Association of serum vitamin D levels on Helicobacter pylori infection: a retrospective study with real-world data.

OBJECTIVE: The aim of this study was to determine whether serum vitamin D levels are associated with H. pylori infection and whether low serum vitamin D levels are an independent risk factor for H. pylori infection. METHODS: We conducted a retrospective analysis of a multicenter cohort study from 2017 to 2019. A total of 415 H. pylori+ patients and 257 H. pylori- patients aged between 18 and 75 years with both 13 C-urea breath test and serum vitamin D level results were included from four hospitals. A questionnaire was used to collect information on potential factors influencing H. pylori infection. RESULTS: Serum vitamin D levels were significantly lower in the H. pylori+ group than in the H. pylori- group (16.7 ± 6.6 ng/ml vs. 19.2 ± 8.0 ng/ml, p < 0.05). Using a cutoff value of 20 ng/ml, the H. pylori infection rate was significantly higher in the vitamin D-deficient group (< 20 ng/ml) than in the vitamin D-nondeficiency group (≥ 20 ng/ml) (66.5% vs. 51.0%, p < 0.001). Ordered logistic regression analysis showed that serum vitamin D levels < 20 ng/ml (OR: 1.652, 95% CI: 1.160-2.351, p = 0.005), higher education levels (OR: 1.774, 95% CI: 1.483-2.119, p < 0.001), family size ≥ 4 (OR: 1.516, 95% CI: 1.081-2.123, p = 0.016), and lower annual income (OR: 1.508, 95% CI: 1.289-1.766, p < 0.001) were independent risk factors for H. pylori infection. CONCLUSION: Lower serum vitamin D levels may be associated with an increased risk of H. pylori infection, and lower serum vitamin D levels are an independent risk factor for increasing H. pylori infection rates. Randomized controlled trials are needed to determine whether supplementation with vitamin D can reduce H. pylori infection rates.

Economic returns and the perceived obstacles to adopting active management in the forest-grassland transition ecoregion in south-central USA.

Forest-grassland ecotones are a mosaic of grassland, savanna, and upland forest. As such, landowners may have opportunities to choose to manage their lands for multiple objectives. We estimated the economic returns from managing forest and rangeland in southeastern Oklahoma, USA to produce different combinations of timber, cattle forage, and white-tailed deer (Odocoileus virginianus Zimmermann) browse for a 40-year period. We further conducted a survey to understand landowner perceptions of obstacles to adopting active management that involve timber harvest and prescribed fire. The highest net return was obtained from the treatment with harvested timber that was burned every four years (uneven-aged woodland/forest) because it had the greatest gross return from a combination of timber (46%), cattle forage (42%), and deer browse (11%). The return from this treatment was greater than that for managed for timber only (closed-canopy forest) or prioritizing cattle and deer (savanna). Survey results suggested that landowners were aware of the benefits of active management but that the majority (66%) considered cost a major obstacle in the management of their forest or rangeland. In particular, women forestland owners and older landowners considered cost an obstacle. Our findings advocate integrated timber, cattle, and deer management as the best economic strategy within the forest-grassland ecotone and for targeted outreach and landowner education related to the benefits of active management.

'Loneliness in the city': examining socio-economics, loneliness and poor health in the North East of England.

OBJECTIVES: The aim of this study was to discover whether lower socio-economic status is associated with increased experiences of loneliness and isolation. The research subsequently determined whether this relationship impacted health inequalities. STUDY DESIGN: The study used a cross-sectional, self-reported survey collecting information on loneliness, isolation and poor health (n = 680). The survey was administered through Sunderland District Council in 2016-2017, and data were analysed at The University of Sunderland. METHODS: The study used a quantitative approach, and data were analysed using descriptive statistics, engaging in univariate, bivariate and multivariate levels of analysis. RESULTS: A number of significant findings emerged from the data analysis, linking lower socio-economic status to experiences of loneliness (P = 0.000) and social isolation (P = 0.000). When determining if social isolation and socio-economics had a detrimental impact on a person's health, no statistical association was discovered (P = 0.098). Yet, there was a significant relationship concerning socio-economic status, loneliness and poor health (P = 0.026). CONCLUSIONS: The authors have identified a number of associations within the data with reference to isolation, loneliness and poor health. Therefore, participants from a lower socio-economic group experienced disproportionately high levels of social isolation and emotional loneliness when compared with other socio-economic groups. The data also demonstrate that participants who experienced loneliness, and who were from a lower socio-economic background, were consistently more likely to report poor health than those from other socio-economic backgrounds.

The association between allostatic load and guaranteed annual income using the Canadian Longitudinal Study on Aging: A cross-sectional analysis of the benefits of guaranteed public pensions.

BACKGROUND: Old Age Security (OAS) represents an public policy through which income-related inequalities in health may be improved. The goal of this cross-sectional study was to investigate the health benefits of receiving OAS in financially insecure older Canadians. METHODS: Using data from the Canadian Longitudinal Study on Aging (CLSA) (n=15,691), ordered logistic regression was used to measure associations between financial insecurity and allostatic load. RESULTS: Receiving OAS as highest personal income source appeared to remove the health penalty of being financially insecure. While financial insecurity was associated with worse allostatic load in both males and females not receiving OAS, those receiving OAS as highest personal income source had better allostatic load compared to other financially insecure older adults (ORM: 0.398, 95 % CI: 0.227, 0.696; ORF: 0.677, 95 % CI: 0.483, 0.949). DISCUSSION: While longitudinal data would be needed to draw causal inferences, these results suggest OAS may play a role improving health outcomes and narrowing income-related health inequalities. Such findings may have important implications on older adults, other vulnerable populations, and future directions of Canadian health and public policy.

Employment and Mental Health of the Chinese Elderly: Evidence from CHARLS 2018.

Improving the mental health of the elderly has become an important strategic goal of healthy aging, among which employment is regarded as an essential factor for the mental health of the elderly. This study adopted ordinary least squares, ordered logit, propensity score matching (PSM), and KHB mediation analysis to examine the influence and mechanism of employment on mental health in older Chinese adults using data from the China Health and Retirement Longitudinal Survey of 2018. The study found that employment positively impacts older adults' mental health in China. This promotive effect of employment was significant for more senior people aged up to 80 years old with lower educational backgrounds and rural household registration. In addition, individual annual income, the financial support provided to children, and support received from children significantly mediate the realization of employment improving older people's mental health. Our findings are expected to provide valuable insight into delayed retirement and active aging in China. Therefore, the government must play the role of support and advocacy to promote employment and safeguard the well-being of older adults.

Treatment Patterns, Socioeconomic Status and Clinical Burden in Mild COPD: A Swedish Real-World, Retrospective Cohort Study, the ARCTIC Study.

Background: Patients with mild chronic obstructive pulmonary disease (COPD) account for more than half of the total COPD population but are often undiagnosed and sparsely studied. This real-world, longitudinal study compared the socioeconomic burden, clinical characteristics and treatment patterns in patients with mild COPD and age- and gender-matched controls. Patients and methods: Our population included mild COPD patients (forced expiratory volume in one second ≥80% of predicted value) and reference controls from 52 Swedish primary care centres over 15 years (2000-2014). We linked electronic medical record (EMR) data to Sweden's National Health Registries. The outcomes analyzed were socioeconomic status including annual income from work, presence of comorbidities and the use of medications. Results: 844 patients with mild COPD were included in this study and matched with 844 reference controls. Compared with the reference controls, mild COPD patients had a significantly lower annual income from work (mean difference, men: 12,559€ and women: 7143€) and were significantly less likely to be married or employed. The presence of comorbidities, including cardiovascular disease, anxiety and depression (only women) was significantly higher in mild COPD patients. The use of medications, such as proton pump inhibitors, antidepressants, central painkillers and sleep medications, was significantly higher in the mild COPD group. Conclusion: Mild COPD presents a considerable socioeconomic and clinical burden compared with reference controls The findings suggest that COPD constitutes a condition that influences health status even in mild disease clearly demanding an increased need for early detection and treatment.

Association Between Parental Socioeconomic Status and Skeletal Muscle Mass in Chinese College Students: Fitness Improvement Tactics in Youths (FITYou) Project.

PURPOSE: The purpose of this study was to determine the association between parental socioeconomic status (SES) and skeletal muscle mass in Chinese college students. METHODS: A cross-sectional study including 2204 college freshmen was conducted in Shenyang, China. Data regarding body composition, health examinations, and a self-reported questionnaire were available from all the participants. Skeletal muscle mass assessment was completed by a bioelectrical impedance analyzer. Information on parental SES (educational levels, annual income, and occupational status) was collected via questionnaires. Covariance analysis was used to adjust for the confounding effects of sex, age, ethnicity, smoking status, alcohol use, and sleep duration. RESULTS: Multivariate analysis showed that college freshmen with higher parental SES levels generally had higher skeletal muscle mass after adjustment for confounding factors (mean [95% confidence interval]: low, 42.4 [42.0, 42.8]; middle, 42.9 [42.6, 43.3]; high, 43.7 [43.4, 44.1], p for trend < 0.001). Similar results were observed for paternal and maternal SES (p for trend < 0.001, respectively), whereas association between paternal SES and youth muscle mass became non-significant after adjusting for maternal SES (p for trend = 0.077). Results also showed positive linear trends for skeletal muscle mass and paternal or maternal educational levels and annual income (p for trend < 0.001, respectively), but not for occupational status. CONCLUSION: This study found a positive association between parental SES and skeletal muscle mass in Chinese college students. Compared to the normalization of height or weight, body mass index-adjusted skeletal muscle mass is more likely to be associated with SES.

Socio-economic status and severity of plaque psoriasis: a cross-sectional study in the metropolitan city of Bologna.

Only a limited amount of data is available on the demographic and socio-economic status of psoriasis patients and its correlation with disease severity and impact on quality of life. The aim of this study was to investigate whether the socio-economic status of psoriasis patients is associated with higher PASI (Psoriasis Area Severity Index) and DLQI (Dermatology Life Quality Index) scores and global severity of disease. A total of 300 adults with plaque psoriasis, attending our psoriasis clinic for the first time (January 2015 to April 2018), were included in the study. Severity of psoriasis was defined according to three different definitions: PASI > 10, DLQI >10, and global severity based on the "Rule of tens" > 10%. The three outcomes were compared between patients with mild psoriasis and those with moderate-to-severe psoriasis using the t-test and χ2-test. Multiple logistic regression analyses were used to evaluate the association between each of the three outcomes and clinical and socio-economic features. Patients with lower educational level, employed in manual or office work, and with lower income were more likely to have moderate-to-severe psoriasis, considering the PASI and DLQI scores separately and the global severity of disease. The association between severity of disease and income was also significant based on multiple regression models. This study confirms the negative association between psoriasis severity and socio-economic status and is aimed at raising awareness among health professionals to investigate and consider this aspect in the management and therapeutic decisions in affected patients.

Development trend of physical examination volume and revenue in health-checkup institutions in China from 2010 to 2019 / 中华健康管理学杂志

Objective:To investigate the development trend of physical examination volume and revenue in health-checkup institutions in China from 2010 to 2019.Methods:In this longitudinal study, the annual income, annual physical examination volume and other indicators reflecting institutional size were collected with questionnaire from 374 health-checkup institutions in the year of 2010, 2015 and 2019. The geometric mean method is used to calculate the compound annual growth rate (CAGR) of the annual physical examination volume, annual income, mean per capita cost from 2010 to 2015 and 2015 to 2019.Results:The annual physical examination volume of health-checkup institutions increased from 1.81 (1.00, 3.20) ×10 4 person times in 2010 to 5.08(3.50, 7.28)×10 4 person times in 2019; the CAGR of the physical examination volume from 2010 to 2015 was 14.04%(8.14%, 23.78%), and it was 9.49%(3.39%, 19.07%) from 2015 to 2019. The annual revenue increased from 768.73 (350.00, 1 623.75) ×10 4 yuan in 2010 to 3 500.00 (1 997.73, 6 818.54) ×10 4 yuan in 2019; the CAGR of annual revenue from 2010 to 2015 was 25.75% (15.17%, 35.09%), and it was 15.67% (8.78%, 26.11%) from 2015 to 2019. The mean per capita cost increased from 434.26 (278.82, 666.66) yuan in 2010 to 755.80 (506.90, 1 005.42) yuan in 2019; the CAGR of the mean per capita cost was 9.82% (1.71%, 17.10%) from 2010 to 2015, and it was 5.37% (0.95%, 10.46%) from 2015 to 2019. Conclusion:From 2010 to 2019, health-checkup institutions in China developed rapidly, and the CAGR of the annual physical examination volume, annual revenue, mean per capita cost are high.