Factors associated with initiation and use of snus among adolescents

Aim: We investigated factors associated with the initiation and continuation of snus use in adolescents in Norway. The associations with adolescents’ own educational plans, the parents’ educational level(s) and tobacco habits were estimated. Methods: In this cross-sectional questionnaire-based study, 1465 patients aged 18–20 years participated. The questionnaire was administered at regular dental examinations in the public dental health service. To assess the association between individual factors and the initiation of tobacco habits, a generalised structural equation model with random effects at the clinic level was used. Binary responses were modelled using multilevel binary logistic regression, while the number of snus boxes used per month was modelled using a multilevel Poisson regression model. Results: Of current (daily and occasional) tobacco users, 85% were snus users, including dual users of both snus and cigarettes. The median age of snus initiation was 16 years. Both parental snus use and smoking were associated with an increased risk of snus initiation, snus use and a higher amount of use. An increased risk of using snus was associated with male gender and with no educational plans or planning for further vocational education. The amount of snus used was higher among current snus users with a prior smoking history and among those planning for further vocational education. Conclusions: These findings may aid in developing and targeting tobacco prevention strategies aimed at young people. Tobacco prevention measures should start at the elementary school level. The strong association with parental tobacco habits underlines the importance of parents’ influence on their children’s tobacco use.

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Socioeconomic Variation of Multimorbidity in Colombian Older Adults

10.21203/rs.3.rs-234121/v1 ◽

2021 ◽

Author(s):

Silvia Marcela Ballesteros ◽

José Moreno-Montoya ◽

Wilhelmus Johannes Andreas Grooten ◽

Pedro Barrera-López ◽

José A. De la Hoz-Valle

Keyword(s):

Mortality Rate ◽

Rural Areas ◽

Urban Areas ◽

Structural Equation ◽

Strong Association ◽

High Body Mass Index ◽

Multidimensional Poverty ◽

The Elderly ◽

Cross Sectional ◽

Multidimensional Poverty Index

Abstract BackgroundMultimorbidity prevalence in the elderly is increasing worldwide. Variations regarding the socioeconomic characteristics of the individuals and their context have been described, mostly in high-income scenarios. This study aims to assess the magnitude and the socioeconomic factors associated with variations on multimorbidity in Colombia.MethodsA cross-sectional multilevel study with a nationally representative sample of 23 694 Colombian adults aged 60 years and older was conducted. Individual socioeconomic, demographic, childhood and health related characteristics, as well as group level variables (multidimensional poverty index and infectious diseases mortality rate) were analyzed. A two-level stepwise structural equation model was used to simultaneously adjust the individual and contextual effects. ResultsMultimorbidity prevalence was 62.3% (95% CI 61.7–62.9). In the multilevel adjusted models, age, female sex, having functional limitations, non-white ethnicity, high body mass index, higher income, physical inactivity, poverty during childhood and living in urban areas were associated with multimorbidity. The mediation analysis showed that living in rural areas was significantly associated with infectious disease mortality rate and other individual associations with multimorbidity were mediated by the multidimensional poverty variable. ConclusionsThis paper demonstrates a strong association between multimorbidity and poverty in a low-middle income country. Differences in the factors involved in the etiology of multimorbidity are expected among wealthy and poor countries regarding availability and prioritization of health services.

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Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon

Scientific Reports ◽

10.1038/s41598-021-00009-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Daniele Melo Sardinha ◽

Rosane do Socorro Pompeu de Loiola ◽

Ana Lúcia da Silva Ferreira ◽

Carmem Aliandra Freire de Sá ◽

Yan Corrêa Rodrigues ◽

...

Keyword(s):

Risk Factors ◽

Brazilian Amazon ◽

The State ◽

Metropolitan Region ◽

Epidemiological Surveillance ◽

Cross Sectional ◽

Factors Associated ◽

Risk Of Death ◽

Increased Risk ◽

Brazilian Amazon Region

AbstractThe Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.

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Faktor Determinan yang Berhubungan dengan Upaya Pengendalian Hipertensi di PSTW Budi Luhur Kota Jambi

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v9i2.222 ◽

2020 ◽

Vol 9 (2) ◽

pp. 234

Author(s):

Fithriyani Fithriyani ◽

Miko Eka Putri

Keyword(s):

Blood Pressure ◽

Elderly People ◽

The Elderly ◽

Smoking History ◽

Bivariate Analysis ◽

Projection Data ◽

Moderate Activity ◽

Cross Sectional ◽

Major Health Problem ◽

Increased Risk

Aging is a natural process that can not be avoided, running continuously, and continuously. Based on population projection data the number of elderly people will increase where the most number is found at the age of 60-64 years 94,012 people. Increasing age decreases bodily functions, decreased organ function and changes in blood pressure, therefore the elderly are advised to check their blood pressure regularly. As they age, blood pressure in the elderly will increase so that there is a higher risk of developing hypertension. Hypertension is a major health problem throughout the world, causing a high prevalence and is associated with an increased risk of cardiovascular disease. Some things that need to be considered in an effort to control hypertension include regular exercise, adequate rest, medical, traditional, regulate diet and reduce salt consumption one teaspoon per day. The purpose of this study was to determine the determinants and factors associated with efforts to control hypertension in the elderly at PSTW Budi Luhur, Jambi City. The research method uses descriptive analysis design with cross sectional approach. Samples were conducted for the elderly with hypertension. The research instrument was in the form of questionnaire sheets by interview. The results obtained 40% of elderly people have a history of smoking, 45% are quite good in consuming food, 60% elderly with moderate activity and 60% elderly are good in controlling hypertension. The results of bivariate analysis showed that there was no correlation between determinant factors (smoking history, food consumption, physical activity) and hypertension control efforts in the elderly in PSTW Budi Luhur, Jambi City

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Household Smoking Situations and Factors Associated with Smoking Cessation among Adult Men in Coastal Fishing Communities

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.01.11415 ◽

2021 ◽

Vol 104 (1) ◽

pp. 59-67

Keyword(s):

Smoking Cessation ◽

Adult Male ◽

Smoking Prevalence ◽

Smoking History ◽

Community Research ◽

Fishing Communities ◽

P Value ◽

Cross Sectional ◽

Factors Associated ◽

Quitting Smoking

Objective: To investigate household smoking situations and factors associated with cessation, focusing on adult male smokers in low socioeconomic coastal fishing communities in southern Thailand. Materials and Methods: An epidemiological community cross-sectional approach was conducted in 371 adult male smokers aged between 20 and 60 years. A self-administered questionnaire was applied to gather the data. Demographic characteristics, household smoking, smoking history, smoking behaviors, and pulmonary symptom data were collected by the community research assistants. Statistical computing was performed with R studio, and a p-value of less than 0.05 was considered significant. Results: The household smoking prevalence was 23.5%. Most smokers were categorized as having high pack-years, and the lowest age at first smoking was ten years old. Imitation and impetuous behaviors were the major leading causes of becoming a new smoker. The number of cigarettes smoked daily was the highest among individuals with more than 20 pack-years. Eighty-four-point-one percent of smokers desired to quit smoking for personal health reasons. Smokers in the 51 to 60 years age group were 49.62 times as likely as adolescents to cease smoking. Participants who first started smoking when they were older than 17 years of age had a 3.56-times higher chance of quitting smoking than those who started smoking when they were younger than 15 years of age (95% CI 1.51 to 8.37). Conclusion: The smoking situation in the coastal fishing communities of the southernmost provinces of Thailand is a worrisome problem. Smoking prevalence remains high, with prevalence increasing with age, and newer smokers starting at younger ages. A high proportion of smokers intended to cease smoking. Therefore, smoking cessation programs would be essential in the present study area. Keywords: Smoking situation, Cessation, Coastal fishing community, Southernmost Thailand

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Frailty and Anticoagulant Therapy in Patients Aged 65 Years or Older with Atrial Fibrillation

Cardiovascular Innovations and Applications ◽

10.15212/cvia.2019.0562 ◽

2020 ◽

Vol 4 (3) ◽

pp. 153-161

Author(s):

Jiapeng Liu ◽

Xin Du ◽

Mengmeng Li ◽

Zhaoxu Jia ◽

Shangxin Lu ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Anticoagulant Therapy ◽

Advanced Age ◽

Elderly Adults ◽

Clinical Frailty Scale ◽

Cross Sectional ◽

Factors Associated ◽

Frailty Status ◽

Increased Risk

Background: Elderly adults with atrial fibrillation (AF) are at increased risk of frailty and thromboembolic complications. However, studies on the prevalence of frailty in AF patients and data on the relationship between frailty and the use of anticoagulants are limited.Methods: We conducted a cross-sectional study involving 500 participants. Patients aged 65 years or older were consecutively selected from the Chinese Atrial Fibrillation Registry study. The patient’s frailty status was assessed with use of the Canadian Study of Health and Aging Clinical Frailty Scale. We assessed the prevalence of and factors associated with frailty, and how frailty affects anticoagulant therapy.Results: In 500 elderly adults with AF (age 75.2±6.7 years; 51.6% female), 201 patients (40.2%) were frail. The prevalence of frailty was higher in females (P=0.002) and increased with age and CHA2DS2-VASc score (P for trend less than 0.001 for both). The factors associated with frailty were a history of heart failure (odds ratio [OR] 2.40, 95% confidence interval [CI] 1.39‐4.14), female sex (OR 2.09, 95% CI 1.27‐3.43), and advanced age (OR 1.13, 95% CI 1.09‐1.17). Frail patients were significantly less likely to have ever been prescribed anticoagulants compared with nonfrail patients (81.7 vs. 54.9%, P<0.001).Conclusions: Frailty is prevalent in elderly adults with AF, especially in females, those of advanced age, and those with heart failure. Frailty status has a significant impact on prescription of anticoagulants for high-risk AF patients.

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A study of the factors affecting the receding age of onset of menarche in young girls

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182887 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2813

Author(s):

Noor Dharmarha ◽

Anuradha Konda

Keyword(s):

Age Of Onset ◽

Strong Association ◽

Simple Random Sampling ◽

Cross Sectional Study ◽

Age At Menarche ◽

P Value ◽

Cross Sectional ◽

Factors Associated ◽

Urban Indian ◽

Age Of Menarche

Background: Present study highlights that the worldwide trend of declining age at menarche is also seen in urban Indian girls. The aim of the study was to evaluate the age of menarche and to find out the factors associated with the timing of menarche.Methods: The study was an observational cross sectional study. 258 healthy, menstruating, adolescent girls aged 10-16 years, were selected by simple random sampling. Pre-designed structured questionnaires were distributed after taking informed consent. Anthropometric measurements were taken using standard techniques. The average age of menarche was calculated. The association of the age at menarche with the proposed factors was analyzed using chi square test and Pearson’s correlation coefficient. “P value” less than 0.05 was considered as significant.Results: The mean age at menarche was found to be 12.23±1.09 years. The study found a strong association between the respondent’s age at menarche and her sister’s age at menarche (p=0.002). The study also found a strong association between age at menarche and the socioeconomic status (p=0.021). This study however found no association of menarcheal age with factors like birth weight, type of diet, frequency of milk intake, body mass index, waist hip ratio, amount of exercise, unstable environment at home and psychosocial stress.Conclusions: The worldwide trend of declining age at menarche is also seen in urban Indian girls. This trend underlines the importance of investigating the factors associated with it and studying the future implications of a lower age at menarche.

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Factors associated with regression of cervical dysplasia in adolescents: A retrospective study

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.5582 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 5582-5582

Author(s):

C. Chen ◽

F. Campbell ◽

J. Patruno ◽

S. Kimmel ◽

R. Boulay ◽

...

Keyword(s):

Multivariate Analysis ◽

Pap Smear ◽

Demographic Data ◽

Cervical Dysplasia ◽

Smoking History ◽

Pap Smears ◽

Factors Associated ◽

Increased Risk ◽

Chi Square Analysis

5582 Background: Sexually active adolescents have high rates of infection with human papilloma virus (HPV) and abnormal pap smears. They are considered a special population as they are likely to regress to normal cytology. The aim of our study was to identify factors associated with regression of cervical dysplasia in adolescents. Methods: We identified adolescent patients (aged 12–21 years) who had abnormal pap smears at the Center for Women's Medicine at Lehigh Valley Hospital in Allentown, PA, by CPT code from a database between Jan 2004 and Dec 2006. A chart review was performed to capture demographic data, cytology, smoking history, number of sexual partners, parity, race, contraceptive choice, use of barrier contraception. Chi-square analysis with logistic regression and multivariate analysis were used to identify factors associated with regression of cervical dysplasia. Results: Two-hundred two patients were identified. Mean age was 18.84 years (14–22 years). One hundred twenty-two (57.8%) were Hispanic, 71 (33.6%) Caucasian, and 16 (7.6%) Black. Fifty-two (24.6%) were pregnant at the time of diagnosis. Seventy-six (36%) were smokers. There were 125 (61.9%) cases of ASCUS, 33.7% (68 cases) LGSIL and 4.5% (9 cases) HGSIL on initial pap smear. One hundred eighteen (55.9%) patients had colposcopy, and of these, 32 (15.2%) had surgical intervention. Follow-up demonstrated that 72 (57.6%) patients had disease regression, 24 (19.2%) persistence and 29 (23.2%) progression. On multivariate analysis, patients who did not smoke were significantly more likely to show regression of cervical dysplasia on pap smear than women who smoked (OR 2.17, 95% CI 1.03–4.55, p = 0.039). Other factors were not statistically significant in predicting regression of cervical dysplasia. Conclusions: Adolescents who smoke were more likely to have persistent cervical dysplasia than non-smoking adolescents, putting smokers at an increased risk of advanced disease. We suggest that this subset have follow-up at shorter intervals and be enrolled in a smoking cessation program. No significant financial relationships to disclose.

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Risk factors associated with a second primary lung cancer (SPLC) in patients (pts) with a previous initial primary lung cancer (IPLC).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e13166 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e13166-e13166

Author(s):

Misako Nagasaka ◽

Dina Farhat ◽

Kimberly Belzer ◽

Seongho Kim ◽

Hirva Mamdani ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Family History ◽

Surgical Resection ◽

Tobacco Use ◽

Primary Lung Cancer ◽

Smoking History ◽

Factors Associated ◽

Increased Risk ◽

First Diagnosis

e13166 Background: The risk for development of a SPLC after treatment of an IPLC is around 1% to 2% per pt per year. The aim of this study was to characterize the risk factors associated with the development of a SPLC. Methods: Pts registered in the Karmanos Cancer Institute Tumor Registry diagnosed with an IPLC between 2000 and 2017 were included in this study. Pts with an IPLC who later developed a SPLC were matched for age, histology and stage to pts with an IPLC who did not develop a SPLC. SPLC was defined as a second lung cancer with a different pathology or if the same pathology, anatomically, molecularly, or chronologically distinct. Six variables including: stage at IPLC, histology, family history, surgery as a primary treatment for IPLC, and smoking history (determined by pack years, and continued tobacco use after first diagnosis) were reviewed. Logistic and Cox regression analyses were performed to determine the relationship of these characteristics with the development of a SPLC, and their association with overall survival (OS). Results: 121 pts with IPLC who later developed an SPLC were identified and compared to 120 pts with IPLC who did not develop a SPLC. Logistic analyses did not show that stage at first diagnosis, histology, family history, smoking history, and continued tobacco use after first diagnosis to be relevant for increased risk of SPLC. Pts who were primarily treated with surgical resection had a significantly higher probability of developing a SPLC (Odds Ratio: 0.24, 95% CI: 0.12 to 0.48, p < 0.001). Pts who did not have surgical resection as their primary mode of treatment for IPLC had a significantly higher risk of death than those who received surgical resection (HR 3.02, 95% CI: 1.99 to 4.57; p < 0.001). Conclusions: Based on our findings, pts who had surgical resection for an IPLC were found to have improved OS and a higher possibility of developing a SPLC. Stage at first diagnosis of IPLC, histology, family history, smoking history and continued use of tobacco after first diagnosis did not correlate with increased risk for SPLC. These results warrant further investigation and if confirmed could have an impact on surveillance recommendations post resection of initial lung cancers.

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Factors Associated with Increased Risk for Clinical Insomnia in Patients with Postherpetic Neuralgia: A Retrospective Cross-Sectional Study

Pain Medicine ◽

10.1093/pm/pnw066 ◽

2016 ◽

Vol 17 (10) ◽

pp. 1917-1922 ◽

Cited By ~ 5

Author(s):

Dong Hoon Lee ◽

Ji Eun Park ◽

Duck Mi Yoon ◽

Kyung Bong Yoon ◽

Kiwook Kim ◽

...

Keyword(s):

Postherpetic Neuralgia ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Increased Risk

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Differential Psychological Factors Associated With Unnecessary Dental Avoidance and Attendance Behavior During the Early COVID-19 Epidemic

Frontiers in Psychology ◽

10.3389/fpsyg.2021.555613 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yi Feng Wen ◽

Peng Fang ◽

Jia-xi Peng ◽

Shengjun Wu ◽

Xufeng Liu ◽

...

Keyword(s):

Perceived Risk ◽

Psychological Factors ◽

Dental Treatment ◽

Bivariate Analysis ◽

Risk Of Infection ◽

Cross Sectional ◽

Treatment Need ◽

Factors Associated ◽

Dental Attendance ◽

Increased Risk

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 is challenging the dental community to an unprecedented degree. Knowledge of the increased risk of infection in dental settings has been disseminated to the public and guidelines have been formulated to assist dental attendance decision-making. However, dental attendance behaviors incompatible with treatment need is not uncommon in clinical settings. Important gaps remain in the knowledge about how psychological factors are affecting dental attendance behaviors during the COVID-19 epidemic. In this cross-sectional study, a questionnaire survey was performed during February and March 2020. A total of 342 and 294 dental patients who attended and avoided dental visits, respectively, were included. The participants were classified into four groups based on dental attendance behavior and emergent/urgent dental treatment need. Bivariate analysis was performed to investigate factors associated with dental attendance. Multivariable logistic regression based on principal component scores was performed to identify major psychological constructs associated with unnecessary dental avoidance and attendance. Among all the factors explored, inability to wear masks during dental treatment (P < 0.001; effect size: 0.32) was most closely associated with the overall pattern of dental attendance among participants. Multivariable regression suggested that unnecessary dental avoidance was associated with perceived risk of infection in general and in dental settings (odds ratio [95% CI]: 0.62 [0.53, 0.72]; p < 0.001), perceived impact of COVID-19 and dental problems on general health (0.79 [0.65, 0.97]; 0.021), and personal traits such as trust and anxiety (0.77 [0.61, 0.98]; 0.038). Unnecessary dental attendance was associated with optimism toward the epidemic (1.68 [1.42, 2.01]; <0.001) and trust (1.39 [1.13, 1.74]; 0.002). Multidisciplinary efforts involving dental and medical professionals as well as psychologists are warranted to promote more widespread adoption, among the general public, of dental attendance behaviors compatible with dental treatment need during the COVID-19 epidemic.

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