Minimal Contribution of the Social Determinants of Health to the Prevalence of Hypertension among Egyptian Public Servants.

BACKGROUND: Previous research suggests the role of social determinants of health (SDH) in the prevalence of hypertension. OBJECTIVE: The study aimed to estimate the contribution of SDH to the prevalence of hypertension. METHODS: We recruited 3072 Egyptian public servants who answered a self-administered questionnaire, including hypertension history. We measured the participants' blood pressure with standardized procedures. The logistic regression models were used to assess the associations between SDH and hypertension. RESULTS: The prevalence of hypertension was 28.2% (34.2% in males and 22.5% in females). The prevalence of undiagnosed hypertension was 16.3% (23.9% and 9.2%, respectively); thus, 57.8% of the hypertensive subjects were unaware of their high blood pressure status. SDH were associated with the odds of having hypertension in the unadjusted analyses. Higher education, being single, and having minor family members were associated with low odds of hypertension. On the other hand, non-professional occupations, job hours, household income, total family members, and work-family conflicts were associated with higher odds of hypertension. However, in the multivariable analyses, which included all SDH and adjusted for age, gender, smoking, physical activity, body mass index, medical history of chronic diseases, and family history of hypertension, only job hours were associated with the odds of having hypertension and undiagnosed hypertension: odds ratio (95% CI) = 1.07 (1.01-1.14) and 1.11 (1.02-1.20), respectively. CONCLUSION: SDH contributed minimally to the odds of having hypertension among public officials in Minia, Egypt. Civil servants with long working hours should be tracked with regular blood pressure monitoring as a high-risk group for hypertension.

Sugary drink consumption and the subsequent risk of gastric cancer: The Japan Public Health Center-based Prospective Study.

BACKGROUND/OBJECTIVES: Evidence on the association between sugary drink consumption and gastric cancer (GC) risk is limited, especially in Asian populations. This study aimed to investigate the association between consumption of sugary drinks (sugar-sweetened beverages and 100% fruit juices) and GC risk in a Japanese population. SUBJECTS/METHODS: This study included 74,455 Japanese individuals aged 45-74 years (35,102 males and 39,353 females) who participated in a population-based cohort study (Japan Public Health Center-based Prospective Study). Sugary drinks were assessed using a food frequency questionnaire. Cox proportional hazard regression was used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) of GC incidence according to the quintile of sugary drink consumption. RESULTS: We identified 2141 patients with GC cases during 16.7 years of follow-up. Sugary drink consumption was not associated with GC risk. The multivariate HR of total, cardia, and non-cardia GC in the highest vs. lowest quintile of sugary drinks consumption in males was 0.98 (95% CI: 0.82-1.17; p-trend 0.48), 0.48 (95% CI: 0.23-0.99; p-trend 0.03), and 1.03 (95% CI: 0.86-1.24; p-trend 0.88), respectively. In females, the respective multivariate HRs were 1.03 (95% CI: 0.79-1.33; p-trend 0.47), 1.28 (95% CI: 0.32-5.12; p-trend 0.53), and 1.01 (95% CI: 0.78-1.32; p-trend 0.56). The results did not change significantly after adjusting for Helicobacter pylori infection and atrophic gastritis status in the subgroup analysis. CONCLUSIONS: In this Japanese prospective cohort study, sugary drink consumption was not associated with GC risk.

A comparative study of the work-family conflicts prevalence, their sociodemographic, family, and work attributes, and their relation to the self-reported health status in Japanese and Egyptian civil workers.

BACKGROUND: Cross-cultural studies studying work-family conflicts (W_F_Cs) are scarce. We compared the prevalence of W_F_Cs, factors correlated with them, and their association with self-rated health between Japan and Egypt. METHODS: Among 4862 Japanese and 3111 Egyptian civil workers recruited by a convenience sample in 2018/2019 and reported self-rated health status, we assessed the W_F_Cs by the Midlife Development in the US (MIDUS) and attributed them to sociodemographic, family, and work variables. We also evaluated the W_F_Cs' gender- and country-specific associations with self-rated health by logistic regression analyses. RESULTS: W_F_Cs were more prevalent in Egyptian than in Japanese women (23.7% vs. 18.2%) and men (19.1% vs. 10.5%), while poor self-rated health was more prevalent in Japanese than Egyptians (19.3% and 17.3% vs. 16.9% and 5.5%). Longer working hours, shift work, and overtime work were positively associated with stronger work-to-family conflict (WFC). Whereas being single was inversely associated with stronger family-to-work conflict (FWC). Living with children, fathers, or alone in Japan while education in Egypt was associated with these conflicts. The OR (95% CI) for poor self-reported health among those with the strong, in reference to weak total W_F_Cs, was 4.28 (2.91-6.30) and 6.01 (4.50-8.01) in Japanese women and men and was 2.46 (1.75-3.47) and 3.11 (1.67-5.80) in Egyptian women and men. CONCLUSIONS: Japanese and Egyptian civil workers have different prevalence and correlated factors of W_F_Cs and self-rated health. W_F_Cs were associated in a dose-response pattern with poor-self-rated health of civil workers in both countries.

Depression in Public Servants of Upper Egypt: Gender-specific Prevalence and Determining Factors.

Mental health disorders, including depression, cause more than half of worldwide disabilities. We aimed to estimate the prevalence of depression and determine its associated factors among Egyptian public servants. We collected data from 3134 subjects (1619 females and 1515 males) via a self-administered questionnaire, including the Center of Epidemiological Studies-Depression (CES-D) scale, medical history, sociodemographic, familial, occupational, and behavioral characteristics of the recruited Egyptian Public servants. We used logistic and linear regression models to assess the determinants of depression. The prevalence of depression was 43.5% (52.9% in females and 33.4% in males) among public servants. The past history of depression was a significant determining factor of depression; adjusted odds ratio (aOR): 95% confidence interval (CI) was 2.58 (1.87, 3.57) in females and 3.28 (2.20, 4.87) in males. Other determinants were daily working hours: aOR = 1.11 (1.02, 1.19) and high job demands: aOR = 2.19 (1.40-3.41) in males, and the high job control in females: aOR = 0.51 (0.36, 0.73). With the past history of depression, job demands, job control, family structure, education level, and working status of the spouse predicted 41% of the total variance in the CES-D score in females; R2 = 0.41; whereas job demands, family structure, job hours per day predicted 40% of in males; R2 = 0.40. In conclusion, the determinants of depression varied by gender. Governmental interventions aiming to improve the work environment (job demands, control, and working hours) and individual responsibilities to improve the living arrangement and education level could help to curb the emerging risk of depression.

Associations of dietary intakes of vitamins B1 and B3 with risk of mortality from CVD among Japanese men and women: the Japan Collaborative Cohort study.

The evidence on the association between B vitamins and the risk of CVD is inconclusive. We aimed to examine the association of dietary vitamins B1 and B3 intakes with risk of CVD mortality among 58 302 Japanese men and women aged 40-79 years participated in the Japan Collaborative Cohort (JACC) study. The Cox proportional hazard model estimated the hazard ratios (HR) and 95% CI of CVD mortality across increasing energy-adjusted quintiles of dietary vitamins B1 and B3 intakes. During 960 225 person-years of follow-up, we documented a total of 3371 CVD deaths. After adjustment for age, sex, and other CVD risk factors, HR of mortality from ischemic heart disease, myocardial infarction, and heart failure in the highest v. lowest vitamin B1 intake quintiles were 0.57 (95 % CI 0·40, 0·80; Pfor trend < 0·01), 0.56 (95 % CI 0·37, 0·82; Pfor trend < 0·01), and 0.65 (95 % CI 0·45, 0·96; Pfor trend = 0·13). The multivariable HR of myocardial infarction mortality in the highest v. lowest vitamin B3 intake quintiles was 0.66 (95 % CI 0·48, 0·90; Pfor trend = 0·02). Atendency towards a reduced risk of haemorrhagic stroke mortality was observed with a higher dietary intake of vitamin B3 (HR: 0·74 (95 % CI 0·55, 1·01)) but not vitamin B1. In conclusion, higher dietary intakes of vitamins B1 and B3 were inversely associated with mortality from ischemic heart disease and a higher dietary intake of vitamin B1 was inversely associated with a reduced risk of mortality from heart failure among Japanese men and women.

Movement of the superior mesenteric artery in patients with superior mesenteric artery syndrome: A case-reference study.

Superior mesenteric artery (SMA) syndrome is related to the reduction of the aortomesenteric angle on detailed imaging studies; i.e., an expert's ultrasonography or angiography. We aimed to test a simpler imaging finding of SMA syndrome. This cross-sectional case-reference study examined whether right movement of the SMA on unenhanced computed tomography (CT) is useful for the diagnosis of SMA syndrome. We reviewed hospital records of patients admitted in 2008-2018. Each case was matched to one non-case patient of the same age and sex. On unenhanced CT scans, we identified the shortest distance between the parallel line that passes through the center of the aorta to the line that bisects the spine and SMA. A negative number of the distance means that the SMA is on the left side of the above-described parallel line. There was a total of 14 cases and 14 non-cases (men, 57.1%) with mean age 78.7 years. Mean body mass index of cases and non-cases were 19.2 and 22.2 kg/m2 , respectively. The more prevalent side of the SMA was the right side. The mean shortest distance was 10.5 mm in cases and 0.7 mm in non-cases (p for independent t test = 0.043). For comparing the observations in SMA cases at several time points, the mean shortest distance at pre-onset was -2.7 mm, with a significant difference from that at onset (p for paired t test = 0.030). In conclusion, right movement of the SMA diagnosed by unenhanced CT is associated with SMA syndrome.

The effect of China's Clean Air Act on cognitive function in older adults: a population-based, quasi-experimental study.

BACKGROUND: Air pollution might accelerate cognitive ageing; it is unclear whether large-scale interventions, such as China's Clean Air Act (CCAA), can mitigate cognitive deterioration. We aimed to evaluate the effect of CCAA on changes in cognitive function in older adults. METHODS: In this population-based, quasi-experimental study, we did a difference-in-differences analysis of the data collected during the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The study design used a counterfactual analysis feature by dividing CLHLS participants into two groups. The intervention group included participants who lived in areas where the provincial government set a target of reducing particulate matter (PM) by at least 5% annually from 2014 onward, whereas the control group consisted of individuals who lived in areas without a PM reduction target. Global cognitive function was measured using the Mini-Mental State Examination (MMSE). We used fixed-effects models to examine the between-group differences in MMSE score changes before and after CCAA implementation. We associated longitudinal changes in MMSE scores with changes in concentrations of PM with a diameter of less than 2·5 µm (PM2·5) concentration and other regulated pollutants. We used alternative models and sensitivity analyses to evaluate the robustness of the results from the main models. FINDINGS: 2812 individuals participated in the 2014 and 2018 surveys (mean age 81·0 years [SD 9·3] in 2014; 1408 [50·1%] female and 1404 [49·9%] male). 2251 (80·0%) were included in the intervention group and 561 (20·0%) in the control group. After controlling for potential confounders, the intervention group had a significantly smaller decline in MMSE scores from 2014 to 2018 compared with the control group: the mean between-group difference was 2·45 points (95% CI 1·32-3·57). Interquartile increases in PM2·5 were associated with a significant MMSE score decline of 0·83 points (95% CI 0·24-1·42); similarly, increases in SO2 were also associated with a significant MMSE score decline of 0·80 points (0·32-1·29). INTERPRETATION: Implementing stringent clean air policies might mitigate the risk of air pollutant-associated cognitive ageing in older people. FUNDING: National Natural Sciences Foundation of China, National Key R&D Program of China, China Postdoctoral Science Foundation funded project, the Duke/Duke-National University of Singapore Collaboration Pilot Project, the National Institute on Aging and Peking University-Baidu Fund, Energy Foundation, and the Fundamental Research Funds for the Central Universities.

Dairy intake and the risk of pancreatic cancer: the Japan Collaborative Cohort Study (JACC Study) and meta-analysis of prospective cohort studies.

Dairy product intake was suggested to reduce the risk of gastrointestinal cancers. This study investigated the association between dairy product intake and the risk of pancreatic cancer (PAC) using a prospective cohort study and meta-analysis of prospective cohort studies. First, we included 59 774 people aged 40-79 years from the Japan Collaborative Cohort Study (JACC Study). The Cox regression was used to compute the hazard ratios (HR) and 95 % CI of incident PAC for individuals who reported the highest intakes of milk, cheese and yogurt compared with not consuming the corresponding dairy products. Then, we combined our results with those from other four prospective cohort studies that were eligible after searching several databases, in a meta-analysis, using the fixed-effects model before evaluating publication bias and heterogeneity across studies. In the JACC Study, the highest v. no intakes of milk, cheese and yogurt were not associated with the reduced risk of PAC after a median follow-up of 13·4 years: HR (95 % CI) = 0·93 (0·64, 1·33), 0·91 (0·51, 1·62) and 0·68 (0·38, 1·21), respectively. The results did not significantly change in the meta-analysis: 0·95 (0·82, 1·11) for milk, 1·16 (0·87, 1·55) for cheese and 0·91 (0·79, 1·05) for yogurt. The meta-analysis showed no signs of publication bias or heterogeneity across studies. To conclude, consumption of milk, cheese and yogurt was not associated with the risk of PAC either in the JACC Study or the meta-analysis.

Non-alcoholic beverages intake and risk of CVD among Japanese men and women: the Japan Public Health Center study.

The association between the intake of non-alcoholic beverages and CVD in Asians is uncertain. The intake of non-alcoholic beverages was estimated in 77 407 participants of the Japan Public Health Centre-based cohort study aged 45-74 years. The Cox regression calculated the hazard ratios (HR) and 95 % CI for incident CVD according to sex-specific quintiles of intake of non-alcoholic beverages. A total of 4578 incident CVD (3751 strokes and 827 CHD) were diagnosed during a 13·6-year median follow-up. The risks of stroke and total CVD were lower for the highest v. lowest intake quintiles of non-alcoholic beverages in men and women: the multivariable HRs (95 % CIs) were 0·82 (0·71, 0·93, Ptrend = 0·005) and 0·86 (0·76, 0·97, Ptrend = 0·02), respectively, in men and were 0·73 (0·63, 0·86, Ptrend = 0·003) and 0·75 (0·65, 0·87, Ptrend = 0·005), respectively, in women. The reduced risk was evident for both ischaemic and haemorrhagic strokes and was mainly attributable to green tea consumption. The intake of non-alcoholic beverages from coffee and other beverages was not associated with the risk of CVD in both men and women. Also, there was no association between the intake of non-alcoholic beverages and the risk of CHD in either sex. In conclusion, the risks of stroke and total CVD were lower with a higher intake of non-alcoholic beverages in Japanese men and women.

Association of B Vitamins and Methionine Intake with the Risk of Gastric Cancer: The Japan Public Health Center-based Prospective Study.

Dietary intake of B vitamins and methionine might associate with carcinogenesis due to their role in DNA synthesis and methylation. Owing to the previous inconsistent findings on gastric cancer risk, we aimed to examine the associations between dietary intakes of B vitamins and methionine and the risk of gastric cancer, according to sodium intake.We included 86,820 Japanese individuals who completed a validated food frequency questionnaire with 138 food items in the Japan Public Health Center-based Prospective Study. Cox proportional hazards regression was used to obtain HRs and 95% confidence intervals (CI) of gastric cancer according to separate intakes of folate, vitamin B6, vitamin B12, and methionine after adjusting for confounding factors, including Helicobacter pylori and atrophic gastritis in the subgroup analysis.We identified 2,269 gastric cancer cases within a median of 15.4 years of follow-up. We found no association between any of the dietary intakes of folate, vitamin B6, vitamin B12, or methionine with the risk of gastric cancer. In the stratified analysis by sodium intake, we observed a positive association between folate intake and risk of gastric cancer among participants with a high sodium intake (≥4.5 g/day) [HR = 1.28 (95% CI, 1.06-1.56), P trend = 0.001; P interaction = 0.02]. Meanwhile, there was no association between folate intake and risk of gastric cancer among participants with low sodium intake (<4.5 g/day) [HR = 0.94 (95% CI, 0.73-1.21), P trend = 0.49].In conclusion, we found no association between any dietary intakes of folate, vitamin B6, vitamin B12, and methionine with the risk of gastric cancer. PREVENTION RELEVANCE: The increased intake of B vitamins and methionine in populations with adequate dietary intake of these nutrients showed no association with the risk of gastric cancer.

Association of dietary intakes of vitamin B12, vitamin B6, folate, and methionine with the risk of esophageal cancer: the Japan Public Health Center-based (JPHC) prospective study.

BACKGROUND: B vitamins and methionine are essential substrates in the one-carbon metabolism pathway involved in DNA synthesis and methylation. They may have essential roles in cancer development. We aimed to evaluate the associations of dietary intakes of vitamin B12, vitamin B6, folate, and methionine with the risk of esophageal cancer (EC) using data from the Japan Public Health Center-based Prospective Study. METHODS: We included 87,053 Japanese individuals who completed a food frequency questionnaire and were followed up from 1995-1998 to 2013 and 2015. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by Cox proportional-hazard regression across quintiles of dietary intakes of B vitamins and methionine. RESULTS: After 1,456,678 person-years of follow-up, 427 EC cases were documented. The multivariable HR (95% CI) of incident EC in the highest versus lowest quintile of dietary intake of vitamin B12 was 1.75 (1.13-2.71; p-trend=0.01). Stratification analysis based on alcohol consumption showed that higher dietary intakes of vitamin B12 and methionine were associated with an increased risk of EC among never-drinkers; HRs (95% CIs) were 2.82 (1.18-6.74; p-trend=0.009; p-interaction=0.18) and 3.45 (1.32-9.06; p-trend=0.003; p-interaction 0.02) for vitamin B12 and methionine, respectively. Meanwhile, there was no association between vitamin B12 and methionine intake with the risk of EC among drinkers. There were no associations between dietary intake of folate or vitamin B6 and the risk of EC. CONCLUSION: Dietary intake of vitamin B12 was positively associated with the risk of EC in the Japanese population.

Association of tea consumption and the risk of gastric cancer in Japanese adults: the Japan Collaborative Cohort Study.

OBJECTIVE: To examine the possible relationship between tea consumption and risk of gastric cancer (GC) among Japanese men and women included in a large Japanese population-based study titled the Japan Collaborative Cohort (JACC) Study. DESIGN: Prospective cohort study. SETTING: A population-based cohort included subjects who were recruited from 24 areas of JACC Study, in which data regarding the incidence of cancer were available. PARTICIPANTS: 63 848 participants (26 025 men and 37 823 women), aged 40-79, were included in the analyses and underwent follow-up (median 13.3 years) prospectively in research on cancer incidence. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome variable was the risk of GC according to the frequency intakes of total tea, green tea, black tea and oolong tea. The adjusted HRs for the risk of GC associated with tea consumption were calculated using the Cox proportional hazards model. RESULTS: 1494 cases of GC were detected (960 men and 534 women) during the follow-up period. The multivariable-adjusted HRs for the risk of GC in the highest versus lowest quintiles of total tea intake were 1.05 (0.83-1.33); p trend=0.50 in men, and 0.82 (0.60-1.12); p trend=0.45 in women. There was no association found between the consumption of green tea, black tea or oolong tea with the risk for GC in either gender. CONCLUSIONS: In this large community-based prospective cohort study, tea consumption was not associated with the risk of GC in either gender.

Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study.

BACKGROUND: Breast cancer represented the leading cause of cancer deaths among women in Japan. Although physical activity has been reported protective against breast cancer, scientific evidence is limited on the risk of breast cancer according to job category or occupational activity in Japanese. Our objective was to examine the association of job category and occupational activity with breast cancer incidence in Japanese female workers using the data from the Japan Collaborative Cohort (JACC) Study. METHODS: A prospective cohort study involving 19,041 women aged 40-79 years who have reported their occupational data and followed-up from 1988 to 2009. All variables were assessed by a self-administered questionnaire. Cancer incidence data were obtained from 24 areas of the JACC study through cancer population data registration, or review of hospital records. The Cox proportional hazard models were operated to calculate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). RESULTS: There were 138 incident cases of breast cancer during 13.3 years median follow-up period. Office workers compared with manual workers were at a higher risk of breast cancer after adjusting for reproductive health factors and physical activity indicators; the multivariable HR (95% CI) was 1.65 (1.07-2.55). Also, women who had mainly a sitting position during work compared with those moving during work had the higher risk: the multivariable HR (95%CI) of 1.45 (1.01-2.12). The excess risk of breast cancer was observed for office workers when time spent in walking was < 30 min/ day; HR (95% CI) was 1.11 (1.01-1.23), and for women mainly at a sitting position during work when time spent in walking was 30-59 min or < 30 min/day; HRs (95% CIs) were 1.87 (1.07-3.27) and 1.74 (1.07-2.83), respectively. CONCLUSION: The job category and occupational activity were associated with risk of breast cancer incidence. A high risk was observed in office workers and in women with a sitting position during work. These observed increased risks were evident in women with less daily walking activity.

Survival status and mortality predictors among severely malnourished under 5 years of age children admitted to Minia University maternity and children hospital.

BACKGROUND: Though effective treatment programs for severely malnourished children are available, mortality rate among children with acute malnutrition continue to rise and little is known about its long-term outcomes and potential predictors of its in-hospital and post-discharge mortality. The aim of this study was to assess the survival status and predictors for mortality in severely malnourished children admitted to Minia University Maternity and Children Hospital. METHODS: A retrospective cohort study which included 135 children under 5 years of age who were admitted to the nutrition rehabilitation ward with severe acute malnutrition (SAM) during the period from January to December 2018. Data were collected from the inpatient's hospital records and the children's parents/guardians were interviewed using a detailed structured questionnaire that inquired about demographic and socioeconomic variables. The logistic and Cox regressions were used to assess the factors associated with the SAM's mortality. RESULTS: A total of 135 children were enrolled into the study. Death rate during hospitalization was 9.6%. The survival rate at the end of the fourth week of admission was 82.4%. There were 6.7% post-discharge deaths among 104 alive discharged children which occurred within 8 weeks after discharge. The adjusted HRs (95% CIs) for total SAM deaths were 1.57 (1.10-2.99) in children < 12 vs ≥ 12 months old; 4.79 (2.23-6.10) in those with WAZ < -3SD, 2.99 (1.16-4.66) in those with edema at admission and 3.44 (1.07-9.86) in children with complications. The respective ORs (95%CIs) for in-hospital SAM deaths in the same groups of children were 2.64 (1.22-6.43), 8.10 (2.16-11.67), 3.04 (1.70-6.06) and 3.71 (1.59-6.78). The main predictor for the SAM's post-discharge mortality was illiteracy of mothers; the adjusted HR (95%CI) was 7.10 (1.58-31.93; p = 0.01). CONCLUSIONS: Age, WAZ, edema and complications at admission were predictors for both in-hospital and total SAM mortality, while mother's education contributed to the early post-discharge mortality. The identification of predictors for mortality is an important preliminary step for interventions aiming to reduce morbidity and mortality.

Sociocultural attitudes toward appearance and body shape dissatisfaction in adolescent Egyptian females: association and moderators.

Body image dissatisfaction is considered a predicting and maintaining factor of a variety of prevalent health problems. This study aimed to assess the influences of sociocultural factors and body mass index (BMI) on body dissatisfaction among university female students. This is a cross-sectional study. It included 1408 adolescent Egyptian females chosen randomly from Minia University students who answered the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4), Body Shape Questionnaire (BSQ) and The Rosenberg Self-Esteem Questionnaire in the period from June to July, 2018. In addition, their BMI was measured. Around one third of the students had major concerns about their body shape. BMI was the strongest predictor for dissatisfaction with body image (Standardized ß = 0.31; p-value: <0.00018). Both total and pressure subscales scores of SATAQ-4 were also significant explanatory variables. Pressures from the family were a strong predictor among urban students, peer pressures among rural students, and both family and peer pressures among students with low self-esteem. This study supported the associations of BMI and sociocultural influences with body image. Residence and self-esteem modified the level of sociocultural influences. Family literacy training and social support for students with low self-esteem are suggested preventive tools of eating and body image disturbances.

Television Viewing Time and Breast Cancer Incidence for Japanese Premenopausal and Postmenopausal Women: The JACC Study.

PURPOSE: The evidence on effects of TV viewing time among premenopausal and postmenopausal women for breast cancer risk remains controversial and limited. MATERIALS AND METHODS: A prospective study encompassing 33,276 (17,568 premenopausal, and 15,708 postmenopausal) women aged 40-79 years in whom TV viewing time, menstrual, and reproductive histories were determined by a self-administered questionnaire. The follow-up was from 1988 to 2009 and hazard ratios (HRs) with 95% confidence intervals (CIs) of breast cancer incidence were calculated for longer TV viewing time in reference to shorter TV viewing time by Cox proportional hazard models. RESULTS: During 16.8-year median follow-up, we found positive associations between TV viewing time and breast cancer incidence with a borderline significant trend among total women and a significant trend among postmenopausal women. Among total women, the multivariable HRs (95% CIs) for risk of breast cancer in reference to < 1.5 hr/day of TV viewing time were 0.89 (0.59-1.34) for 1.5 to < 3.0 hr/day, 1.19 (0.82-1.74) for 3.0 to < 4.5 hr/day, and 1.45 (0.91-2.32) for ≥ 4.5 hr/day (p for trend=0.053) and among postmenopausal women, the corresponding risk estimates were 1.10 (0.42-2.88), 2.54 (1.11-5.80), and 2.37 (0.92-6.10) (p for trend=0.009), respectively. CONCLUSION: Prolonged TV viewing time was associated with increased risk of breast cancer, especially among postmenopausal women.

Work-to-family conflict rather than family-to-work conflict is more strongly associated with sleep disorders in Upper Egypt.

An important factor for which work and family compete is time. Due to lack of evidence, I investigated the associations between work-family conflict (assessed by the National Study of Midlife Development in the US) and sleep disorders (assessed by the Jenkins Sleep Questionnaire) in a cross-sectional study included 1,021 Egyptians aged 18-59 yr. Both work-to-family conflict (WFC) and family-to-work conflict (FWC) were associated with reduced sleep quantity. Moreover, high WFC was associated with sleep disorders; the multivariable ORs (95% CIs) were 2.32 (1.63-3.30) in high versus low WFC, 1.09 (0.79-1.49) in high versus low FWC and 2.41 (1.52-3.83) in high both WFC and FWC vs. low both WFC and FWC. Waking up too early with inability to fall asleep again and waking up tired after the usual amount of sleep were the most common sleep disturbances with high WFC; while insignificant increased risks for waking up several times per night and waking up tired after the usual amount of sleep were observed with high FWC. The study findings suggest the need for occupational and social health promotion programs to help men and women in labor force reach a balanced interaction between work and family life in order to reduce sleep complaints.

Changes in the living arrangement and risk of stroke in Japan; does it matter who lives in the household? Who among the family matters?

Previous studies have suggested associations of family composition with morbidity and mortality; however, the evidence of associations with risk of stroke is limited. We sought to examine the impact of changes in the household composition on risk of stroke and its types in Japanese population. Cox proportional hazard modelling was used to assess the risk of incident stroke and stroke types within a cohort of 77,001 Japanese men and women aged 45-74 years who experienced addition and/or loss of family members [spouse, child(ren), parent(s) and others] to their households over a five years interval (between 1990-1993 and 1995-1998). During 1,043,446 person-years of the follow-up for 35,247 men and 41,758 women, a total of 3,858 cases of incident stroke (1485 hemorrhagic and 2373 ischemic) were documented. When compared with a stable family composition, losing at least one family member was associated with 11-15% increased risk of stroke in women and men; hazard ratios (95% confidence interval) were 1.11 (1.01-1.22) and 1.15 (1.05-1.26), respectively. The increased risk was associated with the loss of a spouse, and was evident for ischemic stroke in men and hemorrhagic stroke in women. The addition of any family members to the household was not associated with risk of stroke in men, whereas the addition of a parent (s) to the household was associated with increased risk in women: 1.49 (1.09-2.28). When the loss of a spouse was accompanied by the addition of other family members to the household, the increased risk of stroke disappeared in men: 1.18 (0.85-1.63), but exacerbated in women: 1.58 (1.19-2.10). In conclusion, men who have lost family members, specifically a spouse have higher risk of ischemic stroke, and women who gained family members; specifically a parent (s) had the higher risk of hemorrhagic stroke than those with a stable family composition.

Work-family conflict and self-rated health among Japanese workers: How household income modifies associations.

To examine associations between work-family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011-2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work-family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04-2.97) for men and 3.54 (95% CI; 2.92-4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work-family conflict were likely to be more evident in the low income group only among women. Work-family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women.