Health and Delusional-Like Experiences: A General Population Study

    PubMed Central

    Saha, Sukanta; Scott, James; Varghese, Daniel; McGrath, John

    2011-01-01

    Objective Delusional-like experiences (DLE) are prevalent in the community. Recent community based studies have found that DLE are more common in those with depression and anxiety disorders, and in those with subclinical symptoms of depression and anxiety. Chronic physical disorders are associated with comorbid depression and anxiety; however, there is a lack of evidence about the association of DLE with common physical conditions. The aim of this study was to explore associations between the common physical disorders and DLE using a large population sample. Methods Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007, a national household survey of 8841 residents aged between 16 and 85 years. The presence of DLE, selected common physical disorders and symptoms were assessed using a modified World Mental Health Composite International Diagnostic Interview (CIDI) schedule. We examined the relationship between DLE, and physical health-related variables using logistic regression, with adjustments for potential confounding factors. Results Of the 8771, 776 (8.4%) subjects positively endorsed one or more DLE. Of the six physical disorders examined, only diabetes and arthritis were significantly associated with the endorsement of DLE. Of the seven broad physical symptoms explored, only hearing problems were consistently associated with DLE. Conclusion Delusional-like experiences are common in the Australian community, and are associated with selected chronic physical disorders and with impaired hearing. The direction of causality between these variables warrants closer research scrutiny. PMID:21541344

  3. [Self-assessment of health status and associated factors: a study in bank workers].

    PubMed

    Petarli, Glenda Blaser; Salaroli, Luciane Bresciani; Bissoli, Nazaré Souza; Zandonade, Eliana

    2015-04-01

    The aim of this study was to determine how bank employees assess their health status and risk factors associated with this indicator in this population. This is a cross-sectional study involving 525 workers of a banking system in the State of Espírito Santo, Brazil. The magnitude of the associations was assessed using logistic regression hierquizada in levels. It was found that 17% (n = 87) of bank self-rated their health status as fair or poor. Were associated with worse self-assessed health of the low socioeconomic level (OR = 1.80; 95%CI: 1.06-3.05), the sedentary lifestyle (OR = 2.64; 95%CI: 1.42-4.89), the excess weight (OR = 3.18; 95%CI: 1.79-5.65), low social support (OR = 3.71; 95%CI: 2.10-6.58), and the presence of chronic diseases (OR = 5,49; 95%CI: 2.46-12.27). It is concluded that, compared with other locations, there was a significant number of banking that self-rated their health status as fair or poor, and that the presence of chronic diseases was presented as the factor with the greatest impact on how the individual evaluates their own health.

  4. The diversity in associations between community social capital and health per health outcome, population group and location studied.

    PubMed

    van Hooijdonk, Carolien; Droomers, Mariël; Deerenberg, Ingeborg M; Mackenbach, Johan P; Kunst, Anton E

    2008-12-01

    Literature on the effect of community social capital on health is inconsistent and could be related to differences in social capital measures, health outcomes, population groups and locations studied. Therefore this study examines the diversity in associations between community social capital and health by investigating different diseases, populations groups and locations. Mortality records and individual data on sex, age, marital status, ethnic origin and place of residence were available for 6 years (1995-2000). Neighbourhood data, i.e. community social capital, socio-economic level and urbanicity, were linked through postcode information. Community social capital was indicated by measures of community interaction, belongingness, satisfaction and involvement. Variations in all-cause and cause-specific mortality across low and high social capital neighbourhoods were estimated through Poisson regression. In addition, analyses were stratified according to population group and to urbanization level. In the total population, community social capital was not related to all-cause mortality (RR = 1.00; CI: 0.99-1.01). However, residents of high social capital neighbourhoods had lower mortality risks for cancer [especially lung cancer (RR = 0.92; CI: 0.89-0.96)] and for suicide (RR = 0.90; CI: 0.83-0.98). Slightly lower mortality risks were also found for men (RR = 0.98; CI: 0.97-0.99), married individuals (RR = 0.96; CI: 0.94-0.97) and for residents living in socially strong neighbourhoods located in large cities (RR = 0.95; CI: 0.91-0.99). The association between community social capital and health differs per health outcome, study population and location studied. This underlines the need to take such diversity into account when aiming to conceptualize the relation between community social capital and health.

  5. Financial strain is associated with increased oxidative stress levels: the Women's Health and Aging Studies.

    PubMed

    Palta, Priya; Szanton, Sarah L; Semba, Richard D; Thorpe, Roland J; Varadhan, Ravi; Fried, Linda P

    2015-01-01

    Elevated oxidative stress levels may be one mechanism contributing to poor health outcomes. Financial strain and oxidative stress are each predictors of morbidity and mortality, but little research has investigated their relationship. Community-dwelling older adults (n = 728) from the Women's Health and Aging Studies I and II were included in this cross-sectional analysis. Financial strain was ascertained as an ordinal response to: "At the end of the month, do you have more than enough money left over, just enough, or not enough?" Oxidative stress was measured using serum protein carbonyl concentrations. Linear regression was used to quantify the relationship between financial strain and oxidative stress. Participants who reported high financial strain exhibited 13.4% higher protein carbonyl concentrations compared to individuals who reported low financial strain (p = 0.002). High financial strain may be associated with increased oxidative stress, suggesting that oxidative stress could mediate associations between financial strain and poor health.

  6. Use of Health Resources and Healthcare Costs associated with Frailty: The FRADEA Study.

    PubMed

    García-Nogueras, I; Aranda-Reneo, I; Peña-Longobardo, L M; Oliva-Moreno, J; Abizanda, P

    2017-01-01

    Frailty is associated with adverse health outcomes, but its association with hospital healthcare costs has not been analyzed. The main objective was to estimate the adjusted annual costs and use of hospital healthcare resources in frail older adults compared to non frail ones. FRADEA Study. Mean follow-up 1044 days (SD 314). Albacete city, Spain. 830 adults ≥70 years. Age, sex, comorbidity measured with the Charlson index and Fried´s Frailty phenotype as independent variables, and use of hospital resources (hospital admissions, emergency visits, and specialist visits), and hospital healthcare costs as outcome variables. Outcome data were collected from Minimum Data Set of the Complejo Hospitalario Universitario Albacete. The cost base year was 2013. Logistic regression and two-part models were used to analyze the association between frailty and the use of healthcare resources. Generalized Linear Models were applied to estimate the impact of frailty and comorbidity on the healthcare costs. The average cost associated with the use of health resources was 1,922€/year. Frail participants had an average total cost of health resources of 2,476€/year, pre-frail 2,056€/year, and non-frail 1,217€/year. 67% of the total health cost was associated with hospital admission cost, 29% with specialist visits cost and 4% with emergency visits cost. Frailty and comorbidity were the most important factors associated with the use of hospital healthcare resources. Adjusted healthcare costs were 592€/year and 458€/year greater in frail and pre-frail participants respectively, compared to non-frail ones, and having a Charlson index ≥ 3, was associated with an increased costs of 2,289€/year. Frailty and comorbidity are meaningful and complementary associated with increased hospital healthcare resources use, and related costs.

  7. Complaints of Sleep Disturbances Are Associated with Cardiovascular Disease: Results from the Gutenberg Health Study

    PubMed Central

    Michal, Matthias; Wiltink, Jörg; Kirschner, Yvonne; Schneider, Astrid; Wild, Philipp S.; Münzel, Thomas; Blettner, Maria; Schulz, Andreas; Lackner, Karl; Pfeiffer, Norbert; Blankenberg, Stefan; Tschan, Regine; Tuin, Inka; Beutel, Manfred E.

    2014-01-01

    Background Despite their high prevalence, sleep disorders often remain unrecognized and untreated because of barriers to assessment and management. The aims of the present study were to examine associations of complaints of sleep disturbances with cardiovascular disease, related risk factors, and inflammation in the community and to determine the contribution of sleep disturbances to self-perceived physical health. Method The sample consists of n = 10.000 participants, aged 35 to 74 years of a population based community sample in Germany. Cross-sectional associations of complaints of sleep disturbances with cardiovascular risk factors and disease, biomarkers of inflammation, depression, anxiety, and physical health status were analyzed. Results 19% of our sample endorsed clinically significant sleep disturbances. In the unadjusted analyses severity of sleep disturbances increased with female sex, low socioeconomic status, living without a partnership, cardiovascular disease, depression, anxiety, poor physical health, increased levels of C-reactive protein and fibrinogen. After multivariate adjustment robust associations with coronary heart disease, myocardial infarction and dyslipidemia remained. Complaints of sleep disturbances were strong and independent contributors to self-perceived poor physical health beyond depression, anxiety and medical disease burden. Conclusions Given the high prevalence of complaints of sleep disturbances and their strong impact on health status, increased efforts should be undertaken for their identification and treatment. PMID:25093413

  8. Coffee Consumption Is Positively Associated with Longer Leukocyte Telomere Length in the Nurses' Health Study.

    PubMed

    Liu, Jason J; Crous-Bou, Marta; Giovannucci, Edward; De Vivo, Immaculata

    2016-07-01

    Coffee is an important source of antioxidants, and consumption of this beverage is associated with many health conditions and a lower mortality risk. However, no study, to our knowledge, has examined whether varying coffee or caffeine consumption levels are associated with telomere length, a biomarker of aging whose shortening can be accelerated by oxidative stress. We performed a large comprehensive study on how coffee consumption is associated with telomere length. We used data from the Nurses' Health Study (NHS), a prospective cohort study of female nurses that began in 1976. We examined the cross-sectional association between coffee consumption and telomere length in 4780 women from the NHS. Coffee consumption information was obtained from validated food-frequency questionnaires, and relative telomere length was measured in peripheral blood leukocytes by the quantitative real-time polymerase chain reaction. Unconditional logistic regression was used to obtain ORs when the telomere length outcome was dichotomized at the median. Linear regression was used for tests of trend with coffee consumption and telomere length as continuous variables. Higher total coffee consumption was significantly associated with longer telomeres after potential confounding adjustment. Compared with non-coffee drinkers, multivariable ORs for those drinking 2 to <3 and ≥3 cups of coffee/d were, respectively, 1.29 (95% CI: 0.99, 1.68) and 1.36 (95% CI: 1.04, 1.78) (P-trend = 0.02). We found a significant linear association between caffeine consumption from all dietary sources and telomere length (P-trend = 0.02) after adjusting for potential confounders, but not after additionally adjusting for total coffee consumption (P-trend = 0.37). We found that higher coffee consumption is associated with longer telomeres among female nurses. Future studies are needed to better understand the influence of coffee consumption on telomeres, which may uncover new knowledge of how coffee consumption

  9. Coffee Consumption Is Positively Associated with Longer Leukocyte Telomere Length in the Nurses’ Health Study12

    PubMed Central

    Liu, Jason J; Crous-Bou, Marta; Giovannucci, Edward; De Vivo, Immaculata

    2016-01-01

    Background: Coffee is an important source of antioxidants, and consumption of this beverage is associated with many health conditions and a lower mortality risk. However, no study, to our knowledge, has examined whether varying coffee or caffeine consumption levels are associated with telomere length, a biomarker of aging whose shortening can be accelerated by oxidative stress. Objective: We performed a large comprehensive study on how coffee consumption is associated with telomere length. Methods: We used data from the Nurses’ Health Study (NHS), a prospective cohort study of female nurses that began in 1976. We examined the cross-sectional association between coffee consumption and telomere length in 4780 women from the NHS. Coffee consumption information was obtained from validated food-frequency questionnaires, and relative telomere length was measured in peripheral blood leukocytes by the quantitative real-time polymerase chain reaction. Unconditional logistic regression was used to obtain ORs when the telomere length outcome was dichotomized at the median. Linear regression was used for tests of trend with coffee consumption and telomere length as continuous variables. Results: Higher total coffee consumption was significantly associated with longer telomeres after potential confounding adjustment. Compared with non-coffee drinkers, multivariable ORs for those drinking 2 to <3 and ≥3 cups of coffee/d were, respectively, 1.29 (95% CI: 0.99, 1.68) and 1.36 (95% CI: 1.04, 1.78) (P-trend = 0.02). We found a significant linear association between caffeine consumption from all dietary sources and telomere length (P-trend = 0.02) after adjusting for potential confounders, but not after additionally adjusting for total coffee consumption (P-trend = 0.37). Conclusions: We found that higher coffee consumption is associated with longer telomeres among female nurses. Future studies are needed to better understand the influence of coffee consumption on telomeres

  10. Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II Study, Helsinki Health Study, and the Japanese Civil Servants Study.

    PubMed

    Lallukka, Tea; Lahelma, Eero; Rahkonen, Ossi; Roos, Eva; Laaksonen, Elina; Martikainen, Pekka; Head, Jenny; Brunner, Eric; Mosdol, Annhild; Marmot, Michael; Sekine, Michikazu; Nasermoaddeli, Ali; Kagamimori, Sadanobu

    2008-04-01

    Adverse health behaviors and obesity are key determinants of major chronic diseases. Evidence on work-related determinants of these behavioral risk factors is inconclusive, and comparative studies are especially lacking. We aimed to examine the associations between job strain, working overtime, adverse health behaviors, and obesity among 45-60-year-old white-collar employees of the Whitehall II Study from London (n=3,397), Helsinki Health Study (n=6,070), and the Japanese Civil Servants Study (n=2,213). Comparable data from all three cohorts were pooled, and logistic regression analysis was used, stratified by cohort and sex. Models were adjusted for age, occupational class, and marital status. Outcomes were unhealthy food habits, physical inactivity, heavy drinking, smoking, and obesity. In London, men reporting passive work were more likely to be physically inactive. A similar association was repeated among women in Helsinki. Additionally, high job strain was associated with physical inactivity among men in London and women in Helsinki. In London, women reporting passive work were less likely to be heavy drinkers and smokers. In Japan, men working overtime reported less smoking, whereas those with high job strain were more likely to smoke. Among men in Helsinki the association between working overtime and non-smoking was also suggested, but it reached statistical significance in the age-adjusted model only. Obesity was associated with working overtime among women in London. In conclusion, job strain and working overtime had some, albeit mostly weak and inconsistent, associations with adverse health behaviors and obesity in these middle-aged white-collar employee cohorts from Britain, Finland, and Japan.

  11. Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.

    PubMed

    Russo, Philip L; Havers, Sally M; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

    2016-12-01

    There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  12. Genome-wide association study of generalized anxiety symptoms in the Hispanic Community Health Study/Study of Latinos.

    PubMed

    Dunn, Erin C; Sofer, Tamar; Gallo, Linda C; Gogarten, Stephanie M; Kerr, Kathleen F; Chen, Chia-Yen; Stein, Murray B; Ursano, Robert J; Guo, Xiuqing; Jia, Yucheng; Qi, Qibin; Rotter, Jerome I; Argos, Maria; Cai, Jianwen; Penedo, Frank J; Perreira, Krista; Wassertheil-Smoller, Sylvia; Smoller, Jordan W

    2017-03-01

    Although generalized anxiety disorder (GAD) is heritable and aggregates in families, no genomic loci associated with GAD have been reported. We aimed to discover potential loci by conducting a genome-wide analysis of GAD symptoms in a large, population-based sample of Hispanic/Latino adults. Data came from 12,282 participants (aged 18-74) in the Hispanic Community Health Study/Study of Latinos. Using a shortened Spielberger Trait Anxiety measure, we analyzed the following: (i) a GAD symptoms score restricted to the three items tapping diagnostic features of GAD as defined by DSM-V; and (ii) a total trait anxiety score based on summing responses to all ten items. We first calculated the heritability due to common variants (h(2)SNP ) and then conducted a genome-wide association study (GWAS) of GAD symptoms. Replication was attempted in three independent Hispanic cohorts (Multi-Ethnic Study of Atherosclerosis, Women's Health Initiative, Army STARRS). The GAD symptoms score showed evidence of modest heritability (7.2%; P = 0.03), while the total trait anxiety score did not (4.97%; P = 0.20). One genotyped SNP (rs78602344) intronic to thrombospondin 2 (THBS2) was nominally associated (P = 5.28 × 10(-8) ) in the primary analysis adjusting for psychiatric medication use and significantly associated with the GAD symptoms score in the analysis excluding medication users (P = 4.18 × 10(-8) ). However, meta-analysis of the replication samples did not support this association. Although we identified a genome-wide significant locus in this sample, we were unable to replicate this finding. Evidence for heritability was also only detected for GAD symptoms, and not the trait anxiety measure, suggesting differential genetic influences within the domain of trait anxiety. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Perceived discrimination is associated with health behaviours among African-Americans in the Jackson Heart Study.

    PubMed

    Sims, Mario; Diez-Roux, Ana V; Gebreab, Samson Y; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

    2016-02-01

    Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviours among African-Americans (AA). The cross-sectional associations of everyday, lifetime and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat and sleep were examined among 4925 participants aged 35-84 years after adjustment for age and socioeconomic status (SES). Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95% CI 1.00 to 1.28 and 1.19, 95% CI 1.05 to 1.34; mean difference in dietary fat: 0.37, p<0.05 and 0.43, p<0.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: -0.08, p<0.05 and -0.18, p<0.001, respectively; and mean difference for lifetime discrimination: -0.08, p<0.05 and -0.24, p<0.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only. Higher levels of perceived discrimination were associated with select health behaviours among men and women. Health behaviours offer a potential mechanism through which perceived discrimination affects health in AA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Perceived Discrimination is Associated with Health Behaviors among African Americans in the Jackson Heart Study*

    PubMed Central

    Sims, Mario; Diez-Roux, Ana V.; Gebreab, Samson Y.; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

    2016-01-01

    Background Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviors among African Americans (AA). Methods The cross-sectional associations of everyday, lifetime, and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat, and sleep were examined among 4,939 35–84 year old participants after adjustment for age and socioeconomic status (SES). Results Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95%CI 1.00,1.28 and 1.19, 95%CI 1.05,1.34; mean difference in dietary fat: 0.37, p<.05 and 0.43, p<.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: −0.08, p<.05 and −0.18, p<.001, respectively; and mean difference for lifetime discrimination: −0.08, p<.05, and −0.24, p<.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only. Conclusions Higher levels of perceived discrimination were associated with select health behaviors among men and women. Health behaviors offer a potential mechanism through which perceived discrimination affects health in AA. PMID:26417003

  15. Characteristics of health care organizations associated with learning and development: lessons from a pilot study.

    PubMed

    Nyström, Monica

    2009-01-01

    Characteristics of health care organizations associated with an ability to learn from experiences and to develop and manage change were explored in this study. Understanding of these characteristics is necessary to identify factors influencing success in learning from the past and achieving future health care quality objectives. A literature review of the quality improvement, strategic organizational development and change management, organizational learning, and microsystems fields identified 20 organizational characteristics, grouped under (a) organizational systems, (b) key actors, and (c) change management processes. Qualitative methods, using interviews, focus group reports, and archival records, were applied to find associations between identified characteristics and 6 Swedish health care units externally evaluated as delivering high-quality care. Strong support for a characteristic was defined as units having more than 4 sources describing the characteristic as an important success factor. Eighteen characteristics had strong support from at least 2 units. The strongest evidence was found for the following: (i) key actors have long-term commitment, provide support, and make sense of ambiguous situations; (ii) organizational systems encourage employee commitment, participation, and involvement; and (iii) change management processes are employed systematically. Based on the results, a new model of "characteristics associated with learning and development in health care organizations" is proposed.

  16. Associations between green space and health in English cities: an ecological, cross-sectional study.

    PubMed

    Bixby, Honor; Hodgson, Susan; Fortunato, Léa; Hansell, Anna; Fecht, Daniela

    2015-01-01

    Green space has been identified as a modifiable feature of the urban environment and associations with physiological and psychological health have been reported at the local level. This study aims to assess whether these associations between health and green space are transferable to a larger scale, with English cities as the unit of analysis. We used an ecological, cross-sectional study design. We classified satellite-based land cover data to quantify green space coverage for the 50 largest cities in England. We assessed associations between city green space coverage with risk of death from all causes, cardiovascular disease, lung cancer and suicide between 2002 and 2009 using Poisson regression with random effect. After adjustment for age, income deprivation and air pollution, we found that at the city level the risk of death from all causes and a priori selected causes, for men and women, did not significantly differ between the greenest and least green cities. These findings suggest that the local health effects of urban green space observed at the neighbourhood level in some studies do not transfer to the city level. Further work is needed to establish how urban residents interact with local green space, in order to ascertain the most relevant measures of green space.

  17. Association of nutrition club membership with markers of health: a cross sectional study.

    PubMed

    Das, Sai Krupa; Vail, Taylor A; Lebrón-Torres, Namibia; Livingston, Kara A; Roberts, Susan B; Rogers, Gail T; Gilhooly, Cheryl H; Urban, Lorien E; Saltzman, Edward; McKeown, Nicola M; Folta, Sara C

    2017-04-11

    Nutrition clubs (NC) operate in community settings and provide members with nutrition education and meal replacements for weight management. NC are owned and operated by distributors of Herbalife products. There are over 6200 NC in the US, but there has been no independent assessment of the association of these NC with biomarkers of health. We conducted a cross-sectional pilot study to compare the health status of 100 NC members to 100 community-matched controls (CC) in the greater Boston area. Each CC was matched to a NC member for community of residence (zip code), age category, gender, BMI category, race/ethnicity, education level (category), and readiness to make health changes. Measures obtained included cardio-metabolic risk factors, body composition, markers of nutritional status, reported health status, dietary intake, physical activity, sleep and depression. Participants were predominantly female (64%) and Hispanic (73%). NC members had significantly lower fasting insulin (P < 0.001) and lower HbA1c (P = 0.008), higher levels of 25 hydroxy-vitamin D (P = 0.001), and vitamin E:cholesterol ratio (P < 0.001), and lower prevalence of metabolic syndrome (P = 0.02) compared to CC. In addition, most of the NC members (99%) were satisfied with Herbalife NC membership for themselves and their families. A higher percentage of NC members (86%) compared to CC (32%) reported being in much better or somewhat better health compared to a year ago (P < 0.001); and they reported significantly better physical health (P = 0.03), and fewer sleep problems (P = 0.03). Herbalife NC membership was positively associated with perceived health and measured cardiometabolic benefits. However, causality cannot be inferred from these findings.

  18. Association of health behaviour with heart rate variability: a population-based study.

    PubMed

    Kluttig, Alexander; Schumann, Barbara; Swenne, Cees A; Kors, Jan A; Kuss, Oliver; Schmidt, Hendrik; Werdan, Karl; Haerting, Johannes; Greiser, Karin H

    2010-11-25

    Reduced heart rate variability (HRV), a non-invasive marker of autonomic dysfunction, and an unhealthy lifestyle are associated with an increased morbidity and mortality of cardiovascular diseases (CVD). The autonomic dysfunction is a potential mediator of the association of behavioural risk factors with adverse health outcomes. We studied the association of HRV with behavioural risk factors in an elderly population. This analysis was based on the cross-sectional data of 1671 participants (age range, 45-83 years) of the prospective, population-based Cardiovascular Disease, Living and Ageing in Halle (CARLA) Study. Physical activity, smoking habits, alcohol consumption and dietary patterns were assessed in standardized interviews. Time and frequency domain measures of HRV were computed from 5-min segments of highly standardized 20-min electrocardiograms. Their association with behavioural risk factors was determined by linear and non-parametric regression modelling. There were only weak and inconsistent associations of higher physical activity, moderate consumption of alcohol, and non-smoking with higher time and frequency domain HRV in both sexes, and no association with dietary pattern. Results changed only marginally by excluding subjects with CVD, diabetes mellitus and use of cardioactive medication. We hypothesized that HRV is associated with behavioural factors and therefore might be a mediator of the effect of behavioural risk factors on CVD, but this hypothesis was not confirmed by our results. These findings support the interpretation that there may be no true causal association of behavioural factors with HRV.

  19. Association of mental distress with smoking status in the community: Results from the Gutenberg Health Study.

    PubMed

    Michal, Matthias; Wiltink, Jörg; Reiner, Iris; Kirschner, Yvonne; Wild, Phillip S; Schulz, Andreas; Zwiener, Isabella; Blettner, Maria; Beutel, Manfred E

    2013-04-25

    Exposition to tobacco smoke is among the major modifiable risk factors in the general population. There is strong evidence for a close association between smoking exposure and mental disorders. Cross-sectional associations of different conditions of smoking status (former, current, and second hand smoking (SHS)) with indicators of mental distress were analyzed in a sample of N=5000 participants (aged 35-74 years) of the population-based survey "Gutenberg Health Study". In the general population clinically significant depression (OR 1.59, 95%CI 1.17-2.17) and a previous diagnosis of depression (OR 1.50, 95%CI 1.16-1.94) were associated with current smoking. Each cigarette per day was associated with a 3% increase for the likelihood of clinically significant depression. We did not find a decreased prevalence for current first and second hand exposure in persons with established cardiovascular or lung disease. In this subgroup mental distress was strongly associated with SHS at home. Main limitations of the study pertain to the reliance on self-report of distress and smoking status and the cross-sectional nature of the data. Despite public health efforts, smoke exposure is still alarmingly high in the general population, especially in persons with mental distress and with established cardiovascular or lung disease. In the management of persons with chronic cardiovascular and lung disease, enquiry of the medical history should include exposure to SHS at home and offer special counseling. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Association between education level and dentition status in Japanese adults: Japan public health center-based oral health study.

    PubMed

    Ueno, Masayuki; Ohara, Satoko; Inoue, Manami; Tsugane, Shoichiro; Kawaguchi, Yoko

    2012-12-01

    The aim of this study was to examine whether there is an educational gradient in dentition status among Japanese adults who are under the universal public health insurance system. Subjects were 1201 community residents aged 55-75 years as of May 2005 who completed a self-administered questionnaire and had a standard clinical oral examination. Analysis focused on the association of three education levels (junior high school, senior high school, and any college or higher education) with dentition status. The proportion of subjects with 20 or more teeth (P < 0.001), number of teeth present (P = 0.037), number of filled teeth (P = 0.016), and two types of functional tooth units (FTUs): FTUs with natural teeth (n-FTUs) (P < 0.001) and FTUs with natural teeth and artificial teeth on implant-supported and fixed prostheses (nif-FTUs) (P < 0.001) were significantly associated with education level after adjusting for confounders. The significant trend of these values in dental indexes indicated a poorer dentition status with a lower education level. The results suggest that the level of education has an independent impact on dentition status in a group of Japanese adults, even after taking into account oral health-related factors. Therefore, providing appropriate oral health information from an early age within a compulsory school education program appears necessary to enhance health literacy and lessen the inequalities in dental health by educational level. © 2012 John Wiley & Sons A/S.

  1. Association between Optimism, Psychosocial Well Being and Oral Health: A Cross-Sectional Study.

    PubMed

    Thiruvenkadam, G; Asokan, Sharath; Baby John, J; Geetha Priya, P R

    The aim of the study was to assess the association of optimism and psychosocial well being of school going children on their oral health status. The study included 12- to 15-year-old school going children (N = 2014) from Tamilnadu, India. Optimism was measured using the revised version of the Life Orientation Test (LOT-R). A questionnaire was sent to the parents regarding their child's psychosocial behavior which included shyness, feeling inferiority, unhappiness and friendliness. Clinical examination for each child was done to assess the DMFT score and OHI-S score. The data obtained were statistically analyzed using Pearson Chi-Square test, Mann-Whitney test and Kruskal-Wallis test with the aid of SPSS software (version 17). Odds Ratio (OR) was calculated with 95% Confidence Interval (CI). The p value ≤ 0.05 was considered statistically significant. Boys with high optimism had significantly lesser DMFT score than the boys with low optimism (p=0.001). Girls with high optimism had significantly higher DMFT score (p=0.001). In psychosocial outcomes, inferiority (p=0.002) and friendliness (p=0.001) showed significant association with DMFT score. Among the boys, children who felt less inferior (p=0.001), less unhappy (p=0.029) and more friendly (p=0.001) had lesser DMFT score. Among the psychosocial outcomes assessed, inferiority and friendliness had significant association with oral health of the children and hence, can be used as a proxy measures oral health.

  2. Relationships between menstrual and menopausal attitudes and associated demographic and health characteristics: The Hilo Women’s Health Study

    PubMed Central

    Sievert, Lynnette L.; Brown, Daniel E.; Rahberg, Nichole; Reza, Angela

    2010-01-01

    The objective of this study was to examine the relation of menstrual attitudes to menopausal attitudes and the demographic and health characteristics associated with each. This cross-sectional study consisted of a randomly selected sample of 1824 respondents aged 16 to 100 years in multi-ethnic Hilo, Hawai`i. Women completed questionnaires for demographic and health information, such as age, ethnicity, education, residency in Hawai`i, menopausal status, exercise, and attitudes toward menstruation and menopause. Women more often chose positive terms, such as “natural,” to describe menstruation (60.8%) and menopause (59.4%). In bivariate analyses, post-menopausal women were significantly more likely to have positive menstrual and menopausal attitudes than pre-menopausal women. Factor analyses were used to cluster attitudes followed by linear regression to identify demographic characteristics associated with factor scores. Asian-American ethnicity, higher education, reporting more exercise, and growing up outside of Hawai`i were associated with positive menstrual attitudes. Higher education, older age, post-menopausal status, growing up outside of Hawai`i and having hot flashes were associated with positive menopausal attitudes. Bivariate correlation analyses suggested significant associations between factor scores for menstrual and menopausal attitudes. Both negative and positive menstrual attitudes were positively correlated with the anticipation of menopause, although negative attitudes toward menstruation were negatively correlated with menopause as a positive, natural life event. Demographic variables, specifically education and where one grows up, influenced women’s attitudes toward menstruation and menopause and should be considered for inclusion in subsequent multi-ethnic studies. Further research is also warranted in assessing the relationship between menstrual and menopausal attitudes. PMID:20853216

  3. Associations between common fibrinogen gene polymorphisms and cardiovascular disease in older adults. The Cardiovascular Health Study.

    PubMed

    Carty, Cara L; Cushman, Mary; Jones, Daniel; Lange, Leslie A; Hindorff, Lucia A; Rice, Kenneth; Jenny, Nancy S; Durda, J Peter; Walston, Jeremy; Carlson, Christopher S; Nickerson, Debbie; Tracy, Russell P; Reiner, Alex P

    2008-02-01

    Elevated plasma fibrinogen is a risk factor for cardiovascular disease (CVD), but associations between fibrinogen single nucleotide polymorphisms (SNPs) and disease risk are inconsistent. We investigated whether common (> or = 5% minor allele frequency) variation in the fibrinogen genes (FGA, FGB, FGG) is associated with fibrinogen concentration, carotid artery intima-medial thickness (IMT) and risk of incident myocardial infarction (MI), ischemic stroke and CVD mortality in European- (EA) and African-descent (AA) adults (> or = 65 years) from the Cardiovascular Health Study. TagSNPs were genotyped in 3,969 EA and 719 AA free of MI or stroke at baseline. Race-specific models included multiple testing correction and adjustment for sex, age and site. Among EA, minor alleles of FGA3807, FGB1437 and FGG902 were associated with higher fibrinogen levels; whereas FGA251, FGA2224, FGA6534 and FGG10034 were associated with lower levels, p<0.004 for each. Strongest associations were seen for FGB1437; each additional copy of the minor allele was associated with 13 mg/dl (95%CI: 9-16) higher fibrinogen level. Similar trends in AA were not significant. Fibrinogen haplotypes were not significantly associated with internal or common carotid IMT. No associations with MI or CVD mortality were seen in EA, though FGB1038 and FGG902 were significantly associated with increased and decreased risk of stroke in men, respectively, as were related haplotypes. FGB1038 was also associated with CVD mortality in AA, HR = 1.9 (95%CI: 1.3-2.7). In conclusion, while fibrinogen genetic variation was strongly associated with fibrinogen levels, there was less evidence of association with the more complex outcomes of IMT and CVD events.

  4. Unfavorable health conditions associated with high social anxiety in the elderly: a community-based study.

    PubMed

    Dahl, Alv A; Olssøn, Ingrid

    2013-02-01

    There is little knowledge concerning unfavorable health conditions (UHC) associated with high level of social phobia/anxiety symptoms (SPAS) in the elderly. This cross-sectional community-based study examines five categories of UHC related to high SPAS in individuals aged 75/76 years compared with controls with lower SPAS. The study was based on data from the Oslo Health Study. Based on self-rating of the MINI-SPIN screening instrument, 246 individuals (9%) had high SPAS (cases) and 2464 (91%) had lower SPAS (controls). The socio-demographic, somatic, lifestyle, social and mental categories of UHC were compared between cases and controls. A significantly higher proportion of cases were in non-paired relationships, had low level of education and low income compared with controls. Among cases, a significantly higher proportion had poor self-rated health, more somatic morbidity, regular use of analgesics and frequent drinking. All indicators of social UHC, except low community activism, were significantly more common among cases compared with controls. Except for use of hypnotics, the same was true for the indicators of mental UHC. Stepwise multivariate logistic regression analysis showed that the socio-demographic, somatic, social and mental UHC steps were significantly associated with high SPAS. Individuals aged 75/76 years with high level of SPAS showed multiple UHC within several areas. Identification and interventions like exposure and though modification geared at such anxiety should be considered.

  5. A Pilot Study into the Association between Oral Health Status and Human Papillomavirus—16 Infection

    PubMed Central

    Sun, Charles Xiaohang; Bennett, Nigel; Tran, Peter; Tang, Kai Dun; Lim, Yenkai; Frazer, Ian; Samaranayake, Lakshman; Punyadeera, Chamindie

    2017-01-01

    Background: Over the next 20 years, oropharyngeal cancers (OPC) will represent the majority of head and neck cancers (HNCs) in the United States. It is estimated that human papillomavirus (HPV) may account for as much as 70% to 80% of OPCs in North America and in certain parts of Europe. It is hence crucial to understand the disease risk factors and natural history of oral HPV infections. We hypothesized that poor oral health (by measures such as poor oral hygiene and periodontal disease) leads to a higher degree of oral HPV-16 infections within a patient cohort from a dental school clinic. This study aims to test this hypothesis and gauge possible disease associations before larger scale studies. Subjects and Methods: 223 participants were recruited in this study from the University of Queensland Dental School clinic. Clinical oral health parameters (such as oral hygiene measures and periodontal disease measurements) have been examined and determined by dental professionals. We have collected oral rinse samples from these volunteers. Results: 10 (4.5%) out of 223 participants were found to have HPV-16 DNA in their oral rinse samples using NB2 endpoint PCR and Sanger sequencing. Within the HPV-16 DNA positive subjects, 7 (70%) and 3 (30%) were associated with poor oral hygiene and periodontal disease, respectively. Conclusion: Our results show a trend towards a positive correlation between oral HPV-16 infection and poor clinical oral health status. PMID:28257064

  6. Muscle weakness is associated with diabetes in older Mexicans: The Mexican Health and Aging Study

    PubMed Central

    Peterson, Mark D.; McGrath, Ryan; Zhang, Peng; Markides, Kyriakos S.; Snih, Soham Al; Wong, Rebeca

    2016-01-01

    Background The risk of cardiovascular problems due to diabetes mellitus is highest among older Mexicans, and yet what remains to be determined is the association between muscle weakness and diabetes in this population. Therefore, the purpose of this study was to determine the association between muscle strength and diabetes among Mexican adults greater than 50 years old. Design Cross-sectional. Setting National sample of households in both urban and rural areas. Participants A sub-sample of 1,841 individuals, aged 50 years and older, was included from the 2012 Mexican Health and Aging Study (MHAS). Measurements Strength was assessed using a hand-held dynamometer, and the single largest reading from either hand was normalized to body mass (NGS). Conditional inference tree analyses were used to identify sex-specific NGS weakness thresholds. Linear regression was used to examine the association between NGS and HbA1c, and logistic regression was used to assess the association between weakness and risk of diabetes (HbA1c ≥6.5% [≥48 mmol/mol]), after controlling for age, sex and waist circumference. Results Normalized grip strength was inversely associated with HbA1c (β=−1.56; p<0.001). Optimal sex-specific NGS weakness thresholds to detect diabetes were ≤0.46 and ≤0.30 for men and women respectively. Weakness was associated with significantly increased odds of diabetes (OR: 1.69, 95%CI: 1.37-2.10), even after adjusting for age, sex, and waist circumference. Conclusions NGS was robustly associated with diabetes and other cardiometabolic risk factors in older Mexicans. This simple screen may serve as a valuable tool to identify adults that are at risk for negative health consequences or early mortality, and that might benefit from lifestyle interventions to reduce risk. PMID:27450948

  7. Omega-6 fatty acids: Opposing associations with risk-The Ludwigshafen Risk and Cardiovascular Health Study.

    PubMed

    Delgado, Graciela E; März, Winfried; Lorkowski, Stefan; von Schacky, Clemens; Kleber, Marcus E

    Omega-6 polyunsaturated fatty acids (omega-6 PUFA) are recommended in European cardiovascular prevention guidelines. However, individual fatty acids have distinct biological functions, and there have been conflicting reports about the association of omega-6 PUFA with cardiovascular risk. The aim of our study was to investigate the association of individual omega-6 fatty acids with mortality in a cohort of patients referred for coronary angiography. Omega-6 PUFA proportions were measured in erythrocytes at baseline in a total of 3259 patients participating in the Ludwigshafen Risk and Cardiovascular Health Study using the HS-Omega-3 Index method. Associations of omega-6 PUFA with mortality were analyzed by Cox regression with adjustment for conventional risk factors. During a median follow-up of 10.0 years, 975 patients (29.9%) died, 614 patients (18.8%) from cardiovascular causes. γ-Linolenic acid was inversely associated with all-cause and cardiovascular mortalities in models adjusted for cardiovascular risk factors with hazard ratios of 0.88 (0.82-0.95) and 0.86 (0.79-0.95) per 1-standard deviation increase, respectively. Adrenic acid and docosapentaenoic acid ω-6 were both directly associated with risk with hazard ratio of 1.10 (1.30-1.18) and 1.12 (1.05-1.19) for all-cause mortality, respectively. No association was found for arachidonic acid. We observed opposing associations of individual omega-6 PUFA with mortality risk. While LA and γ-linolenic acid were associated with reduced risk, there was a direct association for adrenic acid and docosapentaenoic acid. These differences do not support the use of omega-6 PUFA concentrations as a single combined metric, and the prognostic value of each individual member should be examined separately. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  8. Association between Cutaneous Nevi and Breast Cancer in the Nurses' Health Study: A Prospective Cohort Study

    PubMed Central

    Zhang, Mingfeng; Zhang, Xuehong; Qureshi, Abrar A.; Eliassen, A. Heather; Hankinson, Susan E.; Han, Jiali

    2014-01-01

    Background Cutaneous nevi are suggested to be hormone-related. We hypothesized that the number of cutaneous nevi might be a phenotypic marker of plasma hormone levels and predict subsequent breast cancer risk. Methods and Findings We followed 74,523 female nurses for 24 y (1986–2010) in the Nurses' Health Study and estimate the relative risk of breast cancer according to the number of cutaneous nevi. We adjusted for the known breast cancer risk factors in the models. During follow-up, a total of 5,483 invasive breast cancer cases were diagnosed. Compared to women with no nevi, women with more cutaneous nevi had higher risks of breast cancer (multivariable-adjusted hazard ratio, 1.04, 95% confidence interval [CI], 0.98–1.10 for 1–5 nevi; 1.15, 95% CI, 1.00–1.31 for 6–14 nevi, and 1.35, 95% CI, 1.04–1.74 for 15 or more nevi; p for continuous trend = 0.003). Over 24 y of follow-up, the absolute risk of developing breast cancer increased from 8.48% for women without cutaneous nevi to 8.82% (95% CI, 8.31%–9.33%) for women with 1–5 nevi, 9.75% (95% CI, 8.48%–11.11%) for women with 6–14 nevi, and 11.4% (95% CI, 8.82%–14.76%) for women with 15 or more nevi. The number of cutaneous nevi was associated with increased risk of breast cancer only among estrogen receptor (ER)–positive tumors (multivariable-adjusted hazard ratio per five nevi, 1.09, 95% CI, 1.02–1.16 for ER+/progesterone receptor [PR]–positive tumors; 1.08, 95% CI, 0.94–1.24 for ER+/PR− tumors; and 0.99, 95% CI, 0.86–1.15 for ER−/PR− tumors). Additionally, we tested plasma hormone levels according to the number of cutaneous nevi among a subgroup of postmenopausal women without postmenopausal hormone use (n = 611). Postmenopausal women with six or more nevi had a 45.5% higher level of free estradiol and a 47.4% higher level of free testosterone compared to those with no nevi (p for trend = 0.001 for both). Among a subgroup of 362 breast cancer cases and 611 matched

  9. Is complexity of work associated with risk of dementia? The Canadian Study of Health And Aging.

    PubMed

    Kröger, Edeltraut; Andel, Ross; Lindsay, Joan; Benounissa, Zohra; Verreault, René; Laurin, Danielle

    2008-04-01

    The authors evaluated the association of complexity of work with data, people, and things with the incidence of dementia, Alzheimer's disease, and vascular dementia in the Canadian Study of Health and Aging, while adjusting for work-related physical activity. The Canadian Study of Health and Aging is a 10-year population study, from 1991 to 2001, of a representative sample of persons aged 65 years or older. Lifetime job history allowed application of complexity scores and classification of work-related physical activity. Analyses included 3,557 subjects, of whom 400 were incident dementia cases, including 299 with Alzheimer's disease and 93 with vascular dementia. In fully adjusted Cox regression models, high complexity of work with people or things reduced risk of dementia (hazard ratios were 0.66 (95% confidence interval: 0.44, 0.98) and 0.72 (95% confidence interval: 0.52, 0.99), respectively) but not Alzheimer's disease. For vascular dementia, hazard ratios were 0.36 (95% confidence interval: 0.15, 0.90) for high complexity of work with people and 0.50 (95% confidence interval: 0.25, 1.00) for high complexity of work with things. Subgroup analyses according to median duration (23 years) of principal occupation showed that associations with complexity varied according to duration of employment. High complexity of work appears to be associated with risk of dementia, but effects may vary according to subtype.

  10. Factors associated with self-reported health: implications for screening level community-based health and environmental studies

    EPA Science Inventory

    BACKGROUND: Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based heath indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mort...

  11. Factors associated with self-reported health: implications for screening level community-based health and environmental studies

    EPA Science Inventory

    BACKGROUND: Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based heath indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mort...

  12. Systematic review of epidemiological studies on health effects associated with management of solid waste

    PubMed Central

    2009-01-01

    Background Management of solid waste (mainly landfills and incineration) releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Our aim was to systematically review the available epidemiological literature on the health effects in the vicinity of landfills and incinerators and among workers at waste processing plants to derive usable excess risk estimates for health impact assessment. Methods We examined the published, peer-reviewed literature addressing health effects of waste management between 1983 and 2008. For each paper, we examined the study design and assessed potential biases in the effect estimates. We evaluated the overall evidence and graded the associated uncertainties. Results In most cases the overall evidence was inadequate to establish a relationship between a specific waste process and health effects; the evidence from occupational studies was not sufficient to make an overall assessment. For community studies, at least for some processes, there was limited evidence of a causal relationship and a few studies were selected for a quantitative evaluation. In particular, for populations living within two kilometres of landfills there was limited evidence of congenital anomalies and low birth weight with excess risk of 2 percent and 6 percent, respectively. The excess risk tended to be higher when sites dealing with toxic wastes were considered. For populations living within three kilometres of old incinerators, there was limited evidence of an increased risk of cancer, with an estimated excess risk of 3.5 percent. The confidence in the evaluation and in the estimated excess risk tended to be higher for specific cancer forms such as non

  13. Current Methods and Challenges for Epidemiological Studies of the Associations Between Chemical Constituents of Particulate Matter and Health.

    PubMed

    Krall, Jenna R; Chang, Howard H; Sarnat, Stefanie Ebelt; Peng, Roger D; Waller, Lance A

    2015-12-01

    Epidemiological studies have been critical for estimating associations between exposure to ambient particulate matter (PM) air pollution and adverse health outcomes. Because total PM mass is a temporally and spatially varying mixture of constituents with different physical and chemical properties, recent epidemiological studies have focused on PM constituents. Most studies have estimated associations between PM constituents and health using the same statistical methods as in studies of PM mass. However, these approaches may not be sufficient to address challenges specific to studies of PM constituents, namely assigning exposure, disentangling health effects, and handling measurement error. We reviewed large, population-based epidemiological studies of PM constituents and health and describe the statistical methods typically applied to address these challenges. Development of statistical methods that simultaneously address multiple challenges, for example, both disentangling health effects and handling measurement error, could improve estimation of associations between PM constituents and adverse health outcomes.

  14. An ecological study investigating the association between access to urban green space and mental health.

    PubMed

    Nutsford, D; Pearson, A L; Kingham, S

    2013-11-01

    This study aims to find whether proximity to urban green spaces is associated with human mental health. A cross-sectional examination of the relationship between access to urban green spaces and counts of anxiety/mood disorder treatments amongst residents (aged 15 years and over) in Auckland City, New Zealand. Anxiety/mood disorder treatment counts by three age groups were aggregated to 3149 small area units in Auckland. Six measures of green space access were derived using GIS techniques involving total green spaces and useable green spaces. Negative binomial regression models have been fitted to test the relationship between access to green space and area-level anxiety/mood disorder treatment counts, adjusted for age and area-level deprivation. Anxiety/mood disorder treatment counts were associated with three green space measures. The proportion of both total and useable green space within 3 km and distance to nearest useable green space all indicated a protective effect of increased access to green space against anxiety/mood disorder treatment counts. Access to total and useable green space within 300 m did not exhibit significant associations. This study found that decreased distance to useable green space and increased proportion of green space within the larger neighbourhood were associated with decreased anxiety/mood disorder treatment counts in an urban environment. This suggests the benefits of green space on mental health may relate both to active participation in useable green spaces near to the home and observable green space in the neighbourhood environment. © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Maternal late pregnancy anxiety and stress is associated with children's health: a longitudinal study.

    PubMed

    Zijlmans, Maartje A C; Beijers, Roseriet; Riksen-Walraven, Marianne J; de Weerth, Carolina

    2017-07-09

    Maternal prenatal anxiety and stress (PNS) have been positively associated to physical health prob lems in offspring in the first year of life. Whether these associations are transient, persistent, or even progressive over time, is as yet unknown. The goal of this study is to investigate associations between late pregnancy PNS and child health from 18 months to age 6. Mothers were recruited in late pregnancy, and had uncomplicated, singleton pregnancies without physical health problems. Around week 37 of pregnancy, mothers reported on their PNS by means of questionnaires, and provided saliva for determination of circadian cortisol concentrations. Children's illnesses in the preceding year were assessed using maternal reports at 30, 48, 60, and 72 months. Antibiotic use was obtained from medical records between one and six years. Multilevel models (N¼174) showed a positive relation between maternal prenatal general and pregnancy-specific anxiety during late pregnancy and offspring respiratory illnesses and symptoms. Interaction effects with time indicated that more PNS was related to more respiratory illnesses until toddlerhood, but not later in life. Furthermore, maternal prenatal cortisol concentrations were related to child digestive illnesses. A steeper maternal cortisol decline over the day was related to more child digestive illnesses, until around three years of age. Finally, children of mothers who suffered more from daily hassles during pregnancy received more antibiotics between one and six years of age. PNS was not related to general and skin illnesses. Summarizing, this study showed that late pregnancy anxiety and cortisol was associated with children's respiratory and digestive illnesses till the age of 3.0-3.5 years. Additionally, more daily hassles were related to more prescribed antibiotics between one and six years. These findings point in the direction of possible effects of PNS persisting beyond the first year of life and into toddlerhood, but

  16. National Breakthrough Pain Study: prevalence, characteristics, and associations with health outcomes.

    PubMed

    Narayana, Arvind; Katz, Nathaniel; Shillington, Alicia C; Stephenson, Judith J; Harshaw, Qing; Frye, Carla B; Portenoy, Russell K

    2015-02-01

    The National Breakthrough Pain Study is a large observational study that assessed breakthrough pain (BTP) in a population of commercially insured community-dwelling patients with opioid-treated chronic pain. Eligible patients were identified from an administrative claims database, and consenting patients were asked to complete a structured telephone interview and several validated questionnaires. Questionnaires assessed pain interference with function (Brief Pain Inventory-Short Form), health status (Short Form 12 [SF-12] Health Survey), disability (Sheehan Disability Scale), work performance (World Health Organization Health and Work Performance Questionnaire), and mood (Generalized Anxiety Disorder-7 Screener [GAD-7] and Patient Health Questionnaire-2 [PHQ-2]). Of 2198 patients interviewed, 1278 patients had persistent pain controlled with opioid therapy; 1023 (80%) of these patients reported BTP. Patients had a median of 2.0 episodes of BTP per day (range, 1-50) and a median duration of BTP of 45 minutes (range, 1-720). Compared with patients without BTP, patients with BTP had more pain-related interference in function (Brief Pain Inventory, mean ± SD: 34.2 ± 15.6 vs 25.0 ± 15.7 [P < 0.001]), worse physical health (SF-12 physical component score: 29.9 ± 9.6 vs 35.1 ± 10.4 [P < 0.001]) and mental health (SF-12 mental component score: 47.4 ± 11.3 vs 49.3 ± 10.4 [P < 0.001]), more disability (Sheehan Disability Scale global impairment score: 15.1 ± 9.1 vs 10.6 ± 8.5; World Health Organization Health and Work Performance Questionnaire absolute absenteeism: 12.4 ± 59.9 vs 7.7 ± 44.9 hours [both P < 0.001]), and worse mood (GAD-7 score: 7.4 ± 5.9 vs 5.9 ± 5.4; PHQ-2 anhedonia score: 1.2 ± 1.1 vs 0.9 ± 1.0 [both P < 0.001]). In this population of community-dwelling patients with opioid-treated chronic pain, BTP was highly prevalent and associated with negative outcomes. This burden of illness suggests the need for specific treatment plans.

  17. The Oslo health study: cheese intake was negatively associated with the metabolic syndrome.

    PubMed

    Høstmark, Arne T; Tomten, Sissel E

    2011-06-01

    We previously reported that the frequency of cheese intake (FCI) was negatively associated with serum triglycerides and positively associated with high-density lipoprotein cholesterol (HDL), both components of the metabolic syndrome (MetS). We therefore wanted to study whether FCI is associated with MetS. The Oslo Health Study (18,770 subjects), obtained data from 7815 men and 9685 women on cheese intake and risk factors for MetS, except for fasting glucose. MetS requires central obesity and at least 2 of the following: increased triglycerides, low HDL cholesterol, increased systolic or diastolic blood pressure, and elevated fasting blood glucose. We calculated the index SumRisk, providing the number of MetS factors present, and MetSRisk to reflect the combined levels of many MetS factors. The association between FCI and MetSRisk (SumRisk) was studied using regression analyses. In young (30 years), middle-aged (40 and 45 years), seniors (59-60), and old (75-76 years) subjects, there was an inverse association between FCI and MetSRisk (p ≤ 0.005, except in old men). Using regression, we found a consistent negative association (p < 0.001) between FCI and MetSRisk, SumRisk, single MetS components, and the complete MetS, prevailing after controlling for sex, age, time since last meal, intake of fruit/berries, fruit juice, fatty fish, coffee, alcohol, smoking, leisure time physical activity, years at school, and birthplace. FCI was also negatively associated with body mass index (p < 0.02), except in old women. Cheese intake can be negatively and independently associated with (1) an index including the level of many risk factors for MetS, (2) the number of MetS requirements present, (3) single MetS components, and (4) the complete MetS.

  18. Uncertainties Associated with Quantifying Climate Change Impacts on Human Health: A Case Study for Diarrhea

    PubMed Central

    Kolstad, Erik W.; Johansson, Kjell Arne

    2011-01-01

    Background Climate change is expected to have large impacts on health at low latitudes where droughts and malnutrition, diarrhea, and malaria are projected to increase. Objectives The main objective of this study was to indicate a method to assess a range of plausible health impacts of climate change while handling uncertainties in a unambiguous manner. We illustrate this method by quantifying the impacts of projected regional warming on diarrhea in this century. Methods We combined a range of linear regression coefficients to compute projections of future climate change-induced increases in diarrhea using the results from five empirical studies and a 19-member climate model ensemble for which future greenhouse gas emissions were prescribed. Six geographical regions were analyzed. Results The model ensemble projected temperature increases of up to 4°C over land in the tropics and subtropics by the end of this century. The associated mean projected increases of relative risk of diarrhea in the six study regions were 8–11% (with SDs of 3–5%) by 2010–2039 and 22–29% (SDs of 9–12%) by 2070–2099. Conclusions Even our most conservative estimates indicate substantial impacts from climate change on the incidence of diarrhea. Nevertheless, our main conclusion is that large uncertainties are associated with future projections of diarrhea and climate change. We believe that these uncertainties can be attributed primarily to the sparsity of empirical climate–health data. Our results therefore highlight the need for empirical data in the cross section between climate and human health. PMID:20929684

  19. Factors associated with student learning processes in primary health care units: a questionnaire study.

    PubMed

    Bos, Elisabeth; Alinaghizadeh, Hassan; Saarikoski, Mikko; Kaila, Päivi

    2015-01-01

    Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models. The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units. The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above. The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction. These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Association of Serum Erythropoietin with Cardiovascular Events, Kidney Function Decline and Mortality: The Health ABC Study

    PubMed Central

    Garimella, Pranav S.; Katz, Ronit; Patel, Kushang V.; Kritchevsky, Stephen B.; Parikh, Chirag R.; Ix, Joachim H.; Fried, Linda F.; Newman, Anne B.; Shlipak, Michael G.; Harris, Tamara B.; Sarnak, Mark J.

    2015-01-01

    Background Studies suggest that in patients with heart failure (HF), high serum erythropoietin is associated with risk of recurrent HF and mortality. Trials of erythropoietin stimulating agents in persons with kidney disease have also suggested an increased incidence of adverse clinical events. No studies have evaluated the association of endogenous erythropoietin levels with clinical outcomes in the community living older adults. Methods and Results Erythropoietin concentration was measured in 2,488 participants aged 70–79 years in the Health, Aging and Body Composition Study. Associations of erythropoietin with incident HF, coronary heart disease (CHD), stroke, mortality, and ≥30% decline in estimated glomerular filtration rate (eGFR) were examined using Cox proportional hazards and logistic regression over 10.7 years of follow up. Mean (SD) age was 75 (3) years and median (quartile 1, quartile 3) erythropoietin was 12.3 (9.0, 17.2) mIU/mL. There were 503 incident HF events and each doubling of serum erythropoietin was associated with a 25% increased risk of incident HF 1.25 (95% CI 1.13, 1.48) after adjusting for demographics, prevalent cardiovascular disease (CVD), CVD risk factors, kidney function and serum hemoglobin. There was no interaction of serum erythropoietin with chronic kidney disease or anemia (p>0.50). There were 330 incident CHD events, 161 strokes, 1,112 deaths and 698 outcomes of ≥ 30% decline in eGFR. Serum erythropoietin was not significantly associated with these outcomes. Conclusions Higher levels of endogenous erythropoietin are associated with incident HF in older adults. Studies need to elucidate the mechanisms through which endogenous erythropoietin levels associate with specific outcomes. PMID:26721912

  1. Factors associated with job satisfaction among Chinese community health workers: a cross-sectional study

    PubMed Central

    2011-01-01

    Background With the medical reform, the function of community health centres emerged to be more important recently in China. However, the health service capabilities were tremendously different between metropolitan cities and small cities. This study aims to clarify the level of job satisfaction of Chinese community health workers between a metropolitan (Shenyang) and a small city (Benxi) in Liaoning province and explore its associated factors. Methods A cross-sectional survey was conducted from December 2009 to February 2010. A multi-stage sample was used and a total of 2,100 Chinese community health workers from the two cities completed self-administered questionnaire pertaining to job satisfaction indicated by Minnesota Satisfaction Questionnaire (MSQ), demographic characteristic and working situations, stress and job burnout. The effective response rate was 80.7%. Hierarchical regression analysis was performed to explore the related factors. All data analyses for the two cities were performed separately. Results The averages of overall job satisfaction score of Chinese community health workers were 67.17 in Shenyang and 69.95 in Benxi. Intrinsic job satisfaction and extrinsic job satisfaction among Chinese community health workers were significantly different between Shenyang and Benxi (p < 0.05). In Shenyang, hierarchical regression analysis showed that the fourth model explained 36%, 32% of the variance of intrinsic and extrinsic job satisfactions, respectively. In Benxi, the fourth model explained 48%, 52% of the variance of intrinsic and extrinsic job satisfactions, respectively. Three significant predictors of intrinsic and extrinsic job satisfactions for the two cities were the two dimensions (social support and decision latitude) of stress and cynicism of burnout. Conclusion From this study, the job satisfaction among Chinese community health workers in the two cities enjoyed a moderate level of job satisfactions, which represented they are not fully

  2. Rheumatoid Arthritis in Agricultural Health Study Spouses: Associations with Pesticides and Other Farm Exposures.

    PubMed

    Parks, Christine G; Hoppin, Jane A; De Roos, Anneclaire J; Costenbader, Karen H; Alavanja, Michael C; Sandler, Dale P

    2016-11-01

    Farming has been associated with rheumatoid arthritis (RA), but the role of pesticides is not known. We examined associations between RA and pesticides or other agricultural exposures among female spouses of licensed pesticide applicators in the Agricultural Health Study. Women were enrolled between 1993 and 1997 and followed through 2010. Cases (n = 275 total, 132 incident), confirmed by a physician or by self-reported use of disease modifying antirheumatic drugs, were compared with noncases (n = 24,018). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models adjusted for age, state, and smoking pack-years. Overall, women with RA were somewhat more likely to have reported lifetime use of any specific pesticide versus no pesticides (OR = 1.4; 95% CI: 1.0, 1.6). Of the 15 pesticides examined, maneb/mancozeb (OR = 3.3; 95% CI: 1.5, 7.1) and glyphosate (OR = 1.4; 95% CI: 1.0, 2.1) were associated with incident RA compared with no pesticide use. An elevated, but non-statistically significant association with incident RA was seen for DDT (OR = 1.9; 95% CI: 0.97, 3.6). Incident RA was also associated with the application of chemical fertilizers (OR = 1.7; 95% CI: 1.1, 2.7) and cleaning with solvents (OR = 1.6; 95% CI: 1.1, 2.4), but inversely associated with lifetime livestock exposure as a child and adult (OR = 0.48; 95% CI: 0.24, 0.97) compared with no livestock exposure. Our results suggest that specific agricultural pesticides, solvents, and chemical fertilizers may increase the risk of RA in women, while exposures involving animal contact may be protective. Citation: Parks CG, Hoppin JA, De Roos AJ, Costenbader KH, Alavanja MC, Sandler DP. 2016. Rheumatoid arthritis in Agricultural Health Study spouses: associations with pesticides and other farm exposures. Environ Health Perspect 124:1728-1734; http://dx.doi.org/10.1289/EHP129.

  3. Rheumatoid Arthritis in Agricultural Health Study Spouses: Associations with Pesticides and Other Farm Exposures

    PubMed Central

    Parks, Christine G.; Hoppin, Jane A.; De Roos, Anneclaire J.; Costenbader, Karen H.; Alavanja, Michael C.; Sandler, Dale P.

    2016-01-01

    Background: Farming has been associated with rheumatoid arthritis (RA), but the role of pesticides is not known. Objectives: We examined associations between RA and pesticides or other agricultural exposures among female spouses of licensed pesticide applicators in the Agricultural Health Study. Methods: Women were enrolled between 1993 and 1997 and followed through 2010. Cases (n = 275 total, 132 incident), confirmed by a physician or by self-reported use of disease modifying antirheumatic drugs, were compared with noncases (n = 24,018). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models adjusted for age, state, and smoking pack-years. Results: Overall, women with RA were somewhat more likely to have reported lifetime use of any specific pesticide versus no pesticides (OR = 1.4; 95% CI: 1.0, 1.6). Of the 15 pesticides examined, maneb/mancozeb (OR = 3.3; 95% CI: 1.5, 7.1) and glyphosate (OR = 1.4; 95% CI: 1.0, 2.1) were associated with incident RA compared with no pesticide use. An elevated, but non-statistically significant association with incident RA was seen for DDT (OR = 1.9; 95% CI: 0.97, 3.6). Incident RA was also associated with the application of chemical fertilizers (OR = 1.7; 95% CI: 1.1, 2.7) and cleaning with solvents (OR = 1.6; 95% CI: 1.1, 2.4), but inversely associated with lifetime livestock exposure as a child and adult (OR = 0.48; 95% CI: 0.24, 0.97) compared with no livestock exposure. Conclusions: Our results suggest that specific agricultural pesticides, solvents, and chemical fertilizers may increase the risk of RA in women, while exposures involving animal contact may be protective. Citation: Parks CG, Hoppin JA, De Roos AJ, Costenbader KH, Alavanja MC, Sandler DP. 2016. Rheumatoid arthritis in Agricultural Health Study spouses: associations with pesticides and other farm exposures. Environ Health Perspect 124:1728–1734; http://dx.doi.org/10.1289/EHP129 PMID:27285288

  4. Studies on nurse staffing and health care-associated infection: methodologic challenges and potential solutions.

    PubMed

    Shang, Jingjing; Stone, Patricia; Larson, Elaine

    2015-06-01

    Researchers have been studying hospital nurse staffing in relation to health care-associated infections (HAIs) for >2 decades, and the results have been mixed. We summarized published research examining these issues, critically analyzed the commonly used approaches, identified methodologic challenges, proposed potential solutions, and suggested the possible benefits of applying an electronic health record (EHR) system. A scoping review was conducted using MEDLINE and CINAHL from 1990 onward. Original research studies examining relationships between nurse staffing and HAIs in the hospital setting and published in peer-reviewed English-language journals were selected. A total of 125 articles and abstracts were identified, and 45 met inclusion criteria. Findings from these studies were mixed. The methodologic challenges identified included database selection, variable measurement, methods to link the nurse staffing and HAI data, and temporality. Administrative staffing data were often not precise or specific. The most common method to link staffing and HAI data did not assess the temporal relationship. We proposed using daily staffing information 2-4 days prior to HAI onset linked to individual patient HAI data. To assess the relationships between nurse staffing and HAIs, methodologic decisions are necessary based on what data are available and feasible to obtain. National efforts to promote an EHR may offer solutions for future studies by providing more comprehensive data on HAIs and nurse staffing. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Country specific associations between social contact and mental health: evidence from civil servant studies across Great Britain, Japan and Finland.

    PubMed

    Cable, N; Chandola, T; Lallukka, T; Sekine, M; Lahelma, E; Tatsuse, T; Marmot, M G

    2016-08-01

    Little is known about which component, such as social contact of social networks is associated with mental health or whether such an association can be observed across countries. This study examined whether the association between frequent social contact and mental health differs by composition (relatives or friends) and whether the associations are similar across three occupational cohorts from Great Britain, Japan, and Finland. Cross-sectional analysis of data from three prospective cohort studies. Participants were civil servants of a prospective cohort study based in London (Men: n = 4519; Women: n = 1756), in the West Coast of Japan (Men: n = 2571; Women: n = 1102), and in Helsinki, Finland (Men: n = 1181; Women: n = 5633); we included the information on study variables which is complete. Mental health function was the study outcome, indicated by the total score from the Mental Health Component on the Short Form Health Survey36. Participants reported frequencies of contacts with their relatives or friends via a questionnaire. Age, marital status, and occupational position were treated as confounders in this study. Findings from multiple regression showed that the associations between social contact and mental health function were different depending on country of origin and gender. Among British or Japanese men, frequent contact with both friends and relatives was positively associated with their mental health function, while only social contact with friends was significantly associated with mental health of Finnish men. In women, the patterns of the associations between social contact and mental health were more distinctive: friends for Great Britain, relatives for Japan, and friends and relatives for Finland. These significant associations were independent of the confounders. Social contact was related to mental health of working people; however, culture and gender are likely to be tapped into. Copyright © 2015 The Royal Society for Public

  6. The real world cost and health resource utilization associated to manic episodes: The MANACOR study.

    PubMed

    Hidalgo-Mazzei, Diego; Undurraga, Juan; Reinares, María; Bonnín, Caterina del Mar; Sáez, Cristina; Mur, María; Nieto, Evaristo; Vieta, Eduard

    2015-01-01

    Bipolar disorder is a relapsing-remitting condition affecting approximately 1-2% of the population. Even when the treatments available are effective, relapses are still very frequent. Therefore, the burden and cost associated to every new episode of the disorder have relevant implications in public health. The main objective of this study was to estimate the associated health resource consumption and direct costs of manic episodes in a real world clinical setting, taking into consideration clinical variables. Bipolar I disorder patients who recently presented an acute manic episode based on DSM-IV criteria were consecutively included. Sociodemographic variables were retrospectively collected and during the 6 following months clinical variables were prospectively assessed (YMRS,HDRS-17,FAST and CGI-BP-M). The health resource consumption and associate cost were estimated based on hospitalization days, pharmacological treatment, emergency department and outpatient consultations. One hundred sixty-nine patients patients from 4 different university hospitals in Catalonia (Spain) were included. The mean direct cost of the manic episodes was €4,771. The 77% (€3,651) was attributable to hospitalization costs while 14% (€684) was related to pharmacological treatment, 8% (€386) to outpatient visits and only 1% (€50) to emergency room visits. The hospitalization days were the main cost driver. An initial FAST score>41 significantly predicted a higher direct cost. Our results show the high cost and burden associated with BD and the need to design more cost-efficient strategies in the prevention and management of manic relapses in order to avoid hospital admissions. Poor baseline functioning predicted high costs, indicating the importance of functional assessment in bipolar disorder. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  7. Association of a Controlled Substance Scoring Algorithm with Health Care Costs and Hospitalizations: A Cohort Study.

    PubMed

    Starner, Catherine I; Qiu, Yang; Karaca-Mandic, Pinar; Gleason, Patrick P

    2016-12-01

    Patients often misuse a combination of prescription drugs including opioids; however, the relationship between a controlled substance (CS) score and health outcomes is unknown. To examine the association between a CS scoring algorithm and health care use, specifically total cost of care, hospitalizations, and emergency room (ER) visits. This analysis was a retrospective cohort study using administrative claims data from a large U.S. health insurer. Included in the analysis were 999,852 members with a minimum CS score of 2.5 in the fourth quarter (4Q) of 2012, who were continuously enrolled from January 1, 2012, to December 31, 2013, and who were aged 18 years or older. A CS score was calculated using 4Q 2012 (3 months) prescription claims data and divided into 3 components: (1) number of CS claims, (2) number of unique pharmacies and unique prescribers, and (3) evidence of increasing CS use. The primary outcomes were total cost of care (pharmacy and medical costs), all-cause hospitalizations, and ER visits in 2013. We also quantified what a 1-point change in CS score meant for the primary outcomes. 47% of members had a CS score of 2.5, indicating a single CS claim, and 51% of members had a score between 3 and less than 12. The remaining 2% (20,858 members) had a score of 12 or more. There was a statistically significant and consistently increasing association between the 4Q 2012 CS score and hospitalizations, ER visits, and total costs of care in 2013. A 1-point change in CS score was associated with a $1,488 change in total cost of care, 0.9% change in the hospitalization rate, and 1.5% change in the ER visit rate. There is a linear association between increasing CS score and negative health outcomes. Insurers should consider interventions to lower member CS scores. This study was funded internally by Prime Therapeutics. Starner, Qiu, and Gleason are employees of Prime Therapeutics, a pharmacy benefits management company. Karaca-Mandic is an employee of the

  8. The Association between Residence Floor Level and Cardiovascular Disease: The Health and Environment in Oslo Study

    PubMed Central

    2016-01-01

    Background. Increasingly more people live in tall buildings and on higher floor levels. Factors relating to floor level may protect against or cause cardiovascular disease (CVD). Only one previous study has investigated the association between floor level and CVD. Methods. We studied associations between floor of bedroom and self-reported history of stroke, venous thromboembolism (VTE), and intermittent claudication (IC) among 12.525 inhabitants in Oslo, Norway. We fitted multivariate logistic regression models and adjusted for sociodemographic variables, socioeconomic status (SES), and health behaviors. Additionally, we investigated block apartment residents (N = 5.374) separately. Results. Trend analyses showed that disease prevalence increased by floor level, for all three outcomes. When we investigated block apartment residents alone, the trends disappeared, but one association remained: higher odds of VTE history on 6th floor or higher, compared to basement and 1st floor (OR: 1.504; 95% CI: 1.007–2.247). Conclusion. Floor level is positively associated with CVD, in Oslo. The best-supported explanation may be residual confounding by building height and SES. Another explanation, about the impact of atmospheric electricity, is also presented. The results underline a need to better understand the associations between residence floor level and CVD and multistory housing and CVD. PMID:28053608

  9. Association Between Availability and Quality of Health Services in Schools and Reproductive Health Outcomes Among Students: A Multilevel Observational Study

    PubMed Central

    Robinson, Elizabeth; Lawler, Catriona; Bagshaw, Sue; Farrant, Bridget; Bell, Fionna; Dawson, Dianne; Nicholson, Diana; Hart, Mo; Fleming, Theresa; Ameratunga, Shanthi; Clark, Terryann; Kekus, Maria; Utter, Jennifer

    2012-01-01

    Objectives. We determined the association between availability and quality of school health services and reproductive health outcomes among sexually active students. Methods. We used a 2-stage random sampling cluster design to collect nationally representative data from 9107 students from 96 New Zealand high schools. Students self-reported whether they were sexually active, how often they used condoms or contraception, and their involvement in pregnancy. School administrators completed questionnaires on their school-based health services, including doctor and nursing hours per week, team-based services, and health screening. We conducted analyses using multilevel models controlling for individual variables, with schools treated as random effects. Results. There was an inverse association between hours of nursing and doctor time and pregnancy involvement among sexually active students, with fewer pregnancies among students in schools with more than 10 hours of nursing and doctor time per 100 students. There was no association between doctor visits, team-based services, health screening, and reproductive health outcomes. Conclusions. School health services are associated with fewer pregnancies among students, but only when the availability of doctor and nursing time exceeds 10 hours per 100 students per week. PMID:22897539

  10. The Gutenberg health study: associations between occupational and private stress factors and work-privacy conflict.

    PubMed

    Garthus-Niegel, Susan; Hegewald, Janice; Seidler, Andreas; Nübling, Matthias; Espinola-Klein, Christine; Liebers, Falk; Wild, Philipp S; Latza, Ute; Letzel, Stephan

    2016-02-29

    Work-privacy conflict (WPC) is no longer a rarity but constitutes a societal problem. The objectives of the present study were (1) to investigate the distribution and prevalence of WPC among the employed participants in the Gutenberg Health Study at baseline and (2) to study the dependence of WPC on a broad range of private life and occupational characteristics as well as on psychosocial working conditions. This analysis is based on a representative, population-based sample of 3,709 employees participating in the Gutenberg Health Study. Descriptive and bivariable analyses were carried out separately for women and men. Distribution and prevalence of WPC were examined according to socio-demographic and occupational characteristics as well as psychosocial working conditions. Further, stepwise selection of Poisson log-linear regression models were performed to determine which socio-demographic and occupational characteristics were most associated with the outcome variable WPC and to obtain adjusted prevalence ratios from the final model. The multivariable analyses were conducted both separately for women and men and with all subjects together in one analysis. There was a high prevalence of WPC in the present study (27.4 % of the men and 23.0 % of the women reported a high or very high WPC). A variety of factors was associated with WPC, e.g. full-time employment, depression and many of the psychosocial risk factors at work. Also, the multivariable results showed that women were of higher risk for a WPC. By affecting the individual work life, home life, and the general well-being and health, WPC may lead to detrimental effects in employees, their families, employers, and society as a whole. Therefore, the high prevalence of WPC in our sample should be of concern. Among women, the risk for suffering from WPC was even higher, most likely due to multiple burdens.

  11. Mood and its association with metabolic health in adolescents: a longitudinal study, EarlyBird 65.

    PubMed

    Jeffery, Alison N; Hyland, Michael E; Hosking, Joanne; Wilkin, Terence J

    2014-12-01

    Mood comprises two main traits - positive and negative affect, both associated with depression and anxiety. Studies in children have linked depression with obesity, but the association with metabolic health is unclear. To explore the relationship between mood and metabolic health in adolescents. We studied 208 healthy children (115 boys) enrolled in the longitudinal EarlyBird Diabetes Study, and reviewed at 7 and 16 yr. Participants completed the Positive Affect and Negative Affect Schedule - Child Form (PANAS-C) at 16yr to assess positive and negative affect, together representing mood. Measures at 7 and 16 yr: body mass index (BMI), fat (%; dual energy X-ray absorptiometry), physical activity (accelerometer), metabolic risk z-score comprising homeostasis model assessment-insulin resistance (HOMA-IR), triglycerides, total cholesterol/high density lipoprotein (HDL) ratio and blood pressure. Pubertal development was determined by age at peak height velocity. Positive affect was higher in boys than girls, (50 vs. 46, p = 0.001), negative affect higher in girls than boys (26 vs. 22, p < 0.001). Those with lower mood were fatter (r = -0.24, p < 0.001), had higher HOMA-IR (r = -0.12, p = 0.05), higher cholesterol:HDL ratio (r = -0.14, p = 0.02), were less active (r = 0.20, p = 0.003) and had earlier pubertal development (r = 0.19, p = 0.004). Inverse associations between mood and metabolic risk z-score and change in metabolic risk z-score 7-16yr (β = -0.26, p = 0.006, and -0.40, p = 0.004, respectively) were independent of adiposity, physical activity and puberty and sex. Low mood in healthy children is associated with poorer metabolic health independently of adiposity. These findings may have implications for the physical and mental health of contemporary youngsters, given their increasing obesity and cardiometabolic risk. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants.

    PubMed

    Heckman, Carolyn J; Kloss, Jacqueline D; Feskanich, Diane; Culnan, Elizabeth; Schernhammer, Eva S

    2017-03-01

    Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (eg, sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables. The current study used data from 74 323 Nurses' Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted HRs and 95% CIs for skin cancers across categories of shift work and sleep duration. Over 10 years of follow-up, 4308 basal cell carcinoma (BCC), 334 squamous cell carcinoma (SCC) and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI 0.90 to 0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI 0.86 to 1.21) or SCC (HR=0.92, 95% CI 0.80 to 1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI 0.46 to 0.98) and BCC (HR=0.93, 95% CI 0.86 to 1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI 0.83 to 1.06). Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Use of health resources and healthcare costs associated with nutritional risk: The FRADEA study.

    PubMed

    Martínez-Reig, Marta; Aranda-Reneo, Isaac; Peña-Longobardo, Luz M; Oliva-Moreno, Juan; Barcons-Vilardell, Núria; Hoogendijk, Emiel O; Abizanda, Pedro

    2017-05-27

    In spite of its high prevalence and its clinical relevance, the economic impact of malnutrition has not been sufficiently explored. To study whether malnutrition predicts total hospital healthcare costs and costs related to specialist visits, emergency department visits and hospitalization in older adults. Concurrent cohort study in Albacete City, Spain. The study sample included 827 subjects aged 70 and over from the FRADEA Study. Mini Nutritional Assessment(®)-Short Form (MNA(®)-SF) was recorded at baseline. Use of hospital resources (hospital admissions, emergency visits, and specialist visits), and hospital healthcare costs were recorded at follow-up. Generalized linear models (GLM) adjusted for age, sex, comorbidity, polypharmacy, and disability in basic activities of daily living were used to estimate the impact of nutritional factors on total healthcare costs per person/year (€ base year 2013) as well as specialist visit costs, emergency department visit costs and hospitalization costs. The average cost associated with the use of health resources was 1922€/year. Subjects with MNA(®)-SF between 0 and 7 had an average total health cost of 3492€/year, 2744€/year in those with MNA(®)-SF between 8 and 11, and 1542€/year in those with MNA(®)-SF between 12 and 14. Of the total health cost, 67.2% was associated with hospital admission costs. Adjusted healthcare costs were 714€/year greater in subjects with malnutrition or nutritional risk. Subjects with malnutrition or nutritional risk presented an increased adjusted risk of hospitalization (OR1.72, 95% CI 1.22-2.43). Malnutrition assessed by MNA(®)-SF is a prognostic factor of high healthcare cost and use of resources in older adults. Copyright © 2017. Published by Elsevier Ltd.

  14. Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi.

    PubMed

    Mazalale, Jacob; Kambala, Christabel; Brenner, Stephan; Chinkhumba, Jobiba; Lohmann, Julia; Mathanga, Don P; Robberstad, Bjarne; Muula, Adamson S; De Allegri, Manuela

    2015-05-01

    To identify factors associated with delivery outside a health facility in rural Malawi. A cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility. Of the 1812 study respondents, 9% (n = 159) reported to have delivered outside a facility. Unmarried women were significantly more likely [OR = 1.88; 95% CI (1.086-3.173)] to deliver outside a facility, while women from households with higher socio-economic status [third-quartile OR = 0.51; 95% CI (0.28-0.95) and fourth-quartile OR = 0.48; 95% CI (0.29-0.79)] and in urban areas [OR = 0.39; 95%-CI (0.23-0.67)] were significantly less likely to deliver outside a facility. Women without formal education [OR 1.43; 95% CI (0.96-2.14)] and multigravidae [OR = 1.14; 95% CI (0.98-1.73)] were more likely to deliver outside a health facility at 10% level of significance. About 9% of women deliver outside a facility. Policies to encourage facility delivery should not only focus on health systems but also be multisectoral to address women's vulnerability and inequality. Facility-based delivery can contribute to curbing the high maternal illness burden if authorities provide incentives to those not delivering at the facility without losing existing users. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  15. Associations of Pentraxin 3 with Cardiovascular Disease and All Cause Death: The Cardiovascular Health Study

    PubMed Central

    Jenny, Nancy Swords; Arnold, Alice M.; Kuller, Lewis H.; Tracy, Russell P.; Psaty, Bruce M.

    2009-01-01

    Objective We examined associations of pentraxin 3 (PTX3), a vascular inflammation marker, with incident cardiovascular disease (CVD) and all cause death. Methods and Results 1,583 Cardiovascular Health Study participants free of prevalent CVD were included. Non-exclusive case groups were angina (n=476), myocardial infarction (MI; n=237), stroke (n=310), CVD death (n=282) and all cause death (n=772). 535 participants had no events. PTX3 levels were higher in those with subclinical CVD (1.90 ± 1.89 ng/ml) than those without (1.71 ± 1.88 ng/ml; p=0.001). Using Cox regression adjusted for age, sex and ethnicity, a standard deviation increase in PTX3 (1.89 ng/ml) was associated with CVD death (hazard ratio 1.11; 95% confidence interval 1.02–1.21) and all cause death (1.08; 1.02–1.15). PTX3 was not associated with angina (1.09; 0.98–1.20), MI (0.96; 0.81–1.12) or stroke (1.06; 0.95–1.18). Adding C-reactive protein (CRP) or CVD risk factors to the models had no significant effects on associations. Conclusions In these older adults, PTX3 was associated with CVD and all cause death independent of CRP and CVD risk factors. PTX3 likely reflects different aspects of inflammation than CRP and may provide insight into vascular health in aging and chronic diseases of aging that lead to death. PMID:19164811

  16. Emerging health risks associated with modern agriculture practices: a comprehensive study in India.

    PubMed

    Sarkar, Atanu; Aronson, Kristan J; Patil, Shantagouda; Hugar, Lingappa B; vanLoon, Gary W

    2012-05-01

    In order to enhance food production, India has adopted modern agriculture practices and achieved noteworthy success. This achievement was essentially the result of a paradigm shift in agriculture that included high inputs of agrochemicals, water, and widespread practice of monoculture, as well as bureaucratic changes that promoted these changes. There are very few comprehensive analyses of potential adverse health outcomes that may be related to these changes. The objective of this study is to identify health risks associated with modern agricultural practices in the southern Indian state of Karnataka. This study aims to compare high-input and low-input agricultural practices and the consequences for health of people in these communities. The fieldwork was conducted from May to August, 2009 and included a survey carried out in six villages. Data were collected by in-depth personal interviews among 240 households and key informants, field observations, laboratory analyses, and data from secondary sources. The study identified four major visible impacts: occupational hazards, vector borne diseases, changing nutritional status, and inequity in development. In the high-input area, mechanization has resulted in more occurrences of serious accidents and injuries. Ecological changes due to rice cultivation in this area have further augmented mosquito breeding, and there has been a surge in the incidence of Japanese encephalitis and malaria. The traditional coarse cereals (complex carbohydrates, high protein) have been replaced by mill-polished rice (simple carbohydrate, low protein). The prevalence of overweight (BMI>25) has emerged as a new public health challenge, and this is most evident in large-landholding households, especially in the high-input agriculture areas. In all agro-ecological areas, it was observed that women faced a greater risk of both extremes of under-nutrition and being overweight. Output-driven and market-oriented modern agricultural practices have

  17. The Association of Health Literacy With Preventable Emergency Department Visits: A Cross-sectional Study.

    PubMed

    Balakrishnan, Meenakshi P; Herndon, Jill Boylston; Zhang, Jingnan; Payton, Thomas; Shuster, Jonathan; Carden, Donna L

    2017-09-01

    Policymakers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor, and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. The objective was to determine the association of health literacy with preventable ED visits. We conducted an observational cross-sectional study of potentially preventable ED visits (outcome) among adults (≥18 years old) in an ED serving an urban community. We assessed health literacy (predictor) through structured interviews with the Rapid Estimate of Adult Literacy in Medicine (REALM). We recorded age, sex, race, employment, payer, marital and health status, and number of comorbidities through structured interviews or electronic record review. We identified potentially preventable ED visits in the 2 years before the index ED visit by applying Agency for Healthcare Research and Quality technical specifications to identify ambulatory care sensitive conditions using ED discharge diagnoses in hospital administrative data. We used Poisson regression to evaluate the number of preventable ED visits among patients with limited (REALM < 61) versus adequate (REALM ≥ 61) health literacy after adjusting for covariates. Of 1,201 participants, 709 (59%) were female, 370 (31%) were African American, mean age was 41.6 years, and 394 (33%) had limited health literacy. Of 4,444 total ED visits, 423 (9.5%) were potentially preventable. Of these, 260 (61%) resulted in hospital admission and 163 (39%) were treat and release. After covariates were adjusted for, patients with limited literacy had 2.3 (95% confidence interval [CI] = 1.7-3.1) times the number of potentially preventable ED visits resulting in hospital admission compared to

  18. The association between mental health, chronic disease and sleep duration in Koreans: a cross-sectional study.

    PubMed

    Lee, Min-Su; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-riong; Park, Ki Byung; Shin, Dongjin; Cho, Jae-Heung; Ha, In-Hyuk

    2015-12-01

    Sleep duration holds considerable importance as an indicator of mental/physical health. The objective of this study was to investigate the association between sleep duration, mental health, and chronic disease prevalence in Koreans. Of 31,596 subjects eligible for the Korean National Health and Nutrition Examination Survey V (2010-2012), 17,638 participants who answered items on sleep duration (aged ≥ 19 yrs) were analyzed in a cross-sectional study. Association between sleep duration, mental health, and chronic disease prevalence was assessed using logistic regression, and adjusted for various socioeconomic and lifestyle characteristics. Short or long sleep duration showed correlations with mental health, and items of significance showed gender-specific patterns. Women displayed significant associations with stress and depressive symptoms, and men with stress, thoughts of suicide, and psychiatric counseling. While stress was related with short sleep duration in both genders, depressive symptoms showed a relationship with long duration in men, and short duration in women. Prevalence of any chronic disease was associated with ≤ 6 h sleep when adjusted for factors including mental health, and among chronic diseases, cancer and osteoarthritis showed associations with short sleep duration, while diabetes and dyslipidemia were associated with normal sleep duration. Mental health problems were associated with sleep duration with gender-specific patterns. Associations with osteoarthritis, cancer, diabetes, dyslipidemia and abnormal sleep duration persisted after adjustment for mental health.

  19. Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study

    PubMed Central

    Mattei, Josiemer; Demissie, Serkalem; Falcon, Luis M; Ordovas, Jose M

    2010-01-01

    Puerto Ricans living in the United States mainland present multiple disparities in prevalence of chronic diseases, relative to other racial and ethnic groups. Allostatic load (AL), or the cumulative wear and tear of physiological responses to stressors such as major life events, social and environmental burden, has been proposed as a possible mechanism for the inequalities observed in minority groups, but has not been studied in Puerto Ricans. The aim of this study was to determine the association of AL to six chronic diseases (abdominal obesity, hypertension, diabetes, and self-reported cardiovascular disease (CVD), arthritis and cancer) in Puerto Ricans, and to contrast AL to metabolic syndrome (MetS). Participants of the Boston Puerto Rican Health Study (n=1,116, ages 45–75 years) underwent a home-based interview, where questionnaires were completed and biological samples collected. A summary definition of AL was constructed using clinically-defined cutoffs and medication use for 10 physiological parameters in different body systems. Logistic regression models were run to determine associations between AL score and disease status, controlling for age, sex, smoking, alcohol use, physical activity, total fat intake and energy intake. Parallel models were also run with MetS score replacing AL. We found that increasing categories of AL score were significantly associated with abdominal obesity, hypertension, diabetes and self-reported cardiovascular disease (CVD) and arthritis, but not with self-reported cancer. The strength of associations of AL with all conditions, except diabetes and cancer, was similar to or larger than those of MetS score. In conclusion, Puerto Rican older adults experienced physiological dysregulation that was associated with increased odds of chronic conditions. AL was more strongly associated with most conditions, compared to MetS, suggesting that this cumulative measure may be a better predictor of disease. These results have prospective

  20. The dietary inflammatory index is associated with colorectal cancer in the National Institutes of Health-American Association of Retired Persons Diet and Health Study.

    PubMed

    Wirth, Michael D; Shivappa, Nitin; Steck, Susan E; Hurley, Thomas G; Hébert, James R

    2015-06-14

    Diet is a strong moderator of systemic inflammation, an established risk factor for colorectal cancer (CRC). The dietary inflammatory index (DII) measures the inflammatory potential of individuals' diets. The association between the DII and incident CRC was examined, using the National Institutes of Health-American Associations of Retired Persons Diet and Health Study individuals (n 489,422) aged 50-74 years at recruitment, starting between 1995-6, and followed for a mean of 9·1 (sd 2·9) years. Baseline data from a FFQ were used to calculate the DII; higher scores are more pro-inflammatory, and lower scores are more anti-inflammatory. First, primary CRC diagnoses were identified through linkage to state cancer registries. Anatomic location and disease severity also were examined. Cox proportional hazards models estimated CRC hazard ratios (HR) and 95% CI using quartile 1 as the referent. DII quartile 4 compared to quartile 1 was associated with CRC risk among all subjects (HR 1·40, 95% CI 1·28, 1·53; P for trend < 0·01). Statistically significant associations also were observed for each anatomic site examined, for moderate and poorly differentiated tumours, and at each cancer stage among all subjects. Effects were similar when stratified by sex; however, results were statistically significant only in males. The only result reaching statistical significance in females was risk of moderately differentiated CRC tumours (DII quartile 4 v. quartile 1 HR 1·26, 95% CI 1·03, 1·56). Overall, the DII was associated with CRC risk among all subjects. The DII may serve as a novel way to evaluate dietary risk for chronic disorders associated with inflammation, such as CRC.

  1. Dietary Choline Intake Is Directly Associated with Bone Mineral Density in the Hordaland Health Study.

    PubMed

    Øyen, Jannike; Gjesdal, Clara Gram; Karlsson, Therese; Svingen, Gard Ft; Tell, Grethe S; Strand, Elin; Drevon, Christian A; Vinknes, Kathrine J; Meyer, Klaus; Ueland, Per Magne; Nygård, Ottar

    2017-04-01

    Background: Choline is an important nutrient either obtained from a variety of foods or synthesized endogenously, and it is the precursor of betaine. We previously reported positive associations between plasma free choline and bone mineral density (BMD). Animal studies suggest an impact of dietary choline on bone metabolism, but the role of dietary intake of choline and betaine for human bone health is unknown.Objectives: The main aims were to examine the associations of dietary choline, choline species, and betaine with BMD and to study the relations between dietary and plasma free choline and betaine.Methods: Study subjects were participants in the Hordaland Health Study, including 2649 women and 1983 men (aged 46-49 or 71-74 y). BMD was measured by dual-energy X-ray absorptiometry, and dietary intake was obtained by using a validated 169-item food-frequency questionnaire. Risk associations were assessed by logistic regression and correlations by ρ (Spearman's bivariate rank order correlation).Results: Subjects in the lowest compared with the highest tertile of dietary total choline, free choline, glycerophosphocholine, phosphocholine, phosphatidylcholine, and sphingomyelin had a higher risk of low-femoral neck BMD, defined as the lowest BMD quintile. Particularly strong associations were found among middle-aged men for intake of free choline (OR: 1.83; 95% CI: 1.24, 2.69; P = 0.002) and glycerophosphocholine (OR: 2.13; 95% CI: 1.43, 3.16; P < 0.001) and among elderly women for total choline (OR: 1.96; 95% CI: 1.33, 2.88; P = 0.001) and phosphatidylcholine (OR: 1.94; 95% CI: 1.33, 2.84: P = 0.001) intake. No significant associations were observed between dietary betaine and BMD. Dietary total choline, free choline, glycerophosphocholine, phosphatidylcholine, and sphingomyelin correlated weakly with plasma free choline (ρ: 0.07, 0.05, 0.07, 0.07, and 0.05, respectively; P < 0.01). Dietary betaine correlated with plasma betaine (ρ: 0.23; P < 0.001).Conclusion

  2. Food Insecurity Is Associated with Subsequent Cognitive Decline in the Boston Puerto Rican Health Study.

    PubMed

    Wong, Janice C; Scott, Tammy; Wilde, Parke; Li, Yin-Ge; Tucker, Katherine L; Gao, Xiang

    2016-09-01

    Living with hunger and fear of not having enough food is a growing worldwide concern. In our previous cross-sectional study, we found that food insecurity was associated with poor cognitive function, but the direction of this relation remains unclear. We investigated whether food insecurity is associated with subsequent cognitive decline. This was a longitudinal study of 597 participants aged 40-75 y from the Boston Puerto Rican Health Study cohort, with a Mini-Mental State Examination score of ≥24 at baseline. Food security was assessed at baseline with the US Household Food Security Scale. Participants completed cognitive batteries, which included 7 cognitive tests, twice-at baseline and again at a 2-y follow-up. The primary outcome was the change in global cognitive function over 2 y. Multiple linear regression was used to obtain adjusted mean differences and 95% CIs in cognitive decline across baseline food security status. Food insecurity at baseline was associated with a 2-y decline in global cognitive function (P-trend = 0.03) after adjusting for relevant potential confounders, including age, sex, baseline cognitive score, body mass index, education, poverty, acculturation score, depression score, smoking status, use of alcohol, physical activity score, presence of diabetes and hypertension, apolipoprotein E status, plasma homocysteine, healthy eating index, and time between baseline and follow-up measures. Compared with the food-secure group, the decline in the very low food security group was greater [mean difference: -0.26 (95% CI: -0.41, -0.10)]. Baseline food insecurity was significantly associated with a faster decline in executive function (P-trend = 0.02) but not memory function (P-trend = 0.66). Food insecurity was associated with faster cognitive decline in this cohort of Puerto Rican adults. Our study emphasizes the importance of developing interventions for food insecurity that take into account the impact of food insecurity on cognition.

  3. Association between dietary fiber and incident cases of colon polyps: the adventist health study.

    PubMed

    Tantamango, Yessenia M; Knutsen, Synnove F; Beeson, Larry; Fraser, Gary; Sabate, Joan

    2011-09-01

    Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Most cases of CRC arise in adenomatous polyps. It has been estimated that 25%-35% of colon adenoma risk could be avoidable by modification of dietary and life-style habits. We estimated the association between total dietary fiber and fiber intake from fruits, vegetables, and grains, and the risk of physician-diagnosed colon polyps among 2818 men and women who had undergone colonoscopy. Data were drawn from 2 cohort studies-the Adventist Health Study-1 (AHS-1) of 1976 and the Adventist Health Study-2 (AHS-2) conducted from 2002 to 2005. Dietary information was obtained from the self-administered questionnaire from AHS-1, while outcome was assessed from AHS-2 data. Multivariate logistic regression analysis was used to estimate the period risk of incident cases of polyps. A total of 441 incident cases of colon polyps were identified. After adjusting for age, sex, body mass index, physical activity, education, and alcohol and meat consumption, total fiber intake was inversely associated with the risk of colon polyps (odds ratio [OR] for highest vs lowest quartile = 0.71, 95% confidence interval [CI] 0.51-0.99). This association showed a dose-response effect (p = .04). Analyses of various sources of fiber showed the most clear effect of fiber from vegetables including legumes (OR for highest vs lowest quartile = 0.65; 95% CI 0.47-0.90; p = .02). In this population comprising a high proportion of vegetarians, persons who consumed low amounts of fiber, especially fiber contained in vegetables, had a higher risk of developing colon polyps.

  4. Causes of Death Associated With Prolonged TV Viewing: NIH-AARP Diet and Health Study.

    PubMed

    Keadle, Sarah K; Moore, Steven C; Sampson, Joshua N; Xiao, Qian; Albanes, Demetrius; Matthews, Charles E

    2015-12-01

    TV viewing is the most prevalent sedentary behavior and is associated with increased risk of cardiovascular disease and cancer mortality, but the association with other leading causes of death is unknown. This study examined the association between TV viewing and leading causes of death in the U.S. A prospective cohort of 221,426 individuals (57% male) aged 50-71 years who were free of chronic disease at baseline (1995-1996), 93% white, with an average BMI of 26.7 (SD=4.4) kg/m(2) were included. Participants self-reported TV viewing at baseline and were followed until death or December 31, 2011. Hazard ratios (HRs) and 95% CIs for TV viewing and cause-specific mortality were estimated using Cox proportional hazards regression. Analyses were conducted in 2014-2015. After an average follow-up of 14.1 years, adjusted mortality risk for a 2-hour/day increase in TV viewing was significantly higher for the following causes of death (HR [95% CI]): cancer (1.07 [1.03, 1.11]); heart disease (1.23 [1.17, 1.29]); chronic obstructive pulmonary disease (1.28 [1.14, 1.43]); diabetes (1.56 [1.33, 1.83]); influenza/pneumonia (1.24 [1.02, 1.50]); Parkinson disease (1.35 [1.11, 1.65]); liver disease (1.33 [1.05, 1.67]); and suicide (1.43 [1.10, 1.85]. Mortality associations persisted in stratified analyses with important potential confounders, reducing causation concerns. This study shows the breadth of mortality outcomes associated with prolonged TV viewing, and identifies novel associations for several leading causes of death. TV viewing is a prevalent discretionary behavior that may be a more important target for public health intervention than previously recognized. ClinicalTrials.gov number, NCT00340015. Published by Elsevier Inc.

  5. Association of maternal age with child health: A Japanese longitudinal study

    PubMed Central

    2017-01-01

    Average maternal age at birth has been rising steadily in Western and some Asian countries. Older maternal age has been associated with adverse pregnancy and birth outcomes; however, studies on the relationship between maternal age and young children’s health remain scarce. Therefore, we sought to investigate the association of maternal age with child health outcomes in the Japanese population. We analyzed data from two birth cohorts of the nationwide Japanese Longitudinal Survey of Babies in 21st Century (n2001 = 47,715 and n2010 = 38,554). We estimated risks of unintentional injuries and hospital admissions at 18 and 66 months according to maternal age, controlling for the following potential confounders: parental education; maternal parity, smoking status, and employment status; household income; paternal age, and sex of the child. We also included the following as potential mediators: preterm births and birthweight. We observed a decreasing trend in the risks of children’s unintentional injuries and hospital admissions at 18 months according to maternal age in both cohorts. In the 2001 cohort, compared to mothers <25 years, odds ratios of hospital admission at 18 months were 0.97 [95% CI: 0.86, 1.09], 0.92 [0.81, 1.05], 0.76 [0.65, 0.90], and 0.71 [0.51, 0.98] for mothers aged 25.0–29.9, 30.0–34.9, 35.0–39.9, and >40.0 years, respectively, controlling for confounders. Our findings were in line with previous findings from population-based studies conducted in the United Kingdom and Canada suggesting that older maternal age may be beneficial for early child health. PMID:28234951

  6. Association between dementia and midlife risk factors: the Radiation Effects Research Foundation Adult Health Study.

    PubMed

    Yamada, Michiko; Kasagi, Fumiyoshi; Sasaki, Hideo; Masunari, Naomi; Mimori, Yasuyo; Suzuki, Gen

    2003-03-01

    To investigate the association between midlife risk factors and the development of vascular dementia (VaD) or Alzheimer's disease (AD) 25 to 30 years later. A prevalence study within a longitudinal cohort study. Subjects in the Adult Health Study (a prospective cohort study begun in 1958) have been followed through biennial medical examinations in Hiroshima, Japan. One thousand seven hundred seventy-four subjects in Hiroshima, Japan born before September 1932 (1,660 with no dementia, 114 with dementia (51 with AD, and 38 with VaD) diagnosed from 1992 to 1997 according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria). The subjects were examined for effect on dementia of sex, age, education, atomic bomb radiation dose, and midlife factors associated with risk (smoking, alcohol intake, physical activity, dietary habits, systolic blood pressure (SBP), body mass index, and history of diabetes mellitus) that had been evaluated in 1965-1970. VaD prevalence increased significantly with age, higher SBP, and lower milk intake. The odds ratios of VaD for age (in 5-year increments), SBP (10 mmHg increments), and milk intake (almost daily/less than four times a week) were 1.29, 1.33, and 0.35, respectively. The risk factors for VaD were compatible with the risk factors for stroke in this study population. AD prevalence increased significantly with age and lower education. Other midlife factors and radiation dose did not show any significant association with VaD or AD. Increased SBP and low milk intake in midlife were associated with VaD detected 25 to 30 years later. Early behavioral control of the risk factors for vascular disease might reduce the risk of dementia.

  7. The association of menopause status with physical function: the Study of Women's Health Across the Nation.

    PubMed

    Tseng, Lisa A; El Khoudary, Samar R; Young, Elizabeth A; Farhat, Ghada N; Sowers, MaryFran; Sutton-Tyrrell, Kim; Newman, Anne B

    2012-11-01

    The aim of this study was to determine whether postmenopause status is associated with self-reported limitations in physical function. The Study of Women's Health Across the Nation is a multisite, multiethnic, longitudinal study of midlife women. Women aged 45 to 57 years (N = 2,566) completed the physical function scale of the Medical Outcomes Study Short-Form 36 on visit 4 (2000-2001). Scores created a three-category variable of physical function limitations: none (86-100), moderate (51-85), and substantial (0-50). In the Study of Women's Health Across the Nation, menopause status is a five-category list variable based on menstrual bleeding patterns and gynecological surgery. Premenopausal and perimenopausal women using hormones (n = 284) or missing physical function scores (n = 46) were excluded. Multinomial logistic regression was used to relate physical function and menopause status after adjustment for age, ethnicity, site, education, body mass index (BMI), and self-reported diabetes, hypertension, arthritis, depressive symptoms, smoking, and hormone use among postmenopausal women. Of 2,236 women, 8% were premenopausal, 51% were early perimenopausal, 12% were late perimenopausal, 24% were naturally postmenopausal, and 5% were surgically postmenopausal. In the full model, substantial limitations in physical function were higher in postmenopausal women, whether naturally postmenopausal (odds ratio, 3.82; 95% CI, 1.46-10.0) or surgically postmenopausal (odds ratio, 3.54; 95% CI, 1.15-10.84), than in premenopausal women. These associations were attenuated by higher BMI and depressive symptoms but remained significant. Moderate limitations in physical function were not significantly related to menopause status. Women experiencing surgical or naturally occurring postmenopause report greater limitations in physical function compared with premenopausal women, independent of age and only partly explained by higher BMI and depressive symptoms. This suggests that

  8. Association of Adiposity and Mental Health Functioning across the Lifespan: Findings from Understanding Society (The UK Household Longitudinal Study).

    PubMed

    Davillas, Apostolos; Benzeval, Michaela; Kumari, Meena

    2016-01-01

    Evidence on the adiposity-mental health associations is mixed, with studies finding positive, negative or no associations, and less is known about how these associations may vary by age. To examine the association of adiposity -body mass index (BMI), waist circumference (WC) and percentage body fat (BF%)- with mental health functioning across the adult lifespan. Data from 11,257 participants (aged 18+) of Understanding Society: the UK Household Longitudinal Study (waves 2 and 3, 5/2010-7/2013) were employed. Regressions of mental health functioning, assessed by the Mental Component Summary (MCS-12) and the General Health Questionnaire (GHQ-12), on adiposity measures (continuous or dichotomous indicators) were estimated adjusted for covariates. Polynomial age-adiposity interactions were estimated. Higher adiposity was associated with poorer mental health functioning. This emerged in the 30s, increased up to mid-40s (all central adiposity and obesity-BF% measures) or early 50s (all BMI measures) and then decreased with age. Underlying physical health generally accounted for these associations except for central adiposity, where associations remained statistically significant from the mid-30s to 50s. Cardiovascular, followed by arthritis and endocrine, conditions played the greatest role in attenuating the associations under investigation. We found strong age-specific patterns in the adiposity-mental health functioning association that varied across adiposity measures. Underlying physical health had the dominant role in attenuating these associations. Policy makers and health professionals should target increased adiposity, mainly central adiposity, as it is a risk factor for poor mental health functioning in those aged between mid-30s to 50 years.

  9. Association of Adiposity and Mental Health Functioning across the Lifespan: Findings from Understanding Society (The UK Household Longitudinal Study)

    PubMed Central

    2016-01-01

    Background Evidence on the adiposity-mental health associations is mixed, with studies finding positive, negative or no associations, and less is known about how these associations may vary by age. Objective To examine the association of adiposity -body mass index (BMI), waist circumference (WC) and percentage body fat (BF%)- with mental health functioning across the adult lifespan. Methods Data from 11,257 participants (aged 18+) of Understanding Society: the UK Household Longitudinal Study (waves 2 and 3, 5/2010-7/2013) were employed. Regressions of mental health functioning, assessed by the Mental Component Summary (MCS-12) and the General Health Questionnaire (GHQ-12), on adiposity measures (continuous or dichotomous indicators) were estimated adjusted for covariates. Polynomial age-adiposity interactions were estimated. Results Higher adiposity was associated with poorer mental health functioning. This emerged in the 30s, increased up to mid-40s (all central adiposity and obesity-BF% measures) or early 50s (all BMI measures) and then decreased with age. Underlying physical health generally accounted for these associations except for central adiposity, where associations remained statistically significant from the mid-30s to50s. Cardiovascular, followed by arthritis and endocrine, conditions played the greatest role in attenuating the associations under investigation. Conclusions We found strong age-specific patterns in the adiposity-mental health functioning association that varied across adiposity measures. Underlying physical health had the dominant role in attenuating these associations. Policy makers and health professionals should target increased adiposity, mainly central adiposity, as it is a risk factor for poor mental health functioning in those aged between mid-30s to 50 years. PMID:26849046

  10. Association Between Dietary Fiber and Incident Cases of Colon Polyps: The Adventist Health Study

    PubMed Central

    Tantamango, Yessenia M.; Knutsen, Synnove F.; Beeson, Larry; Fraser, Gary; Sabate, Joan

    2011-01-01

    ABSTRACT Background: Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Most cases of CRC arise in adenomatous polyps. It has been estimated that 25%–35% of colon adenoma risk could be avoidable by modification of dietary and life-style habits. Methods: We estimated the association between total dietary fiber and fiber intake from fruits, vegetables, and grains, and the risk of physician-diagnosed colon polyps among 2818 men and women who had undergone colonoscopy. Data were drawn from 2 cohort studies—the Adventist Health Study-1 (AHS-1) of 1976 and the Adventist Health Study-2 (AHS-2) conducted from 2002 to 2005. Dietary information was obtained from the self-administered questionnaire from AHS-1, while outcome was assessed from AHS-2 data. Multivariate logistic regression analysis was used to estimate the period risk of incident cases of polyps. Results: A total of 441 incident cases of colon polyps were identified. After adjusting for age, sex, body mass index, physical activity, education, and alcohol and meat consumption, total fiber intake was inversely associated with the risk of colon polyps (odds ratio [OR] for highest vs lowest quartile = 0.71, 95% confidence interval [CI] 0.51–0.99). This association showed a dose-response effect (p = .04). Analyses of various sources of fiber showed the most clear effect of fiber from vegetables including legumes (OR for highest vs lowest quartile = 0.65; 95% CI 0.47–0.90; p = .02). Conclusions: In this population comprising a high proportion of vegetarians, persons who consumed low amounts of fiber, especially fiber contained in vegetables, had a higher risk of developing colon polyps. PMID:22295127

  11. Factors associated with self-reported ill health among older Ugandans: A cross sectional study

    PubMed Central

    Wandera, Stephen Ojiambo; Golaz, Valerie; Kwagala, Betty; Ntozi, James

    2015-01-01

    Introduction There is limited research on the prevalence and factors associated with self-reported ill health among older people in Uganda. Objective Therefore, the aim of this paper was to estimate the prevalence of self-reported ill health and to identify associated risk factors among older people (age 50+) in Uganda. Materials and methods We conducted secondary analysis of a cross sectional survey data from a weighted sample of 2382 older persons from the 2010 Uganda National Household survey. We used frequency distributions for descriptive statistics, chi-square tests (significance set at 95%) to identify initial associations and multivariable logistic regressions reporting odds ratios to examine observed associations with self-reported ill health. Results Over half (62%) of the older people reported ill health in the 30 days preceding the survey. Self-reported ill health was positively associated with being a woman, being among the oldest old, living in the eastern region, being a household head, being Catholic, self-reported non-communicable diseases (NCDs) and being disabled. Conclusion Gender differentials exist in self-reported ill health among older persons in Uganda. PMID:26043957

  12. Association between witnessing traumatic events and psychopathology in the South African Stress and Health Study

    PubMed Central

    Platt, Jonathan; Williams, David R.; Stein, Dan J.; Koenen, Karestan C.

    2016-01-01

    Background The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders. Methods Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders. Results Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders. Conclusion Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected. PMID:25773525

  13. Factors associated with delivery outside a health facility: cross-sectional study in rural Malawi

    PubMed Central

    Mazalale, Jacob; Kambala, Christabel; Brenner, Stephan; Chinkhumba, Jobiba; Lohmann, Julia; Mathanga, Don P; Robberstad, Bjarne; Muula, Adamson S; De Allegri, Manuela

    2015-01-01

    Objective To identify factors associated with delivery outside a health facility in rural Malawi. Method A cross-sectional survey was conducted in Balaka, Dedza, Mchinji and Ntcheu districts in Malawi in 2013 among women who had completed a pregnancy 12 months prior to the day of the survey. Multilevel logistic regression was used to assess factors associated with delivery outside a facility. Results Of the 1812 study respondents, 9% (n = 159) reported to have delivered outside a facility. Unmarried women were significantly more likely [OR = 1.88; 95% CI (1.086–3.173)] to deliver outside a facility, while women from households with higher socio-economic status [third-quartile OR = 0.51; 95% CI (0.28–0.95) and fourth-quartile OR = 0.48; 95% CI (0.29–0.79)] and in urban areas [OR = 0.39; 95%-CI (0.23–0.67)] were significantly less likely to deliver outside a facility. Women without formal education [OR 1.43; 95% CI (0.96–2.14)] and multigravidae [OR = 1.14; 95% CI (0.98–1.73)] were more likely to deliver outside a health facility at 10% level of significance. Conclusion About 9% of women deliver outside a facility. Policies to encourage facility delivery should not only focus on health systems but also be multisectoral to address women's vulnerability and inequality. Facility-based delivery can contribute to curbing the high maternal illness burden if authorities provide incentives to those not delivering at the facility without losing existing users. PMID:25656750

  14. Higher free thyroxine levels are associated with frailty in older men: the Health In Men Study.

    PubMed

    Yeap, Bu B; Alfonso, Helman; Chubb, Stephen A Paul; Walsh, John P; Hankey, Graeme J; Almeida, Osvaldo P; Flicker, Leon

    2012-05-01

    Frailty is common in the elderly and predisposes to ill-health. Some symptoms of frailty overlap those of thyroid dysfunction, but it is unclear whether differences in thyroid status influence risk of frailty. We evaluated associations between thyroid status and frailty in older men. Cross-sectional epidemiological study. Community-dwelling men aged 70-89 years. Circulating thyrotropin (TSH) and free thyroxine (FT(4) ) were assayed. Frailty was assessed as ≥3 of the Fatigue, Resistance, Ambulation, Illnesses and Loss (FRAIL) scale's 5 domains: fatigue; resistance (difficulty climbing flight of stairs); ambulation (difficulty walking 100 m); illness (>5); or weight loss (>5%), blinded to hormone results. Of 3943 men, 27 had subclinical hyperthyroidism, 431 subclinical hypothyroidism and 608 were classified as being frail (15·4%). There was an inverse log-linear association of TSH with FT(4). There was no association between TSH and frailty. After adjusting for covariates, men with FT(4) in the highest two quartiles had increased odds of being frail (Q3:Q1, odds ratio [OR] = 1·32, 95% confidence interval [CI] = 1·01-1·73 and Q4:Q1, OR = 1·36, 95% CI = 1·04-1·79, P = 0·010 for trend). Higher FT(4) was associated with fatigue (P = 0·038) and weight loss (P < 0·001). The association between FT(4) and frailty remained significant when the analysis was restricted to euthyroid men. High-normal FT(4) level is an independent predictor of frailty among ageing men. This suggests that even within the euthyroid range, circulating thyroxine may contribute to reduced physical capability. Further studies are needed to clarify the utility of thyroid function testing and the feasibility of preventing or reversing frailty in older men. © 2012 Blackwell Publishing Ltd.

  15. Association between Soluble Klotho and Change in Kidney Function: The Health Aging and Body Composition Study.

    PubMed

    Drew, David A; Katz, Ronit; Kritchevsky, Stephen; Ix, Joachim; Shlipak, Michael; Gutiérrez, Orlando M; Newman, Anne; Hoofnagle, Andy; Fried, Linda; Semba, Richard D; Sarnak, Mark

    2017-06-01

    CKD appears to be a condition of soluble klotho deficiency. Despite known associations between low soluble klotho levels and conditions that promote kidney damage, such as oxidative stress and fibrosis, little information exists regarding the longitudinal association between soluble klotho levels and change in kidney function. We assayed serum soluble α-klotho in 2496 participants within the Health Aging and Body Composition study, a cohort of older adults. The associations between soluble klotho levels and decline in kidney function (relative decline: eGFR decline ≥30%; absolute decline: eGFR decline >3 ml/min per year) and incident CKD (incident eGFR <60 ml/min per 1.73 m(2) and >1 ml/min per year decline) were evaluated. We adjusted models for demographics, baseline eGFR, urine albumin-to-creatinine ratio, comorbidity, and measures of mineral metabolism. Among participants, the mean (SD) age was 75 (3) years, 52% were women, and 38% were black. Median (25th, 75th percentiles) klotho level was 630 (477, 817) pg/ml. In fully adjusted models, each two-fold higher level of klotho associated with lower odds of decline in kidney function (odds ratio, 0.78 [95% confidence interval, 0.66 to 0.93] for 30% decline in eGFR, and 0.85 [95% confidence interval, 0.73 to 0.98] for >3 ml/min per year decline in eGFR), but not of incident CKD (incident rate ratio, 0.90 [95% confidence interval, 0.78 to 1.04]). Overall, a higher soluble klotho level independently associated with a lower risk of decline in kidney function. Future studies should attempt to replicate these results in other cohorts and evaluate the underlying mechanism. Copyright © 2017 by the American Society of Nephrology.

  16. Associations of Parity, Breastfeeding, and Fractures in the Women's Health Observational Study.

    PubMed

    Crandall, Carolyn J; Liu, Jingmin; Cauley, Jane; Newcomb, Polly A; Manson, JoAnn E; Vitolins, Mara Z; Jacobson, Lisette T; Rykman, Kelli K; Stefanick, Marcia L

    2017-07-01

    To examine associations of several aspects of parity and history of lactation with incident hip fractures and clinical fractures and, in a subset of women, with bone mineral density. In this observational study, we analyzed data from 93,676 postmenopausal women participating in the Women's Health Initiative Observational Study and all bone density data from the subset of participants who underwent bone density testing at three clinical centers. At baseline, participants were aged 50-79 years. Using Cox proportional hazards regression analysis, we examined associations of fracture incidence and bone density with several aspects of parity (number of pregnancies, age at first pregnancy lasting 6 months or greater, and number of pregnancies lasting 6 months or greater) and breastfeeding (number of episodes of breastfeeding for at least 1 month, number of children breastfed, age when first breastfed, age when last breastfed, total number of months breastfed). The mean baseline age (standard deviation) of participants was 64 (±7.4) years (mean follow-up 7.9 years). During follow-up, the incident rate of hip fracture was 1.27%. Ten percent of participants were nulligravid. In fully adjusted models, number of pregnancies, parity, age at first birth, number of children breastfed, age at first breastfeeding, age at last breastfeeding, and total duration of breastfeeding were not statistically significantly associated with hip fracture incidence. There were no consistent associations of parity or lactation characteristics with overall clinical fracture risk or bone density. However, compared with never breastfeeding, a history of breastfeeding for at least 1 month was associated with a decreased risk of hip fracture (yes compared with no, hazard ratio 0.84, 95% confidence interval 0.73-0.98). Patterns of parity and history of lactation were largely unrelated to fracture risk or bone density.

  17. Association of comorbidity with disability in older women: the Women's Health and Aging Study.

    PubMed

    Fried, L P; Bandeen-Roche, K; Kasper, J D; Guralnik, J M

    1999-01-01

    There is substantial evidence that physical disability results from chronic diseases and that the number of chronic diseases is associated with the presence and severity of disability. There is some evidence that interactions between specific diseases are of import in causing disability. Beyond arthritis, however, little is known of the disease pairs that may be important to focus on in future research. This study explores the associations between multiple disease pairs and different types of physical disability, with the objective of hypothesis development regarding the importance of disease interactions. The study population comprised a representative sample of 3841 women 65 years and older living in Baltimore, screened for participation in the Women's Health and Aging Study. The study design was cross-sectional. An interviewer-administered screening questionnaire was administered regarding self-reported physical disability in 15 tasks of daily life, history of physician diagnosis of 14 chronic diseases, and MiniMental State examination. Task difficulty was empirically grouped into six subsets of minimally overlapping disabilities, with a comparison group consisting of those with no difficulty in any task subset. Multiple logistic regression models were fit assessing the relationship of major chronic diseases and of interactions of disease pairs with each disability subtype and with any disability, adjusting for confounders. Fourteen percent of the population reported mobility difficulty only; 5%, upper extremity difficulty only; 9%, both of these difficulties but no others; 7%, difficulty in higher function but not self-care tasks; 7%, self-care task difficulty but not higher function tasks; and 15%, difficulty in both higher function and self-care (weighted data). Almost all in the latter three groups had difficulty, as well, in mobility or upper extremity tasks. In regression models, specific disease pairs were synergistically associated with different types

  18. Cardiovascular Risk and Its Associated Factors in Health Care Workers in Colombia: A Study Protocol.

    PubMed

    Gamboa Delgado, Edna M; Rojas Sánchez, Lyda Z; Bermon Angarita, Anderson; Rangel Díaz, Yully Andrea; Jaraba Suárez, Silvia J; Serrano Díaz, Norma C; Vega Fernández, Evaristo

    2015-07-30

    Cardiovascular diseases are the leading cause of mortality worldwide, for this reason, they are a public health problem. In Colombia, cardiovascular diseases are the main cause of mortality, having a death rate of 152 deaths per 100,000 population. There are 80% of these cardiovascular events that are considered avoidable. The objective of the study is to determine the prevalence of the cardiovascular risk and its associated factors among the institution's workers in order to design and implement interventions in the work environment which may achieve a decrease in such risk. An analytical cross-sectional study was designed to determine the cardiovascular risk and its associated factors among workers of a high complexity health care institution. A self-applied survey will be conducted considering sociodemographic aspects, physical activity, diet, alcohol consumption, smoking, level of perceived stress, and personal and family history. In a second appointment, a physical examination will be made, as well as anthropometric measurements and blood pressure determination. Also, blood samples for evaluating total and high density lipoprotein cholesterol, triglycerides, and fasting blood sugar will be taken. A ten-year global risk for cardiovascular disease will be determined using the Framingham score. A descriptive analysis of the population's characteristics and a stratified analysis by sex, age, and occupation will be made. Bivariate and multivariate analysis will be made using logistic regression models to evaluate the association between cardiovascular risk and the independent variables. The research protocol was approved by the Scientific and Technical Committee and the Ethics Committee on Research of the Fundación Cardiovascular de Colombia. The protocol has already received funding and the enrollment phase will begin in the coming months. The results of this study will give the foundation for the design, implementation, and evaluation of a program based on

  19. Cardiovascular Risk and Its Associated Factors in Health Care Workers in Colombia: A Study Protocol

    PubMed Central

    2015-01-01

    Background Cardiovascular diseases are the leading cause of mortality worldwide, for this reason, they are a public health problem. In Colombia, cardiovascular diseases are the main cause of mortality, having a death rate of 152 deaths per 100,000 population. There are 80% of these cardiovascular events that are considered avoidable. Objective The objective of the study is to determine the prevalence of the cardiovascular risk and its associated factors among the institution’s workers in order to design and implement interventions in the work environment which may achieve a decrease in such risk. Methods An analytical cross-sectional study was designed to determine the cardiovascular risk and its associated factors among workers of a high complexity health care institution. A self-applied survey will be conducted considering sociodemographic aspects, physical activity, diet, alcohol consumption, smoking, level of perceived stress, and personal and family history. In a second appointment, a physical examination will be made, as well as anthropometric measurements and blood pressure determination. Also, blood samples for evaluating total and high density lipoprotein cholesterol, triglycerides, and fasting blood sugar will be taken. A ten-year global risk for cardiovascular disease will be determined using the Framingham score. A descriptive analysis of the population’s characteristics and a stratified analysis by sex, age, and occupation will be made. Bivariate and multivariate analysis will be made using logistic regression models to evaluate the association between cardiovascular risk and the independent variables. The research protocol was approved by the Scientific and Technical Committee and the Ethics Committee on Research of the Fundación Cardiovascular de Colombia. Results The protocol has already received funding and the enrollment phase will begin in the coming months. Conclusions The results of this study will give the foundation for the design

  20. Longitudinal study of associations between perceived health status and self reported diseases in the French Gazel cohort

    PubMed Central

    Goldberg, P; Gueguen, A; Schmaus, A; Nakache, J; Goldberg, M

    2001-01-01

    STUDY OBJECTIVE—Although perceived health status is an indicator widely used in epidemiological studies, its relation to various diseases is not well known. The objective of this study is to examine these relations in detail.
DESIGN—Marginal models used for a longitudinal study of the association between three health scales and 47 diseases among 12 164 men and 44 diseases among 4415 women.
SETTING—French Gazel cohort during the period from 1991 to 1996.
MAIN RESULTS—The general health status scale was significantly associated with 43 diseases among men, and 31 among women. Some of these significantly associated diseases were physical (for example, cancer and cerebrovascular accident) and others, psychological (for example, depression). The mental fatigue scale was more specifically associated with psychological disorders, including sleep problems, depression, and nervous diseases. Moreover, modifications in subjects' assessment of their health from one year to the next were generally associated with modifications in reported diseases.
CONCLUSION—Although the mechanism that relates the presence of a disease to perceived health status remains in question, these results show clearly that there is a close association between these two domains that justifies the use of perceived health as a proxy for self reported diseases.


Keywords: marginal model; health scale; self rated disease PMID:11238577

  1. The Association between Dietary Omega-3 Fatty Acids and Cardiovascular Death: the Singapore Chinese Health Study

    PubMed Central

    Koh, Angela S.; Pan, An; Wang, Renwei; Odegaard, Andrew O.; Pereira, Mark A.; Yuan, Jian-Min; Koh, Woon-Puay

    2015-01-01

    Background Although studies suggest that omega-3 fatty acids intake may reduce cardiovascular disease (CVD) mortality risk, few studies have differentiated dietary eicosapentaenoic/docosahexaenoic acid (EPA/DHA) from alpha-linolenic acid (ALA), and epidemiological research in Asian populations is limited. Methods and Results The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998. Usual diet was measured at recruitment using a validated semi-quantitative food-frequency questionnaire, and mortality information was identified via registry linkage up to 31 December 2011. Cox proportional hazard models were used to calculate hazard ratios (HRs) with adjustment for potential confounders. We documented 4,780 total cardiovascular deaths (including 2,697 coronary heart disease [CHD] deaths and 1,298 stroke deaths) during 890,473 person-years of follow-up. Omega-3 fatty acids intake was monotonically associated with reduced risk of cardiovascular mortality. Compared to the lowest quartile, the HR [95% confidence interval (CI)] was 0.88 (0.81-0.96), 0.88 (0.80-0.97), and 0.83 (0.74-0.92) for the second, third and highest quartile, respectively (P-trend=0.003). Both EPA/DHA and ALA were independently associated with reduced risk of cardiovascular mortality: the HR (95% CI) comparing extreme quartiles was 0.86 (0.77-0.96; P-trend=0.002) and 0.81 (0.73-0.90; P-trend<0.001), respectively. The associations were similar for deaths from coronary heart disease and stroke, and persisted in participants who were free of CVD at baseline. Conclusions Higher relative intake of both marine (EPA/DHA) and plant (ALA) omega-3 fatty acids are associated with reduced risk of cardiovascular mortality in a Chinese population. PMID:24343844

  2. Exercise Dose, Exercise Adherence, and Associated Health Outcomes in the TIGER Study

    PubMed Central

    Miller, Fred L.; O’Connor, Daniel P.; Herring, Matthew P.; Sailors, Mary H.; Jackson, Andrew S.; Dishman, Rodney K.; Bray, Molly S.

    2013-01-01

    Purpose To effectively evaluate activity-based interventions for weight management and disease risk reduction, objective and accurate measures of exercise dose are needed. This study examined cumulative exercise exposure defined by heart rate-based intensity, duration, and frequency as a measure of compliance with a prescribed exercise program and a predictor of health outcomes. Methods 1,150 adults (21.3 ± 2.7 yrs) completed a 15-week exercise protocol consisting of 30 min/day, three days/wk at 65–85% maximum heart rate reserve (HRR). Computerized HR monitor data were recorded at every exercise session (33,473 valid sessions). To quantify total exercise dose, duration for each session was adjusted for average exercise intensity (%HRR) to create a measure of intensity-minutes for each workout, which were summed over all exercise sessions to formulate a heart rate physical activity score (HRPAS). Regression analysis was used to examine the relationship between HRPAS and physiological responses to exercise training. Compliance with the exercise protocol based on achievement of the minimum prescribed HRPAS was compared to adherence defined by attendance. Results Using HRPAS, 868 participants were empirically defined as compliant, and 282 were non-compliant. HRPAS-based and attendance-based classifications of compliance and adherence differed for approximately 9% of participants. Higher HRPAS was associated with significant positive changes in body mass (p<0.001), BMI (p<0.001), waist and hip circumferences (p<0.001), percent body fat (%Fat, p<0.001), systolic blood pressure (p<0.011), resting heart rate (RHR, p<0.003), fasting glucose (p<0.001), and total cholesterol (p<.02). Attendance-based adherence was associated with body mass, hip circumference, %Fat, RHR, and cholesterol (p<0.05). Conclusions The HRPAS is a quantifiable measure of exercise dose associated with improvement in health indicators beyond that observed when adherence is defined as session

  3. Exercise dose, exercise adherence, and associated health outcomes in the TIGER study.

    PubMed

    Miller, Fred L; O'Connor, Daniel P; Herring, Matthew P; Sailors, Mary H; Jackson, Andrew S; Dishman, Rodney K; Bray, Molly S

    2014-01-01

    To effectively evaluate activity-based interventions for weight management and disease risk reduction, objective and accurate measures of exercise dose are needed. This study examined cumulative exercise exposure defined by HR-based intensity, duration, and frequency as a measure of compliance with a prescribed exercise program and a predictor of health outcomes. One thousand one-hundred fifty adults (21.3 ± 2.7 yr) completed a 15-wk exercise protocol consisting of 30 min·d, 3 d·wk, at 65%-85% maximum HR reserve. Computerized HR monitor data were recorded at every exercise session (33,473 valid sessions). To quantify total exercise dose, duration for each session was adjusted for average exercise intensity (%HR reserve) to create a measure of intensity minutes for each workout, which were summed over all exercise sessions to formulate an HR physical activity score (HRPAS). Regression analysis was used to examine the relation between HRPAS and physiological responses to exercise training. Compliance with the exercise protocol based on achievement of the minimum prescribed HRPAS was compared with adherence defined by attendance. On the basis of HRPAS, 868 participants were empirically defined as compliant, and 282 were noncompliant. HRPAS-based and attendance-based classifications of compliance and adherence differed in approximately 9% of participants. Higher HRPAS was associated with significant positive changes in body mass (P < 0.001), body mass index (P < 0.001), waist and hip circumferences (P < 0.001), percent body fat (P < 0.001), systolic blood pressure (P < 0.011), resting HR (P < 0.003), fasting glucose (P < 0.001), and total cholesterol (P < 0.02). Attendance-based adherence was associated with body mass, hip circumference, percent body fat, resting HR, and cholesterol (P < 0.05). The HRPAS is a quantifiable measure of exercise dose associated with improvement in health indicators beyond that observed when adherence is defined as session attendance.

  4. Association of rule of law and health outcomes: an ecological study.

    PubMed

    Pinzon-Rondon, Angela Maria; Attaran, Amir; Botero, Juan Carlos; Ruiz-Sternberg, Angela Maria

    2015-10-29

    To explore whether the rule of law is a foundational determinant of health that underlies other socioeconomic, political and cultural factors that have been associated with health outcomes. Global project. Data set of 96 countries, comprising 91% of the global population. The following health indicators, infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, were included to explore their association with the rule of law. We used a novel Rule of Law Index, gathered from survey sources, in a cross-sectional and ecological design. The Index is based on eight subindices: (1) Constraints on Government Powers; (2) Absence of Corruption; (3) Order and Security; (4) Fundamental Rights; (5) Open Government; (6) Regulatory Enforcement, (7) Civil Justice; and (8) Criminal Justice. The rule of law showed an independent association with infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, after adjusting for the countries' level of per capita income, their expenditures in health, their level of political and civil freedom, their Gini measure of inequality and women's status (p<0.05). Rule of law remained significant in all the multivariate models, and the following adjustment for potential confounders remained robust for at least one or more of the health outcomes across all eight subindices of the rule of law. Findings show that the higher the country's level of adherence to the rule of law, the better the health of the population. It is necessary to start considering the country's adherence to the rule of law as a foundational determinant of health. Health advocates should consider the improvement of rule of law as a tool to improve population health. Conversely, lack of progress in rule of law may constitute a structural barrier to health improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  5. Association of rule of law and health outcomes: an ecological study

    PubMed Central

    Pinzon-Rondon, Angela Maria; Attaran, Amir; Botero, Juan Carlos; Ruiz-Sternberg, Angela Maria

    2015-01-01

    Objectives To explore whether the rule of law is a foundational determinant of health that underlies other socioeconomic, political and cultural factors that have been associated with health outcomes. Setting Global project. Participants Data set of 96 countries, comprising 91% of the global population. Primary and secondary outcome measures The following health indicators, infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, were included to explore their association with the rule of law. We used a novel Rule of Law Index, gathered from survey sources, in a cross-sectional and ecological design. The Index is based on eight subindices: (1) Constraints on Government Powers; (2) Absence of Corruption; (3) Order and Security; (4) Fundamental Rights; (5) Open Government; (6) Regulatory Enforcement, (7) Civil Justice; and (8) Criminal Justice. Results The rule of law showed an independent association with infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, after adjusting for the countries’ level of per capita income, their expenditures in health, their level of political and civil freedom, their Gini measure of inequality and women's status (p<0.05). Rule of law remained significant in all the multivariate models, and the following adjustment for potential confounders remained robust for at least one or more of the health outcomes across all eight subindices of the rule of law. Findings show that the higher the country's level of adherence to the rule of law, the better the health of the population. Conclusions It is necessary to start considering the country's adherence to the rule of law as a foundational determinant of health. Health advocates should consider the improvement of rule of law as a tool to improve population health. Conversely, lack of progress in rule of law may constitute a structural barrier to health improvement

  6. Association of Multiorgan Computed Tomographic Phenomap With Adverse Cardiovascular Health Outcomes: The Framingham Heart Study.

    PubMed

    Shah, Ravi V; Yeri, Ashish S; Murthy, Venkatesh L; Massaro, Joe M; D'Agostino, Ralph; Freedman, Jane E; Long, Michelle T; Fox, Caroline S; Das, Saumya; Benjamin, Emelia J; Vasan, Ramachandran S; O'Donnell, Christopher J; Hoffmann, Udo

    2017-09-20

    Increased ability to quantify anatomical phenotypes across multiple organs provides the opportunity to assess their cumulative ability to identify individuals at greatest susceptibility for adverse outcomes. To apply unsupervised machine learning to define the distribution and prognostic importance of computed tomography-based multiorgan phenotypes associated with adverse health outcomes. This asymptomatic community-based cohort study included 2924 Framingham Heart Study participants between July 2002 and April 2005 undergoing computed tomographic imaging of the chest and abdomen. Participants are from the offspring and third-generation cohorts. Eleven computed tomography-based measures of valvular/vascular calcification, adiposity, and muscle attenuation. All-cause mortality and cardiovascular disease (myocardial infarction, stroke, or cardiovascular death). The median age of the participants was 50 years (interquartile range, 43-60 years), and 1422 (48.6%) were men. Principal component analysis identified 3 major anatomic axes: (1) global calcification (defined by aortic, thoracic, coronary, and valvular calcification); (2) adiposity (defined by pericardial, visceral, hepatic, and intrathoracic fat); and (3) muscle attenuation that explained 65.7% of the population variation. Principal components showed different evolution with age (continuous increase in global calcification, decrease in muscle attenuation, and U-shaped association with adiposity) but similar patterns in men and women. Using unsupervised clustering approaches in the offspring cohort (n = 1150), we identified a cohort (n = 232; 20.2%) with an unfavorable multiorgan phenotype across all 3 anatomic axes as compared with a favorable multiorgan phenotype. Membership in the unfavorable phenotypic cluster was associated with a greater prevalence of cardiovascular disease risk factors and with increased all-cause mortality (hazard ratio, 2.61; 95% CI, 1.74-3.92; P < .001), independent of

  7. American Public Health Association

    MedlinePlus

    ... is Public Health? Creating Healthy Communities Topics & Issues Climate Change Environmental Health Gun Violence Health Equity Health Reform ... 2017 EST Show More Oct 19 Climate Webinar Climate Changes Children's Health: Protecting Our Future Date: Oct 19 ...

  8. Environmental impact and health risks associated with greywater irrigation: a case study.

    PubMed

    Gross, A; Azulai, N; Oron, G; Ronen, Z; Arnold, M; Nejidat, A

    2005-01-01

    There is an increasing trend to use greywater for irrigation in households. This is partly due to the notion that greywater is of better quality than wastewater and therefore does not need extensive treatment beyond addressing public health issues. The aim of the study was to evaluate the environmental impact and health risks associated with the use of greywater for irrigation on a small private farm. Over a three-year period, each of three plots on a farm was irrigated with either freshwater, fertilized water, or greywater. Irrigation water and soil from the plots were analyzed for a wide range of chemical and microbial variables. Results suggest that greywater may be of similar quality to wastewater in several parameters such as BOD and faecal coliforms. For some other variables such as boron and surfactants, greywater may even be of worse quality than wastewater. Long-term irrigation of arid loess soil with greywater may result in accumulation of salts, surfactants and boron in the soil, causing changes in soil properties and toxicity to plants. Faecal coliforms did not survive in the soil. Treating greywater before using it for irrigation is recommended, even in places where this is not a requirement.

  9. Do we develop public health leaders?- association between public health competencies and emotional intelligence: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Professional development of public health leaders requires a form of instruction which is competency-based to help them develop the abilities to address complex and evolving demands of health care systems. Concurrently, emotional intelligence (EI) is a key to organisational success. Our aim was twofold: i) to assess the relationship between the level of self-assessed public health and EI competencies among Master of European Public Health (MEPH) students and graduates at Maastricht University, and; ii) to determine the relationship between different groups of public health competencies and specific EI skills. Methods A cross-sectional study was conducted including all recent MEPH graduates and students from 2009–2012, out of 67 eligible candidates N = 51 were contacted and N = 33 responded (11 males and 22 females; overall response: 64.7%).Two validated tools were employed: i) public health competencies self-assessment questionnaire, and; ii) Assessing Emotions Scale. Results Females scored higher than males in all seven domains of the self-assessed key public health competencies (NS) and emotional intelligence competences (P = 0.022). Overall, the mean value of public health competencies was the lowest in students with “staff” preferences and the highest among students with mixed job preferences (P < 0.001). There was evidence of a correlation between the overall public health competencies and the overall emotional intelligence competencies (r = 0.61, P < 0.001). Conclusions The study shows a positive correlation between public health specific competencies and EI attributes. It can contribute to the improvement of the educational content of PH curricula by rising awareness through self-assessment and supporting the identification of further educational needs related to leadership. PMID:24742091

  10. Do we develop public health leaders?- association between public health competencies and emotional intelligence: a cross-sectional study.

    PubMed

    Czabanowska, Katarzyna; Malho, André; Schröder-Bäck, Peter; Popa, Daniela; Burazeri, Genc

    2014-04-17

    Professional development of public health leaders requires a form of instruction which is competency-based to help them develop the abilities to address complex and evolving demands of health care systems. Concurrently, emotional intelligence (EI) is a key to organisational success. Our aim was twofold: i) to assess the relationship between the level of self-assessed public health and EI competencies among Master of European Public Health (MEPH) students and graduates at Maastricht University, and; ii) to determine the relationship between different groups of public health competencies and specific EI skills. A cross-sectional study was conducted including all recent MEPH graduates and students from 2009-2012, out of 67 eligible candidates N = 51 were contacted and N = 33 responded (11 males and 22 females; overall response: 64.7%).Two validated tools were employed: i) public health competencies self-assessment questionnaire, and; ii) Assessing Emotions Scale. Females scored higher than males in all seven domains of the self-assessed key public health competencies (NS) and emotional intelligence competences (P = 0.022). Overall, the mean value of public health competencies was the lowest in students with "staff" preferences and the highest among students with mixed job preferences (P < 0.001). There was evidence of a correlation between the overall public health competencies and the overall emotional intelligence competencies (r = 0.61, P < 0.001). The study shows a positive correlation between public health specific competencies and EI attributes. It can contribute to the improvement of the educational content of PH curricula by rising awareness through self-assessment and supporting the identification of further educational needs related to leadership.

  11. Mental health problems of Iranian female adolescents and its association with pubertal development: a nationwide study.

    PubMed

    Rabbani, Ali; Mahmoudi-Gharaei, Javad; Mohammadi, Mohammad Reza; Motlagh, Mohammad Esmaeil; Mohammad, Kazem; Ardalan, Gelayol; Maftoon, Farzaneh; Shahryari, Safiyeh; Khodaei, Shahnaz; Sotoudeh, Aria; Ziaaldini, Hassan; Kamali, Kobra; Motaghian, Molouk

    2012-01-01

    Mental health problems including emotional and behavioral problems during puberty may be under influence of different risk factors including cultures, living in urban or rural areas and ethnic factors which may vary between different countries. The main aim of this study is to investigate the profile of emotional and behavioral problems and the role of factors such as age, stage of puberty, ethnicity, rurality and living in urban area, as risk factors in Iranian girls. As a part of a large national study we evaluated the emotional and behavioral problems in different stages of puberty in a community sample of Iranian adolescent girls from public schools that were selected by clustered random sampling method. In all subjects, demographic characteristics, and pubertal stages were measured. Emotional and behavioral problems were evaluated using Strength and Difficulties Questionnaire (SDQ). The associations of age, pubertal development indices, socioeconomic and demographic factors with the behavioral problems were assessed. A total number of 4576 students enrolled the study and responded to the questions. The mean age of participants was 13.83 ± 2.19 years. The mean total score of difficulties in participants was 14.34 ± 5.81. According to these results 813 (17.8%) adolescents had total problem scores higher than Goodman's cutoff points and the most frequent problem domain was conduct problems (20.5%). According to the results the most related variable with the total difficulty score of SDQ were ethnicity, residency in urban areas and development of menstrual cycle respectively. The results of this study showed that the most correlated factors with mental health problems in Iranian girls during puberty are ethnicity, urbanity and development of menstrual cycle.

  12. Association of Neighborhood Characteristics with Cardiovascular Health in the Multi-Ethnic Study of Atherosclerosis (MESA)

    PubMed Central

    Unger, Erin; Diez-Roux, Ana V.; Lloyd-Jones, Donald M.; Mujahid, Mahasin S.; Nettleton, Jennifer A.; Bertoni, Alain; Badon, Sylvia E.; Ning, Hongyan; Allen, Norrina B.

    2014-01-01

    Background The concept of ‘cardiovascular health’ (CVH) was introduced as a global measure of one’s cardiovascular health. Previous studies established the relationship between neighborhood characteristics and individual cardiovascular risk factors. However, the relationship between neighborhood environment and overall CVH remains unknown. Methods and Results We analyzed data from the MESA baseline exam (2000–2002). Mean age was 61.6 years and 52% were female. Ideal, intermediate and poor categories of cholesterol, body mass index, diet, physical activity, fasting glucose, blood pressure and smoking were defined according to the AHA 2020 Strategic Goals, assigned an individual score and summed to create an overall score. CVH scores were categorized into ideal (11–14 points), intermediate (9–10) and poor (0–8). Neighborhood exposures included favorable food store and physical activity resources densities (by 1-mile buffer), reported healthy food availability, walking/physical activity environment, safety and social cohesion (by census tract). Multinomial logistic regression was used to determine the association of each characteristic with ideal and intermediate CVH, adjusted for demographics and neighborhood socioeconomic status (SES). Over 20% of MESA participants had an ideal CVH score at baseline. In fully adjusted models, favorable food stores (OR= 1.22, 1.06–1.40), physical activity resources (OR=1.19, 1.08–1.31), walking/physical activity environment (OR=1.20, 1.05–1.37) and neighborhood SES (OR=1.22, 1.11–1.33) were associated with higher odds of having an ideal CVH score. Conclusions Neighborhood environment including favorable food stores, physical activity resources, walking/physical activity environment and neighborhood SES are associated with ideal CVH. Further research is needed to investigate the longitudinal associations between neighborhood environment and CVH. PMID:25006187

  13. Bidirectional Association between Self-Reported Hypertension and Gout: The Singapore Chinese Health Study

    PubMed Central

    Pan, An; Teng, Gim Gee; Yuan, Jian-Min; Koh, Woon-Puay

    2015-01-01

    It has been hypothesized that the association between hypertension and gout is bidirectional, however, few studies have examined this in a prospective cohort. We analyzed data from the Singapore Chinese Health Study (SCHS) follow-up I (1999–2004) and II (2006–2010) interviews, when both physician-diagnosed hypertension and gout were self-reported. We included participants with data for both follow-up interviews and who were free of heart disease, stroke and cancer at follow-up I. The analysis of hypertension and risk of gout included 31,137 participants when prevalent gout cases were excluded, while the analysis of gout and risk of hypertension included 20,369 participants when prevalent hypertension cases were excluded. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). The mean age at follow-up I was 60.1 (SD 7.3) years, and the average follow-up was 6.8 (SD 1.4) years. In the analysis of hypertension and risk of gout, 682 incident cases were identified. Compared to normotensive participants, hypertensive patients had an88% increased risk of developing gout (HR 1.88; 95% CI 1.61–2.21). In the parallel analysis, 5,450 participants reported to have newly diagnosed hypertension during follow-up. Compared to participants without gout, those with gout had an18% increased risk of developing hypertension (HR 1.18; 95% CI 1.02–1.37). The bidirectional association was stronger in normal weight adults compared to overweight/obese individuals (Pinteraction = 0.06 and 0.04, respectively). The hypertension to gout association was stronger in women compared to men (Pinteraction = 0.04), while the gout to hypertension association was evident in women but not in men (Pinteraction = 0.02). In conclusion, our results suggest that the hypertension-gout association is bidirectional in this cohort of Singapore Chinese adults. The potential interactions of the bidirectional association with

  14. Functional Status Modifies the Association of Blood Pressure with Death in Elders: Health and Retirement Study.

    PubMed

    Wu, Chenkai; Smit, Ellen; Peralta, Carmen A; Sarathy, Harini; Odden, Michelle C

    2017-07-01

    To examine whether grip strength, gait speed, and the combination of the two physical functioning measures modified the association of systolic BP (SBP) and diastolic BP (DBP) with mortality. Nationally representative cohort study. Health and Retirement Study. 7,492 U.S. adults aged ≥65 years. Grip strength was measured by a hand dynamometer and classified as normal (≥16 kg for female; ≥26 kg for male) and weak. Gait speed was assessed over a 98.5-inch walk and classified as non-slow (≥0.60 m/s for female; ≥0.52 m/s for male) and slow. Over an average follow-up time of 6.0 years, 1,870 (25.0%) participants died. After adjustment for socio-demographic, behavioral, and clinical measures, elevated SBP (≥150 mmHg) and DBP (≥90 mmHg) was associated with a 24% (95% CI, 7-43%) and 25% (95% CI, 5-49%) higher mortality among participants with normal grip strength. In contrast, elevated SBP and DBP was associated with a 6% (95% CI, 31 to -27%) and a 16% (95% CI, 46 to -26%) lower mortality among those with weak grip strength (P-values of interactions: both=.07). The inverse relations between BP with death were most pronounced among slow walkers with weak grip strength. The HRs of elevated SBP and DBP for death was 0.85 (95% CI, 0.56-1.29) and 0.53 (95% CI, 0.30-0.96), respectively, and was substantially different from non-slow walkers with normal grip strength (HR = 1.24 and 1.15, respectively; P-values of interactions: both <.001). Therefore, associations of BP with death varied modestly by gait speed. Grip strength modified the association of BP with death. Combination of grip strength and gait speed has incremental value for modifying the association of BP with death. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  15. Bidirectional Association between Self-Reported Hypertension and Gout: The Singapore Chinese Health Study.

    PubMed

    Pan, An; Teng, Gim Gee; Yuan, Jian-Min; Koh, Woon-Puay

    2015-01-01

    It has been hypothesized that the association between hypertension and gout is bidirectional, however, few studies have examined this in a prospective cohort. We analyzed data from the Singapore Chinese Health Study (SCHS) follow-up I (1999-2004) and II (2006-2010) interviews, when both physician-diagnosed hypertension and gout were self-reported. We included participants with data for both follow-up interviews and who were free of heart disease, stroke and cancer at follow-up I. The analysis of hypertension and risk of gout included 31,137 participants when prevalent gout cases were excluded, while the analysis of gout and risk of hypertension included 20,369 participants when prevalent hypertension cases were excluded. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). The mean age at follow-up I was 60.1 (SD 7.3) years, and the average follow-up was 6.8 (SD 1.4) years. In the analysis of hypertension and risk of gout, 682 incident cases were identified. Compared to normotensive participants, hypertensive patients had an 88% increased risk of developing gout (HR 1.88; 95% CI 1.61-2.21). In the parallel analysis, 5,450 participants reported to have newly diagnosed hypertension during follow-up. Compared to participants without gout, those with gout had an 18% increased risk of developing hypertension (HR 1.18; 95% CI 1.02-1.37). The bidirectional association was stronger in normal weight adults compared to overweight/obese individuals (Pinteraction = 0.06 and 0.04, respectively). The hypertension to gout association was stronger in women compared to men (Pinteraction = 0.04), while the gout to hypertension association was evident in women but not in men (Pinteraction = 0.02). In conclusion, our results suggest that the hypertension-gout association is bidirectional in this cohort of Singapore Chinese adults. The potential interactions of the bidirectional association with obesity and

  16. Prevalence and Cardiovascular Associations of Diabetic Retinopathy and Maculopathy: Results from the Gutenberg Health Study

    PubMed Central

    Raum, Philipp; Lamparter, Julia; Ponto, Katharina A.; Peto, Tunde; Hoehn, René; Schulz, Andreas; Schneider, Astrid; Wild, Philipp S.; Pfeiffer, Norbert; Mirshahi, Alireza

    2015-01-01

    Objective Diabetic retinopathy (DR) is the leading cause of blindness in people of working age. The purpose of this paper is to report the prevalence and cardiovascular associations of diabetic retinopathy and maculopathy (DMac) in Germany. Research Design and Methods The Gutenberg Health Study (GHS) is a population-based study with 15,010 participants aged between 35 at 74 years from the city of Mainz and the district of Mainz-Bingen. We determined the weighted prevalence of DR and DMac by assessing fundus photographs of persons with diabetes from the GHS data base. Diabetes was defined as HbA1c ≥ 6.5%, known diagnosis diabetes mellitus or known diabetes medication. Furthermore, we analysed the association between DR and cardiovascular risk factors and diseases. Results Overall, 7.5% (1,124/15,010) of the GHS cohort had diabetes. Of these, 27.7% were unaware of their disease and thus were newly diagnosed by their participation in the GHS. The prevalence of DR and DMac was 21.7% and 2.3%, respectively among patients with diabetes. Vision-threatening disease was present in 5% of the diabetic cohort. In the multivariable analysis DR (all types) was associated with age (Odds Ratio [95% confidence interval]: 0.97 [0.955–0.992]; p = 0.006) arterial hypertension (1.90 [1.190–3.044]; p = 0.0072) and vision-threatening DR with obesity (3.29 [1.504–7.206]; p = 0.0029). DR (all stages) and vision-threatening DR were associated with duration of diabetes (1.09 [1.068–1.114]; p<0.0001 and 1.18 [1.137–1.222]; p<0.0001, respectively). Conclusions Our calculations suggest that more than a quarter-million persons have vision-threatening diabetic retinal disease in Germany. Prevalence of DR was lower in the GHS compared to East-Asian studies. Associations were found with age, arterial hypertension, obesity, and duration of diabetes mellitus. PMID:26075604

  17. Zinc status and its association with the health of adolescents: a review of studies in India

    PubMed Central

    Kawade, Rama

    2012-01-01

    Background Zinc is important in adolescence because of its role in growth and sexual maturation. Adolescents from developing countries such as India may be at high risk of zinc deficiency because of unwholesome food habits and poor bioavailability of zinc from plant-based diets. Objective (1) to study zinc status and its association with profile of other micronutrients, (2) to construct a simple tool in the form of Adolescent Micronutrient Quality Index (AMQI) to assess quality of diets of the girls and (3) to examine the effect of zinc supplement on health of adolescent girls. Methods Girls (10–16 years) from two secondary schools of Pune, Maharashtra state, in Western India were enrolled in a cross-sectional study (n = 630). Data were collected on dietary intake, cognitive performance, taste acuity, haemoglobin, erythrocyte zinc and plasma levels of zinc, vitamin C, β-carotene and retinol. AMQI was developed using age–sex-specific Indian dietary guidelines and healthy foods and habits described in the recent US dietary guidelines. Zinc-rich recipes were developed considering habitual diets of the girls and vegetarian sources of zinc. An intervention trial (n = 180) was conducted to assess the effect of zinc-rich dietary supplements and ayurvedic zinc (Jasad) supplementation. Results Prevalence of micronutrient deficiencies was high in these girls. Poor cognitive performance was seen in half of the girls, and salt taste perception was affected in 45%. AMQI was correlated with nutrient intakes and blood micronutrient levels (p < 0.01), indicating the potential of AMQI to measure micronutrient quality of diets of adolescent girls. Results of the intervention trial indicated that supplementation of zinc-rich recipes vis-a-vis ayurvedic Jasad zinc has the potential to improve plasma zinc status, cognitive performance and taste acuity in adolescent girls. Conclusions Review of the studies on Indian adolescent girls demonstrates the necessity of adopting zinc and

  18. Zinc status and its association with the health of adolescents: a review of studies in India.

    PubMed

    Kawade, Rama

    2012-01-01

    Zinc is important in adolescence because of its role in growth and sexual maturation. Adolescents from developing countries such as India may be at high risk of zinc deficiency because of unwholesome food habits and poor bioavailability of zinc from plant-based diets. (1) to study zinc status and its association with profile of other micronutrients, (2) to construct a simple tool in the form of Adolescent Micronutrient Quality Index (AMQI) to assess quality of diets of the girls and (3) to examine the effect of zinc supplement on health of adolescent girls. Girls (10-16 years) from two secondary schools of Pune, Maharashtra state, in Western India were enrolled in a cross-sectional study (n = 630). Data were collected on dietary intake, cognitive performance, taste acuity, haemoglobin, erythrocyte zinc and plasma levels of zinc, vitamin C, β-carotene and retinol. AMQI was developed using age-sex-specific Indian dietary guidelines and healthy foods and habits described in the recent US dietary guidelines. Zinc-rich recipes were developed considering habitual diets of the girls and vegetarian sources of zinc. An intervention trial (n = 180) was conducted to assess the effect of zinc-rich dietary supplements and ayurvedic zinc (Jasad) supplementation. Prevalence of micronutrient deficiencies was high in these girls. Poor cognitive performance was seen in half of the girls, and salt taste perception was affected in 45%. AMQI was correlated with nutrient intakes and blood micronutrient levels (p < 0.01), indicating the potential of AMQI to measure micronutrient quality of diets of adolescent girls. Results of the intervention trial indicated that supplementation of zinc-rich recipes vis-a-vis ayurvedic Jasad zinc has the potential to improve plasma zinc status, cognitive performance and taste acuity in adolescent girls. Review of the studies on Indian adolescent girls demonstrates the necessity of adopting zinc and micronutrient-rich diets for positive health building

  19. Dietary & health predictors associated with overweight & obesity in young adults: the Bogalusa Heart Study

    USDA-ARS?s Scientific Manuscript database

    We examined independent associations between diet and lifestyle behaviors; differences in markers of cardiovascular disease (CVD), and type 2 diabetes mellitus (T2DM); and self-reported health problems among normal weight (NW); overweight (OW), and obese (OB) young adults. Cross-sectional data on pa...

  20. Dairy food intake is positively associated with cardiovascular health: findings from Observation of Cardiovascular Risk Factors in Luxembourg study.

    PubMed

    Crichton, Georgina E; Alkerwi, Ala'a

    2014-12-01

    Conflicting findings have been reported about dairy food consumption and risk for cardiovascular disease. Furthermore, few studies have examined dairy food intake in relation to cardiovascular health and the incorporation of lifestyle factors such as diet and physical activity. This study examined whether dairy food consumption was associated with cardiovascular health, recently defined by the American Heart Association. Data were analyzed from 1352 participants from the Observation of Cardiovascular Risk Factors in Luxembourg survey. A validated food frequency questionnaire was used to measure intakes of milk, yogurt, cheese, dairy desserts, ice cream, and butter. Seven cardiovascular health metrics were assessed: smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose. A total cardiovascular health score (CHS) was determined by summing the total number of health metrics at ideal levels. It was hypothesized that greater dairy food consumption (both low fat and whole fat) would be associated with better global cardiovascular health, as indicated by a higher CHS. Total dairy food intake was positively associated with the CHS. Higher intakes of whole fat milk, yogurt, and cheese were associated with better cardiovascular health. Even when controlling for demographic and dietary variables, those who consumed at least 5 servings per week of these dairy products had a significantly higher CHS than those who consumed these products less frequently. Higher total whole fat dairy food intake was also associated with other positive health behaviors, including being a nonsmoker, consuming the suggested dietary intakes of recommended foods, and having a normal body mass index. Increased dairy food consumption was associated with better cardiovascular health. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Association Between Age at Menarche and Gestational Diabetes Mellitus: The Australian Longitudinal Study on Women's Health.

    PubMed

    Schoenaker, Danielle A J M; Mishra, Gita D

    2017-03-05

    In this study, we aimed to examine the association between age at menarche and gestational diabetes mellitus (GDM). Data were from 4,749 women participating in the Australian Longitudinal Study on Women's Health between 2000 and 2012. Age at menarche was reported at baseline in 2000 when women were aged 22-27 years. During 12 years of follow-up, information on GDM diagnosis was obtained for each live birth. Log-binomial regression analysis was used to estimate relative risks and 95% confidence intervals. Analyses adjusted for mother's highest completed educational qualification, nulliparity, polycystic ovary syndrome, physical activity, and body mass index. Mean age at menarche was 12.9 years (standard deviation, 1.4). A first diagnosis of GDM was reported by 357 women (7.5%). Compared with women with menarche at age 13 years, women who had their first menstruation at age ≤11 years had a 51% higher risk of developing GDM (95% confidence interval: 1.10, 2.07) after adjustment for GDM risk factors. Our findings indicate that a young age at menarche may identify women at higher risk of GDM. Further prospective studies are needed to confirm our findings and to elucidate the role of early-life exposures in age at menarche and subsequent GDM risk.

  2. Bidirectional Association between Diabetes and Gout: the Singapore Chinese Health Study

    PubMed Central

    Pan, An; Teng, Gim Gee; Yuan, Jian-Min; Koh, Woon-Puay

    2016-01-01

    We aimed to prospectively investigate the bidirectional association between type 2 diabetes (T2D) and gout. We analyzed follow-up data from the Singapore Chinese Health Study, when self-reports of diagnosed diabetes and gout were enquired at follow-ups I and II. Individuals who participated in both follow-ups and were free of cardiovascular disease or cancer at follow-up I were included. For T2D to gout (analysis I), prevalent gout were further excluded (final n = 31,137). For gout to T2D (analysis II), prevalent diabetes were excluded (final n = 28,668). Cox regression models were used to estimate relative risks (RRs). In the analysis I, the RR of diabetes to incident gout (682 cases) was 0.77 (95% CI 0.60–0.97). In the analysis II, the RR of gout to incident diabetes (2223 cases) was 1.36 (1.12–1.63), but became insignificant after adjustment for hypertension and BMI (1.00; 0.83–1.21). The gout to diabetes association was modified by BMI (Pinteraction = 0.04) and hypertension (Pinteraction = 0.007), and it was marginally significant in adults with BMI<24 while significant among non-hypertensive participants, but not in their counterparts. In conclusion, our results suggest that diabetes is associated with a lower risk of incident gout, while gout is positively related to diabetes among normal weight and non-hypertensive adults. PMID:27161168

  3. Dairy Food Intake Is Inversely Associated with Risk of Hypertension: The Singapore Chinese Health Study.

    PubMed

    Talaei, Mohammad; Pan, An; Yuan, Jian-Min; Koh, Woon-Puay

    2017-02-01

    Epidemiological evidence from Western populations suggests that dairy food intake may reduce the risk of hypertension, probably through its calcium content. However, there are no epidemiological studies among Asian populations with generally lower dairy and calcium consumption. The relation between dairy or calcium intake and risk of hypertension was evaluated in a Chinese population in Singapore. The analysis included 37,124 Chinese men and women aged 45-74 y who participated in the Singapore Chinese Health Study in 1993-1998. The subjects included in the present study had no history of cancer, hypertension, or cardiovascular disease at baseline and completed ≥1 follow-up interview. Diet at baseline was assessed by using a validated 165-item semiquantitative food-frequency questionnaire. The occurrence of new, physician-diagnosed hypertension was ascertained through follow-up interviews during 1999-2004 and 2006-2010. The Cox proportional hazard regression method was used to compute HRs and 95% CIs with adjustment for potential confounders. Dairy food intake was inversely associated with the risk of hypertension in a dose-dependent manner: HRs across quartiles were 1.00 (lowest quartile, reference), 0.97 (95% CI: 0.92, 1.02), 0.98 (95% CI: 0.92, 1.03), and 0.93 (95% CI: 0.88, 0.98) (P-trend = 0.01). Milk accounted for ∼80% of all dairy products consumed in this population. Daily milk drinkers had a lower risk of hypertension (HR: 0.94; 95% CI: 0.89, 0.99) than did nondrinkers. Nondairy calcium intake contributed 80% of total calcium intake. Although dairy calcium intake was associated with a lower risk of hypertension (HR comparing extreme quartiles: 0.88; 95% CI: 0.83, 0.94; P-trend < 0.001), there was no association for nondairy calcium intake (HR: 1.02; 95% CI: 0.94, 1.10; P-trend = 0.58). Baseline dairy food intake, and specifically that of milk, may reduce the risk of developing hypertension in Chinese adults, and this may not be associated with the

  4. Health locus of control in patients undergoing coronary artery surgery - changes and associated outcomes: a seven-year cohort study.

    PubMed

    Rideout, Andrew; Tolmie, Elizabeth; Lindsay, Grace

    2017-01-01

    Health locus of control is a measure of an individual's beliefs in factors that are thought to determine health experiences. Scores are generated and form a graduated linear scale from external to internal control, with respect to their views on health causality. Health locus of control has been considered to be a relatively stable entity. However, it is not clear if this status changes in the advent of serious health challenges, such as coronary artery bypass graft surgery. The aim of this study is to explore the variability of health locus of control and its association with postoperative health in this context. In a longitudinal cohort study of patients undergoing coronary artery bypass graft surgery, a purposive sample ( n=215) were recruited from the waiting list and followed up postoperatively, at approximately one year and seven years later. Patients undergoing coronary artery bypass graft surgery demonstrated marked fluctuations in health locus of control in their peri-operative and rehabilitative phases. Mean health locus of control became more external (often associated with poorer outcomes) peri-operatively, and more internal (generally associated with better health outcomes) in the rehabilitative period. Health locus of control scores were shown to be changeable during a major health care intervention, with possible consequences for patient outcomes and care needs. The significant health belief upheaval demonstrated in this cohort should be considered in assessing patients preoperatively, and managed as part of the patients' clinical journey by both acute and rehabilitation staff. It is likely to have particular importance in individualised assessment and management of future prevention advice for patients.

  5. A comparative study of professional and interprofessional values between health professional associations.

    PubMed

    Tsou, PaiHsuan; Shih, Julie; Ho, Ming-Jung

    2015-01-01

    The need for effective interprofessional collaboration to ensure safe patient care is crucial. However, health professions are guided by separate professional codes of conduct. To examine whether professional codes are consistent across professions, this review examines 13 key health professional associations in the United States and compares their values to the guiding principles of interprofessional practice defined by the Interprofessional Professionalism Collaborative (IPC). Findings indicate that all six of the IPC's principles (altruism/caring, excellence, ethics, respect, communication, and accountability) were shared by the majority of professions, with many emphasizing two additional attributes, integrity and justice, suggesting there is room to expand the IPC's core principles. Few associations included interprofessional communication and collaboration in their professional codes. There is potential for associations to promote greater interprofessional collaboration by reshaping their professional frameworks. With many shared values across professions, establishing a common framework of interprofessional professionalism is feasible.

  6. Single nucleotide polymorphisms in the vitamin D pathway associating with circulating concentrations of vitamin D metabolites and non-skeletal health outcomes: Review of genetic association studies.

    PubMed

    Jolliffe, David A; Walton, Robert T; Griffiths, Christopher J; Martineau, Adrian R

    2016-11-01

    Polymorphisms in genes encoding proteins involved in vitamin D metabolism and transport are recognised to influence vitamin D status. Syntheses of genetic association studies linking these variants to non-skeletal health outcomes are lacking. We therefore conducted a literature review to identify reports of statistically significant associations between single nucleotide polymorphisms (SNP) in 11 vitamin D pathway genes (DHCR7, CYP2R1, CYP3A4, CYP27A1, DBP, LRP2, CUB, CYP27B1, CYP24A1, VDR and RXRA) and non-bone health outcomes and circulating levels of 25-hydroxyvitamin D (25[OH]D and 1,25-dihydroxyvitamin D (1,25[OH]2D). A total of 120 genetic association studies reported positive associations, of which 44 investigated determinants of circulating 25(OH)D and/or 1,25(OH)2D concentrations, and 76 investigated determinants of non-skeletal health outcomes. Statistically significant associations were reported for a total of 55 SNP in the 11 genes investigated. There was limited overlap between genetic determinants of vitamin D status and those associated with non-skeletal health outcomes: polymorphisms in DBP, CYP2R1 and DHCR7 were the most frequent to be reported to associate with circulating concentrations of 25(OH)D, while polymorphisms in VDR were most commonly reported to associate with non-skeletal health outcomes, among which infectious and autoimmune diseases were the most represented.

  7. Associations Between Fetal Growth and Self-Perceived Health Throughout Adulthood: A Co-twin Control Study.

    PubMed

    Mosing, Miriam A; Cnattingius, Sven; Gatz, Margaret; Neiderhiser, Jenae M; Pedersen, Nancy L

    2016-05-01

    The literature shows evidence for long-lasting effects of low birth weight (LBW) on many health outcomes, but little is known about effects on self-perceived health. Findings are mixed and studies are small, mostly focusing on LBW effects on health outcomes before adulthood. Further, as LBW and most health conditions including self-perceived health are partly heritable, associations between birth weight (BW) and adverse health outcomes may also be due to shared genetic as well as other (pre- and postnatal) unmeasured environmental influences. We explored LBW effects on self-perceived health in early and later adulthood using a very large and genetically informative sample of more than 50,000 Swedish twins. In addition, analyses within twin pairs (the co-twin control design) were used to examine potential associations between BW and the offspring's risk for poor self-perceived health independent of shared environmental or genetic factors, evidence which is critical for the understanding of underlying mechanisms. Results showed that lower BW was significantly associated with poorer self-perceived health during adulthood, although the effect size was small. Co-twin control analyses suggested that this increased risk may be due to shared underlying liability (environmental or genetic) rather than a direct effect of BW, but findings were not conclusive.

  8. Association between adiponectin and heart failure risk in the Physicians' Health Study

    PubMed Central

    Djoussé, Luc; Wilk, Jemma B.; Hanson, Naomi Q.; Glynn, Robert; Tsai, Michael Y.; Gaziano, J. Michael

    2012-01-01

    Limited data are available on the association between adiponectin and incident heart failure. In the current ancillary study to the Physicians' Health Study, we used a prospective nested-case control design to examine whether plasma adiponectin concentration was related to the risk of heart failure. We selected 787 incident heart failure cases and 787 matched controls for the current analysis. Each control was selected using a risk set sampling technique at the time of the occurrence of the index case and matched on year of birth, age at blood collection, and race. Adiponectin was measured using ELISA. Heart failure occurrence was self-reported in annual follow-up questionnaire. Validation of self-reported heart failure in this cohort has been published. The mean age was 58.7 years. In a conditional logistic regression adjusting for age, race, time of blood collection, year of birth, hypertension, atrial fibrillation, smoking, alcohol intake, and exercise, estimates of the relative risk (95% confidence interval) were 1.0 (ref), 0.74 (0.53–1.04), 0.67 (0.48–0.94), 0.70 (0.50–0.99), and 0.92 (0.65–1.30) from the lowest to the highest quintile of adiponectin, respectively, p for quadratic trend 0.004. Additional adjustment for potential mediating factors including diabetes, C-reactive protein, and body mass index led to the attenuation of the estimate of effect [1.0 (ref), 0.81 (0.57–1.15), 0.75 (0.53–1.06), 0.83 (0.58–1.18), and 1.26 (0.87–1.81) across consecutive quintiles of adiponectin]. Our data are consistent with a J-shaped association between total adiponectin and the risk of heart failure among US male physicians. PMID:23712986

  9. Demographic and Environmental Factors Associated with Mental Health: A Cross-Sectional Study.

    PubMed

    Kim, Jayeun; Kim, Ho

    2017-04-17

    Relevant demographic and environmental conditions need to be understood before tailoring policies to improve mental health. Using community health survey data from 25 communities in Seoul, 2013, cross-sectional associations between mental health and community level environments were assessed. Mental health outcomes (self-rated stress levels (SRS) and depressive symptoms (DS)) were analyzed. Community environmental factors included green space, green facilities, and annual PM10 level (AnnPM10); socio-demographic factors included sex, age, education, labor market participation, comorbidity, sleep hours, physical activity, smoking, and drinking. A total of 23,139 people with the following characteristics participated: men (44.2%); age groups 19-39 (36.0%), 40-59 (39.4%), 60-74 (19.2%), and 75+ (5.4%). Women had higher odds ratios (OR) for SRS [OR 1.22, 95% Confidence interval (CI) 1.17-1.27] and DS [OR 1.55, 95% CI 1.42-1.71]. Regular physical activity predicted SRS [OR 0.90, 95% CI 0.84-0.95] and DS [OR 0.98, 95% CI 0.88-1.10]; current smoking and drinking were adversely associated with both SRS and DS. Higher accessibility to green space (Q4) was inversely associated with DS [OR 0.89, 95% CI 0.81-0.97] compared to lower accessibility (Q1). AnnPM10, annual levels for particles of aerodynamic diameter <10 µm (PM10), among communities was associated with poorer SRS [OR 1.02, 95% CI 1.00-1.04] by 10 μg/m³ increases. Therefore, both demographic and environmental factors should be considered to understand mental health conditions among the general population.

  10. Visitor behaviour and public health implications associated with exotic pet markets: an observational study

    PubMed Central

    Warwick, Clifford; Arena, Phillip C; Steedman, Catrina

    2012-01-01

    Objectives To conduct on-site assessments of public health implications at key European pet markets. Design Observational study of visitor behaviour at stalls that displayed and sold animals, mainly amphibians and reptiles, to assess potential contamination risk from zoonotic pathogens. We noted initial modes of contact as ‘direct’ (handling animals) as well as ‘indirect’ (touching presumed contaminated animal-related sources) and observed whether these visitors subsequently touched their own head or mouth (H1), body (H2) or another person (H3). Setting Publicly accessible exotic animal markets in the UK, Germany and Spain. Participants Anonymous members of the public in a public place. Main outcome measures Occurrence and frequency of public contact (direct, indirect or no contact) with a presumed contaminated source. Results A total of 813 public visitors were observed as they attended vendors. Of these, 29 (3.6%) made direct contact with an animal and 222 (27.3%) made indirect contact with a presumed contaminated source, with subsequent modes of contact being H1 18.7%, H2 52.2% and H3 9.9%. Conclusions Our observations indicate that opportunities for direct and indirect contact at pet markets with presumed contaminated animals and inanimate items constitute a significant and major concern, and that public attendees are exposed to rapid contamination on their person, whether or not these contaminations become associated with any episode of disease involving themselves or others. These public health risks appear unresolvable given the format of the market environment. PMID:23323203

  11. Cultural activity participation and associations with self-perceived health, life-satisfaction and mental health: the Young HUNT Study, Norway.

    PubMed

    Hansen, Elisabeth; Sund, Erik; Skjei Knudtsen, Margunn; Krokstad, Steinar; Holmen, Turid Lingaas

    2015-06-10

    Leisure time activities and culture participation may have health effects and be important in pulic health promotion. More knowledge on how cultural activity participation may influence self-perceived health, life-satisfaction, self-esteem and mental health is needed. This article use data from the general population-based Norwegian HUNT Study, using the cross-sectional Young-HUNT3 (2006-08) Survey including 8200 adolescents. Data on cultural activity participation, self-perceived health, life-satisfaction, self-esteem, anxiety and depression were collected by self-reported questionnaires. Both attending meetings or training in an organisation or club, and attending sports events were positively associated with each of the health parameters good self-percieved health, good life-satisfaction, good self-esteem, and low anxiety and depression symptoms. We found differences according to gender and age (13-15 years versus 16-19 years old) for several culture activities, where girls aged 16-19 years seemed to benefit most from being culturally active. The extent of participation seemed to matter. Those who had frequent participation in cultural activities reported better health outcomes compared to inactive adolecents. The results from this study indicate that participation in cultural activities may be positively associated with health, life-satisfaction and self-esteem in adolescents and thus important in public health promotion. Possible sex and age differences should be taken into account.

  12. Health-Related Factors Associated with Discrepancies between Children’s Potential and Attained Secondary School Level: A Longitudinal Study

    PubMed Central

    van der Heide, Iris; Gehring, Ulrike; Koppelman, Gerard H.; Wijga, Alet H.

    2016-01-01

    Objectives This longitudinal study examines children’s health-related characteristics in relation to discrepancies between their educational potential assessed by a cognitive test in primary school at age 11 and their attained secondary school level at age 14. Methods Data were used from 1510 participants of the Dutch PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort. Multiple multinomial logistic regression analyses were used to estimate the associations between indicators of physical health, psychosocial health, lifestyle, sleeping patterns and stressful life events and attending a higher or lower level of secondary education than indicated by the cognitive test. Results We found no evidence that physical health contributes to discrepancies between the potential and attained level of secondary education, but attention disorders and stressful life events (nasty experiences and parents’ divorce) were associated with educational attainment below children’s potential level. Furthermore, substance use (alcohol, drugs and smoking) were strongly associated with attending a lower level of secondary education than expected (odds ratios from 2.2 (CI: 1.5–3.3) to 5.0 (CI: 2.8–8.7)). Conclusion In this general population study, attention disorders, stressful life events and especially substance use seemed to be more important than physical health for the discrepancy between expected and attained level of secondary education. The longitudinal design of the present study and the broad range of health-related factors that were studied, adds insights to the process of health-selection. PMID:28005962

  13. Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls

    PubMed Central

    Tunkel, Sarah; Blunt, Ian; Bardsley, Martin

    2013-01-01

    Objectives To test the effect of a telephone health coaching service (Birmingham OwnHealth) on hospital use and associated costs. Design Analysis of person level administrative data. Difference-in-difference analysis was done relative to matched controls. Setting Community based intervention operating in a large English city with industry. Participants 2698 patients recruited from local general practices before 2009 with heart failure, coronary heart disease, diabetes, or chronic obstructive pulmonary disease; and a history of inpatient or outpatient hospital use. These individuals were matched on a 1:1 basis to control patients from similar areas of England with respect to demographics, diagnoses of health conditions, previous hospital use, and a predictive risk score. Intervention Telephone health coaching involved a personalised care plan and a series of outbound calls usually scheduled monthly. Median length of time enrolled on the service was 25.5 months. Control participants received usual healthcare in their areas, which did not include telephone health coaching. Main outcome measures Number of emergency hospital admissions per head over 12 months after enrolment. Secondary metrics calculated over 12 months were: hospital bed days, elective hospital admissions, outpatient attendances, and secondary care costs. Results In relation to diagnoses of health conditions and other baseline variables, matched controls and intervention patients were similar before the date of enrolment. After this point, emergency admissions increased more quickly among intervention participants than matched controls (difference 0.05 admissions per head, 95% confidence interval 0.00 to 0.09, P=0.046). Outpatient attendances also increased more quickly in the intervention group (difference 0.37 attendances per head, 0.16 to 0.58, P<0.001), as did secondary care costs (difference £175 per head, £22 to £328, P=0.025). Checks showed that we were unlikely to have missed reductions in

  14. Evaluation of sex differences in health-related quality of life outcomes associated with child abuse: Results from the Ontario Child Health Study.

    PubMed

    Tanaka, M; Afifi, T O; Wathen, C N; Boyle, M H; MacMillan, H L

    2015-08-01

    Despite the advances in child maltreatment research, there is still the need for comprehensive information about how abuse affects a broad range of categories of young adult functioning, and the extent to which these vary by sex. We examined the associations between child physical abuse (PA) and sexual abuse (SA) and six areas of functioning (mental health, physical health, life satisfaction, illegal substance use, alcohol problems and daily smoking). Data were obtained from the 1983 Ontario Child Health Study and follow-up in 2000/2001 (n = 1893). Multilevel regression estimated the adjusted associations for PA (with severity) and SA with each of the outcomes. Estimates with an entire sample were presented with sex-by-abuse interactions to examine sex differences and then presented separately by sex. In the adjusted model, severe PA and SA were associated with impairment in mental health, and both forms of PA (severe and non-severe) and SA were associated with low life satisfaction. In addition, severe PA was associated with illegal substance use. Child abuse variables were not associated with poor physical health, alcohol problems or smoking. Although sex-stratified analyses revealed different patterns, there was no significant sex difference in the integrated sample. This is among the first community-based studies to show a strong association between child PA and SA and low life satisfaction in young adults. The abuse effects were similar for both sexes.

  15. Age Differences in the Association of Social Support and Mental Health in Male U.S. Veterans: Results From the National Health and Resilience in Veterans Study.

    PubMed

    Weiner, Melissa R; Monin, Joan K; Mota, Natalie; Pietrzak, Robert H

    2016-04-01

    To examine the associations between multiple aspects of social support-perceived support, structural support, and community integration-and mental health difficulties in younger and older male veterans. Drawing from Socioemotional Selectivity Theory (SST), we hypothesized that greater support would be more strongly negatively related to mental health difficulties in older than younger veterans. Cross-sectional Web survey of younger and older male veterans recruited from a contemporary, nationally representative sample of veterans residing in the United States. Data were drawn from the National Health and Resilience in Veterans Study. Participants were 290 younger male veterans (mean age: 37.0 years, SD: 6.9, range: 21-46) and 326 older male veterans (mean age: 81.7 years, SD: 3.2, range: 78-96). Participants completed measures of sociodemographic and military characteristics, perceived and structural social support, community integration, and mental health difficulties. In contrast to SST, higher perceived support was associated with fewer mental health difficulties in younger but not older veterans. In line with SST, community integration was associated with fewer mental health difficulties in older but not younger veterans. Structural support was not associated with mental health difficulties in either group. Results of this study provide mixed support for SST and suggest that different aspects of social support may help promote the mental health of younger and older male U.S. veterans. Promotion of community engagement may help promote mental health in older veterans, whereas promotion of functional social support may help promote mental health in younger veterans. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  16. Associations Between Gender and Obesity Among Adults with Mental Illnesses in a Community Health Screening Study.

    PubMed

    Jonikas, Jessica A; Cook, Judith A; Razzano, Lisa A; Steigman, Pamela J; Hamilton, Marie M; Swarbrick, Margaret A; Santos, Alberto

    2016-05-01

    The prevalence of obesity and its associations with gender, clinical factors, and medical co-morbidities were examined among 457 adults attending public mental health programs in 4 U.S. states. BMI was measured directly and other information was gathered by interview. Over half (59%, n = 270) were obese including 18% (n = 83) who were morbidly obese. In hierarchical ordinary least squares regression analysis controlling for demographic, psychiatric, medical, smoking, and health insurance statuses, women were significantly more likely to be obese than men. Obesity also was more likely among those who were younger and not high school graduates, those with diabetes or hypertension, and those who did not smoke tobacco. Interaction effects were found between gender and diabetes, hypertension, tobacco smoking, education, race, and age. The high prevalence of obesity among women, coupled with interactions between gender and other factors, suggest that targeted approaches are needed to promote optimal physical health in this population.

  17. Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study

    PubMed Central

    Leung, Ying-Ying; Allen, John Carson; Noviani, Maria; Ang, Li-Wei; Wang, Renwei; Yuan, Jian-Min; Koh, Woon-Puay

    2014-01-01

    Purpose Data on the association between body mass index (BMI) and risk of knee osteoarthritis (KOA) are sparse for Asian populations who are leaner than Western populations. We evaluated the association between BMI and risk of total knee replacement (TKR) due to severe KOA among Chinese in Singapore. Methods We used data from the Singapore Chinese Health Study, a population based prospective cohort of 63,257 Chinese men and women, aged 45–74 years at enrollment from 1993 to 1998. Information on height, weight, diet and lifestyle factors were obtained via in-person interviews. TKR cases for severe KOA were identified via linkage with the nationwide hospital discharge database through 2011. Cox regression and weighted least squares regression were used in the analysis. Results The mean BMI among cohort participants was 23.1 kg/m2, and more than two-thirds had BMI below 25 kg/m2. A total of 1,649 had TKR attributable to severe KOA. Risk of TKR increased in a strong dose-dependent manner with increasing BMI throughout the 15–32 kg/m2 range and became less clear at BMI > 32 kg/m2. In the BMI range 16–27 kg/m2, there was a 27% increase in TKR risk for each unit increase in BMI (p for trend < 0.001). Compared to BMI 19–20 kg/m2, the risk estimates of TKR were all statistically significant with increasing unit of BMI ≥ 21 kg/m2. Results were similar for men and women. Conclusion Our results provided evidence for a constant mechanical mechanism underlying BMI and KOA initiation and/or progression. PMID:25450848

  18. Migraine Features, Associated Symptoms, and Triggers: A Principal Component Analysis in the Women's Health Study

    PubMed Central

    Schürks, Markus; Buring, Julie E.; Kurth, Tobias

    2011-01-01

    Aims Migraine has a wide clinical spectrum. Our aim was to group information on migraine characteristics into meaningful components and to identify key components of the migraine phenotype. Methods We performed two principal component analyses, one among participants in the Women's Health Study enrolment cohort and one in a sub-cohort with additional migraine-specific information. Results Among the 9,427 women with migraine attack-related information at enrolment, the three most important components pertained to central nervous system (CNS) sensitization, attack frequency/pain location, and aura/visual phenomena. In the sub-group of 1,675 women with more detailed information, food triggers and unspecific symptoms constituted two principal components that explain more of the variance of the migraine phenotype than the three attack-related components. Conclusions Our results indicate that information on migraine-associated features, symptoms, and triggers is highly correlated allowing the extraction of principal components. Migraine attack-related symptoms are best summarized by symptoms related to CNS sensitization, attack frequency/pain location, and aura/visual phenomena. Taking a more general view, unspecific symptoms and food triggers appear to carry stronger importance in characterizing the migraine phenotype. These components are useful for future research on the pathophysiology and genetics of migraine and may have implications for diagnosing and treating patients. PMID:21398421

  19. National Rural Health Association

    MedlinePlus

    ... and Roster NRHA Past Presidents NRHA Leadership Constituency Groups History of Rural Health History of Rural Health Globalization Urban Bias Dependency Theory Political Economy History of Rural Health IV: '60s ...

  20. Association between Sleep Duration and Self-Reported Health Status: Findings from the Bhutan's Gross National Happiness Study.

    PubMed

    Sithey, Gyambo; Wen, Li Ming; Kelly, Patrick; Li, Mu

    2017-01-15

    Short and long sleep durations have been found to be associated with chronic conditions like diabetes mellitus, hypertension and cardiovascular disease. However, most studies were conducted in developed countries and the results were inconsistent. The aim of this study is to investigate the association between sleep duration and self-reported health status in a developing country setting. We conducted secondary data analysis of the 2010 Gross National Happiness study of Bhutan, which was a nationwide cross sectional study with representative samples from rural and urban areas. The study included 6476 participants aged 15-98 y. The main outcome variable of interest was self-reported health status. Sleep duration was categorized as ≤ 6 h, 7 h, 8 h, 9 h, 10 h, and ≥ 11 h. Multiple logistic regressions were conducted to investigate the association between sleep duration and self-reported health status. The mean sleep duration was 8.5 (± 1.65) h. Only 9% of the respondents slept for 7 h; 6% were short sleepers (≤ 6 h) and 84% were long sleepers (21%, 8 h; 28%, 9 h; 22%, 10 h; 13%, ≥ 11 h). We found that both short (≤ 6 h) and long sleep duration (≥ 11 h) were independently associated with poor self-reported health status. This study found that people with shorter and longer sleep durations were more likely to report poorer health status.

  1. Clarifying Associations between Childhood Adversity, Social Support, Behavioral Factors, and Mental Health, Health, and Well-Being in Adulthood: A Population-Based Study.

    PubMed

    Sheikh, Mashhood A; Abelsen, Birgit; Olsen, Jan A

    2016-01-01

    Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES), childhood traumatic experiences (CTEs), social support and behavioral factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n = 12,981) of the adult population in Tromsø, Norway, this study examines (i) the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress) to social support and behavioral factors in adulthood; (ii) the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioral factors to three multi-item instruments of mental health (SCL-10), health (EQ-5D), and subjective well-being (SWLS) in adulthood; (iii) the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv) the mediating role of adult social support and behavioral factors in these associations. Instrumental support (24.16%, p < 0.001) explained most of the variation in mental health, while gender (21.32%, p < 0.001) explained most of the variation in health, and emotional support (23.34%, p < 0.001) explained most of the variation in well-being. Psychological abuse was relatively more important for mental health (12.13%), health (7.01%), and well-being (9.09%), as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%), health (10.60%), and well-being (20.60%), as compared to mother's and father's education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs

  2. Clarifying Associations between Childhood Adversity, Social Support, Behavioral Factors, and Mental Health, Health, and Well-Being in Adulthood: A Population-Based Study

    PubMed Central

    Sheikh, Mashhood A.; Abelsen, Birgit; Olsen, Jan A.

    2016-01-01

    Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES), childhood traumatic experiences (CTEs), social support and behavioral factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n = 12,981) of the adult population in Tromsø, Norway, this study examines (i) the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress) to social support and behavioral factors in adulthood; (ii) the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioral factors to three multi-item instruments of mental health (SCL-10), health (EQ-5D), and subjective well-being (SWLS) in adulthood; (iii) the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv) the mediating role of adult social support and behavioral factors in these associations. Instrumental support (24.16%, p < 0.001) explained most of the variation in mental health, while gender (21.32%, p < 0.001) explained most of the variation in health, and emotional support (23.34%, p < 0.001) explained most of the variation in well-being. Psychological abuse was relatively more important for mental health (12.13%), health (7.01%), and well-being (9.09%), as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%), health (10.60%), and well-being (20.60%), as compared to mother's and father's education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs

  3. Assessing the association between environmental impacts and health outcomes: a case study from Florida.

    PubMed

    Young, Linda J; Gotway, Carol A; Yang, Jie; Kearney, Greg; DuClos, Chris

    2008-09-10

    The Centers for Disease Control and Prevention (CDC) created the Environmental Public Health Tracking (EPHT) program to integrate hazard monitoring, exposure, and health effects surveillance into a cohesive tracking network. Part of Florida's effort to move toward implementation of EPHT is to develop models of the spatial and temporal association between myocardial infarctions (MIs) and ambient ozone levels in Florida. Existing data were obtained from Florida's Agency for Health Care Administration, Florida's Department of Environmental Protection, the U.S. Census Bureau, and CDC's Behavioral Risk Factor Surveillance System. These data were linked by both ignoring spatial support and using block kriging, a support-adjusted approach. The MI data were indirectly standardized by age, race/ethnicity, and sex. The state of Florida was used as the comparison standard to compute the MI standardized event ratio (SER) for each county and each month. After the data were linked, global models were used initially to relate MIs to ambient ozone levels, adjusting for covariates. The global models provide an estimated relative MI SER for the state. Realizing that the association in MIs and ozone might change across locations, local models were used to estimate the relative MI SER for each county, again adjusting for covariates. Results differed, depending on whether the spatial support was ignored or accounted for in the models. The opportunities and challenges associated with EPHT analyses are discussed and future directions highlighted.

  4. Case studies on genetically modified organisms (GMOs): Potential risk scenarios and associated health indicators.

    PubMed

    De Santis, Barbara; Stockhofe, Norbert; Wal, Jean-Michel; Weesendorp, Eefke; Lallès, Jean-Paul; van Dijk, Jeroen; Kok, Esther; De Giacomo, Marzia; Einspanier, Ralf; Onori, Roberta; Brera, Carlo; Bikker, Paul; van der Meulen, Jan; Gijs, Kleter

    2017-08-30

    Within the frame of the EU-funded MARLON project, background data were reviewed to explore the possibility of measuring health indicators during post-market monitoring for potential effects of feeds, particularly genetically modified (GM) feeds, on livestock animal health, if applicable. Four case studies (CSs) of potential health effects on livestock were framed and the current knowledge of a possible effect of GM feed was reviewed. Concerning allergenicity (CS-1), there are no case-reports of allergic reactions or immunotoxic effects resulting from GM feed consumption as compared with non-GM feed. The likelihood of horizontal gene transfer (HGT; CS-2) of GMO-related DNA to different species is not different from that for other DNA and is unlikely to raise health concerns. Concerning mycotoxins (CS-3), insect-resistant GM maize may reduce fumonisins contamination as a health benefit, yet other Fusarium toxins and aflatoxins show inconclusive results. For nutritionally altered crops (CS-4), the genetic modifications applied lead to compositional changes which require special considerations of their nutritional impacts. No health indicators were thus identified except for possible beneficial impacts of reduced mycotoxins and nutritional enhancement. More generally, veterinary health data should ideally be linked with animal exposure information so as to be able to establish cause-effect relationships. Copyright © 2017. Published by Elsevier Ltd.

  5. Visiting green space is associated with mental health and vitality: A cross-sectional study in four european cities.

    PubMed

    van den Berg, Magdalena; van Poppel, Mireille; van Kamp, Irene; Andrusaityte, Sandra; Balseviciene, Birute; Cirach, Marta; Danileviciute, Asta; Ellis, Naomi; Hurst, Gemma; Masterson, Daniel; Smith, Graham; Triguero-Mas, Margarita; Uzdanaviciute, Inga; de Wit, Puck; van Mechelen, Willem; Gidlow, Christopher; Grazuleviciene, Regina; Nieuwenhuijsen, Mark J; Kruize, Hanneke; Maas, Jolanda

    2016-03-01

    Many epidemiological studies have found that people living in environments with more green space report better physical and mental health than those with less green space. However, the association between visits to green space and mental health has seldom been studied. The current study explored the associations between time spent in green spaces by purposeful visits and perceived mental health and vitality in four different European cities, and to what extent gender, age, level of education, attitude towards nature and childhood nature experience moderate these associations. Data was gathered using a questionnaire administered in four European cities (total n=3748). Multilevel analyses showed significant positive associations between time spent visiting green spaces and mental health and vitality in the pooled data, as well as across the four cities. Significant effect modification was found for level of education and childhood nature experience. The findings confirm the hypothesis that more time spent in green space is associated with higher scores on mental health and vitality scales, independent of cultural and climatic contexts.

  6. Assessment of knowledge and practice of health workers towards tuberculosis infection control and associated factors in public health facilities of Addis Ababa, Ethiopia: A cross-sectional study.

    PubMed

    Demissie Gizaw, Girma; Aderaw Alemu, Zewdie; Kibret, Kelemu Tilahun

    2015-01-01

    Tuberculosis is the leading causes of mortality among infectious diseases worldwide. The risk of transmission from patients to health workers is doubles that of the general population. The close contact to the infectious case before diagnosis is the major risk for tuberculosis infection. The aim of the study was to assess knowledge and practice of health professionals towards tuberculosis infection control and its associated factors in health facilities of Addis Ababa, Ethiopia. A cross-sectional study was conducted from February 29 to April 15/2014 in selected health facilities in Addis Ababa. Five hundred ninety health workers were included in the study. The sample size was assigned to each health facility proportional to their number of health workers. Study subjects were selected from each stratum by simple random sampling technique. Interviewer administered structured questionnaire was used to collect information. Logistic regression was used to identify factors associated with knowledge and practice of health workers towards tuberculosis infection control. Five hundred eighty two participants with 98.6% response rate were involved in the study. Of these, 36.1% had poor knowledge and 51.7% unsatisfactory practice score towards tuberculosis infection control. Having more than six years working experience in health facility (AOR = 2.51; 95% CI: 1.5-4.1) and tuberculosis related training (AOR = 2.51 95% CI; 1.5, 4.1) were significantly associated with knowledge on tuberculosis infection control. Having experience in tuberculosis clinic (AOR =1.93; 95% CI: 1.12, 3.34) and tuberculosis related training (AOR = 1.48; 95% CI: 1.87, 2.51) were significantly associated with practice on tuberculosis infection control. One third of health workers had relatively poor knowledge and nearly half of them had unsatisfactory practice on tuberculosis infection control. Tuberculosis training and work experiences in health facility are determinant factor to knowledge

  7. A study of aged population and associated health risks in rural India.

    PubMed

    Yadava, K N; Yadava, S S; Vajpeyi, D K

    1997-01-01

    This article examines the prevalence of age-related diseases in different socioeconomic and demographic groups. The study is based on a sample of 267 aged persons (> 60 years) collected through a survey entitled "Aging and Health Conditions in Rural Area-A Sample Survey, 1990" conducted in the rural areas of the Varanasi district of Uttar Pradesh, a northern province of India. Various socio-behavioral factors are found to play a significant role in determining the health conditions of aged people. Also, illiteracy and poverty are found to have their own impact on health during aging. It is also noted that due to adverse familial relationships, many stress-related disorders occur which may result in the poor health of the elderly. Demands for old age pensions were made by most of the elderly people in the sample.

  8. Dietary patterns are associated with disease risk among participants in the women's health initiative observational study

    USDA-ARS?s Scientific Manuscript database

    Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infar...

  9. Age Differences in the Association of Social Support and Mental Health in Male U.S. Veterans: Results from the National Health and Resilience in Veterans Study

    PubMed Central

    Weiner, Melissa R.; Monin, Joan K.; Mota, Natalie; Pietrzak, Robert H.

    2015-01-01

    Objective To examine the associations between multiple aspects of social support—perceived support, structural support, and community integration—and mental health difficulties in younger and older male veterans. Drawing from Socioemotional Selectivity Theory (SST), we hypothesized that greater support would be more strongly negatively related to mental health difficulties in older than younger veterans. Design Cross-sectional web survey of younger and older male veterans drawn from a contemporary, nationally representative sample of veterans residing in the United States. Setting Data were drawn from the National Health and Resilience in Veterans Study (NHRVS). Participants Participants were 290 younger male veterans (mean age=37.0, SD=6.9, range=21–46) and 326 older male veterans (mean age=81.7, SD=3.2, range=78–96). Measurements Participants completed measures of socio-demographic and military characteristics, perceived and structural social support, community integration, and mental health difficulties. Results In contrast to SST, higher perceived support was associated with fewer mental health difficulties in younger but not older veterans. In line with SST, community integration was associated with fewer mental health difficulties in older but not younger veterans. Structural support was not associated with mental health difficulties in either group. Conclusion Results of this study provide mixed support for SST and suggest that different aspects of social support may help promote the mental health of younger and older male U.S. veterans. Promotion of community engagement may protect mental health in older veterans, while promotion of functional social support may protect mental health in younger veterans. PMID:26880612

  10. Association between inflammatory potential of diet and mortality in the Iowa Women’s Health study

    PubMed Central

    Blair, Cindy K.; Prizment, Anna E.; Jacobs, David R.; Steck, Susan E.; Hébert, James R.

    2016-01-01

    Purpose Chronic diseases such as cancer and cardiovascular disease (CVD) are well-established causes of disability and premature deaths. Dietary components that are known to affect chronic inflammation have been implicated in the etiology and prognosis of these chronic diseases. We examined the ability of the dietary inflammatory index (DII) to predict overall, cancer and CVD mortality in the Iowa Women’s Health study. Methods The DII was computed from baseline dietary intake assessed in this cohort of 37,525 women, who were aged 55–69 years when enrolled starting in 1986. During the follow-up period, through December 31, 2010, in a total of 17,793 deaths, 5044 cancer- and 6528 CVD-related deaths were identified through mortality record linkage. Cox proportional hazards regression was used to estimate hazard ratios (HR) with DII expressed both as a continuous variable and as quartiles. Results Comparing subjects in DII Quartile 4 versus Quartile 1, modest positive associations were noted for all-cause mortality (HRQ4vsQ1 1.07; 95 % CI 1.01–1.13; p-trend = 0.006), digestive cancer mortality (HRQ4vsQ1 1.19; 95 % CI 1.00–1.43; p-trend = 0.05), CVD mortality (HRQ4vsQ1 1.09; 95 % CI 1.01–1.18; p-trend = 0.08), non-cancer/non-CVD/non-acute mortality (HRQ4vsQ1 1.09; 95 % CI 1.00–1.19; p-trend = 0.19), coronary heart disease (CHD) mortality (HRQ4vsQ1 1.17; 95 % CI 1.05–1.30; p-trend = 0.001) and chronic obstructive pulmonary disease (COPD) mortality (HRQ4vsQ1 1.43; 95 % CI 1.18– 1.75; p-trend = 0.0006). No substantial associations were observed for mortality from stroke, Alzheimer’s disease or unspecified dementia. Conclusion These results indicate that a pro-inflammatory diet, as evidenced by higher DII scores, may be associated with total mortality as well as mortality from digestive cancer, CVD, CHD and COPD. PMID:26130324

  11. Defending behaviors, bullying roles, and their associations with mental health in junior high school students: a population-based study.

    PubMed

    Wu, Wen-Chi; Luu, Shyuemeng; Luh, Dih-Ling

    2016-10-10

    Students should be encouraged to help prevent or stop bullying. However, defending victims of bullying can impact on mental health. It is not only bystanders who may defend victims, but bullies, victims and bully-victims can also have defending behaviors. Nevertheless, most studies of defending behaviors have been limited to an examination of the reactions of bystanders or those not involved in bullying and have ignored the other players. The aim of this study is to investigate the associations between defending behaviors and mental health among bullies, victims, bully-victims and bystanders. Associations among defending behaviors, mental health (including depressive symptoms and social anxiety), and bullying experiences were cross-sectionally examined in 3441 students (13-15 years old.) from 20 randomly selected junior high schools in Taiwan using a self-report questionnaire. SAS 9.3 Survey Analysis procedures were used to conduct descriptive analysis and multiple regression models. Defending behaviors were associated with bullying roles and were higher in victims than in bullies or bystanders. Defending behaviors were positively associated with social anxiety and depressive symptoms. After stratifying by bullying roles, defending behaviors were positively associated with social anxiety in bystanders, and were positively associated with depressive symptoms in victims and bystanders. However, defending behaviors were not significantly associated with mental health indicators in bullies. The associations between defending behaviors and mental health varied according to bullying roles. The results suggest that bystanders and victims experience more mental health effects than bullies. Intervention programs aimed at preventing bullying should focus on strategies that minimize social anxiety and depression in victims and bystanders, and urge students to help vulnerable peers during bullying events.

  12. The complex association of health insurance and maternal health services in the context of a premium exemption for pregnant women: a case study in Northern Ghana.

    PubMed

    Frimpong, Jemima A; Helleringer, Stéphane; Awoonor-Williams, John Koku; Aguilar, Thomas; Phillips, James F; Yeji, Francis

    2014-12-01

    Health insurance premium exemptions for pregnant women are a strategy to increase coverage of maternal health services in sub-Saharan countries. We examine health insurance registration among pregnant women before or after the introduction of a premium exemption, and test whether registration increases utilization of maternal health services. Data were drawn from a retrospective cohort study of 1641 women having given birth between January 2008 and August 2010 in two impoverished districts of Northern Ghana. Among those, 1411 became pregnant after premium exemption was adopted in July 2008. We compared registration rates before and after the exemption. We used logistic regressions to measure the association between insurance registration and receipt of essential maternal health interventions in the context of the premium exemption. We tested whether this association varied across levels of the health system [e.g. hospitals and health centres (HCs) vs community health compounds (CHC)]. Health insurance registration increased significantly among pregnant women after adoption of the premium exemption. Coverage of clinical and diagnostic services was high, but antenatal care (ANC) clients received only partial counselling about safe motherhood (e.g. pregnancy-related danger signs). Three out of four clients who sought ANC in hospitals and HCs delivered at a health facility vs. slightly more than 50% among clients of CHC. In hospitals and HCs, National Health Insurance Scheme (NHIS) registration was associated with higher quality of services. In CHCs, NHIS registrants received fewer diagnostic tests, were less extensively counselled about safe motherhood and were less likely to be vaccinated against tetanus toxoid than non-registered clients. Among CHCs clients, being a NHIS registrant was however associated with an increased likelihood of delivering at a health facility. In the context of premium exemptions, association of health insurance with use of maternal health

  13. Association between health behaviors and cardiorespiratory fitness in adolescents: results from the cross-sectional MoMo-study.

    PubMed

    Peterhans, Eliane; Worth, Annette; Woll, Alexander

    2013-08-01

    The aim of this study was to analyze the association between adolescent and familial health behavioral factors and cardiorespiratory fitness in German adolescent boys and girls. This study is based on a large nationwide cross-sectional study and its substudy on physical activity and fitness of children and adolescents ("Motorik-Modul"). For 1,328 adolescents between 11 and 17 years of age, data on cardiorespiratory fitness (Physical working capacity 170, PWC(170)) and familial and adolescent health behavioral factors were collected. Health behavior was assessed using psychometric questionnaires (socioeconomic status, pubertal stage, daily physical activity, sports-club time, parental physical activity habits, etc.). A hierarchical multiple regression model was used to quantify the association between relative PWC(170) values and health behavior. The relationship between adolescents' health behavioral factors and cardiorespiratory fitness was stronger than the relationship between age, social status, familial health behavior and cardiorespiratory fitness. Familial health behavioral factors explained 4.1% and 2.1% of variance in cardiorespiratory fitness in girls and boys, respectively. Adolescents' health behavioral factors explained 15.2% of variance in girls and 25.7% of variance in boys. For both girls (β = .273) and boys (β = .400), being normal weight had the greatest effect on relative PWC(170) values. The difference in explained variance in cardiorespiratory fitness by familial and adolescents' health behavioral factors between girls and boys indicates that different predictors for cardiorespiratory fitness are important for girls and boys. Hence, sex specific research and interventions aimed at improving familial and adolescent health behavior may be important. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Factors associated with obesity in brazilian children enrolled in the school health program: a case-control study.

    PubMed

    Honório, Renata Félix; Costa Monteiro Hadler, Maria Claret

    2014-09-01

    Case-control studies evaluating the factors associated with childhood obesity are scarce in Brazil. We aimed to analyze the factors associated with obesity in Brazilian schoolchildren enrolled in the School Health Program.A case-control study was conducted on 80 schoolchildren aged 7 to 9 years, 40 of them obese and 40 of normal weight according to the cut-off points established by the World Health Organization (2007). Weight, height and waist circumference were obtained. Socioeconomic, demographic, health, eating behavior and lifestyle data were collected by applying a questionnaire to the person responsible and by determining his/her nutritional status. A binary unconditional logistic regression model (univariate and multivariate) was used for data analysis. The prevalence of obesity was 7.21%. The final model showed that duration of breast-feeding ≥ 6 months of age (OR 5.3; 95% CI: 1.3-22.1), excess weight of the person responsible (OR 7.1; 95% CI: 1.2-40.2), a sedentary level of physical activity (OR 4.1; 95% CI: 1.1- 15.5), and fast chewing (OR 7.4; 95% CI: 2.1-26.9) were significantly associated with childhood obesity. The factors associated with obesity in schoolchildren were duration of breast-feeding ≥ 6 months, persons responsible with excess weight, and sedentary children who chew fast. The present study contributes information to be used for the health actions planned by the School Health Program.

  15. Favorable Cardiovascular Health Is Associated With Lower Health Care Expenditures and Resource Utilization in a Large US Employee Population: The Baptist Health South Florida Employee Study.

    PubMed

    Osondu, Chukwuemeka U; Aneni, Ehimen C; Valero-Elizondo, Javier; Salami, Joseph A; Rouseff, Maribeth; Das, Sankalp; Guzman, Henry; Younus, Adnan; Ogunmoroti, Oluseye; Feldman, Theodore; Agatston, Arthur S; Veledar, Emir; Katzen, Barry; Calitz, Chris; Sanchez, Eduardo; Lloyd-Jones, Donald M; Nasir, Khurram

    2017-03-13

    To examine the association of favorable cardiovascular health (CVH) status with 1-year health care expenditures and resource utilization in a large health care employee population. Employees of Baptist Health South Florida participated in a health risk assessment from January 1 through September 30, 2014. Information on dietary patterns, physical activity, blood pressure, blood glucose level, total cholesterol level, and smoking were collected. Participants were categorized into CVH profiles using the American Heart Association's ideal CVH construct as optimal (6-7 metrics), moderate (3-5 metrics), and low (0-2 metrics). Two-part econometric models were used to analyze health care expenditures. Of 9097 participants (mean ± SD age, 42.7±12.1 years), 1054 (11.6%) had optimal, 6945 (76.3%) had moderate, and 1098 (12.1%) had low CVH profiles. The mean annual health care expenditures among those with a low CVH profile was $10,104 (95% CI, $8633-$11,576) compared with $5824 (95% CI, $5485-$6164) and $4282 (95% CI, $3639-$4926) in employees with moderate and optimal CVH profiles, respectively. In adjusted analyses, persons with optimal and moderate CVH had a $2021 (95% CI, -$3241 to -$801) and $940 (95% CI, -$1560 to $80) lower mean expenditure, respectively, than those with low CVH. This trend remained even after adjusting for demographic characteristics and comorbid conditions as well as across all demographic subgroups. Similarly, health care resource utilization was significantly lower in those with optimal CVH profiles compared with those with moderate or low CVH profiles. Favorable CVH profile is associated with significantly lower total medical expenditures and health care utilization in a large, young, ethnically diverse, and fully insured employee population. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  16. A National Study of the Association between Food Environments and County-Level Health Outcomes

    ERIC Educational Resources Information Center

    Ahern, Melissa; Brown, Cheryl; Dukas, Stephen

    2011-01-01

    Purpose: This national, county-level study examines the relationship between food availability and access, and health outcomes (mortality, diabetes, and obesity rates) in both metro and non-metro areas. Methods: This is a secondary, cross-sectional analysis using Food Environment Atlas and CDC data. Linear regression models estimate relationships…

  17. A National Study of the Association between Food Environments and County-Level Health Outcomes

    ERIC Educational Resources Information Center

    Ahern, Melissa; Brown, Cheryl; Dukas, Stephen

    2011-01-01

    Purpose: This national, county-level study examines the relationship between food availability and access, and health outcomes (mortality, diabetes, and obesity rates) in both metro and non-metro areas. Methods: This is a secondary, cross-sectional analysis using Food Environment Atlas and CDC data. Linear regression models estimate relationships…

  18. Association of Healthy Habits Beliefs and Mortality in Older Adults: A Longitudinal Analysis of the Mexican Health and Aging Study.

    PubMed

    Fernandez-Villa, Julio M; Marquez, David X; Sanchez-Garrido, Natalia; Perez-Zepeda, Mario U; Gonzalez-Lara, Mariana

    2017-06-01

    The aim of this article is to establish the association between beliefs about healthy habits and mortality in a group of Mexican older adults. This is an 11-year follow-up secondary analysis of the Mexican Health and Aging Study. There was a significant difference ( p < .001) in survival rate between those participants who believed that healthy habits have the potential to improve health compared with those who did not. After adjustment for confounders, Cox regression models showed a hazard ratio (HR) of 0.17 (95% confidence interval [CI] [0.07, 0.38], p < .001) for the group that believed in healthy habits. Although the mechanism is not completely clear, according to our results, believing that healthy habits can improve health was associated with lower rates of mortality. Further research should elucidate potential strategies for changing beliefs in older adults with the goal of improving their overall health.

  19. Health problems account for a small part of the association between socioeconomic status and disability pension award. Results from the Hordaland Health Study.

    PubMed

    Østby, Kristian Amundsen; Ørstavik, Ragnhild E; Knudsen, Ann Kristin; Reichborn-Kjennerud, Ted; Mykletun, Arnstein

    2011-01-06

    Low socioeconomic status is a known risk factor for disability pension, and is also associated with health problems. To what degree health problems can explain the increased risk of disability pension award associated with low socioeconomic status is not known. Information on 15,067 participants in the Hordaland Health Study was linked to a comprehensive national registry on disability pension awards. Level of education was used as a proxy for socioeconomic status. Logistic regression analyses were employed to examine the association between socioeconomic status and rates of disability pension award, before and after adjusting for a wide range of somatic and mental health factors. The proportion of the difference in disability pension between socioeconomic groups explained by health was then calculated. Unadjusted odds ratios for disability pension was 4.60 (95% CI: 3.34-6.33) for the group with elementary school only (9 years of education) and 2.03 (95% CI 1.49-2.77) for the group with high school (12 years of education) when compared to the group with higher education (more than 12 years). When adjusting for somatic and mental health, odds ratios were reduced to 3.87 (2.73-5.47) and 1.81 (1.31-2.52). This corresponds to health explaining only a marginal proportion of the increased level of disability pension in the groups with lower socioeconomic status. There is a socioeconomic gradient in disability pension similar to the well known socioeconomic gradient in health. However, health accounts for little of the socioeconomic gradient in disability pension. Future studies of socioeconomic gradients in disability pension should focus on explanatory factors beyond health.

  20. ‘First, do no harm’: are disability assessments associated with adverse trends in mental health? A longitudinal ecological study

    PubMed Central

    Barr, B; Taylor-Robinson, D; Stuckler, D; Loopstra, R; Reeves, A; Whitehead, M

    2016-01-01

    Background In England between 2010 and 2013, just over one million recipients of the main out-of-work disability benefit had their eligibility reassessed using a new functional checklist—the Work Capability Assessment. Doctors and disability rights organisations have raised concerns that this has had an adverse effect on the mental health of claimants, but there are no population level studies exploring the health effects of this or similar policies. Method We used multivariable regression to investigate whether variation in the trend in reassessments in each of 149 local authorities in England was associated with differences in local trends in suicides, self-reported mental health problems and antidepressant prescribing rates, while adjusting for baseline conditions and trends in other factors known to influence mental ill-health. Results Each additional 10 000 people reassessed in each area was associated with an additional 6 suicides (95% CI 2 to 9), 2700 cases of reported mental health problems (95% CI 548 to 4840), and the prescribing of an additional 7020 antidepressant items (95% CI 3930 to 10100). The reassessment process was associated with the greatest increases in these adverse mental health outcomes in the most deprived areas of the country, widening health inequalities. Conclusions The programme of reassessing people on disability benefits using the Work Capability Assessment was independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing. This policy may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits. PMID:26573235

  1. How are individual-level social capital and poverty associated with health equity? A study from two Chinese cities

    PubMed Central

    Sun, Xiaojie; Rehnberg, Clas; Meng, Qingyue

    2009-01-01

    Background A growing body of literature has demonstrated that higher social capital is associated with improved health conditions. However, some research indicated that the association between social capital and health was substantially attenuated after adjustment for material deprivation. Studies exploring the association between poverty, social capital and health still have some serious limitations. In China, health equity studies focusing on urban poor are scarce. The purpose of this study is therefore to examine how poverty and individual-level social capital in urban China are associated with health equity. Methods Our study is based on a household study sample consisting of 1605 participants in two Chinese cities. For all participants, data on personal characteristics, health status, health care utilisation and social capital were collected. Factor analysis was performed to extract social capital factors. Dichotomised social capital factors were used for logistic regression models. A synergy index (if it is above 1, we can know the existence of the co-operative effect) was computed to examine the interaction effect between lack of social capital and poverty. Results Results indicated the poor had an obviously higher probability of belonging to the low individual-level social capital group in all the five dimensions, with the adjusted odds ratios ranging from 1.42 to 2.12. When the other variables were controlled for in the total sample, neighbourhood cohesion (NC), and reciprocity and social support (RSS) were statistically associated with poor self-rated health (NC: OR = 1.40; RSS: OR = 1.34). However, for the non-poor sub-sample, no social capital variable was a statistically significant predictor. The synergy index between low individual-level NC and poverty, and between low individual-level RSS and poverty were 1.22 and 1.28, respectively, indicating an aggravating effect between them. Conclusion In this study, we have shown that the interaction effect

  2. The association between exaggeration in health related science news and academic press releases: retrospective observational study

    PubMed Central

    Vivian-Griffiths, Solveiga; Boivin, Jacky; Williams, Andy; Venetis, Christos A; Davies, Aimée; Ogden, Jack; Whelan, Leanne; Hughes, Bethan; Dalton, Bethan; Boy, Fred

    2014-01-01

    Objective To identify the source (press releases or news) of distortions, exaggerations, or changes to the main conclusions drawn from research that could potentially influence a reader’s health related behaviour. Design Retrospective quantitative content analysis. Setting Journal articles, press releases, and related news, with accompanying simulations. Sample Press releases (n=462) on biomedical and health related science issued by 20 leading UK universities in 2011, alongside their associated peer reviewed research papers and news stories (n=668). Main outcome measures Advice to readers to change behaviour, causal statements drawn from correlational research, and inference to humans from animal research that went beyond those in the associated peer reviewed papers. Results 40% (95% confidence interval 33% to 46%) of the press releases contained exaggerated advice, 33% (26% to 40%) contained exaggerated causal claims, and 36% (28% to 46%) contained exaggerated inference to humans from animal research. When press releases contained such exaggeration, 58% (95% confidence interval 48% to 68%), 81% (70% to 93%), and 86% (77% to 95%) of news stories, respectively, contained similar exaggeration, compared with exaggeration rates of 17% (10% to 24%), 18% (9% to 27%), and 10% (0% to 19%) in news when the press releases were not exaggerated. Odds ratios for each category of analysis were 6.5 (95% confidence interval 3.5 to 12), 20 (7.6 to 51), and 56 (15 to 211). At the same time, there was little evidence that exaggeration in press releases increased the uptake of news. Conclusions Exaggeration in news is strongly associated with exaggeration in press releases. Improving the accuracy of academic press releases could represent a key opportunity for reducing misleading health related news. PMID:25498121

  3. The association between exaggeration in health related science news and academic press releases: retrospective observational study.

    PubMed

    Sumner, Petroc; Vivian-Griffiths, Solveiga; Boivin, Jacky; Williams, Andy; Venetis, Christos A; Davies, Aimée; Ogden, Jack; Whelan, Leanne; Hughes, Bethan; Dalton, Bethan; Boy, Fred; Chambers, Christopher D

    2014-12-09

    To identify the source (press releases or news) of distortions, exaggerations, or changes to the main conclusions drawn from research that could potentially influence a reader's health related behaviour. Retrospective quantitative content analysis. Journal articles, press releases, and related news, with accompanying simulations. Press releases (n = 462) on biomedical and health related science issued by 20 leading UK universities in 2011, alongside their associated peer reviewed research papers and news stories (n = 668). Advice to readers to change behaviour, causal statements drawn from correlational research, and inference to humans from animal research that went beyond those in the associated peer reviewed papers. 40% (95% confidence interval 33% to 46%) of the press releases contained exaggerated advice, 33% (26% to 40%) contained exaggerated causal claims, and 36% (28% to 46%) contained exaggerated inference to humans from animal research. When press releases contained such exaggeration, 58% (95% confidence interval 48% to 68%), 81% (70% to 93%), and 86% (77% to 95%) of news stories, respectively, contained similar exaggeration, compared with exaggeration rates of 17% (10% to 24%), 18% (9% to 27%), and 10% (0% to 19%) in news when the press releases were not exaggerated. Odds ratios for each category of analysis were 6.5 (95% confidence interval 3.5 to 12), 20 (7.6 to 51), and 56 (15 to 211). At the same time, there was little evidence that exaggeration in press releases increased the uptake of news. Exaggeration in news is strongly associated with exaggeration in press releases. Improving the accuracy of academic press releases could represent a key opportunity for reducing misleading health related news. © Sumner et al 2014.

  4. Associations between health and different types of environmental incivility: a Scotland-wide study.

    PubMed

    Ellaway, A; Morris, G; Curtice, J; Robertson, C; Allardice, G; Robertson, R

    2009-11-01

    Concern about the impact of the environment on health and well-being has tended to focus on the physical effects of exposure to toxic and infectious substances, and on the impact of large-scale infrastructures. Less attention has been paid to the possible psychosocial consequences of people's subjective perceptions of their everyday, street-level environment, such as the incidence of litter and graffiti. As little is known about the potential relative importance for health of perceptions of different types of environmental incivility, a module was developed for inclusion in the 2004 Scottish Social Attitudes survey in order to investigate this relationship. A random sample of 1637 adults living across a range of neighbourhoods throughout Scotland was interviewed. Respondents were asked to rate their local area on a range of possible environmental incivilities. These incivilities were subsequently grouped into three domains: (i) street-level incivilities (e.g. litter, graffiti); (ii) large-scale infrastructural incivilities (e.g. telephone masts); and (iii) the absence of environmental goods (e.g. safe play areas for children). For each of the three domains, the authors examined the degree to which they were thought to pose a problem locally, and how far these perceptions varied between those living in deprived areas and those living in less-deprived areas. Subsequently, the relationships between these perceptions and self-assessed health and health behaviours were explored, after controlling for gender, age and social class. Respondents with the highest levels of perceived street-level incivilities were almost twice as likely as those who perceived the lowest levels of street-level incivilities to report frequent feelings of anxiety and depression. Perceived absence of environmental goods was associated with increased anxiety (2.5 times more likely) and depression (90% more likely), and a 50% increased likelihood of being a smoker. Few associations with health were

  5. Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study.

    PubMed

    Silverberg, Jonathan I; Garg, Nitin K; Paller, Amy S; Fishbein, Anna B; Zee, Phyllis C

    2015-01-01

    Sleep disturbances are associated with poor health outcomes in adults. However, little is known about the sleep disturbances that occur in adult eczema. We studied the association between adult eczema and sleep disturbance and their impact on overall health and health care utilization. We used the 2012 National Health Interview Survey, a cross-sectional questionnaire of 34,613 adults. Eczema was associated with higher odds of fatigue (odds ratio (95% confidence interval): 2.97 (2.65-3.34)), regular daytime sleepiness (2.66 (2.34-3.01)), and regular insomnia (2.36 (2.11-2.64)), even after controlling for sleep duration, history of allergic disease, sociodemographics, and body mass index. There were significant interactions between eczema and fatigue, sleepiness, and insomnia as predictors of poorer overall health status, number of sick days, and doctor visits, such that eczema and each of the sleep symptoms were associated with higher odds of poorer outcomes than either eczema or sleep symptoms alone. Latent class analysis was used and identified five classes of fatigue, sleep disturbances, and allergic disorders. Two classes had high probabilities of eczema: one with high probabilities of asthma, hay fever, food allergy, and multiple sleep symptoms and the other with intermediate probability of insomnia alone. Future studies are warranted to better characterize sleep loss in eczema and develop strategies for treatment and prevention.

  6. The association between peptic ulcer diseases and mental health problems: A population-based study: a STROBE compliant article.

    PubMed

    Lee, Young Bok; Yu, Jihan; Choi, Hyun Ho; Jeon, Bu Seok; Kim, Hyung-Keun; Kim, Sang-Woo; Kim, Sung Soo; Park, Yong Gyu; Chae, Hiun Suk

    2017-08-01

    This study aimed to investigate the association between the prevalence of peptic ulcer disease (PUD) and mental health problems, such as severe stress, depressive mood, and suicidal ideation.The population-based cross-sectional study was comprised of 14,266 subjects participating in the fourth annual Korea National Health and Nutrition Examination survey from 2007 to 2009. The participants were divided into 2 groups according to the self-reported questionnaires: the PUD group and the non-PUD group. The association between PUD and mental health problems, such as severe stress, depressed mood, suicidal ideation, and psychological counseling history, were evaluated by using multivariate analysis and logistic regression.Among the 14,266 participants over 19-years old, 813 participants (5.6%) had PUD. Compared to the non-PUD group (n = 13,453), the PUD group had a significantly higher percentage of males, current smokers, and heavy drinkers, lower education status, lower income, and greater presence of diabetes mellitus, hypertension, metabolic syndrome and mental health problems, including severe stress, depressed mood, suicidal ideation, and psychological counseling history. After adjustment for lifestyle and medical and environmental factors, mental health problems were found to be associated with a significantly higher risk for PUD.Psychological problems, such as severe stress, depressed mood, suicidal ideation, and psychological counseling, were associated with PUD prevalence.

  7. Child and family psychiatric and psychological factors associated with child physical health problems: results from the Boricua youth study.

    PubMed

    Feldman, Jonathan M; Ortega, Alexander N; Koinis-Mitchell, Daphne; Kuo, Alice A; Canino, Glorisa

    2010-04-01

    To examine associations among Puerto Rican children's physical health problems and children's internalizing disorders, parental psychopathology and acculturative stress, and family factors. A population-based probability sample of 2491 Puerto Rican children, aged between 5 and 13 years, and caregivers from the South Bronx and the U.S. Commonwealth of Puerto Rico participated in this study. The parent version of the Diagnostic Interview Schedule for Children-IV was used to assess children's internalizing disorders. Children's anxiety disorders, parental psychopathology, and acculturative stress were associated with childhood asthma, abdominal pain, and headaches. Children's depressive disorders, maternal acceptance, and family functioning were associated with abdominal pain and headaches. Parents of children living in Puerto Rico were more likely to report physical health problems in their children than in the Bronx. Children's internalizing disorders, parental psychopathology, and acculturative stress may be important areas to target among Puerto Rican children with physical health problems.

  8. Exercising alone versus with others and associations with subjective health status in older Japanese: The JAGES Cohort Study

    PubMed Central

    Kanamori, Satoru; Takamiya, Tomoko; Inoue, Shigeru; Kai, Yuko; Kawachi, Ichiro; Kondo, Katsunori

    2016-01-01

    Although exercising with others may have extra health benefits compared to exercising alone, few studies have examined the differences. We sought to examine whether the association of regular exercise to subjective health status differs according to whether people exercise alone and/or with others, adjusting for frequency of exercise. The study was based on the Japan Gerontological Evaluation Study (JAGES) Cohort Study data. Participants were 21,684 subjects aged 65 or older. Multivariable logistic regression models were used to examine the association. The adjusted odds ratios (ORs) for poor self-rated health were significantly lower for people who exercised compared to non-exercisers. In analyses restricted to regular exercisers the ORs for poor health were 0.69 (95% confidence intervals: 0.60–0.79) for individuals exercising alone more often than with others, 0.74 (0.64–0.84) for people who were equally likely to exercise alone as with others, 0.57 (0.43–0.75) for individuals exercising with others more frequently than alone, and 0.79 (0.64–0.97) for individuals only exercising with others compared to individuals only exercising alone. Although exercising alone and exercising with others both seem to have health benefits, increased frequency of exercise with others has important health benefits regardless of the total frequency of exercise. PMID:27974855

  9. Care workers health in Swiss nursing homes and its association with psychosocial work environment: A cross-sectional study.

    PubMed

    Dhaini, Suzanne R; Zúñiga, Franziska; Ausserhofer, Dietmar; Simon, Michael; Kunz, Regina; De Geest, Sabina; Schwendimann, Rene

    2016-01-01

    Previous studies have demonstrated poor health of care workers in nursing homes. Yet, little is known about the prevalence of physical and mental health outcomes, and their associations with the psychosocial work environment in nursing homes. (1) To explore the prevalence of physical and mental health outcomes of care workers in Swiss nursing homes, (2) their association with psychosocial work environment. This is a secondary data analysis of the cross-sectional Swiss Nursing Home Human Resources Project (SHURP). We used survey data on socio-demographic characteristics and work environment factors from care workers (N=3471) working in Swiss nursing homes (N=155), collected between May 2012 and April 2013. GEE logistic regression models were used to estimate the relationship between psychosocial work environment and physical and mental health outcomes, taking into account care workers' age. Back pain (19.0%) and emotional exhaustion (24.2%) were the most frequent self-reported physical and mental health. Back pain was associated with increased workload (odds ratios (OR) 1.52, confidence interval (CI) 1.29-1.79), conflict with other health professionals and lack of recognition (OR 1.72, CI 1.40-2.11), and frequent verbal aggression by residents (OR 1.36, CI 1.06-1.74), and inversely associated with staffing adequacy (OR 0.69, CI 0.56-0.84); emotional exhaustion was associated with increased workload (OR 1.96, CI 1.65-2.34), lack of job preparation (OR 1.41, CI 1.14-1.73), and conflict with other health professionals and lack of recognition (OR 1.68, CI 1.37-2.06), and inversely associated with leadership (OR 0.70, CI 0.56-0.87). Physical and mental health among care workers in Swiss nursing homes is of concern. Modifying psychosocial work environment factors offer promising strategies to improve health. Longitudinal studies are needed to conduct targeted assessments of care workers health status, taking into account their age, along with the exposure to all four

  10. Facial fluctuating asymmetry is not associated with childhood ill-health in a large British cohort study.

    PubMed

    Pound, Nicholas; Lawson, David W; Toma, Arshed M; Richmond, Stephen; Zhurov, Alexei I; Penton-Voak, Ian S

    2014-10-07

    The idea that symmetry in facial traits is associated with attractiveness because it reliably indicates good physiological health, particularly to potential sexual partners, has generated an extensive literature on the evolution of human mate choice. However, large-scale tests of this hypothesis using direct or longitudinal assessments of physiological health are lacking. Here, we investigate relationships between facial fluctuating asymmetry (FA) and detailed individual health histories in a sample (n = 4732) derived from a large longitudinal study (Avon Longitudinal Study of Parents and Children) in South West England. Facial FA was assessed using geometric morphometric analysis of facial landmark configurations derived from three-dimensional facial scans taken at 15 years of age. Facial FA was not associated with longitudinal measures of childhood health. However, there was a very small negative association between facial FA and IQ that remained significant after correcting for a positive allometric relationship between FA and face size. Overall, this study does not support the idea that facial symmetry acts as a reliable cue to physiological health. Consequently, if preferences for facial symmetry do represent an evolved adaptation, then they probably function not to provide marginal fitness benefits by choosing between relatively healthy individuals on the basis of small differences in FA, but rather evolved to motivate avoidance of markers of substantial developmental disturbance and significant pathology.

  11. Facial fluctuating asymmetry is not associated with childhood ill-health in a large British cohort study

    PubMed Central

    Pound, Nicholas; Lawson, David W.; Toma, Arshed M.; Richmond, Stephen; Zhurov, Alexei I.; Penton-Voak, Ian S.

    2014-01-01

    The idea that symmetry in facial traits is associated with attractiveness because it reliably indicates good physiological health, particularly to potential sexual partners, has generated an extensive literature on the evolution of human mate choice. However, large-scale tests of this hypothesis using direct or longitudinal assessments of physiological health are lacking. Here, we investigate relationships between facial fluctuating asymmetry (FA) and detailed individual health histories in a sample (n = 4732) derived from a large longitudinal study (Avon Longitudinal Study of Parents and Children) in South West England. Facial FA was assessed using geometric morphometric analysis of facial landmark configurations derived from three-dimensional facial scans taken at 15 years of age. Facial FA was not associated with longitudinal measures of childhood health. However, there was a very small negative association between facial FA and IQ that remained significant after correcting for a positive allometric relationship between FA and face size. Overall, this study does not support the idea that facial symmetry acts as a reliable cue to physiological health. Consequently, if preferences for facial symmetry do represent an evolved adaptation, then they probably function not to provide marginal fitness benefits by choosing between relatively healthy individuals on the basis of small differences in FA, but rather evolved to motivate avoidance of markers of substantial developmental disturbance and significant pathology. PMID:25122232

  12. Associations between parents' subjective time pressure and mental health problems among children in the Nordic countries: a population based study.

    PubMed

    Gunnarsdottir, Hrafnhildur; Bjereld, Ylva; Hensing, Gunnel; Petzold, Max; Povlsen, Lene

    2015-04-10

    The home, the family and the parents represent a context of everyday life that is important for child health and development, with parent-child relationships highlighted as crucial for children's mental health. Time pressure is an emerging feature of modern societies and previous studies indicates that parents with children living at home experience time pressure to a greater extent than people with no children living at home. Previous studies of children's mental health in relation to parents' time pressure are lacking. Hence, the purpose of this study was to examine the association between parents' subjective time pressure and mental health problems among children in the Nordic countries as well as potential disparities between boys and girls in different age groups. 4592 children, aged 4-16 from Denmark, Finland, Norway and Sweden, participating in the 2011 version of the NordChild study, were included. The Strength and Difficulties Questionnaire was used to measure children's mental health and associations to parents' time pressure were assessed by multiple logistic regression analysis. Among children of parents experiencing time pressure, 18.6% had mental health problems compared to 10.1% among children of parents experiencing time pressure not or sometimes. The odds of mental health problems were higher among both boys (OR 1.80 95% CI 1.32-2.46) and girls (OR 1.95 95% CI 1.42-2.66) if their parents experienced time pressure when adjusted for financial stress. The highest prevalence of mental health problems in the case of parental time pressure was found among girls 13-16 years old (23.6%) and the lowest prevalence was found among boys 13-16 years old (10.7%). In this study an association between parents' subjective time pressure and increased mental health problems among children was found. Given that time pressure is a growing feature of modern societies, the results might contribute to an explanation as to mental health problems are common among children

  13. American Health Care Association

    MedlinePlus

    ... preferred... Read More Executive Director | Dogwood Village of Orange County US - VA - Orange, Executive Director Dogwood Village of Orange County Health and Rehabilitation and Senior Living, a ...

  14. The Association of Gum Bleeding with Respiratory Health in a Population Based Study from Northern Europe

    PubMed Central

    Gómez Real, Francisco; Pérez Barrionuevo, Laura; Franklin, Karl; Lindberg, Eva; Bertelsen, Randi Jacobsen; Benediktsdóttir, Bryndís; Forsberg, Bertil; Gislason, Thorarinn; Jögi, Rain; Johannessen, Ane; Omenaas, Ernst; Saure, Eirunn; Schlünssen, Vivi; Skorge, Trude Duelien; Torén, Kjell; Pérez Saavedra, Antonio; Svanes, Øistein; Åstrøm, Anne Nordrehaug

    2016-01-01

    Background There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the exposures to these are partly similar. Aims To investigate whether gum bleeding is related to asthma, respiratory symptoms and self-reported COPD. Methods A postal questionnaire including questions about respiratory and oral health was sent to general population samples in seven Northern European centres. In 13,409 responders, gum bleeding when brushing teeth was reported always/often by 4% and sometimes by 20%. Logistic regressions accounted for age, smoking, educational level, centre and gender. Effects of BMI, cardio-metabolic diseases, early life factors, gastro-oesophageal reflux, dental hygiene, nasal congestion, and asthma medication were addressed. Results Gum bleeding always/often was significantly associated with ≥3 asthma symptoms (OR 2.58, 95% CI 2.10–3.18), asthma (1.62 [1.23–2.14]) and self-reported COPD (2.02 [1.28–3.18]). There was a dose-response relationship between respiratory outcomes and gum bleeding frequency (≥3 symptoms: gum bleeding sometimes 1.42 [1.25–1.60], often/always 2.58 [2.10–3.18]), and there was no heterogeneity between centres (pheterogeneity = 0.49). None of the investigated risk factors explained the associations. The observed associations were significantly stronger among current smokers (pinteraction = 0.004). Conclusions A consistent link between gum bleeding and obstructive airways disease was observed, not explained by common risk factors or metabolic factors. We speculate that oral pathogens might have unfavourable impact on the airways, and that the direct continuity of the mucosa of the oral cavity and the airways reflects a pathway that might provide novel opportunities for interventions. PMID:26808490

  15. The Association of Gum Bleeding with Respiratory Health in a Population Based Study from Northern Europe.

    PubMed

    Gómez Real, Francisco; Pérez Barrionuevo, Laura; Franklin, Karl; Lindberg, Eva; Bertelsen, Randi Jacobsen; Benediktsdóttir, Bryndís; Forsberg, Bertil; Gislason, Thorarinn; Jögi, Rain; Johannessen, Ane; Omenaas, Ernst; Saure, Eirunn; Schlünssen, Vivi; Skorge, Trude Duelien; Torén, Kjell; Pérez Saavedra, Antonio; Svanes, Øistein; Åstrøm, Anne Nordrehaug; Janson, Christer; Svanes, Cecilie

    2016-01-01

    There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the exposures to these are partly similar. To investigate whether gum bleeding is related to asthma, respiratory symptoms and self-reported COPD. A postal questionnaire including questions about respiratory and oral health was sent to general population samples in seven Northern European centres. In 13,409 responders, gum bleeding when brushing teeth was reported always/often by 4% and sometimes by 20%. Logistic regressions accounted for age, smoking, educational level, centre and gender. Effects of BMI, cardio-metabolic diseases, early life factors, gastro-oesophageal reflux, dental hygiene, nasal congestion, and asthma medication were addressed. Gum bleeding always/often was significantly associated with ≥ 3 asthma symptoms (OR 2.58, 95% CI 2.10-3.18), asthma (1.62 [1.23-2.14]) and self-reported COPD (2.02 [1.28-3.18]). There was a dose-response relationship between respiratory outcomes and gum bleeding frequency (≥ 3 symptoms: gum bleeding sometimes 1.42 [1.25-1.60], often/always 2.58 [2.10-3.18]), and there was no heterogeneity between centres (p(heterogeneity) = 0.49). None of the investigated risk factors explained the associations. The observed associations were significantly stronger among current smokers (p(interaction) = 0.004). A consistent link between gum bleeding and obstructive airways disease was observed, not explained by common risk factors or metabolic factors. We speculate that oral pathogens might have unfavourable impact on the airways, and that the direct continuity of the mucosa of the oral cavity and the airways reflects a pathway that might provide novel opportunities for interventions.

  16. Association between child marriage and reproductive health outcomes and service utilization: a multi-country study from South Asia.

    PubMed

    Godha, Deepali; Hotchkiss, David R; Gage, Anastasia J

    2013-05-01

    Despite the pervasiveness of child marriage and its potentially adverse consequences on reproductive health outcomes, there is relatively little empirical evidence available on this issue, which has hindered efforts to improve the targeting of adolescent health programs. The purpose of this study was to assess the association of child marriage with fertility, fertility control, and maternal health care use outcomes in four South Asian countries: India, Bangladesh, Nepal, and Pakistan. Data for the study come from the most recent Demographic and Health Surveys conducted in the study countries; we used a subsample of women aged 20-24 years. Child marriage, defined as first marriage before 18 years of age, is categorized into two groups: first married at ages 15-17 years and first married at age ≤14 years. We used multivariate logistic regression models. The results of the study suggest that child marriage is significantly associated with a history of rapid repeat childbirth, current modern contraceptive use, female sterilization, not using contraception before first childbirth, pregnancy termination, unintended pregnancy, and inadequate use of maternal health services, although the associations are not always consistent across countries. Furthermore, women who married in early adolescence or childhood show a higher propensity toward most of the negative outcomes, compared with women who married in middle adolescence. Child marriage adds a layer of vulnerability to women that leads to poor fertility control and fertility-related outcomes, and low maternal health care use. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Subjective social status: its determinants and association with health in the Swedish working population (the SLOSH study).

    PubMed

    Miyakawa, Michiko; Magnusson Hanson, Linda L; Theorell, Töres; Westerlund, Hugo

    2012-08-01

    This study aims to confirm associations between subjective social status (SSS) and health in the Swedish working population, to investigate if SSS is related to health over and above conventional measures of socio-economic status and to identify factors related to perception of SSS. The study includes 2358 men and 2665 women in the age group of 19-68 years who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH). SSS was measured using the MacArthur scale, a 10-rung ladder on which individuals indicate where they think they stand in the social hierarchy. Health, health behaviors and social situation were also measured in 2006, while more objective measures of socio-economic position were derived from registry data and interviews in 2003. Perception of SSS was cross-sectionally related to age-adjusted prevalence of suboptimal perceived general health, sleep disturbances, musculoskeletal symptoms, depressive symptoms and emotional exhaustion. Relative Indices of Inequalities (RII) showed significant relationships between SSS and health, which were attenuated by adjustment for general life satisfaction. Adjustment for occupational grade, education and income further attenuated the relationship. The main predictors of SSS in 2006 were occupational grade, personal income and education in 2003; household financial situation, general life satisfaction and job control in 2006. When ranking their SSS, women put more weight on household financial situation and men on their personal income. SSS is associated with prevalence of several health complaints in the Swedish working population over and above conventional SES, indicating that SSS is a valid measure of social inequality in health.

  18. Hearing Impairment Prevalence and Associated Risk Factors in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

    PubMed Central

    Cruickshanks, Karen J; Dhar, Sumitrajit; Dinces, Elizabeth; Fifer, Robert C.; Gonzalez, Franklyn; Heiss, Gerardo; Hoffman, Howard J.; Lee, David J.; Newhoff, Marilyn; Tocci, Laura; Torre, Peter; Tweed, Ted S.

    2015-01-01

    Importance Hearing impairment (HI) is a common problem in adults but there have been few studies of hearing in the U.S. Hispanic/Latino population. Little is known about factors associated with HI among Hispanics/Latinos. Objective To determine the prevalence of HI among U.S. Hispanic/Latino adults of diverse backgrounds and determine associations with sociodemographic factors, noise exposure, diabetes, smoking, cardiovascular disease, and other potential risk factors. Design and Setting The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a population-based sample of Hispanics/Latinos in four U.S. communities (Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA). Examinations were conducted in 2008–2011. Participants The HCHS/SOL examined 16,415 self-identified Hispanic/Latino persons aged 18 to 74 years recruited from randomly selected households using a stratified 2-stage area probability sample design based on census block groups and households within block groups. Intervention(s) None Main Outcome(s) and Measures Hearing thresholds were measured by pure-tone audiometry. HI was defined as a pure-tone average (PTA) of thresholds at 0.5,1,2,4 kHz >25 dB HL. Bilateral hearing impairment (BHI) required a PTA>25 dB HL in both ears. Multivariable analyses included adjustments for sociodemographic and lifestyle variables, body mass index, and medical conditions. Results The prevalence of HI was 15.1% overall and 8.2% had BHI. The prevalence of HI was higher among people aged 45 and older, ranging by Hispanic/Latino background from 29–41% among men and 18–31% among women. The multivariable-adjusted odds of HI was greater for participants of Puerto Rican background compared to Mexican background (OR =1.57, 95%CI=1.10, 2.25). The odds of HI were lower with more education and higher income. People with noise exposure were about 30% more likely to have HI. Diabetes (OR=1.57, 95%CI= 1.27, 1.94) and pre-diabetes (OR=1.37, 95%CI= 1.12, 1.67) were

  19. Association between district-level perceived safety and self-rated health: a multilevel study in Seoul, South Korea.

    PubMed

    Kim, Seung-Sup; Choi, Jaesung; Park, Kisoo; Chung, Yeonseung; Park, Sangjo; Heo, Jongho

    2014-07-29

    Several studies have reported the relationship between residents' perceived neighbourhood safety and their health outcomes. However, those studies suffered from unreliability of neighbourhood safety measure and potential residual confounding related to crime rates. In this study, using multilevel analysis to account for the hierarchical structure of the data, we examined associations between district-level perceived safety and self-rated health after adjusting for potential confounders including the district-level crime rate. Cross-sectional study. We used the first wave of Seoul Welfare Panel Study, which has 7761 individuals from 3665 households in 25 administrative districts in Seoul, South Korea. District-level perceived safety was obtained by aggregating responses from the residents that are representative samples for each administrative district in Seoul. To examine an association between district-level safety and residents' self-rated health, we used mixed effect logistic regression. Our results showed that higher district-level perceived safety, an aggregated measure of district residents' responses towards neighbourhood safety, was significantly associated with poor self-rated health after controlling for sex, age, education level, job status, marital status and household income (OR=0.87, 95% CI 0.78 to 0.97). Furthermore, this association was still robust when we additionally adjusted for the district-level crime rate (OR=0.86, 95% CI 0.77 to 0.95). Our study highlights the importance of improving neighbourhood perceived safety to enhance residents' health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Prevention and control of health care-associated infections in Iran: A qualitative study to explore challenges and barriers.

    PubMed

    Esfandiari, Atefeh; Rashidian, Arash; Masoumi Asl, Hossein; Rahimi Foroushani, Abbas; Salari, Hedayat; Akbari Sari, Ali

    2016-10-01

    Globally, the health and economic burden posed by health care-associated infections (HAIs) remains wide and severe. To curb the burden associated with HAIs, countries, including Iran, aim at HAI prevention and control. This study explores the challenges faced by the Iranian health system in addressing the issues associated with the prevention and control of HAIs. A qualitative research method was adopted in exploring the phenomenon. We used the purposive sampling approach in reaching 24 key informants at the national and subnational levels. The thematic framework analysis was conducted for analyzing the interviews. Five main themes emerged from our study demonstrating the obstacles toward the prevention and control of HAIs. They include governance and stewardship, resources, safety culture, monitoring and surveillance systems, and inappropriate prescription of antibiotics. Strengthening of reporting and surveillance systems for HAIs coupled with proper governance and stewardship are crucial in order to improve the health and safety of patients. However, the availability of resources, through an intersectoral approach, is essential to achieve sustained output. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Association of socioeconomic position with maternal pregnancy and infant health outcomes in birth cohort studies from Brazil and the UK

    PubMed Central

    Victora, C G; Lawlor, D A; Golding, J; Menezes, A M B; Araújo, C L; Barros, A J D; Santos, I S; Barros, F C; Smith, G Davey

    2010-01-01

    Background Socioeconomic inequalities in health outcomes are dynamic and vary over time. Differences between countries can provide useful insights into the causes of health inequalities. The study aims to compare the associations between two measures of socioeconomic position (SEP)—maternal education and family income—and maternal and infant health outcomes between ALSPAC and Pelotas cohorts. Methods Birth cohort studies were started in Avon, UK, in 1991 (ALSPAC) and in the city of Pelotas, Brazil, in 1982, 1993 and 2004. Maternal outcomes included smoking during pregnancy, caesarean section and delivery not attended by a doctor. Infant outcomes were preterm birth, intra-uterine growth restriction (IUGR) and breast feeding for <3 months. The relative index of inequality was used for each measure of SEP so that results were comparable between cohorts. Results An inverse association (higher prevalence among the poorest and less educated) was observed for almost all outcomes, with the exception of caesarean sections where a positive association was found. Stronger income-related inequalities for smoking and education-related inequalities for breast feeding were found in the ALSPAC study. However, greater inequalities in caesarean section and education-related inequalities in preterm birth were observed in the Pelotas cohorts. Conclusions Mothers and infants have more adverse health outcomes if they are from poorer and less well-educated socioeconomic backgrounds in both Brazil and the UK. However, our findings demonstrate the dynamic nature of the association between SEP and health outcomes. Examining differential socioeconomic patterning of maternal and infant health outcomes might help understanding of mechanisms underlying such inequalities. PMID:20628081

  2. American College Health Association

    MedlinePlus

    ... College Health Assessment Peer Review Assistance Program Patient Satisfaction Assessment Service Healthy Campus 2020 Continuing Education The ... and behaviors. Learn More >> PSAS The ACHA-Patient Satisfaction Assessment Service gauges patient satisfaction and provides insight ...

  3. Validity of the Associated Symptom Criteria for Generalized Anxiety Disorder: Observations From the Singapore Mental Health Study.

    PubMed

    Lee, Siau Pheng; Ong, Clarissa; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

    2017-05-01

    Previous findings on the diagnostic validity and reliability of generalized anxiety disorder (GAD)-associated symptom criteria suggest need for further evaluation. The current study examined convergent validity and specificity of GAD-associated symptoms in a representative Singapore community sample. The Singapore of Mental Health Study a cross-sectional epidemiological survey conducted among 6166 Singapore residents aged 18 and older. The Composite International Diagnostic Interview version 3.0 was used to diagnose mental disorders. Associated symptoms in the GAD criteria and autonomic hyperactivity symptoms showed convergent validity with a GAD diagnosis. However, associated symptoms of GAD were also linked to major depressive disorder (MDD), bipolar disorder, and obsessive-compulsive disorder, suggesting lack of adequate specificity. The inability of the diagnostic criteria to differentiate GAD from symptoms of other conditions highlights the need to better define its associated symptoms criteria. The relationship of overlapping symptoms between GAD and MDD is also discussed.

  4. Tuberculosis infection control practices and associated factors among health care workers in health centers of West Gojjam zone, Northwest Ethiopia: a cross-sectional study.

    PubMed

    Tamir, Kassahun; Wasie, Belaynew; Azage, Muluken

    2016-08-08

    Tuberculosis (TB) remains a major global health problem. The emerging epidemic of multi- and extensively drug-resistant (M/XDR) TB further imperils health workers, patients and public health. Health facilities with inadequate infection control are risky environments for the emergence and transmission of TB. There was no study that presented data on infection control practices of health care workers. This study aimed to assess tuberculosis infection control practices and associated factors among health care workers in West Gojjam Zone, Northwest Ethiopia. Institution based quantitative cross-sectional study triangulated with qualitative observation and key informant interview was conducted. Six hundred sixty two health care workers were selected by multistage random sampling method. Self-administered structured questionnaire was used to collect quantitative data. Observation checklists and key informant interview guides were used to collect qualitative data. Quantitative data were entered in to Epi Info version 3.5.3 and analyzed using SPSS version 20. Odds ratio with 95 % confidence interval was used to identify factors associated with TB infection control practice of health care workers. Qualitative data were translated, transcribed, analyzed and triangulated with the quantitative findings. The proportion of proper TB infection control (TBIC) practices was 38 %. Qualitative data showed that administrative, environmental and personal respiratory protection control measures were not practiced well. Knowledge on the presence of TBIC plan [AOR = 4.25, 95 % CI: 2.46 - 7.35], knowledge on the presence of national guideline [AOR = 8.95, 95 % CI: 4.35 - 18.40] and working department of the health care workers were independent predictors of TBIC practices. The proportion of proper TBIC practices of health care workers was low. TBIC practices were determined by knowing the presence of TBIC plan and national guideline and working department. Hence, supportive

  5. Food insecurity is associated with subsequent cognitive decline in the Boston Puerto Rican Health Study

    USDA-ARS?s Scientific Manuscript database

    Background: Living with hunger and fear of not having enough food is a growing worldwide concern. In our previous cross-sectional study, we found that food insecurity was associated with poor cognitive function, but the direction of this relation remains unclear. Objective: We investigated whether f...

  6. Association between Sleep Duration and Mortality Is Mediated by Markers of Inflammation and Health in Older Adults: The Health, Aging and Body Composition Study

    PubMed Central

    Hall, Martica H.; Smagula, Stephen F.; Boudreau, Robert M.; Ayonayon, Hilsa N.; Goldman, Suzanne E.; Harris, Tamara B.; Naydeck, Barbara L.; Rubin, Susan M.; Samuelsson, Laura; Satterfield, Suzanne; Stone, Katie L.; Visser, Marjolein; Newman, Anne B.

    2015-01-01

    Study Objective: Inflammation may represent a common physiological pathway linking both short and long sleep duration to mortality. We evaluated inflammatory markers as mediators of the relationship between sleep duration and mortality in community-dwelling older adults. Design: Prospective cohort with longitudinal follow-up for mortality outcomes. Setting: Pittsburgh, Pennsylvania, and Memphis, Tennessee. Participants: Participants in the Health, Aging and Body Composition (Health ABC) Study (mean age 73.6 ± 2.9 years at baseline) were sampled and recruited from Medicare listings. Measurements and Results: Baseline measures of subjective sleep duration, markers of inflammation (serum interleukin-6, tumor necrosis factor-α, and C-reactive protein) and health status were evaluated as predictors of all-cause mortality (average follow-up = 8.2 ± 2.3 years). Sleep duration was related to mortality, and age-, sex-, and race-adjusted hazard ratios (HR) were highest for those with the shortest (< 6 h HR: 1.30, CI: 1.05–1.61) and longest (> 8 h HR: 1.49, CI: 1.15–1.93) sleep durations. Adjustment for inflammatory markers and health status attenuated the HR for short (< 6 h) sleepers (HR = 1.06, 95% CI = 0.83–1.34). Age-, sex-, and race-adjusted HRs for the > 8-h sleeper group were less strongly attenuated by adjustment for inflammatory markers than by other health factors associated with poor sleep with adjusted HR = 1.23, 95% CI = 0.93–1.63. Inflammatory markers remained significantly associated with mortality. Conclusions: Inflammatory markers, lifestyle, and health status explained mortality risk associated with short sleep, while the mortality risk associated with long sleep was explained predominantly by lifestyle and health status. Citation: Hall MH, Smagula SF, Boudreau RM, Ayonayon HN, Goldman SE, Harris TB, Naydeck BL, Rubin SM, Samuelsson L, Satterfield S, Stone KL, Visser M, Newman AB. Association between sleep duration and mortality is mediated by

  7. Social capital in association with health status of women in reproductive age: study protocol for a sequential explanatory mixed methods study.

    PubMed

    Baheiraei, Azam; Bakouei, Fatemeh; Mohammadi, Eesa; Hosseini, Mostafa

    2014-05-09

    Women's health is a general health priority. Preserving and improving women's health is not only a basic human right, but it is also essential for the health of all nations. Women's health in Reproductive age affects long-term health of theirs, their family members, and community. Origins of health inequalities are very complicated. Health outcomes are influenced by biological, social and political factors, so to improve women's health it is necessary to recognize all these factors. Social capital is one of the social determinants of health that might play a considerable role in health inequalities. The association between social capital and health varies according on the sample studied, the type of health outcome and the context in which it is studied. This mixed methods study was designed to determine and explore of relationship between social capital and health status of women of reproductive age in Tehran (capital city of Iran) with its specific social-cultural characteristics. This study is sequential explanatory mixed methods study, follow-up explanations variant, with two strands (phases). This design will be implemented in two distinct phases. The first phase is a population-based cross-sectional survey on 770 women of reproductive age residing in any of the 22 municipal districts across Tehran. Based on a need to further understand the quantitative results, researchers will implement a second qualitative phase that is designed to help explain the initial quantitative results. Finally, the researchers will present an interpretation about explanation of quantitative results using the qualitative data. This study promotes women's health by determining the priorities and designing evidence-based interventions founded on the basic and insightful information provided on social capital and the status of the health of women.

  8. Material, psychosocial and sociodemographic determinants are associated with positive mental health in Europe: a cross-sectional study.

    PubMed

    Dreger, Stefanie; Buck, Christoph; Bolte, Gabriele

    2014-05-28

    To investigate the association between psychosocial, sociodemographic and material determinants of positive mental health in Europe. Cross-sectional analysis of survey data. 34 European countries. Representative Europe-wide sample consisting of 21 066 men and 22 569 women aged 18 years and over, from 34 European countries participating in the third wave of the European Quality of Life Survey (2011-2012). Positive mental health as measured by the WHO-5-Mental Well-being Index, while the lowest 25% centile indicated poor positive mental health. The prevalence of poor positive mental health was 30% in women and 24% in men. Material, as well as psychosocial, and sociodemographic factors were independently associated with poor positive mental health in a Europe-wide sample from 34 European countries. When studying all factors together, the highest OR for poor positive mental health was reported for social exclusion (men: OR=1.73, 95% CI 1.59 to 1.90; women: OR=1.69, 95% CI 1.57 to 1.81) among the psychosocial factors. Among the material factors, material deprivation had the highest impact (men: OR=1.96, 95% CI 1.78 to 2.15; women: OR=1.93, 95% CI 1.79 to 2.08). This study gives the first overview on determinants of positive mental health at a European level and could be used as the basis for preventive policies in the field of positive mental health in Europe. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Assessment of American Heart Association's Ideal Cardiovascular Health Metrics Among Employees of a Large Healthcare Organization: The Baptist Health South Florida Employee Study.

    PubMed

    Ogunmoroti, Oluseye; Younus, Adnan; Rouseff, Maribeth; Spatz, Erica S; Das, Sankalp; Parris, Don; Aneni, Ehimen; Holzwarth, Leah; Guzman, Henry; Tran, Thinh; Roberson, Lara; Ali, Shozab S; Agatston, Arthur; Maziak, Wasim; Feldman, Theodore; Veledar, Emir; Nasir, Khurram

    2015-07-01

    Healthcare organizations and their employees are critical role models for healthy living in their communities. The American Heart Association (AHA) 2020 impact goal provides a national framework that can be used to track the success of employee wellness programs with a focus on improving cardiovascular (CV) health. This study aimed to assess the CV health of the employees of Baptist Health South Florida (BHSF), a large nonprofit healthcare organization. HRAs and wellness examinations can be used to measure the cardiovascular health status of an employee population. The AHA's 7 CV health metrics (diet, physical activity, smoking, body mass index, blood pressure, total cholesterol, and blood glucose) categorized as ideal, intermediate, or poor were estimated among employees of BHSF participating voluntarily in an annual health risk assessment (HRA) and wellness fair. Age and gender differences were analyzed using χ(2) test. The sample consisted of 9364 employees who participated in the 2014 annual HRA and wellness fair (mean age [standard deviation], 43 [12] years, 74% women). Sixty (1%) individuals met the AHA's definition of ideal CV health. Women were more likely than men to meet the ideal criteria for more than 5 CV health metrics. The proportion of participants meeting the ideal criteria for more than 5 CV health metrics decreased with age. A combination of HRAs and wellness examinations can provide useful insights into the cardiovascular health status of an employee population. Future tracking of the CV health metrics will provide critical feedback on the impact of system wide wellness efforts as well as identifying proactive programs to assist in making substantial progress toward the AHA 2020 Impact Goal. © 2015 Wiley Periodicals, Inc.

  10. Genome-Wide Association Study of Blood Pressure Traits by Hispanic/Latino Background: the Hispanic Community Health Study/Study of Latinos.

    PubMed

    Sofer, Tamar; Wong, Quenna; Hartwig, Fernando P; Taylor, Kent; Warren, Helen R; Evangelou, Evangelos; Cabrera, Claudia P; Levy, Daniel; Kramer, Holly; Lange, Leslie A; Horta, Bernardo L; Kerr, Kathleen F; Reiner, Alex P; Franceschini, Nora

    2017-09-04

    Hypertension prevalence varies between ethnic groups, possibly due to differences in genetic, environmental, and cultural determinants. Hispanic/Latino Americans are a diverse and understudied population. We performed a genome-wide association study (GWAS) of blood pressure (BP) traits in 12,278 participants from the Hispanics Community Health Study/Study of Latinos (HCHS/SOL). In the discovery phase we identified eight previously unreported BP loci. In the replication stage, we tested these loci in the 1982 Pelotas Birth Cohort Study of admixed Southern Brazilians, the COGENT-BP study of African descent, women of European descent from the Women Health Initiative (WHI), and a sample of European descent from the UK Biobank. No loci met the Bonferroni-adjusted level of statistical significance (0.0024). Two loci had marginal evidence of replication: rs78701042 (NGF) with diastolic BP (P = 0.008 in the 1982 Pelotas Birth Cohort Study), and rs7315692 (SLC5A8) with systolic BP (P = 0.007 in European ancestry replication). We investigated whether previously reported loci associated with BP in studies of European, African, and Asian ancestry generalize to Hispanics/Latinos. Overall, 26% of the known associations in studies of individuals of European and Chinese ancestries generalized, while only a single association previously discovered in a people of African descent generalized.

  11. Depression Prevalence and Associated Factors Among Alaska Native People: The Alaska Education and Research Towards Health (EARTH) Study

    PubMed Central

    Dillard, Denise A.; Smith, Julia J.; Ferucci, Elizabeth D.; Lanier, Anne P.

    2012-01-01

    Background Few studies have investigated depression among Alaska Native people (ANs). Depression prevalence and associated factors among EARTH Alaska study participants is described. Methods The nine-item Patient Health Questionnaire (PHQ-9) assessed depression among 3,771 ANs. Participants with PHQ-9 scores ≥ 10 out of 27 were classified as positive for depression. Logistic regression analyses evaluated odds of scoring positive versus negative for depression by demographic, cultural, then health and lifestyle factors. Results Twenty percent of women and thirteen percent of men scored positive for depression. Univariate and multivariate models were fit separately for men and women. Among demographic factors, below median income was associated with positive depression scores for both genders. Among men, odds of depression were higher if unmarried and/or if highest educational level was less than high school. Women 34 to 59 years of age had increased odds of scoring positive. Little or no identification with tribal tradition was associated with increased odds of depression in women and decreased odds in men. For both genders, chronic physical conditions and poorer self-reported health were associated with positive depression scores then binge alcohol drinking and current tobacco use increased odds of depression among women only. Limitations Factors analyzed were self-reported without clinician follow-up in a non-random convenience sample of adults. Conclusions Depression is common among ANs with rates comparable to other indigenous cross-sectional investigations. Depression is associated with lower income and poorer physical health. Prevention and intervention efforts should consider gender as other associated factors varied between men and women. PMID:22138285

  12. American Public Health Association

    MedlinePlus

    ... Infectious Diseases has a new Spanish language website! https://t.co… RT @CDCgov: Know when you need ... Together we can fight antibiotic resistance. Be #AntibioticSmart. https://t.… RT @AMJPublicHealth: Whiteness of the #opioidepidemic is ...

  13. Testing multiple statistical hypotheses resulted in spurious associations: a study of astrological signs and health.

    PubMed

    Austin, Peter C; Mamdani, Muhammad M; Juurlink, David N; Hux, Janet E

    2006-09-01

    To illustrate how multiple hypotheses testing can produce associations with no clinical plausibility. We conducted a study of all 10,674,945 residents of Ontario aged between 18 and 100 years in 2000. Residents were randomly assigned to equally sized derivation and validation cohorts and classified according to their astrological sign. Using the derivation cohort, we searched through 223 of the most common diagnoses for hospitalization until we identified two for which subjects born under one astrological sign had a significantly higher probability of hospitalization compared to subjects born under the remaining signs combined (P<0.05). We tested these 24 associations in the independent validation cohort. Residents born under Leo had a higher probability of gastrointestinal hemorrhage (P=0.0447), while Sagittarians had a higher probability of humerus fracture (P=0.0123) compared to all other signs combined. After adjusting the significance level to account for multiple comparisons, none of the identified associations remained significant in either the derivation or validation cohort. Our analyses illustrate how the testing of multiple, non-prespecified hypotheses increases the likelihood of detecting implausible associations. Our findings have important implications for the analysis and interpretation of clinical studies.

  14. Hearing Sensitivity in Older Adults: Associations with cardiovascular risk factors in the Health, Aging, and Body Composition Study

    PubMed Central

    Helzner, Elizabeth P.; Patel, Ami S.; Pratt, Sheila; Sutton-Tyrrell, Kim; Cauley, Jane A; Talbott, Evelyn; Kenyon, Emily; Harris, Tamara B.; Satterfield, Suzanne; Ding, Jingzhong; Newman, Anne B.

    2012-01-01

    Objectives To examine the association of cardiovascular disease (CVD) and its risk factors with age-associated hearing loss, in a cohort of older black and white adults. Study Design Cross-sectional cohort study Setting The Health, Aging, and Body Composition (Health ABC) study; A community-based cohort study of older adults from Pittsburgh, PA and Memphis TN. Participants 2,049 well-functioning adults (mean age: 77.5 years; 37% black) Measurements Pure-tone audiometry and history of clinical CVD were obtained at the 4th annual follow-up visit. Pure-tone averages in decibels reflecting low frequencies (250, 500, and 1000 Hz) middle frequencies (500, 1000, and 2000 Hz) and high frequencies (2000, 4000, and 8000Hz) were calculated for each ear. CVD risk factors, aortic pulse-wave velocity, and ankle-arm index were obtained at the study baseline. Results In gender-stratified models, after adjustment for age, race, study site and occupational noise exposure, risk factors associated with poorer hearing sensitivity among men included higher triglyceride levels, higher resting heart rate and history of smoking. Among women, poorer hearing sensitivity was associated with higher BMI, higher resting heart rate, faster pulse-wave velocity, and low ankle-arm index. Conclusion Modifiable risk factors for CVD may play a role in the development of age-related hearing loss. PMID:21649629

  15. Associations between breakfast eating habits and health-promoting lifestyle, suboptimal health status in Southern China: a population based, cross sectional study.

    PubMed

    Chen, Jieyu; Cheng, Jingru; Liu, Yanyan; Tang, Yang; Sun, Xiaomin; Wang, Tian; Xiao, Ya; Li, Fei; Xiang, Lei; Jiang, Pingping; Wu, Shengwei; Wu, Liuguo; Luo, Ren; Zhao, Xiaoshan

    2014-12-11

    Suboptimal health status (SHS) is the intermediate health state between health and disease, refers to medically undiagnosed or functional somatic syndromes, and has been a major global public health challenge. However, both the etiology and mechanisms associated with SHS are still unclear. Breakfast eating behavior is a dietary pattern marker and previous studies have presented evidence of associations between failure to consume breakfast and increased diseases. Accordingly, in view of the significance of breakfast eating behaviors with respect to health status, the associations between breakfast eating habits and healthy lifestyle, SHS require further elucidation. A cross-sectional survey was conducted within a clustered sample of 24,159 individuals aged 12-80 years in 2012-13 within the population of Southern China. Breakfast eating habits were categorically defined by consumption frequency ('scarcely, sometimes or always'). Health-promoting lifestyle was assessed via the health-promoting lifestyle profile (HPLP-II). SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Of the 24,159 participants, the prevalence rates for the 'health' , 'SHS' , and 'disease' were 18.8%, 46.0%, and 35.2%, respectively. Overall, 19.6% of participants reported 'scarce' breakfast eating habits, with frequent breakfast eaters scoring higher on both HPLP-II and SHMS V1.0. After demographic adjustment, regression analyses revealed a significant association between breakfast eating habits and healthy lifestyle (p <0.001). There were lower levels of breakfast consumption regularity amongst individuals with SHS than those with disease. Categorically 'scarce' breakfast eaters were approximately three times more likely to be assigned SHS (OR: 2.745, 95% CI: 2.468-3.053), while infrequent breakfast eaters ('sometimes') were just less than twice as likely to be assessed as being of SHS (OR: 1.731, 95% CI: 1.595-1.879). Breakfast eating

  16. Health Risks Associated with Meat Consumption: A Review of Epidemiological Studies.

    PubMed

    Battaglia Richi, Evelyne; Baumer, Beatrice; Conrad, Beatrice; Darioli, Roger; Schmid, Alexandra; Keller, Ulrich

    2015-01-01

    Recent evidence from large prospective US and European cohort studies and from meta-analyses of epidemiological studies indicates that the long-term consumption of increasing amounts of red meat and particularly of processed meat is associated with an increased risk of total mortality, cardiovascular disease, colorectal cancer and type 2 diabetes, in both men and women. The association persists after inclusion of known confounding factors, such as age, race, BMI, history, smoking, blood pressure, lipids, physical activity and multiple nutritional parameters in multivariate analysis. The association has not always been noted with red meat, and it has been absent with white meat. There is evidence of several mechanisms for the observed adverse effects that might be involved, however, their individual role is not defined at present. It is concluded that recommendations for the consumption of unprocessed red meat and particularly of processed red meat should be more restrictive than existing recommendations. Restrictive recommendations should not be applied to subjects above about 70 years of age, as the studies quoted herein did not examine this age group, and the inclusion of sufficient protein supply (e. g. in the form of meat) is particularly important in the elderly.

  17. The association between subclinical thyroid dysfunction and dementia: The Health, Aging and Body Composition (Health ABC) Study.

    PubMed

    Aubert, Carole E; Bauer, Douglas C; da Costa, Bruno R; Feller, Martin; Rieben, Carole; Simonsick, Eleanor M; Yaffe, Kristine; Rodondi, Nicolas

    2017-08-29

    Data on the association between subclinical thyroid dysfunction and dementia are limited and conflicting. We aimed to determine whether subclinical thyroid dysfunction was associated with dementia and cognitive decline. Population-based prospective cohort study. Adults aged 70-79 years with measured thyroid function, but no dementia at baseline, and Modified Mini-Mental State (3MS) at baseline and follow-up. Primary outcome was incident-adjudicated dementia, based on 3MS, hospital records and dementia drugs. Secondary outcome was change in 3MS. Models were adjusted for age, sex, race, education and baseline 3MS, and then further for cardiovascular risk factors. Among 2558 adults, 85% were euthyroid (TSH 0.45-4.49mIU/L), 2% had subclinical hyperthyroidism with mildly decreased TSH (TSH 0.10-0.44 mIU/L), 1% subclinical hyperthyroidism with suppressed TSH (TSH < 0.10 mIU/L with normal free thyroxine [FT4]) and 12% subclinical hypothyroidism (TSH 4.50-19.99 mIU/L with normal FT4). Over 9 years, 22% developed dementia. Compared to euthyroidism, risk of dementia was higher in participants with subclinical hyperthyroidism with suppressed TSH (HR 2.38, 95% CI = 1.13;5.04), while we found no significant association in those with mildly decreased TSH (HR 0.79, 95% CI = 0.45;1.38) or with subclinical hypothyroidism (HR 0.91, 95% CI = 0.70;1.19). Participants with subclinical hyperthyroidism with suppressed TSH had a larger decline in 3MS (-3.89, 95% CI = -7.62; -0.15). Among older adults, subclinical hyperthyroidism with a TSH < 0.10 mIU/L was associated with a higher risk of dementia and a larger cognitive decline, while subclinical hyperthyroidism with mildly decreased TSH or subclinical hypothyroidism were not. © 2017 John Wiley & Sons Ltd.

  18. Tertiary education and its association with mental health indicators and educational factors among Arctic young adults: the NAAHS cohort study

    PubMed Central

    Bania, Elisabeth Valmyr; Kvernmo, Siv Eli

    2016-01-01

    Background Completed tertiary education is closely associated with employment and influences income, health and personal well-being. Objective The purpose of the study is to explore predictors for completed tertiary education among indigenous Sami and non-indigenous young people in relation to mental health indicators and educational factors in sociocultural rural and urban contexts across the Arctic part of Norway. Design The Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003–2005. Of all 5,877 10th graders (aged 15–16 years) in north Norway, 83% from all 87 municipalities participated; 450 (9.2%) reported indigenous Sami ethnicity, and 304 (6.2%) reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database and Norwegian Patient Register for 3,987 adolescents who gave their consent for follow-up studies. Results Completion of upper secondary school is the only common predictor of a completed tertiary education degree for both genders. Among females, conduct problems was a significant predictor of lower level education, typically vocational professions, while among males severe mental health problems requiring treatment by the specialist health care system reduced the opportunity to complete tertiary education at intermediate and higher level. Parental higher educational level was associated with less lower education among females and less higher education among males. Men residing in the northernmost and remote areas were less likely to complete education on higher level. Males’ completion of higher level education was strongly but not significantly associated (p=0.057) with higher average marks in lower secondary school. Conclusions The gender differences found in this study emphasize the need for gender-specific interventions to encourage, support and empower young people to attend and complete tertiary education. Young females with

  19. The Association Between Health Insurance Coverage and Skilled Birth Attendance in Ghana: A National Study.

    PubMed

    Khan, Shane M; Singh, Kavita

    2016-03-01

    Skilled birth attendance (SBA) is a key health intervention used by roughly two-thirds of women in Ghana. The National Health Insurance Scheme provided by the Government of Ghana is widely expected to improve maternal health outcomes by removing financial barriers to health services. In this paper, we examine if indeed health insurance is able to improve SBA, a key maternal outcome. We use data from the 2011 Ghana Multiple Indicator Cluster Survey implemented by the Ghana Statistical Services with support from the United Nations Children's Fund (UNICEF). We use a multivariate logistic model controlling for a number of enabling and predisposing factors and past experience with the health system to examine the effect of health insurance on skilled birth attendance. The sample is 2528 women. Our results show that women with health insurance are 47 % more likely to use SBA than women without health insurance. Results also underscore that women with repetitive contact with the health system (such as antenatal care) are more likely to have a skilled delivery (OR 3.00, p value 0.000). We also find that higher parity, rural and poor women are much less likely to use SBA. Health insurance may indeed be a useful mechanism to improve coverage of SBA, though many barriers to delivery care still exist for women. Further work to understand the effect of health insurance on other maternal outcomes is also warranted.

  20. Ten-year prospective study of public health problems associated with early drinking.

    PubMed

    Ellickson, Phyllis L; Tucker, Joan S; Klein, David J

    2003-05-01

    To compare early nondrinkers, experimenters, and drinkers on the prevalence of problem behaviors at grades 7 and 12 and at age 23 (N = 6338, 4265, and 3369, respectively). Results are based on longitudinal self-report data from individuals who were originally recruited from 30 California and Oregon schools at grade 7 (1985) and assessed again at grade 12 (1990) and at age 23 (1995). Logistic regression was used to develop weighted estimates of the prevalence of academic difficulties, employment problems, substance use, and delinquent and violent behaviors within the 3 drinking status groups at grades 7, 12, and/or at age 23. Huber variance estimates, which adjust for weighting and clustering of observations, were used to assess the statistical significance of differences across groups. Early drinkers and experimenters were more likely than nondrinkers to report academic problems, substance use, and delinquent behavior in both middle school and high school. By young adulthood, early alcohol use was associated with employment problems, other substance abuse, and criminal and violent behavior. Early drinkers do not necessarily mature out of a problematic lifestyle as young adults. Interventions for these high-risk youth should start early and address their other public health problems, particularly their tendency to smoke and use other illicit drugs.

  1. PREVALENCE AND ASSOCIATIONS OF MYELINATED RETINAL NERVE FIBERS: Results From the Population-Based Gutenberg Health Study.

    PubMed

    Elbaz, Hisham; Peto, Tunde; Butsch, Christina; Orouji, Elias; Laubert-Reh, Dagmar; Ponto, Katharina A; Binder, Harald; Pfeiffer, Norbert; Mirshahi, Alireza

    2016-12-01

    To determine the prevalence, ocular, and systemic associations of myelinated retinal nerve fibers (MRNF) in a Caucasian cohort. The Gutenberg Health Study (GHS) is a population-based, prospective cohort study encompassing 15,010 subjects in Germany. Gutenberg Health Study participants, aged 35 to 74 years, stratified for gender, decades of age, and residence were examined for ophthalmologic and systemic conditions. Optic disc centered and macular photographs were reviewed for the presence of MRNF. In 25,728 eyes of 12,906 participants (86.0% of the cohort), the prevalence of MRNF was 0.4%. In a binary logistic regression analysis, MRNF was positively associated with history of stroke (OR, 6.8; 95% CI, 2.9-16.1; P < 0.001). Myelinated retinal nerve fibers was not associated with age, sex, cardiovascular conditions other than stroke or ocular parameters, such as refraction, visual acuity, intraocular pressure, or central corneal thickness. This population-based study provides novel data on the prevalence of MRNF in Western Europe. We report a positive association between history of stroke and MRNF. It adds an additional retinal sign for stroke and calls for further studying of the behavior of oligodendrocytes within cerebrovascular diseases.

  2. Association between Perceived Ethnic Discrimination and Health: Evidence from the National Latino and Asian American Study (NLAAS).

    PubMed

    Siordia, C; Covington-Ward, Y D

    2016-01-01

    The field of aging studies continues to better understand between-racial-group health disparities. Previous work provides empirical evidence for a statistical relationship between perceived discrimination and adverse health across all age groups. We contribute to the literature by investigating the quantitative relationship between Perceived Ethnic Discrimination (PED), Self-Rated Physical Health (SR-PH), Self-Rated Mental Health (SR-MH), and their combined score (SR-PH-MH). The cross-sectional observational study used data collected between 2002 and 2004 from the National Latino and Asian American Study (n=4,559; average age=41; 54% female; 18% Mexican; 36% Non-Mexican Latinos; 12% Chinese; 31% Non-Chinese Asians). We provide descriptive statistics for those below and at or above age 65. Multivariable linear models adjusting for age, sex, ethnicity, education, body mass index, and neighborhood perception provide evidence that although a small effect, PED explains between-people variance in SR-PH (β=-0.01; α=0.001), SR-MH (β=-0.03; α=0.001), and SR-PH-MH (β=-0.04; α=0.001). The analysis supports arguments that PED has a non-random association with health. As we continue to explore novel measures of frailty, markers of social stress should be considered.

  3. Work-Related Psychosocial Factors and Mental Health Problems Associated with Musculoskeletal Pain in Nurses: A Cross-Sectional Study

    PubMed Central

    2016-01-01

    Background. Musculoskeletal pain is the most common cause of incapacity among nurses. This study aimed to report the prevalence of musculoskeletal pain among hospital nurses and to explore the associations of work-related psychosocial factors and mental health problems with musculoskeletal pain. Methods. A cross-sectional survey was carried out among registered nurses at Tartu University Hospital during April and May 2011. Binary logistic regression was used to assess the associations between dependent and independent variables. Results. Analysis was based on 404 nurses (45% of the hospital's nursing population). The overall prevalence of MSP was 70% in the past year and 64% in the past month. Lower back (57%) and neck (56%) were the body areas most commonly painful in the past year. Higher quantitative and emotional demands, work pace, low justice and respect in the workplace, influence on work organisation, and role conflicts were significantly associated with musculoskeletal pain among nurses (p < 0.05). All mental health problems and most strongly somatic stress symptoms were associated with musculoskeletal pain. Conclusions. Work-related psychosocial risk factors and mental health problems, especially somatic stress symptoms, have an important impact on the occurrence of musculoskeletal pain among university hospital nurses. PMID:27885319

  4. Work-Related Psychosocial Factors and Mental Health Problems Associated with Musculoskeletal Pain in Nurses: A Cross-Sectional Study.

    PubMed

    Freimann, Tiina; Pääsuke, Mati; Merisalu, Eda

    2016-01-01

    Background. Musculoskeletal pain is the most common cause of incapacity among nurses. This study aimed to report the prevalence of musculoskeletal pain among hospital nurses and to explore the associations of work-related psychosocial factors and mental health problems with musculoskeletal pain. Methods. A cross-sectional survey was carried out among registered nurses at Tartu University Hospital during April and May 2011. Binary logistic regression was used to assess the associations between dependent and independent variables. Results. Analysis was based on 404 nurses (45% of the hospital's nursing population). The overall prevalence of MSP was 70% in the past year and 64% in the past month. Lower back (57%) and neck (56%) were the body areas most commonly painful in the past year. Higher quantitative and emotional demands, work pace, low justice and respect in the workplace, influence on work organisation, and role conflicts were significantly associated with musculoskeletal pain among nurses (p < 0.05). All mental health problems and most strongly somatic stress symptoms were associated with musculoskeletal pain. Conclusions. Work-related psychosocial risk factors and mental health problems, especially somatic stress symptoms, have an important impact on the occurrence of musculoskeletal pain among university hospital nurses.

  5. The Association between Air Pollution and Population Health Risk for Respiratory Infection: A Case Study of Shenzhen, China.

    PubMed

    Xia, Xiaolin; Zhang, An; Liang, Shi; Qi, Qingwen; Jiang, Lili; Ye, Yanjun

    2017-08-23

    Nowadays, most of the research on air pollution and its adverse effects on public health in China has focused on megacities and heavily-polluted regions. Fewer studies have focused on cities that are slightly polluted. Shenzhen used to have a favorable air environment, but its air quality has deteriorated gradually as a result of development in recent years. So far, no systematic investigations have been conducted on the adverse effects of air pollution on public health in Shenzhen. This research has applied a time series analysis model to study the possible association between different types of air pollution and respiratory hospital admission in Shenzhen in 2013. Respiratory hospital admission was divided into two categories for comparison analysis among various population groups: acute upper respiratory infection and acute lower respiratory infection. The results showed that short-term exposure to ambient air pollution was significantly associated with acute respiratory infection hospital admission in Shenzhen in 2013. Children under 14 years old were the main susceptible population of acute respiratory infection due to air pollution. PM10, PM2.5 and NO₂ were the primary air pollutants threatening respiratory health in Shenzhen. Though air pollution level is generally relatively low in Shenzhen, it will benefit public health to control the pollution of particulate matter as well as other gaseous pollutants.

  6. The Association between Air Pollution and Population Health Risk for Respiratory Infection: A Case Study of Shenzhen, China

    PubMed Central

    Liang, Shi; Qi, Qingwen; Jiang, Lili; Ye, Yanjun

    2017-01-01

    Nowadays, most of the research on air pollution and its adverse effects on public health in China has focused on megacities and heavily-polluted regions. Fewer studies have focused on cities that are slightly polluted. Shenzhen used to have a favorable air environment, but its air quality has deteriorated gradually as a result of development in recent years. So far, no systematic investigations have been conducted on the adverse effects of air pollution on public health in Shenzhen. This research has applied a time series analysis model to study the possible association between different types of air pollution and respiratory hospital admission in Shenzhen in 2013. Respiratory hospital admission was divided into two categories for comparison analysis among various population groups: acute upper respiratory infection and acute lower respiratory infection. The results showed that short-term exposure to ambient air pollution was significantly associated with acute respiratory infection hospital admission in Shenzhen in 2013. Children under 14 years old were the main susceptible population of acute respiratory infection due to air pollution. PM10, PM2.5 and NO2 were the primary air pollutants threatening respiratory health in Shenzhen. Though air pollution level is generally relatively low in Shenzhen, it will benefit public health to control the pollution of particulate matter as well as other gaseous pollutants. PMID:28832531

  7. Genomics for public health improvement: relevant international ethical and policy issues around genome-wide association studies and biobanks.

    PubMed

    Pang, T

    2013-01-01

    Genome-wide association studies and biobanks are at the forefront of genomics research and possess unprecedented potential to improve public health. However, for public health genomics to ultimately fulfill its potential, technological and scientific advances alone are insufficient. Scientists, ethicists, policy makers, and regulators must work closely together with research participants and communities in order to craft an equitable and just ethical framework, and a sustainable environment for effective policies. Such a framework should be a 'hybrid' form which balances equity and solidarity with entrepreneurship and scientific advances. A good balance between research and policy on one hand, and privacy, protection and trust on the other is the key for public health improvement based on advances in genomics science.

  8. Health risk factors associated with meat, fruit and vegetable consumption in cohort studies: A comprehensive meta-analysis

    PubMed Central

    Grosso, Giuseppe; Micek, Agnieszka; Godos, Justyna; Pajak, Andrzej; Sciacca, Salvatore; Galvano, Fabio; Boffetta, Paolo

    2017-01-01

    The aim of this study was to perform a meta-analysis to test the association between red, processed, and total meat, as well as fruit and vegetable consumption, and selected health risk factors, including body weight status, smoking habit, physical activity level, level of education, and alcohol drinking in cohort studies on non-communicable disease. A systematic search of electronic databases was performed to identify relevant articles published up to March 2017. In a two-stage approach, frequency-weighted linear regression coefficients were first calculated for each variable, and then combined across studies through meta-regression. Ninety-eight studies including 20 on red meat, 6 on processed meat, 12 on total meat, 37 on fruit and vegetable combined, 21 on fruit and 24 on vegetable consumption were analyzed. Intake of red meat was positively associated with BMI, percentage of overweight and obese, low physical activity, and current and ever smoking and inversely associated with percentage of non-smokers and high physically active individuals. Similar associations were found for red meat were found, although based on fewer data. Intake of fruits and vegetables was positively associated with prevalence of non-smokers, high education and high physical activity, and similar results were found when examining fruit and vegetable consumption separately. Stratification by geographical area revealed that some associations were stronger in US rather than European or Asian cohorts. In conclusions, the distribution of health risk factors associated with high meat and fruit/vegetable consumption may differ from those of low-consumers. Some of these differences may mediate, confound, or modify the relation between diet and non-communicable disease risk. PMID:28850610

  9. Prospective associations between childhood low-level lead exposure and adult mental health problems: the Port Pirie cohort study.

    PubMed

    McFarlane, Alexander C; Searle, Amelia K; Van Hooff, Miranda; Baghurst, Peter A; Sawyer, Michael G; Galletly, Cherrie; Sim, Malcolm R; Clark, Levina S

    2013-12-01

    Low-level environmental lead exposure during childhood is associated with poorer emotional/behavioural functioning in later childhood and adolescence. Scarce research has examined whether these apparent effects persist into adulthood. This study is the first to examine prospective associations between lead exposure across early childhood and several common adult mental health problems. Childhood data (including blood lead concentrations) and adult data (from mental health questionnaires and psychiatric interviews) were available for 210 participants (44% males, mean age=26.3 years) from the Port Pirie cohort study (1979-1982 birth cohort). Participants had a mean childhood (to 7 years) average blood lead concentration of 17.2μg/dL. Among females, childhood blood lead showed small significant positive associations with lifetime diagnoses of drug and alcohol abuse and social phobia, and with anxiety, somatic and antisocial personality problems. For example: for a 10μg/dL blood lead increase, females were 2.84 times (95% CI 1.10, 7.30) more likely to have an alcohol abuse diagnosis. However, adjustment for childhood covariates - particularly stimulation within the home environment - rendered these associations non-significant. No significant or sizeable unadjusted or adjusted associations were seen for males. The associations between early lead exposure and emotional/behavioural functioning in children might persist into adulthood, at least for females. However, it is unclear whether such results arise from residual confounding, or other mechanisms. Interventions that focus on improving the childhood home environment may have a long-term positive impact on adult mental health outcomes. However, more prospective research using large and representative samples is needed to substantiate these results.

  10. Associations between maternal experiences of racism and early child health and development: findings from the UK Millennium Cohort Study.

    PubMed

    Kelly, Yvonne; Becares, Laia; Nazroo, James

    2013-01-01

    Emerging evidence suggests that experienced racism might help explain observed ethnic inequalities in early child health and development. There are few studies outside the US context and none that consider mothers' experiences of racism in relation to a range of early childhood health and developmental markers. The authors used cross-sectional data from the UK Millennium Cohort Study on 2136 mothers and their 5-year-old children from ethnic minority groups. Measures of racism tapped two dimensions of mothers' experience: perceived frequency of racist attacks in residential area and interpersonal racism. Markers of child health and development were obesity; socioemotional difficulties; cognitive: verbal, non-verbal and spatial ability test scores. There was a suggestion that the mothers' experience of interpersonal racism was associated with an increased risk of obesity ('received insults' OR=1.47; 'treated unfairly' OR=1.57; 'disrespectful treatment by shop staff' OR=1.55), but all CIs crossed 1.0, and size estimates were attenuated on further statistical adjustment. Perception of racism in the residential area was associated with socioemotional difficulties (fully adjusted coefficient=1.40, SE=0.47) and spatial abilities (fully adjusted coefficient=-1.99, SE=0.93) but not with verbal or non-verbal ability scores. Maternal experiences of racist insults were associated with non-verbal ability scores (fully adjusted coefficient=-1.70, SE=0.88). The results suggest that mothers' experienced racism is linked to markers of early child health and development. Interventions that aim to improve early child development and address ethnic health inequalities need to incorporate approaches to tackling racism at all levels of society.

  11. An empirical typology of social networks and its association with physical and mental health: a study with older Korean immigrants.

    PubMed

    Park, Nan Sook; Jang, Yuri; Lee, Beom S; Ko, Jung Eun; Haley, William E; Chiriboga, David A

    2015-01-01

    In the context of social convoy theory, the purposes of the study were (a) to identify an empirical typology of the social networks evident in older Korean immigrants and (b) to examine its association with self-rated health and depressive symptoms. The sample consisted of 1,092 community-dwelling older Korean immigrants in Florida and New York. Latent class analyses were conducted to identify the optimal social network typology based on 8 indicators of interpersonal relationships and activities. Bivariate and multivariate analyses were conducted to examine how the identified social network typology was associated with self-rating of health and depressive symptoms. Results from the latent class analysis identified 6 clusters as being most optimal, and they were named diverse, unmarried/diverse, married/coresidence, family focused, unmarried/restricted, and restricted. Memberships in the clusters of diverse and married/coresidence were significantly associated with more favorable ratings of health and lower levels of depressive symptoms. Notably, no distinct network solely composed of friends was identified in the present sample of older immigrants; this may reflect the disruptions in social convoys caused by immigration. The findings of this study promote our understanding of the unique patterns of social connectedness in older immigrants. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. The association between self-reported diabetes and cancer incidence in the NIH-AARP Diet and Health Study.

    PubMed

    Lai, Gabriel Y; Park, Yikyung; Hartge, Patricia; Hollenbeck, Albert R; Freedman, Neal D

    2013-03-01

    Epidemiological studies have observed associations between diabetes and a number of different cancers. Yet the association with cancer overall and the interrelationship of diabetes and obesity with cancer have been unclear. OBJECTIVE, DESIGN, SETTING, AND PARTICIPANTS: We evaluated the association between self-reported diabetes and cancer incidence in the NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health Study, a prospective cohort in which 295,276 men and 199,591 women completed a questionnaire in 1995-1996 and were followed up for cancer through 2006. Hazard ratios (HRs) and 95% confidence intervals (CIs) for cancer incidence, overall and by type, were estimated from multivariate Cox proportional hazards models. Diabetes was positively associated with total incident cancer in women (1.07, 95% CI 1.02-1.12) but inversely in men (0.96, 95% CI 0.93-0.98). However, diabetes was inversely associated with prostate cancer (HR 0.74, 95% CI 0.70-0.78), which constituted 42% of cancers in men. After excluding prostate cancer, diabetes was also positively associated with cancer in men (HR 1.09, 95% CI 1.04-1.14). By site, diabetes was positively associated with anal, bladder, colon, kidney, liver, pancreatic, rectal, and stomach cancers and in women with endometrial cancer. We also evaluated the joint effect of obesity and diabetes and observed that diabetes conferred additional risk, beyond that of overweight or obesity, for cancer overall, excluding prostate, and for certain sites including the bladder, colon, endometrium, kidney, liver, pancreas, rectum, and stomach. Our results suggest an etiological role for diabetes in a number of cancers, independent of obesity, and that preventing diabetes may contribute to reduced cancer risk.

  13. Associations of Openness and Conscientiousness With Walking Speed Decline: Findings From the Health, Aging, and Body Composition Study

    PubMed Central

    Costa, Paul T.; Terracciano, Antonio; Ferrucci, Luigi; Faulkner, Kimberly; Coday, Mathilda (Mace) C.; Ayonayon, Hilsa N.; Simonsick, Eleanor M.

    2012-01-01

    Objectives. The objective of this study was to explore the associations between openness to experience and conscientiousness, two dimensions of the five-factor model of personality, and usual gait speed and gait speed decline. Method. Baseline analyses were conducted on 907 men and women aged 71–82 years participating in the Cognitive Vitality substudy of the Health, Aging, and Body Composition study. The longitudinal analytic sample consisted of 740 participants who had walking speed assessed 3 years later. Results. At baseline, gait speed averaged 1.2 m/s, and an average decline of 5% over the 3-year follow-up period was observed. Higher conscientiousness was associated with faster initial walking speed and less decline in walking speed over the study period, independent of sociodemographic characteristics. Lifestyle factors and disease status appear to play a role in the baseline but not the longitudinal association between conscientiousness and gait speed. Openness was not associated with either initial or decline in gait speed. Discussion. These findings extend the body of evidence suggesting a protective association between conscientiousness and physical function to performance-based assessment of gait speed. Future studies are needed to confirm these associations and to explore mechanisms that underlie the conscientiousness mobility connection in aging adults. PMID:22451484

  14. Opioid use in fibromyalgia is associated with negative health related measures in a prospective cohort study.

    PubMed

    Fitzcharles, Mary-Ann; Faregh, Neda; Ste-Marie, Peter A; Shir, Yoram

    2013-01-01

    As pain is the cardinal symptom of fibromyalgia (FM), strategies directed towards pain relief are an integral component of treatment. Opioid medications comprise a category of pharmacologic treatments which have impact on pain in various conditions with best evidence for acute pain relief. Although opioid therapy other than tramadol has never been formally tested for treatment of pain in FM, these agents are commonly used by patients. We have examined the effect of opioid treatments in patients diagnosed with FM and followed longitudinally in a multidisciplinary pain center over a period of 2 years. In this first study reporting on health related measures and opioid use in FM, opioid users had poorer symptoms and functional and occupational status compared to nonusers. Although opioid users may originally have had more severe symptoms at the onset of disease, we have no evidence that these agents improved status beyond standard care and may even have contributed to a less favourable outcome. Only a formal study of opioid use in FM will clarify this issue, but until then physicians must be vigilant regarding the multiple adverse consequences of opioid therapy.

  15. The association between soya consumption and serum thyroid-stimulating hormone concentrations in the Adventist Health Study-2.

    PubMed

    Tonstad, Serena; Jaceldo-Siegl, Karen; Messina, Mark; Haddad, Ella; Fraser, Gary E

    2016-06-01

    Consumers may choose soya foods as healthful alternatives to animal products, but concern has arisen that eating large amounts of soya may adversely affect thyroid function. The present study aimed to examine the association between soya food consumption and serum thyroid-stimulating hormone (TSH) concentrations in North American churchgoers belonging to the Seventh-day Adventist denomination that encourages vegetarianism. Participants completed six repeated 24 h dietary recalls within a 6-month period. Soya protein and soya isoflavone intakes were estimated, and their relationships to TSH concentrations measured at the end of 6 months were calculated using logistic regression analyses. Calibration sub-study of the Adventist Health Study-2. Women (n 548) and men (n 295) who were not taking thyroid medications. In men, age and urinary iodine concentrations were associated with high serum TSH concentrations (>5 mIU/l), while among women White ethnicity was associated with high TSH. In multivariate models adjusted for age, ethnicity and urinary iodine, soya isoflavone and protein intakes were not associated with high TSH in men. In women higher soya isoflavone consumption was associated with higher TSH, with an adjusted odds ratio (highest v. lowest quintile) of 4·17 (95 % CI 1·73, 10·06). Likewise, women with high consumption of soya protein (midpoint of highest quintile, 11 g/d) v. low consumption (midpoint of lowest quintile, 0 g/d) carried increased odds of high TSH (OR=2·69; 95 % CI 1·34, 5·30). In women high consumption of soya was associated with elevated TSH concentrations. No associations between soya intake and TSH were found in men.

  16. Patient characteristics associated with venous thromboembolic events: a cohort study using pooled electronic health record data.

    PubMed

    Kaelber, David C; Foster, Wendy; Gilder, Jason; Love, Thomas E; Jain, Anil K

    2012-01-01

    To demonstrate the potential of de-identified clinical data from multiple healthcare systems using different electronic health records (EHR) to be efficiently used for very large retrospective cohort studies. Data of 959 030 patients, pooled from multiple different healthcare systems with distinct EHR, were obtained. Data were standardized and normalized using common ontologies, searchable through a HIPAA-compliant, patient de-identified web application (Explore; Explorys Inc). Patients were 26 years or older seen in multiple healthcare systems from 1999 to 2011 with data from EHR. Comparing obese, tall subjects with normal body mass index, short subjects, the venous thromboembolic events (VTE) OR was 1.83 (95% CI 1.76 to 1.91) for women and 1.21 (1.10 to 1.32) for men. Weight had more effect then height on VTE. Compared with Caucasian, Hispanic/Latino subjects had a much lower risk of VTE (female OR 0.47, 0.41 to 0.55; male OR 0.24, 0.20 to 0.28) and African-Americans a substantially higher risk (female OR 1.83, 1.76 to 1.91; male OR 1.58, 1.50 to 1.66). This 13-year retrospective study of almost one million patients was performed over approximately 125 h in 11 weeks, part time by the five authors. As research informatics tools develop and more clinical data become available in EHR, it is important to study and understand unique opportunities for clinical research informatics to transform the scale and resources needed to perform certain types of clinical research. With the right clinical research informatics tools and EHR data, some types of very large cohort studies can be completed with minimal resources.

  17. Patient characteristics associated with venous thromboembolic events: a cohort study using pooled electronic health record data

    PubMed Central

    Foster, Wendy; Gilder, Jason; Love, Thomas E; Jain, Anil K

    2012-01-01

    Objective To demonstrate the potential of de-identified clinical data from multiple healthcare systems using different electronic health records (EHR) to be efficiently used for very large retrospective cohort studies. Materials and methods Data of 959 030 patients, pooled from multiple different healthcare systems with distinct EHR, were obtained. Data were standardized and normalized using common ontologies, searchable through a HIPAA-compliant, patient de-identified web application (Explore; Explorys Inc). Patients were 26 years or older seen in multiple healthcare systems from 1999 to 2011 with data from EHR. Results Comparing obese, tall subjects with normal body mass index, short subjects, the venous thromboembolic events (VTE) OR was 1.83 (95% CI 1.76 to 1.91) for women and 1.21 (1.10 to 1.32) for men. Weight had more effect then height on VTE. Compared with Caucasian, Hispanic/Latino subjects had a much lower risk of VTE (female OR 0.47, 0.41 to 0.55; male OR 0.24, 0.20 to 0.28) and African-Americans a substantially higher risk (female OR 1.83, 1.76 to 1.91; male OR 1.58, 1.50 to 1.66). This 13-year retrospective study of almost one million patients was performed over approximately 125 h in 11 weeks, part time by the five authors. Discussion As research informatics tools develop and more clinical data become available in EHR, it is important to study and understand unique opportunities for clinical research informatics to transform the scale and resources needed to perform certain types of clinical research. Conclusions With the right clinical research informatics tools and EHR data, some types of very large cohort studies can be completed with minimal resources. PMID:22759621

  18. Sociodemographic factors and health conditions associated with the resilience of people with chronic diseases: a cross sectional study 1

    PubMed Central

    Böell, Julia Estela Willrich; da Silva, Denise Maria Guerreiro Vieira; Hegadoren, Kathleen Mary

    2016-01-01

    ABSTRACT Objective: to investigate the association between resilience and sociodemographic variables and the health of people with chronic kidney disease and / or type 2 diabetes mellitus. Method: a cross-sectional observational study performed with 603 people with chronic kidney disease and / or type 2 diabetes mellitus. A tool to collect socio-demographic and health data and the Resilience Scale developed by Connor and Davidson were applied. A descriptive and multivariate analysis was performed. Results: the study participants had on average 61 years old (SD= 13.2), with a stable union (52.24%), religion (96.7%), retired (49.09%), with primary education (65%) and income up to three minimum wages. Participants with kidney disease showed less resilience than people with diabetes. Conclusion: the type of chronic illness, disease duration, body mass index and religious beliefs influenced the resilience of the study participants. PMID:27598377

  19. Environment-Wide Association Study of Blood Pressure in the National Health and Nutrition Examination Survey (1999–2012)

    PubMed Central

    McGinnis, Denise P.; Brownstein, John S.; Patel, Chirag J.

    2016-01-01

    Identifying environmental exposures associated with blood pressure is a priority. Recently, we proposed the environment-wide association study to search for and replicate environmental factors associated with phenotypes. We conducted the environment-wide association study (EWAS) using the National Health and Nutrition Examination Surveys (1999–2012) which evaluated a total of 71,916 participants to prioritize environmental factors associated with systolic and diastolic blood pressure. We searched for factors on participants from survey years 1999–2006 and tentatively replicated findings in participants from years 2007–2012. Finally, we estimated the overall association and performed a second meta-analysis using all survey years (1999–2012). For systolic blood pressure, self-reported alcohol consumption emerged as our top finding (a 0.04 increase in mmHg of systolic blood pressure for 1 standard deviation increase in self-reported alcohol), though the effect size is small. For diastolic blood pressure, urinary cesium was tentatively replicated; however, this factor demonstrated high heterogeneity between populations (I2 = 51%). The lack of associations across this wide of an analysis raises the call for a broader search for environmental factors in blood pressure. PMID:27457472

  20. Environment-Wide Association Study of Blood Pressure in the National Health and Nutrition Examination Survey (1999-2012).

    PubMed

    McGinnis, Denise P; Brownstein, John S; Patel, Chirag J

    2016-07-26

    Identifying environmental exposures associated with blood pressure is a priority. Recently, we proposed the environment-wide association study to search for and replicate environmental factors associated with phenotypes. We conducted the environment-wide association study (EWAS) using the National Health and Nutrition Examination Surveys (1999-2012) which evaluated a total of 71,916 participants to prioritize environmental factors associated with systolic and diastolic blood pressure. We searched for factors on participants from survey years 1999-2006 and tentatively replicated findings in participants from years 2007-2012. Finally, we estimated the overall association and performed a second meta-analysis using all survey years (1999-2012). For systolic blood pressure, self-reported alcohol consumption emerged as our top finding (a 0.04 increase in mmHg of systolic blood pressure for 1 standard deviation increase in self-reported alcohol), though the effect size is small. For diastolic blood pressure, urinary cesium was tentatively replicated; however, this factor demonstrated high heterogeneity between populations (I(2) = 51%). The lack of associations across this wide of an analysis raises the call for a broader search for environmental factors in blood pressure.

  1. Traffic density in area of residence is associated with health-related quality of life in women, the community-based Hordaland Health Study.

    PubMed

    Gundersen, Hilde; Magerøy, Nils; Moen, Bente E; Bråtveit, Magne

    2013-01-01

    Vehicle traffic is increasing worldwide, and this is a major concern because traffic-related air pollution and noise may influence health. The aim of this study was to evaluate whether health-related quality of life (HRQoL) is associated with vehicle traffic density in area of residence. A total of 16,410 individuals, 40 to 45 years old, were asked to participate in this study (response rate: 55% for men, 66% for women). Using the 12-Item Short Form Health Survey (SF-12) questionnaire, both physical and mental HRQoL were investigated. Multiple linear regression analyses showed that women living in areas with high traffic density had significantly poorer physical HRQoL than women living in areas with moderate or low vehicle traffic density. There were no similar findings among men. Mental HRQoL was not associated with vehicle traffic density in the area of residence, neither for women nor for men. There is an association between high vehicle traffic density in residential area and reduced HRQoL in women.

  2. Health-related behaviors associated with subjective sleep insufficiency in Japanese workers: A cross-sectional study.

    PubMed

    Kageyama, Makoto; Odagiri, Keiichi; Mizuta, Isagi; Yamamoto, Makoto; Yamaga, Keiko; Hirano, Takako; Onoue, Kazue; Uehara, Akihiko

    2017-01-28

    ObjectivesSleep disturbances are related to somatic and mental disorders, industrial accidents, absenteeism, and retirement because of disability. We aimed to identify health-related behaviors associated with subjective sleep insufficiency in Japanese workers.MethodsThis cross-sectional study included 5,297 employees (mean age: 43.6 ± 11.3 years; 4,039 men). Multiple logistic regression analysis was used to identify health-related behaviors associated with subjective sleep insufficiency.ResultsOverall, 28.2% of participants experienced subjective sleep insufficiency. There was a significant difference between the genders in the proportion of participants with subjective sleep insufficiency (male: 26.4%; female: 34.3%; p < 0.001). Multiple logistic regression analysis revealed that being a female or ≥40 years, experiencing a weight change of ≥3 kg during the preceding year, not exercising regularly, not walking quickly, and eating a late-evening or fourth meal were associated with subjective sleep insufficiency. After stratifying by gender, age ≥40 years, not exercising regularly, and eating a late-evening or fourth meal were significantly associated with subjective sleep insufficiency in both genders. Not walking quickly, experiencing a weight change, and eating quickly were positively associated with subjective sleep insufficiency only for males. Females who did not engage in physical activity were more likely to have experienced subjective sleep insufficiency, but this relationship was not observed in males.ConclusionsThe results indicated that certain health-related behaviors, specifically not exercising regularly and nocturnal eating habits, were associated with subjective sleep insufficiency in a group of Japanese workers.

  3. Fat mass is positively associated with bone mass in relatively thin adolescents: data from the Kitakata Kids Health Study.

    PubMed

    Kouda, Katsuyasu; Fujita, Yuki; Sato, Yuho; Ohara, Kumiko; Nakamura, Harunobu; Uenishi, Kazuhiro; Iki, Masayuki

    2014-07-01

    Epidemiologic studies have found that higher body weight is associated with better bone health. Body weight consists of both fat mass (FM) and lean soft tissue mass (LSTM). Previous studies have examined the effects of FM levels during childhood on bone health, with conflicting results. In the present study, we investigated the independent contributions of FM to bone mass in Japanese adolescents. Subjects were 235 adolescents aged 15-18 years old in August 2010 and in August 2013 from the Kitakata Kids Health Study in Japan. We obtained cross-sectional data on body composition as well as bone mineral density (BMD). Body composition and BMD were measured using a dual-energy X-ray absorptiometry scanner. We found moderate and positive relationships between FM index and LSTM index (males, r=0.69; females, r=0.44). To verify a potentially additive effect of FM on the variance of bone variables beyond LSTM, we assessed the association between FM index and bone variables after stratification by tertiles of the LSTM index. In the lowest tertile of the LSTM index, FM index was significantly (P<0.05) associated with both femoral neck BMD (males, β=0.48; females, β=0.33) and whole body BMC (males, β=0.41; females, β=0.25). On the other hand, we found no significant associations between FM index and bone variables in other tertiles of the LSTM index. These findings indicate that FM can influence how high bone mass is obtained among relatively thin adolescents, but not among those who are of normal weight or overweight. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions: A Quasi-experimental Study.

    PubMed

    Wherry, Laura R; Miller, Sarah

    2016-06-21

    In 2014, only 26 states and the District of Columbia chose to implement the Patient Protection and Affordable Care Act (ACA) Medicaid expansions for low-income adults. To evaluate whether the state Medicaid expansions were associated with changes in insurance coverage, access to and utilization of health care, and self-reported health. Comparison of outcomes before and after the expansions in states that did and did not expand Medicaid. United States. Citizens aged 19 to 64 years with family incomes below 138% of the federal poverty level in the 2010 to 2014 National Health Interview Surveys. Health insurance coverage (private, Medicaid, or none); improvements in coverage over the previous year; visits to physicians in general practice and specialists; hospitalizations and emergency department visits; skipped or delayed medical care; usual source of care; diagnoses of diabetes, high cholesterol, and hypertension; self-reported health; and depression. In the second half of 2014, adults in expansion states experienced increased health insurance (7.4 percentage points [95% CI, 3.4 to 11.3 percentage points]) and Medicaid (10.5 percentage points [CI, 6.5 to 14.5 percentage points]) coverage and better coverage than 1 year before (7.1 percentage points [CI, 2.7 to 11.5 percentage points]) compared with adults in nonexpansion states. Medicaid expansions were associated with increased visits to physicians in general practice (6.6 percentage points [CI, 1.3 to 12.0 percentage points]), overnight hospital stays (2.4 percentage points [CI, 0.7 to 4.2 percentage points]), and rates of diagnosis of diabetes (5.2 percentage points [CI, 2.4 to 8.1 percentage points]) and high cholesterol (5.7 percentage points [CI, 2.0 to 9.4 percentage points]). Changes in other outcomes were not statistically significant. Observational study may be susceptible to unmeasured confounders; reliance on self-reported data; limited post-ACA time frame provided information on short-term changes only

  5. The Association between Health Behaviours and Academic Performance in Canadian Elementary School Students: A Cross-Sectional Study

    PubMed Central

    McIsaac, Jessie-Lee D.; Kirk, Sara F. L.; Kuhle, Stefan

    2015-01-01

    Background: Establishing early healthy eating and physical activity behaviours is critical in supporting children’s long-term health and well-being. The objective of the current paper was to examine the association between health behaviours and academic performance in elementary school students in a school board in Nova Scotia, Canada. Methods: Our population-based study included students in grades 4–6 across 18 schools in a rural school board. Diet and physical activity were assessed through validated instruments. Academic performance measures were obtained from the school board for Mathematics and English Language Arts (ELA). Associations between health behaviours and academic performance were assessed using multilevel logistic regression. Results: Students with unhealthy lifestyle behaviours were more likely to have poor academic performance for both ELA and Mathematics compared to students with healthy lifestyle behaviours; associations were statistically significant for diet quality, physical activity, sugar-sweetened beverage consumption for ELA; and breakfast skipping, not being physically active at morning recess, and not being physically active after school for Mathematics. The effects of diet and physical activity were independent of each other and there was no interaction between the two exposures. Conclusions: Our findings suggest that support for healthy behaviours may help to improve academic outcomes of students. PMID:26610537

  6. Pulse wave velocity is associated with muscle mass decline: Health ABC study.

    PubMed

    Abbatecola, Angela Marie; Chiodini, Paolo; Gallo, Ciro; Lakatta, Edward; Sutton-Tyrrell, Kim; Tylavsky, Frances A; Goodpaster, Bret; de Rekeneire, Natalie; Schwartz, Ann V; Paolisso, Giuseppe; Harris, Tamara

    2012-04-01

    Age-related mechanisms that lead to sarcopenia are not entirely understood. Basal leg blood flow declines with aging by augmented sympathetic vasoconstriction and arterial stiffening, thus a dysfunction in blood vessel dynamics may have an independent role on sarcopenia. We determined whether pulse wave velocity (PWV), marker of arterial stiffness, was associated with skeletal muscle decline. Observational cohort study of older adults(70-79 years) living in Pittsburgh, PA, USA or Memphis, TN, USA. Analyses included 2,405 participants. Correlations among muscle parameters including skeletal muscle density and intermuscular adipose tissue using mid-thigh CT scans were assessed. Linear mixed models tested the association between the change in the sarcopenic index (SI) (assessed by dual energy X-ray absorptiometry) over time and baseline PWV independently of multiple confounders. SI was defined: appendicular lean mass/squared height and calculated at every follow-up (n = 6). Baseline PWV was significantly higher in black women compared to white women (930 ± 431 vs. 843 ± 366; p = 0.0001), while there were no significant differences between black and white men (943 ± 402 vs. 911 ± 375; p = 0.1786). Baseline analyses showed an independent negative association between PWV and muscle parameters after adjusting for confounders in both genders. The PWV-by-race interaction was significant in women and analyses are reported separately by race. Prospective mixed models showed that PWV was an independent determinant of the SI in all men (β = -0.1043; p = 0.0065) and in white women (β = -0.1091; p = 0.0192). In analyses examining the effect of arterial stiffness on limb lean mass over time, PWV correlated with lower leg (β = -0.2196; p = 0.0002)and arm mass (β = -0.0985; p = 0.0011) in all men and lower leg mass(β = -0.1608; p = 0.0027)in white women. In older persons, arterial stiffening is associated with skeletal muscle mass decline differently for race and

  7. The Avalon Gardens Men's Association: A Community Health Psychology Case Study.

    PubMed

    Borg, Mark B

    2002-05-01

    This article follows the development and progress of the US Department of Housing and Urban Development's 'Healthy and Safe Communities' initiative as it was implemented by a community empowerment organization during a four-year community revitalization project in the aftermath of the Los Angeles riots. The author explores practical aspects of Community Health Psychology through assessing the ways in which its organizing principles were manifest in community-wide processes of individual and community change in one low-income housing project in South Central Los Angeles called Avalon Gardens. Specifically highlighted is how a group of African American and Latino men in the community created a group forum that helped foster, support and sustain an empowerment process that supported health promotion, health consciousness and significant health improvement in the community.

  8. The association of resilience with mental and physical health among older American Indians: the Native Elder Care Study.

    PubMed

    Schure, Marc B; Odden, Michelle; Goins, R Turner

    2013-01-01

    We examined the association of resilience with measures of mental and physical health in a sample of older American Indians (AIs). A validated scale measuring resilience was administered to 185 noninstitutionalized AIs aged>=55 years. Unadjusted analyses revealed that higher levels of resilience were associated with lower levels of depressive symptomatology and chronic pain, and with higher levels of mental and physical health. Resilience remained significantly associated with depressive symptomatology after controlling for demographic and other health measures. Our findings suggest that resilience among older AIs has important implications for some aspects of mental and physical health.

  9. Cross-sectional study of factors associated with community health centre use in a recently urbanised community in Chengdu, China.

    PubMed

    Liu, Danping; Meng, Hongdao; Dobbs, Debra; Conner, Kyaien O; Hyer, Kathryn; Li, Ningxiu; Ren, Xiaohui; Gao, Bo

    2017-06-08

    Public investment in community health centres (CHCs) has been increasing as a response to rapid urbanisation in China. The objectives of this study were: (1) to examine factors associated with CHC use among residents from a recently urbanised community in western China and (2) to describe satisfaction with CHC among users. Cross-sectional design. A community recently converted to urban status with a newly constructed CHC in Southwest China. A random sample of 2259 adults in the Hezuo community in Chengdu, China, completed the survey in 2013. Trained staff interviewed study participants in their homes using structured questionnaires. The survey included questions regarding sociodemographics, health status, access to and usage of healthcare, health behaviours and CHC use. The Andersen's behavioural model of health service use was used to guide multivariable logistic regression modelling in identifying predisposing, enabling and need factors associated with the likelihood of using CHC. Descriptive statistics were used to describe residents' satisfaction with the CHC. A total of 71.8% of the respondents reported using the CHC during the past year. Factors influencing adults' CHC use included: gender, marital status, education level and knowledge of one's blood pressure (predisposing factors); annual household per capita income and walking time to the CHC (enabling factors) and self-rated health as well as physical activities (need factors). CHC users reported modest satisfaction across various aspects of the CHC. Neighbourhood CHC in urban areas provides important services to these residents living in a recently urbanised community. All three categories of factors in the Andersen model help explain the likelihood of CHC use. There is much room for improvement in CHC to enhance customer satisfaction. Future research is needed to improve access to CHCs and promote their use in urbanised populations with low to modest education. © Article author(s) (or their employer

  10. Association of dietary nitrate intake with primary open-angle glaucoma: a prospective analysis from the Nurses' Health Study and Health Professionals Follow-up Study

    PubMed Central

    Kang, Jae H.; Willett, Walter C.; Rosner, Bernard; Buys, Emmanuel; Wiggs, Janey L.; Pasquale, Louis R.

    2016-01-01

    Importance Nitric oxide (NO) signaling alterations in outflow facility and retinal blood flow autoregulation are implicated in primary open-angle glaucoma (POAG). NO donation has emerged as a POAG therapeutic target. An exogenous source of NO is dietary nitrates. Objective We evaluated the association between dietary nitrate intake, derived mainly from green leafy vegetables, and POAG. Design, Setting, Participants We followed biennially participants of the prospective cohorts, Nurses' Health Study (63,893 women; 1984-2012) and Health Professionals Follow-up Study (41,094 men; 1986-2012); at each 2-year risk period, eligible participants were 40+ years old, free of POAG, and reported eye examinations. Exposure Dietary nitrate intake. Information on diet and potential confounders were updated with validated questionnaires. Main outcome measure Incidence of POAG and POAG subtypes; 1,483 cases were confirmed with medical records and classified into subtypes defined by intraocular pressure (IOP) (≥ or < 22 mm Hg) or by visual field (VF) loss pattern at diagnosis (peripheral loss only or early paracentral loss). Cohort-specific and pooled multivariable rate ratios (MVRR) and 95% confidence intervals (CIs) were estimated. Results Compared with the lowest quintile of dietary nitrate intake (Q1;∼80 mg/day), the pooled MVRR for the highest quintile (Q5;∼240 mg/day) was 0.79 (95%CI, 0.66,0.93; p for trend [p-trend]=0.02). The dose-response was stronger (p for heterogeneity [p-het]=0.01) for POAG with early paracentral VF loss (433 cases; Q5 vs. Q1 MVRR=0.56; 95%CI, 0.40,0.79; p-trend=0.0003) than for POAG with peripheral VF loss only (835 cases; Q5 vs. Q1 MVRR=0.85; 95%CI, 0.68,1.06; p-trend=0.50). The association did not differ (p-het=0.75) by POAG subtypes defined by IOP (997 cases with IOP≥22 mm Hg: Q5 vs. Q1 MVRR=0.82; 95%CI, 0.67,1.01; p-trend=0.11 vs. 486 cases with IOP<22 mm Hg: Q5 vs. Q1 MVRR=0.71; 95%CI, 0.53,0.96; p-trend=0.12). Green leafy vegetables

  11. Factors and symptoms associated with work stress and health-promoting lifestyles among hospital staff: a pilot study in Taiwan

    PubMed Central

    2012-01-01

    Background Healthcare workers including physicians, nurses, medical technicians and administrative staff experience high levels of occupational stress as a result of heavy workloads, extended working hours and time-related pressure. The aims of this study were to investigate factors associated with work stress among hospital staff members and to evaluate their health-promoting lifestyle behaviors. Methods We conducted a cross-sectional study from May 1, 2010 to July 30, 2010 and recruited 775 professional staff from two regional hospitals in Taiwan using purposive sampling. Demographic data and self-reported symptoms related to work-related stress were collected. Each subject completed the Chinese versions of the Job Content Questionnaire (C-JCQ) and The Health-Promoting Lifestyle Profile (HPLSP). Linear and binary regression analyses were applied to identify associations between these two measurements and subjects’ characteristics, and associations between the two measurements and stress symptoms. Results Self-reported symptoms of work-related stress included 64.4% of subjects reporting nervousness, 33.7% nightmares, 44.1% irritability, 40.8% headaches, 35.0% insomnia, and 41.4% gastrointestinal upset. C-JCQ scores for psychological demands of the job and discretion to utilize skills had a positive correlation with stress-related symptoms; however, the C-JCQ scores for decision-making authority and social support correlated negatively with stress-related symptoms except for nightmares and irritability. All items on the HPLSP correlated negatively with stress-related symptoms except for irritability, indicating an association between subjects’ symptoms and a poor quality of health-promoting lifestyle behaviors. Conclusions We found that high demands, little decision-making authority, and low levels of social support were associated with the development of stress-related symptoms. The results also suggested that better performance on or a higher frequency of

  12. Factors and symptoms associated with work stress and health-promoting lifestyles among hospital staff: a pilot study in Taiwan.

    PubMed

    Tsai, Yueh-Chi; Liu, Chieh-Hsing

    2012-07-16

    Healthcare workers including physicians, nurses, medical technicians and administrative staff experience high levels of occupational stress as a result of heavy workloads, extended working hours and time-related pressure. The aims of this study were to investigate factors associated with work stress among hospital staff members and to evaluate their health-promoting lifestyle behaviors. We conducted a cross-sectional study from May 1, 2010 to July 30, 2010 and recruited 775 professional staff from two regional hospitals in Taiwan using purposive sampling. Demographic data and self-reported symptoms related to work-related stress were collected. Each subject completed the Chinese versions of the Job Content Questionnaire (C-JCQ) and The Health-Promoting Lifestyle Profile (HPLSP). Linear and binary regression analyses were applied to identify associations between these two measurements and subjects' characteristics, and associations between the two measurements and stress symptoms. Self-reported symptoms of work-related stress included 64.4% of subjects reporting nervousness, 33.7% nightmares, 44.1% irritability, 40.8% headaches, 35.0% insomnia, and 41.4% gastrointestinal upset. C-JCQ scores for psychological demands of the job and discretion to utilize skills had a positive correlation with stress-related symptoms; however, the C-JCQ scores for decision-making authority and social support correlated negatively with stress-related symptoms except for nightmares and irritability. All items on the HPLSP correlated negatively with stress-related symptoms except for irritability, indicating an association between subjects' symptoms and a poor quality of health-promoting lifestyle behaviors. We found that high demands, little decision-making authority, and low levels of social support were associated with the development of stress-related symptoms. The results also suggested that better performance on or a higher frequency of health-promoting life-style behaviors might

  13. Association of Serum Erythropoietin With Cardiovascular Events, Kidney Function Decline, and Mortality: The Health Aging and Body Composition Study.

    PubMed

    Garimella, Pranav S; Katz, Ronit; Patel, Kushang V; Kritchevsky, Stephen B; Parikh, Chirag R; Ix, Joachim H; Fried, Linda F; Newman, Anne B; Shlipak, Michael G; Harris, Tamara B; Sarnak, Mark J

    2016-01-01

    Studies suggest that in patients with heart failure (HF), high serum erythropoietin is associated with risk of recurrent HF and mortality. Trials of erythropoietin-stimulating agents in persons with kidney disease have also suggested an increased incidence of adverse clinical events. No large studies of which we are aware have evaluated the association of endogenous erythropoietin levels with clinical outcomes in the community-living older adults. Erythropoietin concentration was measured in 2488 participants aged 70-79 years in the Health, Aging and Body Composition Study. Associations of erythropoietin with incident HF, coronary heart disease, stroke, mortality, and ≥ 30% decline in estimated glomerular filtration rate were examined using Cox proportional hazards and logistic regression over 10.7 years of follow-up. Mean (SD) age was 75 (3) years and median (quartile 1, quartile 3) erythropoietin was 12.3 (9.0, 17.2) mIU/mL. There were 503 incident HF events, and each doubling of serum erythropoietin was associated with a 25% increased risk of incident HF 1.25 (95% confidence interval 1.13, 1.48) after adjusting for demographics, prevalent cardiovascular disease, cardiovascular disease risk factors, kidney function, and serum hemoglobin. There was no interaction of serum erythropoietin with chronic kidney disease or anemia (P > 0.50). There were 330 incident coronary heart disease events, 161 strokes, 1112 deaths, and 698 outcomes of ≥ 30% decline in estimated glomerular filtration rate. Serum erythropoietin was not significantly associated with these outcomes. Higher levels of endogenous erythropoietin are associated with incident HF in older adults. Studies need to elucidate the mechanisms through which endogenous erythropoietin levels associate with specific outcomes. © 2015 American Heart Association, Inc.

  14. Association Between TSLP Polymorphisms and Eczema in Japanese Women: the Kyushu Okinawa Maternal and Child Health Study.

    PubMed

    Miyake, Yoshihiro; Hitsumoto, Shinichi; Tanaka, Keiko; Arakawa, Masashi

    2015-08-01

    We examined the association between thymic stromal lymphopoietin (TSLP) single nucleotide polymorphisms (SNPs) and eczema in young adult Japanese women. Cases were 188 women who met the criteria of the International Study of Asthma and Allergies in Childhood (ISAAC) for eczema. Controls were 565 women without eczema according to the ISAAC criteria, who had not been diagnosed with asthma, atopic eczema, and/or allergic rhinitis by a doctor and who had no asthma as defined by the European Community Respiratory Health Survey criteria and no rhinoconjunctivitis according to the ISAAC criteria. Compared with women with the TT genotype of SNP rs1837253, those with the TC or CC genotype had a significantly increased risk of eczema after adjustment for age and smoking, although this association was not significant in crude analysis. There were no relationships between SNP rs3806933 or rs2289276 and eczema. The TC and CC genotypes combined of SNP rs1837253 may be significantly positively associated with eczema.

  15. The association between depressive disorders and health care utilization: results from the São Paulo ageing and health study (SPAH).

    PubMed

    Huang, Hsiang; Menezes, Paulo R; da Silva, Simone A; Tabb, Karen; Barkil-Oteo, Andres; Scazufca, Marcia

    2014-01-01

    Although depressive disorders are associated with increased health care utilization in the elderly living in high-income countries, few studies have examined this relationship in Latin America. The present study is part of the São Paulo Ageing and Health Study, a population-based epidemiological study of mental disorders in 2072 low-income adults ≥ 65 years old living in São Paulo, Brazil. Depressive disorders defined as major depressive disorder (MDD) and clinically relevant depressive symptoms (CRDS) were assessed with the Geriatric Mental State and the Neuropsychiatric Inventory. We examined the association between depressive disorders/symptoms and health care utilization (outpatient visits, hospital admissions and medication use in the past 3 months) using count models. The prevalence of MDD and CRDS was 4.9% and 21.4%, respectively. In the fully adjusted model, older adults with MDD were 36% more likely to have one more outpatient visit (RM: 1.36, 95% CI: 1.11-1.67), while older adults with CRDS were 14% more likely to have one more outpatient visit (RM: 1.14, 95% CI: 1.02-1.28). Elderly individuals with MDD had a prevalence of hospital admissions in the previous 3 months that was twice that of those without depression (PR=2.02, 95% CI: 1.09-3.75). Significant differences were not found for medication use. Among low-income older adults living in Brazil, those with MDD are more likely to have a recent hospital admission and outpatient service use than those without depression. Future studies are needed to examine the effectiveness of depression treatments for this population in order to both decrease the burden of illness as well as to minimize health care utilization related to depression. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Nanoparticle pollution and associated increasing potential risks on environment and human health: a case study of China.

    PubMed

    Gao, Yang; Yang, Tiantian; Jin, Jin

    2015-12-01

    The aims of this study are (1) to discuss the mechanism of nanoparticle lifecycle and estimate the impacts of its associated pollution on environment and human health; and (2) to provide recommendation to policy makers on how to leverage nanopollution and human health along with the rapid development of economics in China. Manufactured nanoparticles (MNPs) could either directly or indirectly impair human health and the environment. Exposures to MNP include many ways, such as via inhalation, ingestion, direct contact, or the use of consumer products over the lifecycle of the product. In China, the number of people exposed to MNP has been increasing year by year. To better provide medical care to people exposed to MNP, the Chinese government has established many disease control and prevention centers over China. However, the existing facilities and resources for controlling MNP are still not enough considering the number of people impacted by MNP and the number of ordinary workers in the MNP related industry applying for their occupational identification through the Center for Disease Control and Prevention. China should assess the apparent risk environment and human health being exposed to MNP and develop action plans to reduce the possibility of direct contacts between human beings and the emerging nanomaterials. In addition, we suggest more comprehensive studies on the MNP behavior and the development of quantitative approaches to measure MNP transport, and persistence should be carried out.

  17. Adjustment disorders as a stress-related disorder: a longitudinal study of the associations among stress, resources, and mental health.

    PubMed

    Kocalevent, Rüya-Daniela; Mierke, Annett; Danzer, Gerhard; Klapp, Burghard F

    2014-01-01

    Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design. The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients' presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time. Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β= -0.23, R2corr=0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df=15.26; RMSEA=0.21). Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress.

  18. Adjustment Disorders as a Stress-Related Disorder: A Longitudinal Study of the Associations among Stress, Resources, and Mental Health

    PubMed Central

    Kocalevent, Rüya-Daniela; Mierke, Annett; Danzer, Gerhard; Klapp, Burghard F.

    2014-01-01

    Objective Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design. Methods The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients’ presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time. Results Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β = −0.23, R2corr = 0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df = 15.26; RMSEA = 0.21). Conclusions Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress. PMID:24825165

  19. Post-traumatic stress disorder is associated with poor health behaviors: findings from the heart and soul study.

    PubMed

    Zen, Angelica L; Whooley, Mary A; Zhao, Shoujun; Cohen, Beth E

    2012-03-01

    Posttraumatic stress disorder (PTSD) results in substantial disability, including increased risk of cardiovascular disease (CVD). Poor health behaviors are major risk factors for initial and recurrent CVD events. Therefore, this study investigated whether PTSD is associated with poor health behaviors in patients with CVD. Cross-sectional study of 1,022 men and women with CVD. PTSD was assessed with the Computerized Diagnostic Interview Schedule for DSM-IV. Physical activity, medication adherence and smoking history were determined by self-report questionnaires. Multivariate logistic and linear regression models were used to evaluate the association of PTSD with health behaviors. Of the 1,022 participants, 95 (9%) had PTSD. PTSD was associated with significantly higher rates of physical inactivity in terms of overall exercise (OR 1.6, 95% CI [1.0-2.6]; p = .049), light exercise (OR 1.7, 95% CI [1.0-2.9]; p = .045), and self-rated level of exercise compared to others of their age and sex (OR 1.8, 95% CI [1.0-3.0]; p = .047). Participants with PTSD were more likely to report medication nonadherence, including forgetting medications (OR 1.8, 95% CI [1.0-3.3]; p = .04) or skipping medications (OR 1.7, 95% CI [1.1-2.9]; p = .03). Participants with PTSD also reported a greater smoking history (β 6.4 pack years, 95% CI [1.8-10.9]; p = .006), which remained significant after adjustment for depression and income. Among patients with heart disease, those with PTSD were more likely to report physical inactivity, medication nonadherence and smoking. The majority of these associations were explained by adjustment for comorbid depression and lower income.

  20. Physical activity is independently associated with reduced mortality: 15-years follow-up of the Hordaland Health Study (HUSK)

    PubMed Central

    Kopperstad, Øyvind; Skogen, Jens Christoffer; Sivertsen, Børge; Tell, Grethe S.

    2017-01-01

    Background Physical activity (PA) is associated with lower risk for non-communicable diseases and mortality. We aimed to investigate the prospective association between PA and all-cause and cause-specific mortality, and the impact of other potentially contributing factors. Method Data from the community-based Hordaland Health Study (HUSK, 1997–99) were linked to the Norwegian Cause of Death Registry. The study included 20,506 individuals born 1950–1957 and 2,225 born in 1925–1927 (baseline age 40–49 and 70–74). Based on self-report, individuals were grouped as habitually performing low intensity, short duration, low intensity, longer duration or high intensity PA. The hazard ratios (HR) for all-cause and cause-specific mortality during follow-up were calculated. Measures of socioeconomic status, physical health, mental health, smoking and alcohol consumption were added separately and cumulatively to the model. Results PA was associated with lower all-cause mortality in both older (HR 0.75 (95% CI 0.67–0.84)) and younger individuals (HR 0.82 (95% CI 0.72–0.92)) (crude models, HR: risk associated with moving from low intensity, short duration to low intensity, longer duration PA, and from low intensity, longer duration to high intensity). Smoking, education, somatic diagnoses and mental health accounted for some of the association between physical activity and mortality, but a separate protective effect of PA remained in fully adjusted models for cardiovascular (HR 0.78 (95% CI 0.66–0.92)) and respiratory (HR 0.45 (95% CI 0.32–0.63) mortality (both age-groups together), as well as all-cause mortality in the older age group (HR 0.74, 95%CI 0.66–0.83). Conclusion Low intensity, longer duration and high intensity physical activity was associated with reduced all-cause, respiratory and cardiovascular mortality, indicating that physical activity is beneficial also among older individuals, and that a moderate increase in PA can be beneficial. PMID

  1. Job stress is associated with migraine in current workers: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    PubMed

    Santos, I S; Griep, R H; Alves, M G M; Goulart, A C; Lotufo, P A; Barreto, S M; Chor, D; Benseñor, I M

    2014-10-01

    Migraine is an important source of social burden and work-related costs. Studies addressing the association of migraine with job stress are rare. The aim of this paper was to study the association of job stress components and migraine using structured, validated questionnaires that were part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The ELSA-Brasil is a multicentre cohort of 15,105 civil servants (12,096 current workers) in Brazil. Job strain was assessed using the 17-item Brazilian version of the Swedish Demand-Control-Support Questionnaire. Headache episodes in the preceding 12 months were assessed using a questionnaire based on the International Headache Society criteria. We analysed the association between job stress domains and migraine in men and women using adjusted logistic regression and interaction models. We included 3113 individuals without headache and 3259 migraineurs. Low job control [odds ratio (OR) 1.30; 95% confidence interval (95% CI) 1.10-1.53], high job demands (OR 1.37; 95% CI 1.18-1.59) and low social support (OR 1.49; 95% CI 1.29-1.71) were associated with migraine. Job control was more strongly associated with migraine in women (p for interaction = 0.02). High-strain (high demand and low control) jobs were associated with migraine in both men (OR 1.48; 95% CI 1.11-1.97) and women (OR 1.51; 95% CI 1.17-1.95). We observed a strong association between high-strain jobs and migraine. Job control was a stronger migraine-related factor for women. Low social support was associated with migraine in both sexes. © 2014 European Pain Federation - EFIC®

  2. Epidemiological study for the assessment of health risks associated with graywater reuse for irrigation in arid regions.

    PubMed

    Busgang, Allison; Friedler, Eran; Ovadia, Ofer; Gross, Amit

    2015-12-15

    Graywater reuse is rapidly gaining popularity as a viable source of reclaimed water, mainly for garden irrigation and toilet flushing. The purpose of this study was to determine, by epidemiological survey, the risk for gastroenteritis symptoms associated with graywater reuse. The study comprised a weekly health questionnaire answered by both graywater users and non-graywater users (control group) regarding their health status over a period of 1year, and periodic sampling for graywater quality. Participants were also asked to respond to a one-time lifestyle questionnaire to assess their level of exposure to graywater or potable water used in garden irrigation. Graywater quality was typical and comparable to previous studies, with average fecal coliform concentration of 10(3)CFU 100ml(-1). A Cox Proportional Hazards model indicated a somewhat higher health risk for the control group (P<0.05), suggesting that there was practically no difference in the prevalence of water-related diseases between users of graywater and potable water. Since the concentration of pathogens in the current study was higher than that suggested by quantitative microbial risk assessment (QMRA), yet there was no difference in the prevalence of water-related diseases between control and graywater users, it was postulated that QMRA is conservative and can safely be used toward the establishment of regulations governing graywater reuse. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Preschoolers' parent-rated health disparities are strongly associated with measures of adiposity in the Lifeways cohort study children.

    PubMed

    Shrivastava, Aakash; Murrin, Celine; Kelleher, Cecily C

    2014-07-21

    To examine the relationship between lifecourse factors from preschoolers' microecosystem and their parent-reported (mother-reported) health (PRH), following them prospectively from preconception to age 5 years. To investigate if preschoolers' body mass index (BMI) and waist circumference were associated with preschoolers' PRH when controlled for lifecourse predictors. Lifeways cross-generation cohort study. Ireland. Of 1082 families, 62% mothers responded on a health and lifestyle questionnaire at follow-up. Food frequency, BMI and waist circumference were measured. There were 547 family data sets available for analysis of children's PRH. Mother-reported children's PRH at age 5. Associations with child's individual and familial exposures from preconception to age 5 years examined using logistic regression. In univariate analysis, relatively positive rating of children's PRH were associated with children's lower intake of fats (OR (95% CI) 2.2 (1.1 to 4.3)), higher intake of fruits/vegetables (OR (95% CI) 2.2 (1.1 to 4.3)); as well as familial socioeconomic characteristics {higher household income (OR (95% CI) 3.0 (1.6 to 5.9)), non-entitlement to means-tested healthcare (OR (95% CI) 2.1 (1.0 to 4.3)), mothers' higher education (OR (95% CI) 1.9 (1.0 to 3.6))}, psychosocial characteristics {father's participation in study (OR (95% CI) 2.1 (1.0 to 4.3)), mothers' perceiving better support from partner (OR (95% CI) 2.3 (1.2 to 4.3)), children (OR (95% CI) 1.9 (1.0 to 3.7)) or relatives (OR (95% CI) 2.2 (1.1 to 4.1))}, parents' lifestyle {mothers' lower intake of energy (OR (95% CI) 2.2 (1.1 to 4.3)), fathers' non-smoking status (OR (95% CI) 2.2 (1.1 to 4.4))} and parents' health {mothers' self-rated health relatively positive (OR (95% CI) 5.1 (2.6 to 9.9)), fathers' self-rated health relatively positive (OR (95% CI) 3.0 (1.5 to 6.0))}. In multivariable analysis (χ(2)=34.2, df=21, N=303, R(2 )= 0.26, p<0.05), one of the two strong predictors of children

  4. Occupational Lead Exposure and Associations with Selected Cancers: The Shanghai Men’s and Women’s Health Study Cohorts

    PubMed Central

    Liao, Linda M.; Friesen, Melissa C.; Xiang, Yong-Bing; Cai, Hui; Koh, Dong-Hee; Ji, Bu-Tian; Yang, Gong; Li, Hong-Lan; Locke, Sarah J.; Rothman, Nathaniel; Zheng, Wei; Gao, Yu-Tang; Shu, Xiao-Ou; Purdue, Mark P.

    2015-01-01

    Background Epidemiologic studies of occupational lead exposure have suggested increased risks of cancers of the stomach, lung, kidney, brain, and meninges; however, the totality of the evidence is inconsistent. Objective We investigated the relationship between occupational lead exposure and cancer incidence at the five abovementioned sites in two prospective cohorts in Shanghai, China. Methods Annual job/industry-specific estimates of lead fume and lead dust exposure, derived from a statistical model combining expert lead intensity ratings with inspection measurements, were applied to the lifetime work histories of participants from the Shanghai Women’s Health Study (SWHS; n = 73,363) and the Shanghai Men’s Health Study (SMHS; n = 61,379) to estimate cumulative exposure to lead fume and lead dust. These metrics were then combined into an overall occupational lead exposure variable. Cohort-specific relative hazard rate ratios (RRs) and 95% confidence intervals (CIs) comparing exposed and unexposed participants were estimated using Cox proportional hazards regression and combined by meta-analysis. Results The proportions of SWHS and SMHS participants with estimated occupational lead exposure were 8.9% and 6.9%, respectively. Lead exposure was positively associated with meningioma risk in women only (n = 38 unexposed and 9 exposed cases; RR = 2.4; 95% CI: 1.1, 5.0), particularly with above-median cumulative exposure (RR = 3.1; 95% CI: 1.3, 7.4). However, all 12 meningioma cases among men were classified as unexposed to lead. We also observed non-significant associations with lead exposure for cancers of the kidney (n = 157 unexposed and 17 ever exposed cases; RR = 1.4; 95% CI: 0.9, 2.3) and brain (n = 67 unexposed and 10 ever exposed cases; RR = 1.8; 95% CI: 0.7, 4.8) overall. Conclusions Our findings, though limited by small numbers of cases, suggest that lead is associated with the risk of several cancers in women and men. Citation Liao LM, Friesen MC, Xiang YB

  5. Association Between Depressive Symptoms and Incidence of Crohn’s Disease and Ulcerative Colitis: Results From the Nurses’ Health Study

    PubMed Central

    ANANTHAKRISHNAN, ASHWIN N.; KHALILI, HAMED; PAN, AN; HIGUCHI, LESLIE M.; DE SILVA, PUNYANGANIE; RICHTER, JAMES M.; FUCHS, CHARLES S.; CHAN, ANDREW T.

    2012-01-01

    BACKGROUND & AIMS Depression and psychosocial stress are believed to contribute to the pathogenesis of Crohn’s disease (CD) and ulcerative colitis (UC). Although many mechanisms have been proposed to link these disorders, few prospective studies have examined the relationship between depressed mood and incidence of CD or UC. METHODS We analyzed data from 152,461 women (aged 29–72 years) enrolled since 1992–1993 in the Nurses’ Health Study cohorts I and II. Self-reported depressive symptoms were assessed by using the Mental Health Index (MHI)-5, a validated 5-item subscale of the 36-item Short-Form health survey, which is designed to estimate psychological distress on the basis of scores that range from 0 to 100. Self-reported CD and UC were confirmed through blinded record review by 2 gastroenterologists. Cox proportional hazards models were used to associate recent (within 4 years) and baseline MHI-5 scores with risk for CD or UC, adjusting for other risk factors. RESULTS During 1,787,070 person-years of follow-up, we documented 170 cases of CD and 203 cases of UC. Compared with women with recent MHI-5 scores of 86–100, women with recent depressive symptoms (MHI-5 scores <52) had an increased risk of CD (multivariate-adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.40–3.98; P trend = .001). Baseline depressive symptoms, assessed from the baseline MHI-5 score, were also associated with CD, although with a lower HR (1.62; 95% CI, 0.94–2.77). Recent (HR, 1.14; 95% CI, 0.68–1.92) and baseline depressive symptoms were not associated with increased risk of UC (HR, 1.07; 95% CI, 0.63–1.83). CONCLUSIONS On the basis of data from the Nurses’ Health Study, depressive symptoms increase the risk for CD, but not UC, among women. Psychological factors might therefore contribute to development of CD. Further studies are needed to determine the mechanisms of this association. PMID:22944733

  6. Association between cannabis use and the risk of bladder cancer: results from the California Men's Health Study.

    PubMed

    Thomas, Anil A; Wallner, Lauren P; Quinn, Virginia P; Slezak, Jeffrey; Van Den Eeden, Stephen K; Chien, Gary W; Jacobsen, Steven J

    2015-02-01

    To investigate the association of cannabis use and tobacco smoking on the incidence of bladder cancer within the California Men's Health Study cohort. We evaluated the records of 84,170 participants in a multiethnic cohort of men aged 45-69 years. Information on demographic and lifestyle factors including smoking history and cannabis use was collected using mailed questionnaires between 2002 and 2003. We linked the study data with clinical records including cancer data from electronic health records. Overall 34,000 (41%) cohort members reported cannabis use, 47,092 (57%) reported tobacco use, 22,500 (27%) reported using both, and 23,467 (29%) used neither. Men were followed over an 11-year period and 279 (0.3%) developed incident bladder tumors. Among cannabis users, 89 (0.3%) developed bladder cancer in comparison to 190 (0.4%) men who did not report cannabis use (P < .001). After adjusting for age, race or ethnicity, and body mass index, using tobacco only was associated with an increased risk of bladder cancer (hazard regression [HR], 1.52; 95% confidence interval [CI], 1.12-2.07), whereas cannabis use only was associated with a 45% reduction in bladder cancer incidence (HR, 0.55; 95% CI, 0.31-1.00). Using both cannabis and tobacco was associated with an HR of 1.28 (95% CI, 0.91-1.80). Although a cause and effect relationship has not been established, cannabis use may be inversely associated with bladder cancer risk in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Short-term association between sulfur dioxide and daily mortality: the Public Health and Air Pollution in Asia (PAPA) study.

    PubMed

    Kan, Haidong; Wong, Chit-Ming; Vichit-Vadakan, Nuntavarn; Qian, Zhengmin

    2010-04-01

    Sulfur dioxide (SO(2)) has been associated with increased mortality and morbidity, but only few studies were conducted in Asian countries. Previous studies suggest that SO(2) may have adverse health effects independent of other pollutants. In the Public Health and Air Pollution in Asia (PAPA) project, the short-term associations between ambient sulfur dioxide (SO(2)) and daily mortality were examined in Bangkok, Thailand, and three Chinese cities: Hong Kong, Shanghai, and Wuhan. Poisson regression models incorporating natural spline smoothing functions were used to adjust for seasonality and other time-varying covariates. Effect estimates were obtained for each city and then for the cities combined. The impact of alternative model specifications, such as lag structure of pollutants and degree of freedom (df) for time trend, on the estimated effects of SO(2) were also examined. In both individual-city and combined analysis, significant effects of SO(2) on total non-accidental and cardiopulmonary mortality were observed. An increase of 10 microg/m(3) of 2-day moving average concentrations of SO(2) corresponded to 1.00% [95% confidence interval (CI), 0.75-1.24], 1.09% (95% CI, 0.71-1.47), and 1.47% (95% CI, 0.85-2.08) increase of total, cardiovascular and respiratory mortality, respectively, in the combined analysis. Sensitivity analyzes suggested that these findings were generally insensitive to alternative model specifications. After adjustment for PM(10) or O(3), the effect of SO(2) remained significant in three Chinese cities. However, adjustment for NO(2) diminished the associations and rendered them statistically insignificant in all four cities. In conclusion, ambient SO(2) concentration was associated with daily mortality in these four Asian cities. These associations may be attributable to SO(2) serving as a surrogate of other substances. Our findings suggest that the role of outdoor exposure to SO(2) should be investigated further in this region. (c) 2010

  8. Short-term association between sulfur dioxide and daily mortality: the Public Health and Air Pollution in Asia (PAPA) study

    PubMed Central

    Kan, Haidong; Wong, Chit-Ming; Vichit-Vadakan, Nuntavarn; Qian, Zhengmin

    2012-01-01

    Sulfur dioxide (SO2) has been associated with increased mortality and morbidity, but few studies were conducted in Asian countries. Previous studies suggest that SO2 may have adverse health effects independent of other pollutants. In the Public Health and Air Pollution in Asia (PAPA) project, the short-term associations between ambient sulfur dioxide (SO2) and daily mortality were examined in Bangkok, Thailand, and three Chinese cities: Hong Kong, Shanghai, and Wuhan. Poisson regression models incorporating natural spline smoothing functions were used to adjust for seasonality and other time-varying covariates. Effect estimates were obtained for each city and then for the cities combined. The impact of alternative model specifications, such as lag structure of pollutants and degree of freedom (df) for time trend, on the estimated effects of SO2 were also examined. In both individual-city and combined analysis, significant effects of SO2 on total non-accidental and cardiopulmonary mortality were observed. An increase of 10 μg/m3 of 2-day moving average concentrations of SO2 corresponded to 1.00% [95% confidence interval (CI), 0.75-1.24], 1.09% (95% CI, 0.71-1.47), and 1.47% (95% CI, 0.85-2.08) increase of total, cardiovascular and respiratory mortality, respectively, in the combined analysis. Sensitivity analyses suggested that these findings were generally insensitive to alternative model specifications. After adjustment for PM10 or O3, the effect of SO2 remained significant in three Chinese cities. However, adjustment for NO2 diminished the associations and rendered them statistically insignificant in all four cities. In conclusion, ambient SO2 concentration was associated with daily mortality in these four Asian cities. These associations may be attributable to SO2 serving as a surrogate of other substances. Our findings suggest that the role of outdoor exposure to SO2 should be investigated further in this region. PMID:20122685

  9. Psychological trauma and posttraumatic stress disorder: risk factors and associations with birth outcomes in the Drakenstein Child Health Study

    PubMed Central

    Koen, Nastassja; Brittain, Kirsty; Donald, Kirsten A.; Barnett, Whitney; Koopowitz, Sheri; Maré, Karen; Zar, Heather J.; Stein, Dan J.

    2016-01-01

    Background Prenatal and peripartum trauma may be associated with poor maternal–fetal outcomes. However, relatively few data on these associations exist from low-middle income countries, and populations in transition. Objective We investigated the prevalence and risk factors for maternal trauma and posttraumatic stress disorder (PTSD), and their association with adverse birth outcomes in the Drakenstein Child Health Study, a South African birth cohort study. Methods Pregnant women were recruited from two clinics in a peri-urban community outside Cape Town. Trauma exposure and PTSD were assessed using diagnostic interviews; validated self-report questionnaires measured other psychosocial characteristics. Gestational age at delivery was calculated and birth outcomes were assessed by trained staff. Multiple logistic regression explored risk factors for trauma and PTSD; associations with birth outcomes were investigated using linear regression. Potential confounders included study site, socioeconomic status (SES), and depression. Results A total of 544 mother–infant dyads were included. Lifetime trauma was reported in approximately two-thirds of mothers, with about a third exposed to past-year intimate partner violence (IPV). The prevalence of current/lifetime PTSD was 19%. In multiple logistic regression, recent life stressors were significantly associated with lifetime trauma, when controlling for SES, study site, and recent IPV. Childhood trauma and recent stressors were significantly associated with PTSD, controlling for SES and study site. While no association was observed between maternal PTSD and birth outcomes, maternal trauma was significantly associated with a 0.3 unit reduction (95% CI: 0.1; 0.5) in infant head-circumference-for-age z-scores (HCAZ scores) at birth in crude analysis, which remained significant when adjusted for study site and recent stressors in a multivariate regression model. Conclusions In this exploratory study, maternal trauma and

  10. Non communicable disease multimorbidity and associated health care utilization and expenditures in India: cross-sectional study.

    PubMed

    Pati, Sanghamitra; Agrawal, Sutapa; Swain, Subhashisa; Lee, John Tayu; Vellakkal, Sukumar; Hussain, Mohammad Akhtar; Millett, Christopher

    2014-10-02

    Non communicable disease (NCD) multimorbidity is increasingly becoming common in high income settings but little is known about its epidemiology and associated impacts on citizens and health systems in low and middle-income countries (LMICs). We aim to examine the socio-demographic distribution of NCD multimorbidity (≥2 diseases) and its implications for health care utilization and out-of-pocket expenditure (OOPE) in India. We analyzed cross-sectional nationally representative data from the World Health Organisaion Study on Global Ageing and Adult Health (WHO-SAGE), conducted in India during 2007. Multiple logistic regression was used to determine socio-demographic predictors of self-reported multimorbidity. A two part model was used to assess the relationship between number of NCDs and health care utilization including OOPE. 28.5% of the sample population had at least one NCD and 8.9% had NCD multimorbidity. The prevalence of multimorbidity increased from 1.3% in 18-29 year olds to 30.6% in those aged 70 years and above. Mean outpatient visits in the preceding 12 months increased from 2.2 to 6.2 and the percentage reporting an overnight hospital stay in the past 3 years increased from 9% to 29% in those with no NCD and ≥2 NCDs respectively (p <0.001).OOPE incurred during the last outpatient visit increased from INR 272.1 (95% CI = 249.0-295.2) in respondents with no NCDs to INR 454.1 (95% CI = 407.8-500.4) in respondents with ≥2 NCDs. However, we did not find an increase in OOPE during the last inpatient visit with number of NCDs (7865.9 INR for those with zero NCDs compared with 7301.3 for those with ≥2 NCDs). For both outpatient and inpatient OOPE, medicine constitutes the largest proportion of spending (70.7% for outpatient, 53.6% for inpatient visit), followed by spending for health care provider (14.0% for outpatient, 12.2% for inpatient visit). NCD multimorbidity is common in the Indian adult population and is associated with substantially

  11. Association of methamphetamine use and restrictive interventions in an acute adult inpatient mental health unit: A retrospective cohort study.

    PubMed

    McKenna, Brian; McEvedy, Samantha; Kelly, Kathleen; Long, Bec; Anderson, Jess; Dalzell, Elaine; Maguire, Tessa; Tacey, Mark; Furness, Trentham

    2017-02-01

    The aim of the present study was to describe incidences of restrictive interventions and the association of methamphetamine use at an acute adult inpatient mental health unit in metropolitan Melbourne, Victoria, Australia. A total of 232 consecutive consumer admissions to the inpatient unit across a 3-month period were described for illicit substance use and the use of restrictive interventions (seclusion, mechanical restraint, and physical restraint) prior to and during admission. Of all admissions, 25 (10.8%) involved consumers subjected to a restrictive intervention. Methamphetamine use was either self-reported or detected by saliva test for 71 (30.6%) consumers. Following multivariate analyses, methamphetamine use (odds ratio (OR): 7.83, 95% confidence interval (CI): 2.33-26.31) and restrictive intervention in the emergency department prior to admission (OR: 8.85, 95% CI: 2.83-27.70) were significant independent predictors of the use of restrictive interventions after inpatient admission. Anecdotal observations provided by clinical mental health staff that consumers intoxicated with methamphetamine appear to require restrictive intervention more frequently than other consumers was confirmed with the results of the current study. As the state of Victoria in Australia is on a pathway to the elimination of the use of restrictive interventions in mental health services, clinicians need to develop management strategies that provide specialist mental health care using the least-restrictive interventions. Although 26.8% of methamphetamine users were secluded after admission, restrictive interventions should not be the default management strategy for consumers who present with self-report or positive screen for methamphetamine use. © 2016 Australian College of Mental Health Nurses Inc.

  12. Association of Maternal and Child Health Center (Posyandu) Availability with Child Weight Status in Indonesia: A National Study

    PubMed Central

    Andriani, Helen; Liao, Chu-Yung; Kuo, Hsien-Wen

    2016-01-01

    Little is known about the childhood obesity prevention and treatment practices of Maternal and Child Health services (Posyandu) in Indonesia or in other countries. The present study aims to assess the association of the availability of Posyandu with overweight and obesity in children of different household wealth levels. This was a secondary analysis of data collected in the 2013 Riskesdas (or Basic Health Research) survey, a cross-sectional study, representative population-based data. Height and weight, the availability of Posyandu, and basic characteristics of the study population were collected from parents with children aged 0 to 5 years (n = 63,237). Non-availability of Posyandu significantly raised the odds of being obese (OR = 1.13, 95% CI: 1.06–1.21) and did not show a significant relationship in the odds for overweight (OR = 0.99, 95% CI: 0.93–1.07). This relationship persisted after a full adjustment (OR = 1.16, 95% CI: 1.07–1.25 and OR = 1.04, 95% CI: 0.96–1.13, respectively). There was effect modification by household wealth, which was stronger for obese children. The availability of Posyandu has a protective association with childhood obesity in Indonesia. Posyandu services are well placed to play an important role in obesity prevention and treatment in early life. PMID:26959047

  13. Association of Maternal and Child Health Center (Posyandu) Availability with Child Weight Status in Indonesia: A National Study.

    PubMed

    Andriani, Helen; Liao, Chu-Yung; Kuo, Hsien-Wen

    2016-03-07

    Little is known about the childhood obesity prevention and treatment practices of Maternal and Child Health services (Posyandu) in Indonesia or in other countries. The present study aims to assess the association of the availability of Posyandu with overweight and obesity in children of different household wealth levels. This was a secondary analysis of data collected in the 2013 Riskesdas (or Basic Health Research) survey, a cross-sectional study, representative population-based data. Height and weight, the availability of Posyandu, and basic characteristics of the study population were collected from parents with children aged 0 to 5 years (n = 63,237). Non-availability of Posyandu significantly raised the odds of being obese (OR = 1.13, 95% CI: 1.06-1.21) and did not show a significant relationship in the odds for overweight (OR = 0.99, 95% CI: 0.93-1.07). This relationship persisted after a full adjustment (OR = 1.16, 95% CI: 1.07-1.25 and OR = 1.04, 95% CI: 0.96-1.13, respectively). There was effect modification by household wealth, which was stronger for obese children. The availability of Posyandu has a protective association with childhood obesity in Indonesia. Posyandu services are well placed to play an important role in obesity prevention and treatment in early life.

  14. Lipoprotein-Associated Phospholipase A2 and Incident Peripheral Arterial Disease in Older Adults: The Cardiovascular Health Study.

    PubMed

    Garg, Parveen K; Arnold, Alice M; Hinckley Stukovsky, Karen D; Koro, Carol; Jenny, Nancy S; Mukamal, Kenneth J; Criqui, Michael H; Furberg, Curt D; Newman, Anne B; Cushman, Mary

    2016-04-01

    Although prior studies report a relationship between elevated lipoprotein-associated phospholipase A2 (Lp-PLA2) and incident cardiovascular disease, the prospective association of Lp-PLA2 with incident peripheral arterial disease (PAD) has not been studied. We investigated the association between Lp-PLA2 mass and activity and the risk of developing clinical PAD and low ankle-brachial index (ABI). Among Cardiovascular Health Study participants, a population-based cohort of 5888 adults aged ≥65 years enrolled in 1989 to 1990, Lp-PLA2 mass and activity were measured in 4537 individuals without baseline PAD. Clinical PAD, defined as leg artery revascularization or diagnosed claudication, was ascertained through 2011. Incident low ABI, defined as ABI <0.9 and decline of ≥0.15, was assessed among 3537 individuals who had an ABI >0.9 at baseline and a second ABI measurement 3 or 6 years later. Analyses were adjusted for demographics, cholesterol, smoking, comorbidities, and C-reactive protein. Each standard deviation increment in Lp-PLA2 mass (117 ng/mL) was associated with a higher risk of developing clinical PAD (hazard ratio 1.28; 95% confidence interval 1.13, 1.45) and incident low ABI (odds ratio 1.16; 95% confidence interval 1.00, 1.33). Results per standard deviation increment in Lp-PLA2 activity (13 nmol/min per mL) were similar for clinical PAD (hazard ratio 1.24; 95% confidence interval 1.07, 1.44) and low ABI (odds ratio 1.28; 95% confidence interval 1.09, 1.50). Higher Lp-PLA2 mass and activity were associated with development of both incident clinical PAD and low ABI. Future studies are needed to determine whether pharmacological inhibition of Lp-PLA2 reduces the incidence of PAD. © 2016 American Heart Association, Inc.

  15. Independent associations of dairy and calcium intakes with colorectal cancers in the Adventist Health Study-2 cohort.

    PubMed

    Tantamango-Bartley, Yessenia; Knutsen, Synnove F; Jaceldo-Siegl, Karen; Fan, Jing; Mashchak, Andrew; Fraser, Gary E

    2017-10-01

    Results associating dairy and Ca intakes with colorectal cancer (CRC) risk have been mixed. Most previous analyses have suffered from confounding between dairy and Ca intakes. We examined independent associations between these variables, also dairy foods, and CRC incidence in a population with a large range of dairy intakes. Adventist Health Study-2 is a cohort study where subjects were enrolled 2002-2007. Proportional hazard regression analyses were performed to estimate hazard ratios (HR). Regression calibration was used to correct for dietary measurement error. The population lived in all states of the USA. There were 77712 analytic subjects, all of whom were Seventh-day Adventists. Much of their dietary Ca came from non-dairy sources. During a mean follow-up of 7·8 years, 380 incident colon cancer and 111 incident rectal cancer cases were observed. Comparing extreme quintiles of intake in measurement error-corrected analyses, dairy intake (HR=0·31; 95 % CI 0·09, 0·88), independent of total Ca, was inversely related with risk of rectal cancer but gave little indication of association with colon cancer. However, total Ca intake (independent of dairy) was associated with risk of colon cancer (HR=0·55; 95 % CI 0·28, 0·98) and there was little indication of association with rectal cancer. Traditional regression analyses and associations with macronutrients from dairy generally supported these results. Milk intake was also negatively associated with CRC (HR=0·63; 95 % CI 0·43, 0·89). Dairy intake may decrease the risk of rectal cancer, and Ca may reduce risk of colon cancer and CRC.

  16. Organic food consumption during pregnancy and its association with health-related characteristics: the KOALA Birth Cohort Study.

    PubMed

    Simões-Wüst, Ana Paula; Moltó-Puigmartí, Carolina; Jansen, Eugene Hjm; van Dongen, Martien Cjm; Dagnelie, Pieter C; Thijs, Carel

    2017-08-01

    To investigate the associations of organic food consumption with maternal pre-pregnancy BMI, hypertension and diabetes in pregnancy, and several blood biomarkers of pregnant women. Prospective cohort study. Pregnant women were recruited at midwives' practices and through channels related to consumption of food from organic origin. Pregnant women who filled in FFQ and donated a blood sample (n 1339). Participant groups were defined based on the share of consumed organic products; to discriminate between effects of food origin and food patterns, healthy diet indicators were considered in some statistical models. Consumption of organic food was associated with a more favourable pre-pregnancy BMI and lower prevalence of gestational diabetes. Compared with participants consuming no organic food (reference group), a marker of dairy products intake (pentadecanoic acid) and trans-fatty acids from natural origin (vaccenic and rumenic acids) were higher among participants consuming organic food (organic groups), whereas elaidic acid, a marker of the intake of trans-fatty acids found in industrially hydrogenated fats, was lower. Plasma levels of homocysteine and 25-hydroxyvitamin D were lower in the organic groups than in the reference group. Differences in pentadecanoic acid, vaccenic acid and vitamin D retained statistical significance when correcting for indicators of the healthy diet pattern associated with the consumption of organic food. Consumption of organic food during pregnancy is associated with several health-related characteristics and blood biomarkers. Part of the observed associations is explained by food patterns accompanying the consumption of organic food.

  17. Maternal health care service seeking behaviors and associated factors among women in rural Haramaya District, Eastern Ethiopia: a triangulated community-based cross-sectional study.

    PubMed

    Kifle, Dereje; Azale, Telake; Gelaw, Yalemzewod Assefa; Melsew, Yayehirad Alemu

    2017-01-13

    Regular utilization of maternal health care services reduces maternal morbidity and mortality. This study assessed the maternal health care seeking behavior and associated factors of reproductive age women in rural villages of Haramaya district, East Ethiopia. Community based cross sectional study supplemented with qualitative data was conducted in Haramaya district from November 15 to Decemeber 30, 2015. A total of 561 women in reproductive age group and who gave birth in the last 2 years were randomly included. Bivariate and multivariate logistic regressions model was used to identify the associated factors. Odds ratios with 95% CI were used to measure the strength of association. Maternal health care service seeking of women was found as; antenatal care 74.3% (95% CI; 72.5, 76.14), attending institutional delivery 28.7% (95% CI; 26.8, 30.6) and postnatal care 22.6% (95% CI; 20.84, 24.36). Knowledge of pregnancy complications, Educational status, and religion of women were found to be significantly associated with antenatal health care, delivery and postnatal health care service seeking behaviours triangulated with individual, institutional and socio-cultural qualitative data. The maternal health care service seeking behavior of women in the study area was low. Educational status of the women, birth order and knowledge about pregnancy complications were the major factors associated with maternal health care service seeking behavior Focused health education with kind and supportive health care provider counseling will improve the maternal health care seeking behaviors of women.

  18. Association of ferritin elevation and metabolic syndrome in males. Results from the Aragon Workers' Health Study (AWHS).

    PubMed

    Ledesma, Marta; Hurtado-Roca, Yamilee; Leon, Montserrat; Giraldo, Pilar; Pocovi, Miguel; Civeira, Fernando; Guallar, Eliseo; Ordovas, Jose Maria; Casasnovas, Jose Antonio; Laclaustra, Martin

    2015-05-01

    Ferritin concentration is associated with metabolic syndrome, but the possibility of a nonlinear association has never been explored. This study aimed to examine the relationship between serum ferritin levels and the metabolic syndrome in Spanish adult males. This was a cross-sectional analysis of baseline data from the Aragon Workers' Health Study. Healthy workers from a factory were studied during their annual checkup. Spanish male adults (n = 3386) between the ages of 19 and 65 years participated. We excluded participants with ferritin > 500 μg/L, ferritin < 12 μg/L, or C-reactive protein > 10 mg/L. Metabolic syndrome was defined according to the 2009 consensus definition from the Joint Interim Statement of several international societies. Metabolic syndrome prevalence was 27.1%. We found a positive association between elevated iron stores, measured as serum ferritin concentration, and metabolic syndrome and its criteria. Participants within the highest serum ferritin quintile had a higher risk than those in the lowest quintile for central obesity (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.46-2.42), hypertriglyceridemia (OR, 2.15; 95% CI, 1.69-2.74), and metabolic syndrome (OR, 1.92; 95% CI, 1.48-2.49). The association was nonlinear and occurred at serum ferritin concentrations > 100 μg/L (∼ 33th percentile). Ferritin was also associated with insulin resistance, measured by homeostatic model assessment-insulin resistance (HOMA-IR) (P trend < .001). Our findings suggest that serum ferritin is significantly associated with metabolic syndrome and its criteria (especially central obesity and hypertriglyceridemia), suggesting that ferritin could be an early marker of metabolic damage in the development of metabolic syndrome.

  19. Association of trait and specific hopes: cross sectional study on students and workers of health professions in Split, Croatia

    PubMed Central

    Marković, Domagoj; Marušić, Matko

    2016-01-01

    Introduction. Hope (hoping) is most commonly assessed as a dispositional trait and associated with quality of life, self-care agency and non-attempts of suicide. However, little research has been conducted on hoping for specific events. Materials and Methods. We distributed a survey consisting of Integrative Hope Scale (IHS) and visual analogue scales on which respondents could declare their levels (intensity) of hope for specific events, to all first year health students enrolled at the University Department of Health Studies, Split, Croatia in 2011/2012, as well as to working health professionals attending a nursing conference in April 2012. Results. A total of 161 (89.4%) students and 88 (89.8%) working health professionals returned the completed questionnaires. We found high trait hope scores of students and working health professionals (Md = 111, 95% CI [109–113] vs. Md = 115, 95% CI [112–119]; U = 5,353, P = 0.065), and weak to moderate correlations of trait and specific hopes (r = 0.18–0.48, Spearman’s rank correlation coefficient). Students and workers reported 31 different things they hoped for most in life, of which the most prevalent were being healthy and happy. There was very little agreement between participants’ reported influence of the four factors compromising the trait hope (self-confidence, ambition, optimism, and social support) on their specific hopes. Conclusions. Our findings, while strengthening the validity of hope as a trait, indicate that specific hopes of individuals are moderated by factors not captured by the IHS trait scale. Further research should explore specific hoping in detail, as well as the effectiveness of interventions aimed at increasing specific or generalized hoping. PMID:26819851

  20. Trend study on the association between hospital admissions and the health of Dutch older adults (1995–2009)

    PubMed Central

    Galenkamp, Henrike; Deeg, Dorly J H; de Jongh, Renate T; Kardaun, Jan W P F; Huisman, Martijn

    2016-01-01

    Objectives An increase in hospital admission rates in older people may reflect improved access to healthcare, but also declining health trends in the older population. Owing to a lack of individual-level data, the latter possibility has received little attention. The current study examines associations between health status and hospitalisation rates of older adults in the Netherlands. Design Observational individual-level data linked to hospital register data. Setting Data from 1995 to 2009 from the nationally representative Longitudinal Aging Study Amsterdam were linked to the Dutch Hospital Discharge Register. Participants A total of 5681 observations of 2520 respondents across 4 measurement points (each with a follow-up of 36 months; ages 65–88 years). Outcome measures The contribution of health, demographic, psychosocial and lifestyle characteristics to time trends in hospitalisation was assessed in multivariate models. Results Between 1995 and 2009, the percentage with 1 or more overnight admissions (planned or acute) increased slightly from 38.1% to 39.7%. This was due to an increase in acute admission only (22.2–27.0%). Increased prevalences of chronic diseases, functional limitations and polypharmacy accounted for part of the observed increase in acute admissions. In addition, a more than doubled prevalence of day admissions over time was observed (12.3–28.3%), a trend that was unrelated to changes in individual characteristics. Conclusions This trend study showed a contribution of declines in population health to increases in acute hospital admissions. Since these declines did not provide a full explanation, healthcare reforms and increases in treatment possibilities in this period are likely to have contributed as well. PMID:27531734

  1. Association of socioeconomic status measured by education, and cardiovascular health: a population-based cross-sectional study

    PubMed Central

    Janković, Slavenka; Stojisavljević, Dragana; Janković, Janko; Erić, Miloš; Marinković, Jelena

    2014-01-01

    Objective Cardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS). Design Population-based cross-sectional study. Setting RS, Bosnia and Herzegovina. Participants The study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS. Study variables Participant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m2, physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all seven ideal health metrics present) versus intermediate and poor CVH status. Results Participants with high educational levels had a significantly greater number of ideal CVH metrics, and ideal health factor metrics compared with those with low or medium educational level (OR 0.88 95% CI 0.77 to 0.99 and OR 0.88 95% CI 0.80 to 0.96; OR 0.81 95% CI 0.69 to 0.96 and OR 0.77 95% CI 0.68 to 0.87; respectively). The number of ideal behaviour metrics was not a discriminator of educational groups. Concerning the categories of CVH status the poor CVH was a discriminator for low and medium education compared with those with high education (OR 1.93 95% CI 1.24 to 3.01 and OR 1.54 95% CI 1.08 to 2.19, respectively). Conclusions Our findings emphasise the large potential for preventing cardiovascular disease, showing a low proportion with a favourable CVH profile, especially among low-educated people. It is necessary to consider prevention strategies aimed

  2. Mineral intake and lung cancer risk in the NIH-American Association of Retired Persons Diet and Health study.

    PubMed

    Mahabir, Somdat; Forman, Michele R; Dong, Young Q; Park, Yikyung; Hollenbeck, Albert; Schatzkin, Arthur

    2010-08-01

    Using data from a case-control study, we previously reported that low dietary intakes of magnesium (Mg), iron (Fe), zinc (Zn), copper (Cu), but not selenium (Se) and calcium (Ca), were associated with increased lung cancer risk. Due to dietary recall bias in case-control studies, our objective was to assess whether these findings hold in a prospective cohort study. We analyzed data from the NIH-American Association of Retired Persons Diet and Health study of 482,875 subjects (288,257 men and 194,618 women) who were cancer-free and completed a food frequency questionnaire at enrollment between 1995 and 2003. Cox proportional hazards models were computed to estimate the relative risk adjusted for potential confounders. During a mean follow-up of 7 years, 7,052 lung cancer cases were identified. For all subjects, we observed no significant associations between total (diet + supplement) Ca, Mg, Fe, Cu, Se, and Zn intakes and lung cancer risk. Total Ca intake was protective (P trend < 0.05) for current smokers and subjects with adenocarcinomas. Total Mg intake increased risk (P trend < 0.05) in men and current smokers. Total Fe intake was inversely associated with risk in women (P trend < 0.01). For dietary minerals, Mg increased risk (P trend < 0.05) in all subjects, among men and current smokers. Increased dietary Ca intake reduced risk in women (P trend = 0.05). Dietary Fe decreased risk in all subjects and among women (P trend < 0.05). Mineral intake from supplements did not affect lung cancer risk. Dietary minerals are risk factors for lung cancer. Dietary mineral consumption may influence lung cancer risk, but the associations differ by type of mineral and population subgroups. (c)2010 AACR.

  3. The opinion and response of health professionals associated with academics about the research design and methods: A study

    PubMed Central

    Raheel, Syed Ahmed; Kujan, Omar Bashar

    2016-01-01

    Aim: The study aimed to survey the opinions and responses of health professionals in academics about their interest and experience in research, knowledge over study designs, and application of a common study design to find out the objectives behind any research study. Materials and Methods: A semi-structured questionnaire containing three variables with 15 questions were sent to 300 health professionals associated with academics in the category of Bachelor/Master/Doctorate working at Al-Farabi Colleges campuses located in Riyadh, Saudi Arabia. Data were collected manually, descriptive frequencies were generated and the variables were statistically analyzed using Chi-square test. The knowledge scores between the qualification and gender were carried out using ANOVA and t-test. The final response rate was in conjuction to the statistician to exclude the uncompleted responses from the statistical analysis. Results: The results showed a discrepancy in the participation; of 95 health professionals, (40) were females and (55) were males. Bachelor (16), Masters (61) and Doctorate holders (18) gave their opinion. For the first variable (research experience), all the surveyed categories showed the same response. However, for the second variable (study design and research criteria) bachelor holders showed poor, but equal performance was reported to the master and doctorate holders. In the third variable (objectives and common designs), bachelor holders showed a poor response in contrast to the master and doctorate holders whose have mixed opinions. For knowledge scores, no significance was present between the master and doctorate holders. Conclusion: There is a lack of understanding of the research objectives and common designs frequently used in research studies particularly among the bachelor holders. Additional postgraduate education on research methods is recommended to improve the knowledge and practices of research. PMID:27114956

  4. The opinion and response of health professionals associated with academics about the research design and methods: A study.

    PubMed

    Raheel, Syed Ahmed; Kujan, Omar Bashar

    2016-01-01

    The study aimed to survey the opinions and responses of health professionals in academics about their interest and experience in research, knowledge over study designs, and application of a common study design to find out the objectives behind any research study. A semi-structured questionnaire containing three variables with 15 questions were sent to 300 health professionals associated with academics in the category of Bachelor/Master/Doctorate working at Al-Farabi Colleges campuses located in Riyadh, Saudi Arabia. Data were collected manually, descriptive frequencies were generated and the variables were statistically analyzed using Chi-square test. The knowledge scores between the qualification and gender were carried out using ANOVA and t-test. The final response rate was in conjuction to the statistician to exclude the uncompleted responses from the statistical analysis. The results showed a discrepancy in the participation; of 95 health professionals, (40) were females and (55) were males. Bachelor (16), Masters (61) and Doctorate holders (18) gave their opinion. For the first variable (research experience), all the surveyed categories showed the same response. However, for the second variable (study design and research criteria) bachelor holders showed poor, but equal performance was reported to the master and doctorate holders. In the third variable (objectives and common designs), bachelor holders showed a poor response in contrast to the master and doctorate holders whose have mixed opinions. For knowledge scores, no significance was present between the master and doctorate holders. There is a lack of understanding of the research objectives and common designs frequently used in research studies particularly among the bachelor holders. Additional postgraduate education on research methods is recommended to improve the knowledge and practices of research.

  5. Differential Associations of Depressive Symptom Dimensions with Cardio-Vascular Disease in the Community: Results from the Gutenberg Health Study

    PubMed Central

    Michal, Matthias; Wiltink, Jörg; Kirschner, Yvonne; Wild, Philipp S.; Münzel, Thomas; Ojeda, Francisco M.; Zeller, Tanja; Schnabel, Renate B.; Lackner, Karl; Blettner, Maria; Zwiener, Isabella; Beutel, Manfred E.

    2013-01-01

    A current model suggested that the somatic symptom dimension accounts for the adverse effect of depression in patients with coronary heart disease (CHD). In order to test this model we sought to determine in a large population-based sample how symptom dimensions of depression are associated with CHD, biomarkers and traditional risk factors. The associations of cognitive and somatic symptom dimensions of depression with CHD, risk factors, endothelial function, and biomarkers of inflammation and myocardial stress were analyzed cross-sectionally in a sample of n = 5000 Mid-Europeans aged 35–74 years from the Gutenberg Health Study (GHS). Only the somatic symptom dimension of depression was associated with CHD, biomarkers (inflammation, vascular function) and cardio-vascular risk factors. When multivariable adjustment was applied by demographic and cardiovascular risk factors, the weak associations of the somatic symptom dimension with the biomarkers disappeared. However, the associations of the somatic symptom dimension with CHD, myocardial infarction, obesity, dyslipidemia and family history of myocardial infarction remained. Both dimensions of depression were independently associated with a previous diagnosis of depression and distressed personality (type D). Thus, our results partly confirm current models: Somatic, but not cognitive-affective symptom dimensions are responsible for the association between depression and CHD, inflammation, vascular function and cardiovascular risk factors in the general population. However, our findings challenge the assumptions that somatic depression might be due to inflammation or vascular dysfunction as consequence of progressed atherosclerotic disease. They rather emphasize a close interplay with life-style factors and with a family history of MI. PMID:23967272

  6. Menopausal factors are associated with seronegative RA in large prospective cohorts: results from the Nurses' Health Studies.

    PubMed

    Bengtsson, Camilla; Malspeis, Susan; Orellana, Cecilia; Sparks, Jeffrey A; Costenbader, Karen H; Karlson, Elizabeth W

    2017-01-13

    To investigate whether menopausal factors are associated with development of serologic rheumatoid arthritis (RA) phenotypes. Data were analyzed from Nurses' Health Studies (NHS, 1976-2010; NHSII 1989-2011). In NHS 120,700 female nurses aged 30-55 and in NHSII 116,430 female nurses aged 25-42 were followed via biennial questionnaires on lifestyle and disease outcomes. In total, 1,096 incident RA cases were confirmed by questionnaire and chart review. Seropositive RA was defined as +RF or ACPA+; seronegative RA as -RF and ACPA-. We used Cox proportional hazards models to obtain multivariable adjusted hazard ratios (HR) with 95% confidence intervals (CI) of seropositive/-negative RA associated with menopausal status, age at menopause, type of menopause, ovulatory years and postmenopausal hormone therapy (PMH) use. Postmenopausal women had a two-fold increased risk of seronegative RA, compared with premenopausal women (NHS: HR 1.8, 95% CI 1.1-3.0; NHSII: HR 2.4, 95% CI 1.4-3.9; pooled HR 2.1, 95% CI 1.4-3.0). Natural menopause at early age (≤ 44) was associated with an increased risk of seronegative RA (pooled HR 2.4, 95% CI 1.5-4.0). None of the menopausal factors was significantly associated with seropositive RA. We observed no association between PMH use and the risk of seronegative or seropositive RA, except that PMH use of ≥8 years was associated with increased risk of seropositive RA (pooled HR 1.4, 95% CI 1.1-1.9). Postmenopause and natural menopause at early age were strongly associated with seronegative RA, but only marginally with seropositive RA, suggesting potential differences in the etiology of RA subtypes. This article is protected by copyright. All rights reserved. © 2017, American College of Rheumatology.

  7. Factors associated with generic health-related quality of life in adult asthma patients in Germany: Cross-sectional study.

    PubMed

    Böhmer, Merle M; Brandl, Magdalena; Brandstetter, Susanne; Finger, Tamara; Fischer, Wiebke; Pfeifer, Michael; Apfelbacher, Christian

    2017-04-01

    Given a 9% lifetime prevalence of asthma in Germany and the impairment of health-related quality of life (HRQOL) that goes along with it, it is important to understand parameters affecting HRQOL in asthma patients. Objective of this study was therefore to determine factors associated with generic HRQOL in asthma patients. Data for cross-sectional analyses were obtained from the baseline of an ongoing cohort study. physician-diagnosed asthma; age ≥18 years; disease duration ≥3 months; no acute psychiatric/neurological disease; sufficient knowledge of German. HRQOL was assessed by the Short Form 12 Health Survey Questionnaire (SF-12), which comprises a physical (PCS-12) and a mental component (MCS-12). Information on a broad range of parameters potentially influencing HRQOL was collected by examining the patients' medical records and via a self-administered questionnaire. Those parameters were of socio-demographic, disease-specific, treatment-related or psychosocial nature. We conducted multivariable linear regression analyses to assess determinants of HRQOL. In total, 196 asthma patients participated in the study (mean age: 48 years (range: 18-90); 60.2% females). In multivariable analysis, PCS-12 was negatively associated with older age, being female, insufficient disease control, higher number of medications in tablet form and reporting symptoms of depression. MCS-12 was negatively associated with being female, living alone, insufficient disease control, and reporting symptoms of anxiety or depression. Focusing on disease control and screening for depression and anxiety may be promising approaches to improve HRQOL in adult asthma patients. If a patient shows alarming symptoms of anxiety and/or depression, the patient should then be referred for psychiatric treatment.

  8. Evaluation of the risk factors associated with rectal neuroendocrine tumors: a big data analytic study from a health screening center.

    PubMed

    Pyo, Jeung Hui; Hong, Sung Noh; Min, Byung-Hoon; Lee, Jun Haeng; Chang, Dong Kyung; Rhee, Poong-Lyul; Kim, Jae Jun; Choi, Sun Kyu; Jung, Sin-Ho; Son, Hee Jung; Kim, Young-Ho

    2016-12-01

    Rectal neuroendocrine tumor (NET) is the most common NET in Asia. The risk factors associated with rectal NETs are unclear because of the overall low incidence rate of these tumors and the associated difficulty in conducting large epidemiological studies on rare cases. The aim of this study was to exploit the benefits of big data analytics to assess the risk factors associated with rectal NET. A retrospective case-control study was conducted, including 102 patients with histologically confirmed rectal NETs and 52,583 healthy controls who underwent screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea between January 2002 and December 2012. Information on different risk factors was collected and logistic regression analysis applied to identify predictive factors. Four factors were significantly associated with rectal NET: higher levels of cholesterol [odds ratio (OR) = 1.007, 95 % confidence interval (CI), 1.001-1.013, p = 0.016] and ferritin (OR = 1.502, 95 % CI, 1.167-1.935, p = 0.002), presence of metabolic syndrome (OR = 1.768, 95 % CI, 1.071-2.918, p = 0.026), and family history of cancer among first-degree relatives (OR = 1.664, 95 % CI, 1.019-2.718, p = 0.042). The findings of our study demonstrate the benefits of using big data analytics for research and clinical risk factor studies. Specifically, in this study, this analytical method was applied to identify higher levels of serum cholesterol and ferritin, metabolic syndrome, and family history of cancer as factors that may explain the increasing incidence and prevalence of rectal NET.

  9. Associated factors of behavioural problems in children at preschool age: the Hokkaido study on environment and children's health.

    PubMed

    Minatoya, M; Itoh, S; Araki, A; Tamura, N; Yamazaki, K; Nishihara, S; Miyashita, C; Kishi, R

    2017-05-01

    Finding associated factors with childhood behavioural problems as early as preschool age is important. Studies have revealed several factors including socioeconomic factors, which may vary among different cultural background and population. However, investigation in general Japanese population of preschool age has not been well demonstrated. Thus, the objective of this study was to examine associated factors of childhood behavioural problems using Strengths and Difficulties Questionnaire (SDQ) in a prospective birth cohort study. Total 3813 SDQ were distributed between October 2014 and December 2015 to the subpopulation of prospective birth cohort study, the Hokkaido Study on Environment and Children's Health. The subpopulation consisted of participants who had reached age 5 and were born between April 2008 and December 2010. Baseline questionnaire filled at recruitment and birth record were used to obtain participant information. Children with total difficulties score ≧ 13 were defined as likelihood of behavioural problems. A total of 2553 children with valid answers were included into the analysis. The response rate was 67.1%. Number of children with likelihood of behavioural problems was 521 (20.4%). Boys showed more problematic scores than girls. Multivariate analysis found that maternal pre-pregnancy BMI ≧ 30 kg/m(2) , primipara, maternal education lower than high school, family income during pregnancy < 3 million yen/year and boy gender were the factors associated with increased odds ratio of likelihood of child behavioural problems. This study found that prenatal socioeconomic factors were associated with likelihood of child behavioural problems at preschool age in Japan. © 2016 John Wiley & Sons Ltd.

  10. The association between diabetes mellitus, glucose, and chronic musculoskeletal complaints. Results from the Nord-Trøndelag Health Study

    PubMed Central

    Hoff, Ole M; Midthjell, Kristian; Zwart, John-Anker; Hagen, Knut

    2008-01-01

    Background The relationship between diabetes mellitus (DM) and chronic musculoskeletal complaints (MSCs) is unclear. The aim of this study was to investigate the association between DM, non-fasting glucose and chronic MSCs defined as pain and/or stiffness ≥ 3 months during the past year in the general adult population. Methods The results were based on cross-sectional data from 64,785 men and women (aged ≥ 20 years) who participated in the Nord-Trøndelag Health Survey, which included 1,940 individuals with known DM. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR) with 95% confidence intervals (CIs). Results High non-fasting glucose was associated with a lower prevalence of chronic MSCs compared to a low glucose level. DM was associated with higher prevalence of chronic MSCs, in particular chronic widespread MSCs. In the multivariate analysis, adjusting for glucose level, BMI, age, gender and physical activity, chronic widespread MSCs was 1.6 times more likely (OR = 1.6, 95% CI 1.2–2.2) among individuals < 60 years of age with DM than among those without DM. The association between chronic widespread MSCs and DM was most evident among the group of individuals aged < 60 years with either type 2 DM or unclassified DM (OR = 1.8, 95% CI 1.3–2.5). Conclusion In this cross-sectional study a high non-fasting glucose was associated with lower prevalence of chronic MSCs. Among individuals with known DM chronic widespread MSCs were more likely. PMID:19055732

  11. Association of socioeconomic status measured by education, and cardiovascular health: a population-based cross-sectional study.

    PubMed

    Janković, Slavenka; Stojisavljević, Dragana; Janković, Janko; Erić, Miloš; Marinković, Jelena

    2014-07-15

    Cardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS). Population-based cross-sectional study. RS, Bosnia and Herzegovina. The study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS. Participant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m(2), physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all seven ideal health metrics present) versus intermediate and poor CVH status. Participants with high educational levels had a significantly greater number of ideal CVH metrics, and ideal health factor metrics compared with those with low or medium educational level (OR 0.88 95% CI 0.77 to 0.99 and OR 0.88 95% CI 0.80 to 0.96; OR 0.81 95% CI 0.69 to 0.96 and OR 0.77 95% CI 0.68 to 0.87; respectively). The number of ideal behaviour metrics was not a discriminator of educational groups. Concerning the categories of CVH status the poor CVH was a discriminator for low and medium education compared with those with high education (OR 1.93 95% CI 1.24 to 3.01 and OR 1.54 95% CI 1.08 to 2.19, respectively). Our findings emphasise the large potential for preventing cardiovascular disease, showing a low proportion with a favourable CVH profile, especially among low-educated people. It is necessary to consider prevention strategies aimed at improving CVH in RS, targeting primarily low educational groups

  12. A cross-sectional study of the association between mobile phone use and symptoms of ill health.

    PubMed

    Cho, Yong Min; Lim, Hee Jin; Jang, Hoon; Kim, Kyunghee; Choi, Jae Wook; Shin, Chol; Lee, Seung Ku; Kwon, Jong Hwa; Kim, Nam

    2016-01-01

    This study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms. This study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect. The average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively. Mobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression, but was associated with the severity of

  13. A cross-sectional study of the association between mobile phone use and symptoms of ill health

    PubMed Central

    2016-01-01

    Objectives This study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms. Methods This study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect. Results The average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively. Conclusions Mobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression

  14. Structural and organizational characteristics associated with performance of essential public health services in small jurisdictions: findings from a statewide study in Massachusetts.

    PubMed

    Hyde, Justeen; Arsenault, Lisa; Waggett, Jessica; Mills, Brianna; Cox, Harold; MacVarish, Kathleen; Fried, Lise

    2012-11-01

    This study examined jurisdictional, organizational, and structural characteristics associated with capacity to deliver 10 essential public health services (EPHS) in Massachusetts, a state where a majority of local public health departments serve small municipalities. A survey was administered to local health directors or board of health chairs. The main outcome of the study was capacity to perform EPHS, measured by a 25-item screening tool. Seventy percent of the 351 boards of health in Massachusetts participated in the study. Greatest capacity was demonstrated in EPHS 2 (Diagnose and Investigate Health Problems) and EPHS 6 (Enforce Laws and Regulations). The capacity to perform the 8 other essential services was limited. Bivariate analysis indicates that overall capacity to perform EPHS is significantly associated with population size, poverty rate, annual municipal budget, and perceived understanding of the roles and responsibilities of local boards of health among elected municipal officials. The latter was the strongest predictor of overall capacity in multivariate analysis. Findings are aligned with studies examining factors associated with capacity to perform EPHS in large public health jurisdictions. The results suggest that one strategy for improving capacity to perform EPHS in smaller jurisdictions is to educate elected municipal leaders about the responsibilities of local health officials. Clarification regarding the role small jurisdictions with limited resources can play to ensure the equitable delivery of essential public health services and a strategy for measuring their contributions is important, especially as the national public health accreditation program gains momentum in the United States.

  15. Determinants of periodontal health in pregnant women and association with infants’ anthropometric status: a prospective cohort study from Eastern Uganda

    PubMed Central

    2012-01-01

    Background Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in sub Saharan Africa and has been linked to poor periodontal health during pregnancy. This study investigated predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems at 7 months gestational age and the infants’ anthropometric status. Method A community –based prospective cohort study was conducted in Mbale, Eastern Uganda between 2006 and 2008. Upon recruitment, 713 pregnant women completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices. A total of 593 women were followed up with anthropometric assessments of their infants 3 weeks after delivery. Multiple logistic regression analyses were used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) was used to investigate the relationship between periodontal problems and the child’s anthropometric status in terms of wasting, underweight and stunting. Results A total of 67.0% women presented with periodontal problems, 12.1% with poor oral hygiene, 29.8% with recent dental visit and 65.0% with periodontal symptoms. Of the infants, 2.0% were wasted, 6.9% were underweight and 10.0% were stunted. The odds ratio of having CPI > 0 increased with increased maternal age and single marital status, and was lower in primiparous women and those who used mosquito bed nets. Mean wasting scores discriminated between mothers with CPI = 0 and CPI > 0 as well as between mothers with good and poor OHI-S scores. Conclusions Socio-demographic factors and information about oral health were associated with oral health indicators in pregnant women. Second, the height- for- age status at 3 weeks postpartum was worse in infants of mothers having

  16. Reducing Health Disparity in People with Intellectual Disabilities: A Report from Health Issues Special Interest Research Group of the International Association for the Scientific Study of Intellectual Disabilities

    ERIC Educational Resources Information Center

    Scheepers, M.; Kerr, M.; O'Hara, D.; Bainbridge, D.; Cooper, S.-A.; Davis, R.; Fujiura, G.; Heller, T.; Holland, A.; Krahn, G.; Lennox, N.; Meaney, J.; Wehmeyer, M.

    2005-01-01

    Disparities in the health status and care experienced by people with intellectual disabilities are increasingly being recognized. This special report presents the results of an international expert consensus workshop held under the auspices of the Health Issues Special Interest Research Group of the International Association for the Scientific…

  17. Origin and assessment of groundwater pollution and associated health risk: a case study in an industrial park, northwest China.

    PubMed

    Li, Peiyue; Wu, Jianhua; Qian, Hui; Lyu, Xinsheng; Liu, Hongwei

    2014-08-01

    Groundwater quality which relates closely to human health has become as important as its quantity due to the demand for safe water. In the present study, an entropy-weighted fuzzy water quality index (WQI) has been proposed for performing groundwater quality assessment in and around an industrial park, northwest China, where domestic water requirements are solely met by groundwater. The human health risk was assessed with the model recommended by the United States Environmental Protection Agency. In addition, the sources of major ions and main contaminants were also analyzed. The study shows that groundwater in the study area has been contaminated conjunctively by natural processes and industrial and agricultural activities. Nitrate, manganese (Mn), fluoride, total dissolved solids, total hardness and sulfate are major contaminants influencing groundwater quality. Nitrate and heavy metals such as Mn are mainly affected by human agricultural activities and industrial production, while other contaminants are mainly originated from mineral weathering and water-rock interactions. The results of water quality assessment suggest that half of the groundwater samples collected are of medium quality thus require pretreatment before human consumption. The mean health risk caused by the consumption of contaminated groundwater in the area is 8.42 × 10(-5) per year which surpasses the maximum acceptable level (5 × 10(-5) per year) recommended by the International Commission on Radiologic Protection. The entropy-weighted fuzzy WQI proposed in this study can not only assign proper weights to parameters but also treat uncertainties associated with water quality classification. This study will be of interest to international environmentalists and hydrogeologists. It will also be useful in regional groundwater management and protection.

  18. A qualitative study identifying the cost categories associated with electronic health record implementation in the UK

    PubMed Central

    Slight, Sarah P; Quinn, Casey; Avery, Anthony J; Bates, David W; Sheikh, Aziz

    2014-01-01

    Objective We conducted a prospective evaluation of different forms of electronic health record (EHR) systems to better understand the costs incurred during implementation and the factors that can influence these costs. Methods We selected a range of diverse organizations across three different geographical areas in England that were at different stages of implementing three centrally procured applications, that is, iSOFT's Lorenzo Regional Care, Cerner's Millennium, and CSE's RiO. 41 semi-structured interviews were conducted with hospital staff, members of the implementation team, and those involved in the implementation at a national level. Results Four main overarching cost categories were identified: infrastructure (eg, hardware and software), personnel (eg, training team), estates/facilities (eg, space), and other (eg, training materials). Many factors were felt to impact on these costs, with different hospitals choosing varying amounts and types of infrastructure, diverse training approaches for staff, and different software applications to integrate with the new system. Conclusions Improving the quality and safety of patient care through EHR adoption is a priority area for UK and US governments and policy makers worldwide. With cost considered one of the most significant barriers, it is important for hospitals and governments to be clear from the outset of the major cost categories involved and the factors that may impact on these costs. Failure to adequately train staff or to follow key steps in implementation has preceded many of the failures in this domain, which can create new safety hazards. PMID:24523391

  19. Gender-specific Associations Between Soy and Risk of Hip Fracture in the Singapore Chinese Health Study

    PubMed Central

    Wu, Anna H.; Wang, Renwei; Ang, Li-Wei; Heng, Derrick; Yuan, Jian-Min; Yu, Mimi C.

    2009-01-01

    Although there is some epidemiologic evidence that soy may reduce risk of osteoporotic fracture in women, it is not known whether this risk reduction also occurs for men. The authors examined gender-specific associations between soy intake and hip fracture risk in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese living in Singapore. At recruitment between 1993 and 1998, each subject was administered a food frequency questionnaire and questions on medical history and lifestyle factors. As of December 31, 2006, 276 incident cases of hip fracture in men and 692 cases in women were identified via linkage with hospital discharge databases. For both genders, hip fracture risk was positively associated with cigarette smoking and was inversely associated with body mass index. There was a statistically significant association of tofu equivalents, soy protein, and isoflavones with hip fracture risk among women but not among men. Compared with women in the lowest quartile of intakes for tofu equivalents (<49.4 g/day), soy protein (<2.7 g/day), and isoflavones (<5.8 mg/1,000 kcal/day), those in the second–fourth quartiles exhibited 21%–36% reductions in risk (all P < 0.036). Risk levels were comparable across the second, third, and fourth quartiles of soy intake categories. PMID:19720865

  20. Association of mild anemia with hospitalization and mortality in the elderly: the Health and Anemia population-based study

    PubMed Central

    Riva, Emma; Tettamanti, Mauro; Mosconi, Paola; Apolone, Giovanni; Gandini, Francesca; Nobili, Alessandro; Tallone, Maria Vittoria; Detoma, Paolo; Giacomin, Adriano; Clerico, Mario; Tempia, Patrizia; Guala, Adriano; Fasolo, Gilberto; Lucca, Ugo

    2009-01-01

    Background Mild anemia is a frequent laboratory finding in the elderly usually disregarded in everyday practice as an innocent bystander. The aim of the present population-based study was to prospectively investigate the association of mild grade anemia with hospitalization and mortality. Design and Methods A prospective population-based study of all 65 to 84 year old residents in Biella, Italy was performed between 2003 and 2007. Data from a total of 7,536 elderly with blood tests were available to estimate mortality; full health information available to evaluate health-related outcomes was available for 4,501 of these elderly subjects. Mild grade anemia was defined as a hemoglobin concentration between 10.0 and 11.9 g/dL in women and between 10.0 and 12.9 g/dL in men. Results The risk of hospitalization in the 3 years following recruitment was higher among the mildly anemic elderly subjects than among subjects who were not anemic (adjusted hazard ratio: 1.32; 95% confidence interval: 1.09–1.60). Mortality risk in the following 3.5 years was also higher among the mildly anemic elderly (adjusted hazard ratio: 1.86; 95% confidence interval: 1.34–2.53). Similar results were found when slightly elevating the lower limit of normal hemoglobin concentration to 12.2 g/dL in women and to 13.2 g/dL in men. The risk of mortality was significantly increased in mild anemia of chronic disease but not in that due to β-thalassemia minor. Conclusions After controlling for many potential confounders, mild grade anemia was found to be prospectively associated with clinically relevant outcomes such as increased risk of hospitalization and all-cause mortality. Whether raising hemoglobin concentrations can reduce the risks associated with mild anemia should be tested in controlled clinical trials. PMID:19001283

  1. Greater adherence to a Mediterranean dietary pattern is associated with improved plasma lipid profile: the Aragon Health Workers Study cohort.

    PubMed

    Peñalvo, José L; Oliva, Belén; Sotos-Prieto, Mercedes; Uzhova, Irina; Moreno-Franco, Belén; León-Latre, Montserrat; Ordovás, José María

    2015-04-01

    There is wide recognition of the importance of healthy eating in cardiovascular health promotion. The purpose of this study was to identify the main dietary patterns among a Spanish population, and to determine their relationship with plasma lipid profiles. A cross-sectional analysis was conducted of data from 1290 participants of the Aragon Workers Health Study cohort. Standardized protocols were used to collect clinical and biochemistry data. Diet was assessed through a food frequency questionnaire, quantifying habitual intake over the past 12 months. The main dietary patterns were identified by factor analysis. The association between adherence to dietary patterns and plasma lipid levels was assessed by linear and logistic regression. Two dietary patterns were identified: a Mediterranean dietary pattern, high in vegetables, fruits, fish, white meat, nuts, and olive oil, and a Western dietary pattern, high in red meat, fast food, dairy, and cereals. Compared with the participants in the lowest quintile of adherence to the Western dietary pattern, those in the highest quintile had 4.6 mg/dL lower high-density lipoprotein cholesterol levels (P < .001), 8 mg/dL lower apolipoprotein A1 levels (P = .005) and a greater risk of having decreased high-density lipoprotein cholesterol (odds ratio = 3.19; 95% confidence interval, 1.36-7.5; P-trend = .03). Participants adhering to the Mediterranean dietary pattern had 3.3mg/dL higher high-density lipoprotein cholesterol levels (P < .001), and a ratio of triglycerides to high-density lipoprotein cholesterol that was 0.43 times lower (P = .043). Adherence to the Mediterranean dietary pattern is associated with improved lipid profile compared with a Western dietary pattern, which was associated with a lower odds of optimal high-density lipoprotein cholesterol levels in this population. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  2. USE OF POPULATION STUDIES TO IDENTIFY ASSOCIATIONS BETWEEN ADVERSE HEALTH EFFECTS AND ENVIRONMENTAL EXPOSURES TO ENDOCRINE DISRUPTING HERBICIDES

    EPA Science Inventory

    Not only animal studies, but also population (ecologic) studies can contribute to the identification of endocrine disrupting chemicals. Population studies are fundamental in identifying public health hazards, and provide hypotheses for more targeted studies. Chlorophenoxy herb...

  3. USE OF POPULATION STUDIES TO IDENTIFY ASSOCIATIONS BETWEEN ADVERSE HEALTH EFFECTS AND ENVIRONMENTAL EXPOSURES TO ENDOCRINE DISRUPTING HERBICIDES

    EPA Science Inventory

    Not only animal studies, but also population (ecologic) studies can contribute to the identification of endocrine disrupting chemicals. Population studies are fundamental in identifying public health hazards, and provide hypotheses for more targeted studies. Chlorophenoxy herb...

  4. The Association of Resilience with Mental and Physical Health among Older American Indians: The Native Elder Care Study

    ERIC Educational Resources Information Center

    Schure, Marc B.; Odden, Michelle; Goins, R. Turner

    2013-01-01

    We examined the association of resilience with measures of mental and physical health in a sample of older American Indians (AIs). A validated scale measuring resilience was administered to 185 noninstitutionalized AIs aged greater than or equal to 55 years. Unadjusted analyses revealed that higher levels of resilience were associated with lower…

  5. Diet, physical activity and mental health status are associated with dysglycaemia in pregnancy: the Healthy Start Study.

    PubMed

    Sauder, K A; Starling, A P; Shapiro, A L; Kaar, J L; Ringham, B M; Glueck, D H; Leiferman, J A; Siega-Riz, A M; Dabelea, D

    2016-05-01

    To examine the association between dysglycaemia and multiple modifiable factors measured during pregnancy. The Healthy Start Study collected self-reported data on modifiable factors in early and mid-pregnancy (median 17 and 27 weeks gestation, respectively) from 832 women. Women received one point for each modifiable factor for which they had optimum scores: diet quality (Healthy Eating Index score ≥64), physical activity level (estimated energy expenditure ≥170 metabolic equivalent task-h/week), and mental health status (Perceived Stress Scale score <6 and Edinburgh Postnatal Depression Scale score <13). Dysglycaemia during pregnancy was defined as an abnormal glucose challenge result, ≥1 abnormal results on an oral glucose tolerance test, or a clinical diagnosis of gestational diabetes. Logistic regression models estimated odds ratios for dysglycaemia as a function of each factor and the total score, adjusted for age, race/ethnicity, pre-pregnancy BMI, history of gestational diabetes, and family history of Type 2 diabetes. In individual analyses, only physical activity was significantly associated with a reduced risk of dysglycaemia (adjusted odds ratio 0.67, 95% CI 0.44-1.00). We observed a significant, dose-response association between increasing numbers of optimal factors and odds of dysglycaemia (adjusted P=0.01). Compared with having no optimal modifiable factors, having all three was associated with a 73% reduced risk of dysglycaemia (adjusted odds ratio 0.27, 95% CI 0.08-0.95). An increasing number of positive modifiable factors in pregnancy was associated with a dose-response reduction in risk of dysglycaemia. Our results support the hypothesis that modifiable factors in pregnancy are associated with the risk of prenatal dysglycaemia. © 2016 Diabetes UK.

  6. The American Heart Association Ideal Cardiovascular Health and Incident Type 2 Diabetes Mellitus Among Blacks: The Jackson Heart Study.

    PubMed

    Effoe, Valery S; Carnethon, Mercedes R; Echouffo-Tcheugui, Justin B; Chen, Haiying; Joseph, Joshua J; Norwood, Arnita F; Bertoni, Alain G

    2017-06-21

    The concept of ideal cardiovascular health (CVH), defined by the American Heart Association primarily for coronary heart disease and stroke prevention, may apply to diabetes mellitus prevention among blacks. Our sample included 2668 adults in the Jackson Heart Study with complete baseline data on 6 of 7 American Heart Association CVH metrics (body mass index, healthy diet, smoking, total cholesterol, blood pressure, and physical activity). Incident diabetes mellitus was defined as fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes mellitus drugs, or glycosylated hemoglobin ≥6.5%. A summary CVH score from 0 to 6, based on presence/absence of ideal CVH metrics, was derived for each participant. Cox regression was used to estimate adjusted hazard ratios. Mean age was 55 years (65% women) with 492 incident diabetes mellitus events over 7.6 years (24.6 cases/1000 person-years). Three quarters of participants had only 1 or 2 ideal CVH metrics; no participant had all 6. After adjustment for demographic factors (age, sex, education, and income) and high-sensitivity C-reactive protein, each additional ideal CVH metric was associated with a 17% diabetes mellitus risk reduction (hazard ratio, 0.83; 95% CI, 0.74-0.93). The association was attenuated with further adjustment for homeostasis model assessment for insulin resistance (hazard ratio, 0.89; 95% CI, 0.79-1.00). Compared with participants with 1 or no ideal CVH metric, diabetes mellitus risk was 15% and 37% lower in those with 2 and ≥3 ideal CVH metrics, respectively. The AHA concept of ideal CVH is applicable to diabetes mellitus prevention among blacks. These associations were largely explained by insulin resistance. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  7. Prevalence and associations of diabetic retinopathy in a large cohort of prediabetic subjects: the Gutenberg Health Study.

    PubMed

    Lamparter, Julia; Raum, Philipp; Pfeiffer, Norbert; Peto, Tunde; Höhn, René; Elflein, Heike; Wild, Philipp; Schulz, Andreas; Schneider, Astrid; Mirshahi, Alireza

    2014-01-01

    To evaluate the prevalence of diabetic retinopathy/maculopathy (DR/DMac) and its associations with cardiovascular risk factors (CRF) in participants with prediabetes (PwPD) in a large European cohort within the population-based Gutenberg Health Study (GHS). The study was based on a sub-cohort of the GHS (n=5,000, age: 35-74 y). Prediabetes was diagnosed according to HbA1c levels (5.7-6.4%). DR/DMac was graded from fundus photographs. Blood samples and comprehensive questionnaires served for evaluation of laboratory results and CRF. The prevalence of prediabetes was 22.4%, and of DR/DMac 8.1%/0.2%, respectively. The majority of participants had mild DR (7.2%). A percentage of 0.5 of PwPD presented with moderate and 0.3% with severe non-proliferative disease. None of the subjects had proliferative DR. No independent association was found between any of the analyzed CRF [hypertension, smoking, (family) history of myocardial infarction, congestive heart failure, coronary heart disease, stroke, obesity, dyslipidemia, chronic obstructive pulmonary disease, peripheral artery disease and chronic kidney disease] and DR. Although prevalences of prediabetes and DR in this Caucasian cohort are considerable, retinopathy findings are mainly mild, and no association was found for DR/DMac and CRF. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Risk of atrial fibrillation associated with coffee intake: Findings from the Danish Diet, Cancer, and Health study.

    PubMed

    Mostofsky, Elizabeth; Johansen, Martin Berg; Lundbye-Christensen, Søren; Tjønneland, Anne; Mittleman, Murray A; Overvad, Kim

    2016-06-01

    There have been discrepant findings on whether coffee consumption is associated with the rate of developing atrial fibrillation (AF). We used data on 57,053 participants (27,178 men and 29,875 women) aged 50-64 years in the Danish Diet, Cancer and Health study. All participants provided information on coffee intake via food-frequency questionnaires at baseline. Incident AF was identified using nationwide registries. During a median follow-up of 13.5 years, 3415 AF events occurred. Compared with no intake, coffee consumption was inversely associated with AF incidence, with multivariable-adjusted hazard ratios of 0.93 (95% confidence interval [CI] 0.74-1.15) for more than none to <1 cup/day, 0.88 (95% CI 0.71-1.10) for 1 cup/day, 0.86 (95% CI 0.71-1.04) for 2-3 cups/day, 0.84 (95% CI 0.69-1.02) for 4-5 cups/day, 0.79 (95% CI 0.64-0.98) for 6-7 cups/day and 0.79 (95% CI 0.63-1.00) for >7 cups/day (p-linear trend = 0.02). In this large population-based cohort study, higher levels of coffee consumption were associated with a lower rate of incident AF. © The European Society of Cardiology 2015.

  9. Repeated head trauma is associated with smaller thalamic volumes and slower processing speed: the Professional Fighters’ Brain Health Study

    PubMed Central

    Bernick, Charles; Banks, Sarah J; Shin, Wanyong; Obuchowski, Nancy; Butler, Sam; Noback, Michael; Phillips, Michael; Lowe, Mark; Jones, Stephen; Modic, Michael

    2015-01-01

    Objectives Cumulative head trauma may alter brain structure and function. We explored the relationship between exposure variables, cognition and MRI brain structural measures in a cohort of professional combatants. Methods 224 fighters (131 mixed martial arts fighters and 93 boxers) participating in the Professional Fighters Brain Health Study, a longitudinal cohort study of licensed professional combatants, were recruited, as were 22 controls. Each participant underwent computerised cognitive testing and volumetric brain MRI. Fighting history including years of fighting and fights per year was obtained from self-report and published records. Statistical analyses of the baseline evaluations were applied cross-sectionally to determine the relationship between fight exposure variables and volumes of the hippocampus, amygdala, thalamus, caudate, putamen. Moreover, the relationship between exposure and brain volumes with cognitive function was assessed. Results Increasing exposure to repetitive head trauma measured by number of professional fights, years of fighting, or a Fight Exposure Score (FES) was associated with lower brain volumes, particularly the thalamus and caudate. In addition, speed of processing decreased with decreased thalamic volumes and with increasing fight exposure. Higher scores on a FES used to reflect exposure to repetitive head trauma were associated with greater likelihood of having cognitive impairment. Conclusions Greater exposure to repetitive head trauma is associated with lower brain volumes and lower processing speed in active professional fighters. PMID:25633832

  10. Association of sociodemographic and environmental factors with the mental health status among preschool children-Results from a cross-sectional study in Bavaria, Germany.

    PubMed

    Zach, Angelika; Meyer, Nicole; Hendrowarsito, Lana; Kolb, Stefanie; Bolte, Gabriele; Nennstiel-Ratzel, Uta; Stilianakis, Nikolaos I; Herr, Caroline

    2016-07-01

    It has been reported that a great proportion of mental health disorders have an origin in early childhood. In order to evaluate factors possibly associated with children's health, the health monitoring units have been established since 2004 in six study regions in Bavaria, Germany. The second health monitoring survey, implemented in 2005-06, focuses on the mental health status of preschool children. The goal of this study is (1) to examine the association of sociodemographic and environmental factors with mental health and (2) to analyze the applicability of the results of the health monitoring units to all preschool children in Bavaria by calculating weighting factors. Data on 6206 preschool children are available. Logistic regression analysis is applied to analyze possible associations with mental health. A weighting method is applied to correct for deviances compared to the whole population of preschool children in Bavaria (N=132,783). 11% of preschool children show mental health problems. Regarding different indicators of sociodemographic status, low household income [unadjusted OR 3.34, 95% CI: 2.23-4.98] shows the strongest association of mental health problems. Non-accessibility of green space [unadjusted OR 2.74, 95% CI: 1.87-4.00] is also strongly associated with mental health. The results of the unweighted and weighted analysis are similar. Our findings suggest that sociodemographic status and factors in the living environment show associations with mental health of children. Based on the results of the unweighted and weighted analyses, the second health monitoring analysis shows little deviances compared to data of all Bavarian preschool children. Therefore, the results can be compared to all Bavarian preschool children. Copyright © 2016 Elsevier GmbH. All rights reserved.

  11. Phenotype-Specific Association of Single-Nucleotide Polymorphisms with Heart Failure and Preserved Ejection Fraction: a Genome-Wide Association Analysis of the Cardiovascular Health Study.

    PubMed

    Kao, David P; Stevens, Laura M; Hinterberg, Michael A; Görg, Carsten

    2017-06-01

    Little is known about genetics of heart failure with preserved ejection fraction (HFpEF) in part because of the many comorbidities in this population. To identify single-nucleotide polymorphisms (SNPs) associated with HFpEF, we analyzed phenotypic and genotypic data from the Cardiovascular Health Study, which profiled patients using a 50,000 SNP array. Results were explored using novel SNP- and gene-centric tools. We performed analyses to determine whether some SNPs were relevant only in certain phenotypes. Among 3804 patients, 7 clinical factors and 9 SNPs were significantly associated with HFpEF; the most notable of which was rs6996224, a SNP associated with transforming growth factor-beta receptor 3. Most SNPs were associated with HFpEF only in the absence of a clinical predictor. Significant SNPs represented genes involved in myocyte proliferation, transforming growth factor-beta/erbB signaling, and extracellular matrix formation. These findings suggest that genetic factors may be more important in some phenotypes than others.

  12. A Study in Kuwait of Health Risks Associated with Using Cell Phones

    ERIC Educational Resources Information Center

    Al-Khamees, Nedaa

    2007-01-01

    Previous studies have suggested a link between cell phone use and various symptoms. Analysis of 3,274 completed questionnaires from throughout Kuwait show a significant effect of exposure to cell phones for burning sensation on the ear, temporal pain, pain in the back of the head, auricular pain, noises in the ear, ear numbness, heartbeat…

  13. A Study in Kuwait of Health Risks Associated with Using Cell Phones

    ERIC Educational Resources Information Center

    Al-Khamees, Nedaa

    2007-01-01

    Previous studies have suggested a link between cell phone use and various symptoms. Analysis of 3,274 completed questionnaires from throughout Kuwait show a significant effect of exposure to cell phones for burning sensation on the ear, temporal pain, pain in the back of the head, auricular pain, noises in the ear, ear numbness, heartbeat…

  14. Associations of insulin resistance, inflammation and liver synthetic function with very low-density lipoprotein: The Cardiovascular Health Study.

    PubMed

    Jiang, Z Gordon; de Boer, Ian H; Mackey, Rachel H; Jensen, Majken K; Lai, Michelle; Robson, Simon C; Tracy, Russell; Kuller, Lewis H; Mukamal, Kenneth J

    2016-03-01

    Production of very low-density lipoprotein (VLDL) is increased in states of metabolic syndrome, leading to hypertriglyceridemia. However, metabolic syndrome is often associated with non-alcoholic fatty liver disease, which leads to liver fibrosis and inflammation that may decrease VLDL production. In this study, we aim to determine the interactive impact on VLDL profiles from insulin resistance, impairment in liver synthetic function and inflammation. We examined cross-sectional associations of insulin sensitivity, inflammation, and liver synthetic function with VLDL particle (VLDL-P) concentration and size among 1,850 older adults in the Cardiovascular Health Study. Indices for high insulin sensitivity and low liver synthetic function were associated with lower concentrations of VLDL-P. In addition, insulin resistance preferentially increased concentration of large VLDL and was associated with mean VLDL size. Indices for inflammation however demonstrated a nonlinear relationship with both VLDL-P concentration and VLDL size. When mutually adjusted, one standard deviation (SD) increment in Matsuda index and C-reactive protein (CRP) were associated with 4.9 nmol/L (-8.2 to -1.5, p=0.005) and 6.3 nmol/L (-11.0 to -1.6, p=0.009) lower VLDL-P concentration respectively. In contrast, one-SD increment in factor VII, a marker for liver synthetic function, was associated with 16.9 nmol/L (12.6-21.2, p<0.001) higher VLDL-P concentration. Furthermore, a one-SD increment in the Matsuda index was associated with 1.1 nm (-2.0 to -0.3, p=0.006) smaller mean VLDL size, whereas CRP and factor VII were not associated with VLDL size. Insulin sensitivity, inflammation and markers for liver synthetic function differentially impact VLDL-P concentration and VLDL size. These results underscore the complex effects of insulin resistance and its complications on VLDL production. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Adverse mental health outcomes associated with emotional abuse in young rural South African women: a cross-sectional study

    PubMed Central

    Jewkes, Rachel; Hoffman, Susie; Dunkle, Kristen L.; Nduna, Mzikazi; Shai, Nwabisa J.

    2013-01-01

    There is a lack of data on the prevalence of emotional abuse in youth. The aim of this study was thus to estimate the prevalence of emotional abuse in intimate partnerships among young women in rural South Africa and to measure the association between lifetime experience of emotional abuse (with and without the combined experience of physical and/or sexual abuse) and adverse health outcomes. Between 2002 and 2003, young women from 70 villages were recruited to participate in the cluster randomized controlled trial of an HIV behavioural intervention, Stepping Stones. Data was obtained through the administration of a questionnaire at baseline. Of the 1293 women who had ever been partnered, 189 (14.6%) had experienced only emotional abuse in their lifetimes. Three hundred and sixty-six women (28.3%) experienced emotional abuse with physical and/or sexual abuse in their lifetimes, and one hundred and forty-four women (11.1%) experienced physical and/or sexual abuse without emotional abuse. Hazardous drinking was associated with the experience of physical and/or sexual abuse, with (OR 6.0, 95% CI 1.0 – 36.6) and without emotional abuse (OR 5.8, 95% CI 1.1 – 29.4). Illicit drug use (OR 5.6, 95% CI 2.4 – 12.6), having depressive symptoms (OR 2.9, 95% CI 1.2 – 4.2), having psychological distress (OR 1.9, 95% CI 1.4 – 2.6), and suicidality (OR 79.0, 95% CI 17.3 – 359.6) was associated with the experience of emotional abuse with physical and/or sexual abuse. Suicidality was also strongly associated with having experienced emotional abuse alone (OR 79.5, 95% CI 16.7 – 377.4). This study showed that emotionally abused young women had a greater risk of suicidality than those experiencing no abuse and that the combined experience of emotional with physical and/or sexual abuse was strongly associated with poor mental health outcomes. PMID:21987516

  16. An epidemiological study of dental agenesis in a primary health area in Spain: estimated prevalence and associated factors.

    PubMed

    Tallón-Walton, Victòria; Nieminen, Pekka; Arte, Sirpa; Carvalho-Lobato, Patricia; Ustrell-Torrent, Josep Maria; Manzanares-Céspedes, Maria Cristina

    2010-07-01

    To evaluate the prevalence of dental agenesis and its possible association with other developmental dental anomalies and systemic entities. Descriptive transversal study, for which 1518 clinical records, of patients visited by the Odontological Service of the Primary Health Centre of Cassà de la Selva (Girona-Spain) between December 2002 and February 2006 were reviewed. The data were recorded in relation to the oral and dental anomalies and the associated systemic entities, between the ones referred as concomitant in literature. Values of 9.48% (7.25% excluding the third molars) for dental agenesis and 0.39% for oligodontia were obtained. The presence of dental agenesis concomitant with some other forms of oral and dental anomalies was observed. Attention must be drawn to the fact that a greater number of concomitant systemic entities were observed in those patients that presented a severe phenotypical pattern of dental agenesis. The results of the present study do not differ from the ones reported in studies of similar characteristics among Occidental and Spanish populations. The relationship observed between certain systemic entities and developmental dental anomalies suggest a possible common genetic etiology.

  17. Association of Blood Pressure Trajectory With Mortality, Incident Cardiovascular Disease, and Heart Failure in the Cardiovascular Health Study.

    PubMed

    Smitson, Christopher C; Scherzer, Rebecca; Shlipak, Michael G; Psaty, Bruce M; Newman, Anne B; Sarnak, Mark J; Odden, Michelle C; Peralta, Carmen A

    2017-06-01

    Common blood pressure (BP) trajectories are not well established in elderly persons, and their association with clinical outcomes is uncertain. We used hierarchical cluster analysis to identify discrete BP trajectories among 4,067 participants in the Cardiovascular Health Study using repeated BP measures from years 0 to 7. We then evaluated associations of each BP trajectory cluster with all-cause mortality, incident cardiovascular disease (CVD, defined as stroke or myocardial infarction) (N = 2,837), and incident congestive heart failure (HF) (N = 3,633) using Cox proportional hazard models. Median age was 77 years at year 7. Over a median 9.3 years of follow-up, there were 2,475 deaths, 659 CVD events, and 1,049 HF events. The cluster analysis identified 3 distinct trajectory groups. Participants in cluster 1 (N = 1,838) had increases in both systolic (SBP) and diastolic (DBP) BPs, whereas persons in cluster 2 (N = 1,109) had little change in SBP but declines in DBP. Persons in cluster 3 (N = 1,120) experienced declines in both SBP and DBP. After multivariable adjustment, clusters 2 and 3 were associated with increased mortality risk relative to cluster 1 (hazard ratio = 1.21, 95% confidence interval: 1.06-1.37 and hazard ratio = 1.20, 95% confidence interval: 1.05-1.36, respectively). Compared to cluster 1, cluster 3 had higher rates of incident CVD but associations were not statistically significant in demographic-adjusted models (hazard ratio = 1.16, 95% confidence interval: 0.96-1.39). Findings were similar when stratified by use of antihypertensive therapy. Among community-dwelling elders, distinct BP trajectories were identified by integrating both SBP and DBP. These clusters were found to have differential associations with outcomes.

  18. DEMOGRAPHIC AND HEALTH FACTORS ASSOCIATED WITH ENROLLMENT IN POST-TRIAL STUDIES: THE WOMEN’S HEALTH INITIATIVE HORMONE THERAPY TRIALS

    PubMed Central

    Espeland, Mark A.; Pettinger, Mary; Falkner, Karen L.; Shumaker, Sally A.; Limacher, Marian; Thomas, Fridtjof; Weaver, Kathryn E.; Stefanick, Marcia L.; McQuellon, Cynthia; Hunt, Julie R.; Johnson, Karen C.

    2014-01-01

    Background After clinical trials end, continued follow-up of the assembled cohort often is desirable for additional research. Factors influencing participants’ decisions to consent to additional follow-up and how these shape post-trial cohorts have not been broadly studied. Purpose We examined how two re-enrollment campaigns and the passage of time altered features of the post-trial cohorts compared with the original Women’s Health Initiative Hormone Therapy clinical trials. Methods We examined associations that markers of socio-demography, health, lifestyle and on-trial experiences had with re-enrollment and contrasted the characteristics of successive post-trial cohorts with those of the original enrollees. Results The post-trial enrollment campaigns re-enrolled 81.1% and 82.5% of available women, respectively. Women who re-enrolled tended to have better health characteristics than those not re-enrolled. Compared to women of comparable age in the original cohort, women retained for the second post-trial follow-up less often had a history of cardiovascular disease [odds ratio OR=0.36], hypertension [OR=0.57], diabetes [OR=0.59], or measured cognitive deficit [OR=0.40]. These women more often had graduated from high school [OR=1.72] and had participated in other WHI trials [OR=1.76]. Limitations We have examined experience with creating follow-up cohorst from participants in a single study. Thus, our findings may not apply to other cohorts and protocols. Conclusions Post-trial enrollment in follow-up studies can be successful; however the characteristics of the resulting cohort may differ substantially from the originally assembled group of trial participants. Collection during the original trial of potential predictors of differential re-enrollment may facilitate re-enrollment. PMID:23480899

  19. Masturbation among young women and associations with sexual health: an exploratory study.

    PubMed

    Hogarth, Harriet; Ingham, Roger

    2009-01-01

    Much research into young people's developing sexuality is concerned with risk avoidance and the reduction of negative outcomes. Little research has been conducted into sexual self-exploration and, in particular, masturbation among young people, and this has generally been concerned merely with its prevalence. Little is known about the potential role of masturbation in relation to young people's developing sexuality, especially among young women. This study aimed to explore, using a qualitative approach, how young women reported their experiences of masturbation and whether and how these related to other aspects of their sexual activity. Thematic analysis of interview transcripts was employed to identify the range of reported experiences across participants, as well as the relations between various aspects of sexual development and experiences within participants. The findings revealed a broad continuum of views and opinions on female masturbation, which had strong links with parent and partner communication and the young women's beliefs and values concerning their sexual selves. The article concludes by drawing attention to the apparent relation between positive early childhood communication, young women's positive views of their sexual self, and their subsequent sexual activity.

  20. Mitochondrial genomic variation associated with higher mitochondrial copy number: the Cache County Study on Memory Health and Aging

    PubMed Central

    2014-01-01

    Background The mitochondria are essential organelles and are the location of cellular respiration, which is responsible for the majority of ATP production. Each cell contains multiple mitochondria, and each mitochondrion contains multiple copies of its own circular genome. The ratio of mitochondrial genomes to nuclear genomes is referred to as mitochondrial copy number. Decreases in mitochondrial copy number are known to occur in many tissues as people age, and in certain diseases. The regulation of mitochondrial copy number by nuclear genes has been studied extensively. While mitochondrial variation has been associated with longevity and some of the diseases known to have reduced mitochondrial copy number, the role that the mitochondrial genome itself has in regulating mitochondrial copy number remains poorly understood. Results We analyzed the complete mitochondrial genomes from 1007 individuals randomly selected from the Cache County Study on Memory Health and Aging utilizing the inferred evolutionary history of the mitochondrial haplotypes present in our dataset to identify sequence variation and mitochondrial haplotypes associated with changes in mitochondrial copy number. Three variants belonging to mitochondrial haplogroups U5A1 and T2 were significantly associated with higher mitochondrial copy number in our dataset. Conclusions We identified three variants associated with higher mitochondrial copy number and suggest several hypotheses for how these variants influence mitochondrial copy number by interacting with known regulators of mitochondrial copy number. Our results are the first to report sequence variation in the mitochondrial genome that causes changes in mitochondrial copy number. The identification of these variants that increase mtDNA copy number has important implications in understanding the pathological processes that underlie these phenotypes. PMID:25077862

  1. Genetic Diversity and Association Studies in US Hispanic/Latino Populations: Applications in the Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Conomos, Matthew P.; Laurie, Cecelia A.; Stilp, Adrienne M.; Gogarten, Stephanie M.; McHugh, Caitlin P.; Nelson, Sarah C.; Sofer, Tamar; Fernández-Rhodes, Lindsay; Justice, Anne E.; Graff, Mariaelisa; Young, Kristin L.; Seyerle, Amanda A.; Avery, Christy L.; Taylor, Kent D.; Rotter, Jerome I.; Talavera, Gregory A.; Daviglus, Martha L.; Wassertheil-Smoller, Sylvia; Schneiderman, Neil; Heiss, Gerardo; Kaplan, Robert C.; Franceschini, Nora; Reiner, Alex P.; Shaffer, John R.; Barr, R. Graham; Kerr, Kathleen F.; Browning, Sharon R.; Browning, Brian L.; Weir, Bruce S.; Avilés-Santa, M. Larissa; Papanicolaou, George J.; Lumley, Thomas; Szpiro, Adam A.; North, Kari E.; Rice, Ken; Thornton, Timothy A.; Laurie, Cathy C.

    2016-01-01

    US Hispanic/Latino individuals are diverse in genetic ancestry, culture, and environmental exposures. Here, we characterized and controlled for this diversity in genome-wide association studies (GWASs) for the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We simultaneously estimated population-structure principal components (PCs) robust to familial relatedness and pairwise kinship coefficients (KCs) robust to population structure, admixture, and Hardy-Weinberg departures. The PCs revealed substantial genetic differentiation within and among six self-identified background groups (Cuban, Dominican, Puerto Rican, Mexican, and Central and South American). To control for variation among groups, we developed a multi-dimensional clustering method to define a “genetic-analysis group” variable that retains many properties of self-identified background while achieving substantially greater genetic homogeneity within groups and including participants with non-specific self-identification. In GWASs of 22 biomedical traits, we used a linear mixed model (LMM) including pairwise empirical KCs to account for familial relatedness, PCs for ancestry, and genetic-analysis groups for additional group-associated effects. Including the genetic-analysis group as a covariate accounted for significant trait variation in 8 of 22 traits, even after we fit 20 PCs. Additionally, genetic-analysis groups had significant heterogeneity of residual variance for 20 of 22 traits, and modeling this heteroscedasticity within the LMM reduced genomic inflation for 19 traits. Furthermore, fitting an LMM that utilized a genetic-analysis group rather than a self-identified background group achieved higher power to detect previously reported associations. We expect that the methods applied here will be useful in other studies with multiple ethnic groups, admixture, and relatedness. PMID:26748518

  2. Genetic Diversity and Association Studies in US Hispanic/Latino Populations: Applications in the Hispanic Community Health Study/Study of Latinos.

    PubMed

    Conomos, Matthew P; Laurie, Cecelia A; Stilp, Adrienne M; Gogarten, Stephanie M; McHugh, Caitlin P; Nelson, Sarah C; Sofer, Tamar; Fernández-Rhodes, Lindsay; Justice, Anne E; Graff, Mariaelisa; Young, Kristin L; Seyerle, Amanda A; Avery, Christy L; Taylor, Kent D; Rotter, Jerome I; Talavera, Gregory A; Daviglus, Martha L; Wassertheil-Smoller, Sylvia; Schneiderman, Neil; Heiss, Gerardo; Kaplan, Robert C; Franceschini, Nora; Reiner, Alex P; Shaffer, John R; Barr, R Graham; Kerr, Kathleen F; Browning, Sharon R; Browning, Brian L; Weir, Bruce S; Avilés-Santa, M Larissa; Papanicolaou, George J; Lumley, Thomas; Szpiro, Adam A; North, Kari E; Rice, Ken; Thornton, Timothy A; Laurie, Cathy C

    2016-01-07

    US Hispanic/Latino individuals are diverse in genetic ancestry, culture, and environmental exposures. Here, we characterized and controlled for this diversity in genome-wide association studies (GWASs) for the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We simultaneously estimated population-structure principal components (PCs) robust to familial relatedness and pairwise kinship coefficients (KCs) robust to population structure, admixture, and Hardy-Weinberg departures. The PCs revealed substantial genetic differentiation within and among six self-identified background groups (Cuban, Dominican, Puerto Rican, Mexican, and Central and South American). To control for variation among groups, we developed a multi-dimensional clustering method to define a "genetic-analysis group" variable that retains many properties of self-identified background while achieving substantially greater genetic homogeneity within groups and including participants with non-specific self-identification. In GWASs of 22 biomedical traits, we used a linear mixed model (LMM) including pairwise empirical KCs to account for familial relatedness, PCs for ancestry, and genetic-analysis groups for additional group-associated effects. Including the genetic-analysis group as a covariate accounted for significant trait variation in 8 of 22 traits, even after we fit 20 PCs. Additionally, genetic-analysis groups had significant heterogeneity of residual variance for 20 of 22 traits, and modeling this heteroscedasticity within the LMM reduced genomic inflation for 19 traits. Furthermore, fitting an LMM that utilized a genetic-analysis group rather than a self-identified background group achieved higher power to detect previously reported associations. We expect that the methods applied here will be useful in other studies with multiple ethnic groups, admixture, and relatedness.

  3. Epilepsy is associated with unmet health care needs compared to the general population despite higher health resource utilization--a Canadian population-based study.

    PubMed

    Reid, Aylin Y; Metcalfe, Amy; Patten, Scott B; Wiebe, Samuel; Macrodimitris, Sophie; Jetté, Nathalie

    2012-02-01

    (1) To determine whether health resource utilization (HRU) and unmet health care needs differ for individuals with epilepsy compared to the general population or to those with another chronic condition (asthma, diabetes, migraine); and (2) to assess the association among epilepsy status, sociodemographic variables and HRU. Data on HRU were assessed using the 2001-2005 Canadian Community Health Surveys, a nationally representative population-based survey. Weighted estimates of association were produced as adjusted odds ratio with 95% confidence intervals, and logistic regression was used to explore the association between sociodemographic variables and HRU in those with epilepsy. All data on disease status, HRU, and unmet health care needs were self-reported. Individuals with epilepsy had the highest rate of hospitalizations and the highest mean number of consultations with physicians. Despite higher rates of consultation with psychologists and social workers compared to the general population, those with epilepsy were significantly more likely to say they had unmet mental health care needs. People with epilepsy were also less likely to use dental services compared to the general population. Epilepsy was a significant predictor of HRU in logistic regression models. Given the prevalence of psychiatric comorbidities in those with epilepsy, it is concerning that this group perceives unmet mental health care needs. It is also troublesome that there was decreased utilization of dental health care resources in those with epilepsy considering that these patients are more likely to have poor oral health. Although individuals with epilepsy use more health care services than the general population, this increase appears to be insufficient to address their health care needs. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  4. Associations of Cigarette Smoking With Subclinical Inflammation and Atherosclerosis: ELSA-Brasil (The Brazilian Longitudinal Study of Adult Health).

    PubMed

    Kianoush, Sina; Yakoob, Mohammad Yawar; Al-Rifai, Mahmoud; DeFilippis, Andrew P; Bittencourt, Marcio S; Duncan, Bruce B; Bensenor, Isabela M; Bhatnagar, Aruni; Lotufo, Paulo A; Blaha, Michael J

    2017-06-24

    There is a need to identify sensitive biomarkers of early tobacco-related cardiovascular disease. We examined the association of smoking status, burden, time since quitting, and intensity, with markers of inflammation and subclinical atherosclerosis. We studied 14 103 participants without clinical cardiovascular disease in ELSA-Brasil (Brazilian Longitudinal Study of Adult Health). We evaluated baseline cross-sectional associations between smoking parameters and inflammation (high-sensitivity C-reactive protein [hsCRP]) and measures of subclinical atherosclerosis (carotid intima-media thickness, ankle-brachial index, and coronary artery calcium [CAC]). The cohort included 1844 current smokers, 4121 former smokers, and 8138 never smokers. Mean age was 51.7±8.9 years; 44.8% were male. After multivariable adjustment, compared with never smokers, current smokers had significantly higher levels of hsCRP (β=0.24, 0.19-0.29 mg/L; P<0.001) and carotid intima-media thickness (β=0.03, 0.02-0.04 mm; P<0.001) and odds of ankle-brachial index ≤1.0 (odds ratio: 2.52; 95% confidence interval, 2.06-3.08; P<0.001) and CAC >0 (odds ratio: 1.83; 95% confidence interval, 1.46-2.30; P<0.001). Among former and current smokers, pack-years of smoking (burden) were significantly associated with hsCRP (P<0.001 and P=0.006, respectively) and CAC (P<0.001 and P=0.002, respectively). Among former smokers, hsCRP and carotid intima-media thickness levels and odds of ankle-brachial index ≤1.0 and CAC >0 were lower with increasing time since quitting (P<0.01). Among current smokers, number of cigarettes per day (intensity) was positively associated with hsCRP (P<0.001) and CAC >0 (P=0.03) after adjusting for duration of smoking. Strong associations were observed between smoking status, burden, and intensity with inflammation (hsCRP) and subclinical atherosclerosis (carotid intima-media thickness, ankle-brachial index, CAC). These markers of early cardiovascular disease injury may be

  5. Genome-Wide Study of Percent Emphysema on Computed Tomography in the General Population. The Multi-Ethnic Study of Atherosclerosis Lung/SNP Health Association Resource Study

    PubMed Central

    Manichaikul, Ani; Hoffman, Eric A.; Smolonska, Joanna; Gao, Wei; Cho, Michael H.; Baumhauer, Heather; Budoff, Matthew; Austin, John H. M.; Washko, George R.; Carr, J. Jeffrey; Kaufman, Joel D.; Pottinger, Tess; Powell, Charles A.; Wijmenga, Cisca; Zanen, Pieter; Groen, Harry J. M.; Postma, Dirkje S.; Wanner, Adam; Rouhani, Farshid N.; Brantly, Mark L.; Powell, Rhea; Smith, Benjamin M.; Rabinowitz, Dan; Raffel, Leslie J.; Hinckley Stukovsky, Karen D.; Crapo, James D.; Beaty, Terri H.; Hokanson, John E.; Silverman, Edwin K.; Dupuis, Josée; O’Connor, George T.; Boezen, H. Marike; Rich, Stephen S.

    2014-01-01

    Rationale: Pulmonary emphysema overlaps partially with spirometrically defined chronic obstructive pulmonary disease and is heritable, with moderately high familial clustering. Objectives: To complete a genome-wide association study (GWAS) for the percentage of emphysema-like lung on computed tomography in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung/SNP Health Association Resource (SHARe) Study, a large, population-based cohort in the United States. Methods: We determined percent emphysema and upper-lower lobe ratio in emphysema defined by lung regions less than −950 HU on cardiac scans. Genetic analyses were reported combined across four race/ethnic groups: non-Hispanic white (n = 2,587), African American (n = 2,510), Hispanic (n = 2,113), and Chinese (n = 704) and stratified by race and ethnicity. Measurements and Main Results: Among 7,914 participants, we identified regions at genome-wide significance for percent emphysema in or near SNRPF (rs7957346; P = 2.2 × 10−8) and PPT2 (rs10947233; P = 3.2 × 10−8), both of which replicated in an additional 6,023 individuals of European ancestry. Both single-nucleotide polymorphisms were previously implicated as genes influencing lung function, and analyses including lung function revealed independent associations for percent emphysema. Among Hispanics, we identified a genetic locus for upper-lower lobe ratio near the α-mannosidase–related gene MAN2B1 (rs10411619; P = 1.1 × 10−9; minor allele frequency [MAF], 4.4%). Among Chinese, we identified single-nucleotide polymorphisms associated with upper-lower lobe ratio near DHX15 (rs7698250; P = 1.8 × 10−10; MAF, 2.7%) and MGAT5B (rs7221059; P = 2.7 × 10−8; MAF, 2.6%), which acts on α-linked mannose. Among African Americans, a locus near a third α-mannosidase–related gene, MAN1C1 (rs12130495; P = 9.9 × 10−6; MAF, 13.3%) was associated with percent emphysema. Conclusions: Our results suggest that some genes previously identified as

  6. Cohort study on clustering of lifestyle risk factors and understanding its association with stress on health and wellbeing among school teachers in Malaysia (CLUSTer)--a study protocol.

    PubMed

    Moy, Foong Ming; Hoe, Victor Chee Wai; Hairi, Noran Naqiah; Buckley, Brian; Wark, Petra A; Koh, David; Bueno-de-Mesquita, H Bas; Bulgiba, Awang M

    2014-06-17

    The study on Clustering of Lifestyle risk factors and Understanding its association with Stress on health and wellbeing among school Teachers in Malaysia (CLUSTer) is a prospective cohort study which aims to extensively study teachers in Malaysia with respect to clustering of lifestyle risk factors and stress, and subsequently, to follow-up the population for important health outcomes. This study is being conducted in six states within Peninsular Malaysia. From each state, schools from each district are randomly selected and invited to participate in the study. Once the schools agree to participate, all teachers who fulfilled the inclusion criteria are invited to participate. Data collection includes a questionnaire survey and health assessment. Information collected in the questionnaire includes socio-demographic characteristics, participants' medical history and family history of chronic diseases, teaching characteristics and burden, questions on smoking, alcohol consumption and physical activities (IPAQ); a food frequency questionnaire, the job content questionnaire (JCQ); depression, anxiety and stress scale (DASS21); health related quality of life (SF12-V2); Voice Handicap Index 10 on voice disorder, questions on chronic pain, sleep duration and obstetric history for female participants. Following blood drawn for predefined clinical tests, additional blood and urine specimens are collected and stored for future analysis. Active follow up of exposure and health outcomes will be carried out every two years via telephone or face to face contact. Data collection started in March 2013 and as of the end of March 2014 has been completed for four states: Kuala Lumpur, Selangor, Melaka and Penang. Approximately 6580 participants have been recruited. The first round of data collection and blood sampling is expected to be completed by the end of 2014 with an expected 10,000 participants recruited. Our study will provide a good basis for exploring the clustering of

  7. Discrimination in Healthcare Settings is Associated with Disability in Older Adults: Health and Retirement Study, 2008-2012.

    PubMed

    Rogers, Stephanie E; Thrasher, Angela D; Miao, Yinghui; Boscardin, W John; Smith, Alexander K

    2015-10-01

    As our society ages, improving medical care for an older population will be crucial. Discrimination in healthcare may contribute to substandard experiences with the healthcare system, increasing the burden of poor health in older adults. Few studies have focused on the presence of healthcare discrimination and its effects on older adults. We aimed to examine the relationship between healthcare discrimination and new or worsened disability. This was a longitudinal analysis of data from the nationally representative Health and Retirement Study administered in 2008 with follow-up through 2012. Six thousand and seventeen adults over the age of 50 years (mean age 67 years, 56.3 % female, 83.1 % white) were included in this study. Healthcare discrimination assessed by a 2008 report of receiving poorer service or treatment than other people by doctors or hospitals (never, less than a year=infrequent; more than once a year=frequent). Outcome was self-report of new or worsened disability by 2012 (difficulty or dependence in any of six activities of daily living). We used a Cox proportional hazards model adjusting for age, race/ethnicity, gender, net worth, education, depression, high blood pressure, diabetes, cancer, lung disease, heart disease, stroke, and healthcare utilization in the past 2 years. In all, 12.6 % experienced discrimination infrequently and 5.9 % frequently. Almost one-third of participants (29 %) reporting frequent healthcare discrimination developed new or worsened disability over 4 years, compared to 16.8 % of those who infrequently and 14.7 % of those who never experienced healthcare discrimination (p < 0.001). In multivariate analyses, compared to no discrimination, frequent healthcare discrimination was associated with new or worsened disability over 4 years (aHR = 1.63, 95 % CI 1.16-2.27). One out of five adults over the age of 50 years experiences discrimination in healthcare settings. One in 17 experience frequent healthcare discrimination

  8. Prevalence of Mental Health Problems and Factors Associated with Psychological Distress in Mountain Exercisers: A Cross-Sectional Study in Austria.

    PubMed

    Niedermeier, Martin; Hartl, Arnulf; Kopp, Martin

    2017-01-01

    Knowledge about potential protective factors against mental health problems is highly needed. Regular physical activity (PA) in an outdoor environment, like mountain exercising, might reduce psychological distress. Therefore, the aims of the present study were to assess the prevalence of mental health problems in mountain exercisers and to detect factors associated with psychological distress. In a cross-sectional design, we collected self-reported data of 1,536 Austrian mountain exercisers. The prevalence of mental health problems and psychological distress (Kessler Psychological Distress Scale), the level of PA International Physical Activity Questionnaire, and affective valence during PA (Feeling Scale) were obtained. Stepwise multiple linear regression analysis was conducted to assess factors influencing psychological distress. The prevalence of mental health problems in Austrian mountain exercisers was 14%. Health-enhancing PA level and higher affective valence during PA were significantly associated with lower psychological distress. Minimal PA level was not significantly associated with lower psychological distress compared to inactive PA level. Marital status, education, alpine association membership, and body mass index did not show a significant influence on psychological distress. The prevalence of mental health problems seems to be lower in Austrian mountain exercisers compared to the European population. A health-enhancing PA level and affective valence increasing forms of PA were shown to be associated with lower psychological distress. Results might lead to interventional studies focusing on the potential of outdoor PA, e.g., mountain exercise, as an adjunct treatment in people at risk or with mental health problems.

  9. Associations among health literacy, diabetes knowledge, and self-management behavior in adults with diabetes: results of a dutch cross-sectional study.

    PubMed

    van der Heide, Iris; Uiters, Ellen; Rademakers, Jany; Struijs, Jeroen N; Schuit, A Jantine; Baan, Caroline A

    2014-01-01

    Various studies have examined the association between health literacy and self-management behavior, but few have explored ways through which this occurs. The present study examines to what extent health literacy is associated with diabetes self-management behavior and to what extent diabetes knowledge is a mechanism in this association. The study was based on cross-sectional data retrieved from patient registrations and questionnaires completed in 2010. The sample included 1,714 predominantly type 2 diabetes patients, with a mean age of 67 years. Diabetes self-management was indicated by HbA1c level, glucose self-control and self-reported monitoring of glucose levels, physical activity, and smoking. Multilevel analyses were applied based on multiple imputed data. Lower health literacy was significantly associated with less diabetes knowledge, higher HbA1c level, less self-control of glucose level, and less physical activity. Participants with more diabetes knowledge were less likely to smoke and more likely to control glucose levels. Diabetes knowledge was a mediator in the association between health literacy and glucose self-control and between health literacy and smoking. This study indicates that higher health literacy may contribute to participation in certain self-management activities, in some cases through diabetes knowledge. Diabetes knowledge and health literacy skills may be important targets for interventions promoting diabetes self-management.

  10. Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionals.

    PubMed

    Ben-Arye, Eran; Samuels, Noah; Goldstein, Lee Hilary; Mutafoglu, Kamer; Omran, Suha; Schiff, Elad; Charalambous, Haris; Dweikat, Tahani; Ghrayeb, Ibtisam; Bar-Sela, Gil; Turker, Ibrahim; Hassan, Azza; Hassan, Esmat; Saad, Bashar; Nimri, Omar; Kebudi, Rejin; Silbermann, Michael

    2016-02-15

    The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects. Oncology HCPs from 16 Middle Eastern countries received a 17-item questionnaire asking them to list 5 herbal products in use by their patients with cancer. A literature search (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database) was conducted to identify safety-related concerns associated with the products listed. A total of 339 HCPs completed the study questionnaire (response rate of 80.3%), identifying 44 herbal and 3 nonherbal nutritional supplements. Safety-related concerns were associated with 29 products, including herb-drug interactions with altered pharmacodynamics (15 herbs), direct toxic effects (18 herbs), and increased in vitro response of cancer cells to chemotherapy (7 herbs). Herbal medicine use, which is prevalent in Middle Eastern countries, has several potentially negative effects that include direct toxic effects, negative interactions with anticancer drugs, and increased chemosensitivity of cancer cells, requiring a reduction in dose-density. Oncology HCPs working in countries in which herbal medicine use is prevalent need to better understand the implications of this practice. The presence of integrative physicians with training in complementary and traditional medicine can help patients and their HCPs reach an informed decision regarding the safety and effective use of these products. © 2015 American Cancer Society.

  11. Factors associated to clinical learning in nursing students in primary health care: an analytical cross-sectional study

    PubMed Central

    Serrano-Gallardo, Pilar; Martínez-Marcos, Mercedes; Espejo-Matorrales, Flora; Arakawa, Tiemi; Magnabosco, Gabriela Tavares; Pinto, Ione Carvalho

    2016-01-01

    ABSTRACT Objective: to identify the students' perception about the quality of clinical placements and asses the influence of the different tutoring processes in clinical learning. Methods: analytical cross-sectional study on second and third year nursing students (n=122) about clinical learning in primary health care. The Clinical Placement Evaluation Tool and a synthetic index of attitudes and skills were computed to give scores to the clinical learning (scale 0-10). Univariate, bivariate and multivariate (multiple linear regression) analyses were performed. Results: the response rate was 91.8%. The most commonly identified tutoring process was "preceptor-professor" (45.2%). The clinical placement was assessed as "optimal" by 55.1%, relationship with team-preceptor was considered good by 80.4% of the cases and the average grade for clinical learning was 7.89. The multiple linear regression model with more explanatory capacity included the variables "Academic year" (beta coefficient = 1.042 for third-year students), "Primary Health Care Area (PHC)" (beta coefficient = 0.308 for Area B) and "Clinical placement perception" (beta coefficient = - 0.204 for a suboptimal perception). Conclusions: timeframe within the academic program, location and clinical placement perception were associated with students' clinical learning. Students' perceptions of setting quality were positive and a good team-preceptor relationship is a matter of relevance. PMID:27627124

  12. Gender and psychosocial factors associated with healthy lifestyle in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort: a cross-sectional study.

    PubMed

    Patrão, Ana Luísa; Almeida, Maria da Conceição; Matos, Sheila Maria Alvim; Chor, Dora; Aquino, Estela M L

    2017-08-28

    It has been estimated that over 50% of the premature deaths occurring in Western countries can be attributed to causes rooted in lifestyle. In turn, leading a healthy lifestyle has also been associated with a wide range of psychosocial factors. Today, it is known that these differ among men and women. The present article aimed to identify, from a gender-based perspective, the psychosocial factors associated with healthy lifestyles in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort, the largest study concerning adult health conducted in Latin America to date. This cross-sectional study was conducted using ELSA-Brasil baseline data, collected between 2008 and 2010. Six Brazilian public higher education and research institutions. The ELSA-Brasil cohort consists of approximately 15 000 employees (8218 women and 6887 men), both currently working and retired. The lifestyle indicator was constructed by summing the scores attributed to four different behaviours. The women of the ELSA-Brasil cohort have healthier lifestyles than men. In women, strong associations were found between a healthy lifestyle and age 60 years or older, Asian race and university level of education or higher. In men, being 60 years or older, of Asian or Caucasian race, having a high-school equivalent level of education or higher, being retired, having a housekeeper, having a good or very good self-perception of health and being satisfied with body image were the psychosocial factors associated with leading a healthy lifestyle. The factors that influenced healthy lifestyles were found to differ among men and women, a fact that must be addressed when developing programmes designed to promote health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. The Association of Sleep Duration and Morbid Obesity in a Working Population: The Baptist Health South Florida Employee Study.

    PubMed

    Aziz, Muhammad; Osondu, Chukwuemeka U; Younus, Adnan; Malik, Rehan; Rouseff, Maribeth; Das, Sankalp; Guzman, Henry; Maziak, Wasim; Virani, Salim; Feldman, Theodore; Agatston, Arthur S; Veledar, Emir; Aneni, Ehimen C; Nasir, Khurram

    2017-03-01

    The current study aimed to determine the relationship between self-reported sleep duration and morbid obesity in an employee population. Baptist Health South Florida conducts an annual Health Risk Assessment (HRA) for its employees. Data for this cross-sectional study was collected via this HRA in 2014, and included information on self-reported sleep duration, height and weight for body mass index (BMI), and other biometric measures. Average sleep duration was categorized as short sleep (<6 hr), optimal sleep (6-7.9 hr), and long sleep duration (≥8 hr), while obesity status was categorized as nonobese (BMI <30 kg/m(2)), obese (30-34.9 kg/m(2)), and morbid obese (≥35 kg/m(2)). A total of 9505 participants (mean age 42.8 ± 12.1 years, 75% females, and 55% Hispanic) were included in this study. Prevalence of morbid obesity was about 24% among employees who were sleeping for less than 6 hr compared to 13% and 14% among those sleeping for 6-7.9 hours, and 8 or more hours respectively. In regression analyses, persons who slept less than 6 hr had almost twice the odds of morbid obesity compared to those who slept 6-7.9 hr (odds ratio = 1.8; 1.5-2.2). Our finding that short sleep duration (<6 hr) is significantly associated with a higher risk of morbid obesity should facilitate the development of workplace-based programs that focus on improving sleep among at-risk employees, especially those who work in shift duties to reduce the risk of morbid obesity and other comorbid conditions. Future studies are needed to further explore the relationship of sleep duration and morbid obesity in employee populations.

  14. The influence of mammogram acquisition on the mammographic density and breast cancer association in the mayo mammography health study cohort

    PubMed Central

    2012-01-01

    Introduction Mammographic density is a strong risk factor for breast cancer. Image acquisition technique varies across mammograms to limit radiation and produce a clinically useful image. We examined whether acquisition technique parameters at the time of mammography were associated with mammographic density and whether the acquisition parameters confounded the density and breast cancer association. Methods We examined this question within the Mayo Mammography Health Study (MMHS) cohort, comprised of 19,924 women (51.2% of eligible) seen in the Mayo Clinic mammography screening practice from 2003 to 2006. A case-cohort design, comprising 318 incident breast cancers diagnosed through December 2009 and a random subcohort of 2,259, was used to examine potential confounding of mammogram acquisition technique parameters (x-ray tube voltage peak (kVp), milliampere-seconds (mAs), thickness and compression force) on the density and breast cancer association. The Breast Imaging Reporting and Data System four-category tissue composition measure (BI-RADS) and percent density (PD) (Cumulus program) were estimated from screen-film mammograms at time of enrollment. Spearman correlation coefficients (r) and means (standard deviations) were used to examine the relationship of density measures with acquisition parameters. Hazard ratios (HR) and C-statistics were estimated using Cox proportional hazards regression, adjusting for age, menopausal status, body mass index and postmenopausal hormones. A change in the HR of at least 15% indicated confounding. Results Adjusted PD and BI-RADS density were associated with breast cancer (p-trends < 0.001), with a 3 to 4-fold increased risk in the extremely dense vs. fatty BI-RADS categories (HR: 3.0, 95% CI, 1.7 - 5.1) and the ≥ 25% vs. ≤ 5% PD categories (HR: 3.8, 95% CI, 2.5 - 5.9). Of the acquisition parameters, kVp was not correlated with PD (r = 0.04, p = 0.07). Although thickness (r = -0.27, p < 0.001), compression force (r = -0

  15. Association of Fetuin-A With Incident Fractures in Community-Dwelling Older Adults: The Cardiovascular Health Study.

    PubMed

    Fink, Howard A; Bůžková, Petra; Garimella, Pranav S; Mukamal, Kenneth J; Cauley, Jane A; Kizer, Jorge R; Barzilay, Joshua I; Jalal, Diana I; Ix, Joachim H

    2015-08-01

    Fetuin-A, a serum protein that regulates calcium mineralization, has been associated with bone mineral density (BMD) in several cross-sectional human studies, suggesting a possible beneficial effect on clinically important measures of bone health. Fetuin-A and incidence of subsequent fracture was assessed in 4714 men and women ≥65 years of age. Proportional hazards models were used to estimate risk of incident hip (hospital discharge ICD-9 codes) and composite fracture (hip, pelvis, humerus, or proximal forearm; hospital discharge ICD-9 codes and Medicare claims data). A total of 576 participants had an incident hip fracture (median follow-up 11.2 years) and 768 had an incident composite fracture (median follow-up 6.9 years). In unadjusted analyses, there was no association between fetuin-A (per SD increase) and risk of hip fracture (hazard ratio [HR], 0.96; 95% CI, 0.88 to 1.05) or composite fracture (HR, 0.99; 95% CI, 0.92 to 1.06). Results were not significantly changed after adjustment for potential confounding variables. Analyses modeling fetuin-A in quartiles or within a subset with available BMD measures also showed no statistically significant association with risk of hip or composite fracture. Though fetuin-A was positively associated with areal BMD in partially adjusted models (total hip: β, 0.013 g/cm(2) ; 95% CI, 0.005 to 0.021; femoral neck: β, 0.011 g/cm(2) ; 95% CI, 0.004 to 0.018; and lumbar spine: β, 0.007 g/cm(2) ; 95% CI, 0.001 to 0.028), these associations were no longer significant after further adjustment for BMI and in final multivariate models. In this large sample of community-dwelling older adults, a small positive association between fetuin-A and areal BMD appeared attributable to confounding variables and we found no evidence of an association between fetuin-A and risk of clinical fracture. © 2015 American Society for Bone and Mineral Research.

  16. The association of ideal cardiovascular health with incident type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis.

    PubMed

    Joseph, Joshua J; Echouffo-Tcheugui, Justin B; Carnethon, Mercedes R; Bertoni, Alain G; Shay, Christina M; Ahmed, Haitham M; Blumenthal, Roger S; Cushman, Mary; Golden, Sherita H

    2016-09-01

    Levels of ideal cardiovascular health (ICH) and incident type 2 diabetes mellitus have not been examined in a multiethnic population. We assessed the total and race/ethnicity-specific incidence of diabetes based on American Heart Association (AHA) ICH components. Incident diabetes was assessed among 5341 participants in the Multi-Ethnic Study of Atherosclerosis without prevalent diabetes between 2002 and 2012. ICH components (total cholesterol, BP, dietary intake, tobacco use, physical activity and BMI) were assessed at baseline and participants were categorised as having ideal, intermediate or poor cardiovascular health, as defined by the AHA 2020 impact goals. We developed a scoring system based on the number of ICH components (0-1 'poor', 2-3 'intermediate', and ≥4 'ideal'). HRs were calculated using Cox models. During a median follow-up of 11.1 years, we identified 587 cases of incident diabetes. After multivariable adjustment, participants with 2-3 and ≥4 ICH components vs 0-1 components had a 34% lower (HR 0.66; 95% CI 0.54, 0.80) and a 75% lower (HR 0.25; 95% CI 0.18, 0.35) diabetes incidence, respectively. There were significant differences by race/ethnicity: African-American and Hispanic-American participants with ≥4 ICH components had diabetes incidence rates per 1000 person-years of 5.6 (95% CI 3.1, 10.1) and 10.5 (95% CI 6.7, 16.4), respectively, compared with 2.2 (95% CI 1.3, 3.7) among non-Hispanic white Americans. Meeting an increasing number of AHA 2020 impact goals for dietary intake, physical activity, smoking, BP, cholesterol and BMI was associated with a dose-dependent lower risk of diabetes with significant variation by race/ethnicity.

  17. Pregnancy-Associated Risk Factors of Postpartum Breast Cancer in Korea: A Nationwide Health Insurance Database Study

    PubMed Central

    Kang, Eun Joo; Seo, Jae Hong; Kim, Log Young; Park, Geun U.; Oh, Min-Jeong; Park, Pyoung-Jae; Cho, Geum Joon

    2016-01-01

    Patients with postpartum breast cancer have been reported to have a poor prognosis. The present study aimed to evaluate the pregnancy-related risk factors of postpartum breast cancer in Korea. We collected patient data from the Korea National Health Insurance (KNHI) Claims Database of the Health Insurance Review and Assessment Service (HIRA) for the 2009–2013 period. We evaluated the pregnancy-related risk factors for postpartum breast cancer in two population groups. For Group 1 (women who had given birth during the 2010–2012 period), data on those who were diagnosed with breast cancer from childbirth to 1-year postpartum were extracted. For Group 2, we extracted the data of women who gave birth in 2010 and traced them until December 31, 2013. In Group 1, 1,384,551 deliveries and 317 postpartum breast cancer patients were recorded in Korea between January 1, 2010, and December 31, 2012. Women aged ≥35 years (Odds Ratio [OR], 2.003; 95% Confidence Interval [CI], 1.567–2.560) and those who gave birth via cesarean delivery (OR, 1.237; 95% CI, 0.986–1.553) were considered to be at a higher risk for breast cancer. Lower risk was noted in primiparous women (OR, 0.737; 95% CI, 0.585–0.928). In Group 2, the data of 457,924 women who gave birth in 2010 were traced until December 31, 2013. Among them, 655 patients were diagnosed with breast cancer, and age ≥35 years and cesarean delivery were associated with an higher risk of breast cancer, whereas primiparous status was associated with a lower risk of breast cancer. In conclusion, older age (≥35 years) and cesarean delivery are significant risk factors for postpartum breast cancer, and primiparous women have a lower risk of developing postpartum breast cancer. PMID:27977789

  18. The association of ideal cardiovascular health with incident type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis

    PubMed Central

    Joseph, Joshua J.; Echouffo Tcheugui, Justin B.; Carnethon, Mercedes R.; Bertoni, Alain G.; Shay, Christina M.; Ahmed, Haitham M.; Blumenthal, Roger S.; Cushman, Mary; Golden, Sherita H.

    2016-01-01

    Aims/hypothesis Levels of ideal cardiovascular health (ICH) and incident type 2 diabetes mellitus have not been examined in a multiethnic population. We assessed the total and race/ethnicity-specific incidence of diabetes based on American Heart Association (AHA) ICH components. Methods Incident diabetes was assessed among 5,341 participants in the Multi-Ethnic Study of Atherosclerosis without prevalent diabetes between 2002 and 2012. ICH components (total cholesterol, BP, dietary intake, tobacco use, physical activity and BMI) were assessed at baseline and participants were categorised as having ideal, intermediate or poor cardiovascular health, as defined by the AHA 2020 impact goals. We developed a scoring system based on the number of ICH components (0–1 ‘poor’, 2–3 ‘intermediate’, and ≥4 ‘ideal’). HRs were calculated using Cox models. Results During a median follow-up of 11.1 years, we identified 587 cases of incident diabetes. After multivariable adjustment, participants with 2-3 and ≥4 ICH components vs 0-1 components had a 34% lower (HR 0.66; 95% CI 0.54, 0.80) and a 75% lower (HR 0.25; 95% CI 0.18, 0.35) diabetes incidence, respectively. There were significant differences by race/ethnicity: African-American and Hispanic-American participants with ≥4 ICH components had diabetes incidence rates per 1,000 person-years of 5.6 (95% CI 3.1, 10.1) and 10.5 (95% CI 6.7, 16.4), respectively, compared with 2.2 (95% CI 1.3, 3.7) among non-Hispanic white Americans. Conclusions/interpretation Meeting an increasing number of AHA 2020 impact goals for dietary intake, physical activity, smoking, BP, cholesterol and BMI was associated with a dose-dependent lower risk of diabetes with significant variation by race/ethnicity. PMID:27272340

  19. Does a parental history of cancer moderate the associations between impaired health status in parents and psychosocial problems in teenagers: a HUNT study.

    PubMed

    Jeppesen, Elisabeth; Bjelland, Ingvar; Fosså, Sophie D; Loge, Jon H; Sørebø, Oystein; Dahl, Alv A

    2014-08-01

    Severe disease in a parent is associated with increased psychosocial problems in their children. However, moderating factors of such associations are less studied. In this cross-sectional population-based controlled study we examined the moderating effects of a history of parental cancer on the association between impaired health status in parents and psychosocial problems among their teenagers. Among families with both parents responding to the adult Health Survey of Nord-Trøndelag County of Norway (the HUNT-2 study) 71 couples were identified with primary invasive cancer in one parent. Their 81 teenage children took part in the Young-HUNT study. These families were compared to 322 cancer-free families with 328 teenagers. Based on self-report data the relations between three variables of parental impaired health and six psychosocial problems in teenagers were analyzed family wise by structural equation modeling. Significant associations between parental and teenagers' variables were observed in eight of 18 models. A history of parental cancer was a significant moderator which decreased four of eight significant associations. Such a history significantly weakened the associations between parental poor self-rated health and teenagers' anxiety/depression and school problems. A similar association of a history of parental cancer was found between psychological distress in parents and teenagers' feelings of loneliness and poor self-rated health. This study confirmed strong associations between impaired parental health and psychosocial problems in their teenagers. A history of parental cancer weakened several of the significant associations between parental impaired health variables and psychosocial problems in their teenagers.

  20. Does a parental history of cancer moderate the associations between impaired health status in parents and psychosocial problems in teenagers: a HUNT study

    PubMed Central

    Jeppesen, Elisabeth; Bjelland, Ingvar; Fosså, Sophie D; Loge, Jon H; Sørebø, Øystein; Dahl, Alv A

    2014-01-01

    Severe disease in a parent is associated with increased psychosocial problems in their children. However, moderating factors of such associations are less studied. In this cross-sectional population-based controlled study we examined the moderating effects of a history of parental cancer on the association between impaired health status in parents and psychosocial problems among their teenagers. Among families with both parents responding to the adult Health Survey of Nord-Trøndelag County of Norway (the HUNT-2 study) 71 couples were identified with primary invasive cancer in one parent. Their 81 teenage children took part in the Young-HUNT study. These families were compared to 322 cancer-free families with 328 teenagers. Based on self-report data the relations between three variables of parental impaired health and six psychosocial problems in teenagers were analyzed family wise by structural equation modeling. Significant associations between parental and teenagers' variables were observed in eight of 18 models. A history of parental cancer was a significant moderator which decreased four of eight significant associations. Such a history significantly weakened the associations between parental poor self-rated health and teenagers' anxiety/depression and school problems. A similar association of a history of parental cancer was found between psychological distress in parents and teenagers' feelings of loneliness and poor self-rated health. This study confirmed strong associations between impaired parental health and psychosocial problems in their teenagers. A history of parental cancer weakened several of the significant associations between parental impaired health variables and psychosocial problems in their teenagers. PMID:24723456

  1. Factors associated with free adult preventive health care utilization among physically disabled people in Taiwan: nationwide population-based study.

    PubMed

    Yen, Suh-May; Kung, Pei-Tseng; Tsai, Wen-Chen

    2014-12-05

    Few previous studies have specifically addressed the health care utilization situation of the physically disabled. This study aimed to investigate the utilization of free adult preventive health care for physically disabled people and its' affecting factors. The data was obtained from three nationwide databases from 2006 to 2008. This study comprised 329,264 physically disabled people in Taiwan above the age of 40 who had eligible health checks during 2008. We employed descriptive statistics to analyze the use and rate of free preventive health care use by physically disabled adults. Logistic regression analysis was used to explore the factors that affect physically disabled adults' use of free adult preventive health care. 16.37% of the physically disabled adults used free adult preventive health care. Women (17.66%), married (17.16%), a junior high education level (17.89%), and mildly disabled adults (18.77%) had the highest use rate among various participant subgroups. The variables that significantly influenced the use of free adult preventive health care by the physically disabled included gender, age, education, marital status, urbanization of the residence areas, monthly payroll, aboriginal status, catastrophic illnesses status, relevant chronic diseases, and severity of disability. Physically disabled using preventive health care tend to be low. Governments should use the media to reinforce propagation and education of these services to specific, low-utilization groups, and encourage doctors to actively provide preventive health care to communities.

  2. Digital technologies for population health and health equity gains: the perspective of public health associations.

    PubMed

    Chauvin, James; Perera, Yoshith; Clarke, Michael

    2016-11-01

    Digital technology (DT) plays an increasingly important role in the health sector. This study explores how national public health associations (PHAs) use DT to achieve their mandate. The World Federation of Public Health Associations canvassed and conducted a semi-structured interview with its national public health association members about their use of DT, the challenges they encounter in using it, and their experiences and thoughts as to how to assess its impact, both organizationally as well as on population health and health equity. The study found that digital technology plays an important role in some PHAs, principally those in higher income countries. PHAs want to broaden their use within PHAs and to assess how DT enables PHAs to achieve their organizational mandates and goals, including improved public health and health equity.

  3. Poor housing conditions in association with child health in a disadvantaged immigrant population: a cross-sectional study in Rosengård, Malmö, Sweden

    PubMed Central

    Richter, Jens C; Taj, Tahir; Al-nahar, Lina; Jakobsson, Kristina

    2016-01-01

    Objectives To describe the home environment in terms of housing conditions and their association with child health in a disadvantaged immigrant population. Design A cross-sectional observational study. Setting Enrolment took place during 2010–2011 in Rosengård, Malmö, Sweden. Participants Children aged 0–13 years in 2 study neighbourhoods were recruited from local health records and from schools. 359 children participated, with a participation rate of 40%. Data on health, lifestyle and apartment characteristics from questionnaire-led interviews with the mothers of the children were obtained together with data from home inspections carried out by trained health communicators. Outcome measures Logistic regression analysis was used to estimate ORs for various health outcomes, adjusted for demographic information and lifestyle factors. Results The housing conditions were very poor, especially in one of the study neighbourhoods where 67% of the apartments had been sanitised of cockroaches, 27% were infested with cockroaches and 40% had a visible mould. The association between housing conditions and health was mostly inconclusive, but there were statistically significant associations between current asthma and dampness (OR=4.1, 95% CI 1.7 to 9.9), between asthma medication and dampness (OR=2.8, 95% CI 1.2 to 6.4), and between mould and headache (OR=4.2, 95% CI 1.2 to 14.8). The presence of cockroaches was associated with emergency care visits, with colds, with headache and with difficulty falling asleep, and worse general health was associated with mould and presence of cockroaches. Conclusions The associations between dampness and asthma, and the association between mould and headache, are in line with current knowledge. The presence of cockroaches seemed to be associated with various outcomes, including those related to mental well-being, which is less described in the literature. The results of the present study are hypothesis generating and provide strong

  4. Dietary Patterns Are Associated with Disease Risk among Participants in the Women’s Health Initiative Observational Study123

    PubMed Central

    Van Horn, Linda; Tian, Lu; Neuhouser, Marian L.; Howard, Barbara V.; Eaton, Charles B.; Snetselaar, Linda; Matthan, Nirupa R.; Lichtenstein, Alice H.

    2012-01-01

    Coronary heart disease (CHD) is the leading cause of death in women. A nested case-control study tested whether dietary patterns predicted CHD events among 1224 participants in the Women’s Health Initiative-Observational Study (WHI-OS) with centrally confirmed CHD, fatal or nonfatal myocardial infarct compared to 1224 WHI-OS controls matched for age, enrollment date, race/ethnicity, and absence of CHD at baseline or follow-up. The first six principal components explained >75% of variation in dietary intakes and K-mean analysis based on these six components produced three clusters. Diet cluster 1 was rich in carbohydrate, vegetable protein, fiber, dietary vitamin K, folate, carotenoids, α-linolenic acid [18:3(n-3)], linoleic acid [18:2(n-6)], and supplemental calcium and vitamin D. Diet cluster 2 was rich in total and animal protein, arachidonic acid [20:4(n-6)], DHA [22:6(n-3)], vitamin D, and calcium. Diet cluster 3 was rich in energy, total fat, and trans fatty acids (all P < 0.01). Conditional logistic regression analysis demonstrated diet cluster 1 was associated with lower CHD risk than diet cluster 2 (reference group) adjusted for smoking, education, and physical activity [OR = 0.79 (95% CI = 0.64, 0.99); P = 0.038]. This difference was not significant after adjustment for BMI and systolic blood pressure. Diet cluster 3 was associated with higher CHD risk than diet cluster 2 [OR = 1.28 (95% CI = 1.04, 1.57); P = 0.019], but this difference did not remain significant after adjustment for smoking, education, and physical activity. Within this WHI-OS cohort, distinct dietary patterns may be associated with subsequent CHD outcomes. PMID:22190026

  5. A cross-sectional study about associations between personality characteristics and mental health service utilization in a Korean national community sample of adults with psychiatric disorders.

    PubMed

    Park, Subin; Lee, Yeeun; Seong, Su Jeong; Chang, Sung Man; Lee, Jun Young; Hahm, Bong Jin; Hong, Jin Pyo

    2017-05-05

    Personality traits are not only associated with psychiatric symptoms, but also with treatment seeking behavior. Our purpose was to examine the relationship between mental health service utilization and personality characteristics in a nationwide community sample of Korean adults. Of the 6022 subjects aged 18-74 years who participated in the Korean Epidemiologic Catchment Area study, 1544 (25.6%) with a lifetime diagnosis of any DSM-IV psychiatric disorder were analyzed. Diagnostic assessments were based on the Composite International Diagnostic Interview and personality constructs were measured by Big Five Personality Inventory-10. Of the 1544 participants, 275 (17.8%) had used mental health services. Multivariate analyses revealed positive associations between mental health service utilization and both neuroticism and openness, and an inverse association between mental health service utilization and agreeableness. These findings suggest that specific personality traits may have a role in treatment-seeking behaviors for mental health problems independent of the psychiatric disorder.

  6. Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study

    PubMed Central

    Kim, Daniel; Griffin, Beth Ann; Kabeto, Mohammed; Escarce, José; Langa, Kenneth M.; Shih, Regina A.

    2016-01-01

    Purpose Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function. Methods In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8–20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors. Results Higher MSA-level income inequality predicted lower cognitive function 16–18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (β = -0.86; 95% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods. Conclusions Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States. PMID:27332986

  7. Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.

    PubMed

    Kim, Daniel; Griffin, Beth Ann; Kabeto, Mohammed; Escarce, José; Langa, Kenneth M; Shih, Regina A

    2016-01-01

    Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function. In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8-20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors. Higher MSA-level income inequality predicted lower cognitive function 16-18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (β = -0.86; 95% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods. Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States.

  8. Health effects associated with waterpipe smoking

    PubMed Central

    El-Zaatari, Ziad M; Chami, Hassan A; Zaatari, Ghazi S

    2015-01-01

    Objective It is widely held that waterpipe smoking (WPS) is not associated with health hazards. However, several studies have documented the uptake of several toxicants and carcinogens during WPS that is strongly associated with harmful health effects. This paper reviews the literature on the health effects of WPS. Data sources Three databases-PubMed, MEDLINE and EMBASE-were searched until August 2014 for the acute and long-term health effects of WPS using the terms ‘waterpipe’ and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings. Study selection We included original clinical studies, case reports and systematic reviews and focused on clinical human studies. ∼10% of the identified studies met the selection criteria. Data extraction Data were abstracted by all three authors and summarised into tables. Abstracted data included study type, results and methodological limitations and were analysed jointly by all three authors. Data synthesis WPS acutely leads to increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious complications of long-term use. Lung, gastric and oesophageal cancer are associated with WPS as well as periodontal disease, obstetrical complications, osteoporosis and mental health problems. Conclusions Contrary to the widely held misconception, WPS is associated with a variety of adverse short-term and long-term health effects that should reinforce the need for stronger regulation. In addition, this review highlights the limitations of the published work, which is mostly cross-sectional or retrospective. Prospective studies should be undertaken to assess the full spectrum of health effects of WPS, particularly in view of its growing popularity and attractiveness to youth. PMID:25661414

  9. Associating Pregnancy Intent with Pregnancy: Prospective Findings from the Central Pennsylvania Women’s Health Study (CePAWHS)

    PubMed Central

    Chuang, Cynthia H.; Weisman, Carol S.; Hillemeier, Marianne M.; Camacho, Fabian T.; Dyer, Anne-Marie

    2009-01-01

    Objective We examined whether adult women’s intention for future pregnancy predicted actual pregnancies occurring in a 2-year follow-up study. Methods Data are from the Central Pennsylvania Women’s Health Study population-based longitudinal survey of women ages 18–45 (n=1,420). The analytic sample consists of 889 non-pregnant women who had reproductive capacity. Intention for future pregnancy was ascertained at baseline, and women were re-interviewed 2 years later to document interval pregnancies. The impact of pregnancy intention on subsequent pregnancy was analyzed using multiple logistic regression adjusting for relevant covariates. Results At baseline, 46% of women were considering a future pregnancy. One hundred thirty-seven women became pregnant during the 2-year study; of these pregnancies, 83% were intended (occurring in women considering a future pregnancy at baseline) and 17% were unintended (occurring in women not considering a future pregnancy at baseline). Pregnancies occurred in 28% of women who at baseline were considering future pregnancy and 5% of women not considering pregnancy. In adjusted analysis, baseline pregnancy intention was associated with pregnancy occurrence in women ages 25–34 (adjusted OR 4.19, 95% CI 2.20–7.97) and ages 35–45 (adjusted OR 26.89, 95% CI 9.05–79.93), but not in women ages 18–24. Conclusions In this prospective study, pregnancy intention was strongly associated with pregnancy incidence over a 2-year follow-up period among women ages 25 and older, suggesting that pregnancy intentions could be used to identify women at higher risk of pregnancy. Future investigation is needed to confirm these findings and to explore the reasons why pregnancy intentions were not predictive for women ages 18–24. PMID:19447320

  10. Genome-wide association study of red blood cell traits in Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

    PubMed Central

    Morrison, Jean V.; Brown, Lisa; Schurmann, Claudia; Chen, Diane D.; Liu, Yong Mei; Auer, Paul L.; Taylor, Kent D.; Papanicolaou, George; Kurita, Ryo; Nakamura, Yukio; Loos, Ruth J. F.; North, Kari E.; Thornton, Timothy A.; Pankratz, Nathan; Bauer, Daniel E.

    2017-01-01

    Prior GWAS have identified loci associated with red blood cell (RBC) traits in populations of European, African, and Asian ancestry. These studies have not included individuals with an Amerindian ancestral background, such as Hispanics/Latinos, nor evaluated the full spectrum of genomic variation beyond single nucleotide variants. Using a custom genotyping array enriched for Amerindian ancestral content and 1000 Genomes imputation, we performed GWAS in 12,502 participants of Hispanic Community Health Study and Study of Latinos (HCHS/SOL) for hematocrit, hemoglobin, RBC count, RBC distribution width (RDW), and RBC indices. Approximately 60% of previously reported RBC trait loci generalized to HCHS/SOL Hispanics/Latinos, including African ancestral alpha- and beta-globin gene variants. In addition to the known 3.8kb alpha-globin copy number variant, we identified an Amerindian ancestral association in an alpha-globin regulatory region on chromosome 16p13.3 for mean corpuscular volume and mean corpuscular hemoglobin. We also discovered and replicated three genome-wide significant variants in previously unreported loci for RDW (SLC12A2 rs17764730, PSMB5 rs941718), and hematocrit (PROX1 rs3754140). Among the proxy variants at the SLC12A2 locus we identified rs3812049, located in a bi-directional promoter between SLC12A2 (which encodes a red cell membrane ion-transport protein) and an upstream anti-sense long-noncoding RNA, LINC01184, as the likely causal variant. We further demonstrate that disruption of the regulatory element harboring rs3812049 affects transcription of SLC12A2 and LINC01184 in human erythroid progenitor cells. Together, these results reinforce the importance of genetic study of diverse ancestral populations, in particular Hispanics/Latinos. PMID:28453575

  11. Matrix Metalloproteinase Genes Are Associated with Breast Cancer Risk and Survival: The Breast Cancer Health Disparities Study

    PubMed Central

    Slattery, Martha L.; John, Esther; Torres-Mejia, Gabriela; Stern, Mariana; Lundgreen, Abbie; Hines, Lisa; Giuliano, Anna; Baumgartner, Kathy; Herrick, Jennifer; Wolff, Roger K.

    2013-01-01

    Matrix metalloproteinases (MMPs) contribute to cancer through their involvement in cancer invasion and metastasis. We evaluated genetic variation in MMP1 (9 SNPs), MMP2 (8 SNPs), MMP3 (4 SNPs), and MMP9 (3 SNPs) and breast cancer risk among Hispanic (2111 cases, 2597 controls) and non-Hispanic white (NHW) (1481 cases, 1586 controls) women in the Breast Cancer Health Disparities Study. Ancestral informative markers (n = 104) were assessed to determine Native American (NA) ancestry. MMP1 [4 single nucleotide polymorphisms (SNPs)] and MMP2 (2 SNPs) were associated with breast cancer overall. MMP1 rs996999 had strongest associations among women with the most NA ancestry (OR 1.61,95% CI 1.09,2.40) as did MMP3 rs650108 (OR 1.36, 95% CI 1.05,1.75) and MMP9 rs3787268 (OR 1.52, 95% CI 1.09,2.13). The adaptive rank truncated product (ARTP) showed a significant pathway partp value of 0.04, with a stronger association among women with the most NA ancestry (partp = 0.02). Significant pathway genes using the ARTP were MMP1 for all women (partp = 0.02) and MMP9 for women with the most NA ancestry (partp = 0.024); MMP2 was borderline significant overall (partp = 0.06) and MMP1 and MMP3 were borderline significant for women with the most NA ancestry (partp = 0.07 and 0.06 respectively). MMP1 and MMP2 were associated with ER+/PR+ and ER+/PR-tumors; MMP3 and MMP9 were associated with ER−/PR− tumors. The pathway was highly significant with survival (partp = 0.0041) with MMP2 having the strongest gene association (partp = 0.0007). Our findings suggest that genetic variation in MMP genes influence breast cancer development and survival in this genetically admixed population. PMID:23696797

  12. Matrix metalloproteinase genes are associated with breast cancer risk and survival: the Breast Cancer Health Disparities Study.

    PubMed

    Slattery, Martha L; John, Esther; Torres-Mejia, Gabriela; Stern, Mariana; Lundgreen, Abbie; Hines, Lisa; Giuliano, Anna; Baumgartner, Kathy; Herrick, Jennifer; Wolff, Roger K

    2013-01-01

    Matrix metalloproteinases (MMPs) contribute to cancer through their involvement in cancer invasion and metastasis. We evaluated genetic variation in MMP1 (9 SNPs), MMP2 (8 SNPs), MMP3 (4 SNPs), and MMP9 (3 SNPs) and breast cancer risk among Hispanic (2111 cases, 2597 controls) and non-Hispanic white (NHW) (1481 cases, 1586 controls) women in the Breast Cancer Health Disparities Study. Ancestral informative markers (n = 104) were assessed to determine Native American (NA) ancestry. MMP1 [4 single nucleotide polymorphisms (SNPs)] and MMP2 (2 SNPs) were associated with breast cancer overall. MMP1 rs996999 had strongest associations among women with the most NA ancestry (OR 1.61,95% CI 1.09,2.40) as did MMP3 rs650108 (OR 1.36, 95% CI 1.05,1.75) and MMP9 rs3787268 (OR 1.52, 95% CI 1.09,2.13). The adaptive rank truncated product (ARTP) showed a significant pathway p(artp)  value of 0.04, with a stronger association among women with the most NA ancestry (p(artp) = 0.02). Significant pathway genes using the ARTP were MMP1 for all women (p(artp) = 0.02) and MMP9 for women with the most NA ancestry (p(artp) = 0.024); MMP2 was borderline significant overall (p(artp) =0.06) and MMP1 and MMP3 were borderline significant for women with the most NA ancestry (p(artp) = 0.07 and 0.06 respectively). MMP1 and MMP2 were associated with ER+/PR+ and ER+/PR-tumors; MMP3 and MMP9 were associated with ER-/PR- tumors. The pathway was highly significant with survival (p(artp) = 0.0041) with MMP2 having the strongest gene association (p(artp) = 0.0007). Our findings suggest that genetic variation in MMP genes influence breast cancer development and survival in this genetically admixed population.

  13. Association between arsenic exposure from drinking water and hematuria: Results from the Health Effects of Arsenic Longitudinal Study

    SciTech Connect

    McClintock, Tyler R.; Chen, Yu; Parvez, Faruque; Makarov, Danil V.; Ge, Wenzhen; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam; Slavkovich, Vesna; Bjurlin, Marc A.; Graziano, Joseph H.; and others

    2014-04-01

    Arsenic (As) exposure has been associated with both urologic malignancy and renal dysfunction; however, its association with hematuria is unknown. We evaluated the association between drinking water As exposure and hematuria in 7843 men enrolled in the Health Effects of Arsenic Longitudinal Study (HEALS). Cross-sectional analysis of baseline data was conducted with As exposure assessed in both well water and urinary As measurements, while hematuria was measured using urine dipstick. Prospective analyses with Cox proportional regression models were based on urinary As and dipstick measurements obtained biannually since baseline up to six years. At baseline, urinary As was significantly related to prevalence of hematuria (P-trend < 0.01), with increasing quintiles of exposure corresponding with respective prevalence odds ratios of 1.00 (reference), 1.29 (95% CI: 1.04–1.59), 1.41 (95% CI: 1.15–1.74), 1.46 (95% CI: 1.19–1.79), and 1.56 (95% CI: 1.27–1.91). Compared to those with relatively little absolute urinary As change during follow-up (− 10.40 to 41.17 μg/l), hazard ratios for hematuria were 0.99 (95% CI: 0.80–1.22) and 0.80 (95% CI: 0.65–0.99) for those whose urinary As decreased by > 47.49 μg/l and 10.87 to 47.49 μg/l since last visit, respectively, and 1.17 (95% CI: 0.94–1.45) and 1.36 (95% CI: 1.10–1.66) for those with between-visit increases of 10.40 to 41.17 μg/l and > 41.17 μg/l, respectively. These data indicate a positive association of As exposure with both prevalence and incidence of dipstick hematuria. This exposure effect appears modifiable by relatively short-term changes in drinking water As. - Highlights: • Hematuria is the most common symptom of urinary tract disease. • Arsenic exposure is associated with renal dysfunction and urologic malignancy. • Water arsenic was positively associated with prevalence and incidence of hematuria. • Reduction in exposure lowered hematuria risk especially in low-to-moderate exposed

  14. Pesticides and other agricultural factors associated with self-reported farmer's lung among farm residents in the Agricultural Health Study.

    PubMed

    Hoppin, Jane A; Umbach, David M; Kullman, Greg J; Henneberger, Paul K; London, Stephanie J; Alavanja, Michael C R; Sandler, Dale P

    2007-05-01

    Farmer's lung, or hypersensitivity pneumonitis, is an important contributor to respiratory morbidity among farmers. Using the 1993-7 enrolment data from the Agricultural Health Study, we conducted a cross-sectional study of occupational risk factors for farmer's lung among 50,000 farmers and farm spouses in Iowa and North Carolina using hierarchical logistic regression controlling for age, state, and smoking status. Participants provided information on agricultural exposures, demographic characteristics, and medical history via self-administered questionnaires. Approximately 2% of farmers (n = 481) and 0.2% of spouses (n = 51) reported doctor-diagnosed farmer's lung during their lifetime. We assessed farmers and spouses separately due to different information on occupational exposure history. Only pesticide exposures represented lifetime exposure history, all other farm exposures represented current activities at enrolment. Among farmers, handling silage (OR = 1.41, 95% CI 1.10 to 1.82), high pesticide exposure events (OR = 1.75, 95% CI 1.39 to 2.21), and ever use of organochlorine (OR = 1.34, 95% CI 1.04 to 1.74) and carbamate pesticides (OR = 1.32, 95% CI 1.03 to 1.68) were associated with farmer's lung in mutually-adjusted models. The insecticides DDT, lindane, and aldicarb were positively associated with farmer's lung among farmers. Current animal exposures, while not statistically significant, were positively associated with farmer's lung, particularly for poultry houses (OR = 1.55, 95% CI 0.93 to 2.58) and dairy cattle (OR = 1.28, 95% CI 0.86 to 1.89). The occupational data were more limited for spouses; however, we saw similar associations for dairy cattle (OR = 1.50, 95% CI 0.72 to 3.14) and organochlorine pesticides (OR = 1.29, 95% CI 0.64 to 2.59). While historic farm exposures may contribute to the observed associations with pesticides, these results suggest that organochlorine and carbamate pesticides should be further evaluated as potential risk

  15. Association between comprehensive health literacy and frailty level in community-dwelling older adults: A cross-sectional study in Japan.

    PubMed

    Shirooka, Hidehiko; Nishiguchi, Shu; Fukutani, Naoto; Adachi, Daiki; Tashiro, Yuto; Hotta, Takayuki; Morino, Saori; Nozaki, Yuma; Hirata, Hinako; Yamaguchi, Moe; Aoyama, Tomoki

    2017-05-01

    The present study explored the association between comprehensive health literacy and frailty level in community-dwelling older adults in Japan. This was a cross-sectional study. We enrolled 517 community-dwelling older adults (mean age 73.2 ± 6.3 years; 410 women). We divided the cohort into two groups, non-frail and any-frail, based on Fried Frailty Index scores. We assessed comprehensive health literacy using a 14-item health literacy scale, and classified the participants as having high or low health literacy. We carried out multivariate logistic regression analysis in which the dependent variable was the presence of non-frailty and the independent variable was the presence of high health literacy. The analysis was adjusted for age, sex, body mass index, educational history and cognitive function. There were 132 (25.5%) and 385 (74.5%) participants in the non-frail and any-frail groups, respectively. The analysis showed that high health literacy was independently associated with the non-frail group (odds ratio 1.64, 95% confidence interval 1.03-2.61). The results showed that high health literacy was associated with non-frailty. This result implies that comprehensive health literacy might play a salient role in maintaining good health status in community-dwelling older adults in Japan. Geriatr Gerontol Int 2017; 17: 804-809. © 2016 Japan Geriatrics Society.

  16. Association between dental pain and tooth loss with health-related quality of life: the Korea national health and nutrition examination survey: A population-based cohort study.

    PubMed

    Yang, Sung-Eun; Park, Yong-Gyu; Han, Kyungdo; Kim, Sin-Young

    2016-08-01

    Dental pain and tooth loss are global public health concerns. However, there have been no large cross-sectional epidemiologic studies of a representative sample of an entire country's populations. The purpose of this study was to evaluate the relationships between dental pain and tooth loss with health-related quality of life (HRQOL) using a well characterized, nationally representative, population-based study.This study analyzed data of 3924, representing 21,836,566 adults from the 2012 Korea National Health and Nutrition Examination Survey. Subjects were divided into 4 groups as follows: tooth loss of up to 8 teeth without dental pain, tooth loss of up to 8 teeth with dental pain, tooth loss of 8 to 28 teeth without dental pain, and tooth loss of 8 to 28 teeth with dental pain. Logistic regression was applied to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CI), controlling for a range of covariates.Among the 3924 subjects, representing an estimated 21,836,566 adults, the prevalence of tooth loss of 8 to 28 teeth was 24.6% and the prevalence of dental pain was 35%. The tooth loss of 8 to 28 teeth with dental pain group showed the highest level of impaired HRQOL in all 5 dimensions, and the tooth loss up to 8 teeth without dental pain group showed the lowest level. The proportion of both groups without dental pain decreased significantly from the younger age to older age group. After adjustment for sociodemographic factors, the ORs (95% CI) of mobility, self-case, usual activity, pain/discomfort, and anxiety/depression were 1.93 (1.32-2.84), 1.90 (1.25-2.90), 1.46 (0.88-2.43), 1.48 (0.88-2.49), and 1.46 (0.85-2.51) in tooth loss of 8 to 28 teeth with dental pain group. Although the ORs of tooth loss of 8 to 28 teeth without dental pain group did not significantly increase.Dental pain and tooth loss has a considerable impact of HRQOL in the Korean adult population. In our study, HRQOL is more closely associated with dental pain than with

  17. Longitudinal association between physical activity engagement during adolescence and mental health outcomes in young adults: A 21-year birth cohort study.

    PubMed

    Suetani, Shuichi; Mamun, Abdullah; Williams, Gail M; Najman, Jake M; McGrath, John J; Scott, James G

    2017-07-01

    Previous studies provide mixed evidence that physical activity engagement (PAE) in adolescence is associated with later mental health outcomes. This study aimed to examine the association between PAE at age 14 and mental health outcomes at age 21 using a large birth cohort study. Prospective data from the Mater-University of Queensland Study of Pregnancy, consisting of 3493 young adults, were analyzed. PAE at age 14 was estimated using self-report, and participants were categorized into; (1) frequent, (2) infrequent, or (3) no PAE group. Mental health outcomes at age 21 consisted of; (1) common mental disorders, (2) psychosis-related outcomes, and, (3) emotional and behavioral problems. The association between PAE in adolescence and later mental health outcomes in young adulthood was examined using logistic regression, adjusted for age, sex, body mass index, and adolescent psychopathology. No PAE at age 14 was associated with the increased likelihood of lifetime diagnosis of any affective disorder, elevated delusional ideation, and endorsement of visual perceptual disturbance at age 21. Conversely, infrequent PAE at age 14 was associated with the decreased likelihood of subsequent lifetime diagnosis of any substance use disorder. Our findings suggest that lack of PAE in adolescence influences some, but not all, later mental health outcomes. Interventions to increase PAE in adolescence may represent an opportunity to prevent future mental health problems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Meta-Analysis of Genome-Wide Association Studies with Correlated Individuals: Application to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

    PubMed

    Sofer, Tamar; Shaffer, John R; Graff, Mariaelisa; Qi, Qibin; Stilp, Adrienne M; Gogarten, Stephanie M; North, Kari E; Isasi, Carmen R; Laurie, Cathy C; Szpiro, Adam A

    2016-09-01

    Investigators often meta-analyze multiple genome-wide association studies (GWASs) to increase the power to detect associations of single nucleotide polymorphisms (SNPs) with a trait. Meta-analysis is also performed within a single cohort that is stratified by, e.g., sex or ancestry group. Having correlated individuals among the strata may complicate meta-analyses, limit power, and inflate Type 1 error. For example, in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), sources of correlation include genetic relatedness, shared household, and shared community. We propose a novel mixed-effect model for meta-analysis, "MetaCor," which accounts for correlation between stratum-specific effect estimates. Simulations show that MetaCor controls inflation better than alternatives such as ignoring the correlation between the strata or analyzing all strata together in a "pooled" GWAS, especially with different minor allele frequencies (MAFs) between strata. We illustrate the benefits of MetaCor on two GWASs in the HCHS/SOL. Analysis of dental caries (tooth decay) stratified by ancestry group detected a genome-wide significant SNP (rs7791001, P-value = 3.66×10-8, compared to 4.67×10-7 in pooled), with different MAFs between strata. Stratified analysis of body mass index (BMI) by ancestry group and sex reduced overall inflation from λGC=1.050 (pooled) to λGC=1.028 (MetaCor). Furthermore, even after removing close relatives to obtain nearly uncorrelated strata, a naïve stratified analysis resulted in λGC=1.058 compared to λGC=1.027 for MetaCor.

  19. Association between change in body weight after midlife and risk of hip fracture—the Singapore Chinese Health Study

    PubMed Central

    Ang, L.-W.; Yuan, J.-M.; Koh, W.-P.

    2015-01-01

    Summary The relationship between change in body weight and risk of fractures is inconsistent in epidemiologic studies. In this cohort of middle-aged to elderly Chinese in Singapore, compared to stable weight, weight loss ≥10%over an average of 6 years is associated with nearly 40%increase in risk of hip fracture. Introduction Findings on the relationship between change in body weight and risk of hip fracture are inconsistent. In this study, we examined this association among middle-aged and elderly Chinese in Singapore. Methods We used prospective data from the Singapore Chinese Health Study, a population-based cohort of 63,257 Chinese men and women aged 45–74 years at recruitment in 1993–1998. Body weight and height were self-reported at recruitment and reassessed during follow-up interview in 1999–2004. Percent in weight change was computed based on the weight difference over an average of 6 years, and categorized as loss ≥10 %, loss 5 to <10 %, loss or gain <5 % (stable weight), gain 5 to <10 %, and gain ≥10 %. Multivariable Cox proportional hazards regression model was applied with adjustment for risk factors for hip fracture and body mass index (BMI) reported at follow-up interview. Results About 12 % experienced weight loss ≥10 %, and another 12% had weight gain ≥10 %. After a mean follow-up of 9.0 years, we identified 775 incident hip fractures among 42,149 eligible participants. Compared to stable weight, weight loss ≥10 % was associated with 39 % increased risk (hazard ratio 1.39; 95%confidence interval 1.14, 1.69). Such elevated risk with weight loss ≥10%was observed in both genders and age groups at follow-up (≤65 and >65 years) and in those with baseline BMI ≥20 kg/m2. There was no significant association with weight gain. Conclusions Our findings provide evidence that substantial weight loss is an important risk factor for osteoporotic hip fractures among the middle-aged to elderly Chinese. PMID:25868509

  20. Association between change in body weight after midlife and risk of hip fracture-the Singapore Chinese Health Study.

    PubMed

    Dai, Z; Ang, L-W; Yuan, J-M; Koh, W-P

    2015-07-01

    The relationship between change in body weight and risk of fractures is inconsistent in epidemiologic studies. In this cohort of middle-aged to elderly Chinese in Singapore, compared to stable weight, weight loss ≥10 % over an average of 6 years is associated with nearly 40 % increase in risk of hip fracture. Findings on the relationship between change in body weight and risk of hip fracture are inconsistent. In this study, we examined this association among middle-aged and elderly Chinese in Singapore. We used prospective data from the Singapore Chinese Health Study, a population-based cohort of 63,257 Chinese men and women aged 45-74 years at recruitment in 1993-1998. Body weight and height were self-reported at recruitment and reassessed during follow-up interview in 1999-2004. Percent in weight change was computed based on the weight difference over an average of 6 years, and categorized as loss ≥10 %, loss 5 to <10 %, loss or gain <5 % (stable weight), gain 5 to <10 %, and gain ≥10 %. Multivariable Cox proportional hazards regression model was applied with adjustment for risk factors for hip fracture and body mass index (BMI) reported at follow-up interview. About 12 % experienced weight loss ≥10 %, and another 12 % had weight gain ≥10 %. After a mean follow-up of 9.0 years, we identified 775 incident hip fractures among 42,149 eligible participants. Compared to stable weight, weight loss ≥10 % was associated with 39 % increased risk (hazard ratio 1.39; 95 % confidence interval 1.14, 1.69). Such elevated risk with weight loss ≥10 % was observed in both genders and age groups at follow-up (≤65 and >65 years) and in those with baseline BMI ≥20 kg/m(2).There was no significant association with weight gain. Our findings provide evidence that substantial weight loss is an important risk factor for osteoporotic hip fractures among the middle-aged to elderly Chinese.

  1. Do trust-based beliefs mediate the associations of frequency of private prayer with mental health? A cross-sectional study.

    PubMed

    Pössel, Patrick; Winkeljohn Black, Stephanie; Bjerg, Annie C; Jeppsen, Benjamin D; Wooldridge, Don T

    2014-06-01

    Significant associations of private prayer with mental health have been found, while mechanisms underlying these associations are largely unknown. This cross-sectional online study (N = 325, age 35.74, SD 18.50, 77.5 % females) used path modeling to test if trust-based beliefs (whether, when, and how prayers are answered) mediated the associations of prayer frequency with the Anxiety, Confusion, and Depression Profile of Mood States-Short Form scales. The association of prayer and depression was fully mediated by trust-based beliefs; associations with anxiety and confusion were partially mediated. Further, the interaction of prayer frequency by stress was associated with anxiety.

  2. Is low health literacy associated with overweight and obesity in adolescents: an epidemiology study in a 12–16 years old population, Nanning, China, 2012

    PubMed Central

    2014-01-01

    Background The problem of overweight and obesity in children and adolescents is considered an epidemic in both developed and developing world by the WHO. There has been little study on the relationship between health literacy and body weight among adolescents. This epidemiological study aims to investigate the association between low health literacy and overweight and obesity among a population of Chinese adolescents aged 12–16 years in the city of Nanning, China in 2012. Methods This study was a population-based cross-sectional health survey utilising a two-stage random cluster sampling design. The sample consisted of high school students aged between 12–16 years with the total student population attending high schools in a large city as the sample frame. Health literacy was measured by the Chinese version of the short form of the Test of Functional Health Literacy translated for and validated among Taiwanese adolescents. Overweight and obesity were assessed in accordance to the recommendation of the World Health Organization (WHO) Global Database of Body Mass Index classification methods. Data were analysed using logistic regression modelling techniques with adjustment to the cluster sampling effect. Results A total of 1035 students responded to the survey providing usable information with 628 (48.1%) respondents classified as high, 558 (42.8%) moderate, and 119 (9.1%) low levels of health literacy. After adjusting for potential confounding factors and the cluster sampling effect, low health literacy was significantly associated with overweight and obesity (OR = 1.84, 95% C.I. = 1.13-2.99). Conclusion Results suggested that low health literacy level was associated with many aspects of adolescence health including their body weight. These results have public health implications on an important global problem of adolescence body weight. Enhancing the health literacy should be considered as part of the strategies in combating adolescence weight problem. PMID

  3. Associate Degree Nursing: Model Prerequisites Validation Study. California Community College Associate Degree Programs by The Center for Student Success, A Health Care Initiative Sponsored Project.

    ERIC Educational Resources Information Center

    Phillips, Brad C.; Spurling, Steven; Armstrong, William A.

    California faces a severe nursing shortage, with the number of registered nurses far below what is required to avert a potential state health care crisis. The Associate Degree Nursing (ADN) Project is a joint project involving scholars, educational researchers, and analysts from the Center for Student Success (CSS) housed at City College of San…

  4. Chronic disease and lifestyle factors associated with change in sleep duration among older adults in the Singapore Chinese Health Study.

    PubMed

    Smagula, Stephen F; Koh, Woon-Puay; Wang, Renwei; Yuan, Jian-Min

    2016-02-01

    Identifying risk factors for future change in sleep duration can clarify whether, and if so how, sleep and morbidity are bidirectionally related. To date, only limited longitudinal evidence exists characterizing changes to sleep duration among older adults. This study aimed to identify factors associated with change in sleep duration in a large sample of older adults (≥ 60 years) residing in Singapore (n = 10 335). These adults were monitored as part of the Singapore Chinese Health Study, which collected information regarding daily sleep duration at baseline (assessed in 1993-1998) and at a follow-up wave conducted over a mean of 12.7 years later (assessed in 2006-2010). Among adults sleeping 6-8 h at baseline (n = 8265), most participants (55.6%) remained 6-8 h sleepers at follow-up, while 8.4% became short (< 6 h) and 36.0% became long (> 8 h) sleepers. A history of stroke, diabetes, cancer, hip fracture and greater age all independently increased the odds of having long sleep duration at follow-up, while greater educational attainment and weekly physical activity were both associated with reduced odds of becoming a long sleeper. Other than greater baseline age, the only factor related to higher odds of becoming a short sleeper was concurrent stomach/duodenal ulcer at follow-up. Long sleep duration among older adults may therefore reflect longstanding disease processes, whereas the aetiology of short sleep may predominately involve factors other than those examined. Future research is needed to distinguish if/when long sleep duration serves the disease recovery process, and when long sleep duration complicates disease and requires sleep medicine interventions. © 2015 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

  5. Association between childhood adversities and long-term suicidality among South Africans from the results of the South African Stress and Health study: a cross-sectional study

    PubMed Central

    Bruwer, Belinda; Govender, Ravi; Bishop, Melanie; Williams, David R; Stein, Dan J; Seedat, Soraya

    2014-01-01

    Objective Suicide and suicidal behaviours are significant public health problems and a leading cause of death worldwide and in South Africa. We examined the association between childhood adversities and suicidal behaviour over the life course. Methods A national probability sample of 4351 South African adult participants (aged 18 years and older) in the South African Stress and Health (SASH) study was interviewed as part of the World Mental Health Surveys initiative. Respondents provided sociodemographic and diagnostic information, as well as an account of suicide-related thoughts and behaviours. Suicidality or suicidal behaviour were defined as were defined as suicide attempts and suicidal ideation in the total sample, and suicide plans and attempts among ideators. Childhood adversities included physical abuse, sexual abuse, parental death, parental divorce, other parental loss, family violence, physical illness and financial adversity. The association between suicidality and childhood adversities was examined using discrete-time survival models. Results More than a third of the respondents with suicidal behaviour experienced at least one childhood adversity, with physical abuse, parental death and parental divorce being the most prevalent adversities. Physical abuse, sexual abuse and parental divorce were identified as significant risk markers for lifetime suicide attempts, while physical abuse and parental divorce were significantly correlated with suicidal ideation. Two or more childhood adversities were associated with a twofold higher risk of lifetime suicide attempts. Sexual abuse (OR 9.3), parental divorce (OR 3.1) and childhood physical abuse (OR 2.2) had the strongest associations with lifetime suicide attempts. The effect of childhood adversities on suicidal tendencies varied over the life course. For example, sexual abuse was significantly associated with suicide attempts during childhood and teen years, but not during young and later adulthood

  6. The association of health and voluntary early retirement pension and the modifying effect of quality of supervision: Results from a Danish register-based follow-up study

    PubMed Central

    de Wind, Astrid; Burr, Hermann; Pohrt, Anne; Hasselhorn, Hans Martin; Van der Beek, Allard Johan; Rugulies, Reiner

    2017-01-01

    Objectives: The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VERP. Methods: Employees aged 49–64 years who participated in the Danish Work Environment Cohort Study in 2000 were selected. Their questionnaire data about health and work were linked to register data on social transfer payments, among others VERP, from 2001 to 2012 in the Danish Register for Evaluation of Marginalization (N=1167). Cox proportional hazards analyses were performed to identify the prospective association of general perceived health and quality of supervision on VERP. Relative excess risks due to interaction (RERIs) were calculated to assess whether quality of supervision modified the association between health and VERP. Results: Employees with poor health at baseline had an increased risk of VERP during follow-up (hazard ratio [HR]=1.23; 95% confidence interval [CI] 1.02–1.49). Quality of supervision at baseline was not associated to VERP during follow-up (HR=1.04; 95% CI 0.90–1.21). There was no statistically significant interaction of poor health and poor quality of supervision with regard to risk of VERP (RERI=−0.33; 95% CI −1.79 to 1.14). Conclusions: This study did not support the notion that quality of supervision buffers the association between poor health and VERP. Future research is needed to determine whether other aspects of supervision, for example supervisors’ opportunities to effectuate workplace adjustments, may modify the association of poor health and VERP. PMID:28381121

  7. Association of self-reported physical activity with obstructive sleep apnea: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

    PubMed

    Murillo, Rosenda; Reid, Kathryn J; Arredondo, Elva M; Cai, Jianwen; Gellman, Marc D; Gotman, Nathan M; Marquez, David X; Penedo, Frank J; Ramos, Alberto R; Zee, Phyllis C; Daviglus, Martha L

    2016-12-01

    We examined associations of mild and moderate to severe obstructive sleep apnea (OSA; apnea-hypopnea index ≥5 and ≥15, respectively) with recommended amounts of moderate-vigorous physical activity (MVPA) or vigorous physical activity (VPA) and by type of activity (i.e., recreational, transportation, and work activity). The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multicenter population-based study, enrolled individuals from 2008 to 2011 from four U.S. metropolitan areas (Bronx, New York; Chicago, Illinois; Miami, Florida; San Diego, California). Participants in this study included 14,087 self-identified Hispanic/Latino ages 18 to 74years from the HCHS/SOL. Survey logistic regression analysis was used to compute odds ratios [OR] and 95% confidence intervals [CI], adjusting for sociodemographics, smoking status, and body mass index (BMI). Relative to being inactive, performing some MVPA (>0 to <150min/week) or meeting the recommended MVPA (≥150min/week) were associated with lower odds of mild OSA (ORs and 95% CIs 0.70 [0.61-0.82] and 0.76 [0.63-0.91], respectively), as well as moderate to severe OSA (ORs and 95% CIs 0.76 [0.62-0.93] and 0.76 [0.59-0.98], respectively). Associations of VPA with OSA were not significant. Engaging in medium or high levels of transportation activity was associated with lower odds of mild OSA (OR: 0.84, 95% CI: 0.74-0.96; OR: 0.64, 95% CI: 0.43-0.95, respectively). Performing some recreational MVPA was associated with lower likelihood of mild and moderate to severe OSA (OR: 0.82, 95% CI: 0.71-0.93; OR: 0.79, 95% CI: 0.64-0.97, respectively). Health promotion and OSA prevention efforts should encourage individuals to engage in at least some MVPA.

  8. Associations between Dietary Fiber Intake in Infancy and Cardiometabolic Health at School Age: The Generation R Study.

    PubMed

    van Gijssel, Rafaëlle M A; Braun, Kim V E; Kiefte-de Jong, Jessica C; Jaddoe, Vincent W V; Franco, Oscar H; Voortman, Trudy

    2016-08-30

    Dietary fiber (DF) intake may be beneficial for cardiometabolic health. However, whether this already occurs in early childhood is unclear. We investigated associations between DF intake in infancy and cardiometabolic health in childhood among 2032 children participating in a population-based cohort in The Netherlands. Information on DF intake at a median age of 12.9 months was collected using a food-frequency questionnaire. DF was adjusted for energy intake using the residual method. At age 6 years, body fat percentage, high-density lipoprotein (HDL)-cholesterol, insulin, triglycerides, and blood pressure were assessed and expressed in age- and sex-specific standard deviation scores (SDS). These five factors were combined into a cardiometabolic risk factor score. In models adjusted for several parental and child covariates, a higher DF intake was associated with a lower cardiometabolic risk factor score. When we examined individual cardiometabolic factors, we observed that a 1 g/day higher energy-adjusted DF intake was associated with 0.026 SDS higher HDL-cholesterol (95% CI 0.009, 0.042), and 0.020 SDS lower triglycerides (95% CI -0.037, -0.003), but not with body fat, insulin, or blood pressure. Results were similar for DF with and without adjustment for energy intake. Our findings suggest that higher DF intake in infancy may be associated with better cardiometabolic health in later childhood.

  9. Factors associated with early menarche: results from the French Health Behaviour in School-aged Children (HBSC) study

    PubMed Central

    2010-01-01

    Background Puberty is a transition period making physiological development a challenge adolescents have to face. Early pubertal development could be associated with higher risks of poor health. Our objective was to examine risk behaviours, physical and psychological determinants associated with early menarche (<11 years). Methods Early menarche was assessed in the Health Behaviour in School-aged Children French cross-sectional survey. Data were collected in 2006 by anonymous self-reported standardized questionnaire from a nationally representative sample of 1072 15 years old girls in school classrooms. Family environment, school experience, physical and psychological factors, risk behaviours (substance use and sexual initiation) were recorded. Logistic regression models were applied (analysing for crude and adjusted relationships between early menarche and risk behaviours controlled for family context). Results Median age at menarche was 13.0 years; 57 girls (5.3%) were early-matured. Controlled for familial environment, early menarche was associated with having had more than two life-drunkenness episodes (adjusted OR = 2.5 [1.3-4.6]), early sexual initiation (adjusted OR = 2.8 [1.3-6.0]) and overweight (adjusted OR = 7.3 [3.6-14.9]). Conclusion Early-maturing girls may affiliate with older adolescents, hence engage in risk behaviours linked to their appearance rather than their maturity level. Factors associated with early menarche highlight the need to focus attention on early-matured girls to prevent further health problems linked to risk behaviours. PMID:20353570

  10. Associations between Dietary Fiber Intake in Infancy and Cardiometabolic Health at School Age: The Generation R Study

    PubMed Central

    van Gijssel, Rafaëlle M. A.; Braun, Kim V. E.; Kiefte-de Jong, Jessica C.; Jaddoe, Vincent W. V.; Franco, Oscar H.; Voortman, Trudy

    2016-01-01

    Dietary fiber (DF) intake may be beneficial for cardiometabolic health. However, whether this already occurs in early childhood is unclear. We investigated associations between DF intake in infancy and cardiometabolic health in childhood among 2032 children participating in a population-based cohort in The Netherlands. Information on DF intake at a median age of 12.9 months was collected using a food-frequency questionnaire. DF was adjusted for energy intake using the residual method. At age 6 years, body fat percentage, high-density lipoprotein (HDL)-cholesterol, insulin, triglycerides, and blood pressure were assessed and expressed in age- and sex-specific standard deviation scores (SDS). These five factors were combined into a cardiometabolic risk factor score. In models adjusted for several parental and child covariates, a higher DF intake was associated with a lower cardiometabolic risk factor score. When we examined individual cardiometabolic factors, we observed that a 1 g/day higher energy-adjusted DF intake was associated with 0.026 SDS higher HDL-cholesterol (95% CI 0.009, 0.042), and 0.020 SDS lower triglycerides (95% CI −0.037, −0.003), but not with body fat, insulin, or blood pressure. Results were similar for DF with and without adjustment for energy intake. Our findings suggest that higher DF intake in infancy may be associated with better cardiometabolic health in later childhood. PMID:27589791

  11. Association between health literacy and patient experience of primary care attributes: A cross-sectional study in Japan.

    PubMed

    Aoki, Takuya; Inoue, Machiko

    2017-01-01

    Primary care is regarded as a setting that potentially mitigate patient health literacy (HL) related inequalities. However, there is a lack of evidence about influence of patient HL on the patients' perception of quality of primary care. We aimed to examine the association between HL and patient experience of primary care attributes. We conducted a cross-sectional survey, and sent questionnaires to adult residents who were randomly selected from a basic resident register in Yugawara Town, Kanagawa, Japan. We assessed HL using a 14-item Health Literacy Scale (HLS-14) and patient experience of primary care attributes using a Japanese version of Primary Care Assessment Tool (JPCAT), which comprises six domains: first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a multivariable linear regression analyses to adjust individual covariates. Data were analyzed for 381 residents who had a usual source of care. After adjustment for patients' sociodemographic and health characteristics, patient HL was positively associated with the JPCAT total score (B = 4.49, 95% confidence interval: 0.27 to 8.65 for HLS-14 total score highest quartile, compared with the lowest quartile). Among primary care attributes, HL had significant associations with longitudinality and comprehensiveness (service provided). We found that HL was positively associated with patient experience of primary care attributes in Japanese people. Our findings indicated that greater efforts might be needed to improve patient-centered and tailored primary care to those with low HL.

  12. Associations of adolescent cannabis use with academic performance and mental health: A longitudinal study of upper middle class youth.

    PubMed

    Meier, Madeline H; Hill, Melanie L; Small, Phillip J; Luthar, Suniya S

    2015-11-01

    There is a hypothesis that low socioeconomic status (SES) may explain the link between cannabis use and poorer academic performance and mental health. A key question, therefore, is whether adolescent cannabis use is associated with poorer academic performance and mental health in high SES communities where there is reduced potential for confounding. Youth (n=254) from an upper middle class community were followed prospectively through the four years of high school (from age 14/15 to age 17/18). Past-year frequency of cannabis use was assessed annually. Official school records of academic performance and self-reported mental health symptoms (externalizing and internalizing symptoms) were assessed in grades 9 and 12. Persistent cannabis use across the four years of high school was associated with lower grade-point average (β=-0.18, p=.006), lower Scholastic Aptitude Test (SAT) score (β=-0.13, p=.038), and greater externalizing symptoms (β=0.29, p<.001) in 12th grade, but not with greater internalizing symptoms (β=0.04, p=.53). Moreover, persistent cannabis use was associated with lower grade-point average (β=-0.13, p=.014) and greater externalizing symptoms (β=0.24, p=.002) in 12th grade, even after controlling for 9th grade levels of these outcomes. Similar associations were observed for persistent alcohol and tobacco use. Effects for persistent cannabis use became non-significant after controlling for persistent alcohol and tobacco use, reflecting the difficulties of disentangling effects of cannabis from effects of alcohol and tobacco. Low SES cannot fully explain associations between cannabis use and poorer academic performance and mental health. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Association of Parental Health Literacy with Oral Health of Navajo Nation Preschoolers

    ERIC Educational Resources Information Center

    Brega, A. G.; Thomas, J. F.; Henderson, W. G.; Batliner, T. S.; Quissell, D. O.; Braun, P. A.; Wilson, A.; Bryant, L. L.; Nadeau, K. J.; Albino, J.

    2016-01-01

    Health literacy is "the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions". Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale…

  14. Association of Parental Health Literacy with Oral Health of Navajo Nation Preschoolers

    ERIC Educational Resources Information Center

    Brega, A. G.; Thomas, J. F.; Henderson, W. G.; Batliner, T. S.; Quissell, D. O.; Braun, P. A.; Wilson, A.; Bryant, L. L.; Nadeau, K. J.; Albino, J.

    2016-01-01

    Health literacy is "the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions". Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale…

  15. Perceived discrimination is associated with reduced breast and cervical cancer screening: the Study of Women's Health Across the Nation (SWAN).

    PubMed

    Jacobs, Elizabeth A; Rathouz, Paul J; Karavolos, Kelly; Everson-Rose, Susan A; Janssen, Imke; Kravitz, Howard M; Lewis, Tené T; Powell, Lynda H

    2014-02-01

    Racial disparities in breast and cervical cancer screening have been documented in African American, Hispanic, and Asian populations. Perceived discrimination may contribute to this disparity. The aim of this study was to understand the relationship between perceived everyday racial/ethnic and other discrimination and receipt of breast and cervical cancer screening in a multiethnic population of women. We analyzed data from 3,258 women participating in the Study of Women's Health Across the Nation (SWAN), a multiethnic/racial, longitudinal cohort study of the natural history of the menopausal transition conducted at seven U.S. sites. Participants completed a validated measure of perceived discrimination and reasons for believing that they were treated differently, along with Pap smears, clinical breast exams (CBE), and mammography at each follow-up period. We used multiple logistic regression for the binary outcomes of having a Pap smear, CBE, or mammogram in each of the two follow-up years, using self-reported "race discrimination" and "other discrimination" at baseline as the main predictors. African American women reported the highest percentage of racial discrimination (35%), followed by Chinese (20%), Hispanic (12%), Japanese (11%), and non-Hispanic white women (3%). Non-Hispanic white women reported the highest percentage of "other" discrimination (40%), followed by Chinese (33%), African American (24%), Japanese (23%), and Hispanic women (16%). Perceived racial discrimination was not associated with reduced receipt of preventive screening, except in one fully adjusted model. Reported discrimination owing to "other" reasons, such as age or gender, was associated with reduced receipt of Pap smear (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.74-0.99), CBE (OR 0.78; 95% CI 0.67-0.91), and mammography (OR 0.80; 95% CI 0.69-0.92) regardless of patient race. Perceived discrimination is an important issue across racial/ethnic groups and is negatively

  16. The association between exposure to psychosocial work factors and mental health in older employees, a 3-year follow-up study.

    PubMed

    Havermans, Bo M; Boot, Cécile R L; Hoekstra, Trynke; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

    2017-09-18

    Unfavourable exposure to psychosocial work factors threatens older employees' mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in mental health in older employees at 3-year follow-up. The current study used data from the Study on Transitions in Employment, Ability and Motivation (STREAM), in workers aged 45-65 years (n = 5249). Two-year (2010-2012) exposure was assessed for psychological demands, autonomy, support, mental load, and distributive justice. Linear regression analyses were performed to compare improved exposure to unfavourable psychosocial work factors with stable unfavourable and stable favourable exposure and mental health at follow-up (2013), corrected for confounders. Analyses were stratified for age groups (45-54 and 55-65 years) and gender. In certain subgroups, stable unfavourable exposure to psychological demands, autonomy, support, and distributive justice was associated with a significantly lower mental health score than improved exposure. Stable favourable exposure to support was associated with a higher mental health score than improved support, whereas stable favourable exposure to autonomy was associated with a lower mental health score compared to improved exposure. There is a longitudinal association between changes in exposure to psychosocial work factors and mental health. Improvement in unfavourable exposure to psychosocial work factors was associated with improved mental health. This is important information for organisations that consider deploying measures to improve the psychosocial work environment of older workers.

  17. Association of coping strategies with mortality and health-related quality of life in hemodialysis patients: The Japan Dialysis Outcomes and Practice Patterns Study.