Heavy drinking and alcohol-related injuries in college students

Objective

The main objective of this study is to evaluate the effect of heavy drinking on alcohol-related injuries.

Material and methods

We carried out an open cohort study among university students in Spain (n = 1,382). Heavy drinking and alcohol-related injuries were measured by administrating AUDIT questionnaires to every participant at the ages of 18, 20, 22 and 24. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for consumption of alcohol and cannabis.

Results

The response rate at the beginning of the study was 99.6% (1,369 students). The incidence rate of alcohol-related injuries was 3.2 per 100 students year. After adjusting for alcohol consumption and cannabis use, the multivariate model revealed that a high frequency of heavy drinking was a risk factor for alcohol-related injuries (Odds Ratio = 3.89 [95%CI: 2.16 – 6.99]). The proportion of alcohol-related injuries in exposed subjects attributable to heavy drinking was 59.78% [95%CI: 32.75 – 75.94] while the population attributable fraction was 45.48% [95%CI: 24.91 – 57.77].

Conclusion

We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern.     

Steps/day and metabolic syndrome in African American adults: The Jackson Heart Study

Objective

To examine the relationship between pedometer-measured step count data and the Metabolic Syndrome (MetS) in African American adults.

Method

379 African American adults (mean age 60.1 years; 60% female) enrolled in the Jackson Heart Study (Jackson, MS) from 2000 to 2004 provided sufficient pedometer data for inclusion in this analysis. MetS was classified according to the International Diabetes Federation Task Force on Epidemiology and Prevention.

Results

Using steps/day categorized as tertiles (< 3717 (referent), 3717–6238, > 6238), participants taking 3717–6238 (Odds Ratio (OR)(95% Confidence Interval (CI)) = 0.34 (0.19, 0.61)) and > 6238 steps/day (OR(95% CI) = 0.43 (0.23, 0.78)) had lower odds of having MetS compared to participants in the lowest tertile. Using previously suggested steps/day cut-points (< 2500 (referent), 2500–4999, 5000–7499, ≥ 7500), the odds of having MetS were lower for participants taking 2500–4999 (OR(95% CI) = 0.32 (0.14, 0.72)), 5000–7499 (OR(95% CI) = 0.22 (0.09, 0.53)), and > 7500 (OR(95% CI) = 0.26 (0.11, 0.65)) steps/day compared to those taking < 2500 steps/day.

Conclusion

Compared to lower levels, higher levels of steps/day are associated with a lower prevalence of MetS in this older African American population.     

Life-style and self-rated global health in Sweden: A prospective analysis spanning three decades

Objective

To study the relations between lifestyle factors (smoking, drinking, exercise, vegetable consumption, social relations) and global self-rated health in the adult Swedish population.

Method

The data come from the Swedish Level of Living Survey, a face-to-face panel study. The analysis follows the respondents with good health in 1991 (N = 4035) and uses multivariate logistic regression to assess the relations between lifestyle factors in 1991 and health in 2000 and 2010.

Results

Baseline (1991) exercise, social support, smoking and vegetable consumption are associated with health in 2000 and/or 2010. 2000: Weekly exercise in 1991 increases the probability of good health by 6 percentage points [95% CI: 1–10] compared to no exercise, and smoking 10 or more cigarettes a day decreases the probability of good health by 5 percentage points [95% CI 1–8]. Lacking social support decreases the probability of good health by 17 percentage points (95% CI: 9–25). 2010: Smoking 10 or more cigarettes a day decreases the probability of good health by 10 percentage points [95% CI 5–15], and eating vegetables every day increases the probability of good health by 4 percentage points [95% CI 0.2–7].

Conclusions

Exercise, smoking, social support and vegetable consumption are related to self-rated health 2000 and/or 2010.     

Smoking and air pollution exposure and lung cancer mortality in Zhaoyuan County

Background

Simultaneous exposure to high levels of air pollution and high tobacco consumption at the same place is rare. The aim of the present study was to evaluate the impact of the two factors on the risk of developing lung cancer.

Methods

Data on the number of deaths due to lung cancer and on population from 1970 to 2009 were obtained from Zhaoyuan County. Data on the smoking populations were obtained at random sampling survey during the time in Zhaoyuan. Data on the components of atmospheric surveillance were obtained from the local environmental protection offices. Logarithmic linear regression and general log-linear Poisson age-period-cohort (APC) models were used to estimate age, period, cohort, gender, smoking, and air pollution effects on the risk of lung cancer mortality.

Results

The standardized mortality rates of lung cancer drastically increased from 8.43 in per 100 000 individuals in the 1970–1974 to 25.67 in per 100 000 individuals in the 2005–2009 death survey. The annual change of lung cancer mortality was 3.20%. In the log linear regression model, the age, proportion of smokers, gender, period, and air pollution are significantly associated with lung cancer mortality. The APC analysis shows that the relative risks (RRs) of gender, smoking, and air pollution are 2.29 (95% confidence interval (CI): 2.16–2.43), 3.05 (95% CI = 2.76–3.36), and 1.42 (95% CI = 1.19–1.69), respectively. Compared with the period 1970–1974, high RRs were found during 1995–2009. Compared with the birth cohort 1950–1954, the RRs increased in the birth cohorts of 1910 to the 1940. Compared the aged 35–59 and 60–84 in the1980–1984 death survey (not exposed to air pollution) with that in the 2005–2009 death survey (exposed to air pollution), The two age groups exposed to air pollution, 25 years later, had an increased mortality rates for lung cancer by 2.27 and 3.55 times for males and by 1.47 and 3.35 times for females.

Conclusion

The mortality rates of lung cancer drastically increased in the past 35 years. The trend of lung cancer mortality may be in a great extent possibly due to the effects of combined smoking and air pollution exposure.     

Association between physical activity and major depressive disorder among current or former smokers with pulmonary disease

Objective

To examine the association between physical activity and major depressive disorder (MDD) in a nationally representative sample of current or former smokers with pulmonary impairments.

Methods

The analyzed sample from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 included 536 adults who indicated that they were current or former smokers, had at least mild pulmonary impairment (FEV₁/FVC < 0.70), and provided depression and physical activity data.

Results

After controlling for asthma status, pulmonary impairment, age, poverty-to-income ratio (PIR), education, gender, marital status, body mass index (BMI), cotinine, comorbidity index, race-ethnicity, and smoking status, those who met physical activity guidelines had a 59% (odds ratio (OR) = 0.41; 95% confidence interval (CI): 0.18–0.94) lower odds of having MDD. Using multivariate linear regression with depression symptoms as the outcome variable, and after adjustments, physical activity was inversely associated with depression symptoms in a dose–response manner; lowest tertile was the referent group, middle tertile coefficient: − 1.06 (95% CI: − 1.98 to − 0.14), and highest tertile coefficient: − 1.10 (95% CI: − 1.84 to − 0.34).

Conclusions

Physical activity inversely associates with MDD in adults with pulmonary impairments, and does so in a dose–response manner. This suggests that individuals with pulmonary impairments should be encouraged to engage in enjoyable, safe forms of physical activity in a progressive manner.     

Prevalence of metabolic syndrome and its influencing factors among the Chinese adults: The China Health and Nutrition Survey in 2009

Objective

We aimed to estimate the up-to-date prevalence of metabolic syndrome (MS) and its influencing factors among the Chinese adults.

Methods

Data were obtained from the China Health and Nutrition Survey conducted in 2009, which was a cross-sectional and partially nationally representative study including a total of 7488 Chinese adults (age ≥ 18 years).

Results

The overall age-standardized prevalence estimates of the MS were 21.3% (95%confidence interval (CI): 20.4%–22.2%), 18.2% (95%CI: 17.3%–19.1%) and 10.5% (95%CI: 9.8%–11.2%) based on definitions of revised NCEP ATPIII, IDF and CDS criteria, respectively. Individuals who were women (compared to men: odds ratio [OR] = 1.37, 95% CI = 1.16–1.61), 40 years or older (compared to less than 40 years old: OR = 2.82, 95%CI = 2.37–3.34 for 40–59 years; OR = 4.41, 95%CI = 3.68–5.29 for 60 years or older), overweight/obese (compared to normal weight: OR = 4.32, 95%CI = 3.77–4.95 for overweight; OR = 11.24, 95%CI = 9.53–13.26 for obese), and living in urban area (compared to living in rural area: OR = 1.27, 95%CI = 1.12–1.43) were more likely to have a higher prevalence estimate of MS. In addition, frequency of alcohol consumption and cigarette intake were also found to be significantly associated with probability of MS.

Conclusions

Our results suggest an urgent need to develop national strategies for the prevention, detection, treatment and control of obesity and MS in China.     

Alcohol drinking patterns and health-related quality of life reported in the Spanish adult population

Objectives

To examine the association between alcohol drinking patterns and health-related quality of life (HRQL).

Methods

Population-based cross-sectional study was conducted in 2008–2010 among 12,715 adult individuals in Spain. HRQL was assessed with the SF-12 questionnaire and alcohol intake with a diet history. The threshold between average moderate drinking and average heavy drinking was ≥ 40 g/day of alcohol in men and ≥ 24 g/day in women. Binge drinking was defined as the intake of ≥ 80 g in men and ≥ 60 g in women at any drinking session during the preceding 30 days. Analyses were performed with linear regression and adjusted for the main confounders.

Results

Compared to non-drinkers, all types of average drinkers reported better scores on the SF-12 physical component: β = 1.42 (95% confidence interval 1.03 to 1.81) in moderate drinkers and β = 1.86 (1.07 to 2.64) in heavy drinkers. In contrast, average alcohol consumption was not associated with the mental component of the SF-12. The number of binge drinking episodes and most types of beverage preference showed no association with physical or mental HRQL.

Conclusions

Alcohol drinkers, including those with heavy drinking, reported better physical HRQL than non-drinkers.     

Cluster randomized trial of a toolkit and early vaccine delivery to improve childhood influenza vaccination rates in primary care

Purpose

To increase childhood influenza vaccination rates using a toolkit and early vaccine delivery in a randomized cluster trial.

Methods

Twenty primary care practices treating children (range for n = 536–8183) were randomly assigned to Intervention and Control arms to test the effectiveness of an evidence-based practice improvement toolkit (4 Pillars Toolkit) and early vaccine supplies for use among disadvantaged children on influenza vaccination rates among children 6 months–18 years. Follow-up staff meetings and surveys were used to assess use and acceptability of the intervention strategies in the Intervention arm. Rates for the 2010–2011 and 2011–2012 influenza seasons were compared. Two-level generalized linear mixed modeling was used to evaluate outcomes.

Results

Overall increases in influenza vaccination rates were significantly greater in the Intervention arm (7.9 percentage points) compared with the Control arm (4.4 percentage points; P < 0.034). These rate changes represent 4522 additional doses in the Intervention arm vs. 1390 additional doses in the Control arm. This effect of the intervention was observed despite the fact that rates increased significantly in both arms – 8/10 Intervention (all P < 0.001) and 7/10 Control sites (P-values = 0.04 to <0.001). Rates in two Intervention sites with pre-intervention vaccination rates >58% did not significantly increase. In regression analyses, a child's likelihood of being vaccinated was significantly higher with: younger age, white race (Odds ratio [OR] = 1.29; 95% confidence interval [CI] = 1.23–1.34), having commercial insurance (OR = 1.30; 95%CI = 1.25–1.35), higher pre-intervention practice vaccination rate (OR = 1.25; 95%CI = 1.16–1.34), and being in the Intervention arm (OR = 1.23; 95%CI = 1.01–1.50). Early delivery of influenza vaccine was rated by Intervention practices as an effective strategy for raising rates.

Conclusions

Implementation of a multi-strategy toolkit and early vaccine supplies can significantly improve influenza vaccination rates among children in primary care practices but the effect may be less pronounced in practices with moderate to high existing vaccination rates.Clinical trial registry name/number: From Innovation to Solutions: Childhood Influenza/NCT01664793.     

Parental and community acceptance of the benefits and risks associated with meningococcal B vaccines

Objective

A new meningococcal serogroup B (Men B) vaccine has been licensed in the European Union (EU) and Australia. This study aimed to assess community and parental attitudes to introduction of new Men B vaccines and identify facilitators and barriers to vaccine implementation.

Methods

Cross-sectional survey including face-to-face interviews with adolescents, parents and adults from randomly selected households in South Australia in 2012. Survey data were weighted to the age, gender and geographical area profile of the population.

Results

3055 interviews were conducted with individuals aged 15–97 years, including 966 parents. Participation rate was 66.4%. 82.5% (95% CI 79.7–85.4) of parents (797/966) wanted their child to receive the Men B vaccine, with 12.2% (9.7–14.7) (118/966) unsure. Main parental concerns included potential side effects (41.3% (26.7–46.0)) and adequate vaccine testing (11.7% (9.4–14.1)). Potential for an extra injection at an immunisation visit resulted in 15.7% (12.8–18.5) of parents (n = 152/966) less likely to have their child immunised. Potential redness/swelling at the injection site or mild/moderate fever resulted in only 8.5% (6.3–10.7) and 10.8% (8.5–13.2) of parents, respectively, less likely to have their child immunised. Children being up to date with vaccinations and recommendation from family physician were the strongest independent predictors of parents agreeing their children should be immunised with Men B vaccine (OR = 6.58; p = 0.006 and OR = 4.15; p < 0.001, respectively). Only 16.4% (14.9–17.9) of adults (501/3055) stated that they would not want to receive a Men B vaccine, with family physician recommendation the strongest independent predictor of acceptance (OR = 3.81; p < 0.001).

Conclusions

There is strong community support for introduction of Men B vaccines, with parental willingness to have children immunised, impacted more by number of injections than potential for adverse events such as local reactions or fever.     

Prevalencia de consumo de tabaco en vehículos privados

Objective

To determine the prevalence of smoking among drivers of private vehicles in the city of Lleida (Spain).

Methods

A random sample of 1600 cars passing through six intersections regulated by traffic lights were selected. The variables were age, sex, smoking driver, adult passengers, intersection (urban/interurban), day (working day/weekend), hour (morning/evening) and simultaneous smokers. We calculated the prevalence of smoking drivers and the corresponding odds ratios (ORs), adjusted for the potential confounding variables, as well as their 95% confidence intervals (95% CI).

Results

The prevalence was 6.0% (95% CI: 4.9-7.3) and was higher in men (6.4%), in the group aged 41 to 60 years (6.9%), and in unaccompanied drivers (6.5%). The probability of the driver smoking increased if there was a smoking passenger (aOR = 10.8; 95% CI: 3.6-32.5). The frequency of smoking drivers was higher on working days (aOR = 1.7; 95% CI: 1.0-2.8) and in the morning (aOR = 1.6; 95% CI: 1.0-2.4).

Conclusions

The prevalence of smoking drivers can be considered dangerously high. We recommend avoiding smoking while driving.     

Trends and disparity in zoster vaccine uptake in a managed care population

Objectives

Zoster vaccine is recommended for prevention of herpes zoster among adults aged 60 years and older. We examined the zoster vaccination rates during 2007–2011 and assessed association with age, sex, race/ethnicity, neighborhood income and education attainment in eligible adults at Kaiser Permanente Southern California, a managed care organization in the US.

Methods

We calculated annual zoster vaccination rate among members ≥60 years without documented contraindications. Multivariable logistic regression was performed to examine factors associated with zoster vaccine uptake in an open cohort of 819,466 adults.

Results

The zoster vaccination rates increased annually in all groups and the overall rate reached 21.7% in 2011 (P-trend < 0.001). Coverage was highest among individuals aged 65–74 years, who were female and non-Hispanic White. In the adjusted analysis, odds of vaccination decreased by age. Females (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.17–1.20) and those who lived in neighborhoods with higher education attainment were more likely to be vaccinated (>75% vs. <50% adults with some college education: OR = 1.76, 95% CI = 1.73–1.80). Compared to Whites, non-Hispanic Blacks and Hispanics were less likely to receive the vaccine (non-Hispanic Blacks: OR = 0.56, 95% CI = 0.55–0.58; Hispanics: OR = 0.59, 95% CI = 0.58–0.60).

Conclusion

The zoster vaccine coverage is higher in this insured population than previously reported in the US general population, but it remains low. Significant racial/ethnic disparity was observed and worsened even among individuals with relatively equal access to zoster vaccination.     

Enterobacteriaceae bacteremia: Risk factors for ESBLPE

Objectives

The increasing prevalence of extended spectrum beta-lactamase producing enterobacteriaceae (ESBLPE) requires defining the use of carbapenems in first intention. We analyzed the associations between enterobacteriaceae bacteremia (EbBact) and ESBLPE carriage during 10 years in a 950-bed teaching hospital.

Methods

We analyzed a 10-year (July 2001 to June 2011) prospective collection of bacteremia cases including 2 databases: (1) EbBact and (2) a computerized database of patients carrying EBLSE. Only one episode of EbBact was analyzed per patient and hospital stay. Factors associated with ESBLPE bacteremia were assessed by univariate and multivariate logistic regression analysis.

Results

Overall, 2355 cases of EbBact were identified, among which 135 (5.7%) were ESBLPE (2001–05: 1.4%, 2006–09: 7.6%, 2010–11: 14.2%). ESBLPE bacteremia was observed in 52 of the 88 (59%) patients carrying ESBLPE and in 83/2267 (3.7%) patients not known to be colonized with ESBLPE. Factors associated with ESBLPE bacteremia in patients not known to be colonized were: female gender (ORa = 0.56, CI95% [0.34–0.91]), hospitalization in the ICU (ORa = 2.51 [1.27–5.05]) or medical/surgical wards (ORa = 1.83 [1.04–3.38]), the period (2006–09, ORa = 4.08 [2.21–8.16]; 2010–11, ORa = 8.17 [4.14–17.06] compared to 2001–05), and history of EbBact (ORa = 2.29 [0.97–4.79]).

Conclusion

In case of EbBact, patients known to be colonized with ESBLPE present with ESBLPE bacteremia in more than half of the cases, requiring carbapenems as empirical antibiotic treatment. The global prevalence of ESBLPE among patients presenting with EbBact not known to be colonized with ESBLPE was 3.7%.     

Staying on track: A cluster randomized controlled trial of automated reminders aimed at increasing human papillomavirus vaccine completion

Objectives

To evaluate whether automated reminders increase on-time completion of the three-dose human papillomavirus (HPV) vaccine series.

Methods

Ten reproductive health centers enrolled 365 women aged 19–26 to receive dose one of the HPV vaccine. Health centers were matched and randomized so that participants received either routine follow-up (control) or automated reminder messages for vaccine doses two and three (intervention). Intervention participants selected their preferred method of reminders – text, e-mail, phone, private Facebook message, or standard mail. We compared vaccine completion rates between groups over a period of 32 weeks.

Results

The reminder system did not increase completion rates, which overall were low at 17.2% in the intervention group and 18.9% in the control group (p = 0.881). Exploratory analyses revealed that participants who completed the series on-time were more likely to be older (OR = 1.15, 95% CI 1.01–1.31), report having completed a four-year college degree or more (age-adjusted OR = 2.51, 95% CI 1.29–4.90), and report three or more lifetime sexual partners (age-adjusted OR = 3.45, 95% CI 1.20–9.92).

Conclusions

The study intervention did not increase HPV vaccine series completion. Despite great public health interest in HPV vaccine completion and reminder technologies, completion rates remain low.     

Correlates of seasonal flu vaccination among U.S. home health aides

Introduction

Home health aides (HAs) receive limited training and reach many older patient populations highly susceptible to influenza virus. We sought to examine socio-demographic correlates of seasonal flu vaccination receipt among HAs.

Methods

We analyzed data from the 2007 U.S. National Home Health Aide Survey, a nationally representative sample of HAs reporting on occupational status, job and demographic characteristics and receipt of seasonal flu vaccine (n = 3377).

Results

Seasonal flu vaccine receipt was low among all types of HAs (43.9%). After adjustment for socio-demographic indicators (i.e. age, gender, race and health insurance), home health, home care, hospice and personal care attendants were significantly less likely to report receiving seasonal flu vaccine as compared to licensed nursing assistants (adjusted odds ratio, AOR = 0.42, 95% CI [0.20–0.85]; 0.41, [0.17–0.99]; 0.50, [0.26–0.97], and 0.53, [0.26–0.99], respectively).

Conclusion

Targeted effective vaccination campaigns are needed to improve vaccination rates among home health aides.     

Prevalence and associated factors of intention to participate in HIV voluntary counseling and testing for the first time among men who have sex with men in Hong Kong,China

Objective

We investigated the prevalence and associated factors of men who have sex with men (MSM) and had never participated in Human Immunodeficiency Virus (HIV) voluntary counseling and testing (VCT) but intended to do so in the next six months.

Method

An anonymous cross-sectional survey interviewed 577 MSM in Hong Kong, China, face-to-face or through an electronic questionnaire.

Results

We identified 245 MSM who had never participated in VCT (never-testers), among whom 12.7% intended to do so in the next six months. Factors associated positively with high behavioral intention were: 1) perceived necessity to participate in HIV test regularly (multivariate odds ratios (ORm) = 4.54, 95% confidence interval (CI): 1.30–15.83), 2) perception that > 20% of the local MSM had participated in VCT (ORm = 17.86, 95% CI: 1.89–169.08) and 3) perceived higher chance to have sex with people living with HIV (PLWH) in the next six months (ORm = 2.92, 95% CI: 1.08–7.93). Negatively associated factors were: local residency (ORm = 0.06, 95% CI: 0.01–0.34) and perceived higher chance of having unprotected anal intercourse (UAI) in the next six months (ORm = 0.27, 95% CI: 0.09–0.84). In addition, no interaction term between the independent variable and UAI status was found to be statistically significant.

Conclusion

Many sampled never-testers had low intention to take up VCT and were in the pre-contemplation stage of the Transtheoretical Model. Stage-matched promotions are warranted.     

Muscle strength and physical activity are associated with self-rated health in an adult Danish population

Objective

To describe associations of muscle strength, physical activity and self-rated health.

Method

Isometric muscle strength by maximal handgrip strength (HGS) or muscle strength by 30 s repeated chair stand test (30 s-CS) was combined with leisure time physical activity. Using logistic regression odds ratio was calculated for good self-rated health according to the combined associations among 16,539 participants (59.7% women), mean age 51.9 (SD: 13.8) years, from a cross-sectional study in Denmark 2007–2008.

Results

Good self-rated health was positively associated with higher levels of physical activity and greater muscle strength. Regarding HGS the highest OR for good self-rated health was in the moderate/vigorous physically active participants with high HGS (OR = 6.84, 95% CI: 4.85–9.65 and OR = 7.34, 95% CI: 5.42–9.96 for men and women, respectively). Similarly the highest OR for good self-rated health was in the moderate/vigorous physically active participants with high scores in the 30 s-CS test (6.06, 95% CI: 4.32–8.50 and 13.38, 95% CI: 9.59–18.67 for men and women, respectively). The reference groups were sedentary participants with low strength (HGS or 30 s-CS).

Conclusion

The combined score for physical activity level with either HGS or 30 s-CS was strongly positively associated with self-related health.     

Human papillomavirus vaccination and Pap testing profile in Manitoba,Canada

Background

Females who receive the human papillomavirus (HPV) vaccine may believe they are protected from developing cervical cancer and no longer require screening. Concern has also been expressed that vaccinated females are those that would be screened regularly. This study assesses the Pap testing behavior of vaccinated and non-vaccinated females.

Methods

For this population-based retrospective cohort study, vaccination and screening registries were linked for 3540 vaccinated females aged 15 years and over and 9592 matched non-vaccinated females. Conditional logistic regression, the Kaplan–Meier method and Cox regression were used to examine the association between vaccination and Pap testing.

Results

Vaccinated females were more likely to have had a Pap test within the year prior to the index date than non-vaccinated females (15–19 years old: OR = 1.38, 95% CI 1.20–1.59; 20+ years old: OR = 2.34, 95% CI 1.98–2.76). In the three-year period after the index date, vaccinated females had a significantly higher cumulative probability of having a Pap test (83.3%) than non-vaccinated females (66.1%). Females who had a Pap test within three years prior to the index date were more likely to have a Pap test after the index date (vaccinated: HR = 5.03, 95% CI 4.65–5.45; non-vaccinated HR = 3.97, 95% CI 3.70–4.24). Being vaccinated had a significant effect on Pap testing (15–19 years old: HR = 1.54, 95% CI 1.39–1.69; 20+ years old: HR = 1.87, 95% CI 1.52–2.31). 80.1% of vaccinated females who had a Pap test prior to the index date also had one subsequent to it, compared to 70.1% for non-vaccinated females. 41.1% of females had not been vaccinated nor had a Pap test.

Conclusion

The majority of vaccinated females continue to participate in screening, and do so at a higher rate than non-vaccinated females. Renewed efforts need to be made to include the large proportion of non–vaccinated, non–screened females in vaccination and/or screening.     

Pertussis vaccination coverage among adults in the Lyon area

Background

The compliance with recommendations for Pertussis vaccination was assessed in the Lyon population through vaccination coverage (VC).

Methods

A cross-sectional study was conducted in collaboration with 10 private biological analysis laboratories between October 2010 and March 2012, on 1930 adults (>19 years of age) from the Lyon area. Proof of vaccination (PV) was requested to prove the current vaccination status.

Results

A percentage of 30.3% (585/1930) of surveyed individuals provided a PV. A positive vaccination status was confirmed in 10.76% [CI 95% 8.45–13.48] (63/585) and didn’t vary in relation to gender (P = 0.57), age (P = 0.06), or level of schooling (P = 0.41). Coverage vaccination was not updated in parents with childbearing project (84.2% (64/76) [CI 95% 74.7–91.2]) or people in contact with children less than 6 years of age (83.6% (87/104) [CI 95% 75.6–89.8]). Pertussis vaccination wasn’t confirmed in 80.0% (124/155) of those who thought being vaccine up to date.

Conclusions

The Lyon population poorly complied with the cocooning strategy implemented in 2004. The pertussis vaccine coverage confirmed by a PV proved the inadequate rate of vaccination compared to objectives. It is mandatory to strengthen the vaccinal policy for this vaccine booster.     

Leisure-time physical activity and psychotropic medication: A prospective cohort study

Background

Physical inactivity is a major public health problem associated with an increased risk of mental health problems. The aim of this study was to examine the associations of leisure-time physical activity with subsequent psychotropic medication among middle-aged people employed at baseline.

Methods

Questionnaire survey data collected in 2000–02 among 40–60-year-old employees of the City of Helsinki (N = 8960) were linked with register data on prescribed psychotropic medication (74% gave permission to linkage). The mean follow-up time was 4.2 years. The analysis included 5961 respondents (78% women). The participants were classified into four groups according to physical activity recommendations. Cox regression analysis was used to calculate hazard ratios (HR) for the first psychotropic medication purchase.

Results

Leisure-time physical activity was associated with decreased risk of any psychotropic medication. After adjusting for prior psychotropic medication conditioning exercisers (HR = 0.65, 95% CI, 0.53–0.80), the vigorously active (HR = 0.83, 95% CI, 0.71–0.98) and the moderately active (HR = 0.85, 95% CI, 0.74–0.97) all showed a reduced risk of medication compared with the inactive. The associations were similar for the two main groups of psychotropic medication: antidepressants as well as sedatives and sleep medication.

Conclusions

Leisure-time physical activity is potentially important for preventing mental health problems among the middle-aged.