scholarly journals Trajectories of change in childhood obesity prevalence across local authorities 2007/08–2015/16: a latent trajectory analysis

2018 ◽  
Vol 41 (4) ◽  
pp. 724-731 ◽  
Author(s):  
Russell M Viner ◽  
Dougal S Hargreaves
Keyword(s):  
Childhood Obesity ◽  
Latent Class ◽  
Ethnic Composition ◽  
Obesity Prevalence ◽  
Local Authorities ◽  
White Ethnicity ◽  
Latent Trajectory ◽  
Increased Risk ◽  
High Prevalence ◽  
Class 1

Abstract Background We investigated differing trajectories of childhood obesity prevalence amongst English local authorities (LAs). Methods Data on prevalence of childhood obesity (BMI ≥ 95th centile) for Reception year and Year 6 for 150 LAs in England from 2006/07 to 2015/16 were obtained from the National Child Measurement Programme (NCMP). Latent class mixture modelling (LCCM) was used to identify classes of change in obesity prevalence. Results In Reception, most LAs showed little change across the period (Class 1; stable, moderate obesity prevalence;84%), with a smaller group with a high prevalence that fell thereafter (Class 2; high but falling obesity prevalence; 16%). In Year 6 we identified three classes: moderate obesity prevalence (Class 3; 43%); high and rising obesity prevalence (Class 2; 36%); and stable low obesity prevalence (Class 1; 21%). Greater LA deprivation and higher LA proportion of non-white ethnicity increased risk of being in Class 2 (Reception) or Class 2 or 3 (Year 6) compared with Class 1. Conclusions The prevalence of childhood obesity in LAs in England follow a small number of differing trajectories that are influenced by LA deprivation and ethnic composition. LAs following a stable low obesity trajectory for Year 6 are targets for further investigation.

scholarly journals Do Knee Pain Phenotypes Have Different Risks of Total Knee Replacement?

2020 ◽  
Vol 9 (3) ◽  
pp. 632 ◽  
Author(s):  
Feng Pan ◽  
Jing Tian ◽  
Ishanka P. Munugoda ◽  
Stephen Graves ◽  
Michelle Lorimer ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Joint Replacement ◽  
Structural Damage ◽  
Latent Class ◽  
Emotional Problems ◽  
High Prevalence ◽  
Class 1 ◽  
Total Knee ◽  
Low Prevalence

Pain is the main impetus for osteoarthritis (OA) patients to seek healthcare including joint replacement. The pain experience in OA is heterogeneous and affected by factors across multiple domains—peripheral, psychological, and neurological. This indicates the existence of homogenous subgroups/phenotypes within OA patients with pain. We recently identified three pain phenotypes using a wide spectrum of pain-related factors, including structural damage on magnetic resonance imaging (MRI), emotional problems, number of painful sites, sex, body mass index, education level and comorbidities (i.e., Class 1: high prevalence of emotional problems and low prevalence of structural damage (25%); Class 2: low prevalence of emotional problems and high prevalence of structural damage (20%); Class 3: low prevalence of emotional problems and low prevalence of structural damage (55%)). This study was to examine whether the total knee replacement (TKR) risk over 12 years was different among these three pain phenotypes. Data on 963 participants (mean age 62.8 ± 7.4 years) from a population-based cohort study were utilised. Data on socio-demographic, psychological and comorbidities were collected. MRI of the right knee structural pathology was performed. TKR history was ascertained by linking to the Australian Orthopedic Association National Joint Replacement Registry. Latent class analysis and the Cox proportional hazards model were applied for the analysis. During the follow-up period, 41 right and 44 left TKRs in 67 participants were identified. In multivariable analyses, participants in Class 1 and 2 had a higher risk of having a TKR (Class 1 vs. Class 3, HR (hazard ratio) 4.81, 95%CI (confidence interval) 2.33–9.93; Class 2 vs. Class 3, HR 9.23, 95%CI 4.66–18.30). These associations were stronger in the imaged right knee but were also significant in the left knee. Participants within distinct pain phenotypes have different risks of TKR, suggesting that the identified phenotypes reflect distinct clinical subgroups with different prognoses. The risk for TKR was higher in Class 1 than that in Class 3, suggesting that pain/emotional status is a stronger driver for TKR than structural damage, and that selecting patients for TKR needs to be optimized in clinical practice.

scholarly journals Prevalence of severe childhood obesity in England: 2006–2013

2015 ◽  
Vol 100 (7) ◽  
pp. 631-636 ◽  
Author(s):  
Louisa J Ells ◽  
Caroline Hancock ◽  
Vicky R Copley ◽  
Emma Mead ◽  
Hywell Dinsdale ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Severe Obesity ◽  
Management Strategies ◽  
Obesity Prevalence ◽  
Adequate Treatment ◽  
Prevention Services ◽  
Treatment And Prevention ◽  
Paediatric Obesity ◽  
Increased Risk ◽  
Severely Obese

BackgroundInternational evidence shows that severe paediatric obesity results in an increased risk of ill health and may require specialised weight management strategies, yet there remains a lack of data on the extent of the problem.ObjectiveTo examine the prevalence of severe obesity in children aged 4–5 and 10–11 years, attending English schools between 2006/2007 and 2012/2013.DesignA retrospective analysis of National Child Measurement Programme (NCMP) data.SettingMaintained schools in England.ParticipantsAll children aged 4–5 and 10–11 years included in the NCMP dataset.Main outcome measuresPrevalence of severe childhood obesity, defined using the 99.6th centile of the British 1990 (UK90) growth reference for body mass index (BMI), analysed by sex, geography, ethnic group and deprivation.ResultsThe key findings show that in 2012/2013, severe obesity (BMI ≥UK90 99.6th centile) was found in 1.9% of girls and 2.3% of boys aged 4–5 years, and 2.9% of girls and 3.9% of boys aged 10–11 years. Severe obesity prevalence varies geographically and is more prevalent in children from deprived areas, and among those from black ethnic groups.ConclusionsThe findings from this study should help to raise awareness of the prevalence of severe obesity and support the provision of adequate treatment and prevention services both to support children who are already severely obese and reduce the prevalence of extreme weight in the future.

scholarly journals Lifetime Interpersonal Polyvictimization: Abuse Typologies and Mental Health Outcomes in a Nationally Representative Sample of Men from the United States

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Carol Rhonda Burns ◽  
Cherie Armour
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Latent Class ◽  
The United States ◽  
Mental Health Outcomes ◽  
Traumatic Experience ◽  
Adult Males ◽  
Increased Risk ◽  
Class 1 ◽  
Nationally Representative

BackgroundInterpersonal polyvictimisation experiences are a specific type of traumatic experience that include physical, sexual or psychological attacks against a person and much research has concentrated on female only or mixed samples. Being a victim of one form of victimisation experience increases the risk of further victimisation experience resulting in polyvictimisation, and elevates the likelihood on negative mental health outcomes. ObjectivesThe current study seeks to establish interpersonal polyvictimisation typologies within a male sub-population of a large epidemiologic sample and establish associated risk of psychopathology across a range of mental health outcomes. MethodsUsing data from 15,794 adult males, aged over 18 years who completed the NESARC III, a Latent Class Analysis (LCA) of the endorsement of interpersonal victimisation experiences was conducted to establish latent profiles of interpersonal polyvictimisation. Subsequently regression analysis was conducted to establish risk of psychopathology across a series of DSM 5 diagnosed mental health conditions. FindingsA three-class solution was deemed optimal in line with published fit statistics. Class 3 was categorised by low/no endorsement and was labelled ‘normative’, Class 2 was categorised by high endorsement of childhood indicators and was labelled ‘childhood’, class 1 showed a moderate endorsement across life-course victimisation indicators and was labelled ‘lifecourse’. Interpersonal polyvictimisation profiles showed increased risk of negative mental health outcomes in adulthood suggesting that distinct typologies of interpersonal polyvictimisation exist within the adult male only population. ConclusionsExperiences of interpersonal polyvictimisation are robustly associated with adult psychopathology in males including elevated rates of the likelihood of PTSD, Anxiety and Depression in a dose response fashion. Interventions and support services should therefore be developed and implemented that are targeted to gender specific distinctiveness.

Abstract 15529: Multimorbidity Clusters in Patients Presenting to the Emergency Department With Potential Acute Coronary Syndrome

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Katherine Breen ◽  
Lorna Finnegan ◽  
Karen M Vuckovic ◽  
Anne M Fink ◽  
Wayne D Rosamond ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Family History ◽  
Chronic Conditions ◽  
Latent Class ◽  
Secondary Analysis ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Class 1

Introduction: The increasing prevalence of multimorbidity (> 2 chronic conditions) is a challenge for healthcare providers and systems. Multimorbidity complicates treatment and increases the risk of adverse outcomes. Objectives: To identify multimorbidity classes (clusters of > 2 specific chronic conditions) in a secondary analysis of a multi-site study about symptoms in patients presenting to the emergency department (ED) for potential acute coronary syndrome (ACS). Hypothesis: Specific multimorbidity classes can predict an ACS diagnosis. Methods: Chronic conditions were measured (Charlson Comorbidity Index and ACS Patient Information Questionnaire) in patients who underwent a cardiac evaluation in the ED. Latent class analysis was used to identify multimorbidity classes, and logistic regression determined whether multimorbidity classes were predictive of being ruled-in versus ruled-out for ACS. Results: The sample ( n = 935) was 38% female, with a mean age of 59 years. Four multimorbidity classes were identified and labeled: High multimorbidity (Class 1, hyperlipidemia, hypertension [HTN], obesity, diabetes, and respiratory disorders); Low multimorbidity (Class 2, obesity); Cardiovascular multimorbidity (Class 3, HTN, hyperlipidemia, and coronary heart disease); and Cardio-oncology multimorbidity (Class 4, HTN, hyperlipidemia, and cancer). Patients in Classes 3 and 4 had a 2.8-fold and 1.7-fold increased risk of ruling-in for ACS compared to those in Class 2 who were half as likely to rule-in for ACS (OR 0.45 95% CI 0.33 to 0.61 p=0.001). Class membership differed by sex, age, and family history. Females were more likely to be in Class 1 (44.2%), younger patients in Class 2 (mean age 43.4 ± 9.8 years), older patients in class 4 (mean age 80.0 ± 6.3 years), and those with a family history of sudden cardiac death (< age 55) in Class 3 (58.3%). Conclusion: Multimorbidity classes differed according to demographic and clinical variables. Membership in Classes 3 and 4 were predictive of an ACS diagnosis. Clustering patients by multimorbidity class may inform risk-stratification during evaluation for ACS.

scholarly journals Association of Unhealthy Behaviors with Self-Harm in Chinese Adolescents: A Study Using Latent Class Analysis

Trauma Care ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 75-86
Author(s):  
Rong Yang ◽  
Danlin Li ◽  
Run Tian ◽  
Jie Hu ◽  
Yanni Xue ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Latent Class ◽  
Cluster Sampling ◽  
Class Analysis ◽  
School Students ◽  
High Prevalence ◽  
Class 1 ◽  
Self Harm ◽  
Logistic Regressions ◽  
Harm Prevention

Previous studies have demonstrated the link between individual unhealthy behaviors and self-harm, but little is known about the influence of multiple unhealthy behaviors on self-harm among adolescents. This study aims to identify the potential patterns of unhealthy behaviors and to examine their associations with self-harm, which may become a useful tool for the screening of self-harm in adolescents. A total of 22,628 middle school students (10,990 males and 11,638 females) in six cities was enrolled in this study by multistage stratified cluster sampling from November 2015 to January 2016. Latent class analysis (LCA) was performed based on five kinds of unhealthy behaviors (unhealthy losing weight (ULW), tobacco use (TU), alcohol use (AU), screen time (ST), and mobile phone dependence (MPD)). Multivariate logistic regressions were used to examine associations between identified subgroups and self-harm. Four subgroups of unhealthy behaviors were identified. Class 1 (71.2%) had the lowest engagement in unhealthy behaviors. Class 2 ((ULW/MPD), 22.3%) had a relatively high prevalence of ULW and MPD. Class 3 ((TU/AU/ST), 3.2%) had a relatively high prevalence of TU, AU, and ST. Class 4 (3.3%) consistently engaged in unhealthy behaviors. Compared to class 1, class 2 (ULW/MPD), class 3 (TU/AU/ST), and class 4 showed OR (95%CI) values of 2.101 (1.964–2.248), 2.153 (1.839–2.520), and 3.979 (3.407–4.645) (p < 0.001 for each), respectively. Class 1, class 2 (ULW/MPD), and class 3 (TU/AU/ST) engagement in unhealthy behaviors was associated with increased self-harm. These findings strongly suggested that self-harm prevention efforts focusing on multiple unhealthy behaviors should be seriously considered for early detection of self-harm.

Prevalence of Childhood Obesity In Northeastern Ontario: A Cross-sectional Study

2006 ◽  
Vol 67 (3) ◽  
pp. 143-147 ◽  
Author(s):  
Foyez Haque ◽  
Alberto G. de la Rocha ◽  
Betty Ann Horbul ◽  
Patricia Desroches ◽  
Craig Orrell
Keyword(s):  
Childhood Obesity ◽  
Program Planning ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Obesity Prevalence ◽  
Chi Square ◽  
Cross Sectional ◽  
Northern Ontario ◽  
Control And Prevention ◽  
Chi Square Test

Purpose: In Canada, the incidence of childhood obesity has tripled within the past 20 years. The prevalence of obesity in the Timmins, Ontario, student population was studied to gain knowledge for program planning and resource allocation, and to compare Centers for Disease Control and Prevention (CDC) criteria with Cole’s international criteria for childhood obesity. Methods: Anthropometric measurements of 801 students were taken. Students were chosen from randomly selected schools for each grade. Data were analyzed according to age, gender, and ethnicity. Data were also compared with other studies. Intragroup comparisons were performed using hypothesis testing for significance with the z table and chi-square test. Results: Overweight and obesity prevalence was 28% according to CDC criteria. No statistical difference was found between genders or among ethnic groups, or between this study and other Canadian studies. In comparison with the CDC criteria, Cole’s international criteria indicated less obesity and increased overweight prevalence. These differences were not statistically significant. Conclusions: The findings suggest that in the northern Ontario community of Timmins, the prevalence of childhood obesity is of epidemic proportions. When the findings are shared with different agencies, this study will help the health unit to take necessary public health measures to curb the epidemic.

scholarly journals Evolution of the prevalence of obesity in the adult population in France, 2013–2016: the Constances study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sébastien Czernichow ◽  
Adeline Renuy ◽  
Claire Rives-Lange ◽  
Claire Carette ◽  
Guillaume Airagnes ◽  
...  
Keyword(s):  
Linear Trend ◽  
Adult Population ◽  
Age Groups ◽  
French Population ◽  
Obesity Prevalence ◽  
Point Change ◽  
Men And Women ◽  
Class 1 ◽  
Prevalence Of Obesity ◽  
Age And Sex

AbstractThis study provides trends in obesity prevalence in adults from 2013 to 2016 in France. 63,582 men and women from independent samples upon inclusion from the Constances cohort were included. Anthropometrics were measured at Health Screening Centers and obesity defined as a Body mass index (BMI) ≥ 30 kg/m2; obesity classes according to BMI are as follows: class 1 [30–34.9]; class 2 [35–39.9]; class 3 [≥ 40 kg/m2]. Linear trends across obesity classes by sex and age groups were examined in regression models and percentage point change from 2013 to 2016 for each age category calculated. All analyses accounted for sample weights for non-response, age and sex-calibrated to the French population. Prevalence of obesity ranged from 14.2 to 15.2% and from 14 to 15.3% in women and men respectively from 2013 to 2016. Class 1 obesity category prevalence was the only one to increase significantly across survey years in both men and women (p for linear trend = 0.04 and 0.01 in women and men respectively). The only significant increase for obesity was observed in the age group 18–29 y in both women and men (+ 2.71% and + 3.26% point increase respectively, equivalent to an approximate rise of 50% in women and 93% in men, p = 0.03 and 0.02 respectively). After adjustment for survey non-response and for age and sex distribution, the results show that class 1 obesity prevalence has significantly increased in both women and men from 2013 to 2016, and only in young adults in a representative sample of the French population aged 18–69 years old.

scholarly journals Risk of Nursing Home Use Among Older Americans: The Impact of Psychiatric History and Trajectories of Cognitive Function

2021 ◽  
Author(s):  
Maria T Brown ◽  
Miriam Mutambudzi
Keyword(s):  
Nursing Home ◽  
Cognitive Function ◽  
Latent Class ◽  
Study Data ◽  
Psychiatric Training ◽  
Psychiatric History ◽  
Term Care ◽  
Increased Risk ◽  
Course Variables ◽  
The Impact

Abstract Objectives Mental illness and cognitive functioning may be independently associated with nursing home use. We investigated the strength of the association between baseline (1998) psychiatric history, 8-year cognitive function trajectories, and prospective incidence of nursing home use over a 10-year period while accounting for relevant covariates in U.S. adults aged 65 and older. We hypothesized that self-reported baseline history of psychiatric, emotional, or nervous problems would be associated with a greater risk of nursing home use and that cognition trajectories with the greatest decline would be associated with a subsequent higher risk of nursing home use. Methods We used 8 waves (1998–2016) of Health and Retirement Study data for adults aged 65 years and older. Latent class mixture modeling identified 4 distinct cognitive function trajectory classes (1998–2006): low-declining, medium-declining, medium-stable, and high-declining. Participants from the 1998 wave (N = 5,628) were classified into these 4 classes. Competing risks regression analysis modeled the subhazard ratio of nursing home use between 2006 and 2016 as a function of baseline psychiatric history and cognitive function trajectories. Results Psychiatric history was independently associated with greater risk of nursing home use (subhazard ratio [SHR] 1.26, 95% confidence interval [CI] 1.06–1.51, p &lt; .01), net the effects of life course variables. Furthermore, “low-declining” (SHR 2.255, 95% CI 1.70–2.99, p &lt; .001) and “medium-declining” (2.103, 95% CI 1.69–2.61, p &lt; .001) trajectories predicted increased risk of nursing home use. Discussion Evidence of these associations can be used to educate policymakers and providers about the need for appropriate psychiatric training for staff in community-based and residential long-term care programs.

49 Longitudinal Change of Sleep in the Elderly and Its Associations with Health

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
A Didikoglu ◽  
A Maharani ◽  
A Payton ◽  
M M Canal ◽  
N Pendleton
Keyword(s):  
Older Adults ◽  
Latent Class ◽  
Sport Participation ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Longitudinal Change ◽  
Sleep Timing ◽  
Increased Risk ◽  
Health And Mortality ◽  
Evening Class

Abstract Introduction In elderly populations, sleep quality deteriorates and sleep time shifts towards earlier times. These sleep characteristics have been associated with cardiovascular, metabolic and psychiatric disorders, cognitive decline and mortality. Our aims are to examine longitudinal changes of sleep in older adults and to investigate the relationship between sleep variations, general health and mortality. Methods The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age cohort (6,375 participants, recruited in the North of England, between 1983 and 1993) was used. Mixed models were used to investigate individual sleep trajectories (5 waves in 30-year period). Sleep timing and efficiency trajectories were clustered using latent class analysis and analysed against daily habits, health and mortality. Results Older adults have decreased sleep efficiency (~20%) and early sleep time (~30 min) between 40 and 100 years of age. Those in the high sleep efficiency latent class had minimal decrease in their sleep efficiency as they aged. Belonging to the high sleep efficiency latent class was associated with having lower prevalence of hypertension, circulatory problems, arthritis, breathing problems and recurrent depression compared to the low efficiency latent class. Results showed a higher risk of hypertension and metabolic syndrome in the evening-type latent class compared to morning-type individuals. Evening class was associated with traits related to lower health such as reduced sport participation, increased risk of depression and psychoticism personality, late eating, increased smoking and alcohol usage. Survival analysis revealed that individuals in the evening class had 1.15-fold increased risk of all-cause mortality compared to those with morning preferences. Conclusion Ageing is associated with decreased sleep efficiency and early sleep timing. However, there are detectable subgroups of sleep traits that are related to prevalence of different diseases and longevity. Understating these subgroups may pave the way for new treatments for healthy sleeping habits in older population.

scholarly journals Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors—results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS)

2021 ◽  
Author(s):  
Salome Adam ◽  
Melissa S. Y. Thong ◽  
Eva Martin-Diener ◽  
Bertrand Camey ◽  
Céline Egger Hayoz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Depressive Symptoms ◽  
Cancer Survivorship ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Symptom Cluster ◽  
Depression Symptom ◽  
Class 1 ◽  
Eortc Qlq

Abstract Purpose Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL). Methods Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis. Results Three classes were identified: class 1 (61.4%) – “low pain, low physical and emotional fatigue, moderate depressive symptoms”; class 2 (15.1%) – “low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms”; class 3 (23.5%) – high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1. Conclusion Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors’ needs.

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