Results from the Scottish National HAI Prevalence Survey

A national point prevalence survey was undertaken over the period of one calendar year in Scotland from October 2005 to October 2006. The prevalence of healthcare-associated infection (HAI) was 9.5% in acute hospitals and 7.3% in non-acute hospitals. The highest prevalence of HAI in acute hospital inpatients was found in the following specialties: care of the elderly (11.9%), surgery (11.2%), medicine (9.6%) and orthopaedics (9.2%). The lowest prevalence was found in obstetrics (0.9%). The most common types of HAI in acute hospital inpatients were: urinary tract infections (17.9% of all HAI), surgical site infections (15.9%) and gastrointestinal infections (15.4%). In non-acute hospitals one in ten inpatients in two specialties (combined) - medicine (11.4%) and care of the elderly (7.8%) - was found to have HAI, and one in 20 inpatients in psychiatry (5.0%) had HAI. In non-acute hospital patients, urinary tract infections were frequent (28.1% of all HAI) and similarly skin and soft tissue infection (26.8% of all HAI). When combined, these two HAI types affected 4% of all the inpatients in non-acute hospitals. This is the first survey of its kind in Scotland and describes the burden of HAI at a national level.     

吸烟与肌肉骨骼疾患的关联性

目的 探索吸烟与肌肉骨骼疾患(musculoskeletal disorders, MSDs)的关系，为MSDs的预防控制提供依据。方法 采用整群随机抽样法，选择某汽车生产企业工龄≥1年的一线工人为研究对象，采用自行设计的《肌肉骨骼疾患问卷》进行调查。根据工人是否吸烟将其分为吸烟组和对照组，采用倾向得分匹配(propensity score matching, PSM)方法按1︰1比例均衡两组人群混杂因素，比较两组工人身体各部位MSDs发生率，并计算吸烟人群归因危险度百分比(population attributable risk percent, PAR%)。结果 匹配后吸烟组颈部、下背部MSDs发生率均高于对照组(P<0.05),OR(95%CI)值分别为1.41(1.03,1.94)和1.59(1.20,2.12);匹配后两组人群肩部、上背部、肘部、手/腕部、髋/臀部、膝部、踝/足部MSDs发生率差异均无统计学意义(P>0.05);吸烟对颈和下背部MSDs的PAR%分别为12.14%和16.59%。结论 吸烟可引起颈部、下背部罹患MSDs的风险升高，应采取相应措施降低...     

Prevalence of Same-Sex Behavior and Orientation in England: Results from a National Survey

There are few data sources on the prevalence of same-sex sexual orientation in England. We aimed to measure the prevalence of same-sex orientation and behavior in the English general population and assess the impact of enquiry format on reporting. The Adult Psychiatric Morbidity Survey 2007 used a multi-stage, stratified probability-sampling design (n = 7,403). Two questions addressed sexual orientation and sexual partnership and each had two versions. Version A of the sexual orientation question used “homosexual.” Version B used “gay or lesbian.” Version A of the sexual partnership question required participants who had male and female partners to say which was predominant, while Version B had a midpoint response option: “about equally with men and women.” Participants were randomized between versions. Overall, 5.3% of men and 5.6% of women reported they were not entirely heterosexual. The question using “gay or lesbian” elicited higher (though not statistically significant) reporting of non-heterosexual orientation than the question using “homosexual.” A significantly larger proportion of men and women (96.0 and 96.1%) reported entirely heterosexual partnerships in response to Version A of the partnership question than in response to Version B (94.0 and 92.9%) where Version B asked specifically about “kissing, touching, intercourse, or any other form of sex.” These figures constitute the first national prevalence data on combined sexual orientation and sexual behavior in England, based on a random probability sample of the general population. They demonstrate that people are willing to report their sexual orientation in survey research, but reporting is sensitive to question wording.     

Association between vision impairment and suicidal ideation among older adults: Results from National Survey on Drug Use and Health

BackgroundVision impairment (VI) is a significant risk factor for depression among older adults. The stigma attached to VI, which has multidimensional aspects consisting of ageism and ableism, may constitute a major impediment to accepting one’s VI and engaging in help-seeking behaviors, which could have led to suicide prevention.ObjectiveThis study aims to investigate the relative strength of association for VI on suicidal ideation among a nationally representative sample of older adults.MethodsThe study sample was composed of 10,635 adults aged 65 years and over, drawn from the 2015–2017 National Survey on Drug Use and Health. Respondents were asked if they had serious thoughts about suicide in the past year.ResultsOf the total sample, 6.85% reported VI (n = 729), defined as being blind or having serious difficulty seeing, even when wearing glasses. In comparison to those without VI, older adults with VI were more likely to report impoverished sociodemographic status and poor health conditions. After adjusting for a comprehensive set of covariates, multivariate logistic regression analyses revealed that older adults with VI were more likely to report suicidal ideation, compared to their counterparts without VI (OR = 3.12, 95% CI [1.24, 7.85]. p < 0. 05). Of the covariates, major depressive episodes presented the strongest positive association with suicidal ideation (OR = 14.11, 95% CI [8.93, 22.29], p < 0. 05).DiscussionThis study contributes to the scant body of literature by identifying the relative strength of association between VI and suicide in a nationally representative sample.     

Work-family conflict and mental disorders in the United States: cross-sectional findings from The National Comorbidity Survey

BACKGROUND: Work-family conflict (WFC) may have negative effects on workers' health and productivity. The objective of this analysis was to assess the association between WFC and mental disorders that occurred in the past month. METHODS: Data from the U.S. National Comorbidity Survey were used. The 1-month prevalence of mental disorders was estimated by levels of WFC and by gender. RESULTS: Compared to participants who reported low WFC, those who reported high WFC had a significantly higher prevalence of mental and/or substance use related disorders in the past month. Working hours and domestic roles did not have significant impacts on the association between WFC and mental disorders, irrespective of gender. CONCLUSIONS: Work and family roles and the balance between the two are important for workers' mental health. The influence of WFC on mental health should be investigated in conjunction with important work environment characteristics in longitudinal studies.     

Does social status predict adult smoking and obesity? Results from the 2000 Mexican National Health Survey

Abstract

Socioeconomic status is generally associated with better health, but recent evidence suggests that this ‘social gradient’ in health is far from universal. This study examines whether social gradients in smoking and obesity in Mexico – a country in the midst of rapid socioeconomic change – conform to or diverge from results for richer countries. Using a nationally representative sample of 39,129 Mexican adults, we calculate the odds of smoking and of being obese by educational attainment and by household wealth. We conclude that socioeconomic determinants of smoking and obesity in Mexico are complex, with some flat gradients and some strong positive or negative gradients. Higher social status (education and assets) is associated with more smoking and less obesity for urban women. Higher status rural women also smoke more, but obesity for these women has a non-linear relationship to education. For urban men, higher asset levels (but not education) are associated with obesity, whereas education is protective of smoking. Higher status rural men with more assets are more likely to smoke and be obese. As household wealth, education and urbanisation continue to increase in Mexico, these patterns suggest potential targets for public health intervention now and in the future.     

Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the National Comorbidity Survey

Most health and work productivity studies have focused on individual conditions without considering comorbidity. We illustrate the implication of this neglect by examining the effects of comorbid mental disorders on role impairment (number of sickness absence and work cut-back days in the past month) among people with chronic physical disorders. A nationally representative household survey of 5877 respondents assessed current mental and physical disorders and role impairments. Four physical disorders were sufficiently common to be studied: hypertension, arthritis, asthma, and ulcers. All 4 physical disorders were associated with significant role impairments in bivariate analyses. However, further analysis showed that these impairments were almost entirely confined to cases with comorbid mental disorders. Effectiveness trials in workplace samples are needed to evaluate the cost-effectiveness of treating comorbid mental disorders among workers with chronic physical disorders.     

Stroke Prevalence: an analysis of data from the 1977 National Health Interview Survey.

Data gathered in the 1977 National Health Interview Survey indicate that stroke continues to be a major health problem in the United States. It affects approximately 2 percent of the civilian noninstitutionalized population over age 20. An examination of the stroke population revealed differences in the prevalence rates by various demographic factors, particularly age. More than 70 percent of the stroke victims were limited in their activities, and about 85 percent of all the victims had been informed of their condition by a physician. Only 62 percent indicated that they were hospitalized for their first stroke, and this finding remained unchanged when only recent strokes were examined. The low hospitalization rate may reflect a lack of information on patients who died during the interval of on those who did not associate their hospitalizations with their strokes.     

Prevalence of mental disorders in an urban area in Brazil

OBJECTIVE: To detect the prevalence of mental disorders among the elderly residents of an urban area. METHODS: A sample of 327 elderly residents (60 years and older) of the city of Montes Claros, in northern Minas Gerais, was selected by means of probabilistic sampling, in multiple strata, within a homogeneous stratum. The sample unit was the home. Mental disorders were determined by means of the Short Psychiatric Evaluation Schedule (SPES). Univariate analysis was done via the chi-squared test and multivariate analysis via logistical regression. RESULTS: The estimated prevalence of mental disorders was 29.3%. Their presence was associated with female sex, number of illnesses, functional capacity and place of residence (shantytown/non-shantytown). CONCLUSIONS: Comparing the results with other community studies, the prevalence of mental disorders among the elderly in the urban area of Montes Claros was high and was associated with multiple illnesses, incapacity and poverty. This reality is a matter for concern because of its impact on quality of life relating to this population's health, and on healthcare services over the next few decades.     

Association between overweight or obesity and household income and parental body mass index in Australian youth: analysis of the Australian National Nutrition Survey, 1995

This study is a secondary data analysis based on the 1995 Australian National Nutrition Survey (NNS). A random subsample of 1581 school children aged 7-15 years old from the NNS was studied. The results show the prevalence of overweight, obesity and combined overweight and obesity was 10.6-20.9%, 3.7-7.2% and 15.6-25.7%, respectively. The odds ratio of overweight or obese boys with highest household income was significantly smaller than those with the lowest household income. The proportion of combined overweight and obesity in children whose parents were overweight or obese was significantly greater compared with those whose parents were not. The trend of increasing prevalence of overweight or obesity among children with increasing parental body mass index (BMI) was significant after adjusting for age except the trend of father's BMI for boys. This study provided baseline data on the recent prevalence of overweight or obesity of Australian school children using new international absolute BMI cut-off points. It indicated that young school girls (7-9 years) were more likely to be overweight or obese compared with boys, the prevalence rates of overweight or obesity in older boys (13-15 year) was significantly greater than in other age groups while in girls it was the opposite. The boys with lowest household income ($0-17 500) were more likely to be overweight or obese compared with those with the highest household income (greater than $67 500). Having parents especially mothers who were overweight or obese may increase the risk of children being overweight or obese.     

Prevalence of Overweight and Obesity Among Women of Childbearing Age: Results from the 2002 National Survey of Family Growth

Objective To estimate the prevalence of overweight and obesity among U.S. women of childbearing age. Methods Our study population was drawn from the 2002 National Survey of Family Growth (NSFG) and consisted of non-pregnant female respondents aged 20–44 years with a valid body mass index (BMI) (N = 5,958). Univariate and bivariate analyses were conducted to document variations in the prevalence of overweight and obesity by age, race and Hispanic origin, and socioeconomic status. Results Overall, 24.5% of women 20–44 years of age were overweight (BMI 25.0–29.9 kg/m²) and 23.0% were obese (BMI ≥ 30.0 kg/m²). Among those who were obese, 10.3% met the criteria for class II or III obesity (BMI ≥ 35.0 kg/m²). Non-Hispanic black and women were 2.25 times more likely to be overweight or obese compared to non-Hispanic white women (95% CI: 1.87–2.69). This disparity in risk between non-Hispanic black and non-Hispanic white women declined and no longer achieved statistical significance after adjustment for education, household income, and health insurance coverage. Conclusions Nearly one in two U.S. women of childbearing age are either overweight or obese. The racial/ethnic disparity in prevalence rates may be due in part to variability in educational attainment, household income, and stability of health insurance coverage.     

Association between workplace psychosocial factors and mental health in Black,Hispanic, and White women: Cross-sectional findings from the National Health Interview Survey

Research evaluating the relation of workplace psychosocial factors to mental health among U.S. women of different racial/ethnic backgrounds is limited. This study investigated the relationship between work-related psychosocial factors and mental health among non-Hispanic Black, Hispanic, and non-Hispanic White women using data from the 2010 National Health Interview Survey. Independent variables of interest included job insecurity, workplace harassment, and work-family conflict (WFC). Multiple Poisson regression models were used to examine the associations between the outcome and independent variables. The prevalence of unfavorable mental health was highest among non-Hispanic Black women (36%) compared to Hispanic (34%) and non-Hispanic White (30%) women. A higher proportion of non-Hispanic Black women reported WFC compared to Hispanics and non-Hispanic Whites (χ² = 15.50, p < .01), while more Hispanics reported job insecurity (χ² = 116.81, p < .01). Prevalence of workplace harassment did not differ significantly by race/ethnicity. Odds of unfavorable mental health were significantly higher for women reporting psychosocial work factors. Unexpectedly, a greater association between psychosocial work factors and unfavorable mental health was observed among non-Hispanic White women compared to non-White women; however, caution should be taken in interpreting these cross-sectional results. Future studies should investigate temporal associations and additional psychosocial variables that were not available for use in the current study.     

Association between lung function and mental health problems among adults in the United States: findings from the First National Health and Nutrition Examination Survey

The objective of this study was to determine the association between lung function and mental health problems among adults in the United States. Data were drawn from the First National Health and Nutrition Examination Survey (1971-1975), with available information on a representative sample of US adults aged 25-74 years. Lung function was assessed by spirometry, and provisional diagnoses of restrictive and obstructive airway disease were assigned based on percentage of expected forced expiratory volume. Mental health problems were assessed with the General Well-Being scales. Restrictive lung function and obstructive lung function, compared with normal lung function, were each associated with a significantly increased likelihood of mental health problems. After adjustment for differences in demographic characteristics, obstructive lung function was associated with significantly lower overall well-being (p = 0.025), and restrictive lung function was associated with significantly lower overall well-being (p < 0.001), general health (p < 0.0001), vitality (p < 0.0001), and self-control (p = 0.001) and with higher depression (p = 0.002) subscale scores compared with no lung function problems. Consistent with previous findings from clinical and community-based studies, these results extend available data by providing evidence of a link between objectively measured lung function and self-reported mental health problems in a representative sample of community adults. Future studies are needed to determine the mechanisms of these associations.     

Association between workplace bullying and common mental disorders in civil servants from a middle-income country

Workplace bullying (WB) is associated with Common mental disorders (CMD) in high-income countries, but there is a lack of evidence relating to this subject in low- and middle-income countries. Therefore, this study aimed to investigate the association between bullying and CMD in Brazil. A cross-sectional study with 907 judicial civil servants from Porto Alegre, southern Brazil, was carried out. WB was measured by the Negative Acts Questionnaire (NAQ-r) and CMD by the Self-Reporting Questionnaire (SRQ-20). Logistic regression was used to analyse data and test hypotheses. The overall prevalence of CMD was 32.8%, while the overall prevalence of bullying was 18.3%. WB was strongly associated with CMD, even after controlling for confounders. After adjustment for sociodemographic, personality and occupational confounders, weekly and daily exposures to negative acts increased 4.32 (95% CI: 2.00–9.33) and 6.80 (95% CI: 3.42–13.51) times the risk of CMD, respectively. Considering the operational definition, bullied workers had a 3.45 (95% CI: 2.26–5.25) higher risk of CMD. The results are consistent with studies from high-income countries. Different ways of categorising exposure to WB and testing association with CMD are suggested. Interventions to prevent bullying, focusing on work processes and psychosocial factors at work, could reduce the risk of mental health problems.     

MetS Prevalence and Its Association with Dietary Patterns among Chinese Middle-Aged and Elderly Population: Results from a National Cross-Sectional Study

The prevalence of metabolic syndrome (MetS) increased dramatically over the past years among adults in a separate province in China; little is known about newly diagnosed MetS in middle-aged and above residents nationwide. We investigated the prevalence of MetS and its components, the dietary patterns, and their relationship among the middle-aged and above population of China by using data from a national cross-sectional survey. General information involving lifestyles and health stations was collected, and dietary intake using a 3-day 24 h dietary recall and weighing method for edible oil and condiments was conducted. Height, weight, waist circumference, and blood pressure were measured, and fasting serum lipids and glucose were tested by trained clinical staff. Dietary patterns were derived from 23 food categories by using cluster analysis, and a multivariate logistic regression model was used to evaluate the odd ratio of MetS and its component across obtained dietary patterns. The estimated prevalence of MetS was 37.1% among 40,909 middle-aged and older participants in the study. Participants were classified into diversity pattern, northern pattern, and southern pattern that, respectively, accounted for 9.8%, 47.2%, and 43.0% of the total. Compared with those inclined to the northern pattern, participants prone to the southern pattern decreased the risk of MetS (OR = 0.81, 95%CI: 0.75- 0.87; p < 0.001), central obesity (OR = 0.70, 95%CI: 0.65–0.76; p < 0.001), and HDL-C (OR = 0.82, 95%CI: 0.76–0.89; p < 0.001), and elevated BP (OR = 0.86, 95%CI: 0.79–0.93; p < 0.001) respectively. However, participants of the southern pattern tended to have a higher risk of elevated glucose; the OR (95%CI) was 1.13 (1.05, 1.22; p = 0.002) after adjusting for potential confounding factors. Greater adherence to diverse dietary patterns was negatively related to the risk of central obesity and elevated blood pressure with an OR (95%CI) of 0.82 (0.71, 0.94; p = 0.005) and 0.77 (0.67, 0.88; p < 0.001), respectively. We concluded that dietary improvement and health promotion for MetS should be based on the district-specific nutritional status of the Chinese middle-aged and elderly population.     

Breakfast and the diets of Australian adults: an analysis of data from the 1995 National Nutrition Survey

The aim of this study was to describe the nutrients provided to Australian adults by the breakfast meal and to compare the food and nutrient intakes and health of regular breakfast eaters and breakfast skippers. The Australian Bureau of Statistics was commissioned to undertake additional analysis of data collected in the 1995 Australian National Nutrition Survey (NNS). The survey included 24-h recalls, physical measurements and a food habits questionnaire collected during the period February 1995-March 1996, with a nationally representative sample of 10,851 Australians aged 19 years and older. The median nutrient intakes at breakfast and the proportion of the daily total contributed by breakfast were calculated. Differences between regular breakfast eaters and breakfast skippers in terms of nutrient intake, body mass index and health status were compared using Student t-tests. The findings show the typical Australian breakfast was low in fat, high in carbohydrate and a good source of thiamin, riboflavin, niacin, calcium and magnesium. In the NNS regular breakfast eaters had more adequate diets overall, particularly those aged 65+ years. People who did not eat breakfast cereal were much more likely to have inadequate nutrient intakes, especially of thiamin, riboflavin, calcium, magnesium and iron. Regular breakfast eaters were more likely to rate their health as excellent or good than those who skip breakfast, but there was no difference between the fat intake or the body mass index of regular breakfast eaters compared with breakfast skippers. Regular breakfast consumption is associated with better diets for adults overall.     

Associations between behavioural risk factors and smoking,heavy smoking and future smoking among an Australian population-based sample

IntroductionTobacco smoking co-occurs with behavioural risk factors including diet, alcohol use and obesity. However, the association between behavioural risk factors and heavy smoking (> 20 cig/day) compared to light–moderate smoking is unknown. The link between behavioural risk factors and future smoking for both ex and current smokers is also unknown. This study sought to examine these relationships. It is hypothesised that behavioural risk factors will be more strongly associated with heavy smoking.MethodData from Wave 7 (2007) of the Household and Labour Dynamics in Australia (HILDA) survey was analysed using logistic regression to determine relationships between diet (fruit and vegetable consumption, and unhealthy diet choices), alcohol consumption, obesity and physical activity with light–moderate smoking and heavy smoking. The association between these risk factors and future smoking (2008) was assessed for current and ex-smokers (2007).ResultsObese respondents were less likely to be light/moderate smokers (RRR: 0.53; 95% CI: 0.43, 0.66) but not heavy smokers. Those who consume confectionary weekly were less likely to be light/moderate smokers (RRR: 0.73; 95% CI: 0.61, 0.87), but not heavy smokers. Smokers in 2007 were more likely to continue smoking in 2008 if they consumed 1–4 drinks per occasion (OR: 2.52; 95% CI: 1.13, 5.62). Ex-smokers in 2007 were less likely to relapse in 2008 if they consumed recommended levels of both fruit and vegetables (OR: 0.31; CI: 0.10, 0.91).ConclusionThe relationships between heavy smoking and behavioural risk factors differ from moderate–light smoking. Future primary care interventions would benefit from targeting multiple risk factors, particularly for heavy smokers.     

Association between Oropharyngeal Dysphagia and Malnutrition in Dutch Nursing Home Residents: Results of the National Prevalence Measurement of Quality of Care

Objectives

Nursing home residents often suffer from multi-morbidities and geriatric syndromes leading to lower quality of life or mortality. Oropharyngeal dysphagia (OD) and malnutrition are profound conditions in this complex profile of multi-morbidities and are associated with deprived mental –and physical health status, e.g. aspiration pneumonia or dehydration. This study aimed to assess the association between OD and malnutrition in Dutch nursing home residents.

Design

Data for this cross-sectional study were obtained from the annual National Prevalence Measurement of Quality of Care (LPZ).

Setting

The National Prevalence Measurement of Quality of Care was conducted in Nursing Homes in The Netherlands.

Participants

Participants were nursing home residents age 65 or older and admitted to psychogeriatric- or somatic wards.

Measurements

The measurements were taken by trained nurses from the participating nursing homes. Anthropometric measurements and unintended weight loss (%) were assessed to determine nutritional status (malnutrition). OD was assessed by means of a standardized questionnaire assessing clinically relevant symptoms of OD such as swallowing problems or sneezing/coughing while swallowing. Cox regression was applied to assess the association between malnutrition and clinically relevant symptoms of OD in older Dutch nursing home residents.

Results

Approximately 12% of the residents suffered from swallowing problems and 7% sneezed/coughed while swallowing liquids or solid foods. Approximately 10% of the residents was malnourished. Residents with OD symptoms were more often malnourished compared to residents without OD symptoms. Approximately 17% of the problematic swallowers were concurrently malnourished. Increased risk for malnutrition was found in residents suffering from swallowing problems (PR 1.5, 95%CI 1.2–1.9), as well as in residents that sneezed/ coughed while swallowing (PR 1.3, 95%CI 1.0–1.7). Stratification based on wards revealed that problematic swallowers from somatic wards were at a high risk of malnutrition (PR 1.9, 95%CI 1.3–2.8).

Conclusion

Clinically relevant symptoms of oropharyngeal dysphagia, such as swallowing problems and sneezing/coughing while swallowing are associated with increased risk of malnutrition in psychogeriatric and somatic Dutch nursing home residents.