Prevalence and risk factors of violence against women and children during COVID-19, Germany

ObjectiveTo assess the prevalence and exacerbating factors of violence against women and children in Germany during the coronavirus disease 2019 pandemic.MethodsWe conducted a representative online survey with partnered women (18–65 years) between 22 April and 8 May 2020, when participants had been under lockdown for a month. We determined the prevalence of several forms of violence within the previous month using both direct elicitation and a list experiment. We conducted a multivariable logistic regression to assess the impact of pandemic-associated risk factors.FindingsOf our 3818 survey respondents, 118 (3.09%; 95% confidence interval, CI: 2.54 to 3.64) reported incidents of physical conflict, 293 (7.67%; 95% CI: 6.83 to 8.52) reported emotional abuse, and 97 (6.58%; 95% CI: 5.31 to 7.85) of 1474 respondents with children reported child corporal punishment. We estimated that 3.57% (95% CI: −0.33 to 7.46) had non-consensual intercourse with their partner. Our regression analysis revealed an increased risk of physical conflict with home quarantine (odds ratio, OR: 2.38; 95% CI: 1.56 to 3.61), financial worries (OR: 1.60; 95% CI: 0.98 to 2.61), poor mental health (OR: 3.41; 95% CI: 2.12 to 5.50) and young (< 10 years) children (OR: 2.48; 95% CI: 1.32 to 4.64); we obtained similar results for other forms of violence. Awareness and use of pertinent support services was low.ConclusionOur findings of an increased risk of domestic violence during the pandemic should prompt policy-makers to improve the safety of women and children. Interventions to alleviate risks factors and extend support services are required.     

Anger expression, negative life events and violent behaviour among male college students in Ethiopia

AIMS: To assess the prevalence of violent behaviour and to identify risk factors associated with violent behaviour among male college students in Ethiopia. METHODS: A cross-sectional study among 1294 male college students in Awassa, Ethiopia was conducted in June 2006. A self-administered questionnaire was used to collect information concerning violent acts, anger expression, and sociodemographic and lifestyle characteristics. Multivariable logistic regression procedures were used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: More than half of the students (54.3%) reported committing at least one act of physical violence during the current academic year. Academic year of studies, use of khat, a natural stimulant with amphetamine-like effects, anger proneness and stressful life events were statistically significant covariates associated with committing acts of violence. Seniors, as compared with freshmen, were less likely to admit violent behaviour (OR=0.46; 95% CI 0.30-0.71). Those who reported using khat were more likely to report committing violent acts (OR=1.46, 95% CI 1.02-2.08) than were non-users. Students with moderate levels of anger expression (scores of 11- 14) were 3.40 times more likely to report committing acts of violence (OR=3.40; 95% CI 2.42-4.79) than were those with low levels of anger expression (scores v11). For students with high levels of anger expression (> or = 15 scores), the corresponding OR was 7.62 (95% CI 5.15-11.29). Participants who had experienced > or = 4 negative life events during the current academic year were more likely (OR=2.41; 95% CI 1.58-3.69) to report violent behaviour than were those with fewer stressful life events. CONCLUSIONS: Screening for violent behaviour and violence prevention programmes, particularly those in educational settings, should include strategies that address students' stressful life events, anger management, and substance use.     

Written violence policies and risk of physical assault against Minnesota educators

Few research studies on school violence policies use quantitative methods to evaluate the impact of policies on workplace violence. This study analyzed nine different written violence policies and their impact on work-related physical assault in educational settings. Data were from the Minnesota Educators' Study. This large, nested case control study included cases (n=372) who reported physical assaults within the last year, and controls (n=1116) who did not. Multivariate logistic regression analyses, using directed acyclic graphs, estimated risk of assault. Results of the adjusted multivariate model suggested decreased risks of physical assault were associated with the presence of policies regarding how to report sexual harassment, verbal abuse, and threat (OR 0.53; 95 per cent CI: 0.30-0.95); assurance of confidential reporting of events (OR 0.67; 95 per cent CI: 0.44-1.04); and zero tolerance for violence (OR 0.70; 95 per cent CI: 0.47-1.04).     

Violent behaviour among adolescents in Iceland: a national survey

BACKGROUND: Violence among adolescents may have serious developmental, physical, and mental health consequences for the affected individuals. In this study, we assessed the prevalence of violent behaviour and its correlates among 15-16 year old schoolchildren in Iceland. METHODS: In 1997, a cross-sectional survey was conducted among a random half of all Icelandic schoolchildren aged 15-16 years. The overall response rate was 91% (N = 3872). In the present study, socio-demographic background, social support, negative life events, psychological distress, and substance use were considered in relation to violent behaviour using logistic regression techniques. RESULTS: The majority of the respondents reported having committed violence within the last year. Boys were more likely to use violence than girls (odds ratio [OR] = 5.6; 95% CI: 4.7, 6.6). Respondents who had experienced >/=4 negative life events in the past year were more likely to use violence than respondents with no negative life events (OR = 3.0; 95% CI: 2.2, 4.2). Smokers were more likely than non-smokers to use violence (OR = 1.7; 95% CI: 1.2, 2.2), and adolescents who had used alcohol >20x in their lifetime were more than twice as likely to commit violence compared with those who had never used alcohol (OR = 2.5; 95% CI: 1.8, 3.4). CONCLUSION: Rates of violent behaviour among Icelandic schoolchildren were high. Gender, parental support, life stress, anger/aggression, and substance use were all significantly related to the perpetration of violent acts.     

Menarche,early pregnancy,and obesity in selected Brazilian women from a health care center in Belo Horizonte,Minas Gerais,Brazil

The aim of this study was to investigate obstetric variables potentially associated with obesity among 486 Brazilian childbearing-age women aged 15-59 residing in the municipality of Belo Horizonte, Minas Gerais State. Body fat (BF) was measured through impedance analysis, and obesity was defined as BF > 30%. The association between obstetrics factors and obesity was evaluated through multivariate logistic regression. The following variables remained in the logistic regression after adjustments for total income, smoking, alcohol consumption, and physical activity: age at menarche < 12 years (OR = 3.02; 95% CI: 1.62-5.61), age > 30 and < 39 (OR = 1.72; 95% CI: 1.01-2.92), age > 40 years (OR = 3.32; 95% CI: 1.76-6.27), age at first childbirth (OR = 1.99; 95% CI: 1.07-3.68), and the following interaction: age group > 30 and < 39 and age at menarche (OR = 0.27; 95% CI: 0.09-0.83). It appears that obstetric factors affect obesity through a complex network of interrelations that involve the covariates studied above. It is important to support efficient programs to prevent obesity, as well as family planning programs emphasizing a reduction in the prevalence of teenage pregnancies.     

Analysis of risk factors for hypertension in Colima, Mexico]

OBJECTIVE: To evaluate the possible association that age, sex, excess weight, family history of hypertension, alcoholism, and sedentary lifestyle have with hypertension in the adult population of the city of Colima, Mexico. METHODS: This was a population-based analytic cross-sectional study. A structured survey was used with 280 adults older than 30 years of age who were living in the city of Colima in 2001 and 2002. The variables studied were sex, age, weight, height, family history of hypertension, engaging in physical exercise, smoking, and consuming alcohol. Blood pressure (BP) was measured with the auscultatory method. Borderline or doubtful measurements were checked again four or five days later. Hypertension was defined as systolic BP > or = 140 mm Hg and diastolic blood pressure > or = 90 mm Hg, or as the person being under antihypertensive treatment. The odds ratios (ORs) of the variables studied were calculated, along with their 95% confidence intervals (95% CIs). The association between the variables and hypertension was estimated through logistic regression, and their interaction through the coefficient of the interaction products. RESULTS: The overall prevalence of hypertension was 28.6%. The prevalence was higher in men than in women (42.1% vs. 19.2%; OR = 3.04, 95% CI: 1.8 to 5.2) and in people older than 49 years than in people 30 to 49 years old (36.8% vs. 21.9%; OR = 2.07, 95% CI: 1.22 to 3.50). A family history of hypertension and excess weight were associated with hypertension, while physical exercise had a protective effect (OR = 0.45; 95% CI: 0.23 to 0.86). There was interaction between hypertension and age > or = 50 years, a family history of hypertension, overweight, and physical exercise, especially among women. CONCLUSIONS: The prevalence of hypertension in Colima is very similar to that for Mexico as a whole. The strong association that hypertension had with male gender, regardless of the other variables, emphasizes the need for promoting prevention campaigns that focus more on men.     

Factors associated with influenza vaccination among elderly Spanish women

OBJECTIVES: Influenza vaccination is an effective intervention to diminish morbidity and mortality associated with this disease in aged populations and at-risk groups. The objective of this work was to describe population patterns of vaccination among Galician women and to identify factors associated with vaccination. STUDY DESIGN: Cross-sectional study. METHODS: Cases aged 65 years and over were selected from the Women's Social and Health Interview, Galicia 2000 (n = 1111). The association between influenza vaccination last season and several sociodemographic, lifestyle, health status and health services variables was assessed by logistic regression. RESULTS: In total, 56.3% of cases had received the influenza vaccine. The following variables were significantly associated with vaccination: age 70-74 years (odds ratios, OR=1.56; 95% CI: 1.09-2.26); age> or =75 years (OR=1.88; 95% CI: 1.31-2.71); residence in towns with 5000-20,000 inhabitants (OR=1.79; 95% CI: 1.16-2.77); annual income 6.010 (OR=1.39; 95% CI: 1.01-1.90); unfavourable self-perception of health (OR=1.46; 95% CI: 1.06-2.00); not being a caregiver (OR=1.67; 95% CI: 1.17-2.38); married (OR=1.45; 95% CI: 1.05-2.01); tetanus vaccination (OR=1.43; 95% CI: 1.07-1.93); and visiting a physician in the last 2 years (OR=4.83; 95% CI: 2.61-8.93). CONCLUSIONS: The level of vaccination among Galician women is low, although it is higher than that in Spanish women overall. This work has identified groups of women who are less likely to be vaccinated, and who should be targeted in future vaccination campaigns.     

新确诊癌症患者的焦虑、抑郁及失眠现状分析

目的探究新确诊癌症患者群体的焦虑、抑郁及失眠现状及其影响因素。 方法选取2018年1月至10月广东省人民医院肿瘤中心病房及门诊收治的新确诊癌症患者571例进行回顾性横断面调查研究，其中男性52例(9.1%)，女性519例(90.9%)；年龄21～88岁，平均(47.5±11.4)岁。分析患者的一般人口学、临床及社会心理学资料，通过抑郁症筛查量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)以及失眠症状筛查评价研究对象的焦虑、抑郁及失眠现状，采用多因素Logistic回归分析各影响因素与新确诊癌症患者出现焦虑、抑郁的相关性。 结果在新确诊癌症患者中，焦虑症状检出率为28.2%(161/571)，抑郁症状检出率为35.0%(200/571)，失眠症状检出率为89.0%(508/571)。高龄(年龄>60岁，OR＝2.387，95%CI：1.002～5.687)、无业(OR＝1.860，95%CI：1.017～3.402)、独居(OR＝16.012，95%CI：2.880～89.014)、共病(OR＝0.573，95%CI：0.377～0.870)、高生活压力(OR＝1.519，95%CI：1.192～1.936)和消极性格倾向(OR＝6.005，95%CI：3.641～9.904)是新确诊癌症患者出现抑郁症状的危险因素。高生活压力(OR＝1.802，95%CI；1.412～2.300)、消极性格倾向(OR＝4.344，95%CI：2.699～6.992)和癌症家族史(OR＝1.788，95%CI：1.137～2.812)是新确诊癌症患者出现焦虑症状的危险因素。 结论新确诊的癌症患者处于特殊的身心应激状态，是焦虑、抑郁、失眠等心理问题的高发人群。应注意筛查患者的心理健康问题，及时做好心理干预，必要时加强心理及药物治疗。同时还应加强患者的家庭及社会支持，提高其心理弹性及应对能力，从而促进患者身心恢复，提高患者生活质量。     

童年期目睹家庭暴力与大学生自伤和暴力行为的关联

目的了解大学生童年期目睹家庭暴力的发生状况及其与大学生自伤和暴力行为的关系,为儿童青少年身心健康相关研究提供参考。方法于2018年10月采用自编"安徽省大学生健康相关行为问卷"对合肥市4所高校4 034名大学生进行调查,多因素Logistic回归分析用于探讨童年期目睹不同类型家庭暴力对大学生自伤和暴力行为的影响。结果大学生童年期目睹家庭情感暴力、轻度躯体暴力、重度躯体暴力的报告率分别为27. 6%,22. 4%,10. 7%。单因素分析显示,童年期有目睹家庭轻度躯体暴力、重度躯体暴力和情感暴力大学生自伤行为、躯体暴力、情感暴力和性暴力的报告率均高于童年期无目睹家庭暴力的大学生,差异均有统计学意义(P值均<0. 05)。多因素Logistic回归分析(控制混杂因素)显示,童年期目睹父母间重度躯体暴力和情感暴力是大学生自伤行为(OR=1. 53,95%CI=1. 05~2. 23;OR=2. 15,95%CI=1. 51~3. 04)和情感暴力(OR=1. 65,95%CI=1. 16~2. 35;OR=2. 57,95%CI=1. 87~3. 53)的影响因素;童年期目睹父母重度躯体暴力是大学生躯体暴力(OR=4. 99,95%CI=2. 58~9. 62)和性暴力行为(OR=8. 68,95%CI=3. 30~22. 81)的影响因素(P值均<0. 05)。结论童年期目睹父母间家庭暴力会增加大学生自伤和暴力行为的发生风险,尤其是父母间重度躯体暴力。     

Violence against women by their intimate partner and common mental disorders

The World Health Organization considers gender violence a cause of anxiety, depression and suicidal thoughts among women. This study investigated the association between violence committed against women by their intimate partners, defined by psychologically, physically and sexually abusive acts, and common mental disorders, assessed by using the Self Reporting Questionnaire (SRQ-20). A population-based household survey was carried out among women aged 15–49 years in two sites: São Paulo, the largest Brazilian city, and Zona da Mata of Pernambuco, a region with both urban and rural areas in the Northeast of the country. A large proportion of women reported violence (50.7%). The most frequent forms were psychological violence alone (18.8%) or accompanied by physical violence (16.0%). The prevalence of mental disorders was 49.0% among women who reported any type of violence and 19.6% among those who did not report violence (p < 0.0001). After adjustment for demographic and socioeconomic characteristics, the nature of the relationship, stressful life events and social support, all the forms of violence studied, with the exception of sexual violence alone or accompanied by either physical or psychological violence (p = 0.09), were significantly associated with mental disorders: physical violence alone (OR 1.91; CI 95% 1.2–3.0), psychological violence alone (OR 2.00; CI 95% 1.5–2.6), sexual violence alone or accompanied by either physical or psychological violence (OR 1.80; CI 95% 0.9–3.6), both psychological and physical violence (OR 2.56; CI 95% 1.9–3.5) and all three forms of violence (OR 2.68; CI 95% 1.8–4.0).This is the first population-based study on the association between intimate partner violence and mental health in Brazil. It contributes to the existing body of research and confirms that violence, frequently experienced by women in the country, is associated with mental disorders. Policies and strategies aimed at reducing gender-based violence are necessary for preventing and reducing anxiety and depression among women.     

Female victims of intimate partner physical domestic violence (IPP-DV), California 1998

BACKGROUND: This study was conducted to identify factors associated with adult female victims of intimate partner physical domestic violence (IPP-DV) in California and to estimate statewide IPP-DV prevalence. METHODS: We analyzed data from the 1998 California Women's Health Survey, a random, computer-assisted telephone interview (CATI) survey of 4006 California women aged > or = 18, conducted by the California Department of Health Services. RESULTS: Data from the survey indicated that 6% of the women reported that in the previous 12 months, their intimate partners threw objects at them, or hit them with an object, or kicked, pushed, slapped, choked, beat up, or threatened them with a gun or a knife. Odds ratio (OR) analyses controlling for age and race/ethnicity suggest that a large number of factors are associated statistically with IPP-DV victims. These factors include feelings of ill physical and mental health; pregnancies at early age; smoking status; nutritional needs; low income; participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program; having children aged < 18 in the household; and limited access to health care. Among the non-U.S.-born respondents, IPP-DV victims were significantly younger when they entered the United States than their nonvictim counterparts. A multiple logistic regression model identified the following factors as main correlates with IPP-DV: feelings of being overwhelmed in the past 30 days (OR = 3.4, 95% confidence interval [CI] = 2.5-4.6); aged 18 to 44 (OR = 2.8, 95% CI = 1.9-4.1); current smoking status (OR = 2.1, 95% CI = 1.5-2.9); participation in WIC in the previous 2 years (OR = 1.8, 95% CI = 1.2-2.6); and being out of work (OR = 1.4, 95% CI = 1.1-1.9). CONCLUSIONS: The above findings suggest that a variety of venues (e.g., schools, mental and physical health care providers, WIC, immigration programs, and social services) will be needed in order to identify/gain access to IPP-DV victims, provide referral resources, and implement any future prevention efforts.     

Physical activity levels in adults living in Bogotá (Colombia): prevalence and associated factors

OBJECTIVE: To determine the prevalence of physical activity levels in adults aged 18 to 65 years in Bogotá city and identify the factors associated with regular physical activity. METHODS: We conducted a population-based, cross-sectional survey in 3,000 adult residents of Bogotá in 2003 who were selected through a multistage probabilistic sample. Physical activity levels were determined using the short version of the International Physical Activity Questionnaire. Factors associated with regular physical activity were identified by logistic regression models. RESULTS: The adjusted prevalence of persons undertaking regular physical activity was 36.8%. After adjustment for potential confounders, regular physical activity was more likely in men (odds ratio [OR] = 1.62; 95% CI, 1.31-2.01) and in those whose self-perceived health status was good or very good (OR = 1.87; 95% CI, 1.41-2.49) and was less likely in those aged 30-49 years or 50-65 years (OR = 0.78; 95% CI, 0.63-0.96, and OR = 0.60; 95% CI, 0.43-0.82, respectively) and in those whose main activity in the previous 30 days was searching for a job (OR = 0.71; 95% CI, 0.51-0.97) or carrying out household tasks (OR = 0.72; 95% CI, 0.54-0.96). In women, unlike men, age groups showed no association with regular physical activity. CONCLUSION: This study shows gender differences in the prevalence of physical activity levels and associated factors. Future studies should establish, in the context of Latin American cities, whether it is appropriate to determine specific measures in each domain, in addition to overall physical activity levels.     

The Association of Healthy Lifestyle Behaviors with Overweight and Obesity among Older Adults from 21 Countries

This study aimed to analyze the association of healthy lifestyle behaviors with overweight and obesity among Europeans aged 65+ years. Data were from the 2014 European Social Survey, analyzing 21 countries. Five lifestyle behaviors (physical activity, fruit and vegetable consumption, sleep quality, drinking alcohol, and smoking) were analyzed. Binary logistic regressions were performed. A total of 8938 participants (4099 men) 65 years and older, mean age—73.6 (SD: 6.6) presented prevalence of overweight of 42.3% (95% CI: 41.3 to 43.3) and obesity of 20.9% (95% CI: 20.1 to 21.8). Adopting five healthy behaviors was associated with lower odds of obesity (OR = 0.50, 95% CI: 0.39 to 0.63), but not overweight (OR: 0.93; 95% CI: 0.79 to 1.10). Physical activity (≥5 days/week) was the most protective behavior, reducing by 42% the odds of obesity. Sex moderated the association of fruits and vegetables consumption, alcohol use, and smoking with obesity. Strategies aiming to reduce obesity levels in older adults should focus on the promotion of multiple lifestyle health behaviors, particularly physical activity in order to decrease vulnerability risk in old age.     

Experience of physical violence and mental health among young men and women: a population-based study in Sweden

Background

In Sweden mental ill-health has increased among the young, especially among young women. Our aim was to investigate the association between experience of physical violence during the past year and self rated psychological health among young men and women.

Methods

The study population consisted of men (n?=?2,624) and women (n?=?3,569) aged 18–34 years who participated in the 2008 public health survey study in Skåne. The survey was a cross-sectional stratified random sample postal questionnaire study with a 54.1% participation rate. Associations were investigated by logistic regression models.

Results

The prevalence of poor psychological health was 18.9% among men and 27.7% among women. One in ten men and one in twenty women had experienced physical violence during the past year. Most men were violated in public places, while women were most often violated at home. Women who had experienced violence during the past year showed more than doubled odds of poor psychological health, odds ratio (OR): 2.66 (95% confidence interval (CI): 2.00, 3.53). Such an association could not be seen in men OR: 1.12 (95% CI: 0.85, 1.47). Adjustment for covariates (i.e. age, country of birth, socioeconomic status, economic stress, alcohol risk consumption, emotional support, instrumental support and generalized trust in other people) did not change the association found among women.

Conclusion

Violated women, but not men, showed nearly doubled odds of poor psychological health after multiple adjustments. There was also a gender difference regarding location of violence. Awareness of gender differences regarding context and mental impact of violence may assist public health workers in reducing the consequences of violence and to design preventive strategies.     

Determinants of malnutrition risk among the older adult community: a secondary analysis of the Health, Wellbeing, and Aging Study (SABE) in Mexico

OBJECTIVE: To determine the psychosocial and health determinants associated with malnutrition risk (MR) among older adults living in the community of Mexico City, Mexico. METHODS: This was a cross-sectional study. Secondary analysis was performed on the data of adults who were 60 or more years of age, living in the metropolitan area of Mexico city, and had participated in the multi-city study on Health, Wellbeing, and Aging in 1999 and 2000. Information on 820 participants was analyzed (mean age 69.7 +/- 7.6 years; 62.9% female). In addition to the MR (dependent variable) that was established through a basic nutrition evaluation, the following variables were analyzed: sociodemographics, body mass index, comorbidity, symptoms of depression, oral health, mental function, functional capability, among others. Independent associations from among the variables and the MR were calculated by univariate and multivariate logistic regression analysis. Odds ratios (OR) and 95% confidence intervals (95%CI) were determined. RESULTS: MR was present in 261 (31.8%) participants. The univariate logistic regression analysis adjusted for possible confounding variables showed that the following variables demonstrated significant and independent associations with MR among the study sample population: not having a pension (adjusted OR = 1.45; 95%CI: 1.01 - 2.38); feeling that one did not have enough money to live on (adjusted OR = 2.52; 95%CI: 1.69 - 3.74); having osteoarthritis (adjusted OR = 2.34; 95%CI: 1.42 - 3.85); having a low body mass index (adjusted OR = 0.89; 95%CI: 0.85 - 0.93); having symptoms of depression (adjusted OR = 5.41; 95%CI: 1.90 - 15.34); eating only once daily (adjusted OR = 12.95; 95%CI: 5.19 - 32.28) or twice daily (adjusted OR = 3.27; 95%CI: 2.18 - 4.9); and having physical difficulty with getting to bed (adjusted OR = 3.25; CI 95%: 1.58 - 6.68), going out alone (adjusted OR = 2.70; CI 95%: 1.54 - 4.73), and using the telephone (adjusted OR = 1.95; CI 95%: 1.10 - 3.43). CONCLUSIONS: There are multiple and various determinants of malnutrition risk. To determine MR, the older adult's financial and social situation must be carefully evaluated along with the more traditional health and anthropometric information.     

河南省新乡县农村居民脑卒中流行现况及影响因素分析

目的 了解河南省新乡县农村地区成年常住居民脑卒中流行现况及其影响因素。方法 于2017年4月—2017年6月采用整群抽样方法,随机抽取河南省新乡县朗公庙、七里营2个乡镇17个农村村落的成年常住居民(≥18岁)10 691人进行脑卒中及相关因素的问卷调查、体格检查与实验室检测。结果 本次调查共纳入资料完整对象10 455人进行分析,河南省新乡县农村地区脑卒中粗患病率为6.60%,年龄标准化患病率为5.05%;其中40岁以上人群脑卒中粗患病率为6.58%,标准化患病率为2.89%;男性、女性的性别粗患病率分别为8.39%和5.35%,标准化患病率分别为3.63%和2.39%。在脑卒中常见慢性共患病中,高血压共病率最高,为55.94%,糖尿病共病率最低,为14.64%。多因素logistic回归分析显示,年龄≥50岁(50～59岁:OR = 3.968, 95%CI: 2.654～5.933; 60～69岁:OR = 8.694, 95%CI: 5.906～12.798; ≥70岁:OR = 8.854, 95%CI: 5.855～13.390)、职业为农民(OR = 1.821, 95%CI:1.174～2.824)、高血压(OR = 2.151, 95%CI: 1.816～2.547)、血脂异常(OR = 2.434, 95%CI: 1.950～3.038)、糖尿病(OR = 1.393, 95%CI: 1.091～1.778)、冠心病(OR = 1.385, 95%CI: 1.117～1.718)可能是脑卒中患病的危险因素(P＜0.05);女性(OR = 0.542, 95%CI: 0.455～0.646)、有适度(OR = 0.668, 95%CI: 0.544～0.819)/剧烈运动(OR = 0.696, 95%CI: 0.571～0.849)可能是脑卒中患病的保护因素(P＜0.05)。结论 河南省新乡县农村地区成年常住居民脑卒中患病率较高,男性、≥50岁、农民、无适度/剧烈运动者、合并高血压、血脂异常、冠心病和糖尿病者仍是脑卒中防治的重点人群。     

Prevalence and Influencing Factors of Metabolic Syndrome among Adults in China from 2015 to 2017

The prevalence and influencing factors of metabolic syndrome (MetS) in Chinese residents aged 20 or older were investigated. The data were collected from China Nutrition and Health Surveillance (2015–2017), which used a stratified, multistage, random sampling method. A total of 130,018 residents aged 20 years or older from 31 provinces were included in this study. The National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria were used to define MetS. The standardised prevalence of high waist circumference, high blood pressure and low high-density lipoprotein cholesterol were 40.8%, 49.4% and 41.1%, respectively. The following factors were associated with a higher prevalence of MetS: female [odds ratio (OR) = 1.773, 95% CI = 1.709–1.840]; older age (OR = 1.037, 95% CI = 1.036–1.039); living in north China (OR = 1.087, 95% CI = 1.058–1.117); high body mass index (OR = 1.402, 95% CI = 1.395–1.408); higher income [OR (95% CI): 1.044 (1.007–1.083), 1.083 (1.044–1.124) and 1.123 (1.078–1.170) for moderate, high, and very high income, respectively]; family history of hypertension (OR = 1.237, 95% CI = 1.203–1.273); family history of diabetes (OR = 1.491, 95% CI = 1.426–1.558) and current smoking status (OR = 1.143, 95% CI = 1.098–1.191). Living in the countryside (OR = 0.960, 95% CI = 0.932–0.988), moderate alcohol consumption (OR = 0.917, 95% CI = 0.889–0.946) and being physically active (OR = 0.887, 95% CI = 0.862–0.913) were associated with a lower prevalence of MetS. The prevalence of MetS among residents aged 20 years or older in China is increasing, especially among women, people aged 45 years or older and urban residents. Preventive efforts, such as quitting smoking and engaging in physical activity, are recommended to reduce the risk of MetS.     

Hormone replacement therapy and acute myocardial infarction: a large observational study exploring the influence of age

BACKGROUND: We examined whether the discrepancy between observational studies and randomized clinical trials (RCTs) on the effect of hormone replacement therapy (HRT) on myocardial infarction (MI) could be explained by differences in age of participants at the time of either HRT initiation or the MI event. METHODS: A matched case-control study was performed using the General Practice Research Database. Cases (n = 22 225) had a first diagnosis of MI between 1987 and 2001; up to six controls (n = 144 085) were matched to each case based on age, sex, and practice. Conditional logistic regression was performed adjusting for traditional cardiovascular risk factors, as well as, cardiovascular drug use and consultation rate. RESULTS: HRT users had a lower overall risk of MI compared with never users [odds ratio (OR): 0.76; 95% confidence interval (95% CI) 0.68-0.86); results were similar for opposed (OR: 0.73; 95% CI 0.68-0.86) and unopposed (OR: 0.79; 95% CI 0.66-0.96) therapy. This apparent benefit increased with older age at HRT initiation(18-44 years: OR = 0.99; 95% CI 0.74-1.33; 45-54 years: OR = 0.84; 95% CI 0.71-1.00; 55-64 years: OR = 0.67; 95% CI 0.54-0.82; 65-74 years: OR = 0.50; 95% CI 0.34-0.74; >75 years: OR = 0.55; 95% CI 0.23-1.32). Moreover, the cardioprotective effect was greater for MIs occurring at older ages (P-value for interaction = 0.003). CONCLUSION: The effect of HRT on MI becomes more pronounced with older age at initiation and at older ages at the time of an MI event. These findings contradict the hypothesis that the apparent protection seen in observational studies was due to the inclusion of younger participants.     

Time of adhesion to the Family Health Strategy protects elderly against cardiovascular and cerebrovascular accidents in Florianópolis, 2003 to 2007

The Family Health Strategy (FHS) provides longitudinal follow-up and integrated healthcare. This study evaluated the influence of the time of adhesion to the FHS upon the incidence of cardiovascular and cerebral vascular accidents among the elderly enrolled in the CASSI-Florianópolis. The events were selected because of their high incidence, good notification and association with risk factors the FHS is able to modify. The longer the time of adhesion to the strategy the lower the incidence of these events, demonstrating the effectiveness of the FHS. A historical cohort study was conducted with 674 senior participants (60 or more years), registered between November/2003 and March/2007. The analysis used Student's T test, bivariate and multivariate analysis with logistic regression. The independent risk factors were: age over 80 years, (OR=3,44; CI 95%: 1,8-6,2), diabetes (OR=2,62; CI 95%: 1,4-4,7), hypertension (OR=1,68; CI 95%: 1,0-2,6) and physical inactivity (OR=2,06; CI 95%: 1,2-3,2). The study found no significant association between gender, dislipidemia, obesity, smoking, alcoholism and the studied events. The long time of adhesion to the FHS showed independent protective effect (OR=0,43; CI 95%: 0,2-0,8) after adjustment to earlier covariates, being effective in reducing the incidence of cardiovascular and cerebral vascular accidents among the enrolled population of elderly.