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To estimate the prevalence and identify the factors associated with undiagnosed hypertension in India. A secondary data analysis using the National Family Health Survey (NFHS-5) covering the period 2019–2021. Information on hypertension among individuals aged 15–49 years was extracted from the survey dataset. We estimated the prevalence of undiagnosed hypertension using physical measurements along with self-reported data from the survey. A log-binomial model with survey-adjusted Poisson regression was used to estimate the prevalence ratio between undiagnosed and diagnosed hypertension. Multinomial logistic regression analysis examined the factors associated with diagnosed hypertension (vs healthy) and undiagnosed hypertension (vs healthy). All the analyses were survey-weight adjusted and stratified by gender. The survey-adjusted prevalence of undiagnosed hypertension was 8.75% (8.62%–8.87%) and was higher among males [13.56% (13.03%–14.12%)] than in females [8.14% (8.03%–8.25%)]. The proportion of individuals with undiagnosed hypertension among total hypertension was 44.99% (44.44%–45.55%) and was higher in males [65.94% (64.25%–67.60%)] than in females [42.18% (41.66%–42.71%)]. Our findings revealed that age, higher body mass index, no access to health care, and having no comorbidities were risk factors for undiagnosed hypertension. One in twelve people had undiagnosed hypertension, and of those with hypertension, one in two were undiagnosed, with males being disproportionately affected. Targeted public health interventions are crucial to improve hypertension screening, particularly among middle-aged and obese individuals without comorbidities. [ABSTRACT FROM AUTHOR]

Purpose: This study explores the relationship between depression and cardiovascular disease (CVD) in the US adult population, focusing on sex differences. Design: Cross-sectional study. Setting: National Health and Nutrition Examination Survey data (2013-2018). Participants: A total of 14 699 community-dwelling adults (≥20 years). Measure: The Patient Health Questionnaire (PHQ-9) depression screening tool assessed depressive symptoms. CVD events included heart failure, coronary heart disease, angina, heart attack, or stroke. Analysis: Adjusted prevalence ratios were estimated using a Poisson regression model. Results: The study finds a positive association between CVD incidents and both mild to moderate depressive symptoms (aPR:1.42, P =.002) and moderately severe to severe depression (aPR:1.72, P =.024). Overall, females exhibit a 47% lower likelihood of CVD incidents compared to males. However, in a subgroup analysis, increased depressive symptoms correlate with higher CVD incidents in females (aPRs range: 2.09 to 3.43, P <.001) compared to males (aPRs range: 1.45 to 1.77, P <.001). Conclusion: Depression is associated with increased cardiovascular disease (CVD) risk. Females generally have a lower CVD risk than males, but more severe depressive symptoms elevate CVD risk in females. These findings emphasize the significance of considering sex differences. Further research is needed to understand the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Context: Miscarriage is the most distressing complication in early pregnancy, with one in every five pregnant women ending in a miscarriage, and its causes are multifactorial. AIM: This study aimed to find the risk and protective factors of miscarriage among women aged 15–49 years in India by using the National Family Health Survey (NFHS-5) data. Methods and Material: The data were taken from NFHS-5; 53,560 women aged 15–49 years who had reported either a miscarriage (n = 5104) or livebirth (n = 48,456) during the last 12 months preceding the survey were included in the study. Statistical Analysis Used: Various sociodemographic, lifestyle, comorbid, and fertility-related factors were considered in the Poisson regression analysis, and adjusted prevalence ratios were obtained. Results: Significant sociodemographic risk factors were age less than 20 years or more than 34 years, urban residence, primary and higher education levels, wealth index middle and above, and occupation as employed. Muslim religion, Scheduled Tribe, and Other Backward Class castes were statistically significant protective factors. Obesity, severe anemia, hypertension, and thyroid disorder were the significant comorbid risk factors, whereas tobacco chewing was the only significant lifestyle risk factor. A higher number of ever-born children was the fertility-related risk factor, whereas the use of intrauterine devices was a significant protective factor for miscarriage. Conclusions: To reduce the incidence of miscarriage in developing countries like India, the respective governments and healthcare providers should develop intervention programs targeting women in well-educated and high-income families.

Modified Poisson regression, which estimates the regression parameters in the log-binomial regression model using the Poisson quasi-likelihood estimating equation and robust variance, is a useful tool for estimating the adjusted risk and prevalence ratio in binary outcome analysis. Although several goodness-of-fit tests have been developed for other binary regressions, few goodness-of-fit tests are available for modified Poisson regression. In this study, we proposed several goodness-of-fit tests for modified Poisson regression, including the modified Hosmer-Lemeshow test with empirical variance, Tsiatis test, normalized Pearson chi-square tests with binomial variance and Poisson variance, and normalized residual sum of squares test. The original Hosmer-Lemeshow test and normalized Pearson chi-square test with binomial variance are inappropriate for the modified Poisson regression, which can produce a fitted value exceeding 1 owing to the unconstrained parameter space. A simulation study revealed that the normalized residual sum of squares test performed well regarding the type I error probability and the power for a wrong link function. We applied the proposed goodness-of-fit tests to the analysis of cross-sectional data of patients with cancer. We recommend the normalized residual sum of squares test as a goodness-of-fit test in the modified Poisson regression. [ABSTRACT FROM AUTHOR]

BackgroundAbdominal obesity, excess fat around the abdomen, is more harmful than other fat types and is a key diagnostic criterion for metabolic syndrome. It poses a growing global public health concern. This study aimed to assess the prevalence of and determinants of abdominal obesity among adults in southwest Ethiopia.MethodsA cross-sectional study involving 624 adults in Semen Bench district, southwest Ethiopia was conducted from May 23 to June 23, 2022. The data was gathered using questionnaires and anthropometric measurements. The data were analyzed using Stata version 18. A robust Poisson regression was used due to the abdominal obesity prevalence exceeding 10%. Variables with p-values < 0.25 in the bivariate analysis were included in the multivariable analysis. The adjusted prevalence ratio (APR) and 95% confidence interval were reported to indicate statistical significance and the strength of associations.ResultsThe prevalence of abdominal obesity was 18% (95% CI: 15–21%). After adjusting for confounding variables, the determinants of abdominal obesity included participants aged 31–50 (APR = 3.62, 95% CI: 2.67–8.95) and 51–65 (APR = 3.24, 95% CI: 2.51–8.69), being female (APR = 2.65, 95% CI: 1.63–4.98), having a low wealth index (APR = 1.46, 95% CI: 1.19–3.76), physical inactivity (APR = 1.39, 95% CI: 1.06–4.18), lack of adequate dietary diversity (APR = 3.08, 95% CI: 2.09–6.42), and food insecurity (APR = 2.84, 95% CI: 1.82–7.68).ConclusionThe research revealed that 18% of the participants exhibited abdominal obesity. Factors such as advanced age, being female, having a low wealth index, physical inactivity, insufficient dietary diversity, and food insecurity were identified as contributors to abdominal obesity. Therefore, it is crucial to develop targeted interventions to address modifiable factors, as this can also help prevent the onset of non-communicable chronic diseases associated with abdominal obesity.

Post-graduate students and faculty usually conduct case-control studies. However, sometimes they conduct cohort studies that are short-duration. Most investigators enroll the participants in two groups according to the exposure. Then, follow the participants for some duration. At the end of the study, relative risk is calculated, and the work is published in some journal. The exposure may be one time, which may or may not be quantified. The follow-up duration may not be participant-specific, and differential follow-up does not exist. The author has given three examples: the first example of consanguineous marriages and congenital disabilities, the second example of the ABO blood group system and childhood asthma, and the third example of insecticide spraying and stillbirth. In the given examples, cumulative or density incidence cannot be calculated in a true sense and, therefore, risk ratio. Even estimating the incidence of outcome variables in some studies is not appropriate. Risk ratio calculation in such scenarios is questionable because exposure quantification, follow-up period, and combination are the limiting factors. In case-control studies, the prevalence ratio is calculated, which is analogous to relative risk. The author suggests that, in such circumstances, prevalence ratio calculation will be more appropriate.

Post-graduate students and faculty usually conduct case-control studies. However, sometimes they conduct cohort studies that are short-duration. Most investigators enroll the participants in two groups according to the exposure. Then, follow the participants for some duration. At the end of the study, relative risk is calculated, and the work is published in some journal. The exposure may be one time, which may or may not be quantified. The follow-up duration may not be participant-specific, and differential follow-up does not exist. The author has given three examples: the first example of consanguineous marriages and congenital disabilities, the second example of the ABO blood group system and childhood asthma, and the third example of insecticide spraying and stillbirth. In the given examples, cumulative or density incidence cannot be calculated in a true sense and, therefore, risk ratio. Even estimating the incidence of outcome variables in some studies is not appropriate. Risk ratio calculation in such scenarios is questionable because exposure quantification, follow-up period, and combination are the limiting factors. In case-control studies, the prevalence ratio is calculated, which is analogous to relative risk. The author suggests that, in such circumstances, prevalence ratio calculation will be more appropriate. [ABSTRACT FROM AUTHOR]

Abstract Background Cross-sectional studies are useful for the estimation of prevalence of a particular event with concerns in specific populations, as in the case of diseases or other public health interests. Most of these studies have been carried out with binary binomial logistic regression model which estimates OR values that could be overestimated due to the adjustment of the model. Thus, the selection of the best multivariate model for cross-sectional studies is a priority to control the overestimation of the associations. Methods We compared the precision of the estimates of the prevalence ratio (PR) of the negative Log-binomial model (NLB) with Mantel–Haenszel (MH) and the regression models Cox, Log-Poisson, Log-binomial, and the OR of the binary logistic regression in population-based cross-sectional studies. The prevalence from a previous cross-sectional study carried out in Colombia about the association of mental health disorders with the consumption of psychoactive substances (e.g., cocaine, marijuana, cigarette, alcohol and risk of consumption of psychoactive substances) were used. The precision of the point estimates of the PR was evaluated for the NLB model with robust variance estimates, controlled with confounding variables, and confidence interval of 95%. Results The NLB model adjusted with robust variance showed accuracy in the measurements of crude PRs, standard errors of estimate and its corresponding confidence intervals (95%CI) as well as a high precision of the PR estimate and standard errors of estimate after the adjustment of the model by grouped age compared with the MH PR estimate. Obtained PRs and 95%CI entre NLB y MH were: cocaine consumption (2.931,IC95%: 0.723–11.889 vs. 2.913, IC95%: 0.786–12.845), marijuana consumption (3.444, IC95%: 1.856–6.391 vs. 3.407, IC95%: 1.848, 6.281), cigarette smoking (2.175,IC95%: 1.493, 3.167 vs. 2.209, IC95%: 1.518–3.214), alcohol consumption (1.243,IC95%: 1.158–1.334 vs. 1.241, IC95%: 1.157–1.332), and risk of consumption of psychoactive substances (1.086, IC95%: 1.047–1.127 vs. 1.086, IC95%: 1.047, 1.126). The NLB model adjusted with robust variance showed mayor precision when increasing the prevalence, then the other models with robust variance with respect to MH. Conclusions The NLB model with robust variance was shown as a powerful strategy for the estimation of PRs for cross-sectional population-based studies, as high precision levels were identified for point estimators, standard errors of estimate and its corresponding confidence intervals, after the adjustment of confounding variables. In addition, it does not represent convergence issues for high prevalence cases (as it occur with the Log-binomial model) and could be considered in cases of overdispersion and with greater precision and goodness of fit than the other models with robust variance, as it was shown with the data set of the cross-sectional study used in here.

Introduction: Hepatitis B virus (HBV) is a major public health problem affecting 400 million people worldwide, and is a common cause of chronic liver failure (cirrhosis) and hepatocellular carcinoma. Sixty-eight percent of infected people are from the African and Pacific regions. Vertical transmission from mother to newborn baby is one of the mechanisms by which chronic hepatitis virus infection spreads, besides infections from contaminated needles and syringes and sexual contact. Hepatitis B chronic infection is endemic in many poor countries, especially in Africa. Method: A cross-sectional study was conducted between July and August 2021. Pregnant women attending the antenatal care (ANC) in Bor State referral hospital, South Sudan, were interviewed to collect information on their socio-demographic characteristics and risk factors for hepatitis B infection. The objective was to determine the seroprevalence of hepatitis B chronic infection through blood testing. Prevalence ratios for certain risk factors were calculated. Results: Two hundred pregnant women were enrolled. The Prevalence Rate for chronic infection with hepatitis B virus, diagnosed using the rapid immune-chromatographic assay for Hepatitis B surface antigen (HBsAg), was 8.5%. (95% CI; 4.7% - 12.3%). None of the suspected risk factors studied were found to be significantly associated with testing positive for HBV, except for a history of previous jaundice. Conclusion: The prevalence of HBV chronic infection among pregnant women in Bor, Jonglei State, is high; hence, there is a need for established public health interventions that can lead to a reduction of HBV vertical transmission. Treatment of pregnant women with HBV chronic infection using anti-viral medications during pregnancy might curb the vertical transmission rates.

Objective Estimate the prevalence of hypertensive disorder of pregnancy (HDP) at term, define population characteristics, and calculate adverse maternal outcomes. Methods Retrospective study. Results We included 4,702,468 pregnancies. HDP increased linearly from 4.5% (2014) to 6.0% (2018). HDP was more frequent among black (PR 1.19), obese (PR 2.31 to 3.70), with gestational (PR 1.87) or pregestational diabetes (PR 2.16). Increased transfusion (PR 2.52), intensive care unit admission (PR 3.38), and unplanned hysterectomy (PR 1.78) with HDP. Conclusion Our study quantifies the increased risks for maternal and neonatal complications related to the development of HDP at or beyond 39 weeks among nulliparous women.

Background: Cross-sectional studies are useful for the estimation of prevalence of a particular event with concerns in specific populations, as in the case of diseases or other public health interests. Most of these studies have been carried out with binary binomial logistic regression model which estimates OR values that could be overestimated due to the adjustment of the model. Thus, the selection of the best multivariate model for cross-sectional studies is a priority to control the overestimation of the associations. Methods: We compared the precision of the estimates of the prevalence ratio (PR) of the negative Log-binomial model (NLB) with Mantel–Haenszel (MH) and the regression models Cox, Log-Poisson, Log-binomial, and the OR of the binary logistic regression in population-based cross-sectional studies. The prevalence from a previous cross-sectional study carried out in Colombia about the association of mental health disorders with the consumption of psychoactive substances (e.g., cocaine, marijuana, cigarette, alcohol and risk of consumption of psychoactive substances) were used. The precision of the point estimates of the PR was evaluated for the NLB model with robust variance estimates, controlled with confounding variables, and confidence interval of 95%. Results: The NLB model adjusted with robust variance showed accuracy in the measurements of crude PRs, standard errors of estimate and its corresponding confidence intervals (95%CI) as well as a high precision of the PR estimate and standard errors of estimate after the adjustment of the model by grouped age compared with the MH PR estimate. Obtained PRs and 95%CI entre NLB y MH were: cocaine consumption (2.931,IC95%: 0.723–11.889 vs. 2.913, IC95%: 0.786–12.845), marijuana consumption (3.444, IC95%: 1.856–6.391 vs. 3.407, IC95%: 1.848, 6.281), cigarette smoking (2.175,IC95%: 1.493, 3.167 vs. 2.209, IC95%: 1.518–3.214), alcohol consumption (1.243,IC95%: 1.158–1.334 vs. 1.241, IC95%: 1.157–1.332), and risk of consumption of psychoactive substances (1.086, IC95%: 1.047–1.127 vs. 1.086, IC95%: 1.047, 1.126). The NLB model adjusted with robust variance showed mayor precision when increasing the prevalence, then the other models with robust variance with respect to MH. Conclusions: The NLB model with robust variance was shown as a powerful strategy for the estimation of PRs for cross-sectional population-based studies, as high precision levels were identified for point estimators, standard errors of estimate and its corresponding confidence intervals, after the adjustment of confounding variables. In addition, it does not represent convergence issues for high prevalence cases (as it occur with the Log-binomial model) and could be considered in cases of overdispersion and with greater precision and goodness of fit than the other models with robust variance, as it was shown with the data set of the cross-sectional study used in here. [ABSTRACT FROM AUTHOR]

While a rising prevalence of anemia in the United States was reported in older studies, recent data are lacking. To estimate the prevalence and time trends of anemia in the United States and to examine how these estimates differ by gender, age, race, and household income to poverty threshold ratio (HIPR), we used the National Health and Nutrition Examination Surveys from 1999 to 2020. The presence of anemia was determined using the World Health Organization criteria. Survey-weighted raw and adjusted prevalence ratios (PRs) were determined using generalized linear models for the overall population and by gender, age, race, and HIPR. In addition, an interaction between gender and race was explored. Complete data on anemia, age, gender, and race were available on 87,554 participants (mean age = 34.6 years, women = 49.8%, Whites = 37.3%). Anemia prevalence increased from 4.03% during the 1999–2000 survey cycle to 6.49% during 2017–2020. In adjusted analyses, anemia prevalence was higher in >65 than in 26–45 years old (PR = 2.14, 95% confidence interval (CI) = 1.95, 2.35), in Blacks than Whites (PR = 3.97, 95% CI = 3.63, 4.35), in women than men (PR = 1.98, 95% CI = 1.83, 2.13), and in those with HIPR ≤ 1 than >4 (PR = 0.68, 95% CI = 0.61, 0.75). Gender modified the relationship between anemia and race; when compared to their male counterparts, Black, Hispanic, and other women had higher anemia prevalence than White women (all interaction p values <0.05). The anemia prevalence in the United States has risen from 1999 to 2020 and remains high among the elderly, minorities, and women. The difference in anemia prevalence between men and women is larger in non-Whites. [ABSTRACT FROM AUTHOR]

Estimate the prevalence of hypertensive disorder of pregnancy (HDP) at term, define population characteristics, and calculate adverse maternal outcomes. Retrospective study. We included 4,702,468 pregnancies. HDP increased linearly from 4.5% (2014) to 6.0% (2018). HDP was more frequent among black (PR 1.19), obese (PR 2.31 to 3.70), with gestational (PR 1.87) or pregestational diabetes (PR 2.16). Increased transfusion (PR 2.52), intensive care unit admission (PR 3.38), and unplanned hysterectomy (PR 1.78) with HDP. Our study quantifies the increased risks for maternal and neonatal complications related to the development of HDP at or beyond 39 weeks among nulliparous women. [ABSTRACT FROM AUTHOR]

In clinical research, assessing the association between two variables is a critical and fundamental task. Clinical studies aim to establish the effect size of the exposure to a variable on a given outcome. To measure this effect size, various statistical measures are used, among the most common are the prevalence ratio (PR), the relative risk (RR), the odds ratio (OR), the hazard ratio (HR), the incidence rate ratio (IRR), the attributable risk (AR), the number needed to treat (NNT), the mean difference (MD), and the linear regression coefficient (β). Each of these measures has its advantages and limitations, and their choice depends on the type of study and the nature of the data being analyzed. Therefore, it is important to understand the interpretation and use of each of them to perform an appropriate analysis. In this article, our goal is to explain in a practical way how to interpret these measures and how to use their p-values and 95% confidence intervals to assess statistical inference. Understanding how to evaluate the association between two variables is crucial for the design and analysis of high-quality clinical studies. This enables evidence-based decision-making and promotes improvements in patient care. [ABSTRACT FROM AUTHOR]

Background: There is dearth of community based nationally representative data on Reproductive tract infections (RTI). Evidence suggests the stigma associated with the symptoms lead to poor health seeking behaviour among women. Objective: To estimate the prevalence and determinants of RTI symptoms among women of reproductive age (WRA) group in a selected rural and urban slum of district Faridabad, Haryana. Methodology: An analytical cross-sectional study was conducted among 15-49 years age group ever married women residing in an urban slum and rural area of Faridabad. Minimum sample size was calculated to be 345. Systematic random sampling was used to interview eligible population using a predesigned structured questionnaire. Outcome variable of interest was at least one symptom of RTI. Prevalence ratio was calculated to identify the association between determinants and outcome. Results: Prevalence of at least one symptom of RTI among the women in urban area was 46.3% and 39.8% in rural area. Condom usage was higher among rural (20.4%) as compared to urban women (13.4%). Women in rural area reported higher proportion of abortions as compared to urban slum (10.2% vs 7.4%). The bivariable analysis revealed that use of sanitary pads, high parity, condom usage by partner and age at marriage as significant association with outcome. When subjected to generalized linear model non usage of condoms by partner (Adj PR (95%CI); 3.31 (1.14-9.57)) remained as an independent determinant of risk of RTI symptoms. Conclusion: Condom usage by partner in this study has emerged out be a protective factor for risk of RTI symptoms. [ABSTRACT FROM AUTHOR]

Abstract Introduction Uncontrolled blood pressure contributes a huge contribution to many hypertension-related complications and it is one of the unbeaten problems for patients taking antihypertensive drugs. The association of social support and other factors with uncontrolled blood pressure during the covid-19 pandemic is not well investigated. Therefore, this study explored the determinants of blood pressure control status during the COVID-19 pandemic among patients with hypertension who were on an antihypertensive treatment. Method A cross-sectional study was done from March to May 2021 among adults aged 18 or more patients with hypertension for three months or more on treatment in Dessie City. An interview-administered questionnaire was done using simple random sampling from hypertension follow-up register for 380 patients with hypertension. Blood pressure measurement was taken from their arm using a stethoscope and mercury sphygmomanometer at a sitting position with 90-degree back support. Uncontrolled blood pressure was also computed either the systolic or diastolic blood pressure greater than or less than the limit of uncontrolled blood pressure with regarding the age and diabetic status of patients. The perceived social support-related questionnaire was adopted from the Multidimensional Scale of Perceived Social Support (MSPSS) -12 item checklist. It was sum-up and transformed into three categories using tertile of their computed raw scores. The adjusted prevalence ratio with a 95 percent confidence interval (CI) was used to calculate the strength of the association between uncontrolled blood pressure and independent predictors using log-binomial regression analysis. A P-value less than 0.05 was declared as statistically significant in multivariable log-binomial regression analysis. Result A total of 360 study participants were included in this study. The prevalence of uncontrolled blood measures in patients with hypertension with a 95% CI was 55.8(50.7, 61.0). In a multivariable analysis adjusted prevalence ratio with 95% CI for poor medication adherence 1.86(1.59,2.19), being male 1.35(1.11,1.64), secondary education 0.52(0.35,0.77), and low social support 1.24(1.01, 1.54) were the predictors of uncontrolled blood pressure. Conclusion Uncontrolled blood pressure for patients with hypertension on treatment is higher during the COVID-19 pandemic. Being male, poor medication adherence, educational status and low social support are factors that contribute to uncontrolled blood pressure.

Growing evidence suggests that engagement in nature-based recreation can improve people's well-being. However, there is a lack of information regarding which specific nature-based recreation activities are related to specific well-being indicators. We conducted a cross-sectional study to explore how different types of nature-based recreation (i.e., any nature-based activities, forest-based activities, gardening, nature-based adventure activities) relate to five indicators of well-being on the WHO-5 index among American (n = 606), Brazilian (n = 448), and Spanish (n = 438) adults. Americans and Brazilians who reported engaging in nature-based recreation at least monthly in the last 12 months, or weekly during a typical week, were more likely to feel cheerful, relaxed, vigorous, rested after waking up, and interested in life than those who did not engage that frequently. Results in these two countries were similar across all five indicators of well-being and types of nature-based activity, except for gardening, where we observed slightly weaker correlations. In Spain, the correlation between nature-based recreation and well-being tended to be null or even negative, highlighting some variability in these relationships across countries. Further cross-country experimental work is needed to support these findings and identify the relative efficacy of specific nature-based interventions for enhancing human well-being around the world. • Nature-based recreation is associated with well-being across multiple countries. • Americans and Brazilians who engage in nature-based recreation regularly have better well-being. • Nature-based adventure and forest-based activities were associated with better well-being than gardening. • Nature-health associations mixed for the Spanish sample, highlighting cross-country variability. [ABSTRACT FROM AUTHOR]

BACKGROUND: Occupational blood and body fluid exposures (OBBFEs) are one of the biological risks run by health professionals, especially in hospitals. OBJECTIVE: The objectives of this study were to assess the occurrence and reporting of occupational blood and body fluid exposures (OBBFEs) in university hospital medical staff and to investigate factors associated to declared OBBFE and factors associated to reported OBBFE. METHODS: A self-administered questionnaire has been e-mailed to all junior and senior medical staff in four university hospital centers in one administrative region of France in 2017. RESULTS: 292 of the 1,228 respondents declared at least one OBBFE. More than two-thirds (70.2%) were under-reporters and more than half (53.8%) non-reporters. Younger subjects, surgical specialties and other associated work accidents were risk factors for OBBFE. Considering the reporting procedure too complex was a risk factor for underreporting. CONCLUSIONS: Underreporting by hospital medical staff was a persistent phenomenon, with a high rate. The OBBFE reporting procedure needs rethinking. [ABSTRACT FROM AUTHOR]

Background: Abdominal obesity, excess fat around the abdomen, is more harmful than other fat types and is a key diagnostic criterion for metabolic syndrome. It poses a growing global public health concern. This study aimed to assess the prevalence of and determinants of abdominal obesity among adults in southwest Ethiopia., Methods: A cross-sectional study involving 624 adults in Semen Bench district, southwest Ethiopia was conducted from May 23 to June 23, 2022. The data was gathered using questionnaires and anthropometric measurements. The data were analyzed using Stata version 18. A robust Poisson regression was used due to the abdominal obesity prevalence exceeding 10%. Variables with p -values < 0.25 in the bivariate analysis were included in the multivariable analysis. The adjusted prevalence ratio (APR) and 95% confidence interval were reported to indicate statistical significance and the strength of associations., Results: The prevalence of abdominal obesity was 18% (95% CI: 15-21%). After adjusting for confounding variables, the determinants of abdominal obesity included participants aged 31-50 (APR = 3.62, 95% CI: 2.67-8.95) and 51-65 (APR = 3.24, 95% CI: 2.51-8.69), being female (APR = 2.65, 95% CI: 1.63-4.98), having a low wealth index (APR = 1.46, 95% CI: 1.19-3.76), physical inactivity (APR = 1.39, 95% CI: 1.06-4.18), lack of adequate dietary diversity (APR = 3.08, 95% CI: 2.09-6.42), and food insecurity (APR = 2.84, 95% CI: 1.82-7.68)., Conclusion: The research revealed that 18% of the participants exhibited abdominal obesity. Factors such as advanced age, being female, having a low wealth index, physical inactivity, insufficient dietary diversity, and food insecurity were identified as contributors to abdominal obesity. Therefore, it is crucial to develop targeted interventions to address modifiable factors, as this can also help prevent the onset of non-communicable chronic diseases associated with abdominal obesity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yosef, Sebeta, Tekalign, Sisay, Bekele, Tesfaw and Shifera.)

Previous studies reported higher lung cancer incidence in women than men among persons aged 35-54 years in the United States, a reversal of historically higher rates in men. We examined whether this pattern varies by state. Based on lung cancer incidence (2015-2019) data among adults aged 35-54 years from Cancer in North America database and historical cigarette smoking prevalence data (2004-2005) among adults 20-39 years from the Behavioral Risk Factor Surveillance System, incidence rates in women were equal to or higher than rates in their male counterparts in 40 of 51 states, with statistically significant differences in 20 states (two-sided, p < .05). In contrast, current and ever smoking prevalence in women compared to men was statistically significantly lower (33 and 34 states, respectively) or similar. Furthermore, there was no association between differences in historical smoking prevalence and lung cancer incidence by sex. Lung cancer incidence rate is higher in young women than young men in most states and is unexplained by differences in smoking prevalence., (© 2024 UICC.)

Context: Miscarriage is the most distressing complication in early pregnancy, with one in every five pregnant women ending in a miscarriage, and its causes are multifactorial., Aim: This study aimed to find the risk and protective factors of miscarriage among women aged 15-49 years in India by using the National Family Health Survey (NFHS-5) data., Methods and Material: The data were taken from NFHS-5; 53,560 women aged 15-49 years who had reported either a miscarriage (n = 5104) or livebirth (n = 48,456) during the last 12 months preceding the survey were included in the study., Statistical Analysis Used: Various sociodemographic, lifestyle, comorbid, and fertility-related factors were considered in the Poisson regression analysis, and adjusted prevalence ratios were obtained., Results: Significant sociodemographic risk factors were age less than 20 years or more than 34 years, urban residence, primary and higher education levels, wealth index middle and above, and occupation as employed. Muslim religion, Scheduled Tribe, and Other Backward Class castes were statistically significant protective factors. Obesity, severe anemia, hypertension, and thyroid disorder were the significant comorbid risk factors, whereas tobacco chewing was the only significant lifestyle risk factor. A higher number of ever-born children was the fertility-related risk factor, whereas the use of intrauterine devices was a significant protective factor for miscarriage., Conclusions: To reduce the incidence of miscarriage in developing countries like India, the respective governments and healthcare providers should develop intervention programs targeting women in well-educated and high-income families., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Background: Increasing prevalence of childhood allergic rhinitis(AR) needs a deeper understanding on the potential adverse effects of early life exposure to air pollution. Objectives: The main aim was to evaluate the effects of maternal exposure to PM2.5 and chemical constituents during pregnancy on preschool children’s AR, and further to explore the modification effects of regions and exclusive breastfeeding. Methods: A multi-center population-based study was performed in 6 cities from 3 regions of China in 2011–2012. Maternal exposure to ambient PM2.5 and main chemical constituents(BC, OM, SO42−, NO3−, NH4+) during pregnancy was assessed and a longitudinal prospective analysis was applied on preschool children’s AR. The modification effects of regions and exclusive breastfeeding were investigated. Results: A total of 8.8% and 9.8% of children reported doctor-diagnosed allergic rhinitis(DDAR) and current hay fever, respectively, and 48.6% had less than 6 months of exclusive breastfeeding. The means of PM2.5 during pregnancy were 52.7 μg/m3, 70.3 μg/m3 and 76.4 μg/m3 in the east, north and central south of China, respectively. Multilevel log-binomial model regression showed that each interquartile range(IQR) increase of PM2.5 during pregnancy was associated with an average increase in prevalence ratio (PR) of DDAR by 1.43(95% confidence interval(CI): 1.11, 1.84) and current hay fever by 1.79(95% CI: 1.26, 2.55), respectively. Among chemical constituents, black carbon (BC) had the strongest associations. Across 3 regions, the eastern cities had the highest associations, followed by those in the central south and the north. For those equal to or longer than 6 months of exclusive breastfeeding, the associations were significantly reduced. Conclusions: Children in east of China had the highest risks of developing AR per unit increase of maternal exposure to PM2.5 during pregnancy, especially BC constituent. Remarkable decline was found in association with an increase in breastfeeding for ≥6 months, in particular in east of China.

Introduction: Uncontrolled blood pressure contributes a huge contribution to many hypertension-related complications and it is one of the unbeaten problems for patients taking antihypertensive drugs. The association of social support and other factors with uncontrolled blood pressure during the covid-19 pandemic is not well investigated. Therefore, this study explored the determinants of blood pressure control status during the COVID-19 pandemic among patients with hypertension who were on an antihypertensive treatment. Method: A cross-sectional study was done from March to May 2021 among adults aged 18 or more patients with hypertension for three months or more on treatment in Dessie City. An interview-administered questionnaire was done using simple random sampling from hypertension follow-up register for 380 patients with hypertension. Blood pressure measurement was taken from their arm using a stethoscope and mercury sphygmomanometer at a sitting position with 90-degree back support. Uncontrolled blood pressure was also computed either the systolic or diastolic blood pressure greater than or less than the limit of uncontrolled blood pressure with regarding the age and diabetic status of patients. The perceived social support-related questionnaire was adopted from the Multidimensional Scale of Perceived Social Support (MSPSS) -12 item checklist. It was sum-up and transformed into three categories using tertile of their computed raw scores. The adjusted prevalence ratio with a 95 percent confidence interval (CI) was used to calculate the strength of the association between uncontrolled blood pressure and independent predictors using log-binomial regression analysis. A P-value less than 0.05 was declared as statistically significant in multivariable log-binomial regression analysis. Result: A total of 360 study participants were included in this study. The prevalence of uncontrolled blood measures in patients with hypertension with a 95% CI was 55.8(50.7, 61.0). In a multivariable analysis adjusted prevalence ratio with 95% CI for poor medication adherence 1.86(1.59,2.19), being male 1.35(1.11,1.64), secondary education 0.52(0.35,0.77), and low social support 1.24(1.01, 1.54) were the predictors of uncontrolled blood pressure. Conclusion: Uncontrolled blood pressure for patients with hypertension on treatment is higher during the COVID-19 pandemic. Being male, poor medication adherence, educational status and low social support are factors that contribute to uncontrolled blood pressure. [ABSTRACT FROM AUTHOR]

Abstract Objectives This cross-sectional study assessed the prevalence of self-reported noncompliance with mandatory seatbelt-use law and examined the factors associated with noncompliance with seatbelt-use while driving in adult working population in Kuwait. Methods During October 2017, 822 adults aged 21–60 years from 11 government ministries and departments were enrolled in this study. Data were collected using a pre-tested, structured, and self-administered questionnaire. We computed the prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving and evaluated the factors associated with noncompliance with seatbelt-use law while driving using a multivariable log-binomial regression model. The adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (CI) were computed using model’s parameters’ estimates. Results Of 822 participants, 64.4% were females, 56.6% were 21 to 30 years old, 86.5% were Kuwaitis, and 70.3% had college and/or university level education. The prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving was 55.5%, whereas the prevalence of noncompliance with self-reported mandatory use seatbelt as a passenger was 80.9%. Multivariable log-binomial regression model showed that after adjusting for the influence of other variables in the model, participants were more likely to be noncompliers with mandatory seatbelt law while driving, if they believed that seatbelt does not protect against injuries during road traffic crashes (RTC) (adjusted PR = 1.20; 95% CI: 1.06–1.37; p = 0.004) or if they were ever fined for not wearing seatbelt (adjusted PR = 1.34; 95% CI: 1.24–1.47; p

Abstract Background There is increasing evidence linking environmental tobacco smoke (ETS) exposure at homes to the development of asthma among adolescents. Few studies have addressed this issue in the Middle Eastern countries including Kuwait. Therefore, this cross-sectional study assessed the prevalence of ETS exposure at home, prevalence of asthma and other respiratory conditions and examined the ETS exposure at home and personal tobacco smoking as risk factors for self-reported asthma among high-school students in Kuwait. Methods In this cross-sectional study, we enrolled participants from nine high-schools of Hawally Governorate of Kuwait during October 2015. We adapted a previously validated self-administered questionnaire for data collection. Prevalence of self-reported asthma and ETS exposure (≥ 1 smoker at home vs. none) were computed. The association between exposures of interest and self-reported asthma status was examined using a multivariable log-binomial regression model. Results Of 800 enrolled participants, 746 (92.2%) consented and completed the questionnaire. The participants with mean (SD) age of 16.8 (0.68) years were predominantly Kuwaiti (74.8%) and female (50.1%). The prevalence of ETS exposure at home and personal current smoking was 54 and 12.4% respectively. Self-reported asthma prevalence was 20.5%. Furthermore, the prevalence of physician-diagnosed asthma, wheezing during the last 12 months and wheezing ‘ever’ was 16.4, 20.1 and 26.2%, respectively. Fitted multivariable log-binomial regression model revealed that compared with the non-asthmatic, participants with self-reported asthma tended to be current smokers (adjusted prevalence ratio (adjusted PR) = 1.82; 95% CI: 1.30–2.56; p = 0.001) or have had ETS exposure at home (adjusted PR = 1.64; 95% CI: 1.21–2.23; p = 0.002). Conclusions We recorded a high prevalence of ETS exposure at home, high prevalence of self-reported asthma and identified ETS exposure at home and being a current smoker as strong risk factors for self-reported asthma among adolescents. Voluntary household smoking bans may substantially minimize the ETS exposure among adolescents. Additionally, such restriction may inculcate an antismoking attitude and prevent smoking initiation among adolescents. Such efforts may bring about reduction in ETS exposure and associated asthma risk and other smoking-related morbidities in this and other similar settings.

Introduction: Sexually transmitted Infections (STIs) are major public health concerns reaching an all-time high, globally. In Malaysia data on the prevalence of STIs remains scarce which limits the understanding of STI transmission dynamics and the role of interventions in the control of STIs. The aim of this study is to determine the epidemiology characteristics of STIs mainly from Malaysian private healthcare institutions. Method: A two years (2016 and 2017) retrospective review was conducted on 160 multiplex RT-PCR STI reports from KPJ hospitals, Malaysia. Results: There were 65 (40.6 %) patients positive STIs [male: 21/65 (32.3 %); female: 44/65 (67.7 %)]. The STIs was prevalent among young adults (56/65; 86.2 %) from the central region (46/65; 70.8 %). Females had 1.7 times greater risk to develop STI (20 per 100) and two times higher chance to have multiple STIs (10 per 100) in comparison to male. The single STIs was caused mainly by U. parvum (N=17). In males, U. urealyticum (N=3) and C. trachomatis (N=3) were prevalent, while U. parvum (N=15) was prevalent in females. There were 19 dual infections of STIs which were commonly caused by U. parvum and M. hominis (N=5). There were seven STIs cases caused by three pathogens concurrently including U. urealyticum, U. parvum and C. trachomatis (N=2) and U. urealyticum, M. genitalium and C. trachomatis (N=2). Females from urban communities have higher risk in comparison to males for developing multiple STIs. Conclusion: This study provides an imperative platform for temporal trends of STIs in Malaysia which reflects the health status of certain populations that warrant immediate public health interventions. [ABSTRACT FROM AUTHOR]

Objective: Evidence suggested that traumatic events, including pandemics, can be associated with psychiatric symptoms like increased anxiety and depression. However, there were many unknowns concerning the emergent global coronavirus-19 (COVID-19), including its impact on psychiatric health within the United States. Our study aimed to track trends of mental health problems in individuals who presented with psychiatric complaints in an emergent setting. Methods: A total of 1776 patients and 1610 patients presented to Emergency Department (ED) with psychiatric complaints between January 1 – July 9 of the years of 2019 and 2020, respectively, in Millcreek Community Hospital (MCH) Erie, PA. This study was an electronic medical record review (EMR), therefore the data were collected exclusively from EMR over the two-year span. ED prevalence was calculated as the number of total psychiatric MCH ED cases divided by the total number of all MCH ED patients, and prevalence ratio (PR) between 2019 and 2020 was used to reflect change of overall ED psychiatric prevalence. Results: Clinical notes revealed increased ED psychiatric chief complaint prevalence, as indicated by a PR greater than one, in multiple categories in comparison to before the COVID-19 outbreak. Concerning primary psychiatric disorders, there was increased ED prevalence in chief complaint of total mood disorders (PR = 1.21) with major depressive disorder (PR = 1.23) and bipolar disorder (PR = 1.47), neurodevelopment disorders (PR = 1.25) with attention deficit hyperactivity disorder (ADHD) (PR = 1.19) and intellectual disability (PR = 1.52), trauma- and stressor-related disorders (PR = 1.56) with post-traumatic stress disorder (PTSD) (PR = 1.39) and adjustment disorder (PR = 1.73), substance abuse and addiction disorders (PR = 1.29), and personality disorders (PR = 1.56). Conclusions: The pandemic outbreak dramatically impacted mental health in an ER setting. Further research on mental health disparities in conjunction with the COVID-19 pandemic is critical to help predict and address risk for chronic symptoms and sequela to help anticipate and improve psychiatric patient care and well-being during potential future pandemics.

Abstract Background Although alcohol use disorders contribute a high proportion of population disease burden, the treatment gap is large, especially in low- and middle-income countries. To narrow this gap, contextually relevant evidence is needed to inform service development in low- and middle-income country settings. The aim of this study was to assess the magnitude of the treatment gap for alcohol use disorder, help-seeking behavior, stigma and barriers to care among people with alcohol use disorder in rural Ethiopia. Methods A cross-sectional, house-to-house survey was conducted in Sodo district, south Ethiopia. A sample of 1500 adults was selected using simple random sampling from a census of households and screened for alcohol use disorder using the alcohol use disorders identification tool (AUDIT). Help-seeking, barriers to care and internalized stigma were investigated among people with moderately severe alcohol use disorder (AUDIT score ≥ 16). Poisson regression with robust variance was used to examine factors associated with alcohol use disorder. Results The prevalence of alcohol use disorder (AUDIT ≥8) in the past 12 months was 13.9% (25.8% in men and 2.4% in women, p-value

Psychosocial risks can negatively affect adolescents' physical, psychological, and social health. Grounded on the cumulative risk theory, the objective of this study was to analyze the differences in health-related quality of life (HRQoL) depending on the accumulation of several psychosocial risks (bullying, cyberbullying, cyberdating abuse, sexting, online grooming, and problematic Internet use). The participants were 3,212 Spanish adolescents (53.7% females) with a mean age of 13.92 ± 1.44, who completed self-report online questionnaires that assessed each of the aforementioned risks and HRQoL. Overall, 41.4% of the female participants and 36.8% of the males presented at least one risk, with significant differences between sexes. The percentage of participants who presented an accumulation of three or more risks was 8.2%. Risk accumulation was related to a lower HRQoL score than those who presented no risks. The scores in HRQoL decrease at up to four risks, point at which the differences ceased to be significant. [ABSTRACT FROM AUTHOR]

Background: Little is known about the change in prevalence of comorbidities during the disease course of people with multiple sclerosis (MS) and whether the prevalences vary by MS onset type. Objective: To calculate the change in prevalence of comorbidities between symptom onset and the time of study, to compare the prevalences of comorbidities with those in the Australian population at the time of study and to examine onset-type differences. Methods: Comorbidity data from 1518 participants of the Australian MS Longitudinal Study and Australian population comparator data (2014–2015 National Health Survey) were used. The change in prevalence between time points and prevalence ratios (PR) at the time of study (crude, age and sex adjusted, and stratified by onset type) was calculated. Results: Comorbidities were common, and those with the largest increases in prevalence between MS symptom onset and the time of study were depression (+ 26.9%), anxiety (+ 23.1%), hypertension (+ 21.9%), elevated cholesterol (+ 16.3%), osteoarthritis (+ 17.1%), eye diseases (+ 11.6%), osteoporosis (+ 10.9%) and cancer (+ 10.3%). Compared to the general population and after age and sex adjustment, participants had a significantly higher prevalence for 14/19 comorbidities at the time of study. The associations were strongest for anaemia, cancer (both PR > 4.00), anxiety, depression, migraine (all PR > 3.00), psoriasis and epilepsy (both PR > 2.00). No significant differences were seen by onset type. Conclusion: Comorbidities are common at MS symptom onset and increase with MS duration. Having MS may thus contribute to accrual of comorbidities. This emphasises the importance of optimal screening for and management of comorbidities in early MS and throughout the disease course. [ABSTRACT FROM AUTHOR]

Abstract Background Schistosomiasis, caused by Schistosoma japonicum, remains one of the most important parasitic diseases, and detection of S. japonicum infections in humans plays a crucial role in control and treatment. However, comparisons between the parasitological and the immunological examinations in the fields of China are lacking. Therefore we performed a meta-analysis to compare the seroprevalence of Schistosoma japonicum, as determined by IHA or ELISA, with coprological prevalence, as determined by Kato-Katz, and estimate the ratio of the serological to the egg-positive prevalence in order to evaluate the potential threat of egg-negative but worm-positive schistosomiasis. Methods Studies published up to July 2018 on the parasitological and immunological examinations of schistosomiasis in the fields of China were searched in five databases including CNKI, WanFang, VIP, PubMed and Web of Science. The ratio of the serological to the egg-positive prevalence and its 95%CI for each study were calculated, and then point estimates and their 95%CIs of pooled prevalence ratio were meta-analyzed. Subgroup meta-analyses were also performed according to potential influential factors. Results A total of 23 articles were included. The prevalence ratio varied from 0.57 to 48.83 for IHA to Kato-Katz and ranged from 0.38 to 13.97 for ELISA to Kato-Katz. The pooled ratio was 4.72 (95%CI: 3.87~ 5.76) for IHA to KK and 4.65 (95%CI: 3.50~ 6.17) for ELISA to KK. Subgroup analyses implied that the ratio of the serological to the egg-positive prevalence may decrease with the endemic levels. The highest prevalence ratio was observed when Kato-Katz was performed with three slides per stool or in hilly and mountainous regions. Conclusions The worm-determined prevalence by IHA or ELISA is 4- to 5-fold higher than the egg-determined prevalence by Kato-Katz, which implied Kato-Katz may largely underestimate the prevalence of S. japonicum in China. The degree of underestimation was greater when Kato-Katz with three slides per stool was carried out, especially in low endemic areas or in hilly and mountainous regions. Therefore, more attention should be paid to those egg-negative but worm-positive patients with the aim of final elimination of S. japonicum in China.

Objectives: This cross-sectional study assessed the prevalence of self-reported noncompliance with mandatory seatbelt-use law and examined the factors associated with noncompliance with seatbelt-use while driving in adult working population in Kuwait. Methods: During October 2017, 822 adults aged 21–60 years from 11 government ministries and departments were enrolled in this study. Data were collected using a pre-tested, structured, and self-administered questionnaire. We computed the prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving and evaluated the factors associated with noncompliance with seatbelt-use law while driving using a multivariable log-binomial regression model. The adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (CI) were computed using model's parameters' estimates. Results: Of 822 participants, 64.4% were females, 56.6% were 21 to 30 years old, 86.5% were Kuwaitis, and 70.3% had college and/or university level education. The prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving was 55.5%, whereas the prevalence of noncompliance with self-reported mandatory use seatbelt as a passenger was 80.9%. Multivariable log-binomial regression model showed that after adjusting for the influence of other variables in the model, participants were more likely to be noncompliers with mandatory seatbelt law while driving, if they believed that seatbelt does not protect against injuries during road traffic crashes (RTC) (adjusted PR = 1.20; 95% CI: 1.06–1.37; p = 0.004) or if they were ever fined for not wearing seatbelt (adjusted PR = 1.34; 95% CI: 1.24–1.47; p < 0.001). Furthermore, participants were significantly more likely to be noncompliers with mandatory seatbelt law while driving, if they were unaware of implemented mandatory seatbelt law in Kuwait (adjusted PR = 1.11; 95% CI: 1.04–1.19; p = 0.003). Conclusions: The prevalence of noncompliance with mandatory seatbelt-use law in the adult working population of Kuwait is considerably high. Being unaware of mandatory seatbelt use law, belief that seatbelt does not protect during RTC, and having ever been fined in the past for not having seatbelt on while driving were significant predictors of noncompliance with seatbelt-use law. These results warrant the focused mass education and rigorous enforcement of seatbelt-use law while driving. These strategies are likely to enhance the adherence to seatbelt-use law and minimize RTCs related injuries and mortality among adult drivers in this and other similar settings in the region. If implemented, future studies may look at the impact of such interventions on RTCs related frequency and severity of injuries in this and other similar settings. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence linking environmental tobacco smoke (ETS) exposure at homes to the development of asthma among adolescents. Few studies have addressed this issue in the Middle Eastern countries including Kuwait. Therefore, this cross-sectional study assessed the prevalence of ETS exposure at home, prevalence of asthma and other respiratory conditions and examined the ETS exposure at home and personal tobacco smoking as risk factors for self-reported asthma among high-school students in Kuwait.Methods: In this cross-sectional study, we enrolled participants from nine high-schools of Hawally Governorate of Kuwait during October 2015. We adapted a previously validated self-administered questionnaire for data collection. Prevalence of self-reported asthma and ETS exposure (≥ 1 smoker at home vs. none) were computed. The association between exposures of interest and self-reported asthma status was examined using a multivariable log-binomial regression model.Results: Of 800 enrolled participants, 746 (92.2%) consented and completed the questionnaire. The participants with mean (SD) age of 16.8 (0.68) years were predominantly Kuwaiti (74.8%) and female (50.1%). The prevalence of ETS exposure at home and personal current smoking was 54 and 12.4% respectively. Self-reported asthma prevalence was 20.5%. Furthermore, the prevalence of physician-diagnosed asthma, wheezing during the last 12 months and wheezing 'ever' was 16.4, 20.1 and 26.2%, respectively. Fitted multivariable log-binomial regression model revealed that compared with the non-asthmatic, participants with self-reported asthma tended to be current smokers (adjusted prevalence ratio (adjusted PR) = 1.82; 95% CI: 1.30-2.56; p = 0.001) or have had ETS exposure at home (adjusted PR = 1.64; 95% CI: 1.21-2.23; p = 0.002).Conclusions: We recorded a high prevalence of ETS exposure at home, high prevalence of self-reported asthma and identified ETS exposure at home and being a current smoker as strong risk factors for self-reported asthma among adolescents. Voluntary household smoking bans may substantially minimize the ETS exposure among adolescents. Additionally, such restriction may inculcate an antismoking attitude and prevent smoking initiation among adolescents. Such efforts may bring about reduction in ETS exposure and associated asthma risk and other smoking-related morbidities in this and other similar settings. [ABSTRACT FROM AUTHOR]

Introduction: We examined the association between cumulative silica exposures in taconite mining and non-malignant respiratory disease (NMRD) using a comprehensive assessment of current and historical exposure measurements in a cross-sectional study of Minnesota taconite mining workers. We also explored the impact of exposure measurement methods by comparing estimated exposure risk from two different exposure measurement modeling approaches. Methods: Miners were screened with an occupational and medical history questionnaire, spirometry testing and chest x-rays per ILO guidelines. Current and historical occupational exposure assessments were obtained, the former measuring about 679 personal samples over the period of the study for respirable dusts, including silica, in 28 major job functions. Cumulative silica exposure ((mg/m3) × years) was estimated as a cumulative product of time worked and year-specific silica job exposure concentrations. Chest x-ray abnormalities were based on B-reader agreement with a third B-reader for arbitration. Forced vital capacity (FVC) less than lower limits of normal for age, height, race and gender was used to determine spirometric restrictive ventilatory defect (RVD). Prevalence ratios (PR) of exposure-outcome associations, with 95% confidence intervals (CI), were estimated using multivariate Poisson regression. Results: Cumulative silica exposure was associated with RVD prevalence (PR = 1.41, 95% CI = 1.09–1.81) and prevalence of parenchymal abnormalities on chest x-ray (PR = 1.30, 95% CI = 1.00–1.69) using exposure estimates based primarily on current study measurements, and assuming unchanged historical exposure trend. Conversely, when exposures were defined incorporating available actual historical values, no associations were observed between silica exposure and either RVD (PR = 0.76, 95% CI = 0.41–1.40) or parenchymal (PR = 0.87, 95% CI = 0.45–1.70) outcomes. Conclusions: This study demonstrated that the estimated association between silica dust exposure and lung disease is highly sensitive to the approach used to estimate cumulative exposure. Cumulative values based on conservative estimates of past exposure, modeled from recently measured respirable silica, showed an association with restriction RVD on spirometry. Silica exposure was also significantly associated with increased parenchymal findings on chest x-ray using this approach. Conversely, these findings were absent when actual available historical data was used to estimate cumulative silica exposure. These differences highlight the challenges with estimating occupational dust exposure, the potential impact on calculated exposure risk and the need for long term quality exposure data gathering in industries prone to risk from inhaled respirable dusts. [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence and characteristics of mental disability attributed to psychosis among persons aged 15 years and over in China, so as to provide scientific evidences for prevention and rehabilitation of mental disability. Methods: It was a secondary data analysis using data from the Second National Sample Survey on Disability. Prevalence of disability attributed to psychosis was the ratio of the number of disable persons due to psychosis to the number of total population. Prevalence ratios (PR) were estimated from Poisson regression with robust variance for the independent effects of related factors on the prevalence of mental disability attributed to psychosis. Results: The mental disability attributed to psychosis was 4. 16%c. Among all types of psychosis, mental disability attributed to schizophrenia was the highest (3. 75%o). And the severity of mental disability attributed to psychosis was higher than that of non-psychosis disorders. Female (PR = 1. 50), persons with older age (PR for persons aged 30 -49 years, 50 - 64 years, and 65 years and over were 12. 78, 13. 90 and 6. 56 respectively), persons never married (PR = 11. 74), or divorced or widowed (PR - 3. 22), and people living in western areas (PR = 1. 09) had higher prevalence of mental disability attributed to psychosis, while persons from minority ethnic groups (PR = 0. 74), finished junior high school (PR = 0. 82), and population with non-agriculture household registrations (PR = 0. 81) had lower prevalence. Conclusion: Attention should be paid to disability prevention and rehabilitation in Chinese adults with mental disability attributed to psychosis. Women, older persons, unstable marriage status, living in western area, Han ethnic group, and people with agriculture household registrations should be the key population for the prevention and treatment of mental disability attributable to psychosis. [ABSTRACT FROM AUTHOR]

In the last decades, the use of the epidemiological prevalence ratio (PR) instead of the odds ratio has been debated as a measure of association in cross-sectional studies. This article addresses the main difficulties in the use of statistical models for the calculation of PR: convergence problems, availability of tools and inappropriate assumptions. We implement the direct approach to estimate the PR from binary regression models based on two methods proposed by Wilcosky & Chambless and compare with different methods. We used three examples and compared the crude and adjusted estimate of PR, with the estimates obtained by use of log-binomial, Poisson regression and the prevalence odds ratio (POR). PRs obtained from the direct approach resulted in values close enough to those obtained by log-binomial and Poisson, while the POR overestimated the PR. The model implemented here showed the following advantages: no numerical instability; assumes adequate probability distribution and, is available through the R statistical package.

Background: National administrative healthcare data may be used as a case-finding method for prevalence studies of chronic disease in the United States, but the completeness of ascertainment likely varies depending on the disease under study. Methods: We used 3 case-finding sources (Medicare, Medicaid, and Veterans Administration data) to estimate the prevalence of amyotrophic lateral sclerosis (ALS) in the United States for 2002–2004, and applied the capture-recapture methodology to estimate the degree of under-ascertainment when relying solely on these sources for case identification. Results: Case-finding completeness was 76% overall and did not vary by race, but was lower for males (77%) than for females (88%), and lower for patients under age 65 (66%) than patients over age 65 (79%). The uncorrected ALS prevalence ratio was 2.8/100,000 in 2002, 3.3/100,000 in 2003, and 3.7/100,000 in 2004. After correcting for under-ascertainment, the annual prevalence increased by approximately 1 per 100,000 to 3.7/100,000 in 2002 (95% CI 3.66–3.80), 4.4/100,000 in 2003 (95% CI 4.34–4.50), and 4.8/100,000 in 2004 (95% CI 4.76–4.91). Conclusions: Federal healthcare claims databases ascertained are a very efficient method for identifying the majority of ALS-prevalent cases in the National ALS Registry, and may be enhanced by having patients self-register through the registry web portal. [ABSTRACT FROM AUTHOR]

Background: This study aimed to (i) assess the prevalence of exposure to environmental tobacco smoke (ETS) at homes, (ii) assess the prevalence of atopic dermatitis and (iii) evaluate the association between ETS exposure and atopic dermatitis status among adolescents.Methods: During October 2015, a cross-sectional study design was implemented using a self-administered, modified version of the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire among students enrolled in nine high schools of one of the six governorates of Kuwait. Prevalence of ETS exposure at home (1 or more smokers at home vs. none) and atopic dermatitis were computed. A multivariable log-binomial regression model was used to evaluate the adjusted association between ETS exposure and atopic dermatitis.Results: Of 800 invited students, 746 (93.3%) participated, of whom 74.8% were Kuwaiti and 50.1% were female with a mean (SD) age of 16.8 (0.68) years. Prevalence of ETS exposure at home was 54%. Prevalence of atopic dermatitis was 14.9%. A final multivariable log-binomial regression model showed that compared with the adolescents free from atopic dermatitis, adolescents with atopic dermatitis were significantly more likely to have had ETS exposure at home (adjusted prevalence ratio = 1.49; 95% CI: 1.03-2.14; p = 0.034) or tended to be female (adjusted prevalence ratio = 1.42; 95% CI: 0.99-2.03; p = 0.054).Conclusions: A high prevalence of ETS exposure at home among adolescents was recorded. ETS exposure and female gender were significantly associated with atopic dermatitis status. Intervention fostering voluntary adoption of a smoke-free home rule may help protect the adolescents against ETS exposure and alleviate the menace of associated morbidity. [ABSTRACT FROM AUTHOR]

Objectives: This cross-sectional study assessed one-year period prevalence of road traffic crashes (RTCs) and examined the factors associated with RTCs among young adults in Kuwait.Design and Settings: During December 2016, 1500 students enrolled in 15 colleges of Kuwait University were invited to participate in the study. Students 18 years old or older and who drive by themselves were eligible. Data were collected using a structured self-administered questionnaire. One-year period prevalence of RTCs (≥1 vs. none) was computed. Multivariable log-binomial regression model was used to identify the risk factors associated with one-year period prevalence of RTCs.Results: Of 1500 invited individuals, 1465 (97.7%) participated, of which 71.4% (1046/1465) were female, 56.4% (804/1426) were aged between 21 and 25 years, and 67.1% (980/1460) were Kuwaitis. One-year period prevalence of RTC was 38.9%. The final multivariable log-binomial regression model showed that after adjusting for the influences of other variables in the model, participants were more likely to have had at least one RTC during the past year, if they habitually sped over limit (adjusted PR = 1.19; 95% confidence interval (CI): 1.04-1.36), crossed a red light (adjusted PR = 1.33; 95% CI: 1.16-1.52), or if they have had three or more speeding tickets (adjusted PR = 1.40; 95% CI: 1.13-1.73) compared to those who reportedly had no RTC during the same period.Conclusion: One-year period prevalence of RTCs among university students in Kuwait, though relatively lower than the reported figures in similar populations elsewhere in the region, is yet high enough to warrant diligent attention. Habitual speeding, having had three or more speeding tickets, and the practice of crossing a red light were significantly and independently associated with at least one RTC during the past year. Targeted education and enforcement of existing traffic laws may reduce the RTCs frequency in this relatively young population. Future studies may look at impact of such interventions. [ABSTRACT FROM AUTHOR]