Search

This study examined the relationship between dietary intake, body weight, and body mass index (BMI) in adult Thais as a function of smoking status. A cross-sectional, nationally representative survey using health and dietary questionnaires and anthropometric measurements were used. Participants were 7858 Thai adults aged 18 years and older recruited from 17 provinces in Thailand. Results demonstrated that smoking is associated with lower weights and BMI. However, when smokers were stratified by smoking intensity, there was no dose-response relationship between smoking and body weight. There is no conclusive explanation for weight differences across smoking groups in this sample, and the results of the present study did not clearly support any of the purported mechanisms for the differences in body weight or BMI. In addition, because the substantial negative health consequences of smoking are far stronger than those associated with modest weight differences, smoking cannot be viewed as an appropriate weight management strategy., (© 2011 APJPH.)

The authors examined the relationship between socioeconomic status and smoking in Thai adults. A nationally representative sample of 7858 Thais adults (18 years and older) was surveyed during 2004 to 2005. Four demographic/socioeconomic indicators were examined in logistic models: gender, education, occupational status, and annual household income. Overall, 22.2% of the participants were smokers. Men were more likely to be smokers across all age groups and regions. Compared with nonsmokers, current smokers were less educated, more likely to be employed, but had lower household income. When stratified by gender, education and job levels were strongly associated with smoking prevalence among males. A significant relationship was found between annual household income and smoking. Those who lived under the poverty line were more likely to smoke than persons who lived above the poverty line in both genders. The present study demonstrated that socioeconomic factors, especially education level and occupational class, have a strong influence on smoking behavior in Thai adults.

Objective: Weight assessment is a critical aid in patient care. It is particularly important in monitoring progression of pregnancies, heart failure status, and when adjusting medications. Although weight is generally determined using a scale, few studies have evaluated the precision of non-household scales. The objective of this study was to assess scale precision across a variety of settings., Methods: An evaluation of scales from randomly selected primary care clinics (n=30), diabetology/endocrinology clinics (n=7), weight loss facilities (n=25), and fitness centers (n=30) was performed. Assessments were completed on a total of 223 scales: 94 from primary care clinics, 32 from diabetology/endocrinology clinics, 39 from weight loss centers, and 58 from fitness centers. Scales were assessed for condition, location in facility, resting surface, commercial designation, and calibration history. Scale precision was validated using 100 lb. (45.5 kg), 150 lb. (68.3 kg), 200 lb. (90.9 kg), and 250 lb. (113.6 kg) certified weights., Results: Overall, scales demonstrated decreased precision with increased weight. At higher weights, more than 15% of scales were off by more than 6 lbs. (2.3 kg), approximately 1 Body Mass Index (BMI) unit. While facility type was not significant, condition, location in facility, resting surface, commercial designation, and calibration history were significant., Conclusions: This study demonstrates that many scales used to measure body weight are imprecise and that scales in health care settings are no more precise than those in other facilities. Clinical decisions based on scales that are imprecise have the potential to cause iatrogenic complications in patient care.

Depression is a well-established risk factor for cardiovascular disease-related morbidity and mortality. It is common to screen for depression in patients undergoing coronary revascularization prior to revascularization; however, the validity of this assessment is unclear as some patients may experience transient, reactive depression rather than persistent depression. The authors evaluated whether an initial or 1-month postprocedure screen was optimal for identifying consistently depressed patients. Depression at 1-month postprocedure was a stronger predictor of depression at months 2 to 6 than baseline depression. After adjusting potential confounding variables, there was a much stronger relationship between 1-month and 6-month depression status (OR = 28.7 if depressed at 1 month, p < .001) than between baseline and 6-month depression status (OR = 6.5 if depressed at baseline, p < .001). Screening for depression at the time of revascularization is not as predictive of depression at 6 months as it is 1 month postprocedure.

Several studies have demonstrated that a sizeable proportion of patients undergoing coronary artery bypass graft (CABG) demonstrate persistent declines in cognitive functioning. However, several important questions remain regarding cognitive changes following CABG. First, can patients vulnerable to cognitive decline after CABG be identified, providing valuable information that can be factored into clinical decisions? Second, the specificity of CABG as a cause of cognitive decline, when compared to other coronary procedures such as percutaneous coronary interventions, has not been established. Third, what mechanisms account for the neurocognitive decline after CABG? Several mechanisms have been proposed to lead to post-CABG neurocognitive deficits, including pre-CABG neurocognitive deficits, physiological injury, psychosocial factors, and/or the patient's perceptual processes. Finally, no study has demonstrated that cognitive changes, as measured by neuropsychological tests, have ecological validity. Specifically, behavioral sciences research is needed to demonstrate that measured cognitive changes significantly impact health status independent of other risk factors.