scholarly journals Multiple Social Vulnerabilities to Health Disparities and Hypertension and Death in the REGARDS Study

Hypertension ◽  
2021 ◽  
Author(s):  
Jordan B. King ◽  
Laura C. Pinheiro ◽  
Joanna Bryan Ringel ◽  
Adam P. Bress ◽  
Daichi Shimbo ◽  
...  
Keyword(s):  
Relative Risk ◽  
Racial Differences ◽  
Risk Ratio ◽  
Social Vulnerability ◽  
Economic Education ◽  
Community Context ◽  
Relative Risk Ratio ◽  
Adjusted Relative Risk ◽  
Regards Study ◽  
Social Vulnerabilities

Social vulnerabilities increase the risk of developing hypertension and lower life expectancy, but the effect of an individual’s overall vulnerability burden is unknown. Our objective was to determine the association of social vulnerability count and the risk of developing hypertension or dying over 10 years and whether these associations vary by race. We used the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) and included participants without baseline hypertension. The primary exposure was the count of social vulnerabilities defined across economic, education, health and health care, neighborhood and built environment, and social and community context domains. Among 5425 participants of mean age 64±10 SD years of which 24% were Black participants, 1468 (31%) had 1 vulnerability and 717 (15%) had ≥2 vulnerabilities. Compared with participants without vulnerabilities, the adjusted relative risk ratio for developing hypertension was 1.16 (95% CI, 0.99–1.36) and 1.49 (95% CI, 1.20–1.85) for individuals with 1 and ≥2 vulnerabilities, respectively. The adjusted relative risk ratio for death was 1.55 (95% CI, 1.24–1.93) and 2.30 (95% CI, 1.75–3.04) for individuals with 1 and ≥2 vulnerabilities, respectively. A greater proportion of Black participants developed hypertension and died than did White participants (hypertension, 38% versus 31%; death, 25% versus 20%). The vulnerability count association was strongest in White participants ( P value for vulnerability count×race interaction: hypertension=0.046, death=0.015). Overall, a greater number of socially determined vulnerabilities was associated with progressively higher risk of developing hypertension, and an even higher risk of dying over 10 years.

Abstract 13: Racial Differences in the Impact of Multiple Social Vulnerabilities to Health Disparities and Hypertension and Death in the Reasons for Geographic and Racial Differences in Stroke (regards) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jordan B King ◽  
Laura Pinheiro ◽  
Joanna Bryan Ringel ◽  
Adam P Bress ◽  
Daichi Shimbo ◽  
...  
Keyword(s):  
Health Disparities ◽  
Racial Differences ◽  
Economic Education ◽  
Community Context ◽  
Adjusted Relative Risk ◽  
Black Adults ◽  
Regards Study ◽  
Social Vulnerabilities ◽  
The Impact

Background: Individual social vulnerabilities to health disparities increase the risk of developing hypertension and lower life expectancy, but their cumulative effect on these outcomes is unknown. Methods: Using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, we included participants aged 45 years or older without hypertension at baseline (i.e., systolic/diastolic blood pressure <130/80 mm Hg and no antihypertensive medication use). The exposure was count of vulnerabilities at baseline which were defined across economic, education, health and health care, neighborhood and built environment, and social and community context domains. The primary outcome took on three levels: 1) alive at follow-up without hypertension (reference group), 2) alive at follow-up with hypertension, or 3) deceased prior to follow-up 10-year risk of hypertension or death. Multinomial logistic regression was used to determine associations of the count of vulnerabilities with hypertension and survival status at the second in-home visit, expressed as adjusted relative risk ratios (aRRR). Analyses were stratified by race. Results: Among 5425 participants (mean±SD age of 63±10 years, 24% black, and 54% female), 1785 (33%) participants developed hypertension and 1135 (21%) participants died. A greater proportion of black participants developed hypertension and died than did white participants (hypertension, 38% vs 31%; death, 25% vs 20%). The associations between vulnerability count and both hypertension and death were stronger in white participants than black participants (p-value for vulnerability count*race interaction: hypertension = 0.042, death =0.021; Figure 1). Conclusions: The relative effect of multiple social vulnerabilities on hypertension development may be stronger in white adults than black adults. Nonetheless, black adults experience the highest absolute rates of hypertension in all subpopulations.

scholarly journals Use of poppers and HIV risk behaviours among men who have sex with men in Paris, France: an observational study

Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 370 ◽  
Author(s):  
H. Rhodes Hambrick ◽  
Su Hyun Park ◽  
Joseph J. Palamar ◽  
Anthony Estreet ◽  
John A. Schneider ◽  
...  
Keyword(s):  
Relative Risk ◽  
Smartphone Application ◽  
Anal Intercourse ◽  
Relative Risk Ratio ◽  
Adjusted Relative Risk ◽  
Condomless Anal Intercourse ◽  
Hiv Seroconversion ◽  
Sex With Men ◽  
Group Sex ◽  
Sexually Transmissible Infection

The use of inhaled nitrites, or poppers, among men who have sex with men (MSM) is prevalent, yet has been associated with HIV seroconversion. We surveyed 580 MSM from a geosocial networking smartphone application in Paris, France, in 2016. Of the respondents, 46.7% reported popper use within the previous 3 months. Regression models adjusted for sociodemographic characteristics found that the use of poppers was significantly (P < 0.05) associated with the following during the prior 3 months: condomless anal intercourse (adjusted relative risk (aRR) 1.27, 95% confidence interval (CI) 1.07–1.50), use of alcohol and/or drugs during sex once or twice (adjusted relative risk ratio (aRRR) 2.33, 95% CI 1.44–2.03), three to five times (aRRR 5.41, 95% CI 2.98–9.84) or six or more times (aRRR 4.09, 95% CI 2.22–7.56), participation in group sex (aRRR 3.70, 95% CI 2.33–5.90) and self-reported diagnosis with any sexually transmissible infection over the previous year (aRR 1.63, 95% CI 1.18–2.27), specifically chlamydia (aRR 2.75, 95% CI 1.29–4.29) and syphilis (aRR 2.27, 95% CI 1.29–4.29).

Efficacité du pré-signalement d'arrêt scolaire avec feux jaunes et avec feux de détresse

2002 ◽  
Vol 29 (3) ◽  
pp. 475-483
Author(s):  
Jean-François Bruneau ◽  
Denis Morin ◽  
Marcel Pouliot
Keyword(s):  
Relative Risk ◽  
Risk Ratio ◽  
Relative Effectiveness ◽  
Video Camera ◽  
Efficiency Index ◽  
Relative Risk Ratio ◽  
School Bus ◽  
School Buses ◽  
Light System ◽  
Yellow Lights

The pre-stop warning is activated by the bus drivers to warn motorists that the school bus will soon stop, requiring all vehicles to stop. On buses equipped with an eight-light system, four yellow flashing lights, located near the roof, precede the four red flashing lights activated with the stop-arm. In Québec, where pre-stop warning is not required, it is permitted to use the "hazard lights" as a pre-stop signal, when the school bus has red lights only. This study rates the relative effectiveness of the two systems, in fall and spring time. Advance signal lights are tested on the same routes : two- and four-lane rural or near urban highways, with high posted speeds (70 km/h and over). A video camera is aimed at oncoming traffic along with a radar antenna. Changes in drivers' speeds are studied with a relative risk ratio and an efficiency index, validated through expected frequencies. The eight-light system reduced significantly the rate of illegal passing and the overall speed during advance signal. The eight-light system was more effective than the hazard lights for all tested parameters, including visibility, traffic, weather, and season. The near-roof position of the yellow lights probably explains the gap between the two systems.Key words: advance signalling device, pre-stop warning, eight-light system, amber lights, hazard lights, school buses, illegal passing, speed, relative risk ratio, road safety, rural area.

Determinants of unintended pregnancies among nursing mothers in southwest Nigeria

2020 ◽  
Vol 14 (2) ◽  
pp. 1-17
Author(s):  
Adebukunola Olajumoke Afolabi ◽  
Adenike Ayobola Olaogun ◽  
Kolade Afolayan Afolabi ◽  
Esther Kikelomo Afolabi
Keyword(s):  
Relative Risk ◽  
Unintended Pregnancy ◽  
Risk Ratio ◽  
Significant Risk ◽  
Relative Risk Ratio ◽  
Fisher Exact Test ◽  
Pregnancy Intentions ◽  
Unintended Pregnancies ◽  
Nursing Mothers ◽  
Southwest Nigeria

Background/aims Studies have identified risks for unintended pregnancies, globally and in Nigeria, which include ineffective contraception, strong opposition to family planning by partners, number of living children and birth interval. These factors have contributed to the increasing rate of unintended pregnancy and the high rate of induced abortion, with associated consequences such as obstetric haemorrhage, infection and increased maternal morbidity and mortality. However, there is a paucity of information regarding the influence of culture and religion on pregnancy intentions. This study aimed to examine the influence of culture, religion, sociodemographic characteristics, and reproductive characteristics on nursing mothers' perception of unintended pregnancy in southwest Nigeria. Methods This study used a sequential explanatory mixed-method approach, with both quantitative and qualitative elements. A conceptual hierarchical model was used to analyse the influence of three levels of characteristics (sociodemographic, religious and cultural, reproductive) on unintended pregnancy in southwest Nigeria. A total of 400 nursing mothers attending either a postnatal, immunisation, infant welfare or under-five clinic were selected via multistage sampling from primary healthcare centres. Quantitative data were collected from these participants using a semi-structured questionnaire, administered by a researcher. These data were analysed using both bivariate and multivariate analysis. First, they were analysed with either a chi-squared or Fisher exact test, then subjected to a regression model analysis. Qualitative data were collected and subjected to content analysis via focus group discussions with a total of 32 purposively selected participants. Results Approximately 36.5% participants reported their index pregnancy as being unintended. With regression analysis, age (25–34 years: relative risk ratio=0.42, P=0.02; 35–44 years: relative risk ratio=0.21, P=0.003), parity (relative risk ratio=10.38, P<0.00), ethnicity (relative risk ratio=0.13, P=0.002) and religion (relative risk ratio=0.26, P=0.048) were found to be significant risk factors for unintended pregnancy. Conclusions Age, parity, ethnicity and religion were the main determinants of unintended pregnancies. Intervention programmes should therefore be aware of these variables and address myths and misconceptions about pregnancy intentions.

Odds ratio—two properties rarely mentioned

2019 ◽  
pp. 69-73
Author(s):  
Steve Selvin
Keyword(s):  
Breast Cancer ◽  
Relative Risk ◽  
Risk Ratio ◽  
Cancer Incidence ◽  
Odds Ratio ◽  
Breast Cancer Incidence ◽  
Relative Risk Ratio ◽  
Military Women ◽  
Statistical Techniques

Two often confused statistical techniques are the odds ratio and relative risk ratio. These basic statistics are discussed and illustrated by contrasting risks from an analysis of breast cancer incidence among military women who served in Vietnam.

Relative-risk ratio was a useful measure of differential association in cohort and case-series studies

2007 ◽  
Vol 60 (4) ◽  
pp. 361-365 ◽  
Author(s):  
M.N. Hocine ◽  
P. Tubert-Bitter ◽  
T. Moreau ◽  
M. Chavance ◽  
E. Varon ◽  
...  
Keyword(s):  
Relative Risk ◽  
Risk Ratio ◽  
Case Series ◽  
Differential Association ◽  
Relative Risk Ratio

scholarly journals Disparities and relative risk ratio of preterm birth in six Central and Eastern European centers

2015 ◽  
Vol 56 (2) ◽  
pp. 119-127 ◽  
Author(s):  
Chander P Arora ◽  
Marian Kacerovsky ◽  
Balazs Zinner ◽  
Tibor Ertl ◽  
Iuliana Ceausu ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Relative Risk ◽  
Risk Ratio ◽  
Relative Risk Ratio ◽  
Eastern European

scholarly journals Previous Antibiotic Exposure Increases Risk of Infection with Extended-Spectrum-β-Lactamase- and AmpC-Producing Escherichia coli and Klebsiella pneumoniae in Pediatric Patients

2016 ◽  
Vol 60 (7) ◽  
pp. 4237-4243 ◽  
Author(s):  
Danielle M. Zerr ◽  
Arianna Miles-Jay ◽  
Matthew P. Kronman ◽  
Chuan Zhou ◽  
Amanda L. Adler ◽  
...  
Keyword(s):  
Relative Risk ◽  
Relative Risk Ratio ◽  
Adjusted Relative Risk ◽  
Third Generation ◽  
Beta Lactamase ◽  
Antibiotic Exposure ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

ABSTRACTThe objective of this study was to determine whether antibiotic exposure is associated with extended-spectrum-beta-lactamase- or AmpC-producingEscherichia coliorKlebsiella pneumoniaeinfections in children. We collected extended-spectrum-beta-lactamase- or AmpC-producingE. coliorK. pneumoniaeisolates and same-species susceptible controls from normally sterile sites of patients aged ≤21 years, along with associated clinical data, at four free-standing pediatric centers. After controlling for potential confounders, the relative risk of having an extended-spectrum-beta-lactamase-producing isolate rather than a susceptible isolate was 2.2 times higher (95% confidence interval [CI], 1.49 to 3.35) among those with antibiotic exposure in the 30 days prior to infection than in those with no antibiotic exposure. The results were similar when analyses were limited to exposure to third-generation cephalosporins, other broad-spectrum beta-lactams, or trimethoprim-sulfamethoxazole. Conversely, the relative risk of having an AmpC-producing versus a susceptible isolate was not significantly elevated with any antibiotic exposure in the 30 days prior to infection (adjusted relative risk ratio, 1.12; 95% CI, 0.65 to 1.91). However, when examining subgroups of antibiotics, the relative risk of having an AmpC-producing isolate was higher for patients with exposure to third-generation cephalosporins (adjusted relative risk ratio, 4.48; 95% CI, 1.75 to 11.43). Dose-response relationships between antibiotic exposure and extended-spectrum-beta-lactamase-producing or AmpC-producing isolates were not demonstrated. These results reinforce the need to study and implement pediatric antimicrobial stewardship strategies, and they indicate that epidemiological studies of third-generation cephalosporin-resistantE. coliandK. pneumoniaeisolates should include resistance mechanisms when possible.

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