查看更多>>摘要：Background Most studies estimate hepatitis C virus (HCV) disease prevalence from convenience samples. Consequently, screening policies may not include those at the highest risk for a new diagnosis. Methods Clalit Health Services members aged 25-74 as of 31 December 2009 were included in the study. Rates of testing and new diagnoses of HCV were calculated, and potential risk groups were examined. Results Of the 2 029 501 included members, those aged 45-54 and immigrants had lower rates of testing (12.5% and 15.6%, respectively), higher rates of testing positive (0.8% and 1.1%, respectively), as well as the highest rates of testing positive among tested (6.1% and 6.9%, respectively). Discussion In this population-level study, groups more likely to test positive for HCV also had lower rates of testing. Policy makers and clinicians worldwide should consider creating screening policies using on population-based data to maximize the ability to detect and treat incident cases.
查看更多>>摘要：Background Socioeconomic status, especially during childhood, is known as one of the key factors affecting health. This study's objective was to investigate the association between childhood socioeconomic and mental health status in adulthood. Methods This cross-sectional study was conducted on 2062 employees of Tehran University of Medical Sciences. Depression, stress and anxiety were measured using the validated DASS-42 questionnaire. A self-rated question was used to assess childhood socioeconomic status. Other variables including age, sex, marital status, and also wealth index, were measured. Linear regression models were used to analyze the data. Results 24.6% of men and 33.8% of women had degrees of depression (mild, moderate, severe or very severe). 32.9% of men and 29.4% of women had mild, moderate, severe or very severe anxiety. 36.3% of men and 45.2% of women also exhibited mild, moderate, severe or very severe stress. Results showed after adjusting for the current socioeconomic status, childhood socioeconomic status has a relationship with the mental health of individuals. Conclusion People with a suboptimal childhood socioeconomic status seem to be a high-risk group for depression, stress and anxiety in adulthood. Strategies need to put into practice to improve the mental health of these people.
Chakravarthy, RohiniStallings, Sarah C.Edwards, Digna R. VelezZhao, Sifang Kathy...
10页
查看更多>>摘要：Background Collecting social determinants of health in electronic health records is time-consuming. Meanwhile, an Area Deprivation Index (ADI) aggregates sociodemographic information from census data. The objective of this study was to ascertain whether ADI is associated with stage of human papillomavirus (HPV)-related cancer at diagnosis. Methods We tested for the association between the stage of HPV-related cancer presentation and ADI as well as the association between stage and the value of each census-based measure using ordered logistic regression, adjusting for age, race and sex. Results Among 3247 cases of HPV-related cancers presenting to an urban academic medical center, the average age at diagnosis was 57. The average stage at diagnosis was Surveillance, Epidemiology and End Results Stage 3. In the study population, 43% of patients were female and 87% were white. In this study population, there was no association between stage of HPV-related cancer presentation and either aggregate or individual census variables. Conclusions These results may reflect insufficient sample size, a lack of socio-demographic diversity in our population, or suggest that simplifying social determinants of health into a single geocoded index is not a reliable surrogate for assessing a patient's risk for HPV-related cancer.
查看更多>>摘要：Background Little is known about the prevalence of multimorbidity among middle-aged veterans. Multimorbidity holds implications for planning for a population with high health care utilization, poor quality of life and marked need for interdisciplinary care. Methods The current study used the US 2017 Behavior Risk Factor Surveillance System to measure multimorbidity in three ways: (1) reporting two or more health conditions, (2) reporting two or more conditions controlling for demographic characteristics (e.g. income) and health risk behaviors (e.g. smoking) and (3) a weighted index using health-related quality of life. Results After age 25, veterans' risk for multimorbidity increased across all age groups. The increased odds of reporting multimorbidity was highest when comparing veterans aged 35-44 to non-veterans of the same ages. Veterans aged 35-44 are 50% (adjusted odds ratios (AOR) 1.50, 95% confidence interval (CI) 1.16, 1.94) to 80% (AOR 1.80, 95% CI 1.46, 2.23) more likely to report multimorbidity when compared with same aged non-veterans. Conclusions Younger veterans may benefit from comprehensive interdisciplinary services to aid in the treatment of multiple medical conditions. Failure to account for the impact of chronic conditions on quality of life may lead to an underestimate of the health care needs of veterans across the lifespan.
查看更多>>摘要：Background The epidemiology of multiple chronic conditions in China is poorly understood. We investigated the prevalence of multimorbidity among the middle-aged and elderly population in China and analyzed its demographic and socioeconomic correlates. Methods Data were obtained from the baseline of the China Kadoorie Biobank Study, which recruited over 0.5 million participants between 2004 and 2008. We calculated the prevalence by the characteristics of multimorbidity. The demographic and socioeconomic correlates were analyzed using a multivariable logistic regression model. Results 15.9% of the participants were multimorbid. Although the prevalence of multimorbidity increased with age, the absolute number of people with multimorbidity was much higher among middle-aged adults (30-60 years, n = 42 041) than the elderly group (>60 years, n = 38 834). The odd of multimorbidity was higher in males (aOR =1.09, 95% CI: 1.07-1.11) and among those who were unemployed (aOR = 1.58, 95% CI: 1.55-1.62). Those who received the highest level of education were most likely to be multimorbid compared with those with no education (aOR = 1.14, 95% CI: 1.09-1.19). Such an association was similar when treating multimorbidity as multinomial variable. Conclusions Multimorbidity is a public health concern, with higher prevalence among the elderly, males and those who belong to a lower socioeconomic stratum. Actions are needed to curb multimorbidity epidemic in China.
Kettle, Victoria E.Hamer, MarkMunir, FehmidahHoudmont, Jonathan...
9页
查看更多>>摘要：Background There is a dearth of literature on how different domains of sitting time relate to other health behaviours. Therefore, this study aimed to explore these associations in a sample of office workers. Methods 7170 Northern Irish Civil Servants completed an online survey which included information on workday and non-workday sitting time in five domains (travel, work, TV, computer-use, leisure-time), physical activity, fruit and vegetable intake, alcohol consumption and cigarette smoking. An unhealthy behaviour score was calculated by summing the number of health behaviours which did not meet the current guidelines. Multinomial regressions examined associations between unhealthy behaviour score and each domain of sitting time. Results >= 7 hours sitting at work and >= 2 hours TV viewing on a workday both more than doubled the odds of partaking in >= 3 unhealthy behaviours [Odds ratio, OR = 2.03, 95% CI, (1.59-2.61); OR = 2.19 (1.71-2.80)] and >= 3 hours of TV viewing on a non-workday nearly tripled the odds [OR = 2.96 (2.32-3.77)]. Conclusions High sitting time at work and TV viewing on a workday and non-workday are associated with increased odds of partaking in multiple unhealthy behaviours. Interventions need to focus on these domains and public health policy should consider sitting time as an important health behaviour.
Gruer, L. D.Cezard, G., IWallace, L. A.Hutchinson, S. J....
10页
查看更多>>摘要：Background Ethnicity can influence susceptibility to infection, as COVID-19 has shown. Few countries have systematically investigated ethnic variations in infection. Methods We linked the Scotland 2001 Census, including ethnic group, to national databases of hospitalizations/deaths and serological diagnoses of bloodborne viruses for 2001-2013. We calculated age-adjusted rate ratios (RRs) in 12 ethnic groups for all infections combined, 15 infection categories, and human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) viruses. Results We analysed over 1.65 million infection-related hospitalisations/deaths. Compared with White Scottish, RRs for all infections combined were 0.8 or lower for Other White British, Other White and Chinese males and females, and 1.2-1.4 for Pakistani and African males and females. Adjustment for socioeconomic status or birthplace had little effect. RRs for specific infection categories followed similar patterns with striking exceptions. For HIV, RRs were 136 in African females and 14 in males; for HBV, 125 in Chinese females and 59 in males, 55 in African females and 24 in males; and for HCV, 2.3-3.1 in Pakistanis and Africans. Conclusions Ethnic differences were found in overall rates and many infection categories, suggesting multiple causative pathways. We recommend census linkage as a powerful method for studying the disproportionate impact of COVID-19.
查看更多>>摘要：Background The immunization program has been an important part of Indian public health policy for three decades; yet only 62% of children are being fully immunized. Vaccine hesitancy is a major contributor to the immunization gap that needs to be addressed. Methods A cross-sectional descriptive study of prevalence and predictors of vaccine hesitancy was conducted in 350 households having at least one child in the age group of 13-24 months. Statistical analysis was done using chi-square test and logistic regression. Results The prevalence of vaccine hesitancy was 28.9%. Fear of needles, concern about pain during vaccination, lack of family support, and apprehension regarding side effects were ascertained as reasons for vaccine hesitancy. The type of family, time taken to reach the health facility and antenatal care received by the mother were significant predictors of vaccine hesitancy. Conclusion The prevalence of vaccine hesitancy was found to be high. In 2019, the World Health Organization earmarked vaccine hesitancy as one of the major roadblocks to better global health. A better understanding of the subject can help public health agencies enhance vaccination coverage, not just in children but also as a tool to protect entire populations in this age of re-emerging epidemics.
查看更多>>摘要：Background Undernutrition has been shown to be associated with various infectious diseases. However, the recent improvement in nutritional status and management for infectious diseases worldwide necessitates the re-evaluation of this association. Methods A retrospective study was conducted in children aged <14 years old with dengue, malaria or acute diarrhea who visited or were admitted to Tha Song Yang hospital, near the Thai-Myanmar border. Results Most of the patients had mild disease and most of the undernourishment was mild. The prevalence of underweight in dengue, malaria and acute diarrhea was 24.0%, 34.7% and 38.7%, respectively, and the prevalence of low height for age was 12.0%, 36.0% and 36.0%, respectively. Malaria and acute diarrhea were associated with underweight but not low height for age. Dengue was neither associated with underweight nor low height for age. Conclusion Although there has been an improvement in nutritional status and health care facilities, underweight has been still prevalent in rural areas and associated with malaria and acute diarrhea. Implication The surveillance for nutritional status should be continuously performed particularly in children with some diseases, e.g. malaria and acute diarrhea, and additional food supplementation should be provided.
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Oxford Univ Press