Epidemiology of heavy alcohol use in Ukraine: findings from the world mental health survey

AIMS: To describe the epidemiology of heavy alcohol use in Ukraine, using data from the world mental health (WMH) survey in Ukraine. METHODS: The WMH composite international diagnostic interview was administered in 2002 to a national probability sample of Ukrainian adults (n=4725). An algorithm for classifying heavy use in the past year was developed from self-reports about the quantity and frequency of drinking, and its convergent validity was demonstrated. Prevalence rates and socio-demographic risk factors were examined separately for men and women. RESULTS: The 12-month rates of heavy alcohol use were 38.7% in men and 8.5% in women (22.0% overall). Among heavy alcohol users, 92% of men and 52% of women consumed at least 80 g of ethanol in a typical drinking day on a monthly basis in the year before the interview. The most significant risk factors in men and women were age (26-54 years for men; 18-25 years for women), living in the Southeast region, being in the labour force whether employed or unemployed, and for men, low education and being the father of a young child. A highly significant linear relationship of number of risk factors with heavy alcohol use was found for both sexes. CONCLUSIONS: The rates for men were similar to those reported in a Russian national survey with the exception of Southeast Ukraine where the rate was >10% higher. The highest rates were among men who were middle-aged, fathers and unemployed. Future prospective studies are needed to assess the impact of heavy alcohol use on Ukrainian health, mental health and occupational and social functioning.     

浙江省德清县农村社区成人卫生服务利用状况调查

采用流行病学现况研究设计,整群抽取浙江省德清县4个农村社区,面对面调查6068名18—64周岁的社区户籍居民,以了解德清农村社区成人居民卫生服务利用情况。结果提示转型期农村社区居民的有效卫生需求未得到合理满足,目前的新农合制度有待于完善。     

Social gradients in oral health in older adults: findings from the English longitudinal survey of aging

Objectives. We examined prospective associations between socioeconomic position (SEP) markers and oral health outcomes in a national sample of older adults in England.Methods. Data were from the English Longitudinal Survey of Aging, a national cohort study of community-dwelling people aged 50 years and older. SEP markers (education, occupation, household income, household wealth, subjective social status, and childhood SEP) and sociodemographic confounders (age, gender, and marital status) were from wave 1. We collected 3 self-reported oral health outcomes at wave 3: having natural teeth (dentate vs edentate), self-rated oral health, and oral impacts on daily life. Using multivariate logistic regression models, we estimated associations between each SEP indicator and each oral health outcome, adjusted for confounders.Results. Irrespective of SEP marker, there were inverse graded associations between SEP and edentulousness, with proportionately more edentate participants at each lower SEP level. Lower SEP was also associated with worse self-rated oral health and oral impacts among dentate, but not among edentate, participants.Conclusions. There are consistent and clear social gradients in the oral health of older adults in England, with disparities evident throughout the SEP hierarchy.The inverse linear relationship between socioeconomic position (SEP) and health is well established.^1–4 The uneven distribution of health across socioeconomic strata has been observed in both industrialized and less developed countries and for most common diseases and causes of death.^1,5–8 In most cases, the association between SEP and health is characterized by a linear graded pattern, with people in each lower SEP category having successively worse levels of health and dying earlier than those that are better off, a characteristic known as the social gradient in health.⁹Although there is clear and consistent evidence about the existence of the social gradient in working-age adults,^10,11 studies in older adults are less consistent, with some showing attenuation of the gradient^12,13 and others reporting that it persisted^14,15 or even increased¹⁶ in magnitude.Oral health is particularly important at older ages with tooth loss shown to be independently associated with disability and mortality.^17–20 Oral health status in older people is also an important determinant of nutritional status.²¹Socioeconomic disparities in oral health have been consistently demonstrated for various indicators, mostly clinical and disease related^22–31 but also subjective measures of oral health and quality of life.^30,32–38 Some of these studies have explicitly assessed the existence of an oral health gradient,^{23,25–31,34–37} but almost all were carried out on adolescents and adults, with very few focusing on older people.^33,36 These few relevant studies are cross-sectional and inconclusive and have used a limited number of SEP indicators (typically, education and occupational class), thereby hindering any comprehensive analysis on the relationship between SEP and oral health.We addressed the gap in the literature about the existence of an oral health gradient at older ages by examining the prospective associations between a wide range of SEP indicators (education, occupation, household income, household wealth, subjective social status [SSS], and childhood SEP) and various oral health outcomes (presence of natural teeth, self-rated oral health, and oral impacts) in a national sample of older adults from the English Longitudinal Survey of Aging (ELSA). We explored whether there are any significant socioeconomic inequalities in oral health among older people in England and, if so, whether these take the form of a gradient.     

Global health research priorities: mobilizing the developing world

The paper focuses on two questions: (i) how to set research priorities in a transparent, systematic, fair and legitimate way?; and (ii) how to mobilize low and middle-income countries to take more ownership in defining their own research policies, rather than merely being passive recipients of international aid for research and development? I propose that the recently developed Child Health and Nutrition Research initiative (CHNRI) methodology is becoming widely accepted as a feasible answer to both those questions. In this paper, I review its numerous applications to date and show how it evolved into a practical and systematic tool that can assist priority setting in health research investments in diverse contexts. The CHNRI methodology also addresses support for different instruments of health research to achieve better balance between fundamental research, translation research and implementation research. The wide application of CHNRI methodology is expected to maximise the potential of health research to reduce disease burden and gradually reduce inequities that exist between support for research on the health problems of the rich and the poor. I believe that this tool will find application within many low and middle-income countries and assist them to pull together their own experts and actively define their priorities for research and development in the coming years.     

Perceptions of traditional information sources and use of the world wide web to seek health information: findings from the health information national trends survey

As medical information becomes increasingly available and individuals take a more active role in managing their personal health, it is essential for scholars to better understand the general public's information-seeking behavior. The study reported here explores the use of the World Wide Web to seek health information in a contemporary information-media environment. Drawing from uses and gratifications theory and the comprehensive model of health information seeking, perceptions of traditional information sources (e.g., mass media, one's health care provider, etc.) are posited to predict use of the Web to seek health information and perceptions of information acquired from searches. Data from the Health Information National Trends Survey (HINTS; N = 3982) were analyzed to test study hypotheses. Trust in information-oriented media, entertainment-oriented media, and one's health care provider all predicted Web use behavior and perceptions. The implications of the findings for research on information seeking and the role of the Web in patient empowerment are discussed.     

Healthy eating blog readership: A cross-sectional survey in Australian adults

Aims

To investigate whether members of the public read blogs for the purpose of accessing healthy eating information; examine demographic predictors of healthy eating blog readership, specifically education, gender, age, body mass index, and residential location; and explore the reasons for reading, and not reading, healthy eating blogs.

Methods

This study used a cross-sectional online self-reported survey design collected over three time points (round 1: December 2017–March 2018, round 2: August 2018–December 2018, round 3: December 2021–March 2022). The total sample of participants comprised of 238 respondents with a mean age of 46 years old, who mostly reported gender as female (82%), being educated with a university degree (69%), and predominantly resided in urban and city areas (84%).

Results

Fifty-one percent of respondents reported reading healthy eating blogs, suggesting that consumers were proactively seeking healthy eating information through this avenue. Participants who identified as female were 3.2 times more likely to read healthy eating blogs. Commonly, healthy eating blogs were read to receive practical information that aligned with current food choices. The main reason participants reported not reading healthy eating blogs was not thinking about using them (29%).

Conclusions

Understanding who is seeking healthy eating information through blogs, and their reasons doing so, is important to continue research into the potential effectiveness of blogs as a platform to communicate healthy eating and nutrition messages. This study provides direction for further investigation into how dietetics professionals could effectively use blogs to disseminate healthy eating information and positively influence consumer food choices and dietary intake.     

Self-rated health among multiracial young adults in the United States: findings from the add health study

Objective: The multiracial adult population is one of the fastest growing segments of the U.S. population, yet much remains to be learned about multiracial health. Considerable research finds racial/ethnic disparities in self-rated health, however subgroups within the multiracial population have not been consistently described.

Design: We use data from the National Longitudinal Survey of Adolescent Health (Add Health) and multivariate logistic regression analyses to compare self-rated health of multiracial and monoracial young adults (n?=?7880).

Results: Overall, there were no significant differences in poor self-rated health status of multiracial adults as a single group odds ratio 0.84 (95% CI: 0.52–1.36) compared to monoracial White adults. Analyses further revealed important variations in health-status by specific subgroups and show that some multiracial subgroups may not fit existing patterns of health disparities. For instance, Asian-White multiracial adults do not fit documented patterns of health disparities and report better health than monoracial Asian and monoracial White adults.

Conclusion: This study illustrates that the inclusion of specific multiracial categories provides evidence to enhance understanding of the pathways that are linked to health outcomes and the implications for health disparities.     

Similar asthma prevalence estimates obtained from preadolescent and parent survey responses

OBJECTIVE: We compared agreement between child and parent responses to questions assessing prevalence of asthma and other severe respiratory symptoms. STUDY DESIGN AND SETTING: Fifth-grade children enrolled in public schools and their parents separately completed a health survey, which included respiratory symptom questions from the International Study of Asthma and Allergies in Childhood (ISAAC). Agreement on respiratory symptom questions was assessed with Cohen's Kappa coefficient. Asthma prevalence estimates based on responses to several questions were also compared using child and parent data. The analysis was based on a study sample size of 230 matched parent and child questionnaires. RESULTS: High levels of agreement (Kappa: 0.76 and 0.79) between child and parent responses were observed for current and lifetime asthma, and similar asthma prevalence estimates were obtained from child and parent response data. Five of the questions on potentially severe respiratory symptoms had low to fair levels of agreement (Kappa: -0.01 to 0.38), resulting in statistically significantly different prevalence estimates in three of the five symptoms. CONCLUSIONS: Separate parent and child responses to a series of respiratory symptom and asthma questions yielded similar estimates for asthma prevalence but different estimates for the prevalence of several severe respiratory symptoms.     

The work impact of asthma and rhinitis: findings from a population-based survey

Asthma and rhinitis are common chronic conditions that affect adults of working age. Little is known about their relative impacts on work loss and decreased productivity. Using random digit telephone dialing, we carried out a population-survey of adults in Northern California aged 18-50 years. We interviewed 125 persons with asthma (with or without concomitant rhinitis) and 175 persons with rhinitis alone. Study eligibility was based on subject report of a physician's diagnosis of asthma and/or a rhinitis-related condition. Any adult labor force participation since condition onset was lower among those with asthma (88%) than among those with rhinitis alone (97%) (P = 0.002). In contrast, among those still employed, decreased job effectiveness was more frequently reported in the rhinitis group (43 of 121; 36%) compared to those with asthma (14 of 72; 19%) (P = 0.02). Condition-attributed lost work was common in both groups, with more than 20% reporting one or more complete or partial work days lost in the 4 weeks previous to interview. Taking into account age, gender, race, and smoking status, those with asthma were more likely to have no labor force participation after diagnosis (OR = 3.0; 95% CI 1.1-7.7) and less likely to report decreased job effectiveness among those remaining employed (OR = 0.4; 95% CI 0.2-0.9). Excluding subjects from the rhinitis group most likely to have unreported asthma based on past medication use had little impact on these associations. Both asthma and rhinitis negatively affect work productivity. Those with asthma are less likely to be employed at all, while among those remaining on the job, rhinitis is a more potent cause of decreased work effectiveness. The economic impact of asthma and rhinitis and related conditions may be under-appreciated.     

Correlates of employment status in individuals with asthma: a cross-sectional survey

Background

This study aims to elucidate factors that among adults with asthma are associated with working full-time.

Methods

This cross-sectional survey of 2613 working-age adults with asthma included questions on asthma history, symptoms and use of asthma medication, socioeconomic factors and health behavior. Full-time workers were compared to groups according to employment status: unemployed, work disability and retired due to age.

Results

Adults with asthma working full time were younger and more often nonmanual workers, experienced less asthma symptoms, used less asthma medication and smoked less than subjects with work disability. After adjusting for age, gender, smoking and professional status, having frequent symptoms of asthma during last month was associated with an increase in the risk of unemployment (OR 2.3, 95% CI 1.3–4.2) and with an increase in the risk of work disability (OR 4.4, 95% CI 2.3–8.2).

Conclusions

Among adults with asthma, full-time work was associated with younger age, less symptomatic asthma despite of less medication, nonmanual work and less smoking. Having more severe symptoms of asthma was associated with undesirable employment status such as unemployment or work disability. Possibilities to change from manual to nonmanual work may be important in preventing work disability and early exit from work.

     

Effort-reward imbalance model and self-reported health: cross-sectional and prospective findings from the GAZEL cohort

Psychosocial factors at work have been found to be significant contributors to health, especially cardiovascular health. This study is aimed at exploring the relationship between psychosocial factors at work as defined by the effort-reward imbalance (ERI) model and self-reported health, using alternative formulations of this model, and comparing cross-sectional and prospective analyses for a large occupational cohort of men and women. The French version of the ERI model was used to measure the three scales of effort, reward, and overcommitment. Self-reported health was used as health outcome. Covariates included chronic diseases, frequent depressive symptoms, and personal, occupational, and behavioural factors. The cross-sectional and prospective analyses concerned, respectively, 10175 and 6286 workers. Men and women were analysed separately. Cross-sectional analysis revealed that ERI was significantly associated with self-reported health whatever the formulation used (ratio over one, quartiles, continuous ratio, or log-transformed ratio) for both genders. When effort and reward were studied as two separate variables, reward was a significant risk factor for both genders, whereas effort was for men only. Overcommitment was also found to be a risk factor for self-reported health for both sex. Prospective analysis showed that ERI was a significant predictor of poor self-reported health for men and women for two formulations (continuous ratio and log-transformed ratio). For both genders, effort did not predict self-reported health, but reward did. Overcommitment was predictive of poor self-reported health for men only. Our results highlighted the predictive effects of the ERI model on self-reported health in a 1-year follow-up study. They urged to explore various formulations of the ERI model. They also underlined the need for longitudinal study design and separate analyses for men and women in the field of psychosocial factors at work.     

Correlates of consumer trust in online health information: findings from the health information national trends survey

The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N?=?7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.     

儿童哮喘的全球流行及影响因素

哮喘是儿童期最常见的慢性疾病。20多年来,其患病率在全球范围内呈现惊人的上升趋势,给个人和各国卫生资源带来沉重的负担。识别高危人群及认识危险因素是哮喘病最有效的预防策略。该文就哮喘的全球流行状况及影响因素进行综述。     

Global health education in Italian medical schools: survey from 2007 to 2010

Global Health (GH) issues are becoming a common feature of Medical and Public Health Schools worldwide. In Italy the Network for Education on Global Health (RIISG) was created with the purpose of spreading the concept of GH. The aim of the study was to assess the availability of educational opportunities in Italian Health Faculties from 2007 to 2010. A survey was carried out using a questionnaire administered to Professors. A frequency distribution of GH elective courses, grouped by three Italian geographical areas (North, Centre, South and Islands), for each academic year was assessed. The features of the courses - consistent with the pattern of course, suggested by RIISG - were analysed through a score. From 2007 onwards, in chronological order the surveyed faculties were 40, 36, 36 and the main coverage of survey was 92%. The courses listed were 26, 22 and 40 respectively for each academic year considered. The average of the courses number highlighted an increasing trend: national mean rose from 0.65 (SD +/- 1.53) in 2007 to 1.11 (SD +/- 1.18) in 2010. Regarding the evaluation of consistency a national improvement was shown. The assessment revealed a limited educational offer and differences between macroareas. Further investigations are needed.