Sleep Quality and Its Correlates among Adolescents of Western Nepal: A Population-Based Study.

Sleep quality has a long-term impact on health leading to depression among adolescent students. We conducted a cross-sectional study to assess the prevalence of sleep quality and its associated factors among adolescents of western, Nepal. 514 adolescents from different schools were selected by the probability proportionate to size (PPS) method. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among adolescents. The collected data were entered in EpiData 3.2 version, then extracted to excel 2019 and was analyzed with the help of RStudio (version 1.2.5033). Frequency distribution and percentage were identified as descriptive analysis whereas chi-square test was done. Variables that were found statistically significant (P < 0.05) were further analyzed using the logistic regression model. The prevalence of sleep quality in this study was 39.1%. In a bivariate analysis, ethnicity, religion, place of residence, drinking status of father, reason for selecting the currently studying faculty, satisfaction with academic performance, use of tobacco, relationship with friends or classmates, more use of internet per day, and use of internet before falling asleep were found to be statistically significant with sleep quality. Those students who left their home without informing their parents were more than three times at the risk of sleep quality than those students who never ran away from their home without informing their parents (AOR = 3.435, CI: 1.237-9.540). The overall prevalence of sleep quality among school going adolescent students was 39.1 percent which was comparatively high.

Depression among Adolescents of Rural Nepal: A Community-Based Study.

This community-based study is aimed at finding out the prevalence of depression, and its correlates among adolescents of rural Nepal. Data were collected among adolescents after multistage stratified proportionate random sampling by using the Patient Health Questionnaire (PHQ-9) to assess the depression among adolescent. Chi-square test and logistic regression model were applied. The prevalence of depression was found to be 27%. Adolescents who were not satisfied with their academic performance were 2.4 times more likely to have the risk of depression (AOR = 2.417, CI: 1.097-5.326). Likewise, tobacco users were almost fourteen times (AOR = 13.858, CI: 2.090-91.90), who intended to harm themselves were two times (AOR = 2.323, CI: 1.078-5.005), sleep deprivation were fifteen folds (AOR = 14.911, CI: 7.376-30.145), often scolded by their parents was almost three times (AOR = 2.931, CI: 1.195-7.436), and having poor relationship with friends were 2.4 times more likely (AOR = 2.371, CI: 1.078-5.215) of having depression. Sleep deprivation has a long-term negative impact on health leading depression.

HDL cholesterol: A potential mediator of the association between urinary cadmium concentration and cardiovascular disease risk.

Evidence from previous studies has shown that exposure to metals is associated with cardiovascular disease (CVD). However, the association between metal mixtures and CVD risk and the potential mechanisms in epidemiologic studies remain unclear. The data of 14,795 adults who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) 1999-2016 were analyzed. Multivariate logistic regression was performed to investigate the associations between urinary metal levels and CVDs. Weighted quantile sum (WQS) regression was performed to examine the effects of mixed metals on CVDs. Multivariate linear regression and mediation analysis were conducted to explore the associations between metals and blood lipids. Urinary cadmium (Cd) was significantly associated with an increased total CVD risk and with individual CVD risk. The odds ratio (OR) for CVD in the highest quartile of the WQS index was 1.43 (95% confidence interval [CI]: 1.19, 1.71). One augmented urinary Cd concentration unit (Log10) was associated with a 0.93 mg/dL decrease in HDL cholesterol, a 1.34 mg/dL increase in LDL cholesterol and a 1.30 mg/dL increase in total cholesterol in the fully adjusted model. Mediation analysis showed that HDL cholesterol mediated 4.91% of the association between urinary Cd and the prevalence of CVD. Our findings suggest that urinary Cd and metal mixtures were significantly and positively associated with CVD. The downregulation of HDL cholesterol might play a significant role in mediating Cd exposure-associated CVD risk increases.

Levels of a mixture of heavy metals in blood and urine and all-cause, cardiovascular disease and cancer mortality: A population-based cohort study.

People are exposed to heavy metals in many ways during the course of their daily life. However, the effect of mixtures of heavy metals on mortality in the U.S. general population is unclear. We aimed to investigate the association between heavy metal concentrations (blood [lead, cadmium and mercury] and urine [barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, titanium, tungsten and uranium]) and all-cause, cardiovascular disease (CVD) and cancer mortality. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2014. Poisson regression was performed to analyze the associations between single-metal and multimetal exposure and mortality. The following variables were adjusted as covariates: demographic variables (age, education, sex and ethnicity), anthropometric variables (body mass index), lifestyle variables (family income, serum cotinine category and physical activity) and medical comorbidities (CVD and diabetes). A total of 26,056 subjects from the NHANES were included in the present study (mean follow-up, 7.4 years). The age of the participants ranged from 20 to 85 years. The blood metal mixture was associated with all-cause mortality (RR = 1.38, 95% CI 1.25, 1.51), CVD mortality (RR = 1.43, 95% CI 1.06, 1.94) and cancer mortality (RR = 1.41, 95% CI 1.12, 1.76) and cadmium had the highest weight in the weighted quantile sum (WQS) regression for all associations. The urinary metal mixture was associated with an increased risk of all-cause (RR = 1.48, 95% CI 1.30, 1.68) and cancer mortality (RR = 1.60, 95% CI 1.02, 2.52). Sex differences were found in the associations of both blood and urine metal mixtures with cancer mortality. Our study suggests a potential positive association for the concentrations of heavy metal mixtures with overall, CVD and cancer mortality based on a large sample of the U.S. general population. Nevertheless, further studies are needed to confirm these important findings.