Validation of the Diabetes Numeracy Test With Adolescents With Type 1 Diabetes

There is currently a lack of valid instruments to measure adolescent diabetes numeracy. The Diabetes Numeracy Test (DNT) was adapted for type 1 diabetes and was administered to 2 samples of adolescents. Sample 1 was administered the 39-item version of the DNT (DNT-39) with measures of self-management, responsibility, reading, and glycemic control (A1C). Sample 2 was administered the 14-item version of the DNT (DNT-14) with measures of self-management, responsibility, problem solving, and A1C. Both versions of the DNT showed adequate internal reliability. In Sample 1, the DNT-39 and DNT-14 were related (r = .87, p = .001), and both DNT versions were related to parent education (for DNT-14, r = .31, p = .02; for DNT-39, r = .29, p = .03) and reading (for DNT-14, r = .36, p = .005; for DNT-39, r = .40, p = .001). In Sample 2, the DNT-14 was related to A1C (r = ?.29, p = .001), reading skills (r = .36, p = .005), diabetes problem solving (r = .27, p = .02), adolescent age (r = .19, p = .03), and parent education (r = .31, p = .02). In combined analyses, 75% of items were answered correctly on the DNT-14 (range = 7–100), and performance was associated with age (r = .19, p = .03), pump use (r = .33 p = .001), and A1C (r = ?.29, p = .001). The DNT-14 is a feasible, reliable, and valid numeracy assessment that indicated adolescents with type 1 diabetes have numeracy deficits that may affect their glycemic control.     

Body mass index,abdominal fatness,weight gain and the risk of psoriasis: a systematic review and dose–response meta-analysis of prospective studies

Greater body mass index (BMI) has been associated with increased risk of psoriasis in case–control and cross-sectional studies, however, the evidence from prospective studies has been limited. We conducted a systematic review and dose–response meta-analysis of different adiposity measures and the risk of psoriasis to provide a more robust summary of the evidence based on data from prospective studies. PubMed and Embase databases were searched for relevant studies up to August 8th 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random effects model. The summary relative risk (RR) for a 5 unit increment in BMI was 1.19 (95% CI 1.10–1.28, I² = 83%, n = 7). The association appeared to be stronger at higher compared to lower levels of BMI, p_nonlinearity < 0.0001, and the lowest risk was observed at a BMI around 20. The summary RR was 1.24 (95% CI 1.17–1.31, I² = 0%, p_{heterogeneity} = 0.72, n = 3) per 10 cm increase in waist circumference, 1.37 (95% CI 1.23–1.53, I² = 0%, p_{heterogeneity} = 0.93, n = 3) per 0.1 unit increase in waist-to-hip ratio, and 1.11 (95% CI 1.07–1.16, I² = 47%, p_{heterogeneity} = 0.15, n = 3) per 5 kg of weight gain. Adiposity as measured by BMI, waist circumference, waist-to-hip ratio, and weight gain is associated with increased risk of psoriasis.     

Association of exposure to Bisphenol A with obesity and cardiometabolic risk factors in children and adolescents

In this study, the association of exposure to Bisphenol A (BPA) with obesity and cardiometabolic risk factors was investigated on 132 children and adolescents aged 6–18 years living in Isfahan, Iran. Potential contributors to BPA exposure were assessed by a questionnaire. Total BPA was detected in urine samples of all participants without significant difference in boys and girls.

The mean body mass index (BMI) and waist circumference (WC) increased significantly across the BPA tertiles (p for trend = < 0.001). Similar trend was documented for systolic blood pressure (SBP) and diastolic blood pressure (DBP) as well as fasting blood sugar. The risk of obesity was 12.48 times higher in participants in the third tertile of BPA than in others (95% CI: 3.36–46.39, p < 0.001). The current study showed significant association between BPA exposure with obesity and some cardiometabolic risk factors in children and adolescents, however, further longitudinal studies are necessary to evaluate the clinical effects of this finding.

Abbreviations: BMI: Body Mass Index; BPA: Bisphenol A; BSTFA: N, O-Bistrifluoroacetamide; CDC: Centers for Disease Control and Prevention; CI: Circumference Interval; DBP: Diastolic Blood Pressure; DLLME: Dispersive liquid-liquid microextraction method; FBS: Fasting Blood Glucose; HDL: high-density lipoprotein cholesterol were; LDL: low-density lipoprotein cholesterol; OR: Odd Ratio; PA: Physical Activity; SBP: Systolic Blood Pressure; TC: total cholesterol; TG: triglycerides; WC: Waist Circumference.     

Visceral adiposity and subclinical atherosclerosis in healthy young men

Abstract

Background: Atherosclerosis begins in childhood and develops silently for decades before clinical events such as myocardial infarction or stroke occur. Only few studies have evaluated the relationship between CVD risk factors and carotid artery Intimal Media Thickness (IMT) in young asymptomatic people. Aim: The aim of this study is to investigate risk factors for cardiovascular disease associated with higher Carotid Intimal Media Thickness (IMT) in healthy young subjects. Methods: A cohort of 106 healthy young men, mean age 21?±?2 years (mean?±?SD), BMI 24.4?±?2.8 (kg/m²), on military duty, participated in this cross-sectional study. Waist circumference, carotid intima–media thickness (IMT), blood pressure, and plasma concentrations of relevant metabolic parameters were measured at fasting. Smoking and habitual dietary patterns were evaluated by a semiquantitative questionnaire. Results: The population was divided into two groups on the basis of IMT values: the lowest three quartiles versus the highest quartile (cut-off value?=?0.7?mm). BMI, waist circumference, systolic (SBP), and diastolic (DBP) blood pressure were significantly higher in the group with higher IMT (p?=?0.02). All other variables, including dietary parameters and smoking, were similar in the two groups. Data analysis showed that IMT values correlated positively with SBP (r?=?0.22; p?=?0.025), DBP (r?=?0.27; p?=?0.005), waist circumference (r?=?0.29; p?=?0.002), and fat mass (r?=?0.24; p?=?0.01), and negatively with kcal/kg of body weight (r?=??0.220.22; p?=?0.022) – an indirect marker of physical activity. Based on multiple regression analysis, waist circumference and DBP were the only variables independently associated with IMT (p?=?0.029). Conclusions: In a non-selected sample of healthy young adult males, a larger waist circumference and a higher diastolic blood pressure – albeit within normal values – are the only parameters independently associated with higher IMT.     

Association between habitual dietary and lifestyle behaviours and skin autofluorescence (SAF), a marker of tissue accumulation of advanced glycation endproducts (AGEs), in healthy adults

Purpose

Advanced glycation endproducts (AGEs) are produced endogenously and also enter the body during the consumption of AGEs present in heat-processed food. It is unknown whether AGEs of dietary origin accumulate within the body of healthy individuals. AGEs can deposit within skin tissue long-term by crosslinking extracellular matrix proteins. The fluorescent nature of many AGEs enables their detection within the skin by non-invasively measuring skin autofluorescence (SAF). This study aimed to identify habitual dietary and lifestyle behaviours cross-sectionally associated with SAF in an adult population sample.

Methods

251 Healthy adult volunteers completed validated food frequency and physical activity questionnaires. Waist circumference, BMI, blood pressure and blood glucose was also measured. SAF was measured using an AGE Reader.

Results

Significant positive correlations were found between SAF and chronological age (r = 0.63, P < 0.001), waist circumference (r = 0.28, P < 0.01), body weight (r = 0.24, P < 0.05), BMI (r = 0.23, P < 0.05) and consumption of meat and meat products (r = 0.22, P < 0.05). A negative correlation was found between SAF and cereal consumption (r = ?0.21, P < 0.05). Cigarette smokers also had a significantly higher SAF than non-smokers (2.4 vs 2.0 U, P < 0.05). Regression analysis identified age, cigarette smoking, waist circumference and intake of meat products as significant predictors of SAF. The regression model explained 48% of the variation in SAF.

Conclusions

Age, cigarette smoking, waist circumference and dietary consumption of meat/meat products were positively associated with SAF in this sample. Further research is required to determine whether frequent consumption of foods containing large quantities of dietary AGEs contribute to pathological disease processes in healthy individuals.

     

Characterisation of gastric cancer and its relation to environmental factors: a case study in Shenqiu County,China

This article presents the results of spatial analysis of gastric cancer and its relation to environmental conditions in Shenqiu County, China. Retrospective data on gastric cancer mortality (GCM) were analysed at various spatial scales, with its relation to environmental factors explored at an appropriate scale. The results considered 2 × 2 km² grid as the optimal level for characterising GCM due to the highest Moran’s I (I = 0.68, p < 0.01). Then, three clustering regions were clearly identified. Meanwhile, GCM was obviously associated with topography (r = ?0.11, p < 0.10), farmland (r = 0.11, p < 0.10), population density (r = 0.10, p < 0.10) and river density (r = 0.11, p < 0.10) in the buffered zones. It indicates that spatial grid technique is suitable for characterising GCM in Shenqiu County, and that GCM was geographically associated with environmental conditions. We suggest that preventive measures for controlling the environment-related malignant neoplasm should not be limited in the regions suffering from this disease but be reasonably extended to surrounding areas.     

Gender differences in variables associated with sleep quality in chronic tension type headache

We aimed to evaluate gender differences in the relationships between headache features, sleep quality, anxiety, depressive symptoms, and burden of headache in 193 patients (73 percent women) with chronic tension type headache (CTTH). Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Headache features were collected with a four-week diary. The Hospital Anxiety and Depression Scale was used to assess anxiety/depressive symptoms. Headache Disability Inventory was used to evaluate the burden of headache. In men with CTTH, sleep quality was positive correlated with headache frequency (r = 0.310; p = .018), emotional (r = 0.518; p < .001) and physical (r = 0.468; p < .001) burden of headache, and depressive symptoms (r = 0.564; p < .001). In women, positive correlations were observed between sleep quality and headache intensity (r = 0.282; p < .001), headache frequency (r = 0.195; p = .021), emotional burden (r = 0.249; p = .004), and depressive symptoms (r = 0.382; p < .001). The results of stepwise regression analyses revealed that depressive symptoms and emotional burden of headache explained 37.2 percent of the variance in sleep quality in men (p < .001), whereas depressive symptoms and headache intensity explained 17.4 percent of the variance in sleep quality in women (p < .001) with CTTH. Gender differences associated with poor sleep should be considered for proper management of individuals with CTTH.     

Increases in body mass index and waist circumference as outcomes of working overtime

This epidemiologic study was undertaken to determine whetherworking overtime is associated with anthropometric indices andserum lipids, risk factors for obesity, in white-collar workers.Non-management white-collar male workers were eligible. Bodyweight and height, waist circumference, skinfold thickness,serum total cholesterol and triglycerides were measured. Weight,height and waist circumference data obtained 3 years previouslywere also used. Lifestyle information was obtained by meansof a self-administered questionnaire. Overtime hours correlatedsignificantly with the 3-year change in body mass index (r=0.206,p<0.0017) and waist circumference (r=0.218, p=0.0091), butnot with either the most recent anthropometric indices or serumlipids. Overtime hours were also intercorrelated (r=0.436, p<0.0001)with dinner time. The present study suggested that working overtimeis associated with the increases in BMI and waist circumferenceover a 3-year period although the associations were weak. Additionally,eating habits of those with working overtime might reflect anintervening effect on the anthropometric changes.     

Why Communication Is Crucial: Meta-Analysis of the Relationship Between Safer Sexual Communication and Condom Use

The purpose of this study was to quantitatively synthesize the growing literature on the relationship between safer sexual communication (SSC) among sexual partners and condom use, and to systematically examine a number of conceptual and methodological moderators of this relationship. Data from 53 articles published in 27 journals met criteria for the study. Fifty-five independent effect sizes coded from samples totaling N = 18,529 were meta-analyzed. Results indicate that the mean sample-size weighted effect size of the SSC-condom use relation was r = .22, and a number of conceptual variables were found to moderate this relationship. Specifically, communication about condom use (r = .25) and sexual history (r = .23) had significantly (p < .05) larger effect sizes than communication about safer sex (r = .18). In addition, SSC measures operationalized differently had significantly (p < .05) different effect sizes. From largest to smallest, these were behavioral format (r = .29), intentional format (r = .18), and self-efficacy format (r = .13). Measures that tried to assess persuasion attempts as compared with informational exchanges were not found to have significantly different effect sizes (p > .05). Further, methodological moderators tended to be unrelated to effect size. Implications for the future study of safer sexual communication as well as the importance of emphasizing communication skills in HIV preventive interventions are discussed.     

Role of access to parks and markets with anthropometric measurements,biological markers,and a healthy lifestyle

Background: This study examined the association between access to urban green spaces and markets with anthropometric measurements, biological markers, sociodemographic, and healthy lifestyle.

Methods: Geographic information systems were used to establish a correlation between environmental features and cardiovascular risk parameters. A total number of 832 (age range 18–74 years) individuals were selected for this study.

Results: Body mass index was significantly and positively related to the distance to parks (ρ = 0.079, p < 0.05), but negatively related to the distance to markets (ρ = ?0.125, p < 0.05). In addition, waist circumference was similar and positively related to distance to parks (ρ = 0.097, p < 0.05) and negatively related to distance to markets (ρ = ?0.092, p < 0.05). With respect to biochemical parameters, when there was an increase in the distance to markets, high-density lipoprotein cholesterol increased and glycemia decreased.

Conclusion: The results of this study suggest the importance of the role of environmental factors such as parks and markets in the development of cardiovascular risk.     

The impact of a randomized dietary and physical activity intervention on chronic inflammation among obese African-American women

ABSTRACT

Lifestyle interventions may reduce inflammation and lower breast cancer (BrCa) risk. This randomized trial assessed the impact of the Sistas Inspiring Sistas Through Activity and Support (SISTAS) study on plasma C-reactive protein (CRP), interleukin-6 (IL-6) and Dietary Inflammatory Index (DII). This unblinded, dietary and physical activity trial was implemented in 337 obese (body mass index [BMI] ≥30 kg/m²) African American (AA) women recruited between 2011 and 2015 in South Carolina through a community-based participatory approach with measurements at baseline, 3 months, and 12 months. Participants were randomized into either intervention (n = 176) or wait-list control group (n = 161). Linear mixed-effect models were used for analyses of CRP and IL-6. Baseline CRP was significantly higher in those with greater obesity, body fat percentage, and waist circumference (all p <.01). No difference was observed between groups for CRP or IL-6 at 3 or 12 months; however, improvements in diet were observed in the intervention group compared to the control group (p = .02) at 3 months but were not sustained at 12 months. Although the intervention was not successful at reducing levels of CRP or IL-6, a significant decrease was observed in DII score for the intervention group, indicating short-term positive dietary change.     

Identifying occupational and nonoccupational exposure to mercury in dental personnel

The objective of this study was to investigate the occupational and nonoccupational exposure to mercury (Hg) vapor in dental personnel by examining the relationships between blood mercury, urine mercury, and their ratio with air mercury. The method was performed on 50 occupational exposed and 50 unexposed controls (25 men and 25 women). The mercury concentrations in air and human biological samples were determined based on the National Institute for Occupational Safety and Health (NIOSH) method and standard method (SM) by a new mode of liquid-phase microextraction, respectively. The mean mercury concentrations in urine (μg Hg⁰/g creatinine) and blood were significantly higher than control group, respectively (19.41 ± 5.18 vs 2.15 ± 0.07 μg/g and 16.40 ± 4.97 vs 2.50 ± 0.02 μg/L) (p <.001). The relationships between mercury concentration in blood/urine ratio (r = .380) with dental office air are new indicators for assessing occupational exposure in dental personnel.     

Assessment of risk factors for developing incident aortic stenosis: the Tromsø Study

To disclose risk factors of incident aortic stenosis (AS) and progression of established AS. A prospective cohort study. The Tromsø Study, a population based health survey. Over a 14 years span we performed three repeated echocardiographic examinations (1994, 2001 and 2008) of a random sample of initially 3,243 participants. Data from the only hospital serving this population were included in the follow up. Throughout the study 132 participants were diagnosed with incident AS, defined as mean aortic valve gradient ≥15 mmHg. Cox proportional hazards regression disclosed age (HR 1.11, 95 %CI 1.08–1.14), systolic blood pressure (BP) (HR 1.01, 95 % CI 1.00–1.02), active smoking (HR 1.71, 95 % CI 1.09–2.67), and waist circumference (HR 1.02, 95 % CI 1.00–1.03) as independent predictors of incident AS. Analysis of risk factors for progression of AS disclosed a higher mean aortic gradient at first measurement (p = 0.015), weight (p = 0.015), a low haemoglobin (Hgb) (p = 0.030) and high density lipoprotein (HDL) (p = 0.032) as significant independent predictors. Age, systolic BP, smoking and waist circumference were independent predictors of incident AS, whereas cholesterol was not. Mean aortic gradient at first measurement, weight, an elevated HDL and low Hgb increase the progression rate of the disease. Our data indicate that calcific aortic valve disease is a distinct pathophysiological process, with age, smoking and “wear and tear” of the valve being major contributors to the disease development.     

Association of Bisphenol A Exposure with Breastfeeding and Perceived Insufficient Milk Supply in Mexican Women

Introduction Estrogen inhibits lactation and bisphenol A (BPA) is a high production environmental estrogen. We hypothesize an inhibitory effect of BPA on lactation and aim to analyze the association between third trimester pregnancy urinary BPA and breastfeeding rates 1 month postpartum. Methods Odds ratios (OR) and 95 % confidence intervals (95 % CI) of breastfeeding and perceived insufficient milk supply (PIM) in relation to maternal peripartum urinary BPA concentrations were calculated in 216 mothers. Results 97.2 % of mothers in the lowest BPA tertile were breastfeeding at 1 month postpartum, compared to 89.9 % in highest (p = 0.01). Adjusted ORs (95 % CI) for not breastfeeding at 1 month were 1.9 (0.3, 10.7) and 4.3 (0.8, 21.6) for second and third BPA tertiles, respectively, compared to the lowest (p = 0.06, trend). 4.2 % reported PIM in the lowest BPA tertile, compared to 8.7 % in the highest (p = 0.03). Adjusted ORs (95 % CI) for PIM were 1.8 (0.4, 7.7) and 2.2 (0.5, 9.5), for the second and third BPA tertiles, respectively, compared to the lowest (p = 0.29, trend). Discussion These results suggest an association between maternal BPA exposure and decreased breastfeeding.     

Improved latrine cleanliness through behaviour change and changes in quality of latrine construction: a longitudinal intervention study in rural Burundi

Latrine cleanliness increased in the intervention group compared to the control group (increase from 21 to 31 % of latrines classified as clean in intervention [N = 198] and decrease from 37 to 27 % in control [N = 91]). Improved habitual latrine cleaning lead to latrines being 3.5 times more likely to improve in observed latrine cleanliness (χ² = 16.36, p < .001) and so did improvements in quality of latrine construction, eg households that had installed a lid were 7.39 times more likely to have a cleaner latrine (χ² = 4.46, p < .05). Changes in psychosocial factors, namely forgetting, personal norm, satisfaction with cleanliness, explained much of the change in habitual latrine cleaning (adj. r² = .46). Behaviour change interventions targeting psychosocial factors and quality of latrine construction seem promising to ensure clean and hygienic latrines.     

Assessing Mercury Exposure and Biomarkers in Largemouth Bass (Micropterus Salmoides) from a Contaminated River System in California

We evaluated mercury (Hg) exposure and two biomarkers, metallothionein (MT) gene expression and histopathological alterations in a wild fish species, largemouth bass (Micropterus salmoides), collected from the Sacramento-San Joaquin Delta, CA, a region polluted with Hg from historic mining activities. Hg is highly toxic and can disrupt multiple physiological systems in vertebrate species, including the immune system. Total mercury (THg) concentration in muscle tissue ranged from 0.12 to 0.98 ppm (wet weight) and was not related to body condition (r ² = 0.005, p = 0.555). Using linear regression analysis, we found a positive relationship between MT gene expression (as determined using quantitative polymerase chain reaction) and copper, zinc, manganese, aluminum, and nickel (decreased to one variable by way of principal component analysis) (r ² = 0.379, p = 0.044), a negative relationship with selenium (r ² = 0.487, p = 0.017), and a weak, negative relationship with THg concentrations (r ² = 0.337, p = 0.061). Juvenile largemouth bass collected from Hg-contaminated areas displayed histopathological features of immunosuppression compared with those collected from less contaminated areas as evidenced by significantly lower macrophage density in kidney and liver tissue (p = 0.018 and 0.020, respectively), greater trematode density in liver tissue (p = 0.014), and a greater number of adult trematodes. Our results suggest that largemouth bass may be experiencing sublethal effects from chronic Hg exposure. Furthermore, our findings illustrate the utility of examining multiple sublethal markers of effect to assess the impacts of contaminant exposure on physiological function in wild species.     

Validity of self-reported intensity of exposure to second-hand smoke at home against environmental and personal markers

The objective of this study was to assess the validity of two questions about the perception of intensity of exposure to secondhand smoke (SHS) at home using as a reference environmental markers (airborne nicotine and benzene) and biomarkers of exposure (cotinine in saliva and urine). This was a cross-sectional study in a convenience sample of 49 non-smoking volunteers. We found a high correlation between self-reported SHS exposure and airborne nicotine (r_sp = 0.806, p < 0.05), salivary cotinine (r_sp = 0.752, p < 0.05), and urinary cotinine (r_sp = 0.626, p < 0.05). We did not find differences between the score question and the conventional ones (p > 0.05). In conclusion, the significant correlation of the two questions proposed with environmental markers and personal markers indicates their potential validity to assess exposure to SHS at home.     

Body mass index,abdominal fatness,and the risk of sudden cardiac death: a systematic review and dose–response meta-analysis of prospective studies

Although overweight and obesity are established risk factors for some types of heart disease including ischemic heart disease, heart failure and atrial fibrillation, less is known about the association between adiposity and sudden cardiac death. We conducted a systematic review and meta-analysis of prospective studies to clarify the association between adiposity and risk of sudden cardiac death. PubMed and Embase databases were searched up to July 20th 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. The summary RR was 1.16 (95% CI 1.05–1.28, I² = 68%, n = 14) per 5 unit increment in BMI, and 1.82 (95% CI 1.61–2.07, I² = 0%, n = 3) per 0.1 unit increase in waist-to-hip ratio, and 1.03 (95% CI 0.93–1.15, I² = 0%, n = 2) per 10 cm increase in waist circumference. The heterogeneity in the analysis of BMI and sudden cardiac death persisted across most subgroup analyses. The association was stronger among studies with longer follow-up compared to short follow-up and was observed in the European and American studies, but not in the Asian studies. There was a J-shaped association between BMI and sudden cardiac death and the lowest risk was observed in the normal weight range, however, the increased risk with a low BMI was attenuated among studies with a longer duration of follow-up. This meta-analysis suggest an increased risk of sudden cardiac death with increasing BMI and waist-to-hip ratio, however, further studies with stratification for smoking status are needed of waist circumference, weight changes and adiposity at younger ages.     

Comorbid pain experiences in young women with dysmenorrhea

ABSTRACT

The association among dysmenorrhea, chronic pain, and conditions classified as central sensitivity syndromes (CSS) is largely unknown. We investigated the co-occurrence of dysmenorrhea with chronic pain and other CSS (e.g., fibromyalgia, migraines); and, whether severity of menstrual symptoms was associated with severity of chronic pain and of somatic symptoms. Women from a mid-sized Canadian university women (N = 248, Mage = 21.52) completed measures of menstrual pain severity, chronic pain severity, somatic symptoms severity, and the presence of comorbid CSS. Pearson’s correlations assessed the relationship between severity of dysmenorrhea, chronic pain, and somatic symptoms. MANOVA procedures assessed the interaction between dysmenorrhea and chronic pain and χ² analyses were used to test the frequency of CSS among women with dysmenorrhea. Higher ratings of menstrual symptom severity were associated with increased chronic pain severity (r =.66, p <.001), and somatic symptom severity (r =.66, p <.001). Women with dysmenorrhea were not more likely to experience chronic pain, but were more likely to report a CSS, χ² (1) = 5.12, p <.05. Dysmenorrhea symptoms may extend beyond the menstrual phase and be associated with more severe symptoms among women with comorbid pain and somatic concerns.