Case-control study of lifetime total physical activity and prostate cancer risk

A population-based case-control study of physical activity and prostate cancer risk was conducted in Alberta, Canada, between 1997 and 2000. A total of 988 incident, histologically confirmed cases of stage T2 or greater prostate cancer were frequency matched to 1,063 population controls. The Lifetime Total Physical Activity Questionnaire was used to measure occupational, household, and recreational activity levels from childhood until diagnosis. Multivariable logistic regression analyses were conducted. No association for total lifetime physical activity and prostate cancer risk was found (odds ratio (OR) for > or =203 vs. <115 metabolic equivalent-hours/week/year=0.87, 95% confidence interval (CI): 0.65, 1.17). By type of activity, the risks were decreased for occupational (OR=0.90, 95% CI: 0.66, 1.22) and recreational (OR=0.80, 95% CI: 0.61, 1.05) activity but were increased for household (OR=1.36, 95% CI: 1.05, 1.76) activity when comparing the highest and lowest quartiles. For activity performed at different age periods throughout life, activity done during the first 18 years of life (OR=0.78, 95% CI: 0.59, 1.04) decreased risk. When activity was examined by intensity of activity (i.e., low, <3; moderate, 3-6; and vigorous, >6 metabolic equivalents), vigorous activity decreased prostate cancer risk (OR=0.70, 95% CI: 0.54, 0.92). This study provides inconsistent evidence for the association between physical activity and prostate cancer risk.     

Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: study of women's health across the nation

Objectives. We investigated whether vasomotor symptom reporting or patterns of change in symptom reporting over the perimenopausal transition among women enrolled in a national study differed according to race/ethnicity. We also sought to determine whether racial/ethnic differences were explained by sociodemographic, health, or lifestyle factors.

Methods. We followed 3198 women enrolled in the Study of Women’s Health Across the Nation during 1996 through 2002. We analyzed frequency of vasomotor symptom reporting using longitudinal multiple logistic regressions.

Results. Rates of vasomotor symptom reporting were highest among African Americans (adjusted odds ratio [OR]=1.63; 95% confidence interval [CI]=1.21, 2.20). The transition to late perimenopause exhibited the strongest association with vasomotor symptoms (adjusted OR = 6.64; 95% CI = 4.80, 9.20). Other risk factors were age (adjusted OR=1.17; 95% CI=1.13, 1.21), having less than a college education (adjusted OR = 1.91; 95% CI = 1.40, 2.61), increasing body mass index (adjusted OR=1.03 per unit of increase; 95% CI=1.01, 1.04), smoking (adjusted OR=1.63; 95% CI=1.25, 2.12), and anxiety symptoms at baseline (adjusted OR=3.10; 95% CI=2.33, 4.12).

Conclusions. Among the risk factors assessed, vasomotor symptoms were most strongly associated with menopausal status. After adjustment for covariates, symptoms were reported most often in all racial/ethnic groups in late perimenopause and nearly as often in postmenopause.

     

Case-control study of lifetime physical activity and breast cancer risk

A population-based case-control study of 1,233 incident breast cancer cases and 1,237 controls was conducted in Alberta, Canada, in 1995-1997 to examine the effect of lifetime physical activity patterns on breast cancer risk. No associations between physical activity and breast cancer were found for premenopausal women. For postmenopausal women in the highest quartile (> or =161 metabolic equivalent (MET)-hours/week per year) versus the lowest quartile (<104.8 MET-hours/week per year) of lifetime total physical activity, the adjusted odds ratio was 0.70 (95% confidence interval (CI): 0.52, 0.94). When the risks associated with each type of activity were examined for postmenopausal women, household and occupational activity conferred the largest risk reductions (odds ratio (OR) = 0.57, 95% CI: 0.41, 0.79 and OR = 0.59, 95% CI: 0.44, 0.81, respectively, for highest vs. lowest quartiles of activity), while recreational activity was not associated with any risk reductions. For postmenopausal women, the authors found stronger risk reductions for those who were also nonsmokers (OR = 0.64, 95% CI: 0.46, 0.88), non-alcohol-drinkers (OR = 0.39, 95% CI: 0.11, 0.77), or nulliparous (OR = 0.22, 95% CI: 0.07, 0.70) when they compared the highest with the lowest quartile of lifetime total physical activity. This study provides evidence that lifetime total activity reduces risk of postmenopausal breast cancer.     

Does physical activity modify the association between body mass index and colorectal adenomas?

Although both physical inactivity and obesity have been associated with an increased risk of colorectal adenomas, it is unclear whether physical activity modifies the relationship between obesity and colorectal adenomas or through what mechanism this might occur. The aim of this study is to evaluate whether physical activity modifies the relationship between body mass index (BMI) and colorectal adenomas and whether apoptosis is a plausible mechanism responsible for this effect modification. Study subjects were part of a large, cross-sectional study, the Diet and Health Study III. Consecutive patients underwent colonoscopy between August 1998 and March 2000. Apoptosis was measured by morphological evaluation of hematoxylin and eosin-stained sections obtained from rectal pinch biopsy samples. There were 226 patients with adenomas and 494 adenoma-free controls. When comparing overweight subjects with the referent group (high physical activity/normal BMI), the relative odds of having an adenoma decreased as physical activity increased: low (odds ratio, OR=1.6; 95% confidence interval, CI=0.7-3.4); moderate (OR=1.1; 95% CI=0.6-2.0); and high (OR=0.8; 95% CI=0.4-1.6). When comparing obese subjects with the referent group, relative odds of having an adenoma were increased regardless of physical activity level. Apoptosis was not associated with obesity or physical activity. Our results suggest that physical activity may modify the association between obesity and colorectal adenoma until a high level of obesity is achieved. Apoptosis does not appear to be associated with obesity or physical activity.     

体力活动与女性乳腺癌发病关系的病例对照研究

目的 探讨体力活动与乳腺癌发病的关系。方法 采用以医院为基础的病例对照研究,调查某大学2所附属医院2012年4月~2014年12月间确诊的25～70岁549例乳腺癌患者和同期同医院就诊的549例非肿瘤患者的体力活动情况和相关危险因素。采用非条件Logistic回归模型分析体力活动与乳腺癌发病的关系。结果 校正各种混杂因素后,非职业性体力活动与乳腺癌发病风险降低有关（OR=0.69,95% CI:0.48～1.00）;与不参加体育活动者相比,参加体育活动对乳腺癌发病有保护作用（OR=0.61,95% CI:0.43～0.87）;与久坐不动的职业相比,轻度职业活动对乳腺癌发病有保护作用（OR=0.67,95% CI:0.47～0.97）,而家务活动与乳腺癌发病风险无关。不同雌激素受体（estrogen receptor,ER）和孕激素受体（progesterone receptor,PR）状态的亚组分析中,非职业性体力活动与ER+/PR+乳腺癌的发病风险降低有关。结论 非职业性体力活动、体育活动和轻度职业活动对女性乳腺癌有保护作用。     

Relationship between various physical activity domains and self-perceived health and obesity in women

The purpose of this study was to determine the relationship between self-perceived health and obesity and recreational, occupational, commuting, and total physical activity in women. The sample included 956 Estonian women aged 18-50. Cross-sectional data were collected in the Estonian Women Physical Activity Study via a mail-out survey in 2008 using the Global Physical Activity Questionnaire and self-reported measures of health indicators. The associations between physical activity and health indicators were examined using multiple logistic regression and were adjusted for potential confounding factors (age, education, and income). The women in the highest occupational physical activity group were significantly less likely to have good health (OR 0.51; CI 0.33-0.77) compared to women with no occupational physical activity. A significant association was observed, however, between being in the highest recreational physical activity group and having better self-perceived health (OR = 2.09, 95% CI 1.36-3.21) and not being obese (BMI ≥ 30) (OR = 0.42, 95% CI 0.21-0.86). A higher total amount of physical activity was not related to better health status or obesity. These findings suggest that the specific domains of physical activity may be more important for self-perceived health and obesity among women than the total amount of physical activity.     

Physical activity patterns in a diverse population of women

BACKGROUND: Demographic and psychosocial correlates of activity in domains other than recreational activity have not been well characterized and may be particularly relevant for health promotion efforts aimed at women. METHODS: Cross-sectional relationships between recreational, occupational, and household/caregiving physical activity and demographic and psychosocial factors were assessed with a mail survey in a random sample of 2,636 ethnically diverse women members of a large health maintenance organization, ages 20-65. Activity was assessed with a modified Baecke questionnaire that uses categorical responses regarding frequency of domain-specific activities to create four semicontinuous activity indices (sports/exercise, active living, occupational, household/caregiving). RESULTS: Multivariable logistic regression analysis showed that the likelihood of being in the highest quartile of the sports/exercise and active-living indices, compared with the other three quartiles, was decreased among older, nonwhite, less well educated, heavier women who had young children at home, lacked motivation to exercise, and perceived external obstacles to exercise behavior. The odds ratios (ORs) ranged from 0.38, 95% confidence interval (CI) 0.33-0.45, associated with low motivation, to 0.95, 95% CI 0.93-0.98, associated with increasing body mass index. Social support and confidence in one's ability to continue to exercise, even when faced with other pressures and demands (termed self-efficacy), were associated with increased likelihood of high levels of sports/exercise and active living (OR = 2.34, 95% CI 1. 83-2.98 and OR = 3.96, 95% CI 2.92-5.38, respectively). In contrast, the highest quartile of household/caregiving activity was positively associated with increasing age (OR = 1.28, 95% CI 1.16-1.42), Hispanic ethnicity (OR = 1.58, 95% CI 0.55-1.01), being married (OR = 1.70, 95% CI 1.33-2.18), having young children at home (OR = 6.99, 95% CI 4.33-11), and greater time constraints as a barrier to exercise (OR = 1.55, 95% CI 1.38-1.74) and was negatively associated with employment (OR = 0.38, 95% CI 0.30-0.47). Increased likelihood of the highest quartile of occupational activity was associated with high school education or less (OR = 2.26, 95% CI 1.74-2.94) and current smoking (OR = 1.66, 95% CI 1.23-2.23), while self-efficacy regarding exercise was associated with decreased likelihood (OR = 0. 77, 95% CI 0.61-0.96). CONCLUSIONS: These findings suggest that demographic and psychosocial correlates of physical activity vary by domain and that initiatives to promote physical activity in the population need to take these differences into account.     

Recreational physical activity and risk of head and neck cancer: a pooled analysis within the international head and neck cancer epidemiology (INHANCE) Consortium

Increasing evidence suggests that physical activity could prevent cancer, but scanty data is available on head and neck cancer (HNC). The aim of our study is to clarify the effect of recreational physical activity (rPA) on HNC. We analyzed data from four case-control studies, including 2,289 HNC cases and 5,580 controls. rPA was classified as: none/low (reference group), moderate and high. We calculated summary Odds Ratios (ORs) by pooling study-specific ORs. Overall, moderate rPA was associated with 22% lower risk of HNC compared to those with none or very low rPA levels [OR?=?0.78, 95% Confidence Interval (95% CI): 0.66, 0.91]. Moderate rPA is associated with reduced risk of oral (OR?=?0.74, 95% CI: 0.56, 0.97) and pharyngeal cancer (OR?=?0.67, 95% CI: 0.53, 0.85), as well as high rPA levels (OR?=?0.53, 95% CI: 0.32, 0.88 for oral cavity, OR?=?0.58, 95% CI: 0.38, 0.89 for pharynx). High rPA levels, however, is associated with higher risk of laryngeal cancer (OR?=?1.73, 95% CI: 1.04, 2.88). Stratified analyses showed that such inverse association between moderate rPA and HNC was more evident among males (OR?=?0.75, 95% CI: 0.62, 0.90), subjects ≥45?years (OR?=?0.78, 95% CI: 0.66, 0.93), and ever smokers and ever drinkers (OR?=?0.72, 95% CI: 0.59, 0.88). High rPA significantly reduces HNC risk among subject ≥45?years (OR?=?0.66, 95% CI: 0.48, 0.91). Promoting rPA might be inversely associated with HNC.     

Adulthood lifetime physical activity and breast cancer

BACKGROUND: Epidemiologic studies have shown that breast cancer risk is reduced 30% to 40% in highly physically active compared with inactive women. However, the effects of moderate activities, timing of activities, and intervening effects of other risk factors remain less clear. METHODS: We analyzed data on physical activity patterns in 2176 incident breast cancer cases and 2326 controls in a population-based breast cancer case-control study in Poland conducted in 2000-2003. Using unconditional logistic regression analyses, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) associated with physical activity levels (measured by average metabolic equivalents of energy expenditure hours per week), controlling for potential confounders. RESULTS: Total adult lifetime activity reduced risk of breast cancer, with individuals in the highest quartile having an OR of 0.80 (CI = 0.67-0.96) compared with the lowest quartile. Reduced risks were most consistent for the highest quartiles of moderate-to-vigorous activities: moderate/vigorous recreational activities (OR = 0.74; CI = 0.62-0.89), outdoor activities (0.81; 0.68-0.97), heavy physical work (0.60; 0.42-0.87), and combined high intensity (metabolic equivalent >6.0) activities (0.75; 0.63-0.90). These relations were not modified by body mass index, menopausal status, or family history of breast cancer. Reductions in risk with moderate/vigorous recreational activities were stronger for larger tumors and those with nodal involvement. Women who increased their recreational activity in their 50s had significantly reduced risk, with those in the highest tertile of change being at a 27% lower risk. CONCLUSIONS: Leisure-time moderate-to-vigorous activities reduce breast cancer risk irrespective of underlying host characteristics.     

Medical history, sexual, and maturational factors and prostate cancer risk

PURPOSE: Sexual, physical, and medical factors were investigated in a case-control study of prostate cancer. METHODS: This population-based study, conducted from 1995 to 1999 in northeastern Ontario, used cancer registry-identified cases (n=760), aged 45 to 84 years, diagnosed between 1995 and 1998. Age-frequency matched controls (n=1632) were obtained from telephone listings. Two separate logistic regression analyses considered: 1) sexual and physical; and 2) medical factors. RESULTS: For the sexual-physical model, marital status, family income, maximum height, number of marriages, having children, age at first marriage, birth, and needing to shave, and acne were not significantly related to risk. In the medical model, a family history of prostate cancer (OR, 2.99; 95% CI, 2.21-4.04) and history of venereal disease (OR, 2.12; 95% CI, 1.27-3.53) were associated with significantly increased risk. A history of allergies (OR, 0.78; 95% CI, 0.60-1.00), benign prostatic hyperplasia (OR, 0.63; 95% CI, 0.49-0.81), and an annual physical exam (OR, 0.43; 95% CI, 0.21-0.85) were associated with reduced risk. Other factors considered in the medical conditions model, body mass index, smoking non-filter cigarettes, and family income were not associated with prostate cancer. CONCLUSIONS: This study is consistent with other studies that suggest that infectious agents may be involved in prostate cancer development.     

Recreational drug use: a major risk factor for gastroschisis?

The authors tested the hypothesis that the birth prevalence of gastroschisis is positively associated with use of recreational drugs in early pregnancy. A matched case-control study was carried out in three regions of the United Kingdom over the period January 2001 through August 2003. For each case, three liveborn controls were matched by initial intended place of delivery, region, and maternal age. Maternal hair analysis provided independent verification of recreational drug use. Conditional logistic regression was used to estimate mutually adjusted odds ratios. Estimates were revised using data from hair analysis. Statistically significant adjusted odds ratios for gastroschisis were associated with first-trimester use of 1) any recreational drug (odds ratio (OR) = 2.2, 95% confidence interval (CI): 1.2, 4.3) and 2) vasoconstrictive recreational drugs (defined as cocaine, amphetamines, and ecstasy) (OR = 3.3, 95% CI: 1.0, 10.5). Other significant exposures included aspirin use (OR = 20.4, 95% CI: 2.2, 191.5), cigarette smoking (OR = 1.7, 95% CI: 1.1, 2.6), and prior history of gynecologic infection/disease (OR = 2.6, 95% CI: 1.2, 5.6). Recreational drug use is a significant risk factor for gastroschisis and is one of a constellation of potentially preventable exposures which include cigarette smoking, aspirin use, and history of gynecologic infection/disease. Maternal hair analysis proved an acceptable and valuable method of independently verifying recreational drug use.     

Measles vaccine effectiveness and risk factors for measles in Dhaka,Bangladesh

OBJECTIVE: To evaluate vaccine effectiveness and to assess risk factors for measles in Dhaka, Bangladesh. METHOD: A case-control study, involving 198 cases with 783 age-matched neighbourhood controls and 120 measles cases with 365 age-matched hospital controls, was conducted in 1995-96 in three large hospitals in Dhaka. FINDINGS: Measles vaccine effectiveness was estimated at 80% (95% confidence interval (CI) = 60-90%) using neighbourhood controls; very similar results were obtained using hospital controls. Visits to a health facility 7-21 days before onset of any symptoms were associated with increased risk of measles compared with neighbourhood (adjusted odds ratio (OR) = 7.0, 95% CI = 4.2-11.6) or hospital (adjusted OR = 1.7, 95% CI = 1.01-2.8) controls. Cases were more likely than controls to come from a household where more than one child lived (adjusted OR = 1.6, 95% CI = 1.1-2.5 versus neighbourhood controls; adjusted OR = 1.8, 95% CI = 1.02-3.0 versus hospital controls). CONCLUSIONS: To improve measles control in urban Dhaka missed immunization opportunities must be reduced in all health care facilities by following WHO guidelines. For measles elimination, more than one dose of vaccine would be required.     

南京市男男性行为者新型毒品使用情况及相关因素

  目的  了解南京市男男性行为者（men who have sex with men,MSM）新型毒品的使用情况及其相关因素。  方法  采用滚雪球、同伴推荐和互联网招募等方式招募MSM参加调查。采用多因素Logistic回归分析模型分析新型毒品使用的相关因素。  结果  876名MSM中,29.6%自述使用过新型毒品,人类免疫缺陷病毒（human immunodeficiency virus,HIV）和梅毒的感染率分别为9.5%和9.0%。控制了相关社会人口学因素的影响后,新型毒品使用者近6个月与同性发生无保护肛交（OR=1.83,95% CI:1.35~2.47,P < 0.001）、近6个月多性伴（OR=2.25,95% CI:1.65~3.05,P < 0.001）、HIV感染（OR=1.95,95% CI:1.21~3.17,P=0.007）和梅毒感染（OR=1.71,95% CI:1.02~2.84,P=0.040）的可能性较高。多因素分析结果显示,年龄<30岁（OR=1.50,95% CI:1.07~2.11,P=0.020）、性取向自我认定为同性恋（OR=1.65,95% CI:1.16~2.34,P=0.005）、互联网交友（OR=1.58,95% CI:1.07~2.35,P=0.022）、月收入≥ 5000元（OR=1.57,95% CI:1.13~2.17,P=0.007）、性角色自我认定为"被插入方"（OR=1.55,95% CI:1.04~2.32,P=0.033）的MSM使用新型毒品的可能性较高。  结论  南京市MSM新型毒品使用比例较高,新型毒品使用和HIV感染、梅毒感染及高危性行为有关联,新型毒品使用的危害性和警示性教育应成为MSM社区参与宣传教育关注的重点。     

Indoor environment and respiratory symptoms in children living in the Dutch-German borderland

OBJECTIVE: To investigate the relation between indoor environmental risk factors and respiratory symptoms in 7-8-year-old children living in the Dutch-German borderland. METHODS: A nested case-control study was conducted among children participating in a large longitudinal study on respiratory health. Parents of all 781 children with respiratory complaints and an equal number of randomly selected controls were asked to complete a questionnaire, including questions on indoor environment. RESULTS: The parents of 1191 children (76.2%) participated. Past exposure to environmental (OR = 2.73, 95% CI 1.14-6.67) as well as in utero exposure (OR = 2.28, 95% CI 1.15-4.53) to tobacco smoke, use of an unvented geyser for water heating (OR = 3.01, 95% CI 1.21-7.56), long-term exposure to dampness (OR = 2.98, 95% CI 1.10-8.28) or pets (OR = 2.18, 95% CI 1.39-3.42) increased the risk of asthmatic symptoms in 7-8-year-old children. A middle or low socio-economic status also increased the risk of asthmatic symptoms. An inverse association with asthmatic symptoms was seen for wall-to-wall carpeting (OR = 0.57, 95% CI 0.33-0.95) and insulation measures (OR = 0.46, 95% CI 0.25-0.83). Except for the presence of an unvented geyser, these environmental risk factors also presented a risk for coughing symptoms in children. CONCLUSION: This study showed an increased risk of respiratory symptoms in children exposed to several indoor environmental risk factors.     

Foods as risk factors for colorectal adenomas: a case-control study in Burgundy (France)

Foods associated with precancerous colorectal adenoma, especially those associated with large adenomas, are poorly understood. We compared food intake in polyp-free controls (n = 427) with small adenoma (n = 154) or large adenoma (n = 208) cases in Burgundy (France). Logistic regression models controlled for age, gender, and energy. Consumption of lean meat was associated with a reduced risk of small adenomas [odds ratio (OR) for 4th vs. 1st quartile = 0.3, 95% confidence interval (CI) = 0.2-0.6] and large adenomas (OR = 0.4, 95% CI = 0.3-0.7) compared with controls. There was an increased risk with p t s and meat spread [OR = 2.1, 95% CI = 1.1-3.7 (small adenomas) and OR = 2.6, 95% CI = 1.5-4.4 (large adenomas)], bread [OR = 2.0, 95% CI = 1.1-3.6 (small adenomas) and OR = 2.2, 95% CI = 1.3-3.7 (large adenomas)], and pasta (OR = 1.7, 95% CI = 0.9-3.0 in small adenomas only). Animal fats were associated with an increased risk of large adenomas compared with small adenomas (OR = 2.4, 95% CI = 1.1-5.0), whereas yogurt intake was associated with a lower risk (OR for high vs. no intake = 0.5, 95% CI = 0.3-0.9). These findings suggest that some risk factors that have been found to be associated with cancer, such as refined cereal products and high-fat animal products, also influence early stages of colorectal carcinogenesis.     

Do simple prudent health behaviours protect men from myocardial infarction?

BACKGROUND: We tested whether behaviours such as discarding obvious fat on meat, cessation of smoking, avoidance of passive smoking, habitual use of reduced fat milk, prudent consumption of alcohol and regular but moderate physical exercise are associated with a reduction of cardiovascular risk. METHODS: This was a population-based case-control study done in Perth, Western Australia. The cases (n = 336) were men aged 27-64 years with a first-ever acute myocardial infarction (AMI) during the period 1992-1993, and who survived at least 28 days. The controls (n = 735) were participants in a population-based survey of cardiovascular risk factors conducted during May-November 1994. Both groups completed the same questionnaire and the data were analysed with multiple logistic regression using backward elimination technique. RESULTS: Among men aged 27-64 years simple measures such as participation in nonvigorous exercise (odds ratio [OR] = 0.5, 95% CI: 0.4-0.7), and avoidance of added salt (OR = 0.6, 95% CI: 0.4-0.9) are associated with significant and important protection from AMI. CONCLUSION: After 25 years of falling mortality in Australia, lifestyles can still be significantly improved to reduce heart disease even further.     

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.     

Homicide on the job: workplace and community determinants

Homicide is the second leading cause of death on the job for workers in the United States. To identify workplace-level predictors of homicide risk, a case-control study of worker killings in North Carolina in 1994-1998 was conducted. Workplaces were the units of analysis: case workplaces (n = 105) were those where a worker was killed during the study period, while controls (n = 210) were a density sample of North Carolina workplaces, matched on time and industry sector. Potential risk and protective factors were assessed in telephone interviews with workplace managers. Associations were measured by the exposure odds ratio and 95% confidence interval, estimated via conditional logistic regression. Characteristics associated with notably higher risk included being at the current location for 2 years or less (odds ratio (OR) = 5.3, 95% confidence interval (CI): 2.2, 12.6), having only one worker (OR = 2.9, 95% CI: 1.2, 7.2), and having night (OR = 4.9, 95% CI: 2.7, 8.8) or Saturday (OR = 4.2, 95% CI: 1.9, 9.2) hours. Workplaces with only male employees (OR = 3.1, 95% CI: 1.5, 6.5) or with African-American or Asian employees were also more likely to experience a killing. While few of the preceding risk factors are directly modifiable through workplace interventions, it is important to identify them before developing or evaluating preventive measures.     

Perceived exertion in physical activity and risk of gestational diabetes mellitus

BACKGROUND: Physical activity has been associated with decreased risk of gestational diabetes mellitus. Expanding on 2 previously published analyses of absolute exertion measures (time spent and energy expended), we assessed the relation between perceived exertion during usual prepregnancy recreational physical activity and gestational diabetes. METHODS: We analyzed data from a Washington State 1998-2002 case-control study (216 cases, 472 controls) and a 1996-2002 prospective cohort study (897 participants) separately. We used logistic regression models to derive odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Among case-control participants, risk of gestational diabetes was markedly lower for women who reported very strenuous to maximal exertion in usual activity during the year before pregnancy versus those who reported negligible or minimal exertion (adjusted OR = 0.19; CI = 0.15-0.50). There was a direct inverse relation between perceived exertion and risk of gestational diabetes. This relation was also evident among the subset of participants who did not meet physical activity guidelines in the year before pregnancy. Similarly, the OR among cohort participants reporting very strenuous to maximal exertion was 0.57 (0.24-1.37) versus those reporting negligible to moderate exertion. CONCLUSIONS: These results suggest that risk of gestational diabetes is inversely related to the exertion perceived during recreational physical activity in the year before pregnancy. Perceived exertion may be a valuable addition to behavior and fitness measures in assessing relations between physical activity and pregnancy-related health outcomes.     

Physical activity, obesity, energy intake, and the risk of non-Hodgkin's lymphoma: a population-based case-control study

The authors conducted a population-based case-control study of 1,030 cases with histologically confirmed, incident non-Hodgkin's lymphoma (NHL) and 3,106 controls to assess the impact of recreational physical activity, obesity, and energy intake on NHL risk in Canada from 1994 to 1997. Compared with those for subjects in the lowest quartiles of total recreational physical activity, multivariable-adjusted odds ratios for subjects in the highest quartile were 0.79 (95% confidence interval (CI): 0.59, 1.05) for men and 0.59 (95% CI: 0.42, 0.81) for women. Obesity (body mass index > or = 30 kg/m2) was associated with odds ratios of 1.59 (95% CI: 1.18, 2.12) for men and 1.36 (95% CI: 1.00, 1.84) for women. For men and women with a lifetime maximum body mass index of > or = 30 kg/m2, respective odds ratios were 1.55 (95% CI: 1.16, 2.06) and 1.10 (95% CI: 0.83, 1.46). For men and women in the highest quartiles of calorie intake, respective odds ratios were 1.95 (95% CI: 1.45, 2.62) and 1.13 (95% CI: 0.84, 1.52). Some differences were found between histologic subtypes of NHL for these associations. This study suggests that recreational physical activity decreases NHL risk, while obesity and excess calorie intake increase it. More studies are needed to confirm these results, especially the differences between histologic subtypes.