青少年功能性消化不良流行病学特征及其影响因素分析

探讨青少年功能性消化不良(Functional Dyspepsia,FD)流行病学特征及其相关影响因素,为功能性消化不良的病因学研究和预防措施制定提供可行有效的依据.方法 采用分层随机整群抽样方法,选取苏州市中学生924名,进行功能性消化不良及其影响因素的问卷调查.按照罗马Ⅲ诊断标准诊断功能性消化不良.结果 青少年FD总患病率为11.58%,其中男生患病率为9.09%,女生为14.19%,差异有统计学意义(x2=5.864,P<0.05);初中生FD患病率为11.63%,高中生为11.54%,差异无统计学意义(r=0.002,P>0.05).多因素Logistic回归分析显示,女性、挑食、经常服用药物、便秘是发生FD可能的危险因素(OR值分别为1.633,1.722,2.351,2.408,P值均<0.05).结论 青少年FD总体患病率较高.应针对相关危险因素制定切实有效的预防措施,从而降低青少年功能性消化不良的患病率.     

Health among teenagers and young adults

The objective of this article is to analyse different behaviours and opinions about health and health determinants of Spanish young people by age, sex, and place of residence. They have a broad concept of their health, tending to identify health as physical activity and healthy eating behaviours. Most of them (91%) declared enjoying good or very good health. Depending upon the age, sex, and place of residence 10 to 20% could have mental health problems. Young people consider illegal drugs as their main health problem. Boys have higher prevalence of overweight and obesity than girls. However, girls reported more often than boys that they perceived themselves as obese. Practice of sporting activities is influenced by family and friends. The proportion of young people that practice sport declines after the age of 15, both in boys and girls. Young people perceive cannabis consumption as normal, but remain ambivalent towards other illegal drugs and asked for more information about drugs. We found a high proportion of young people declaring that they not would try illegal drugs. In the urban settings, smoking is more common among girls than among boys, but the contrary happens in rural areas. Most of them know that smoking is harmful for health, and among those who are smokers, 20 to 40% declared that they want to stop smoking. They consider that health care services are useless for preventing health problems. It is necessary to improve behaviours involving safety, such as use of seat belts and helmets, mainly in rural areas. Young people associated traffic accidents with driving conditions rather than with identification of risk.     

Cigarette brand preferences of teenagers and adults

Individual interviews were conducted with 726 Glasgow childrenaged 6–17 years. The majority of the secondary schoolchildren made good judgements of the cigarette brands preferredby teenage and adult smokers. The young smokers were particularlygood at this. These findings add to the growing body of evidenceindicating that young people are much more aware of mattersrelating to cigarettes (such as brand names and imagery) thanadults realize, and that underage smokers are more aware ofthese matters than nonsmokers of the same age. Primary school children with parents who smoked tended to bemore aware of brand preferences than primary school childrenwhose parents did not smoke.This indicates that the childrenof smokers tend to be more attuned to brand preferences, andthat much of this early learning occurs in the home. The young smokers showed an enhanced preference for the brandmost preferred by adults. This replicates a phenomenon reportedin Australia. The preferred brand in Glasgow, Kensitas Club,is heavily advertised in the Glasgow press. The findings suggest that children are highly sensitive to theadvertising of cigarette brands, and provide further supportfor recent research indicating that cigarette advertising promotesand reinforces smoking among the young.     

Poor self-rated mastication and associated factors in Brazilian adults

This study estimated the prevalence of bad/very bad self-rated mastication and investigated associated factors among Brazilian adults. The sample included 13,431 adults examined and interviewed in the SBBrazil project. Self-rated mastication was combined in three categories: good/ very good (the reference), fair, and bad/very bad. Multinomial logistic regression was performed to measure the association between fair and bad/very bad self-rated mastication and all independent variables included in the analysis, with significance set at p < 0.05. 55.6% of participants rated their mastication as good/very good, 24.9% as fair, and 19.5% as bad/very bad. In the final multivariate analysis, factors associated with bad or fair self-rated mastication were: receiving no information on how to avoid oral problems; presenting fewer than 23 remaining teeth; requiring total or partial prosthesis; bad/very bad self-rated oral health; gingival pain and/or toothache in the previous year; and need of dental treatment. In conclusion, various factors were associated with self-rated mastication, especially subjective conditions, thus emphasizing its importance as an oral health indicator.     

中国成年人饮酒习惯及影响因素

目的 了解中国成年居民的饮酒状况及其影响因素。方法 以2010－2012年中国居民营养与健康状况监测为依托,纳入135 824名≥18岁成年人进行横断面调查。采用多因素logistic回归分析我国居民饮酒状况及其影响因素。结果 我国成年人饮酒率为30.5%,其中男性饮酒率为53.8%,女性饮酒率为12.2%。在现在饮酒者中,男性和女性的过量饮酒率分别为14.0%和1.1%,每天饮酒率分别为25.7%和10.9%。男性饮酒类型主要为混合酒,女性为啤酒。我国饮酒人群的有害饮酒率为7.1%。随着年龄的增加,过量饮酒率、每天饮酒率和有害饮酒率呈先上升再下降趋势。饮酒率、过量饮酒率、每天饮酒率和有害饮酒率与身体活动呈正相关。结论 我国成年居民饮酒率、过量饮酒率、每天饮酒率和有害饮酒率均较高。饮酒状况与年龄、性别、婚姻状况、文化程度、吸烟状况和身体活动相关。     

Chewing impairment and associated factors among adults

OBJECTIVE

The aim of this study was to estimate the prevalence of chewing impairment according to sex, and its associated factors in adults.

METHODS

A cross-sectional population-based study was carried out with 2,016 subjects aged between 20 and 59 years in Florianopolis, SC, Southern Brazil, in 2009. The sampling was undertaken in two stages, census tracts and households. The outcome ''chewing impairment'' was obtained from the question "How often do you have chewing impairment due to teeth or denture problems?". Analyses were carried out with demographics and socioeconomic factors, dental services utilization, and self-related oral health using multivariable logistic regression and stratified by sex.

RESULTS

The response rate was 85.3% (1,720 adults). The prevalence of chewing impairment was 13,0% (95%CI 10.3;15.8) and 18,0% (95%CI 14.6;21.3) among men and women, respectively. Women and men fifty years old and over, who had ten or fewer natural teeth and those who reported toothache were more likely to have chewing impairment. The combination of tooth loss and toothache on chewing impairment was almost four times higher among women.

CONCLUSIONS

The magnitude of the associations among socioeconomic, demographics and self-related oral health factors was different according to sex, in general higher for women, with emphasis on toothache. The findings suggest that the impact of oral conditions varies by sex.     

Exercise and risk factors associated with metabolic syndrome in older adults

BACKGROUND: Older people with elevated blood pressure (BP) often have metabolic syndrome, a clustering of central obesity, insulin resistance, dyslipidemia, and hypertension. Exercise reduces many of these risk factors. This study examined whether the benefits of exercise on cardiovascular and metabolic disease risk factors are mediated by exercise-induced changes in fitness or body composition. METHODS: Randomized controlled trial, comprising 6 months of exercise training, conducted between July 1999 and November 2003. Participants included men and women (n =115) aged 55 to 75 years with untreated systolic blood pressure (SBP) of 130 to 159 or diastolic blood pressure of (DPB) 85 to 99 mm Hg. Fitness measures included BP, lipids, lipoproteins, insulin, and glucose; peak oxygen uptake and muscle strength; and body composition measured by anthropometry, dual-energy x-ray absorptiometry, and magnetic resonance imaging. RESULTS: A total of 51 men and 53 women completed the trial. Exercise significantly increased aerobic and muscle fitness, lean mass, and high-density lipoprotein cholesterol and reduced total and abdominal fat. DBP was reduced more among exercisers. There were no associations among changes in fitness with risk factors. Reductions in total body and abdominal fat and increases in leanness, largely independent of weight loss, were associated with improved SBP, DBP, total cholesterol, very low-density lipoprotein cholesterol, triglycerides, lipoprotein(a), and insulin sensitivity. At baseline, 42.3% of participants had metabolic syndrome. At 6 months, nine exercisers (17.7%) and eight controls (15.1%) no longer had metabolic syndrome, whereas four controls (7.6%) and no exercisers developed it (p =0.06). CONCLUSIONS: Although exercise improved fitness, the reductions in total and abdominal fatness and increase in leanness were more strongly associated with favorable changes in risk factors for cardiovascular disease and diabetes, including those that constitute metabolic syndrome.     

Risk factors associated with participation in the Ontario, Canada doctors'' strike.

To identify factors associated with participation in the 1986 Ontario, Canada doctors' strike, we surveyed 1,028 physicians; 69 percent responded, of whom 42 percent participated in the strike. Risk factors for participation included income greater than $135,000, being a surgeon or gynecologist, having previously "opted out" of the Ontario Health Insurance Plan, being professionally dissatisfied, being politically conservative, favoring political activism by physicians, holding a positive view of the social consequences of extrabilling, and perceiving family, associates, patients and the public to favor the strike. Eighty percent of strikers, but 32 percent of non-strikers, met criteria we established for four strike-prone groups: the "economically rational," the "ideologically committed," the "professionally disaffected," and the "socially malleable." Respondents belonging to one or more of these groups were much more likely to have participated in the strike (64 percent vs 17 percent). Strategies to deal with physician militancy should address the multiplicity of motives that appeared to have influenced doctors in Ontario.     

Sex differences in factors associated with prediabetes in Korean adults

ObjectivesIdentifying the factors associated with prediabetes is necessary for the early detection and management of high-risk individuals with prediabetes. The purpose of this study was to identify the factors associated with prediabetes according to sex in Korean adults.MethodsUsing the Korean National Health and Nutrition Examination Survey from 2015 to 2019, a total of 13,595 adults (5,565 males and 8,030 females) aged ≥20 years were included in the data analysis. Logistic regression analysis was performed to identify the factors associated with prediabetes according to sex in Korean adults.ResultsIn both males and females, age and a family history of type 2 diabetes were associated with prediabetes. In males, current and past smoking habits were associated with increased prediabetes. In addition, low-intensity physical activity and prolonged sedentary behavior were associated with a higher prevalence of prediabetes. Females with a lower education level (less than middle school graduation) showed a higher risk of prediabetes.ConclusionSex-specific prevention strategies for prediabetes should be developed. In addition, older individuals and those with a family history of type 2 diabetes should be screened for prediabetes.     

Environmental and policy factors associated with overweight among adults in Missouri

PURPOSE: To measure the association between environmental and policy factors (i.e., community perceptions, community infrastructure, and worksite infrastructure) and being overweight. DESIGN: Cross-sectional data from the Missouri Cardiovascular Disease Survey, a one-time random-digit-dialed telephone interview of noninstitutionalized adults. SETTING: Missouri, 1999 to 2000. SUBJECTS: The response rate was 69.6%. A total of 2821 adults completed the interview. The sample was weighted to represent the population of Missouri: 52% female, 71% white, and 59% overweight. MEASURES: The survey comprised 92 closed-ended multiple-choice items. Overweight was defined as a body mass index greater than or equal to 25 kg/m2 on the basis of self-reported height and weight. RESULTS: After adjustment for demographic and behavioral factors, environmental variables associated with being overweight included negative (i.e., unsafe and unpleasant) community perceptions (adjusted odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.1, 2.3) and the absence of outdoor exercise facilities (OR = 1.2; CI = 1.0, 1.5). Worksite policy variables were not related to the outcome; however, negative community perceptions (OR = 2.8; CI = 1.5, 5.2) and the absence of sidewalks and shoulders (OR = 1.7; CI = 1.3, 2.4) were associated with overweight among employed persons. CONCLUSIONS: An ecological perspective, focusing on the physical and social environment, was adopted to address the subject of overweight and obesity. Results of this study show that negative perceptions of the physical environment and the absence of enabling infrastructure are modestly associated with overweight, in comparison with other known risk factors. Environmental and policy interventions that promote healthier lifestyles by encouraging physical activity and healthy eating may have an effect on reducing the prevalence of overweight and obesity.     

Individual factors associated with medical consultation by adults

OBJECTIVE: To identify individual characteristics associated with a higher likelihood of consulting a physician and excess physician appointments. METHODS: We carried out a population-based study including 3,100 adults (> 20 years) living in the city of Pelotas, Southern Brazil between October and December 2003, using a multi-stage cluster sampling strategy. Subjects were interviewed to obtain socioeconomic, demographic, and health-related data, as well as information on the number of medical appointments in the past three months. Overusage was defined as > 4 appointments. Multivariate analysis was carried out using Poisson regression based on a conceptual model, and results are presented as prevalence ratios and their respective 95% confidence intervals. RESULTS: The prevalence of medical appointments was 55.1%. Higher likelihood of consulting a physician was associated with female sex, hospital admission in the past year, former smoking, diabetes, and arterial hypertension. We found an increasing trend in the number of appointments with increasing age (p < 0.001) and decreasing self-perceived health status (p < 0.001). Prevalence of over utilization was 9%, and showed positive association with increased body mass index, (p = 0.01), increasing age (p = 0.006), and decreasing self-perceived health status (p < 0.001). CONCLUSIONS: Presence and over utilization of physician appointments were associated with female sex, hypertension, and hospital admission in past year, as well as with increasing age and decreasing self-perceived health status.     

Is smoking associated with depression and anxiety in teenagers?

OBJECTIVES. An association of smoking with depression and anxiety has been documented in adult smokers. This study examines this association in a representative group of teenage smokers. METHODS. A two-stage cluster sample of secondary school students in Victoria, Australia, were surveyed by using a computerized questionnaire, which included a 7-day retrospective diary for tobacco use and a structured psychiatric interview. RESULTS. Subjects reporting high levels of depression and anxiety were twice as likely to be smokers after the potential confounders of year level, sex, alcohol use, and parental smoking were controlled for. Regular smokers were almost twice as likely as occasional smokers to report high levels of depression and anxiety. In a stratified analysis, an association between regular smoking and psychiatric morbidity was found in girls of all ages but for boys only in the youngest group. CONCLUSIONS. The cross-sectional association is consistent with the use of smoking by teenage girls as self-medication for depression and anxiety. Therefore, future health promotional campaigns might consider strategies that attend to perceived psychological benefits of smoking.     

An exploration of socioeconomic variation in lifestyle factors and adiposity in the Ontario Food Survey through structural equation modeling

Title  

An exploration of socioeconomic variation in lifestyle factors and adiposity in the Ontario Food Survey through structural equation models.