Childhood risk factors for homelessness among homeless adults.

OBJECTIVES. This effort used data from the Course of Homelessness study and comparative secondary data on the general population to identify negative childhood and family background experiences that may increase risk for adult homelessness. METHODS. Frequencies of negative childhood experiences were examined among a probability sample of 1563 homeless adults. Differences in risk for such experiences were calculated by sex, age cohort, and racial/ethnicity status. Where possible, rates of negative childhood experiences among the homeless were compared with the general population. RESULTS. Substantial numbers of this sample experienced multiple problems as children across several domains: poverty, residential instability, and family problems. Women and Whites disproportionately reported experiences suggestive of personal or family problems; non-Whites disproportionately reported experiences suggestive of personal or family problems; non-Whites disproportionately reported experiences suggestive of poverty. Homeless adults were at increased risk of childhood out-of-home placement, tenure in public housing, and homelessness, but not at greater risk for physical abuse. Women appeared to be at greater risk for sexual abuse. CONCLUSIONS. The problems that homeless individuals experience as adults have very clear analogs in their childhoods. Vulnerability to homelessness stems from factors unevenly distributed across age, sex, and race/ethnicity groups.     

Risk factors for homelessness among indigent urban adults with no history of psychotic illness: a case-control study

OBJECTIVES: This study identified risk factors for homelessness among indigent urban adults without dependent children and with no history of psychotic illness. METHODS: We conducted a matched case-control study, stratified by sex, of 200 newly homeless men and women and 200 indigent men and women with no history of homelessness. Newly homeless case subjects were recruited from shelter assessment centers in New York City. Never-homeless control subjects, selected from public assistance centers, were single adults applying for home relief. Control subjects were matched with case subjects according to ethnicity, age, and sex. Trained interviewers employed standardized research instruments to probe 3 domains of risk factors: symptom severity and substance use disorder, family support and functioning, and prior use of services. RESULTS: Significant interaction effects by sex were present for symptom severity, heroin use disorder, and prior service use. Greater numbers of the homeless of both sexes lacked a high school diploma and had less income from all sources, including from their families, than of the never homeless. CONCLUSIONS: Newly homeless men and women with no history of psychotic illness differed from their never-homeless counterparts in the 3 domains investigated, but socioeconomic factors were also important.     

Risk factors for homelessness among schizophrenic men: a case-control study.

OBJECTIVES. To identify risk factors for homelessness among the severely mentally ill, we conducted a case-control study of 100 indigent schizophrenic men meeting criteria for literal homelessness and 100 such men with no homeless history. METHODS. Subjects were recruited from shelter, clinic, and inpatient psychiatric programs in Upper Manhattan. Clinical interviewers employed standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. RESULTS. Homeless subjects showed significantly higher levels of positive symptoms, higher rates of a concurrent diagnosis of drug abuse, and higher rates of antisocial personality disorder. Homeless subjects experienced greater disorganization in family settings from birth to 18 years and less adequate current family support. Fewer homeless subjects than subjects in the never-homeless comparison group had a long-term therapist. These differences remained when demographic variables were adjusted statistically. CONCLUSIONS. Homeless schizophrenic men differed from their domiciled counterparts in all three domains we investigated; family background, nature of illness, and service use history. Findings are discussed in relation to policy and programs for the severely mentally ill.     

Risk factors for trading sex among homeless young adults

Although numerous homeless youth report trading sex, few studies have examined risk factors associated with trading sex and even fewer have employed multivariate analyses to examine this relationship, even though trading sex is associated with many negative health outcomes. Based on a sample of 151 homeless young adults in the midwestern United States, logistic regression analyses revealed that for each additional year of age, youth were 37% more likely to have traded sex (AOR = 1.37; 95% CI = .99–1.90). White youth were 84% less likely to have traded sex than non-white youth (AOR = .16; 95% CI = .03–.77). Furthermore, youth who had been employed full time were 80% less likely to have traded sex (AOR = .20; 95% CI = .05–.85). For every one unit increase in depressive symptoms, there was an 11% increase in the likelihood of ever having traded sex (AOR = 1.11; 95% CI = .99–1.24). Additionally, those who had friends who traded sex were approximately five times more likely to have ever traded sex themselves compared to those with no friends who had traded sex (AOR = 5.17; 95% CI = .95–28.12). Finally, youth who were propositioned to trade sex were almost five and one-half times more likely to have ever done so compared to youth who had not been propositioned (AOR = 5.45; 95% CI = 1.02–29.17). Overall, the results have important implications for the health and well-being of this high-risk population.

Risk factors for domestic violence: findings from a South African cross-sectional study

In 1998 a cross-sectional study of violence against women was undertaken in three provinces of South Africa. The objectives were to measure the prevalence of physical, sexual and emotional abuse of women, to identify risk factors and associated health problems and health service use. A multi-stage sampling design was used with clusters sampled with probability proportional to number of households and households were randomly selected from within clusters. One randomly selected woman aged 18-49 years was interviewed in each selected home. Interviews were held with a total 1306 women, the response rate was 90.3% of eligible women. For the risk factor analysis, multiple logistic regression models were fitted from a large pool of candidate explanatory variables, while allowing for sampling design and interviewer effects. The lifetime prevalence of experiencing physical violence from a current or ex-husband or boyfriend was 24.6%, and 9.5% had been assaulted in the previous year. Domestic violence was significantly positively associated with violence in her childhood, her having no further education, liberal ideas on women's roles, drinking alcohol, having another partner in the year, having a confidant(e), his boy child preference, conflict over his drinking, either partner financially supporting the home, frequent conflict generally, and living outside the Northern Province. No significant associations were found with partners' ages, employment, migrant status, financial disparity, cohabitation, household possessions, urbanisation, marital status, crowding, communication, his having other partners, his education, her attitudes towards violence or her perceptions of cultural norms on women's role. The findings suggest that domestic violence is most strongly related to the status of women in a society and to the normative use of violence in conflict situations or as part of the exercise of power. We conclude by discussing implications for developing theory on causal factors in domestic violence.     

Moderate alcohol use and depression in young adults: findings from a national longitudinal study

OBJECTIVES: We examined the association between moderate alcohol use and depressive mood among young adults before and after adjustment for demographic, health, and socioeconomic factors that may act as confounders. METHODS: We analyzed 2 waves of interview data collected from 13892 young adults who participated in the National Longitudinal Study of Adolescent Health to compare frequency of depressive symptoms in moderate drinkers with frequency of symptoms in young adults in other alcohol use categories. RESULTS: With adjustment for health and socioeconomic factors, frequency of depressive symptoms were similar among moderate drinkers, lifetime and long-term abstainers, and heavy/heavier moderate drinkers but remained significantly higher among heavy drinkers. CONCLUSIONS: Moderate alcohol use may have no effect on depression in young adults relative to abstinence from alcohol use.     

成人社区获得性肺炎患病危险因素的研究

摘要:目的　探讨社区获得性肺炎（Community-Acquired Pneumonia;CAP）患病的相关危险因素,为制定社区获得性肺炎防治策略和措施提供科学依据。方法　以2013年3-10月罗湖区人民医院14岁以上132例社区获得性肺炎住院患者为病例组,以同时期在该院普外科住院,并且年龄、性别、居住社区与病例匹配的132例非肺炎病例为对照组,采用自制问卷调查人口学特征、基础疾病、生活习惯、环境因素等信息,采用条件Logistic回归方法分析社区获得性肺炎患病危险因素。结果　共招募病例和对照各132名,看护6岁以下小孩（OR＝5.797,95%CI:2.809～11.965）、高血压（OR＝4.425,95%CI:1.619～12.092）、住房通风不佳（OR＝5.458,95%CI:2.022～14.738）、吸烟≥20年（OR＝3.832,95%CI:1.248～11.772）、月收入≥6 000（OR＝3.242,95%CI:1.085～5.648）、劳累（OR＝3.242,95%CI:1.341～7.839）是CAP的危险因素,锻炼（OR＝0.434,95%CI:0.235～0.800）是CAP的保护因素。结论　深圳市成人社区获得性肺炎患病受住房通风、看护6岁以下小孩、劳累、高收入以及吸烟习惯等多个因素影响,具有这些特征的成人应注意锻炼,加强对CAP的预防。     

Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam

Background  

To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless.     

Risk factors for subarachnoid hemorrhage in a longitudinal population study

The known risk factors of atherosclerotic diseases may be involved in the development of a subarachnoid hemorrhage. We studied the morbidity and mortality due to subarachnoid hemorrhage among 42,862 men and women aged 20-69 years who had participated in a large health survey in Finland. During a mean follow-up of 12 years, 102 non-fatal and 85 fatal cases of subarachnoid hemorrhage were observed. The total incidence was 37 per 100,000 person-years. Smoking and hypertension were positively associated and body mass index was inversely associated with the risk of subarachnoid hemorrhage. These associations were not confounded by age or each other. No statistically significant association with risk was detected for serum cholesterol level, hematocrit content, known heart disease, or diabetes. The risk was especially elevated among lean hypertensive subjects and lean smoking subjects. The age-adjusted relative risks of subarachnoid hemorrhage for lean, hypertensive smokers were 18.3 (95% confidence interval (CI), 7.8-42.7) among women and 6.7 (95% CI, 2.3-19.7) among men as compared to the risk among subjects without these risk factors. We conclude that modifiable risk factors are predictive of subarachnoid hemorrhage, for which reason subarachnoid hemorrhage may in part be preventable. Leanness combined with arterial hypertension and/or smoking, in particular, poses a substantially elevated risk.     

Risk factors for childhood diarrhea incidence: dynamic analysis of a longitudinal study

BACKGROUND: Several longitudinal studies have investigated factors associated with childhood diarrhea in developing countries. However, most studies have neglected important dynamic features of the longitudinal design and hierarchical interrelationships among the potential risk factors. METHODS: We conducted a longitudinal study of 902 children, age 0 to 36 months at baseline, in a large urban center in northeastern Brazil. Diarrhea data were collected by following children from October 2000 until January 2002 with biweekly home visits. We used a dynamic time-to-event analysis to account for several longitudinal features. We applied an effect-decomposition strategy to quantify direct and indirect effects of risk factors grouped in different blocks. RESULTS: Child's age and an autoregressive effect of past diarrhea episodes explained some of the decline of diarrhea incidence observed throughout the study (from more than 14 episodes to 2 episodes per child-year), a phenomenon already observed but not explained in other longitudinal diarrhea studies. We identified the following major diarrhea determinants: low socioeconomic status, poor sanitation conditions, presence of intestinal parasites, and absence of prenatal examination. The effect of socioeconomic status was mediated mostly by living and sanitation conditions. CONCLUSION: Our study shows important advantages of applying a dynamic analysis approach to longitudinal observational studies of diarrhea or other acute diseases and highlights the complex interrelationships of diarrhea determinants. Our results confirm the importance of sanitation as a major determinant of child health in urban settings of developing countries.     

成人过敏性哮喘危险因素的病例对照研究

目的 探讨导致成人过敏性哮喘及其发作的危险因素。方法 采用病例对照流行病学研究方法,收集102例成人过敏性哮喘患者和394例健康对照人群的一般社会人口学特征、疾病健康状况、吸烟史、职业接触史、室内环境状况以及家族史等信息。结果 单因素及多因素统计分析结果均显示:成人过敏性哮喘患者职业粉尘接触率高于对照组且差异有统计学显著性(P<0.05,OR=1.78);住房类型为平房/筒子楼较多层/高层楼导致过敏性哮喘或其发作的可能性大(P<0.05,OR=3.24),哮喘患者家中床褥晾晒频率较对照组低且差异具有统计学显著性(P<0.10,OR=1.53);哮喘患者家中起居室地面使用木板比例高于对照组且差异有统计学显著性(P<0.01,OR=2.33);室内油烟污染程度哮喘患者组高于对照组且差异有统计学显著性(P<0.01,OR=2.52);同时还发现,双亲中有慢性支气管炎(慢支)或哮喘疾病史可增加其子女患过敏性哮喘的危险性(P<0.01,OR=2.32)。结论 室内环境因素中住房状况差、床褥晾晒频率少、起居室地面使用木板、室内油烟污染可能是成人过敏性哮喘的危险因素,同时职业接触粉尘、双亲有慢支或哮喘疾病史也与该疾病具有一定的关系。研究结果提示成人过敏性哮喘是遗传和环境双重因素共同作用导致的一种复杂疾病。     

Mortality and cataract: findings from a population-based longitudinal study.

The study was carried out in a rural population in central India. A random sample of 11 village communities provided 1020 persons aged 40-64 years, who were examined in 1982 and again reassessed in 1986. Statistical analysis, based on the Mantel-Haenszel method for stratified data, showed increased mortality in persons who had central lens opacities, compared with those who had trivial or no central lens opacities. The significant age-adjusted death ratio was just over 2 (2.2), as were the age/sex-adjusted and age/vision-adjusted estimates, which indicate doubling of mortality in the cataract cohort. Multiple regression analysis using the Cox proportional-hazards model gave very similar results. Statistical tests for homogeneity of death ratios across the various age/sex/vision strata were carried out, and the observed association between cataract and mortality was found to be consistent, both in males and in females, in the youngest and oldest age groups, and among those with adequate vision of 6/18 or better as well as among persons with serious visual impairment. There were no known diabetics in the study sample, which came from what could reasonably be regarded as a non-diabetic population.     

Risk factors for Alzheimer's disease: a population-based, longitudinal study in Manitoba, Canada.

BACKGROUND: Current knowledge of risk factors for Alzheimer's disease (AD) is limited. Data from a longitudinal, population-based study of dementia in Manitoba, Canada were used to investigate risk factors for AD. METHODS: Cognitively intact subjects completed a risk factor questionnaire assessing sociodemographic, genetic, environmental, medical and lifestyle exposures. Five years later, 36 subjects had developed AD and 658 remained cognitively intact. RESULTS: Older subjects or those who had fewer years of education were at greater risk of AD. After adjusting for age, education and sex, occupational exposure to fumigants/ defoliants was a significant risk factor for AD (relative risk [RR] = 4.35; 95% CI : 1.05--17.90). A history of migraines increased the risk of AD (RR = 3.49; 95% CI : 1.39--8.77); an even stronger effect was noted among women. Self-reported memory loss at baseline was associated with subsequent development of AD (RR = 5.15; 95% CI : 2.36--11.27). Vaccinations and occupational exposure to excessive noise reduced the risk of AD. CONCLUSIONS: Some well-known risk factors for AD were confirmed in this study and potential new risk factors were identified. The association of AD with a history of migraines and occupational exposure to defoliants/fumigants is of particular interest because these are biologically plausible risk factors.     

Factors associated with maintenance of regular condom use among single heterosexual adults: a longitudinal study

OBJECTIVE: The aims of this study were to describe behavioural and psychosocial characteristics of single heterosexuals towards regular condom use, and to identify factors associated with the maintenance of this behaviour over time. METHOD: A cohort of 179 single heterosexual adults (83 men and 96 women, mean age: 32 years) was followed over a period of 2 years. The data were collected, by phone interviews, at baseline and 1 and 2 years later. The phone numbers were generated using a random digit strategy. RESULTS: The following changes were observed: over time fewer people were sexually active, but those who were, reported more often having had more than one sexual partner. No significant change was observed regarding condom use. The psychosocial variables remained stable during the study period. To have a favourable intention was the main factor associated with maintenance of condom use. Having had a STD, personal normative beliefs and positive attitude were also associated with regular condom use. DISCUSSION: Promotion strategies should highlight the importance of acting as a responsible person, reinforce the advantages of using condoms, and select strategies that favour the implementation of intention of using condoms.     

Risk factors for the incidence of hyperuricaemia: a 6-year longitudinal study of middle-aged Japanese men

BACKGROUND: Few longitudinal studies on the determinants of increase in serum uric acid (SUA) have been completed. METHODS: In all, 1445 hyperuricaemia-free (<7.5 mg/dl SUA, no medication for and no past history of hyperuricaemia) male office workers aged 30-54 years of T Corporation in Osaka, Japan were re-examined for six successive years. Subjects who were found to be hyperuricaemic or had started medication for hyperuricaemia during repeat surveys were defined as incident cases. RESULTS: Among the subjects (n = 1365) not receiving medication for hypertension, diabetes mellitus or renal disease, multivariate analysis using the Cox proportional hazards model indicated that the incidence of hyperuricaemia had significant relationships with body mass index (adjusted hazard ratio [HR] = 1.13 for a 2 kg/m2 increase; 95% CI: 1.02-1.26), mean blood pressure (HR = 1.07 for a 5 mmHg increase; 95% CI: 1.00-1.13), log triglyceride level (HR = 2.21 for a 10 mg/dl increase; 95% CI: 1.12-4.37), alcohol intake (HR = 2.33 for drinking 46.0 g of ethanol per day or more relative to non-drinking; 95% CI: 1.55-3.50) and smoking (HR = 0.65 for current-smoking relative to non-smoking; 95% CI: 0.46-0.92). Age (HR = 0.89 for a 5-year increase; 95% CI: 0.78-1.00) and haemoglobin A1c (HbA1c) (HR = 0.89 for a 0.5% increase; 95% CI: 0.78-1.00) achieved marginal significance. CONCLUSIONS: Obesity, high blood pressure, high triglyceride level, and alcohol intake are contributory factors for the development of hyperuricaemia among middle-aged Japanese men. High HbA1c level and smoking may be negative factors for the incidence of hyperuricaemia.     

The health and housing in transition study: a longitudinal study of the health of homeless and vulnerably housed adults in three Canadian cities

Objectives

While substantial research has demonstrated the poor health status of homeless populations, the health status of vulnerably housed individuals is largely unknown. Furthermore, few longitudinal studies have assessed the impact of housing transitions on health. The health and housing in transition (HHiT) study is a prospective cohort study that aims to track the health and housing status of a representative sample of homeless and vulnerably housed single adults in three Canadian cities (Toronto, Ottawa, and Vancouver). This paper discusses the HHiT study methodological recruitment strategies and follow-up procedures, including a discussion of the limitations and challenges experienced to date.

Methods

Participants (n?=?1,192) were randomly selected at shelters, meal programmes, community health centres, drop-in centres, rooming houses, and single-room occupancy hotels from January to December 2009 and are being re-interviewed every 12?months for a 2-year period.

Results

At baseline, over 85% of participants reported having at least one chronic health condition, and over 50% reported being diagnosed with a mental health problem.

Conclusions

Our findings suggest that, regardless of housing status, participants had extremely poor overall health.     

Risk factors for postneonatal mortality: results from a record linkage study

A population-based computer record linkage of infant births and deaths was conducted for 1978 and 1979 covering Canadian provinces. Birthweight was inversely related to risk of postneonatal death for all causes examined, including accidental deaths. Length of gestation was inversely associated with risk, but the strength of the relationship was much weaker than that noted for birthweight. A logistic regression model was used to assess the effects of variables, as reported on birth certificates, on postneonatal mortality. Maternal age less than 25 years, unmarried marital status and one or more previous births were all statistically significantly related to increased risk.