Influenza vaccination in the time of COVID-19: A national U.S. survey of adults

IntroductionDecisions about influenza vaccination for fall-winter 2020 were made against the backdrop of the COVID-19 pandemic. During May 2020, the authors examined intended vaccination in the next 12 months in relationship to demographic variables, healthcare attitudes, and personal COVID-19 experiences for two samples of adults--those who did not receive influenza vaccine during the prior 12 months, and those who did.MethodsIn May 2020, a cross-sectional online survey was conducted with a national US sample. Participants reported prior influenza vaccination (yes/no during prior 12 months) and anticipated vaccination (yes/no during next 12 months). Covariates included demographic characteristics (e.g., gender, race-ethnicity, political ideology), general beliefs (e.g., benefits of vaccines, altruistic attitudes), and COVID-19 health beliefs and experiences (COVID-19 worry and severity, perception of COVID-19 as a community threat, knowing someone with COVID-19). For each group, hierarchical multivariable logistic regression was conducted with intent to vaccinate as the outcome.ResultsAmong participants (n = 3502), 47% did not receive influenza vaccine in the prior 12 months and 53% had; 25.5% of non-vaccinators and 91.9% of vaccinators intended future vaccination. For non-vaccinators, odds of intending vaccination was associated with race/ethnicity (Hispanics were more likely to intend than white-NH; AOR = 1.74; 95% CI = 1.23–2.4), greater perceived benefits of vaccination (AOR = 2.19; 95% CI = 1.88–2.54), and perception of COVID-19 as a community threat (AOR = 1.91; 95% CI = 1.49–2.45). For vaccinators, odds of intending vaccination was associated with age (AOR = 1.04; 95% CI = 1.03–1.05), race/ethnicity (Black-NH and Other-NH were less likely to intend than white-NH, AOR = 0.60; 95% CI = 0.36–0.999; and AOR = 0.45; 95% CI = 0.24–0.84, respectively), greater perceived benefits of vaccination (AOR = 1.88; 95% CI = 1.45–2.45) and greater perception of collective benefits of vaccines (AOR = 1.48; 95% CI = 1.15–1.90).ConclusionsThe COVID-19 pandemic may have served as a cue to action for influenza vaccination intention among some prior non-vaccinators whereas intention among prior vaccinators is more related to positive attitudes toward vaccination.     

Risk factors differ between recurrent and incident preeclampsia: a hospital-based cohort study

PurposeTo examine whether risk factors, including prepregnancy body mass index (BMI), differ between recurrent and incident preeclampsia.MethodsData included electronic medical records of nulliparas (n = 26,613) delivering 2 times or more in Utah (2002–2010). Modified Poisson regression models were used to examine (1) adjusted relative risks (RR) of preeclampsia and 95% confidence intervals (CI) associated with prepregnancy BMI; (2) maternal risk factor differences between incident and recurrent preeclampsia among primiparous women.ResultsIn the first pregnancy, compared with normal weight women (BMI: 18.5–24.9), preeclampsia risks for overweight (BMI: 25–29.9), obese class I (BMI: 30–34.9), and obese class II/III (BMI: ≥35) women were 1.82 (95% CI = 1.60–2.06), 2.10 (95% CI = 1.76–2.50), and 2.84 (95% CI = 2.32–3.47), respectively, whereas second pregnancy–incident preeclampsia risks were 1.66 (95% CI = 1.27–2.16), 2.31 (95% CI = 1.67–3.20), and 4.29 (95% CI = 3.16–5.82), respectively. Recurrent preeclampsia risks associated with BMI were highest among obese class I women (RR = 1.60; 95% CI = 1.06–2.42) without increasing in a dose-response manner. Nonwhite women had higher recurrence risk than white women (RR = 1.70; 95% CI = 1.16–2.50), whereas second pregnancy–incident preeclampsia risk did not differ by race.ConclusionPrepregnancy BMI appeared to have stronger associations with risk of incident preeclampsia either in the first or second pregnancy, than with recurrence risk. Nonwhite women had higher recurrence risk.     

Attitudes of parents towards influenza vaccine in the Eastern Mediterranean Region: A multilevel analysis

BackgroundSeasonal influenza vaccines (SIVs) can protect against influenza and substantially reduce the risk of influenza-related hospitalizations and fatalities in children. This study aimed to assess parental attitudes towards SIVs in the Eastern Mediterranean region (EMR).MethodsThrough an anonymous online survey conducted in 19 countries in the EMR, parents or caregivers over 18 years who had at least one child above 6 months filled out the Parent Attitudes about Childhood Vaccines questionnaire. As data had two levels; country and individual factors, we utilized multilevel binary logistic regression models.ResultsIn total, 6992 respondents filled out the questionnaire. Of them, 47.4 % were residents of middle-income countries, 72.4 % of the mothers were between 26 and 45 years old, 56.5 % had at least a university degree, and approximately 51.6 % were unemployed. Nearly 50.8 % of the respondents were hesitant to vaccinate their children against seasonal influenza. Parental attitudes towards seasonal influenza vaccination differed significantly between countries, p < 0.001. The main predictors of parental seasonal influenza vaccine hesitancy (VH) were parents vaccination (odds ratio (OR) = 0.42, 95 % CI = 0.32–0.55, p < 0.001)), the mother's education if mother educated vs. who did not receive any education (OR ranged from 0.48 to 0.64, p < 0.05), living in low-income countries (OR = 0.52, 95 % CI = 0.35–0.77, p < 0.01), mountain residence (0.69, 95 % CI = 0.49–0.99, p < 0.05), health workers as a source of information (OR = 0.70, 95 % CI = 0.58–0.85, p < 0.001), children vaccination against COVID-19 (OR = 0.52, 95 % CI = 0.41–0.65, p < 0.001), not receiving routine vaccinations (OR = 1.93, 95 % CI = 1.09–3.44, p = 0.025), and if parents respondents could not remember whether their child had suffered from seasonal influenza in the previous year (OR = 1.57, 95 % CI = 1.33–1.84, p < 0.001).ConclusionA high seasonal influenza VH rate was found in the EMR. Health authorities should implement different interventions targeting the identified modifiable risk factor to increase vaccine uptake among children, especially those at risk of complication from seasonal influenza infection.     

Prolonged postpartum length of hospital stay among women with disabilities

BackgroundPrior studies have found higher proportions of cesarean deliveries and longer postpartum hospital stays among women with disabilities compared to women without disabilities. However, no research has assessed how length of stay may differ for women with different types of disability while also considering mode of delivery.ObjectiveTo examine the association of disability status and disability type with length of stay, taking into account disability-related differences in mode of delivery.MethodsWe conducted a retrospective cohort study using linked maternal and infant hospital discharge and vital records data for all births in California between 2000 and 2012 (n = 6,745,201). We used multivariable regression analyses to assess association of disability status and type with prolonged length of stay (>2 days for vaginal delivery or >4 days for cesarean) while controlling for covariates.ResultsWomen with disabilities had significantly elevated adjusted odds of prolonged length of stay compared to women without disabilities (aOR = 1.40, 95% CI = 1.32–1.49). Adjusted odds were highest for women with vision disabilities (aOR = 1.67, 95% CI = 1.46–1.90), followed by women with IDD (aOR = 1.53, 95% CI = 1.30–1.80), and women with physical disabilities (aOR = 1.41, 95% CI = 1.32–1.50). Women with hearing disability had the lowest adjusted odds of prolonged length of stay (aOR = 1.17, 95% CI = 1.03–1.33).ConclusionsProlonged length of stay did not appear to be due solely to the higher proportion of cesarean deliveries in this population. Further research is needed to better understand the reasons for prolonged length of stay among women with disabilities and develop strategies to assist women with disabilities in preparing for and recovering from childbirth.     

Physical Activity is Associated With Fewer Subjective Cognitive Complaints in 47 Low- and Middle-Income Countries

ObjectivesTo determine the association between physical activity (PA) and subjective cognitive complaints (SCCs), and the influential factors in this association.DesignCross-sectional study.Setting and ParticipantsCommunity-based data of the World Health Survey, which included 248,504 individuals from 47 low- and middle-income countries (LMICs), were analyzed [mean age = 38.6 (standard deviation 16.1) years; 50.7% female].MethodsPA was assessed with the International Physical Activity Questionnaire. Participants were grouped into those who meet (high PA) the 150 minutes of moderate-to-vigorous intensity PA per week recommendation, and those who do not (low PA). Two questions on subjective memory and learning complaints in the past 30 days were used (scales ranged from 1 to 5, with higher scores representing more severe SCC). Multivariable ordinal logistic regression and mediation analyses were performed.ResultsOverall, after adjusting for sociodemographic and a wide range of behavioral, psychological, and physical factors, low PA was associated with a higher risk for having more severe subjective memory complaints [odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.04-1.23] and learning complaints (OR = 1.18, 95% CI = 1.12-1.26). Significant associations were only observed among the middle-aged (45-64 years; learning complaints OR = 1.19, 95% CI = 1.06-1.33) and older populations (≥65 years; memory complaints OR = 1.31, 95% CI = 1.15-1.49, and learning complaints OR = 1.41, 95% CI = 1.24-1.60). Chronic physical conditions, sleep problems, depression, and anxiety explained between 7.7% and 29.4% of the PA-SCC association among those aged ≥45 years.Conclusions and ImplicationsLow PA was associated with increased odds for more severe SCCs in middle-aged and older adults in LMICs. Given the particularly rapid increase in dementia in LMICs, more longitudinal research is warranted from this setting to understand the utility of PA promotion in the prevention of cognitive impairment.     

Active school transport and fast food intake: Are there racial and ethnic differences?

ObjectivesTo investigate whether active school transport was associated with fast food consumption, and to examine differences across racial/ethnic groups.MethodsAdolescent data (n = 3194) from the 2009 California Health Interview Survey were analyzed with logistic regression models to examine the association between active school transport (AST) and fast food intake across racial/ethnic groups.ResultsIn the overall sample, AST during 1–2 days in the past week was associated with greater likelihood of fast food intake (OR: 1.58; 95% CI: 1.03–2.43), compared with zero days of AST, controlling for demographic and other factors. The association between AST and fast food intake differed significantly by race/ethnicity (p < 0.01). Among Latino adolescents, greater frequency of AST was significantly associated with greater likelihood of fast food intake (1–2 days OR, 2.37, 95%CI: 1.05–5.35; 3–4 days OR, 2.78, 95% CI: 1.04–7.43; 5 days OR, 2.20, 95%CI: 1.23–3.93). Among White and Asian adolescents, there was a curvilinear pattern: relative to adolescents who reported zero days of AST, those who did AST 1–2 days/week had greater likelihood of fast food intake, but AST of 3–4 days and 5 days/week was associated respectively, with higher and lower likelihood of fast food intake among both groups.ConclusionsAST appears to be a risk factor for fast food intake, and may expose some ethnic groups more than others to increased opportunity to purchase and consume fast food. Programs and policies to promote AST among adolescents should incorporate efforts to encourage healthy eating and discourage concentration of fast food outlets near schools.     

Drug and alcohol use disorders among adults with select disabilities: The national survey on drug use and health

BackgroundDeaths caused by drugs and alcohol have reached high levels in the US, and prior research shows a consistent association between disability status and substance misuse.ObjectiveUsing national data, this study quantifies the association between disability status and drug and alcohol use disorders among US adults.MethodsThe most recent pre-pandemic years (2018–2019) of the cross-sectional National Survey on Drug Use and Health (n = 83,439) were used to examine how the presence of any disability, and specific disabilities, were associated with past year drug and alcohol use disorders. Logistic regression was used to estimate adjusted odds ratios (aORs) controlling for potential sociodemographic confounders.ResultsAdults with any disability had increased odds of drug (aOR = 2.7; 95% CI = 2.5–3.0), and alcohol use disorder (aOR = 1.8; 95% CI = 1.6–2.0), compared to adults without disability. Examining specific types of disabilities, adults with cognitive limitations only had increased odds of drug (aOR = 3.1; 95% CI = 2.6–3.6), and alcohol use disorders (aOR = 2.2; 95% CI = 1.9–2.5), compared to adults without disability. Smaller associations were observed between vision and complex activity limitations and drug use disorder. Adults with two or more types of limitations had increased odds of drug (aOR = 3.7; 95% CI = 3.3–4.3), and alcohol use disorders (aOR = 2.3; 95% CI = 2.0–2.6).ConclusionsThe presence of disability, especially cognitive limitation only, or two or more types of limitations, is associated with elevated odds of drug and alcohol use disorder among US adults. Additional research should examine the temporal relationship between and mechanisms linking disability and substance misuse.     

Poor self-rated health is associated with sedentary behavior regardless of physical activity in adolescents - PeNSE study.

ObjectivesTo analyze the independent and combined associations of physical activity (PA) and sedentary behavior (SB) with self-rated health (SRH) in a large sample of adolescents.MethodsData from 100,873 students with mean age of 14.3 (±1.1) years were analyzed. SRH, PA and SB were assessed by questionnaires. Age, ethnicity, maternal education, geographical region of country, type of city, industrialized and sugary foods consumption were covariates. Logistic regression models were used to analyze the data according to gender.Results≥300 min/week of PA [OR:1.12 (95%CI:1.04–1.21)] and <4 h of sitting time [OR:1.42 (95%CI:1.32–1.54)] were associated with good SRH among boys, while only lower sitting time was associated with good SRH among girls [OR:1.32 (95%CI:1.23–1.41)]. Physically active and with low sitting time adolescents were more likely to have good SRH [Boys OR:1.57 (95%CI:1.41–1.75); Girls OR:1.32 (95%CI:1.18–1.46)], than inactive and with high sitting time counterparts. However, high sitting time was associated with poor SRH independently of ≥300 min/week of PA.ConclusionPA and sitting time were independently associated with SRH in Brazilian adolescents. Moreover, reaching ≥300 min/week of PA was not sufficient to attenuate the negative association between high sitting time and SRH.     

Incidence of sport-related traumatic brain injury and risk factors of severity: a population-based epidemiologic study

PurposeFew studies of sport-related traumatic brain injury (TBI) are population-based or rely on directly observed data on cause, demographic characteristics, and severity. This study addresses the epidemiology of sport-related TBI in a large population.MethodsData on all South Carolina hospital and emergency department encounters for TBI, 1998–2011, were analyzed. Annual incidence rate of sport-related TBI was calculated, and rates were compared across demographic groups. Sport-related TBI severity was modeled as a function of demographic and TBI characteristics using logistic regression.ResultsA total of 16,642 individuals with sport-related TBI yielded an average annual incidence rate of 31.5/100,000 population with a steady increase from 19.7 in 1998 to 45.6 in 2011. The most common mechanisms of sport-related TBI were kicked in football (38.1%), followed by fall injuries in sports (20.3%). Incidence rate was greatest in adolescents ages 12-18 (120.6/100,000/persons). Severe sport-related TBI was strongly associated with off-road vehicular sport (odds ratio [OR], 4.73; 95% confidence interval [95% CI], 2.92?7.67); repeated head trauma (OR, 4.36; 95% CI, 3.69?5.15); equestrian sport (OR, 2.73; 95% CI, 1.64?4.51); and falls during sport activities (OR, 2.72; 95% CI, 1.67?4.46).ConclusionsThe high incidence of sport-related TBI in youth, potential for repetitive mild TBI, and its long-term consequences on learning warrants coordinated surveillance activities and population-based outcome studies.     

The association between disability and unintentional injuries among adolescents in a general education setting: Evidence from a Swedish population-based school survey

BackgroundUnintentional injuries are the leading cause of death among adolescents. Adolescents with disabilities may be particularly vulnerable with an increased risk of unintentional injuries.ObjectiveTo study the association between a set of disabilities and unintentional injury risks among adolescents, accounting for comorbidity, subjective disability severity and sex.MethodCross-sectional data from a Swedish national school survey including 4,741 students (15 and 17-year olds) conducted in 2016 was analyzed using log-binomial generalized linear models.ResultsWe found a 33% increased risk of injury the last 12 months and a 53% increased risk of injury leading to hospitalization for adolescents with any disability compared to their peers with no disability. The differences in injury risk were greater for girls than boys. There was a dose-response relationship between disability severity and injury risk. In analyses adjusted for sociodemographic factors and comorbidity, attention-deficit/hyperactivity disorder (ADHD) and epilepsy were associated with an increased risk of injury the last 12 months, risk ratios [RR] were 1.41 (95% Confidence Interval [CI] 1.08–2.97) and 1.79 (95% CI 1.10–1.81) respectively. Autism spectrum disorder was associated with a decreased injury risk the last 12 months (RR = 0.43, CI 0.2–0.92). ADHD, mobility impairment and visual impairment were associated with hospitalization due to injury during lifetime.ConclusionsThere was an increased risk of unintentional injuries for adolescents with disabilities compared to their non-disabled peers, specifically for individuals with ADHD, epilepsy, visual impairment and mobility impairment. Injury prevention strategies may include adapting the physical environment and medical treatment.     

Risk Factors for Machinery-related Injury among Iowa Farmers: A Case-Control Study Nested in the Agricultural Health Study

Abstract

Farm machinery is a major cause of injury morbidity and mortality among farmers. This case-control study assessed risk factors for machinery-related injuries among Iowa farmers. A screener questionnaire sent to 6,999 farmers in 1998 identified 205 farmers who had machinery-related injuries requiring medical advice/treatment in the previous year. Possible risk factors for injury were assessed among these farmers compared with 473 farmers with no injury in the previous year. A multiple logistic regression analysis showed significant associations between machinery-related injury and hours per week spent on farmwork (OR = 2.02; 95% CI 1.38–2.94), fewer years of farming experience (OR = 1.79; 95% CI 1.14–2.79), wearing a hearing aid (OR = 4.37; 95% CI 1.55–12.25), and a high CAGE score suggesting problem drinking (OR = 2.49; 95% CI 1.00–6.19). This is the first study to show associations between machinery-related injury and hearing impairment, problem drinking, and fewer years of farming experience. These findings may be useful for future interventions to decrease injuries related to farm machinery.     

Is physical inactivity associated with depressive symptoms among adolescents with high screen time? Evidence from a developing country

BackgroundIncreasing levels of screen use and physical inactivity in developing countries may be deleterious for adolescent mental health. This study aimed to examine how physical inactivity is associated with concurrent depressive symptoms among adolescents with high recreational screen time in Bangladesh.MethodsA self-administered survey was conducted among 898 secondary school students of Dhaka city, Bangladesh. High screen-time was assessed using the Adolescent Sedentary Activity Questionnaire (ASAQ), with a cut-off of >2 h/day. Scores ≥10 on the 10-item Center for Epidemiological Studies Depression Scale (CESD10) suggested depressive symptoms. The Three-Day Physical Activity Recall (3DPAR) instrument was used to estimate physical activity, with those doing ≤60 min/day of moderate-vigorous physical activity (MVPA) classified as not meeting MVPA recommendations. Of the 599 adolescents who were determined to have high recreational screen time (>2 h/day), 505 completed the CESD10, and form the basis for this analysis.ResultsOf the adolescents with high recreational screen time, 32% did not meet MVPA recommendations and 25% reported depressive symptoms. Generalized estimating equations modelling on CESD scores showed that depressive symptoms were more prevalent among adolescents with high screen time who also did not meet MVPA recommendations (OR 2.37; 95% CI: 1.23–4.59), after adjusting for a set of confounders including sociodemographic, psychosocial and lifestyle factors.ConclusionsAdolescents in Dhaka city with high recreational screen time and not meeting physical activity recommendations are also likely to have depressive symptoms. More research is needed to understand the causal directions of these relationships.     

Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

ObjectiveSensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium.DesignCross-sectional study nested in the 2017 “Delirium Day” project.Setting and ParticipantsPatients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy.MethodsDelirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters).ResultsA total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2–2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1–1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6–1.2, P = .36; OR 1.1; CI 0.8–1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6–1.2, P = .27; OR 1.1, CI 0.8–1.4, P = .63).Conclusions and implicationsOur findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.     

Self-reported hearing loss is associated with poorer perceived health care access,timeliness, satisfaction,and quality: Findings from the Survey of the Health of Wisconsin

BackgroundHearing loss is a highly prevalent chronic condition impacting communication and may negatively influence patients’ health care experiences.ObjectiveDetermine associations of hearing loss with perceived health care access, timeliness, satisfaction, and quality in a representative sample of the general population.MethodsThe Survey of the Health of Wisconsin (SHOW) is a household-based examination survey that collects data from a representative sample of Wisconsin residents. SHOW participants from years 2008–2013 with data on self-reported hearing loss and health care access, timeliness, satisfaction, and quality were included in this study. Age- and sex- and multivariable-adjusted (additionally adjusted for race/ethnicity, education, marital status, public health region, smoking, chronic disease, self-reported health, and insurance coverage) logistic regression models were used to evaluate associations of hearing loss with participants’ health care experiences. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals.ResultsThere were 2438 individuals (42.1% men) included in this study with an average age of 48.3 (range 21–74; standard deviation [SD] 14.4) years. The number of participants who self-reported hearing loss was 642 (26.3%). After multivariable adjustment, hearing loss was associated with increased odds of perceived difficulties with health care access (OR 1.47 [1.05, 2.05]), timeliness (OR 1.69 [1.23, 2.32]), quality (OR 2.54 [1.50, 4.32]), and satisfaction (OR 2.50 [1.51, 4.13]).ConclusionsGiven the high prevalence of hearing loss and the growing aging population, there is an urgent need to prioritize interventions to improve health care provision for individuals with hearing loss.     

Association of Pisa Syndrome With Mortality in Patients With Parkinson's Disease

ObjectivesIn Parkinson's disease, Pisa syndrom (PS) has been associated with disease stage and severity, combined treatment with levodopa and dopamine agonists, gait disorders, and comorbidities. Some forms of PS are potentially reversible; nevertheless, little is known about the impact of this syndrome on survival.DesignProspective study with a median follow-up of 2 years.Setting and participantsPatients with Parkinson's disease, age 65 years and older (N = 189), attending a geriatric day hospital.MeasurementsAccording to established criteria, PS was diagnosed in the presence of at least 10° lateral flexion of the trunk reducible by passive mobilization or supine positioning. Cox regression was adopted to assess the association of PS with all-cause mortality.ResultsPS was diagnosed in 40 patients (21%); over the follow-up, 21 (11%) subjects died. In Cox regression, PS was associated with higher mortality [hazard ratio (HR) 4.10; 95% confidence interval (CI) = 1.36-12.38], after adjusting; other variables associated with mortality were age (HR = 1.19, 95% CI = 1.08-1.32), beta blockers (HR = 4.35, 95% CI = 1.23-15.39), and albumin levels (HR = 0.05, 95% CI = 0.01-0.33). The association of PS with mortality remained significant also after adjusting for variables associated with this syndrome (HR = 4.04, 95% CI = 1.33-12.25).Conclusions/ImplicationsPS represents a risk factor for earlier mortality in Parkinson's disease; further studies are needed to ascertain the underlying causes and whether treatment of this condition might improve survival.     

Perceived control moderates the relationship between social capital and binge drinking: longitudinal findings from the Montreal Neighborhood Networks and Health Aging (MoNNET-HA) panel

BackgroundCross-sectional research suggests social capital has negative consequences for problem drinking behaviors. Previous studies have suggested psychosocial resources, including perceived control, may buffer this association. Little research has examined whether such relationships persist longitudinally.MethodsRandom effects models examined between-person relationships among problem drinking, social capital, and perceived control, and whether perceived control moderated the relationship between social capital and drinking. Fixed effects models assessed whether social capital and perceived control were related to changes in problem drinking.ResultsGreater network capital and generalized trust predicted higher odds of binge drinking (RR = 1.08; 95% CI = 1.03-1.12 and RR = 1.23; 95% CI = 1.03-1.48, respectively). Perceived control moderated the positive association of network capital with binge drinking (RR = 0.91; 95% CI = 0.87-0.96).ConclusionsThe present findings support previous notions about the complex role of social capital on health, and offer new insights on the role of perceived control on problem drinking.     

Efficacy and Generalizability of Falls Prevention Interventions in Nursing Homes: A Systematic Review and Meta-analysis

ObjectivesTo determine the efficacy of fall intervention programs in nursing homes (NHs) and the generalizability of these interventions to people living with cognitive impairment and dementia.DesignSystematic review and meta-analysis.Setting and ParticipantsNH residents (n = 30,057) living in NHs defined as residential facilities that provide 24-hours-a-day surveillance, personal care, and some clinical care for persons who are typically aged ≥65 years with multiple complex chronic health conditions.MethodsMeta-analysis of falls prevention interventions on number of falls, fallers, and recurrent fallers.ResultsThirty-six studies met inclusion criteria for the systematic review. Overall, fall prevention interventions reduced the number of falls [risk ratio (RR) = 0.73, 95% confidence interval (CI) = 0.60-0.88], fallers (RR = 0.80, 95% CI = 0.72-0.89), and recurrent fallers (RR = 0.70, 95% CI = 0.60-0.81). Subanalyses revealed that single interventions have a significant effect on reducing fallers (RR = 0.78, 95% CI = 0.69-0.89) and recurrent fallers (RR = 0.60, 95% CI = 0.52-0.70), whereas multiple interventions reduce fallers (RR = 0.69, 95% CI = 0.39-0.97) and multifactorial interventions reduce number of falls (RR = 0.65, 95% CI = 0.45-0.94).Conclusions and ImplicationsExercise as a single intervention reduced the number of fallers and recurrent fallers by 36% and 41%, respectively, in people living in NHs. Other effective interventions included staff education and multiple and multifactorial interventions. However, more research on exercise including people with cognitive impairment and dementia is needed to improve the generalizability of these interventions to the typical NH resident.     

Association of Child Marriage With Suicidal Thoughts and Attempts Among Adolescent Girls in Ethiopia

PurposeLittle information exists on the mental health implications of child marriage in Africa. This study examined the association between child marriage and suicidal ideation and suicide attempt among girls aged 10–17 years.MethodsData were drawn from a 2007 cross-sectional survey conducted in the Amhara region, Ethiopia. Multilevel logistic regression was used to analyze risk factors for suicidality.ResultsApproximately 5.2% of girls reported ever being married, 5.4% were promised in marriage, and 9.3% reported receiving marriage requests. Girls who were ever married (odds ratio [OR] = 1.81; 95% confidence interval [CI] = 1.03–3.18), were promised in marriage (OR = 2.35; 95% CI = 1.38–4.01) or had received marriage requests (OR = 2.29; 95% CI = 1.46–3.59) were significantly more likely than girls who were never in the marriage process to have had suicidal thoughts in the past 3 months. Residence in communities with high involvement in stopping child marriage was protective of suicidal ideation. The odds of suicide attempt were twice as high among girls with marriage requests as among those with none.ConclusionsChild marriage was associated with increased odds of suicidality. Findings call for stronger community engagement in child marriage prevention and mental health support for child brides.     

The role of family conflict on risky sexual behavior in adolescents aged 15 to 21

PurposeFamily conflict is related to numerous risky behavioral outcomes during adolescence; however, few studies have examined how family conflict is associated with risky sexual behavior during adolescence.MethodsData from 1104 adolescents aged 15 to 21 who completed the 2008 National Longitudinal Survey of Youth were analyzed. Information on family conflict (family fighting and family criticizing) and sexual behavior (number of sexual partners in past year and use of contraception at last intercourse) was self-reported. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs).ResultsAfter adjustment, adolescents whose family members often fought had increased odds of not using contraception at last intercourse and having two or more sexual partners in the past year (OR, 1.40 [95% CI, 1.04–1.88] and OR, 1.62 [95% CI, 1.23–2.14], respectively). Adolescents whose family members often criticized each other also had increased odds of not using contraception at last intercourse and having two or more sexual partners in the past year (OR, 1.46 [95% CI, 1.12–1.90] and OR, 1.22 [95% CI, 0.96–1.55], respectively).ConclusionsFamily conflict was associated with risky sexual behaviors in this racially/ethnically diverse sample of adolescents. If confirmed in other studies, adolescents who experience family conflict may be an important population to target with information regarding safer sex practices.