Individual and school environment factors associated with overweight in adolescents of the municipality of Rio de Janeiro, Brazil

AbstractObjectiveTo identify the association of individual and school environment factors with overweight among adolescents.DesignCross-sectional study. Sociodemographic and behavioural information was collected using an anonymous self-administered questionnaire. Indicators on human and physical resources of the schools were based on information collected in interviews with school principals. Overweight was defined based on the BMI Z-score for age and sex recommended by WHO. Logistic regression models were used for statistical analysis.SettingRio de Janeiro, Brazil.SubjectsBy means of a two-stage (classrooms and students) probabilistic sampling, subjects comprised 1632 students enrolled in the last year of primary education of the municipal public school network, stratified by city region.ResultsThe mean prevalence of overweight at schools was 17·2 %, ranging from 0 % to 50 %. Adolescents more likely to be overweight were those who attended schools without knives and forks or ceramic/glass plates for students in the school refectory (prevalence odds ratio (POR) = 1·40; P = 0·04), those whose head of household had completed between 8 and 10 years of schooling (POR = 1·46; P = 0·03), those who did not live with both parents (POR = 1·24; P = 0·06) and those who had not practised physical activity outside school on at least 1 d in the 7 d before the study (POR = 1·56; P = 0·04).ConclusionsSociodemographic and behavioural variables of adolescents and school characteristics were associated with overweight, confirming individual and context effects on this health disorder. Studies such as the present one, identifying variables in context, may support actions to prevent overweight among adolescents.

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Clustering of subpatent infections in households with asymptomatic rapid diagnostic test-positive cases in Bioko Island, Equatorial Guinea independent of travel to regions of higher malaria endemicity: a cross-sectional study

Malaria Journal ◽

10.1186/s12936-021-03844-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Dianna E. B. Hergott ◽

Jennifer E. Balkus ◽

Guillermo A. García ◽

Kurtis R. Cruz ◽

Annette M. Seilie ◽

...

Keyword(s):

Control Strategies ◽

Cross Sectional Study ◽

Prevalence Odds Ratio ◽

Cross Sectional ◽

Travel History ◽

Logistic Regression Models ◽

Bioko Island ◽

Malaria Indicator Survey ◽

Effective Interventions ◽

History Of

Abstract Background Prevalence of falciparum malaria on Bioko Island remains high despite sustained, intensive control. Progress may be hindered by high proportions of subpatent infections that are not detected by rapid diagnostic tests (RDT) but contribute to onward transmission, and by imported infections. Better understanding of the relationship between subpatent infections and RDT-detected infections, and whether this relationship is different from imported versus locally acquired infections, is imperative to better understand the sources of infection and mechanisms of transmission to tailor more effective interventions. Methods Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was performed on a sub-set of samples from the 2015 Malaria Indicator Survey to identify subpatent infections. Households with RDT(+) individuals were matched 1:4 with households with no RDT(+) individuals. The association between living in a household with an RDT(+) individual and having a subpatent infection was evaluated using multivariate hierarchical logistic regression models with inverse probability weights for selection. To evaluate possible modification of the association by potential importation of the RDT(+) case, the analysis was repeated among strata of matched sets based on the reported eight-week travel history of the RDT(+) individual(s). Results There were 142 subpatent infections detected in 1,400 individuals (10.0%). The prevalence of subpatent infections was higher in households with versus without an RDT(+) individual (15.0 vs 9.1%). The adjusted prevalence odds of subpatent infection were 2.59-fold greater (95% CI: 1.31, 5.09) for those in a household with an RDT(+) individual compared to individuals in a household without RDT(+) individuals. When stratifying by travel history of the RDT(+) individual, the association between subpatent infections and RDT(+) infections was stronger in the strata in which the RDT(+) individual(s) had not recently travelled (adjusted prevalence odds ratio (aPOR) 2.95; 95% CI:1.17, 7.41), and attenuated in the strata in which recent travel was reported (aPOR 1.76; 95% CI: 0.54, 5.67). Conclusions There is clustering of subpatent infections around RDT(+) individual(s) when both imported and local infection are suspected. Future control strategies that aim to treat whole households in which an RDT(+) individual is found may target a substantial portion of infections that would otherwise not be detected.

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The number of household members as a risk factor for peptic ulcer disease

Scientific Reports ◽

10.1038/s41598-021-84892-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mi Hong Yim ◽

Keun Ho Kim ◽

Bum Ju Lee

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Living Alone ◽

Cross Sectional ◽

Ulcer Disease ◽

Logistic Regression Models ◽

Household Members ◽

H Pylori

AbstractPeptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.

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Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms

Chemical Senses ◽

10.1093/chemse/bjaa081 ◽

2020 ◽

Author(s):

Richard C Gerkin ◽

Kathrin Ohla ◽

Maria G Veldhuizen ◽

Paule V Joseph ◽

Christine E Kelly ◽

...

Keyword(s):

Symptom Onset ◽

Respiratory Symptom ◽

Respiratory Illness ◽

Cross Sectional Study ◽

Cross Sectional ◽

Logistic Regression Models ◽

Olfactory Loss ◽

Visual Analog Scales ◽

Cardinal Symptoms ◽

Smell Loss

Abstract In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4<OR<10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.

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Perceived Experiences of Community Violence Among Adolescents: A School Survey From Rio de Janeiro, Brazil

Journal of Interpersonal Violence ◽

10.1177/08862605211005132 ◽

2021 ◽

pp. 088626052110051

Author(s):

Claudia L. de Moraes ◽

Érika B. dos Santos ◽

Michael E. Reichenheim ◽

Stella R. Taquette ◽

Luciane Stochero ◽

...

Keyword(s):

Public Schools ◽

Community Violence ◽

Rio De Janeiro ◽

Public Health Problem ◽

Cross Sectional Study ◽

Global Public Health ◽

Cross Sectional ◽

Interpersonal Aggression ◽

Adolescent Students ◽

Management Actions

Community violence (CV) is a global public health problem due to its high frequency and severe consequences. Although CV is one of the leading causes of death among adolescents, little is known about the everyday CV situations that do not lead to death. This study aimed to estimate the frequency of exposure to and involvement in CV situations among adolescent students from public and private schools in the city of Rio de Janeiro, Brazil. This was a cross-sectional study of 693 individuals in their second year of high school selected through stratified multistage random sampling. Information about their exposure to and involvement in CV was collected through a self-completed multidimensional questionnaire in the classrooms. For approximately 30% of the adolescents, someone close to them had been murdered, and 40% had already seen the corpse of a victim of homicide. Seventeen percent reported having been directly involved in CV situations. Approximately 38%, 13%, and 25% had been victims of robberies, interpersonal aggression, and death threats to either themselves or their relatives, respectively. Many of these situations occurred more than once. In general, CV was more frequently reported by boys and by those who did not live with both parents. Adolescents from higher economic classes experienced more interpersonal aggression and felt a greater need to carry a gun. Those who belonged to the lower economic classes and studied in public schools were more exposed to lethal violence than other students. The results call attention to the very high percentage of adolescent students that are involved in CV situations as well as to the differences in violence rates among population subgroups. Such findings should be considered when planning CV prevention and management actions in schools and other socialization spaces for adolescents.

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Do Hospitals with a Higher Level of Maternal Care Designation Have Better Maternal Outcomes?

American Journal of Perinatology ◽

10.1055/s-0038-1672140 ◽

2018 ◽

Vol 36 (06) ◽

pp. 653-658 ◽

Cited By ~ 2

Author(s):

Sindhu Srinivas ◽

Katy Kozhimannil ◽

Peiyin Hung ◽

Laura Attanasio ◽

Judy Jou ◽

...

Keyword(s):

High Risk ◽

Maternal Care ◽

Maternal Morbidity ◽

Cross Sectional Study ◽

Severe Maternal Morbidity ◽

Maternal Outcomes ◽

Cross Sectional ◽

Discharge Data ◽

Logistic Regression Models ◽

The Impact

Background A recent document by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine introduced the concept of uniform levels of maternal care (LMCs). Objective We assessed LMC across hospitals and measured their association with maternal morbidity, focusing on women with high-risk conditions. Study Design We collected data from hospitals from May to November 2015 and linked survey responses to Statewide Inpatient Databases (SID) hospital discharge data in a retrospective cross-sectional study of 247,383 births admitted to 236 hospitals. Generalized logistic regression models were used to examine the associations between hospitals' LMC and the risk of severe maternal morbidity. Stratified analyses were conducted among women with high-risk conditions. Results High-risk pregnancies were more likely to be managed in hospitals with higher LMC (p < 0.001). Women with cardiac conditions had lower odds of maternal morbidity when delivered in level I compared with level IV units (adjusted odds ratio: 0.29; 95% confidence interval: 0.08–0.99; p = 0.049). There were no other significant associations between the LMC and severe maternal morbidity. Conclusion A higher proportion of high-risk pregnancies were managed within level IV units, although there was no overall evidence that these births had superior outcomes. Further prospective evaluation of LMC designation with patient outcomes is necessary to determine the impact of regionalization on maternal outcomes.

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Health Literacy and Its Mediating Role in Predicting Health Behaviors Among Chinese Secondary Students

Asia Pacific Journal of Public Health ◽

10.1177/1010539520980926 ◽

2020 ◽

pp. 101053952098092

Author(s):

Shuaijun Guo ◽

Lucio Naccarella ◽

Xiaoming Yu ◽

Rebecca Armstrong ◽

Geoffrey Browne ◽

...

Keyword(s):

Health Literacy ◽

Health Behaviors ◽

Secondary Students ◽

School Environment ◽

Mainland China ◽

Holistic Approach ◽

Cross Sectional Study ◽

Cross Sectional ◽

Mediating Role ◽

Chinese School

While health literacy research in mainland China has gained increasing attention, most studies focus on adults. This study aimed to examine the mediating role of health literacy in the relationship between a range of upstream factors and health behaviors among Chinese secondary students. A cross-sectional study was conducted with 650 students in Years 7 to 9 from 4 secondary schools in Beijing. Based on an adapted health literacy framework from Manganello, a self-administered questionnaire was designed to collect information on upstream factors, health literacy, and health behaviors. Path analysis results showed that the proposed framework was mostly supported by empirical data after modification indices were examined and 3 direct paths were added. Students’ self-efficacy, social support, and school environment were associated with health literacy, which in turn predicted health behaviors. A holistic approach is needed to improve both adolescent health literacy and health behaviors for Chinese school-aged adolescents.

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Demographic and social correlates and indicators for behavioural compliance with personal protection among Chinese community-dwellers during COVID-19: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-041453 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041453

Author(s):

Xin Xu ◽

Kimberly Ann Chew ◽

Xiaolin Xu ◽

Zhihua Wu ◽

Xiaohua Xiao ◽

...

Keyword(s):

Middle Age ◽

Social Indicators ◽

Age Groups ◽

Cross Sectional Study ◽

Inverse Association ◽

Personal Protection ◽

Cross Sectional ◽

Protective Measures ◽

Logistic Regression Models ◽

Community Dwellers

ObjectivesExamine compliance with personal protective measures in communities for the prevention and control of local transmission of the COVID-19, and explore indicators for such behavioural compliance.DesignCross-sectional design with a self-selecting sample. Data collected in February 2020.SettingCommunity dwellers in China.Participants2956 participants aged 16 and above completed the study and were included in the analysis.Outcome measuresNationwide COVID-19 survey. Demographics and self-reported compliance with four personal protective measures—home quarantine, mask-wearing, temperature-taking and hand-sanitising were collected. Outbreak severity and timeliness of personal protection order were obtained from the China Center for Disease Control and Prevention website. Logistic regression models were employed to examine the association between demographic and social indicators and behavioural compliance.ResultsCompliance with home quarantine was only associated with gender (men, OR=0.61 (0.51–0.73), inverse association) but no other indicators. In contrast, men had higher compliance with mask-wearing (OR=1.79 (1.49–2.16)) and temperature-taking (OR=1.27 (1.05–1.53)). Compared with younger adults (≤20 years), the middle-age groups (31–40 and 41–50 years of age) were more compliant with all protective behaviours, except for home quarantine (OR=0.71 (0.54–0.93) and 0.67 (0.46–0.97), respectively).ConclusionMale gender was associated with lower compliance with home quarantine yet higher compliance with mask-wearing and temperature-taking. The middle-age participants (31–50 years) had lower compliance with home quarantine but higher with other measures. These findings may be supported by the economic considerations and the long-inherited Confucian values among Chinese. In light of the ongoing COVID-19 pandemic, public health authorities should tailor policy implementation to disparities in psychosocial indicators.

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The multimorbidity of hypertension and osteoarthritis and relation with sleep quality and hyperlipemia/hyperglycemia in China’s rural population

Scientific Reports ◽

10.1038/s41598-021-96523-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Li Ran ◽

Qi Chen ◽

Jingyi Zhang ◽

Xinlong Tu ◽

Xiaodong Tan ◽

...

Keyword(s):

Sleep Quality ◽

Regression Models ◽

Joint Effect ◽

Cross Sectional Study ◽

Poor Sleep ◽

Sectional Study ◽

Additive Interaction ◽

Cross Sectional ◽

Logistic Regression Models ◽

Remote Rural Area

AbstractHypertension (HTN) and osteoarthritis (OA) are frequent in middle-aged and elderly people, and the co-occurrence of these two diseases is common. However, the pathogenesis of the multimorbidity of both diseases and the relation with sleep quality, hyperlipemia, and hyperglycemia is unclear. We conducted a cross-sectional study to make sense of the multimorbidity of HTN and OA and the relation with sleep quality, hyperlipemia, and hyperglycemia. The relation between sleep quality and OA and its joint effect with hyperlipemia or hyperglycemia was evaluated with logistic regression models. The additive interaction was assessed with the relative excess risk due to interaction (REEI), the attributable proportion (AP), and the synergy index (S). According to this research in a remote rural area, approximately 34.2% of HTN patients are accompanied with OA and 49.1% are suffering poor sleep. Both hyperlipemia/hyperglycemia and sleep quality were related to OA prevalence with crude ORs of 1.43 (95% CI 1.014–2.029) and 1.89 (95% CI 1.411–2.519, P < 0.001) respectively. An observed additive effect was found greater than the sum of the effects of sleep quality and hyperlipemia/hyperglycemia posed on OA prevalence alone. This additive interaction was observed in females (OR = 3.19, 95% CI 1.945–5.237) as well as males ≥ 65 years old (OR = 2.78, 95% CI 1.693–4.557), with RERI, AP, and S significant. Therefore, poor sleep and hyperlipemia/hyperglycemia are associated with OA, and further studies on the additive interaction among females and males ≥ 65 are warranted.

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Setting – based prevalence and correlates of central obesity: findings from a cross-sectional study among formal sector employees in Dodoma City, Central Tanzania

BMC Public Health ◽

10.1186/s12889-020-10142-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mariam John Munyogwa ◽

Kaloli Sayi Ntalima ◽

Secilia Ng’weshemi Kapalata

Keyword(s):

Central Obesity ◽

Simple Random Sampling ◽

Cross Sectional Study ◽

Formal Sector ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Logistic Regression Models ◽

Face To Face ◽

Chi Square Test

Abstract Background Obesity at the workplace has been associated with symptoms of lower self-esteem, increased individual and employer healthcare costs, increased absenteeism and presenteeism and reduced productivity. Therefore, this study was designed to study the prevalence and correlates of central obesity among formal sector employees in Dodoma City. Methods Study design was a cross-sectional survey conducted from March to June, 2019. Participants were employees from formal sector employment defined as those paid regular monthly wage and with either a secured permanent or temporary contract. Simple random sampling was used to select four out of fifteen large buildings hosting various establishments. Respondents were obtained conveniently and interviewed face to face. Central obesity was defined as a waist circumference greater than 102 cm for males and greater than 88 cm for females. Chi-square test was conducted to assess the differences among the groups. Simple and multiple logistic regression models were fitted to identify the correlates of central obesity. Results A total of 392 respondents (98% response rate) agreed and participated in the study. The overall prevalence of central obesity was found to be 41.8% (164/392). The prevalence of central obesity was significantly higher among females (67.4% p < 0.001), respondents aged ≥51 years (60%, p = < 0.001), administrators (55.1% p = < 0.05), respondents with salary of > 1,000,000 Tanzanian Shilling (TSh.) per month (54.4%, p = < 0.05), respondents who eat homemade meals at the workplace (64.2%, p = < 0.05) and respondents with hypertension (62.5%, p = < 0.05). Correlates of central obesity were found to be female sex (AOR = 9.53; 95% CI: 5.49, 16.78), increased age, eating homemade meals at the workplace (AOR = 2.32; 95% CI: 1.04, 4.19) and hypertension (AOR = 3.15; 95% CI: 1.41, 6.91). Conclusions The present study revealed high prevalence of central obesity among formal sector employees in Dodoma City. Scholars and stakeholders are urged to generate more evidences and design appropriate interventions to curb the situation.

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Abstract P707: Trends, Predictors and Outcomes of Cerebrovascular Disease Amongst Patients With Thrombotic Microangiopathy

Stroke ◽

10.1161/str.52.suppl_1.p707 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Priyadarshee Patel ◽

Urvish K Patel ◽

Graca Vanessa ◽

Abhinav Patel ◽

Davis Chacko ◽

...

Keyword(s):

Thrombotic Microangiopathy ◽

Thrombus Formation ◽

Cerebral Arteries ◽

Temporal Trends ◽

Cross Sectional Study ◽

Coagulation System ◽

Trend Test ◽

Cross Sectional ◽

Logistic Regression Models ◽

The Usa

Background: Thrombotic Microangiopathy (TMA) is a rare disorder affecting the coagulation system causing microangiopathic thrombus formation within various blood vessels including the cerebral arteries. It may be seen in association with thrombocytopenia, anemia, purpura and kidney failure as well as complications of various systemic viral illnesses. We sought to estimate the trends, predictors, and outcomes of CeVD in patients having ™ from a nationally representative database of the USA. Methods: In this cross-sectional study, we identified hospitalization with TM using ICD-9/10-CM from the National Inpatient Sample (NIS) for the years 2008-2017. Prevalence of CeVD was identified by validated ICD-9/10-CM codes. We utilized Cochran Armitage trend test and multivariable survey logistic regression models to analyze temporal trends, outcomes and predictors of any CeVD in TM patients. Results: Out of a total 58,850 hospitalizations among TMA patients, 4,668 (7.9%) developed CeVD. Prevalence of CeVD increased from 6.2% in 2008 to 8.2% in 2017 (pTrend<0.001). Patients who developed CeVD were older and more likely to be female. In multivariable regression analysis, increasing age (OR 1.2; 95%CI 1.1-1.2; p<0.0001); females (OR 1.3; 95%CI 1.1-1.6;p<0.0004); African American (OR 1.4; 95%CI 1.2-1.7;p<0.001) and hypertension (OR 1.3; 95%CI 1.1-1.6; p<0.0001). CeVD was also associated with higher length of stay (18 vs 12 days; p<0.001). Additionally, CeVD was associated with higher in-hospital mortality (aOR 2.1; 95%CI 1.7-2.5; p<0.001) and discharge to facility (aOR 3.0; 95%CI 2.4-3.5; p<0.001) after adjusting with confounders. Conclusion: We observed the mildly incremental prevalence of CeVD among TMA patients. We were able to identify the TMA patient population susceptible to CeVD, most commonly occurring in older, females and African Americans. CeVD was also associated with significantly poor outcomes in TM. These findings may pose similarities to other systemic viral illness-induced thrombotic microangiopathy such as COVID-19. Further studies are required to improve the outcomes of these susceptible patient populations.

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