National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis

BACKGROUND@#This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis.@*METHODS@#Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression.@*RESULTS@#The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively.@*CONCLUSIONS@#The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women.

Design and psychometric evaluation of self-care behavior assessment tool in diabetic patients.

OBJECTIVE S: Diabetes is the most common metabolic disease with an increasing prevalence throughout the world due to the changes in lifestyle. Appropriate self-care promotes the life condition of people with chronic illnesses and reduces the side effects of such diseases, so this study was designed to develop a scale for evaluating self-care in middle-aged patients diabetes. METHODS: In this methodological study, the following 4 steps were conducted for design and psychometric measurement of the questionnaire: 1) Data collection was carried out during a supplementary cross-sectional survey of the qualitative study; 2) determining the face validity (the assessment of facility, difficulty, and ambiguity of the items and their importance for patients) and content validity of the questionnaire (the assessment of appropriateness and necessity of items by experts opinions and measuring CVR and CVI; 3) the internal consistency of the questionnaire was evaluated by determining the Cranach's alpha coefficient (α = 0.85), and 4) test-retest of the scale with a 2-weeks interval confirmed appropriate stability for the scale (ICC = 0.81). The normality of data was also evaluated using skewness and kurtosis. CFA was performed using AMOS version 24 software. RESULTS: The first version of this questionnaire was produced with 71 items, of which 27 items were deleted during the process of validity and reliability confirmation. The final version of the questionnaire was provided with 44 items. For this study, 460 samples were used to examine the psychometric properties of the self-care scale.The confirmatory factor analysis showed a good fit to the data. Before the performing CFA, KMO and Bartlett's test of sphericity were evaluated and the results indicated an adequate sample (KMO = 0.956 and Bartlett's test: χ2 = 14,288.048, df = 946, P < 0.001). CONCLUSION: The findings showed that the designed questionnaire could assess self-care in patients with diabetes. This is a short, easy-to-use questionnaire that helps you understand what the patient needs to perform self-care behaviors.

Comparison of univariate and two-stage approaches for estimating crash frequency by severity-Case study for horizontal curves on two-lane rural roads.

The Highway Safety Manual (HSM) procedures apply specific safety performance functions (SPFs) and crash modification factors (CMFs) appropriate for estimating the safety effects of design and operational changes to a roadway. Although the applicability of the SPFs and CMFs may significantly vary by crash severity, they are mainly based on total crash counts, with different approaches for estimation of crashes by crash severity. The variety of approaches in the HSM and in the literature in general suggests that there may be no one best approach for all situations, and that there is a need to develop and compare alternative approaches for each potential application. This paper addresses this need by demonstrating the development and comparison of alternative approaches using horizontal curves on two-lane roads as a case study. This site type was chosen because of the high propensity for severe crashes and the potential for exploring a wide range of variables that affect this propensity. To facilitate this investigation, a two-stage modeling approach is developed whereby the proportion of crashes for each severity level is estimated as a function of roadway-specific factors and traffic attributes and then applied to an estimate of total crashes from an SPF. Using Highway Safety Information System (HSIS) curve data for Washington state, a heterogeneous negative binomial (HTNB) regression model is estimated for total crash counts and then applied with severity distribution functions (SDFs) developed by a generalized ordered probit model (GOP). To evaluate the performance of this two-stage approach, a comparison is made with predictions directly obtained from estimated univariate SPFs for crash frequency by severity and also from a fixed proportion method that has been suggested in the HSM. The results revealed that, while the two-stage SDF approach and univariate approach adopt different procedures for model estimation, their prediction accuracies are similar, and both are superior to the fixed proportion method. In short, this study highlights the potential of the two-stage SDF approach in accounting for crash frequency variations by severity levels, at least for curved two-lane road sections, and especially for the all too frequent cases where samples are too small to estimate viable univariate crash severity models.

Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

Investigation of factors affecting the injury severity of single-vehicle rollover crashes: A random-effects generalized ordered probit model.

Rollover crashes are responsible for a notable number of serious injuries and fatalities; hence, they are of great concern to transportation officials and safety researchers. However, only few published studies have analyzed the factors associated with severity outcomes of rollover crashes. This research has two objectives. The first objective is to investigate the effects of various factors, of which some have been rarely reported in the existing studies, on the injury severities of single-vehicle (SV) rollover crashes based on six-year crash data collected on the Malaysian federal roads. A random-effects generalized ordered probit (REGOP) model is employed in this study to analyze injury severity patterns caused by rollover crashes. The second objective is to examine the performance of the proposed approach, REGOP, for modeling rollover injury severity outcomes. To this end, a mixed logit (MXL) model is also fitted in this study because of its popularity in injury severity modeling. Regarding the effects of the explanatory variables on the injury severity of rollover crashes, the results reveal that factors including dark without supplemental lighting, rainy weather condition, light truck vehicles (e.g., sport utility vehicles, vans), heavy vehicles (e.g., bus, truck), improper overtaking, vehicle age, traffic volume and composition, number of travel lanes, speed limit, undulating terrain, presence of central median, and unsafe roadside conditions are positively associated with more severe SV rollover crashes. On the other hand, unpaved shoulder width, area type, driver occupation, and number of access points are found as the significant variables decreasing the probability of being killed or severely injured (i.e., KSI) in rollover crashes. Land use and side friction are significant and positively associated only with slight injury category. These findings provide valuable insights into the causes and factors affecting the injury severity patterns of rollover crashes, and thus can help develop effective countermeasures to reduce the severity of rollover crashes. The model comparison results show that the REGOP model is found to outperform the MXL model in terms of goodness-of-fit measures, and also is significantly superior to other extensions of ordered probit models, including generalized ordered probit and random-effects ordered probit (REOP) models. As a result, this research introduces REGOP as a promising tool for future research focusing on crash injury severity.

Association between Dietary Inflammatory Index (DII) and risk of prediabetes: a case-control study.

The possible relationship between diet-related inflammation and the risk of prediabetes requires further investigation, especially in non-Western populations. We examined the ability of the dietary inflammatory index (DII) to predict the risk of prediabetes in a case-control study conducted at specialized centers in Esfahan, Iran. A total of 214 incident cases of prediabetes were selected with the nonrandom sampling procedure, and the 200 controls randomly selected from the same clinics were frequency-matched on age (±5 years) and sex. DII scores were computed based on dietary intake assessed using a validated and reproducible 168-item food-frequency questionnaire. Linear and logistic regression models were used to estimate multivariable beta estimates and odds ratios (ORs). Subjects in tertile 3 versus tertile 1 (T3VS1) of DII had significantly higher fasting plasma glucose (DIIT3VS1: b = 4.49; 95% CI 1.89, 7.09), oral glucose tolerance (DIIT3VS1: b = 8.76; 95% CI 1.78, 15.73), HbA1c (DIIT3VS1: b = 0.30; 95% CI 0.17, 0.42), low-density lipoprotein (DIIT3VS1: b = 16.37; 95% CI 11.04, 21.69), triglyceride (DIIT3VS1: b = 21.01; 95% CI 8.61, 33.42) and body fat (DIIT3VS1: b = 2.41; 95% CI 0.56, 4.26) and lower high-density lipoprotein (DIIT3VS1: b = -3.39; 95% CI -5.94, -0.84) and lean body mass (DIIT3VS1: b = -3.11; 95% CI -4.83, -1.39). After multivariate adjustment, subjects in the most pro-inflammatory DII group had 19 times higher odds of developing prediabetes compared with subjects in tertile 1 (DIIT3VS1: OR = 18.88; 95% CI 7.02, 50.82). Similar results were observed when DII was used as a continuous variable, (DIIcontinuous: OR = 3.62; 95% CI 2.50, 5.22). Subjects who consumed a more pro-inflammatory diet were at increased risk of prediabetes compared with those who consumed a more anti-inflammatory diet.

Effect of Different Dietary Levels of Atorvastatin and L-Carnitine on Performance, Carcass Characteristics and Plasma Constitutes of Broiler Chickens.

The effects of L-carnitine, atorvastatin and their combination on growth and lipid metabolism of broiler chickens is not yet known. Thus, the objective of the present study was to investigate the effects of dietary L-carnitine and atorvastatin on the performance, carcass characteristics and blood parameters in broilers. Different dietary levels of L-carnitine (0, 150 and 300 mg/kg, respectively) and atorvastatin (0, 1 and 2 g/kg, respectively) were added to the daily birds' ration. Significant positive effects (P<0.05) on broiler body weight for both L-carnitine and atorvastatin were reported, and this effect became clear starting from the 4th week of rearing period till the slaughter age. Dietary treatments had also significant (P<0.05) positive effects on broilers empty carcass, breast and drumstick weights. Conversely, L-carnitine slightly increased abdominal fat, whereas supplementing atorvastatin slightly reduced it (P<0.05). However, Combining the treatments, resulted in reduction of abdominal fat pad, showing also the best development of breast and drumstick muscles (P<0.05). Moreover, the weight of gizzard, liver and heart were significantly higher in birds treated with the highest doses supplied (P<0.05). Dietary treatments had also influence on blood biochemical parameters of broilers. In overall, our findings suggest that combining dietary L-carnitine and atorvastatin supported birds growth and muscles development reducing the body fat deposition. However, further studies are needed to deeply study the potential effect of statins on meat quality.