The joint contribution of physical activity,insomnia symptoms,and smoking to the cost of short‐term sickness absence

Physical inactivity has been associated with both insomnia symptoms and smoking. Further, they are all independently associated with increased sickness absence (SA) from work. However, joint contribution of either physical activity (PA) with insomnia symptoms or with smoking to SA and, especially, their direct cost for the employer is poorly understood. Therefore, we aimed to examine these joint associations with short‐term (<15 days) SA cost. The Helsinki Health Study is a cohort of midlife employees of the City of Helsinki, Finland (baseline n = 8960, response rate 67%). During 2000‐2002, the participants were mailed a survey questionnaire that gathered information on health behavior and sociodemographic characteristics. SA, salary, and time of employment were followed up through the employer's personnel register between 2002 and 2016 for those with a written consent to the use of their register data (78% of the participants). Individual salary data were used to calculate the direct cost of short‐term SA. Data were analyzed with a two‐part model. Inactive participants with frequent insomnia symptoms had 2526€ (95% CI 1736€‐3915€) higher cost of short‐term SA than vigorously active participants without insomnia symptoms. Furthermore, inactive smokers had 4166€ (95% CI 2737€‐5595€) higher cost for the employer over the follow‐up than vigorously active non‐smokers. In conclusion, this study showed that PA and insomnia symptoms as well as PA and smoking are jointly associated with short‐term SA cost. The results emphasize encouraging employers to improve work environments so that they promote active lifestyle, good sleep, and non‐smoking in order to reduce the cost of SA.     

The relationship of actual height loss with health-seeking behaviors and risk factors in perimenopausal and menopausal women

PURPOSE: To explore whether there is a difference in the perceived height and actual height in the perimenopausal or menopausal woman and discover the difference's effect on osteoporosis health-seeking preventive behaviors and risk factor awareness. DATA SOURCES: Sixty-three perimenopausal and menopausal women, aged 45-70 years, who presented at three Midwestern clinics for their annual physical exam. Data were collected with The Osteoporosis Questionnaire, which included the Osteoporosis Risk Questionnaire, Health-O-Meter height measuring stick, tape measure with inch-rule for arm span measurements, and balance scale for weight. CONCLUSIONS: There were a significant relationship between actual height loss and osteoporosis risk factors (r = 0.41595, p = 0.0007) and a trend for a relationship between adjusted height loss and osteoporosis risk factors (r = 0.2407, p = 0.0574). IMPLICATIONS FOR PRACTICE: Due to the great expense of current testing for bone mass density loss, the results of this study may help clinicians more readily identify markers for increased risk of osteoporosis through simple height measurements and osteoporosis risk factor assessments during annual visits.     

The Impact of an Immersive Elective on Learners’ Understanding of Lifestyle Medicine and Its Role in Patients’ Lives

Objective. To design an immersive, active learning, lifestyle medicine (LM) elective and evaluate its impact on a pharmacy learners’ ability to understand the challenges of implementing lifestyle changes.Design. A 3-credit elective was developed that incorporated goal setting and immersion into the realm of LM as experienced by both the patient and the practitioner. Learners were assessed via a survey instrument, formal assignments, reflections, and the Presidential Fitness Challenge.Assessment. Learners reported that their ability to initiate LM as a primary intervention within a care plan significantly increased after taking this course. They also improved their overall health.Conclusion. By identifying and implementing self-identified lifestyle modifications, learners increased confidence in their abilities to produce evidence-based outcomes for patients. Learners were able to understand the challenges of trying to change their daily habits as they undertook their own personal goals.     

全民健康生活方式示范社区创建对居民健康知识知晓的影响

目的了解全民健康生活方式行动示范社区创建对深圳市南山区某社区居民健康生活方式相关知识知晓率的影响。方法2012年5-7月对南山区某社区居民开展为期3个月的全民健康生活方式示范社区创建活动,内容包括组织管理、环境建设、活动开展以及效果评估4个方面。采用单纯随机抽样法,分别于示范社区创建前后抽取该社区1560名及1280名≥8岁的常住居民．用现场面对面问卷调查的方式对居民健康知识知晓情况进行创建前后的效果分析。问卷内容包括健康生活方式、控油限盐、合理运动以及BMI4个方面的10个问题。结果创建前获得有效问卷1534份,其中男性729人,女性805人,平均年龄40岁;创建后获得有效问卷1272份,其中男性619人,女性653人,平均年龄43岁。创建前后抽取的调查人群在性别、年龄等人口学特征上均衡可比（P〉0．05）,创建后调查人群对健康生活方式知识的总知晓率为57．94％（7370／12720）,其中10个问题的知晓率在41．35％～76．57％之间,较创建前总知晓率（41．17％,6316／15340）有明显提高（P〈0．01）。创建后,女性、男性的总知晓率分别为60．17％、55．59％,分别与创建前的42．12％、40．12％相比有明显升高（均P〈0．01）,其中女性、男性分别有9、6个问题的知识知晓率有明显提高（P〈0．05或P〈0．01）,其中两者不同表现为女性在“不健康生活方式与疾病的关系”、“日行一万步的内涵”以及“身体活动的内涵”方面知识的知晓率明显提高。0—18、19～59以及≥60岁年龄段人群在创建后的总知晓率分别为55．00％、57．15％和68．70％,分别与创建前的19．00％、42．45％和36．74％相比有明显升高（均P〈0．01）,其中3个年龄组分别有7、8、9个问题的知晓率有明显提高（P〈0．05或P〈0．01）。结论全民健康生活方式行动示范社区创建提高了该地区居民健康知识的知晓率,应加强≤18岁居民健康知识的宣传教育。     

Relations among restricted and repetitive behaviors,anxiety and sensory features in children with autism spectrum disorders

The purpose of this study was to explore how atypical reactions to sensory stimuli contribute to the relation between restricted and repetitive behaviors and anxiety in children with autism spectrum disorders (ASD). In Study 1, factor analysis of restricted and repetitive behaviors was carried out using the Repetitive Behavior Questionnaire-2 (RBQ-2), completed by 120 parents of 2- to 17-year-olds with ASD. Two subtypes resulted: repetitive sensory and motor behaviors, and insistence on sameness, accounting for 40% of the variance. This two-factor solution was retained even when the sensory items of the RBQ-2 were removed. In Study 2, 49 of the same parents also completed the Spence Anxiety Scales and the Sensory Profile. The insistence on sameness factor was significantly associated with anxiety while the repetitive motor behaviors factor was not. The relation between anxiety and insistence on sameness was mediated by sensory avoiding and to a lesser extent by sensory sensitivity. Implications for arousal explanations of ASD and for clinical practice are discussed.     

Reinfection in a large cohort of prison inmates with sustained virological response after treatment of chronic hepatitis C in Catalonia (Spain), 2002–2016

BackgroundPrisoners and other high-risk patients who show a sustained virological response (SVR) after treatment for hepatitis C virus (HCV) can become reinfected. We aimed to calculate the rate of HCV reinfection in a large cohort of inmates with SVR and to determine factors that predict reinfection.MethodsWe included all inmates treated for hepatitis C in Catalonia (Spain) from January 2002 to December 2016 who achieved SVR and in whom viral load was subsequently determined. The incidence rate was calculated per 100 person-years (100 py) of follow up. Risk factors associated with reinfection were evaluated by bivariate log-rank test and multivariate Cox regression. Hazard ratio (HR) and their 95% confidence intervals (CI) were calculated.Results602 patients were included, with a mean age of 37.9 years: 95% were men, 74.1% had a history of intravenous drug use (IDU) and 28.7% were HIV-infected. Patients were followed for a total of 2154.9 years (average 3.58 ± 3.1 years). 63 (10.5%) had HCV reinfection. 41 (65.1%) presented different genotype/subgenotype, 8 the initial genotype/subgenotype, and in 14 (22.2%) the genotype could not be determined. Of the 21 reinfected patients who were interviewed, 20 (95.2%) reported IDU after antiviral treatment, and 7 (33.3%) during treatment. The overall incidence of reinfection was 2.9 cases per 100 py. All reinfections occurred in patients with IDU history. At multivariate level, HIV infection was associated with reinfection (HR = 3.03; CI:1.82-5.04).ConclusionIn HIV-infected inmates with IDU history, the rate of reinfection of HCV post-SVR is very high. Prisons play a key role in the detection and treatment of infection and reinfection by HCV and in the post-treatment monitoring in these patients, which should be combined with counseling and the optimization of the harm reduction programs. Effective control of these vulnerable groups favours the elimination of the HCV infection.