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1.
Natl Vital Stat Rep ; 69(3): 1-11, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32510315

RESUMEN

Objectives-This report presents data on recent trends for three sexually transmitted infections (STIs)-chlamydia, gonorrhea, and syphilis-reported among women giving birth in the United States from 2016 through 2018, and rates by selected characteristics for 2018. Methods-Data are from birth certificates and are based on 100% of births registered in the United States for 2016, 2017, and 2018. Birth certificate data on infections during pregnancy are recommended to be collected from the mother's medical records (1). Mothers are to be reported as having an infection if there is a confirmed diagnosis or documented treatment for the infection in their medical record (2). Results-Among women giving birth in 2018, the overall rates of chlamydia, gonorrhea, and syphilis were 1,843.9, 310.2, and 116.7 per 100,000 births, respectively. The rates for these STIs increased 2% (chlamydia), 16% (gonorrhea), and 34% (syphilis) from 2016 through 2018. In 2018, rates of chlamydia and gonorrhea decreased with advancing maternal age, whereas those for syphilis decreased with maternal age through 30-34 years and then increased for women aged 35 and over. In 2018, rates of all three STIs were highest for non-Hispanic black women, women who smoked during pregnancy, women who received late or no prenatal care, and women for whom Medicaid was the principal source of payment for the delivery. Among women aged 25 and over, rates of each of the STIs decreased with increasing maternal education.


Asunto(s)
Complicaciones Infecciosas del Embarazo/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Adulto , Certificado de Nacimiento , Infecciones por Chlamydia/epidemiología , Infecciones por Chlamydia/etnología , Grupos de Población Continentales/estadística & datos numéricos , Parto Obstétrico/economía , Escolaridad , Femenino , Gonorrea/epidemiología , Gonorrea/etnología , Humanos , Edad Materna , Medicaid/estadística & datos numéricos , Embarazo , Complicaciones Infecciosas del Embarazo/etnología , Atención Prenatal/estadística & datos numéricos , Enfermedades de Transmisión Sexual/etnología , Fumar/epidemiología , Fumar/etnología , Sífilis/epidemiología , Sífilis/etnología , Estados Unidos/epidemiología , Adulto Joven
2.
South Med J ; 113(6): 311-319, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32483642

RESUMEN

OBJECTIVES: Prevalence and trends in all cardiovascular disease (CVD) risk factors among young adults (18-39 years) have not been evaluated on a large scale stratified by sex and race. The aim of this study was to establish the prevalence and temporal trend of CVD risk factors in US inpatients younger than 40 years of age from 2007 through 2014 with racial and sex-based distinctions. In addition, the impact of these risk factors on inpatient outcomes and healthcare resource utilization was explored. METHODS: A cross-sectional nationwide analysis of all hospitalizations, comorbidities, and complications among young adults from 2007 to 2014 was performed. The primary outcomes were frequency, trends, and race- and sex-based differences in coexisting CVD risk factors. Coprimary outcomes were trends in all-cause mortality, acute myocardial infarction, arrhythmia, stroke, and venous thromboembolism in young adults with CVD risk factors. Secondary outcomes were demographics and resource utilization in young adults with versus without CVD risk factors. RESULTS: Of 63 million hospitalizations (mean 30.5 [standard deviation 5.9] years), 27% had at least one coexisting CVD risk factor. From 2007 to 2014, admission frequency with CVD risk factors increased from 42.8% to 55.1% in males and from 16.2% to 24.6% in females. Admissions with CVD risk were higher in male (41.4% vs 15.9%) and white (58.4% vs 53.8%) or African American (22.6% vs 15.9%) patients compared with those without CVD risk. Young adults in the Midwest (23.9% vs 21.1%) and South (40.8% vs 37.9%) documented comparatively higher hospitalizations rates with CVD risk. Young adults with CVD risk had higher all-cause in-hospital mortality (0.4% vs. 0.3%) with a higher average length of stay (4.3 vs 3.2 days) and charges per admission ($30,074 vs $20,124). CONCLUSIONS: Despite modern advances in screening, management, and interventional measures for CVD, rising trends in CVD risk factors across all sex and race/ethnic groups call for attention by preventive cardiologists.


Asunto(s)
Diabetes Mellitus/epidemiología , Dislipidemias/epidemiología , Hipertensión/epidemiología , Obesidad/epidemiología , Enfermedades Vasculares Periféricas/epidemiología , Fumar/epidemiología , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/etnología , Americanos Asiáticos/estadística & datos numéricos , Bases de Datos Factuales , Diabetes Mellitus/etnología , Dislipidemias/etnología , Grupos Étnicos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Mortalidad Hospitalaria , Hospitalización , Humanos , Hipertensión/etnología , Indios Norteamericanos/estadística & datos numéricos , Masculino , Infarto del Miocardio/epidemiología , Infarto del Miocardio/etnología , Obesidad/etnología , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Enfermedades Vasculares Periféricas/etnología , Prevalencia , Factores de Riesgo , Factores Sexuales , Fumar/etnología , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etnología , Estados Unidos/epidemiología , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/etnología , Adulto Joven
3.
Aust N Z J Public Health ; 44(3): 186-192, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32459387

RESUMEN

OBJECTIVE: To examine whether baseline measures of stress, life satisfaction, depression and alcohol use predict making or sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers. METHODS: We analysed data from the nationally representative quota sample of 1,549 Aboriginal and Torres Strait Islander adults who reported smoking at least weekly in the Talking About The Smokes baseline survey (April 2012-October 2013) and the 759 who completed a follow-up survey a year later (August 2013-August 2014). RESULTS: More smokers who reported negative life satisfaction, feeling depressed, higher stress or drinking heavily less often than once a week at baseline made a quit attempt between the baseline and follow-up surveys. In contrast, of these smokers who had made quit attempts between surveys, more who reported higher stress were able to sustain abstinence for at least one month; other associations were inconclusive. Conclusions and implications for public health: Health staff and Aboriginal and Torres Strait Islander smokers need not see being more stressed as an obstacle to quitting among Aboriginal and Torres Strait Islander people. Health staff should emphasise the benefits to mental health that come with successfully quitting smoking.


Asunto(s)
Alcoholismo/psicología , Depresión/psicología , Satisfacción Personal , Fumadores/psicología , Fumar/efectos adversos , Estrés Psicológico/psicología , Adulto , Alcoholismo/etnología , Australia/epidemiología , Investigación Participativa Basada en la Comunidad , Depresión/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Fumar/epidemiología , Fumar/etnología , Cese del Hábito de Fumar/etnología , Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Estrés Psicológico/etnología
4.
N Z Med J ; 133(1514): 33-40, 2020 05 08.
Artículo en Inglés | MEDLINE | ID: mdl-32379737

RESUMEN

BACKGROUND: Aortic dissection is a life-threatening condition frequently requiring emergency surgery. Key risk factors include hypertension and aortopathy syndromes; however, possible ethnic associations and differences in presentation and outcomes are less well established. We compared characteristics and outcomes of type A aortic dissection surgery by ethnicity. METHODS: Consecutive patients having type A aortic dissection surgery at Auckland City Hospital March 2003-March 2017 were divided into three ethnic groups: Maori, Pasifika and 'other', and analysed for characteristics, presentation and outcomes. RESULTS: Among 327 patients, 45 (14%) were Maori, 91 (28%) were Pasifika Islander and 191 (58%) were other ethnicities. Mean age was lowest for Maori 51+/-12 years, then Pasifika 56+/-12 and other ethnicities 63+/-13 (P<0.001). Maori and Pasifika ethnicities had higher body mass index, more hypertension, dyslipidaemia and smoking, but lower proportion presenting in critical pre-operative state. Operative mortality occurred in 5 (11%), 18 (20%) and 42 (22%) for Maori, Pasifika and other ethnicities (P=0.258). Pasifika had higher age-standardised operative mortality standardised mortality ratio 6.00, 95% confidence interval 3.67-9.30 than 'other' ethnicities, while Maori had higher age-standardised late mortality 5.71, 2.90-10.2 respectively, and the latter association persisted in multivariable analysis. Critical pre-operative state and malperfusion syndrome independently predicted operative mortality. CONCLUSION: Maori and Pasifika patients were younger and present less unwell with type A aortic dissection, but had higher prevalence of cardiovascular risk factors. They had higher age-standardised late and operative mortality respectively, suggesting that aggressive management and risk factor control are critical for these patients.


Asunto(s)
Aneurisma Disecante/etnología , Aneurisma Disecante/cirugía , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Procedimientos Quirúrgicos Vasculares/mortalidad , Adulto , Anciano , Índice de Masa Corporal , Dislipidemias/etnología , Femenino , Humanos , Hipertensión/etnología , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Gravedad del Paciente , Factores de Riesgo , Fumar/etnología , Resultado del Tratamiento
6.
Diabetes Res Clin Pract ; 161: 108028, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31962087

RESUMEN

BACKGROUND: Australian Indigenous women experience high rates of social disadvantage and type 2 diabetes (T2D) in pregnancy, but it is not known how social factors and maternal behaviours impact neonatal adiposity in offspring of women with hyperglycaemia in pregnancy. METHODS: Participants were Indigenous (n = 404) and Europid (n = 240) women with gestational diabetes mellitus (GDM) or T2D in pregnancy and their offspring in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study. Social, economic factors, and maternal behaviours were measured in pregnancy and six neonatal anthropometric outcomes were examined after birth. RESULTS: On univariate analysis, maternal education < 12 years (p = 0.03), unemployment (p = 0.001), welfare income vs no welfare income (p = 0.001), lower area based socio-economic score (p < 0.001), and fast food intake > 2 times/week (p = 0.002) were associated with increased sum of skinfolds (SSF) in offspring. Smoking was significantly associated with a reduction in anthropometric measures, except SSF. In multivariable models adjusted for ethnicity, BMI and hyperglycaemia, social and economic factors were no longer significant predictors of neonatal outcomes. Smoking was independently associated with a reduction in length, head circumference and fat free mass. Frequent fast food intake remained independently associated with SSF (ß-coefficient 1.08 mm, p = 0.02). CONCLUSION: In women with hyperglycaemia in pregnancy, social factors were associated with neonatal adiposity, particularly skinfold measures. Promoting smoking cessation and limited intake of energy-dense, nutrient-poor foods in pregnancy are important to improve neonatal adiposity and lean mass outcomes. Addressing inequities in social and economic factors are likely to be important, particularly for Indigenous women or women experiencing social disadvantage.


Asunto(s)
Adiposidad/fisiología , Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Recién Nacido/metabolismo , Conducta Materna/fisiología , Embarazo en Diabéticas , Efectos Tardíos de la Exposición Prenatal/metabolismo , Adiposidad/etnología , Adulto , Australia/epidemiología , Peso al Nacer/fisiología , Índice de Masa Corporal , Estudios de Cohortes , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Gestacional/epidemiología , Diabetes Gestacional/metabolismo , Femenino , Humanos , Hiperglucemia/complicaciones , Hiperglucemia/epidemiología , Hiperglucemia/metabolismo , Masculino , Obesidad/complicaciones , Obesidad/epidemiología , Obesidad/metabolismo , Grupos de Población/estadística & datos numéricos , Embarazo , Resultado del Embarazo/epidemiología , Resultado del Embarazo/etnología , Embarazo en Diabéticas/epidemiología , Embarazo en Diabéticas/metabolismo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Fumar/efectos adversos , Fumar/epidemiología , Fumar/etnología , Factores Socioeconómicos , Adulto Joven
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1420-1425, 2019 Nov 10.
Artículo en Chino | MEDLINE | ID: mdl-31838815

RESUMEN

Objective: To understand the trends of smoking and passive smoking exposure in adults in Shaanxi province from 2007 to 2015. Methods: Data was from China Chronic Disease and Risk Factor Surveillance in 2007, 2010, 2013 and 2015 to calculate the rates of smoking, smoking cessation and passive smoking exposure, as well as the amount of smoking of smokers indicated by each surveillance. Cochran-Armitage test was used to assess the trends across survey periods. The weighting rate was calculated by using sampling weight and data from the 6(th) national census in 2010. Sensitivity analysis was done to test the trends as well. Results: The results of the surveillance indicated that the smoking rate in 2007 was 38.26%, highest in the results of four surveys, it decreased to 30.95% in 2013 and then increased to 34.11% in 2015 (Cochran-Armitage test: Z=2.46, P=0.014). The amount of smoking increased from 16.90 cigarettes per day in 2007 to 17.76 cigarettes per day in 2015. The overall rate of smoking cessation was 11.02% in 2007 and 16.95% in 2015 (Cochran- Armitage test: Z=-4.18, P<0.01). We observed the passive smoking exposure rate was 48.10% in 2010 and 63.88% in 2015 (Cochran-Armitage test: Z=-10.60, P<0.01). We found no difference in trends by sensitivity analysis. Conclusions: The smoking rate and amount of cigarettes smoked in adults in Shaanxi remained stable and at a high level. The rate of smoking cessation increased gradually, while the passive smoking exposure rate increased rapidly.


Asunto(s)
Vigilancia de la Población/métodos , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Fumar/tendencias , Contaminación por Humo de Tabaco/estadística & datos numéricos , Adolescente , Adulto , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Fumar/etnología , Cese del Hábito de Fumar/psicología , Encuestas y Cuestionarios
8.
BMC Public Health ; 19(1): 1632, 2019 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-31801498

RESUMEN

BACKGROUND: Few population-based studies have assessed dietary behaviors in the rural multiethnic population of Northern Norway. The present study determined dietary patterns and investigated their association with Sami ethnicity, sociodemographic factors, and lifestyle factors in a multiethnic population in rural Northern Norway. METHODS: This cross-sectional study included 4504 participants of the SAMINOR 2 Clinical Survey (2012-2014) aged 40-69 years. All participants completed a lifestyle and food frequency questionnaire. Dietary patterns were determined using principal component analysis. Associations between food patterns and ethnicity, sociodemographic factors, and lifestyle factors were examined by multiple linear regression. RESULTS: Six dietary patterns were identified that accounted for 28% of the variability in food intake in the study sample: 'processed meat/westernized', 'fish/traditional', 'fruit/vegetables', 'reindeer/traditional', 'bread and sandwich spreads', and 'sweets and bakery goods'. The 'reindeer/traditional' pattern was most common among the inland Sami population. The 'fish/traditional' pattern was most common among costal multiethnic Sami and least common among inland Sami and among women independent of ethnicity. The 'fish/traditional' pattern was also positively associated with older age, high education level, small household size, and smoking. Adherence to the 'processed meat/westernized' pattern was lower among inland Sami than inland/coastal non-Sami; no ethnic differences in adherence to this pattern were found between costal multiethnic Sami and inland/coastal non-Sami. Unhealthy lifestyle factors, like low physical activity level and smoking, and younger age were mainly associated with the 'processed meat/westernized' pattern, whereas socioeconomic factors like low education, low gross annual household income, and large household size were related to the 'sweets and bakery goods' pattern. Male gender, low education level, and smoking were associated with the 'bread and sandwich spreads' pattern. The 'fruit/vegetables' pattern was characterized by healthy dietary choices and a health-conscious lifestyle, and was more common in women with a high education level and income. CONCLUSIONS: Adherence to the six identified dietary patterns was characterized by different sociodemographic and lifestyle factors. Ethnicity, in combination with geographical region of residence, was associated with dietary behaviors. This study provides knowledge that will be useful in future studies on dietary patterns related to chronic diseases in the rural population of Northern Norway.


Asunto(s)
Dieta/etnología , Grupos Étnicos/estadística & datos numéricos , Estilo de Vida/etnología , Población Rural/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Estudios Transversales , Ejercicio Físico , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Noruega/epidemiología , Análisis de Componente Principal , Factores Sexuales , Fumar/etnología , Factores Socioeconómicos
10.
Pathol Res Pract ; 215(12): 152723, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31704150

RESUMEN

BACKGROUND: Long non-coding RNA Nuclear Paraspeckle Assembly Transcript 1 (NEAT1) is a novel lncRNA localized specifically to nuclear paraspeckles. The study analyses the association between NEAT1 genetic polymorphisms and the susceptibility of lung cancer in a Chinese Northeast Population. METHODS: The NEAT1 rs512715 and rs2239895 genetic polymorphisms were genotyped in 462 lung cancer cases and 559 controls by a Real-Time Polymerase Chain Reaction (PCR) with the TaqMan discrimination assay. RESULTS: Our study found that the polymorphisms of two SNPs increased or decreased the risk of lung cancer were not obvious, but statistical significance in non-small cell lung cancer and lung squamous cell carcinoma can be observed. Compared with homozygous CC genotype carriers, the GC genotype of rs2239895 was positively related to the risk of lung squamous cell carcinoma (OR 1.805, 95% CI, 1.168-2.789, P = 0.008). Similarly, associations between rs2239895 and lung squamous cell carcinoma risk were found (CC + GC vs. GG, OR 1.668, 95%CI, 1.093-2.545, P = 0.018) in dominant model. In stratified analysis for age, rs2239895 GC genotype was observed to increase the risk of non-small-cell lung cancer compared with CC genotype (OR 1.562, 95%CI, 1.029-2.371, P = 0.036). However, the study showed that negative correlation the lung cancer risk and rs512715 polymorphisms. There was no remarkable relationship between the both additive and multiplicative model about the two SNPs. CONCLUSIONS: The polymorphisms rs2239895 were associated with the risk of lung squamous cell carcinoma. The interaction between the two SNPs and the cigarette smoking was no notable difference.


Asunto(s)
Adenocarcinoma del Pulmón/genética , Biomarcadores de Tumor/genética , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Células Escamosas/genética , Neoplasias Pulmonares/genética , Polimorfismo de Nucleótido Simple , ARN Largo no Codificante/genética , Adenocarcinoma del Pulmón/diagnóstico , Adenocarcinoma del Pulmón/etnología , Adulto , Anciano , Grupo de Ascendencia Continental Asiática/genética , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/etnología , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etnología , Estudios de Casos y Controles , China/epidemiología , Femenino , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etnología , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Fumar/efectos adversos , Fumar/etnología
11.
Medicine (Baltimore) ; 98(40): e17113, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577700

RESUMEN

BACKGROUND: Periodontitis is a common disease with an unclear pathological mechanism. No precise consensus has been reached to evaluate the association between the IL-10 rs1800872 (- 592, -590, -597 C>A) polymorphism and periodontal disease. Thus, we performed this meta-analysis to collect more evidence-based information. METHODS: Four online databases, PubMed, Embase, Web of Science, and China Biology Medicine disc (CBM), were searched in August 2018. An odds ratio (OR) with a 95% confidence interval (CI) was applied to evaluate the association of the rs1800872 with periodontitis susceptibility. RESULTS: Twenty three case-control studies with 2714 patients and 2373 healthy controls were evaluated. The overall analyses verified that the IL-10 rs1800872 polymorphism was significantly associated with an increased risk of periodontitis in the allelic model, homozygote model, dominant model, and recessive model (A vs C: OR = 1.28, 95%CI = 1.11-1.49, P = .00, I = 56.87%; AA vs CC: OR = 2.06, 95%CI = 1.32-3.23, P = .00, I = 73.3%; AA + AC vs CC: OR = 1.42, 95%CI = 1.03-1.96, P = .03, I = 76.2%; AA vs AC + CC: OR = 1.78, 95%CI = 1.26-2.56, P = .00, I = 76.7%). Moreover, the subgroup analysis based on ethnicity, periodontitis type, and smoking status showed significant differences. CONCLUSIONS: The results of our meta-analysis demonstrate that rs1800872 is associated with periodontitis susceptibility in Caucasians and Asians. Moreover, A allele, AA genotype, CC genotype may be closely associated with chronic periodontitis (CP), while A allele, AA genotype may be closely associated with aggressive periodontitis (AgP).


Asunto(s)
Interleucina-10/genética , Periodontitis/etnología , Periodontitis/genética , Periodontitis Agresiva/etnología , Periodontitis Agresiva/genética , Alelos , Grupo de Ascendencia Continental Asiática/genética , Estudios de Casos y Controles , China , Periodontitis Crónica/etnología , Periodontitis Crónica/genética , Grupo de Ascendencia Continental Europea/genética , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Polimorfismo de Nucleótido Simple , Factores de Riesgo , Fumar/etnología
12.
Artículo en Inglés | MEDLINE | ID: mdl-31615105

RESUMEN

BACKGROUND: Although social, behavioral, and health factors influence prevalence and intensity of pain, very few studies have investigated correlates of pain among economically disadvantaged older African American (AA) adults. OBJECTIVE: This study explored social, behavioral, and health correlates of pain intensity among community-dwelling AA older adults in an economically disadvantaged area of Los Angeles. METHODS: A cross-sectional study on 740 AA older adults (age ≥ 55 years) was conducted in South Los Angeles between 2015 and 2018. Exploratory variables were age, gender, educational attainment, financial difficulties, living alone, marital status, smoking, drinking, pain-related chronic medical conditions (CMCs), and depressive symptoms. Dependent variable was pain intensity. Linear regression was used for data analysis. RESULTS: Age, financial difficulties, living alone, smoking, pain-related chronic medical conditions, and depressive symptoms were associated with pain intensity. Individuals with lower age, higher financial difficulties, those who lived alone, those with a higher number of pain-related chronic medical conditions, more depressive symptoms, and nonsmokers reported more pain intensity. Gender, educational attainment, marital status, and drinking were not associated with pain intensity. CONCLUSION: The results may help with the health promotion of economically disadvantaged AA older adults in urban areas.


Asunto(s)
Afroamericanos , Disparidades en el Estado de Salud , Dolor/etnología , Determinantes Sociales de la Salud , Factores de Edad , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/etnología , Estudios Transversales , Depresión/etnología , Femenino , Identidad de Género , Humanos , Vida Independiente , Modelos Lineales , Los Angeles/epidemiología , Masculino , Persona de Mediana Edad , Dolor/complicaciones , Dolor/psicología , Dimensión del Dolor , Pobreza , Prevalencia , Factores Sexuales , Fumar/etnología , Factores Socioeconómicos , Poblaciones Vulnerables
13.
Artículo en Inglés | MEDLINE | ID: mdl-31581468

RESUMEN

Background: Although obesity may have a role as a risk factor for cerebrovascular mortality, less is known about how demographic and social groups differ in this regard. Aims: This study had two aims: first to investigate the predictive role of baseline obesity on long-term risk of mortality due to cerebrovascular disease, and second, to test racial variation in this effect. Methods: the Americans' Changing Lives Study (ACL) 1986-2011 is a state of the art 25-year longitudinal cohort study. ACL followed a nationally representative sample of Blacks (n = 1156) and Whites (n = 2205) for up to 25 years. Baseline obesity was the main predictor of interest, time to cerebrovascular death was the main outcome of interest. Demographic characteristics, socioeconomic status (educational attainment and household income), health behaviors (exercise and smoking), and health (hypertension and depressive symptoms) at baseline were covariates. Cox proportional hazards models were used to test additive and multiplicative effects of obesity and race on the outcome. Results: From the total 3,361 individuals, 177 people died due to cerebrovascular causes (Whites and Blacks). In the pooled sample, baseline obesity did not predict cerebrovascular mortality (hazard ratio (HR) = 0.86, 0.49-1.51), independent of demographic, socioeconomic, health behaviors, and health factors at baseline. Race also interacted with baseline obesity on outcome (HR = 3.17, 1.09-9.21), suggesting a stronger predictive role of baseline obesity on cerebrovascular deaths for Black people compared to White individuals. According to the models that were run specific to each race, obesity predicted risk of cerebrovascular mortality for Blacks (HR = 2.51, 1.43-4.39) but not Whites (HR = 0.69, 0.31-1.53). Conclusions: Baseline obesity better predicts long-term risk of cerebrovascular death in Black individuals compared to White people. More research should explore factors that explain why racial differences exist in the effects of obesity on cerebrovascular outcome. Findings also have implications for personalized medicine.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Trastornos Cerebrovasculares/etnología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Obesidad/etnología , Adulto , Anciano , Anciano de 80 o más Años , Animales , Trastornos Cerebrovasculares/mortalidad , Depresión/etnología , Ejercicio Físico , Femenino , Conductas Relacionadas con la Salud/etnología , Humanos , Hipertensión/etnología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Factores de Riesgo , Fumar/etnología , Factores Socioeconómicos , Estados Unidos
14.
PLoS One ; 14(8): e0220777, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31404115

RESUMEN

BACKGROUND: Millions of children and others across the world are being dangerously exposed to tobacco smoke and toxins in their own homes. Whilst there is limited interest in laws and interventions controlling tobacco use in public places in Bangladesh, no attention has been given to preventing tobacco-use inside homes. This study explores the familial and socio-cultural factors that provide obstacles for ensuring tobacco-free homes in Bangladesh. MATERIALS AND METHODS: A mixed-method design was adopted and from among the 1,436 tobacco users identified in a population of 11,853, 400 (tobacco users) were selected for cross-sectional survey. This survey involved a probability proportional sampling procedure, and 24 In-Depth Interviews. Multivariate logistic regression was performed to explore the association of familial and socio-cultural factors with tobacco-use at home adjusted by other demographic characteristics. Thematic content analysis was done on the qualitative data, and then inferences were drawn out collectively. RESULTS: This study revealed that the prevalence of tobacco-use in the home was 25.7% in urban residential areas in Bangladesh. Multivariate logistic regression analysis identified that familial and socio-cultural factors were significantly associated with tobacco-use at home: marital status (OR 3.23, 95% CI: 1.37-6.61), education (OR 2.14, 95% CI: 1.15-3.99), smoking habits of older family members (OR 1.81 95% CI: 0.91-2.89), tobacco being offered as hospitality and for entertainment (OR 1.85, 95% CI: .94-2.95) and lack of religiosity practice (OR 2.39, 95% CI: 1.27-4.54). Qualitative findings indicated that social customs, lack of religious practice, tobacco-use of older family members, and lack of family guidance were key obstacles for enabling tobacco-free homes in urban areas. CONCLUSION: Use of tobacco at home is continuing as part of established familial and socio-cultural traditions. If tobacco-use at home is not addressed seriously by the authorities then the emerging threat of second-hand smoke exposure and harmful consequences of tobacco- use will be exacerbated.


Asunto(s)
Cultura , Familia , Prevención del Hábito de Fumar , Adulto , Bangladesh/epidemiología , Estudios Transversales , Familia/psicología , Femenino , Vivienda , Humanos , Entrevistas como Asunto , Modelos Logísticos , Masculino , Prevalencia , Fumar/epidemiología , Fumar/etnología , Fumar/psicología , Factores Socioeconómicos , Encuestas y Cuestionarios , Población Urbana
15.
Inquiry ; 56: 46958019864479, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31328601

RESUMEN

E-cigarette use among adolescents is well-documented, but less is known about adult users of e-cigarettes. The purpose of this study was to examine associations between sociodemographic factors and e-cigarette use in a nationally representative sample of adults in the United States. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for years 2015-2016 were analyzed to assess e-cigarette use among 5989 adults aged ≥18 years. Multivariable logistic regression was conducted to examine associations between the sociodemographic exposures of age, sex, race, marital status, education level, employment status, and poverty-income ratio and the outcome of e-cigarette use. The weighted prevalence of ever use of e-cigarettes was 20%. Compared with adults aged ≥55 years, odds of e-cigarette use were 4.77 times (95% confidence interval [CI] = 3.63-6.27) higher among ages 18 to 34 years and 2.16 times (95% CI = 1.49-3.14) higher among ages 35 to 54 years. Higher odds of e-cigarette use were observed among widowed/divorced/separated participants compared with those who were married/living with a partner, among participants with less than high school (odds ratio [OR] = 1.47; 95% CI = 1.08-2.00) or high school/general educational development (GED) education (OR=1.41; 95% CI = 1.12-1.77) compared with those with college degrees/some college, and among those with incomes below the poverty level (OR=1.31; 95% CI = 1.01-1.69) compared with above the poverty level. For non-smokers of conventional cigarettes, higher odds of e-cigarette use were observed among males compared with females, Mexican Americans/Other Hispanics compared with non-Hispanic whites, and non-working participants compared with those who were working. Overall findings indicate that individuals who are widowed/divorced/separated, individuals with lower education, and with incomes below the poverty level are likely to report ever use of e-cigarettes. As increasing evidence demonstrates negative health consequences, e-cigarette initiation may ultimately contribute to additional smoking-related health inequalities even among non-smokers of conventional cigarettes.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Fumar/epidemiología , Factores Socioeconómicos , Adulto , Factores de Edad , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Prevalencia , Fumar/etnología , Productos de Tabaco , Estados Unidos
16.
PLoS Med ; 16(7): e1002853, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31335910

RESUMEN

BACKGROUND: With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority. This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. METHODS AND FINDINGS: We harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54-105 (mean = 72.7) years and without dementia at baseline. Studies had 2-15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mass index, cardiovascular disease, depression, diabetes, self-rated health, high cholesterol, hypertension, peripheral vascular disease, physical activity, smoking, and history of stroke. Associations with risk factors were determined for a global cognitive composite outcome (memory, language, processing speed, and executive functioning tests) and Mini-Mental State Examination score. Individual participant data meta-analyses of multivariable linear mixed model results pooled across cohorts revealed that for at least 1 cognitive outcome, age (B = -0.1, SE = 0.01), APOE*4 carriage (B = -0.31, SE = 0.11), depression (B = -0.11, SE = 0.06), diabetes (B = -0.23, SE = 0.10), current smoking (B = -0.20, SE = 0.08), and history of stroke (B = -0.22, SE = 0.09) were independently associated with poorer cognitive performance (p < 0.05 for all), and higher levels of education (B = 0.12, SE = 0.02) and vigorous physical activity (B = 0.17, SE = 0.06) were associated with better performance (p < 0.01 for both). Age (B = -0.07, SE = 0.01), APOE*4 carriage (B = -0.41, SE = 0.18), and diabetes (B = -0.18, SE = 0.10) were independently associated with faster cognitive decline (p < 0.05 for all). Different effects between Asian people and white people included stronger associations for Asian people between ever smoking and poorer cognition (group by risk factor interaction: B = -0.24, SE = 0.12), and between diabetes and cognitive decline (B = -0.66, SE = 0.27; p < 0.05 for both). Limitations of our study include a loss or distortion of risk factor data with harmonization, and not investigating factors at midlife. CONCLUSIONS: These results suggest that education, smoking, physical activity, diabetes, and stroke are all modifiable factors associated with cognitive decline. If these factors are determined to be causal, controlling them could minimize worldwide levels of cognitive decline. However, any global prevention strategy may need to consider ethno-regional differences.


Asunto(s)
Cognición , Disfunción Cognitiva/etnología , Grupos Étnicos/psicología , Factores de Edad , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/psicología , Comorbilidad , Diabetes Mellitus/etnología , Ejercicio Físico , Femenino , Educación en Salud , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Fumar/efectos adversos , Fumar/etnología , Accidente Cerebrovascular/etnología
17.
Geriatr Gerontol Int ; 19(9): 930-937, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31309695

RESUMEN

AIM: To quantify variations in health-related behaviors (HRB) clustering of older adults in Western and Eastern countries. METHODS: Using six aging cohorts from the USA, England, Europe, Japan, Korea and China, latent class analysis was applied to access the clustering of smoking, alcohol consumption, physical activity and social activity. RESULTS: A total of 104 552 participants (55% women) aged ≥50 years in 2010 were included. Despite a different number of clusters identified, three consistent cluster profiles emerged: "Multiple-HRB" (ex-/never smoking, moderate drinking, frequent physical and social activity); "Inactives" (socially and physically inactive without other risk behaviors); and "(ex-)Smokers with Risk Behaviors". Sex and cohort variations were shown. For men in Western cohorts, "Multiple-HRB" was the predominant cluster, whereas their Asian counterparts were more likely to be members of the "Smokers with risk behavior" and "Inactives" clusters. Most women, particularly those in Asian cohorts, were never smokers and non-drinkers, and most of them belonged to the socially "Inactives" cluster. CONCLUSIONS: We provide a person-centered understanding of HRB clustering of older adults over selected countries by sex, informing tailored health promotion for the target population. Geriatr Gerontol Int 2019; 19: 930-937.


Asunto(s)
Envejecimiento , Consumo de Bebidas Alcohólicas , Ejercicio Físico/psicología , Conductas Relacionadas con la Salud/etnología , Promoción de la Salud/métodos , Estilo de Vida/etnología , Conducta Sedentaria/etnología , Fumar , Anciano , Envejecimiento/etnología , Envejecimiento/psicología , Consumo de Bebidas Alcohólicas/etnología , Consumo de Bebidas Alcohólicas/psicología , Análisis por Conglomerados , Comparación Transcultural , Europa (Continente)/epidemiología , Lejano Oriente/epidemiología , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Persona de Mediana Edad , Asunción de Riesgos , Fumar/etnología , Fumar/psicología , Estados Unidos/epidemiología
18.
Artículo en Inglés | MEDLINE | ID: mdl-31242661

RESUMEN

Background: This article explores ethnic minority generational differences in smoking behavior, frequency of alcohol consumption, and dietary style in Britain, and whether these differences can be explained by generational differences in socioeconomic status and ethnic identity. Method: Multivariate analyses using wave 2 (2010-2012) and wave 5 (2013-2015) of the United Kingdom Household Longitudinal Study on smoking behavior, frequency of alcohol consumption, and dietary style from 59,189 White British, 1690 Indians, 960 Pakistanis, 555 Bangladeshis, 1060 Black Caribbeans, and 1059 Black Africans, adjusted for demographic characteristics, socioeconomic status and ethnic identity. Results: While we find little evidence for generational differences in dietary style, second-generation Indians, Pakistanis, and Black Caribbeans have a significantly higher probability of smoking than the first-generation, and all second-generation minorities are significantly more likely to consume alcohol than their first-generation counterparts. Such generational differences in alcohol consumption are partly explained by second-generation minorities' weakened ethnic identity and higher socioeconomic status. Conclusions: This study facilitates a better understanding of minority generational differences in health behaviors and the role of socioeconomic status and ethnic identity, highlighting the need for future policy interventions to target certain second-generation ethnic minorities who have adopted certain host society unhealthy lifestyles.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Dieta , Grupos Étnicos , Grupos Minoritarios , Fumar/epidemiología , Adulto , Anciano , Consumo de Bebidas Alcohólicas/etnología , Efecto de Cohortes , Grupo de Ascendencia Continental Europea , Femenino , Conductas Relacionadas con la Salud , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Salud de las Minorías , Fumar/etnología , Clase Social , Reino Unido/epidemiología , Adulto Joven
19.
Health Promot Chronic Dis Prev Can ; 39(6-7): 207-215, 2019 Jun.
Artículo en Inglés, Francés | MEDLINE | ID: mdl-31210046

RESUMEN

INTRODUCTION: Ongoing surveillance of youth substance use is essential to quantify harms and to identify populations at higher risk. In the Canadian context, historical and structural injustices make monitoring excess risk among Indigenous youth particularly important. This study updated national prevalence rates of tobacco, alcohol, and marijuana use among Indigenous and non-Indigenous students. METHODS: Differences in tobacco, alcohol, and marijuana use were examined, using logistic regression, among 1700 Indigenous and 22 800 non-Indigenous youth in Grades 9-12 who participated in the 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey. Differences by sex were also examined. Mean age of first alcohol and marijuana use was compared in the two populations using OLS regression. Results were compared to 2008/09 data. RESULTS: While smoking, alcohol, and marijuana rates have decreased compared to 2008/09 in both populations, the gap between the populations has mostly not. In 2014/15, Indigenous youth had higher odds of smoking (odds ratio [OR]: 5.26; 95% confidence interval [CI]: 3.54-7.81) and past-year drinking (OR: 1.43; 95% CI: 1.16- 1.76) than non-Indigenous youth. More Indigenous than non-Indigenous youth attempted quitting smoking. Non-Indigenous males were less likely to have had at least one drink in the past-year compared to non-Indigenous females. Indigenous males and females had higher odds of past-year marijuana use than non-Indigenous males (OR: 1.84; 95% CI: 1.32-2.56) and females (OR: 2.87; 95% CI: 2.15-3.84). Indigenous youth, especially males, drank alcohol and used marijuana at younger ages. CONCLUSION: Additional policies and programs are required to help Indigenous youth be successful in their attempts to quit smoking, and to address high rates of alcohol and marijuana use.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Indios Norteamericanos , Uso de la Marihuana/epidemiología , Fumar/epidemiología , Estudiantes/estadística & datos numéricos , Adolescente , Conducta del Adolescente , Consumo de Bebidas Alcohólicas/etnología , Canadá/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Uso de la Marihuana/etnología , Vigilancia de la Población , Prevalencia , Factores Sexuales , Fumar/etnología
20.
PLoS Med ; 16(6): e1002821, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31211777

RESUMEN

BACKGROUND: College affirmative action programs seek to expand socioeconomic opportunities for underrepresented minorities. Between 1996 and 2013, 9 US states-including California, Texas, and Michigan-banned race-based affirmative action in college admissions. Because economic opportunity is known to motivate health behavior, banning affirmative action policies may have important adverse spillover effects on health risk behaviors. We used a quasi-experimental research design to evaluate the association between college affirmative action bans and health risk behaviors among underrepresented minority (Black, Hispanic, and Native American) adolescents. METHODS AND FINDINGS: We conducted a difference-in-differences analysis using data from the 1991-2015 US national Youth Risk Behavior Survey (YRBS). We compared changes in self-reported cigarette smoking and alcohol use in the 30 days prior to survey among underrepresented minority 11th and 12th graders in states implementing college affirmative action bans (Arizona, California, Florida, Michigan, Nebraska, New Hampshire, Oklahoma, Texas, and Washington) versus outcomes among those residing in states not implementing bans (n = 35 control states). We also assessed whether underrepresented minority adults surveyed in the 1992-2015 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) who were exposed to affirmative action bans during their late high school years continued to smoke cigarettes between the ages of 19 and 30 years. Models adjusted for individual demographic characteristics, state and year fixed effects, and state-specific secular trends. In the YRBS (n = 34,988 to 36,268, depending on the outcome), cigarette smoking in the past 30 days among underrepresented minority 11th-12th graders increased by 3.8 percentage points after exposure to an affirmative action ban (95% CI: 2.0, 5.7; p < 0.001). In addition, there were also apparent increases in past-30-day alcohol use, by 5.9 percentage points (95% CI: 0.3, 12.2; p = 0.041), and past-30-day binge drinking, by 3.5 percentage points (95% CI: -0.1, 7.2, p = 0.058), among underrepresented minority 11th-12th graders, though in both cases adjustment for multiple comparisons resulted in failure to reject the null hypothesis (adjusted p = 0.083 for both outcomes). Underrepresented minority adults in the TUS-CPS (n = 71,575) exposed to bans during their late high school years were also 1.8 percentage points more likely to report current smoking (95% CI: 0.1, 3.6; p = 0.037). Event study analyses revealed a discrete break for all health behaviors timed with policy discussion and implementation. No substantive or statistically significant effects were found for non-Hispanic White adolescents, and the findings were robust to a number of additional specification checks. The limitations of the study include the continued potential for residual confounding from unmeasured time-varying factors and the potential for recall bias due to the self-reported nature of the health risk behavior outcomes. CONCLUSIONS: In this study, we found evidence that some health risk behaviors increased among underrepresented minority adolescents after exposure to state-level college affirmative action bans. These findings suggest that social policies that shift socioeconomic opportunities could have meaningful population health consequences.


Asunto(s)
Consumo de Alcohol en la Universidad/etnología , Conductas de Riesgo para la Salud , Grupos Minoritarios/legislación & jurisprudencia , Fumar/etnología , Fumar/legislación & jurisprudencia , Universidades/legislación & jurisprudencia , Adolescente , Femenino , Encuestas Epidemiológicas/métodos , Humanos , Masculino
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