Factors Associated With Scoliosis in Schoolchildren: a Cross-Sectional Population-Based Study

Background

The present study aimed to investigate the prevalence of scoliosis and to analyze the factors associated with scoliosis in schoolchildren aged between 7 and 17 years.

Methods

This is a cross-sectional and quantitative study with stratified random selection of public school students in the city of Santa Cruz, Brazil. The presence of scoliosis was examined, as well as the flexibility of the posterior muscle chain, socioeconomic characteristics, anthropometry, lifestyle habits, sexual maturation, and ergonomics of school furniture. In order to identify factors associated with scoliosis, the variables were divided in biological, socioeconomic, lifestyle, and ergonomic factors, and crude and adjusted prevalence ratios (PRs) were estimated by means of Poisson regression analysis.

Results

Two hundred and twelve pupils participated in this study (mean age 11.61 years, 58% female). The prevalence of scoliosis was 58.1% (n = 123) and associated with female sex (PR 2.54; 95% CI, 1.33–4.86) and age between 13 and 15 years (PR 5.35; 95% CI, 2.17–13.21). Sleeping in a hammock was inversely associated with scoliosis (PR 0.44; 95% CI, 0.23–0.81).

Conclusions

Scoliosis seems to be positively associated with female sex and age between 13 and 15 years, whereas the habit of sleeping in a hammock is negatively associated with the onset of scoliosis.Key words: scoliosis, children, risk factors     

Factors Associated with Hepatitis B Knowledge Among Vietnamese Americans: A Population-Based Survey

Vietnamese Americans have high rates of hepatitis B virus (HBV) infection but low rates of knowledge and screening. A population-based survey conducted in 2011 of Vietnamese Americans in two geographic areas (n?=?1666) was analyzed. The outcome variables were having heard of HBV and a score summarizing knowledge of HBV transmission. Most respondents (86.0%) had heard of HBV. Correct knowledge of transmission ranged from 59.5% for sex, 68.1% for sharing toothbrushes, 78.6% for during birth, and 85.0% for sharing needles. In multivariable analyses, factors associated with having heard of HBV and higher knowledge included Northern California residence, longer U.S. residence, higher education, family history of HBV, and discussing HBV with family/friends. Higher income was associated with having heard of HBV. English fluency and being U.S.-born were associated with higher knowledge. Interventions to increase knowledge of HBV transmission are needed to decrease this health disparity among Vietnamese Americans.     

Particulate pollution in Ulaanbaatar, Mongolia

The World Health Organization (WHO) listed the air pollution in Ulaanbaatar (Mongolia) among the top 5 cities with the worst air quality in the world. Air quality in the winter season reaches highs of 750 μg/m³ for daily average fine particulates (PM) due to increased coal combustion and lower mixing heights (<200 m), coupled with the city’s geography surrounded by mountains, which further restricts the vertical and horizontal dispersion of the pollutants. The annual average concentrations in 2010–2011 ranged 136?±?114 μg/m³ (the WHO guideline for fine PM is 10 μg/m³). The single largest source of particulate pollution in Ulaanbaatar is coal and biomass combustion in households and heat-only boilers, followed by power plants. In this paper, we present sector-specific emissions for 2010 accounting for 62,000 tons of fine PM, 55,000 tons of sulfur dioxide, and 89,000 tons of nitrogen oxide emissions. The inventory is spatially disaggregated at 0.01° resolution on a GIS platform for use in a chemical transport model (ATMoS). The modeled concentrations for the urban area ranged 153?±?70 μg/m³, when overlaid on gridded population, resulted in estimated 1,000–1,500 premature deaths per year due to outdoor air pollution. This study also highlights the linkages between indoor and outdoor air pollution. In these harsh temperate conditions, with 50 % of the emissions originating from Ger households, they are as big a health risk for indoor air quality as they are for outdoor air quality. Any intervention improving combustion efficiency or providing clean fuel for these stoves will have a combined benefit for indoor air quality, outdoor air quality, and climate policy. The analysis shows that aggressive pollution control measures are imperative to protect the population in Ulaanbaatar from excess exposure levels, and implementation of control measures like the introduction of heat efficient stoves, clean coal for heating boilers, and urban transport planning will result in significant health benefits, which surpass any costs of institutional, technical, and economic interventions.     

Factors Associated With the Utilization of Maternal Health Care Services Among Adolescent Women in Malawi

The poor maternal health care service utilization among adolescent women remains an intimidating challenge in Malawi. This study examines the factors associated with the utilization of selected maternal health care services among married adolescent women (aged 15–19 years) using data from the Malawi Demographic and Health Survey, 2010. Maternal age, household economic status, and status of the child were found to be significant factors associated with at least four antenatal care visits; whereas personal barriers, birth order and interval, religion, and ethnic group explain the variation in the utilization of postnatal care within 42 days of delivery.     

Sociodemographic and Anthropometric Factors Associated With Screen-Based Sedentary Behavior Among Japanese Adults: A Population-Based Cross-Sectional Study

Background

Concern over the health risks of sedentary behavior has highlighted the need to examine factors associated with screen-based (television/computer) sedentary behavior. The present study examined the association of screen-based sedentary behavior with body weight and sociodemographic attributes among Japanese adults.

Methods

A population-based cross-sectional study enrolled 1034 Japanese adults aged 40 to 69 years who lived in 2 Japanese cities. Sociodemographic variables, height, weight, and time spent on screen-based sedentary behavior were collected by self-administered questionnaire. Differences in screen time in relation to body mass index and weight gain since age 20 years were assessed by the Mann-Whitney U test. Independent associations of each variable with screen time were examined by forced-entry logistic regression analyses.

Results

Mean (SD) age and median (interquartile range) duration of screen time per week were 55.6 (8.4) years and 832.0 (368.8–1263.1) minutes, respectively, for men, and 55.3 (8.4) years and 852.6 (426.0–1307.5) minutes, respectively, for women. Screen time among participants with weight gain was longer than among those with a weight gain of less than 10 kg (P = 0.08). Unmarried and unemployed participants had longer screen times. Participants aged 40 to 49 years were less likely than older age groups to spend time on screen-based sedentary behavior during leisure hours.

Conclusions

The present findings imply that strategies are necessary to discourage screen-based sedentary behavior among all demographic groups, especially among adults who are elderly, unmarried, or unemployed.Key words: weight status, Japanese, sedentary behavior, sociodemographic     

Factors Associated With Health Care Access and Outcome

This study aims to (1) assess ethnic differences in health care access and health outcome between Asian Americans and Whites and between Asian American subgroups, (2) examine effects of cultural factors, and (3) investigate moderating effects of health risk behaviors between cultural characteristics and health care access and outcome. Data were derived from the 2007 California Health Interview Survey. Asian Americans (n = 4,462) and Whites (n = 4,470) were included. There were significant ethnic differences in health care access and health perception between Asian Americans and Whites and across Asian American subgroups. Health risk behaviors moderated relationships between cultural factors and health care access and outcome. Findings reveal that ethnicity affects an individual's health care access and health perception, and their health behaviors are an important factor that may improve or worsen outcomes. This study may increase our knowledge base of research and interventions to enhance ethnic minority populations' health care accessibility and perceptions.     

Cigarette Smoking Among Adults With Mobility Impairments: A US Population-Based Survey

Objectives. Smokers with mobility impairments have greater health risks than the general population. We report the prevalence of cigarette smoking and quit attempts among people with mobility impairments.Methods. We conducted an analysis of 13 308 adults (aged 21–85 years) with mobility impairments (special ambulatory equipment and difficulty walking 0.25 miles without equipment) responding to the National Health Interview Survey (2011).Results. Among 21- to 44-year-old adults with mobility impairments, 39.2% were smokers, compared with only 21.5% of adults without mobility impairments (odds ratio [OR] = 1.64; 95% confidence interval [CI] = 1.07, 2.52). Among 45- to 64-year-old adults with mobility impairments, 31.2% were smokers versus 20.7% without mobility impairments (OR = 1.35; 95% CI = 1.09, 1.68). Women aged 21 to 44 years with mobility impairments had the highest smoking prevalence (45.9%), exceeding same-aged women without mobility impairments(18.9%; OR = 2.56; 95% CI = 1.32, 4.97). Men with mobility impairments had greater smoking prevalence (24.1%) than women with mobility impairments (15.1%; P < .01). Smokers with mobility impairments were less likely to attempt quitting (19.9%) than smokers without mobility impairments (27.3%; P < .01).Conclusions. Smokers with mobility impairments should be targeted for cessation, particularly those who are younger and female.The prevalence of cigarette smoking has reached an asymptote: 19.0% of US adults are smokers, which is not significantly different from the smoking prevalence in 2004 (20.9%).1,2 A reason for this stagnancy may be the high smoking rates within underserved populations, coupled with lack of targeting underserved smokers for cessation treatment.3 Smokers with physical disabilities are underserved, as they are less likely to receive smoking cessation counseling4 and less likely to use evidenced based treatments.5 Furthermore, smokers with physical disabilities encounter numerous barriers to treatment engagement and attendance, such as lack of transportation, architectural access issues, pain, fatigue, energy fluctuations, and procedures of daily care.6–9 Smokers with physical disabilities also have greater risk factors for smoking, such as greater levels of depression and stress, and low income.10–14 Continued smoking exacerbates physical disabilities15–17 and causes or contributes to many secondary conditions including respiratory and circulatory difficulties, muscle weakness, delayed wound healing, worsening arthritis, and osteoporosis.18–22People with physical disabilities constitute 16.2% of the US population,14 and the majority of the population will experience physical disability at during their lifetime.23 Yet the prevalence of smoking among people with physical disabilities is unknown. Previous studies report on smoking prevalence for people with disabilities by collapsing across several types of disabilities (psychiatric, sensory and physical disabilities)2,10,24 rather than reporting smoking prevalence within each type. This has led to a wide range of smoking prevalence rates (24%–43%), depending upon which disability groups were included.The smoking rate among people with mobility impairments, a subpopulation of people with physical disabilities, is unknown. Mobility impairments and use of assistive devices are highly associated with reduced quality of life, development of secondary conditions, and depression,4,11,13,18,21,25 factors known to impede quitting smoking.26–28 Therefore, smoking prevalence might be greater among people with mobility limitations who use an assistive device. Brawarsky et al.29 used the 1996–1999 Massachusetts Behavioral Risk Factor Surveillance and found a 26.9% smoking prevalence among people with orthopedic problems, but their study used a heterogeneous sample including people with back or neck problems as well as people with mobility problems. In addition to being outdated and state specific, their study combines people needing ambulatory assistance with those who do not. Two other studies assessed smoking prevalence among different disability subtypes using national data from The National Health Interview Survey (NHIS): one measured smoking prevalence among people with movement difficulties (including fingers and hands),24 and one measured smoking prevalence among people with mobility limitations.30 Both studies report data more than 10 years old, and neither study reports on smoking cessation behaviors, or whether an assistive device was used.The current study uses a national sample to examine smoking prevalence and quit attempts among people with mobility impairments who use an assistive ambulatory device, compared with people without mobility impairments. We define “mobility impairments” as the use of special ambulatory equipment (e.g., cane, wheelchair, or leg braces) and difficulty walking a quarter mile without the use of special equipment. We do not propose mobility impairments as a proxy for physical disability. Rather, we believe that people with mobility impairments are an important underserved subpopulation among those with physical disabilities. Furthermore, we do not propose that people with mobility impairments are particularly underserved compared with other people with disabilities, but rather that those with mobility impairments are clearly underserved compared with the general population. Because physical disability (including mobility impairment) increases with age4,14 and smoking prevalence decreases with age,2 we also examined smoking prevalence across 3 different age groups between people with and without mobility impairments. We also explored gender differences in smoking prevalence for men and women with mobility impairments.     

准格尔旗居民医疗需求及利用调查分析

目的：了解内蒙古准格尔旗的居民卫生需求及利用情况，为当地政府制定和改进公共卫生工作提供决策参考。方法：随机抽取城市和农村居民1076人进行问卷调查。结果：两周患病率为33．7％，年住院率1．2％。看病的费用占家庭年收入的8．3％。有40．8％居民没有享受任何形式医疗保障。结论：卫生需求和卫生服务结合不够紧密。政府应加强卫生经费投人和现有卫生资源的合理配置，改善医疗保障体系，满足居民卫生需求。     

Family Factors Associated With Suicide Attempts Among Chinese Adolescent Students: A National Cross-Sectional Survey

PurposeTo determine the prevalence and associated family factors of suicide attempts among junior and/or senior high school students, so as to provide bases for preventive measures of suicide in China.MethodsA total of 13,512 students from 32 junior and/or senior high schools in grades 7 to 11 in eight cities of China participated in a self-administered anonymous survey to report their frequency of suicide attempts during the past year. Sociodemographic characteristics, tobacco, and alcohol use in the past 30 days were asked. Stressful family life events were used to evaluate the subjects' family characteristics.ResultsOverall, 2.7% (338/12,470) in-school adolescents reported a suicide attempt during the past year, girls significantly more often than boys. Considered independently, all stressful family life events were strongly associated with increased risk for self-reported suicide attempts. When taking sociodemographic characteristics, life style, and all the five family factors selected from factor analysis into consideration, there was a significant independent impact of three family factors on increasing suicide attempts risk among adolescents. The most notable risks were derived from improper parental rearing behavior, separation from parents, and social problems of the family members. However, neither poor material conditions of family life nor family member's adversity contribute significantly to the risk.ConclusionsThis study not only indicates that suicide attempt is a significant public health issue among in-school adolescents in China, but also confirms that adolescents with family problems commonly manifest suicide attempts, which highlights the importance of considering family environmental factors when assessing suicide risk.     

Factors Associated with Underweight,Overweight, and Eating Disorders in Young Korean Women: A Population-Based Study

Both underweight (UW) and overweight (OW) conditions are problematic in young women. The aim of this study was to examine the factors associated with extreme weight status and eating disorders (EDs) in young Korean women. A total of 808 women (mean age 22.3 ± 3.4 years) participated, including 144 with UW [Body Mass Index (BMI) < 18.5kg/m²], 364 with NW, and 137 with OW or obesity (BMI ≥ 25kg/m²), and 63 patients with anorexia nervosa (AN) and 100 with bulimia nervosa (BN). Participants completed questionnaires regarding nutrients consumed, eating behaviors, health behaviors, body image, and obsessive-compulsive symptoms with face to face interviews. The associations between the status of participants and the data were analyzed with NW group as a reference. OW status was associated with overeating and with frequent eating. UW status was associated with less frequent overeating and with longer sleep duration. AN status was associated with less frequent consumption of alcohol. BN status was associated with a larger discrepancy between the ideal and current body shape. Both OW status and BN were associated with more obsessive-compulsive symptoms. The results suggested that certain dietary, health, and psychological factors are associated with extreme weight conditions and EDs.     

准格尔旗居民卫生服务需求及卫生服务利用调查分析

目的了解内蒙古准格尔旗的居民卫生服务需求及卫生服务利用情况,为当地政府制定政策和改进公共卫生工作提供决策参考。方法随机抽取城市和农村居民1076人进行问卷调查。结果两周患病率为33.7%,年住院率为12.1‰。看病的费用占家庭年收入的9.9%,有40.8%的居民没有享受任何形式的医疗保障。结论卫生服务需求和卫生服务利用结合不够紧密。政府应加强卫生经费投入力度和现有卫生资源的合理配置,改善医疗保障体系,满足居民卫生服务需求。     

Factors Associated With Emergency Department Utilization By Urban Lesbian, Gay, And Bisexual Individuals

There are no published studies to date on emergency department (ED) utilization by the lesbian, gay, and bisexual (LGB) community despite documented lack of access to health care for this community. This study explored the frequency of ED visits and socio-demographic and health-related factors associated with ED utilization among a convenience sample of LGB individuals. A sample of 360 LGB individuals was interviewed to assess socio-demographics, sexual practices, mental health, drug use, chronic disease history, and frequency of emergency department use. Emergency department utilization was categorized as 0, 1, or ≥2 visits. Bivariate statistics were applied to assess the association of various factors with emergency department utilization. Patient characteristics were as follows: age, 29.0; male, 53.1 percent; Hispanic, 57.8 percent; Black, 37.2 percent; and reported less than a college degree, 79.4 percent. Most (77.7 percent) had a primary care doctor and (86.3 percent) were comfortable discussing LGB-related health issues with their provider. Over 12 months, 25.3 percent had 1 ED visit and 16.4 percent had ≥2 ED visits. One or more emergency department visits was significantly associated with lower age, lower education, lower income, recent psychological distress, recent mental health counseling or medications, desired mental health treatment, abuse by partner, cigarette use, marijuana use, and asthma (p < 0.05). Despite reported access to primary care, our LGB sample exhibited a higher proportion of single and ≥2 ED visits than comparable populations. Mental health and cigarette use were associated with emergency department utilization and deserve further exploration for reducing emergency department visitation by and improving emergency department care for LGB individuals.     

嘉定区高一学生健康素养水平及其影响因素调查

目的了解上海市嘉定区高一学生健康素养水平状况,为有关部门制订针对中学生的健康教育措施提供科学依据。方法采用整群抽样方法,抽取嘉定区4所中学高一年级全体学生进行问卷调查,共调查1348名学生,其中男性643人,女性705人。结果本次研究中,中学生总体健康素养水平为33.7%(454/1348)。学校等级、父亲文化程度、母亲文化程度、学生自己谈恋爱情况与是否具备健康素养存在统计学意义,而学生的性别、年龄与是否具备健康素养无统计学意义。结论普通中学学生、家长文化水平低的学生以及有恋爱情况的学生是健康素养干预的重点人群。     

Social Factors Associated with Readiness for Sexual Activity in Adolescents: A Population-Based Cohort Study

Archives of Sexual Behavior - Various factors are associated with sexual activity in adolescence and it is important to identify those that promote healthy and adaptive romantic and sexual...     

Peer Reviewed: Behavioral Risk Factors Associated With Overweight and Obesity Among Older Adults: the 2005 National Health Interview Survey

Introduction

Obesity is associated with coronary heart disease, stroke, certain cancers, hypertension, and type 2 diabetes. Concern about obesity among older adults is growing, and research to examine behaviors associated with risk for increased weight in this population is needed. We examined differences by sex in behaviors associated with overweight and obesity among older adults (aged ≥50 years).

Methods

We analyzed data from the 2005 National Health Interview Survey using logistic regression to predict the likelihood of overweight (body mass index [BMI], 25.0-29.9 kg/m²) and obesity (BMI ≥30.0 kg/m²) relative to healthy weight (BMI, 18.5-24.9 kg/m²) among older adults. We used self-reported weights and heights. Correlates were risk behaviors for chronic disease (smoking status, alcohol intake, consumption of fruits and vegetables, leisure-time physical activity, walking for leisure, walking for transportation, and strength training).

Results

Among older men, the prevalence of overweight was 46.3%, and the prevalence of obesity was 25.1%. Among older women, the prevalence of overweight was 33.4%, and the prevalence of obesity was 28.8%. In adjusted logistic regression models, sex differences were observed in the significance of most risk factors for overweight and obesity. Men who were occasional, light, or moderate drinkers were 28% more likely to be obese than men who were nondrinkers; women who were heavy drinkers were 55% less likely to be obese than women who were nondrinkers. Compared with men and women who were regularly active during leisure time, inactive men were 39% more likely to be obese, and inactive women were 28% more likely to be obese.

Conclusion

Several risk behaviors for chronic disease appear to be associated with overweight and obesity among older adults. Modification of these behaviors has the potential to reduce weight.     

北京市崇文区流动人口健康状况及社区卫生需求利用情况调查

目的了解北京市祟文区流动人口健康状况和社区卫生服务利用与需求情况。方法自行设计调查问卷,于2010年8—9月,采用多阶段整群抽样方法对北京市崇文区常住居民（包括没有户籍但居住半年以上的流动人口）进行问卷调查、体格检查,其中流动人口801名。结果崇文区流动人口高血压、糖尿病、冠心病、脑卒中四种慢性病患病率分别为8．7％、3．2％、2．2％、1．0％;超重率、肥胖率分别为26．1％、5．9％;两周患病率、年住院率分别为2．8％,3．0％。流动人口有病后去社区卫生服务机构就诊的占33．4％。前五位社区卫生服务需求分别为取药（57．7％）、打针输液（51．6％）、疾病的早期诊治（21．6％）、健康管理（16．6％）、出诊（16．5％）。结论崇文区流动人口中高血压、糖尿病、冠心病、脑卒中四种慢病患病率低于户籍人口,社区卫生服务利用率较低。社区卫生服务机构要充分发挥其作用,加强辖区流动人口的健康教育、健康促进、慢病管理等基本公共卫生服务工作。     

Routine Health Information Utilization and Associated Factors among Health Professionals Working in Public Health Facilities of the South Region,Ethiopia

BackgroundRoutine health information is the pillar for planning and management of health services and plays a vital role in effective and efficient health service delivery, decision making, and the improvement of programs. Therefore, this study aimed to assess routine health information utilization and associated factors among health professionals working in public health facilities of the south region.MethodsInstitution based cross-sectional study design was employed. Data was collected from randomly selected 719 participants using a pre-tested, interviewer administered structured questionnaire. Bivariate and multivariate logistic regression analyses were carried out.ResultThe overall utilization of routine health information was 63.1. Place of residence, HMIS personnel, HMIS code, overwhelming data source, population based data, data quality control, feedback, monitoring chart, 8.467) and data transfer policy were factors significantly associated with utilization of routine health information.ConclusionSix out of ten health professionals had utilized routine health information. Place of residence, HMIS personnel, HMIS code, overwhelming data source, population based data, data quality control, feedback, monitoring chart and data transfer policy had significant associations with routine health information utilization. Therefore, concerned health authorities need to work on these factors to improve the utilization.     

A Local Community Health Survey: Findings From A Population-Based Survey Of The Largest Jewish Community In Chicago

Accurate estimates of health risk factors and outcomes are difficult to obtain for certain ethnic populations. The health of Jewish individuals is particularly hard to determine because of the small group size and because health data rarely include information on religious affiliation. Furthermore, local level health information (for any population subgroup) is limited. To assess health risk factors and outcomes, as well as issues related to access to care, within a Jewish community in Chicago, a group of community agencies and researchers initiated a unique, population-based health survey. Specifically, a three-stage sampling design was used to select a representative sample of 201 adults and 58 children in the most concentrated Jewish neighborhood in the city. Nearly 500 questions were asked, covering a wide variety of demographic, socioeconomic, and health-related topics. The findings revealed that these Jewish individuals were generally as healthy (or healthier) than the average residents of Chicago and the U.S.; however, many serious health concerns still existed. In particular, health problems such as obesity, depression, disability, and domestic violence were common and, in some cases, more prevalent than in the general population. This local level information provides the first accurate estimates of key health variables for the estimated 23,000 Jewish individuals living in this community. This type of data is essential because it enables the efforts and priorities of health and social service providers to be focused on the most pressing health problems. Moreover, this project provides an example for other population subgroups (based on residence, ethnicity, religious affiliation, country of origin, or other characteristics) who would benefit from local level health information.     

Mental Health Conditions are Associated With Increased Health Care Utilization Among Urban Family Medicine Patients

Purpose: To assess the relationship between the presence of a mental health condition and health care utilization among family medicine patients. METHODS: We used the Patient Health Questionnaire plus a posttraumatic stress disorder screen to measure 6 common mental health conditions. In a sample of 367 patients recruited from 3 urban family medicine practices affiliated with Boston University Medical Center, we measured self-reported health care utilization of primary care provider visits, emergency department visits, nonpsychiatric hospitalizations, and outpatient mental health visits. We determined the association between screening positive for the mental health conditions and health care utilization using both multivariable logistic regression and Poisson regression methods while controlling for sex, age, race, income, insurance status, marital status, educational level, and the presence of chronic medical conditions. RESULTS: After controlling for potential confounders, generalized anxiety disorder, panic disorder, and posttraumatic stress disorder were statistically significantly associated with more PCP visits, ED visits, and nonpsychiatric hospitalizations. Neither major nor minor depression were associated with more PCP visits, ED visits, or nonpsychiatric hospitalizations, except that minor depression was associated with 103% increase in PCP visits (P < .001). Alcohol use disorder was associated with 16% fewer PCP visits (P = .01) but 238% more nonpsychiatric hospitalizations (P < .001). CONCLUSIONS: After controlling for confounders we found that mental health conditions among a sample of family medicine patients were associated with increased use of ED services, nonpsychiatric hospitalizations, and, to a lesser extent, PCP visits.