Non-cancer health risk assessment from exposure to cyanide by resident adults from the mining operations of Bogoso Gold Limited in Ghana.

Science.gov (United States)

Obiri, S; Dodoo, D K; Okai-Sam, F; Essumang, D K

2006-07-01

Cyanide is a very toxic chemical that is used to extract gold from its ores. Wastewaters from gold mining companies such as Bogoso Gold Limited (BGL) contain cyanide and other potentially toxic chemicals that have adverse effects on human beings and aquatic organisms. This study was conducted to evaluate the human health risk assessment from exposure to free cyanide via oral and dermal contact of surface/underground water by resident adults within the concession of Bogoso Gold Limited. The chronic non-cancer health risk from exposure to cyanide in River Bogo Upstream is 230 and 43 (by Central Tendency Exposure (CTE) parameters respectively). This means that approximately 230 and 43 resident adults are likely to suffer diseases related to cyanide intoxication via oral and dermal contact respectively. For chronic exposure to River Bogo Downstream by resident adults, the non-cancer health risks are: 0.031 and 0.57 via oral and dermal contact for CTE parameters respectively, which also means that, the non-cancer health risks associated with cyanide intoxication is negligible as the hazard index is less than 1.0 via oral and dermal contacts respectively. The results showed that health risk for acute exposure to cyanide by the resident adults is very high. Hence the residents attribute most of the unexplained deaths in the communities to accidental ingestion and dermal contact of cyanide water.

Depression Risk in Young Adults With Juvenile- and Adult-Onset Lupus: Twelve Years of Followup.

Science.gov (United States)

Knight, Andrea M; Trupin, Laura; Katz, Patricia; Yelin, Edward; Lawson, Erica F

2018-03-01

To compare major depression risk among young adults with juvenile-onset and adult-onset systemic lupus erythematosus (SLE), and to determine demographic and health-related predictors of depression. Young adults with SLE ages 18-45 years (n = 546) in the Lupus Outcomes Study completed annual telephone surveys from 2002-2015, including assessment of depression using the Center for Epidemiologic Studies Depression Scale (CES-D), and self-report measures of sociodemographics and health characteristics. Juvenile-onset SLE was defined as age adult-onset SLE. Older age, lower educational attainment, and physical function, higher disease activity, and a history of smoking were associated with an increased depression risk. Juvenile-onset SLE patients had a higher risk of major depression across all educational groups. Young adults with SLE, particularly those with juvenile-onset disease, are at high risk for major depression, which is associated with increased disease activity, poorer physical functioning, and lower educational attainment. Early depression intervention in young adults with SLE has the potential to improve both medical and psychosocial outcomes. © 2017, American College of Rheumatology.

Assessment of mercury health risks to adults from coal combustion

Energy Technology Data Exchange (ETDEWEB)

Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

1994-05-01

The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

The risk of eating disorders and bone health in young adults: the mediating role of body composition and fitness.

Science.gov (United States)

Garrido-Miguel, Miriam; Torres-Costoso, Ana; Martínez-Andrés, María; Notario-Pacheco, Blanca; Díez-Fernández, Ana; Álvarez-Bueno, Celia; García-Prieto, Jorge Cañete; Martínez-Vizcaíno, Vicente

2017-11-13

To analyze the independent relationship between the risk of eating disorders and bone health and to examine whether this relationship is mediated by body composition and cardiorespiratory fitness (CRF). In this cross-sectional study, bone-related variables, lean mass, fat mass (by DXA), risk of eating disorders (SCOFF questionnaire), height, weight, waist circumference and CRF were measured in 487 university students aged 18-30 years from the University of Castilla-La Mancha, Spain. ANCOVA models were estimated to test mean differences in bone mass categorized by body composition, CRF or risk of eating disorders. Subsequently, linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis. The marginal estimated mean ± SE values of total body bone mineral density for the categories "no risk of eating disorders" and "risk of eating disorders" were 1.239 ± 0.126 eating disorders and bone health in young adults. Body composition and CRF mediate the association between the risk of eating disorders and bone health. These findings highlight the importance of maintaining a healthy weight and good CRF for the prevention of the development of eating disorders and for the maintenance of good bone health in young adults. Level V, cross-sectional descriptive study.

Chronic Health Conditions as a Risk Factor for Falls among the Community-Dwelling US Older Adults: A Zero-Inflated Regression Modeling Approach

Directory of Open Access Journals (Sweden)

Yoshita Paliwal

2017-01-01

Full Text Available Falls are an important health concern among older adults due to age-related changes in the body. Having a medical history of chronic health condition may pose even higher risk of falling. Only few studies have assessed a number of chronic health conditions as risk factor for falls over a large nationally representative sample of US older adults. In this study, Behavioral Risk Factor Surveillance System (BRFSS 2014 participants aged 65 years and older (n = 159,336 were evaluated. It was found that 29.7% (n=44,550 of the sample experienced at least one fall and 16.3% (n=20,444 experienced more than one fall in the past 12 months. According to the study findings, having a medical history of stroke, CKD, arthritis, depression, and diabetes independently predict the risk of first-time falling as well as the risk of recurrent falling in older adult population while controlling for other factors. On the other hand, having a medical history of the heart attack, angina, asthma, and COPD did not predict the risk of first-time falling, but did predict the risk of recurrent falling after experiencing the first fall in this population.

Chronic Health Conditions as a Risk Factor for Falls among the Community-Dwelling US Older Adults: A Zero-Inflated Regression Modeling Approach.

Science.gov (United States)

Paliwal, Yoshita; Slattum, Patricia W; Ratliff, Scott M

2017-01-01

Falls are an important health concern among older adults due to age-related changes in the body. Having a medical history of chronic health condition may pose even higher risk of falling. Only few studies have assessed a number of chronic health conditions as risk factor for falls over a large nationally representative sample of US older adults. In this study, Behavioral Risk Factor Surveillance System (BRFSS) 2014 participants aged 65 years and older ( n = 159,336) were evaluated. It was found that 29.7% ( n = 44,550) of the sample experienced at least one fall and 16.3% ( n = 20,444) experienced more than one fall in the past 12 months. According to the study findings, having a medical history of stroke, CKD, arthritis, depression, and diabetes independently predict the risk of first-time falling as well as the risk of recurrent falling in older adult population while controlling for other factors. On the other hand, having a medical history of the heart attack, angina, asthma, and COPD did not predict the risk of first-time falling, but did predict the risk of recurrent falling after experiencing the first fall in this population.

Fall risk and prevention needs assessment in an older adult Latino population: a model community global health partnership.

Science.gov (United States)

Hanlin, Erin R; Delgado-Rendón, Angélica; Lerner, E Brooke; Hargarten, Stephen; Farías, René

2013-01-01

The impact of falls in older adults presents a significant public health burden. Fall risk is not well-described in Latino populations nor have fall prevention programs considered the needs of this population. The objectives of this study were to develop a needs assessment of falls in older adult Latinos at a community center (CC), determine fall prevention barriers and strengths in this population, determine the level of interest in various fall prevention methods, and provide medical students an opportunity for participation in a culturally diverse community project. A cross-sectional survey was conducted with a convenience sample of older adult program participants. The survey was developed in collaboration with both partners. CC participants were approached by the interviewer and asked to participate. They were read the survey in their preferred language and their answers were recorded. Data were analyzed using descriptive statistics. We conducted 103 interviews. We found that 54% of participants had fallen in the last year, and of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. Of all respondents, 52% had 5 or more of the 10 surveyed risk factors for falling; 4% had no risk factors. Of all respondents, 75% were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (78% and 65%, respectively). Older adult Latinos in this selected population frequently fall and are worried about falling. Risk factors are prevalent. A fall prevention program is warranted and should include exercise classes and a connection with local primary care providers. A partnership between an academic organization and a CC is an ideal collaboration for the future development of prevention program.

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for CVD Prevention in Adults with Risk Factors

Science.gov (United States)

Understanding Task Force Recommendations Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors The U.S. Preventive ...

Childhood height, adult height, and the risk of prostate cancer

DEFF Research Database (Denmark)

Bjerregaard, Lise Geisler; Aarestrup, Julie; Gamborg, Michael

2016-01-01

PURPOSE: We previously showed that childhood height is positively associated with prostate cancer risk. It is, however, unknown whether childhood height exerts its effects independently of or through adult height. We investigated whether and to what extent childhood height has a direct effect...... on the risk of prostate cancer apart from adult height. METHODS: We included 5,871 men with height measured at ages 7 and 13 years in the Copenhagen School Health Records Register who also had adult (50-65 years) height measured in the Danish Diet, Cancer and Health study. Prostate cancer status was obtained...... through linkage to the Danish Cancer Registry. Direct and total effects of childhood height on prostate cancer risk were estimated from Cox regressions. RESULTS: From 1996 to 2012, 429 prostate cancers occurred. Child and adult heights were positively and significantly associated with prostate cancer risk...

Menthol tobacco use is correlated with mental health symptoms in a national sample of young adults: implications for future health risks and policy recommendations

Directory of Open Access Journals (Sweden)

Amy M. Cohn

2016-01-01

Menthol is disproportionately used among young adults tobacco users with mental health problems, above and beyond the impact of a variety of other mental health and tobacco use risk factors. Findings suggest a strong link between menthol tobacco use and poor health outcomes. Policies should be developed to deter menthol tobacco use in vulnerable groups.

Selected Health Status Indicators and Behaviors of Young Adults, United States-2003

Science.gov (United States)

Eaton, Danice K.; Kann, Laura; Okoro, Catherine A.; Collins, Janet

2007-01-01

This study examined the prevalence of selected clinical preventive health services, health status indicators, health risk behaviors, and health-promoting behaviors among adults aged 18 to 24 years in the general U.S. population. The study analyzed data from the 2003 Behavioral Risk Factor Surveillance System. Nearly 30% of young adults lacked…

Social, Economic, and Health Disparities Among LGBT Older Adults.

Science.gov (United States)

Emlet, Charles A

2016-01-01

LGBT older adults are a heterogeneous population with collective and unique strengths and challenges. Health, personal, and economic disparities exist in this group when compared to the general population of older adults, yet subgroups such as transgender and bisexual older adults and individuals living with HIV are at greater risk for disparities and poorer health outcomes. As this population grows, further research is needed on factors that contribute to promoting health equity, while decreasing discrimination and improving competent service delivery.

Demographics, Health, and Risk Behaviors of Young Adults Who Drink Energy Drinks and Coffee Beverages

Science.gov (United States)

Kelly, Caitlin K.

2016-01-01

Objective: The present study investigates risk behaviors, sleep habits, and mental health factors associated with caffeinated beverage use in young adults. Materials and Methods: Students from a midsize private university (n = 159) completed a 15-minute anonymous questionnaire, including questions on risk behaviors, sleep habits, alcohol, and caffeine consumption. We compared behaviors between the top ∼15% (“high end”) of energy drink users (≥3/month) and coffee users (≥16/month) to those with less frequent or no caffeine consumption. Results: Caffeine consumption was frequent among young adults. In the last month, 36% of students had an energy drink, 69% had coffee or espresso, and 86% reported having any caffeine; however, the majority of students were unaware of the caffeine content in these beverages. High-end energy drink consumers reported more risk-taking behaviors (increased drug and alcohol use and less frequent seat belt use), sleep disturbances (later bedtimes, harder time falling asleep, and more all-nighters), and higher frequency of mental illness diagnoses than those who consumed fewer energy drinks. In contrast, the frequency of most risk behaviors, sleep disturbances, and mental illness diagnoses was not significantly different between the high-end and general population of coffee drinkers. Conclusion: Students with delayed sleep patterns, mental illness, and higher frequency of substance use and risk behaviors were more likely to be regular energy drink users but not regular coffee drinkers. It is unclear whether the psychoactive content in energy drinks results in different behavioral effects than just caffeine in coffee, and/or different personality/health populations are drawn to the two types of beverages. PMID:27274417

Prevalence of Elevated Cardiovascular Risks in Young Adults: A Cross-sectional Analysis of National Health and Nutrition Examination Surveys.

Science.gov (United States)

Patel, Krishna K; Taksler, Glen B; Hu, Bo; Rothberg, Michael B

2017-06-20

The 2013 cholesterol management guidelines from the American College of Cardiology and American Heart Association (ACC/AHA) recommend lipid screening in all adults older than 20 years to identify those at increased risk for atherosclerotic cardiovascular disease (ASCVD). Statins may be considered for patients with elevated 10-year risk (>5%) or a low-density lipoprotein cholesterol (LDL-C) level of 4.92 mmol/L (190 mg/dL) or greater. To describe the prevalence of elevated ASCVD risk among nondiabetic adults younger than 50 years. Cross-sectional. NHANES (National Health and Nutrition Examination Survey), 1999 to 2000 through 2011 to 2012. Adults aged 30 to 49 years without known ASCVD or diabetes. 10-year ASCVD risk was estimated by using the 2013 ACC/AHA ASCVD risk calculator. Participants were subdivided by age, sex, and history of smoking and hypertension. The percentages of adults in each subgroup with a 10-year ASCVD risk greater than 5% and of those with an LDL-C level of 4.92 mmol/L (190 mg/dL) or greater were estimated. Low-prevalence subgroups were defined as those in which a greater than 1% prevalence of elevated cardiovascular risk could be ruled out (that is, the upper 95% confidence bound for prevalence was ≤1%). Overall, 9608 NHANES participants representing 67.9 million adults were included, with approximately half (47.12%, representing 32 million adults) in low-prevalence subgroups. In the absence of smoking or hypertension, 0.09% (95% CI, 0.02% to 0.35%) of adult men younger than 40 years and 0.04% (CI, 0.0% to 0.26%) of adult women younger than 50 years had an elevated risk. Among other subgroups, 0% to 75.9% of participants had an increased risk. Overall, 2.9% (CI, 2.3% to 3.5%) had an LDL-C level of 4.92 mmol/L (190 mg/dL) or greater. No information was available regarding cardiovascular outcomes. In the absence of risk factors, the prevalence of increased ASCVD risk is low among women younger than 50 and men younger than 40 years. None.

An Investigation into the Lifestyle, Health Habits and Risk Factors of Young Adults

Directory of Open Access Journals (Sweden)

Yahya Al-Nakeeb

2015-04-01

Full Text Available This project examined the lifestyle, health habits and risk factors of young adults at Qatar University. It explored the clustering and differences in dietary habits, body mass index (BMI and physical activity (PA amongst male and female students, both Qatari and non-Qatari. Seven hundred thirty two students aged 18–25 years completed a self-reported questionnaire and an objective measure of BMI. Males and females had a high prevalence of being overweight and obesity and low levels of PA, according to well-established international standards. Three clusters were identified based on the students’ lifestyle and dietary habits. Cluster 1 (high risk factors included those who engaged the least in healthy dietary practices and consumed the most unhealthy foods, participated in less PA and had the highest BMI. Cluster 2 (moderate risk factors included those with considerably more habits falling into the moderate category, engagement in the most PA, the least TV and computer viewing time and had the lowest BMI. Cluster 3 (low risk factors included those who engaged the most with the four healthy dietary practices, the least with the four unhealthy dietary practices and participated in moderate PA per week. This project provides valuable data that could be used by policy makers to address issues concerning student’s health.

Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults

Directory of Open Access Journals (Sweden)

Shervin Assari

2016-09-01

Full Text Available Objectives: Despite the well-established association between self-rated health and mortality, research findings have been inconsistent regarding how men and women differ on this link. Using a national sample in the United States, this study compared American male and female older adults for the predictive role of baseline self-rated health on the short-term risk of mortality. Methods: This longitudinal study followed 1500 older adults (573 men (38.2% and 927 women (61.8% aged 66 years or older for 3 years from 2001 to 2004. The main predictor of interest was self-rated health, which was measured using a single item in 2001. The outcome was the risk of all-cause mortality during the 3-year follow-up period. Demographic factors (race and age, socio-economic factors (education and marital status, and health behaviors (smoking and drinking were covariates. Gender was the focal moderator. We ran logistic regression models in the pooled sample and also stratified by gender, with self-rated health treated as either nominal variables, poor compared to other levels (i.e. fair, good, or excellent or excellent compared to other levels (i.e. good, fair, or poor, or an ordinal variable. Results: In the pooled sample, baseline self-rated health predicted mortality risk, regardless of how the variable was treated. We found a significant interaction between gender and poor self-rated health, indicating a stronger effect of poor self-rated health on mortality risk for men compared to women. Gender did not interact with excellent self-rated health on mortality. Conclusion: Perceived poor self-rated health better reflects risk of mortality over a short period of time for older men compared to older women. Clinicians may need to take poor self-rated health of older men very seriously. Future research should test whether the differential predictive validity of self-rated health based on gender is due to a different meaning of poor self-rated health for older men

[Sexually transmitted diseases and other risks in the adult film industry].

Science.gov (United States)

Kluger, N

2014-02-01

The adult film industry nowadays represents a legal multi-billion dollar business. The main health risks of adult performers are well known. They mainly include the transmission of sexually transmitted diseases such as HIV, hepatitis, gonorrhoea, Chlamydia, herpes and papillomavirus. However, despite regular follow-up, the frequency of STD remains significant in this high-risk population since a large part of the industry continues to reject systematic use of condoms. Besides, performers are also exposed to other physical and mental health issues often not known to the public. This article provides a comprehensive review of what is known about STD and other risks among the community of performers in the adult film industry. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The relationship between physical ill-health and mental ill-health in adults with intellectual disabilities.

Science.gov (United States)

Dunham, A; Kinnear, D; Allan, L; Smiley, E; Cooper, S-A

2018-05-01

People with intellectual disabilities face a much greater burden and earlier onset of physical and mental ill-health than the general adult population. Physical-mental comorbidity has been shown to result in poorer outcomes in the general population, but little is known about this relationship in adults with intellectual disabilities. To identify whether physical ill-health is associated with mental ill-health in adults with intellectual disabilities and whether the extent of physical multi-morbidity can predict the likelihood of mental ill-health. To identify any associations between types of physical ill-health and mental ill-health. A total of 1023 adults with intellectual disabilities underwent comprehensive health assessments. Binary logistic regressions were undertaken to establish any association between the independent variables: total number of physical health conditions, physical conditions by International Classification of Disease-10 chapter and specific physical health conditions; and the dependent variables: problem behaviours, mental disorders of any type. All regressions were adjusted for age, gender, level of intellectual disabilities, living arrangements, neighbourhood deprivation and Down syndrome. The extent of physical multi-morbidity was not associated with mental ill-health in adults with intellectual disabilities as only 0.8% of the sample had no physical conditions. Endocrine disease increased the risk of problem behaviours [odds ratio (OR): 1.22, 95% confidence interval (CI): 1.02-1.47], respiratory disease reduced the risk of problem behaviours (OR: 0.73, 95% CI: 0.54-0.99) and mental ill-health of any type (OR: 0.73, 95% CI: 0.58-0.92), and musculoskeletal disease reduced the risk of mental ill-health of any type (OR: 0.84, 95% CI: 0.73-0.98). Ischaemic heart disease increased the risk of problem behaviours approximately threefold (OR: 3.29, 95% CI: 1.02-10.60). The extent of physical multi-morbidity in the population with intellectual

The Mental Health of Older LGBT Adults.

Science.gov (United States)

Yarns, Brandon C; Abrams, Janet M; Meeks, Thomas W; Sewell, Daniel D

2016-06-01

There are approximately one million older lesbian, gay, bisexual, and transgender (LGBT) adults in the USA. Their mental health issues result from interactions between genetic factors and stress associated with membership in a sexual minority group. Although advancements in acceptance and equal treatment of LGBT individuals have been occurring, sexual minority status remains associated with risks to physical and mental well-being. Older LGBT adults are more likely to have experienced mistreatment and discrimination due to living a majority of their lives prior to recent advancements in acceptance and equal treatment. All LGBT adults experience one common developmental challenge: deciding if, when, and how to reveal to others their gender identity and/or sexual orientation. LGBT individuals have higher rates of anxiety, depression, and substance use disorders and also are at increased risk for certain medical conditions like obesity, breast cancer, and human immunodeficiency virus (HIV). Improved education and training of clinicians, coupled with clinical research efforts, holds the promise of improved overall health and life quality for older LGBT adults.

Food Security and Cardiovascular Disease Risk Among Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2003?2008

OpenAIRE

Ford, Earl S.

2013-01-01

Introduction Little is known about the relationship between food security status and predicted 10-year cardiovascular disease risk. The objective of this study was to examine the associations between food security status and cardiovascular disease risk factors and predicted 10-year risk in a national sample of US adults. Methods A cross-sectional analysis using data from 10,455 adults aged 20 years or older from the National Health and Nutrition Examination Survey 2003?2008 was conducted. Fou...

Cigarette pack design and perceptions of risk among UK adults and youth.

Science.gov (United States)

Hammond, David; Dockrell, Martin; Arnott, Deborah; Lee, Alex; McNeill, Ann

2009-12-01

It is illegal in the EU for tobacco packaging to suggest that some cigarettes are safer than others. This study examined consumer perceptions of cigarette packs in the UK, including perceptions of 'plain packaging', in which colour and other design elements are removed, whilst retaining the brand name. 516 adult smokers and 806 youth aged 11-17 participated in an online survey. Participants were asked to compare pairs of cigarette packs on five measures: taste, tar delivery, health risk, attractiveness and either ease of quitting (adult smokers) or brand they would choose if trying smoking (youth). Adults and youth were significantly more likely to rate packs with the terms 'smooth', 'silver' and 'gold' as lower tar, lower health risk and either easier to quit smoking (adults) or their choice of pack if trying smoking (youth). For example, more than half of adults and youth reported that brands labelled as 'smooth' were less harmful compared with the 'regular' variety. The colour of packs was also associated with perceptions of risk and brand appeal: compared with Marlboro packs with a red logo, Marlboro packs with a gold logo were rated as lower health risk by 53% and easier to quit by 31% of adult smokers. Plain packs significantly reduced false beliefs about health risk and ease of quitting, and were rated as significantly less attractive and appealing to youth for trying smoking. Current regulations have failed to remove potentially misleading information from tobacco packaging. Removing colours from packs (plain packaging), as well as terms such as 'smooth' 'gold' and 'silver' would significantly reduce false beliefs and increase compliance with existing legislation.

Familial risk for lifestyle-related chronic diseases: can family health history be used as a motivational tool to promote health behaviour in young adults?

Science.gov (United States)

Prichard, I; Lee, A; Hutchinson, A D; Wilson, C

2015-08-01

Risk for colorectal cancer, breast cancer, heart disease and diabetes has both a familial and a lifestyle component. This quasi-experimental study aimed to determine whether a Family Health History (FHH) assessment and the subsequent provision of risk information would increase young adults' (17-29 years) intentions to modify health behaviours associated with the risk of these chronic diseases (i.e. alcohol consumption, fruit and vegetable intake and physical activity) and to talk to their family about their risk. After baseline measures of current and intended health-related behaviours, participants (n = 116) were randomly allocated to either a FHH assessment or control information. Based on the FHH provided, participants in the FHH condition were then classified as 'above-average risk' or 'average risk'. One week later, participants were provided with tailored health information and completed follow-up measures of intended health-related behaviours and perceived vulnerability. Participants classified as 'above-average risk' had increased perceptions of vulnerability to a chronic disease. Despite this, no group differences were found in intentions to change physical activity or fruit and vegetable consumption. Participants with above-average risk reported greater intentions to decrease the frequency of their alcohol consumption than average risk/control participants. In addition, completing a FHH assessment promoted intended communication with family members about chronic disease risk. FHH assessments may have the greatest value within the family context. SO WHAT? Future research could examine the impact of providing FHH information to different family members as a health promotion strategy.

An Adult Protective Services' view of collaboration with Mental Health Services.

Science.gov (United States)

Teaster, Pamela B; Stansbury, Kim L; Nerenberg, Lisa; Stanis, Patricia

2009-10-01

Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients.

Systematic Review of Yoga Interventions to Promote Cardiovascular Health in Older Adults.

Science.gov (United States)

Barrows, Jennifer L; Fleury, Julie

2016-06-01

The benefits of physical activity are well established, yet few older adults engage in adequate physical activity to optimize health. While yoga may reduce the risk of cardiovascular disease, few studies have focused on the efficacy of yoga-based physical activity to promote cardiovascular health in older adults. The objective of this review is to provide an evaluation of yoga interventions to reduce cardiovascular risk in older adults. Four databases were searched for randomized controlled trials of yoga interventions in older adults. Studies with cardiovascular outcomes were included. Literature searches identified nine articles eligible for review. Significant health benefits were reported, including favorable changes in blood pressure, body composition, glucose, and lipids. Yoga practices, participant characteristics, and outcome measures were variable. There was limited use of theory. Yoga is safe and feasible in older adults; additional research is warranted to examine the specific components of yoga interventions essential to reducing cardiovascular risk. © The Author(s) 2015.

Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services.

Science.gov (United States)

Solis, Guillermina R; Champion, Jane Dimmitt

2017-03-01

Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

Health conditions and lifestyle risk factors of adults living in Puerto Rico: a cross-sectional study.

Science.gov (United States)

Mattei, Josiemer; Tamez, Martha; Ríos-Bedoya, Carlos F; Xiao, Rui S; Tucker, Katherine L; Rodríguez-Orengo, José F

2018-04-12

Puerto Rico is experiencing an economic and healthcare crisis, yet there are scarce recent and comprehensive reports on the population's health profile. We aimed to describe prevalent risk factors and health conditions of adults living in Puerto Rico and assess their interrelationship. Participants (n = 380) aged 30-75y recruited from a 2015 convenience sample in primary care clinics in the San Juan, Puerto Rico metropolitan area answered cross-sectional interviewer-administered questionnaires on sociodemographic characteristics, lifestyle behaviors, self-reported medically-diagnosed diseases, health services, and psychosocial factors. Anthropometric measures were obtained. Logistic regression models assessed factors associated with having ≥2 cardiometabolic conditions or ≥ 2 chronic diseases. Most participants had completed ≥college education (57%), had household income diabetes (21%). Higher odds of having ≥2 cardiometabolic conditions (37%) was observed among participants aged ≥50y, with sedentary physical activity, and self-rated fair/poor diet. Odds of having ≥2 chronic diseases (62%) were higher among ≥50y, sleeping difficulties, > 2 h/day television, and self-rated fair/poor diet. Participants obtained (79%) and trusted (92%) health information from physicians. While most participants with a cardiometabolic condition reported receiving medical recommendations on diet (> 73%) and physical activity (> 67%), fewer followed them ( 73%). Participants following medical recommendations were more likely to report healthy vs. poor behaviors (90% vs. 75%, self-rated diet); (73% vs. 56%, physical activity). Adults living in Puerto Rico have multiple lifestyles risk factors and high prevalence of chronic diseases, namely cardiometabolic and psychological conditions. Comprehensive epidemiological studies are needed to identify contributors to chronic disease, including lifestyle behaviors. Concerted multi-level public health and clinical

Alcohol Consumption at Any Level Increases Risk of Injury Caused by Others: Data from the Study on Global AGEing and Adult Health

Directory of Open Access Journals (Sweden)

Thomas Clausen

2015-01-01

Full Text Available Background Alcohol use is a well-known risk factor for injury. However, information is needed about alcohol drinking patterns and the risk of injury among older adults in low- and middle-income countries as this population grows. We aimed to examine the influence of drinking patterns on the burden of injury and investigate factors associated with different types of injury in older populations in six emerging economies. Methods Data from more than 37,0 adults aged 50 years and older were included from the Study on Global AGEing and Adult Health (SAGE Wave 1 conducted in six emerging economies, namely, China, Ghana, India, Mexico, Russia, and South Africa. We investigated past-year reported injuries from falls, traffic accidents, and being hit or stabbed. Alcohol drinking patterns were measured as lifetime abstinence, ever but not past- week use, and gender-specific past-week low-risk and high-risk use. We stratified by gender and used logistic regression models to observe the association between alcohol drinking pattern and risk of injury by controlling for other factors. Results During the year prior to interview, 627 (2.2% subjects reported bodily injury resulting from a car accident, 1,156 (4.2% from a fall, and 339 (.9% from being hit or stabbed during the past year. For women, only being a high-risk drinker increased the risk of being hit or stabbed, whereas for men, all levels of drinking were associated with an increased risk of being hit or stabbed. We observed a higher risk of being hit or stabbed from past-week high-risk drinking among women (odds ratio [OR] = 6.09, P < 0.01 than among men (OR = 3.57, P < 0.01. We observed no association between alcohol drinking pattern and injury due to car accidents for either women or men. Conclusions The risk of experiencing injury due to violence increased with level of alcohol exposure of the victim. The increase in alcohol use in emerging economies calls for further study into the consequences of

Risk factors for falls and fall-related injuries in adults 85 years of age and older.

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Grundstrom, Anna C; Guse, Clare E; Layde, Peter M

2012-01-01

Falls are a leading cause of morbidity and mortality in older adults. No previous studies on risk factors for falls have focused on adults 85 years and older, the most rapidly growing segment of adults. We examined demographic, health, and behavioral risk factors for falls and fall-related injuries in adults 65 years and older, with a particular focus on adults 85 years and older. We analyzed self-reported information from the Behavioral Risk Factor Surveillance System (BRFSS) for 2008. Data was available for 120,923 people aged 65 or older and 12,684 people aged 85 or older. Of those aged 85 or older, 21.3% reported at least one fall in the past 3 months and 7.2% reported at least one fall related injury requiring medical care or limiting activity for a day or longer. Below average general health, male sex, perceived insufficient sleep, health problems requiring assistive devices, alcohol consumption, increasing body mass index and history of stroke were all independently associated with a greater risk of falls or fall related injuries. The greater risk of falling in those 85 years and older appeared to be due to the deterioration of overall health status with age; among those with excellent overall health status, there was no greater risk of falling in adults 85 years and older compared to those 65-84 years of age. Our results suggest that those with risk factors for falls and fall-related injuries may be appropriate targets for evidence-based fall prevention programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

International classification of function, disability and health framework for fall risk stratification in community dwelling older adults

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Majumi M. Noohu

2017-05-01

Full Text Available Falls is an important cause for mortality and morbidity in older adults. The fall risk assessment is an integral component of fall prevention in older adults. The international classification of function, disability and health (ICF can be an ideal comprehensive model for fall risk assessment. There is lack of information relating ICF and fall risk assessment in community dwelling older adults. In this study we tried to assess the fall risk using different domains of ICF using various clinical tools. A total of 255 subjects were recruited through convenient sampling method from geriatric clinic (OPD of All India Institute of Medical Sciences, New Delhi. The study was single session cross-section design. The body mass index (BMI, grip strength, depression score (Geriatric depression scale:short form; GDS-S and co morbidities were used to assess body function and structure domain, timed up and go (TUG, Berg balance scale (BBS and elderly fall screening test (EFST scores were used for activity domain, selfreported cause of fall, medications and uses of assistive device for environmental factors. Then the association of body function and structure, activity and environmental factors were determined with falls. There was an association of fall in analysis in subjects with no fall and one or more falls for, BMI, grip strength (kg, GDS-S score, no. of co morbidities, chronic pain, TUG, BBS, TUG (s, BBS, EFST, slip/trip, walking cane, hypoglycemic and antihypertensives medications (unadjusted and adjusted odds ratio.The diabetes, and hyper tension showed association for adjusted odds ratio only. In subjects with one fall and more than one fall, TUG, BBS, EFST, GDS-S score, NSAIDS and antidepressants use showed a significant association with fall (unadjusted and adjusted odds ratio. The ICF may be used in routine for fall risk assessment in community dwelling older adults.

Do Sedentary Behaviors Modify the Health Status of Older Adults?

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Elizabeth K. Lenz

2014-01-01

Full Text Available Evidence suggests sedentary behavior (SB negatively impacts the health of adults but less is known about SB impact on older adult (OA health.  Seventy OA (73.4±6years living in the southeast region of Wisconsin, United States of America (USA completed three SB diaries and had risk factors associated with cardiovascular disease (CVD assessed. Sedentary behaviors were quantified as time spent in sitting/lying activities. Pearson correlation coefficients, independent samples t-tests, and one-way ANOVA were performed to explore the relationship between SB and health. Older adults engaged in 620.3±91.2mins/d of SB with television watching (144.3±99.8mins/d being the most prominent. Total SB and television watching were correlated to multiple risk factors for CVD (r=-.241-.415, p=.009-.027 and these variables worsened as OA spent more time in those activities. Television watching was the only SB that increased across risk categories of CVD [F (2,67 =4.158, p=.020, eta squared=.11]. These results suggest SB, especially television watching to be related to risk factors of CVD in OA.

Risk Factors for Incident Carotid Artery Revascularization among Older Adults: The Cardiovascular Health Study

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Parveen K. Garg

2016-11-01

Full Text Available Background: Population-based risk factors for carotid artery revascularization are not known. We investigated the association between demographic and clinical characteristics and incident carotid artery revascularization in a cohort of older adults. Methods: Among Cardiovascular Health Study participants, a population-based cohort of 5,888 adults aged 65 years or older enrolled in two waves (1989-1990 and 1992-1993, 5,107 participants without a prior history of carotid endarterectomy (CEA or cerebrovascular disease had a carotid ultrasound at baseline and were included in these analyses. Cox proportional hazards multivariable analysis was used to determine independent risk factors for incident carotid artery revascularization. Results: Over a mean follow-up of 13.5 years, 141 participants underwent carotid artery revascularization, 97% were CEA. Baseline degree of stenosis and incident ischemic cerebral events occurring during follow-up were the strongest predictors of incident revascularization. After adjustment for these, factors independently associated with an increased risk of incident revascularization were: hypertension (HR 1.53; 95% CI: 1.05-2.23, peripheral arterial disease (HR 2.57; 95% CI: 1.34-4.93, and low-density lipoprotein cholesterol (HR 1.23 per standard deviation [SD] increment [35.4 mg/dL]; 95% CI: 1.04-1.46. Factors independently associated with a lower risk of incident revascularization were: female gender (HR 0.51; 95% CI: 0.34-0.77 and older age (HR 0.69 per SD increment [5.5 years]; 95% CI: 0.56-0.86. Conclusions: Even after accounting for carotid stenosis and incident cerebral ischemic events, carotid revascularization is related to age, gender, and cardiovascular risk factors. Further study of these demographic disparities and the role of risk factor control is warranted.

Concordance of Motion Sensor and Clinician-Rated Fall Risk Scores in Older Adults.

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Elledge, Julie

2017-12-01

As the older adult population in the United States continues to grow, developing reliable, valid, and practical methods for identifying fall risk is a high priority. Falls are prevalent in older adults and contribute significantly to morbidity and mortality rates and rising health costs. Identifying at-risk older adults and intervening in a timely manner can reduce falls. Conventional fall risk assessment tools require a health professional trained in the use of each tool for administration and interpretation. Motion sensor technology, which uses three-dimensional cameras to measure patient movements, is promising for assessing older adults' fall risk because it could eliminate or reduce the need for provider oversight. The purpose of this study was to assess the concordance of fall risk scores as measured by a motion sensor device, the OmniVR Virtual Rehabilitation System, with clinician-rated fall risk scores in older adult outpatients undergoing physical rehabilitation. Three standardized fall risk assessments were administered by the OmniVR and by a clinician. Validity of the OmniVR was assessed by measuring the concordance between the two assessment methods. Stability of the OmniVR fall risk ratings was assessed by measuring test-retest reliability. The OmniVR scores showed high concordance with the clinician-rated scores and high stability over time, demonstrating comparability with provider measurements.

Differences in risk aversion between young and older adults

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Albert SM

2012-02-01

Full Text Available Steven M Albert1, John Duffy21Department of Behavioral and Community Health Sciences, 2Department of Economics, University of Pittsburgh, Pittsburgh, PA, USAAbstract: Research on decision-making strategies among younger and older adults suggests that older adults may be more risk averse than younger people in the case of potential losses. These results mostly come from experimental studies involving gambling paradigms. Since these paradigms involve substantial demands on memory and learning, differences in risk aversion or other features of decision making attributed to age may in fact reflect age-related declines in cognitive abilities. In the current study, older and younger adults completed a simpler, paired lottery choice task used in the experimental economics literature to elicit risk aversion. A similar approach was used to elicit participants' discount rates. The older adult group was more risk averse than the younger (P < 0.05 and had a higher discount rate (15.6%–21.0% versus 10.3%–15.5%, P < 0.01, indicating lower expected utility from future income. Risk aversion and implied discount rates were weakly correlated. It may be valuable to investigate developmental changes in neural correlates of decision making across the lifespan.Keywords: aging, decision making, risk, time preference, behavioral economics

Can an Internet-based health risk assessment highlight problems of heart disease risk factor awareness? A cross-sectional analysis.

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Dickerson, Justin B; McNeal, Catherine J; Tsai, Ginger; Rivera, Cathleen M; Smith, Matthew Lee; Ohsfeldt, Robert L; Ory, Marcia G

2014-04-18

Health risk assessments are becoming more popular as a tool to conveniently and effectively reach community-dwelling adults who may be at risk for serious chronic conditions such as coronary heart disease (CHD). The use of such instruments to improve adults' risk factor awareness and concordance with clinically measured risk factor values could be an opportunity to advance public health knowledge and build effective interventions. The objective of this study was to determine if an Internet-based health risk assessment can highlight important aspects of agreement between respondents' self-reported and clinically measured CHD risk factors for community-dwelling adults who may be at risk for CHD. Data from an Internet-based cardiovascular health risk assessment (Heart Aware) administered to community-dwelling adults at 127 clinical sites were analyzed. Respondents were recruited through individual hospital marketing campaigns, such as media advertising and print media, found throughout inpatient and outpatient facilities. CHD risk factors from the Framingham Heart Study were examined. Weighted kappa statistics were calculated to measure interrater agreement between respondents' self-reported and clinically measured CHD risk factors. Weighted kappa statistics were then calculated for each sample by strata of overall 10-year CHD risk. Three samples were drawn based on strategies for treating missing data: a listwise deleted sample, a pairwise deleted sample, and a multiple imputation (MI) sample. The MI sample (n=16,879) was most appropriate for addressing missing data. No CHD risk factor had better than marginal interrater agreement (κ>.60). High-density lipoprotein cholesterol (HDL-C) exhibited suboptimal interrater agreement that deteriorated (eg, κInternet-based health risk assessments such as Heart Aware may contribute to public health surveillance, but they must address selection bias of Internet-based recruitment methods.

A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults.

Science.gov (United States)

Rice, Laura A; Ousley, Cherita; Sosnoff, Jacob J

2015-01-01

To systematically review peer-reviewed literature pertaining to risk factors, outcome measures and interventions managing fall risk in non-ambulatory adults. Twenty-one papers were selected for inclusion from databases including PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Consumer Health Complete and Web of Science. Selected studies involved a description of fall related risk factors, outcomes to assess fall risk and intervention studies describing protocols to manage fall risk in non-ambulatory adults. Studies were selected by two reviewers and consultation provided by a third reviewer. The most frequently cited risk factors/characteristics associated with falls included: wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. The majority of the outcomes were found to evaluate seated postural control. One intervention study was identified describing a protocol targeting specific problems of individual participants. A global fall prevention program was not identified. Several risk factors associated with falls were identified and must be understood by clinicians to better serve their clients. To improve objective assessment, a comprehensive outcome assessment specific to non-ambulatory adults is needed. Finally, additional research is needed to examine the impact of structured protocols to manage fall risk in non-ambulatory adults. Falls are a common health concern for non-ambulatory adults. Risk factors commonly associated with falls include wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. Limited outcome measures are available to assess fall risk in non-ambulatory adults. Clinicians must be aware of the known risk factors and provide comprehensive education to their clients on the potential for falls. Additional research is needed to develop and evaluate protocols to clinically manage fall

Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE).

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Stewart Williams, Jennifer; Kowal, Paul; Hestekin, Heather; O'Driscoll, Tristan; Peltzer, Karl; Yawson, Alfred; Biritwum, Richard; Maximova, Tamara; Salinas Rodríguez, Aarón; Manrique Espinoza, Betty; Wu, Fan; Arokiasamy, Perianayagam; Chatterji, Somnath

2015-06-23

In 2010 falls were responsible for approximately 80 % of disability stemming from unintentional injuries excluding traffic accidents in adults 50 years and over. Falls are becoming a major public health problem in low- and middle-income countries (LMICs) where populations are ageing rapidly. Nationally representative standardized data collected from adults aged 50 years and over participating in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 in China, Ghana, India, Mexico, the Russian Federation and South Africa are analysed. The aims are to identify the prevalence of, and risk factors for, past-year fall-related injury and to assess associations between fall-related injury and disability. Regression methods are used to identify risk factors and association between fall-related injury and disability. Disability was measured using the WHO Disability Assessment Schedule Version 2.0 (WHODAS 2.0). The prevalence of past-year fall-related injuries ranged from 6.6 % in India to 1.0 % in South Africa and was 4.0 % across the pooled countries. The proportion of all past-year injuries that were fall-related ranged from 73.3 % in the Russian Federation to 44.4 % in Ghana. Across the six countries this was 65.7 %. In the multivariable logistic regression, the odds of past-year fall-related injury were significantly higher for: women (OR: 1.27; 95 % CI: 0.99,1.62); respondents who lived in rural areas (OR: 1.36; 95 % CI: 1.06,1.75); those with depression (OR: 1.43; 95 % CI: 1.01,2.02); respondents who reported severe or extreme problems sleeping (OR: 1.54; 95 % CI: 1.15,2.08); and those who reported two or more (compared with no) chronic conditions (OR: 2.15; 95 % CI: 1.45,3.19). Poor cognition was also a significant risk factor for fall-related injury. The association between fall-related injury and the WHODAS measure of disability was highly significant (Prisk factors for falls in older adults in this group of LMICs. Clinicians and

Prevalence of 10-Year Risk of Cardiovascular Diseases and Associated Risks in Canadian Adults: The Contribution of Cardiometabolic Risk Assessment Introduction

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Solmaz Setayeshgar

2013-01-01

Full Text Available Background. Cardiovascular disease (CVD is the leading cause of death in adult Canadians. Cardiometabolic risk (CMR derived from 10-year risk of cardiovascular diseases and metabolic syndrome (MetS needs to be evaluated in Canadian adults. Objective. To determine CMR among Canadian adults by sociodemographic and lifestyle characteristics. Subjects and Methods. Data from the Canadian Health Measures Survey (CHMS, Cycle 1, 2007–2009, was used. Framingham Risk Score (FRS was implemented to predict 10-year risk of CVD, and metabolic syndrome was identified using the most recent criteria. The 10-year risk of CVD was multiplied by 1.5 in individuals with MetS to obtain CMR. Data were weighted and bootstrapped to be able to generalize the results nationally. Results and Conclusion. CMR gave more accurate estimation of 10-year risk of CVD in Canadian adults from 30 to 74 years than using only FRS. The 10-year risk of CVD in Canadian adults significantly increased when CMR was taken into account from 8.10% to 9.86%. The CVD risk increased by increase in age, decrease in education, and decrease in physical activity and in smokers. Canadians with medium risk of CVD consumed significantly less fruit and vegetable juice compared to Canadians with low risk. No other dietary differences were found.

Long-term exercise adherence after public health training in at-risk adults

DEFF Research Database (Denmark)

Riktrup Hansen Saida, Trine Gro; Juul Sørensen, Tina; Langberg, Henning

2017-01-01

and self-rated health. Predictors of long-term exercise adherence were assessed by logistic regression, estimating crude odds-ratios (OR) and 95% confidence intervals (95% CIs) and adjusting for age, gender, education, smoking, moderate and vigorous exercise. Results: In total, 214 adults (mean age 58......Objectives: Sustainment of healthy exercise behavior is essential in preventing cardiovascular disease and diabetes. Few studies have explored long-term exercise adherence after an exercise referral scheme. The objective of this study was to examine 12-month exercise adherence after an exercise...... intervention program. Methods: This was a pragmatic follow-up study in at-risk people performed between June 2012 and January 2014. The main outcome measure was self-reported single-item exercise adherence. Secondary outcomes were change in exercise level, quality of life rated on a visual analog scale...

Sleep duration and risk of stroke mortality among Chinese adults: Singapore Chinese health study.

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Pan, An; De Silva, Deidre Anne; Yuan, Jian-Min; Koh, Woon-Puay

2014-06-01

Prospective relation between sleep duration and stroke risk is less studied, particularly in Asians. We examined the association between sleep duration and stroke mortality among Chinese adults. The Singapore Chinese Health Study is a population-based cohort of 63 257 Chinese adults aged 45 to 74 years enrolled during 1993 through 1998. Sleep duration at baseline was assessed via in-person interview, and death information during follow-up was ascertained via record linkage with the death registry up to December 31, 2011. Cox proportional hazard models were used to calculate hazard ratios with adjustment for other comorbidities and lifestyle risk factors of stroke mortality. During 926 752 person-years of follow-up, we documented 1381 stroke deaths (322 from hemorrhagic and 1059 from ischemic or nonspecified strokes). Compared with individuals with 7 hours per day of sleep, the multivariate-adjusted hazard ratio (95% confidence interval) of total stroke mortality was 1.25 (1.05-1.50) for ≤5 hours per day (short duration), 1.01 (0.87-1.18) for 6 hours per day, 1.09 (0.95-1.26) for 8 hours per day, and 1.54 (1.28-1.85) for ≥9 hours per day (long duration). The increased risk of stroke death with short (1.54; 1.16-2.03) and long durations of sleep (1.95; 1.48-2.57) was seen among subjects with a history of hypertension, but not in those without hypertension. These findings were limited to risk of death from ischemic or nonspecified stroke, but not observed for hemorrhagic stroke. Both short and long sleep durations are associated with increased risk of stroke mortality in a Chinese population, particularly among those with a history of hypertension. © 2014 American Heart Association, Inc.

Improving nursing students' assessment of fall risk in community-dwelling older adults.

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Patton, Susan K

2016-12-09

Nationally, approximately one third of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence-based protocols by health care providers to identify older adults at risk of falling is limited, and rates of participation by older adults in prevention activities is low. Because of nursing's increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community-dwelling older adults and increased access of older adults to falls risk assessment. There is a need to extend research to inform teaching and learning strategies for fall prevention. After pretesting, a convenience sample of 52 undergraduate nursing students and 22 graduate nursing students completed an online education program and performed a falls risk assessment on an older adult. After completing the clinical assignment, students completed a posttest and self-efficacy survey. Data were analyzed using multivariate statistical tests. Results revealed an increase in knowledge and student self-reporting of efficacy of fall risk assessment skills for the older adult population. This study suggests that nursing students acquired the necessary knowledge and self-efficacy for assessing fall risk of older adults through the combination of an online learning module and participating in actual fall risk assessment of an older adult.

YOUNG ADULT DATING RELATIONSHIPS AND THE MANAGEMENT OF SEXUAL RISK.

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Manning, Wendy D; Giordano, Peggy C; Longmore, Monica A; Flanigan, Christine M

2012-04-01

Young adult involvement in sexual behavior typically occurs within a relationship context, but we know little about the ways in which specific features of romantic relationships influence sexual decision-making. Prior work on sexual risk taking focuses attention on health issues rather than relationship dynamics. We draw on data from the Toledo Adolescent Relationships Study (TARS) (n = 475) to examine the association between qualities and dynamics of current/most recent romantic relationships such as communication and emotional processes, conflict, demographic asymmetries, and duration and the management of sexual risk. We conceptualize 'risk management' as encompassing multiple domains, including (1) questioning the partner about previous sexual behaviors/risks, (2) using condoms consistently, and (3) maintaining sexual exclusivity within the relationship. We identify distinct patterns of risk management among dating young adults and find that specific qualities and dynamics of these relationships are linked to variations in risk management. Results from this paper suggest the need to consider relational dynamics in efforts to target and influence young adult sexual risk-taking and reduce STIs, including HIV.

YOUNG ADULT DATING RELATIONSHIPS AND THE MANAGEMENT OF SEXUAL RISK

Science.gov (United States)

Manning, Wendy D.; Giordano, Peggy C.; Longmore, Monica A.; Flanigan, Christine M.

2012-01-01

Young adult involvement in sexual behavior typically occurs within a relationship context, but we know little about the ways in which specific features of romantic relationships influence sexual decision-making. Prior work on sexual risk taking focuses attention on health issues rather than relationship dynamics. We draw on data from the Toledo Adolescent Relationships Study (TARS) (n = 475) to examine the association between qualities and dynamics of current/most recent romantic relationships such as communication and emotional processes, conflict, demographic asymmetries, and duration and the management of sexual risk. We conceptualize ‘risk management’ as encompassing multiple domains, including (1) questioning the partner about previous sexual behaviors/risks, (2) using condoms consistently, and (3) maintaining sexual exclusivity within the relationship. We identify distinct patterns of risk management among dating young adults and find that specific qualities and dynamics of these relationships are linked to variations in risk management. Results from this paper suggest the need to consider relational dynamics in efforts to target and influence young adult sexual risk-taking and reduce STIs, including HIV. PMID:23805015

Social risk factors for falls among rural Nigerian community-dwelling older adults.

Science.gov (United States)

Maruf, Fatai Adesina; Muonwe, Chidile; Odetunde, Marufat

2016-06-01

Reports on social risk factors for falls are scarce. This study explored the associations of selected sociodemographic and health variables with falls among rural Nigerian community-dwelling older adults. The present cross-sectional study involved 131 community-dwelling older adults (84 women and 47 men) recruited at an outreach center. Demographic (age, sex and marital status), social (frequency of visiting relations and friends, and number of consistent informal carers) and health (number of comorbid conditions) variables were recorded. Having fewer than two informal carers (0.26, 95% CI 0.10-0.68) was independently associated with reduced risk for falls. Visiting relations and friends less than twice per week was independently associated with greater risks for falls (3.85, 95% CI 1.42-10.46) and recurrent falls (4.86, 95% CI 1.25-18.85). The number of informal carers and frequency of social visits are risk factors for falls in older adults, and need to be taken into consideration in any strategy for fall prevention in older adults. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

Dietary Pattern during 1991–2011 and Its Association with Cardio Metabolic Risks in Chinese Adults: The China Health and Nutrition Survey

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Ming Li

2017-11-01

Full Text Available Increased prevalence of overweight and obesity, diabetes, hypertension, and other cardio metabolic risks has become a public health concern in China, a country undergoing nutrition transition. We investigated the dietary pattern during 1991–2011 and its association with these risks in a longitudinal study among adults; Adults in The China Health and Nutrition Survey were included. Three-day food consumption was collected by 24 h recall method. Anthropometric measures, blood pressure, fasting blood glucose and lipids was collected in 2009. Dietary pattern was generated using principal components analysis. The associations between dietary pattern and cardio metabolic risk were assessed with generalized linear regression adjusted for age, sex, and social economic status (SES. “Traditional” pattern loaded with rice, meat, and vegetables, and “Modern” pattern had high loadings of fast food, milk, and deep-fried food. “Traditional” pattern was inversely associated with cardio metabolic risks, with linear slopes ranging from −0.15 (95% confidence interval (CI: −0.18, −0.12 for hypertension to −0.67 (95% CI: −0.73, −0.60 for impaired glucose control. “Modern” pattern was associated positively with those factors, with slopes ranging 0.10 (95% CI: 0.04, 0.17 for high cholesterol to 0.42 (95% CI: 0.35, 0.49 for impaired glucose control. Dietary patterns were associated with cardio metabolic risk in Chinese adults.

Testing the efficacy of a brief sexual risk reduction intervention among high-risk American Indian adults: study protocol for a randomized controlled trial

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Rachel Chambers

2016-04-01

Full Text Available Abstract Background American Indian adults are more likely to experience co-occurring mental health and substance use disorders than adults of other racial/ethnic groups and are disproportionately burdened by the most common sexually transmitted infections, namely chlamydia and gonorrhea. Several behavioral interventions are proven efficacious in lowering risk for sexually transmitted infection in various populations and, if adapted to address barriers experienced by American Indian adults who suffer from mental health and substance use problems, may be useful for dissemination in American Indian communities. The proposed study aims to examine the efficacy of an adapted evidence-based intervention to increase condom use and decrease sexual risk-taking and substance use among American Indian adults living in a reservation-based community in the Southwestern United States. Methods/Design The proposed study is a randomized controlled trial to test the efficacy of an adapted evidence-based intervention compared to a control condition. Participants will be American Indian adults ages 18–49 years old who had a recent episode of binge substance use and/or suicide ideation. Participants will be randomized to the intervention, a two-session risk-reduction counseling intervention or the control condition, optimized standard care. All participants will be offered a self-administered sexually transmitted infection test. Participants will complete assessments at baseline, 3 and 6 months follow-up. The primary outcome measure is condom use at last sex. Discussion This is one of the first randomized controlled trials to assess the efficacy of an adapted evidence-based intervention for reducing sexual risk behaviors among AI adults with substance use and mental health problems. If proven successful, there will be an efficacious program for reducing risk behaviors among high-risk adults that can be disseminated in American Indian communities as well as other

Risk Estimation Modeling and Feasibility Testing for a Mobile eHealth Intervention for Binge Drinking Among Young People: The D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults) Project.

Science.gov (United States)

Carrà, Giuseppe; Crocamo, Cristina; Schivalocchi, Alessandro; Bartoli, Francesco; Carretta, Daniele; Brambilla, Giulia; Clerici, Massimo

2015-01-01

Binge drinking is common among young people but often relevant risk factors are not recognized. eHealth apps, attractive for young people, may be useful to enhance awareness of this problem. We aimed at developing a current risk estimation model for binge drinking, incorporated into an eHealth app--D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults)--for young people. A longitudinal approach with phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) was followed. Risk/protective factors identified from the literature were used to develop a current risk estimation model for binge drinking. Relevant odds ratios were subsequently pooled through meta-analytic techniques with a random-effects model, deriving weighted estimates to be introduced in a final model. A set of questions, matching identified risk factors, were nested in a questionnaire and assessed for wording, content, and acceptability in focus groups involving 110 adolescents and young adults. Ten risk factors (5 modifiable) and 2 protective factors showed significant associations with binge drinking and were included in the model. Their weighted coefficients ranged between -0.71 (school proficiency) and 1.90 (cannabis use). The model, nested in an eHealth app questionnaire, provides in percent an overall current risk score, accompanied by appropriate images. Factors that mostly contribute are shown in summary messages. Minor changes have been realized after focus groups review. Most of the subjects (74%) regarded the eHealth app as helpful to assess binge drinking risk. We could produce an evidence-based eHealth app for young people, evaluating current risk for binge drinking. Its effectiveness will be tested in a large trial.

Perceptions of a HIV testing message targeted for at-risk adults with low functional health literacy

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Hunter, Susan L.

This study analyses warehoused data collected by Georgia State University and Centers for Disease Control and Prevention (GSU/CDC) researchers after developing an HIV testing message for urban adults with low functional health literacy. It expands previous work by examining data collected when 202 primarily African-American homeless clients of an urban community based organization (CBO) reviewed both the low literacy brochure (Wallace et al., 2006) and a standard HIV brochure (Georgia Department of Human Resources, 1997). Participants' health literacy was assessed using 2 measures; the Rapid Estimate of Adult Literacy in Medicine or REALM (Davis, Crouch, Long & Green) and the Test of Functional Health Literacy Assessment or TOFHLA (Nurss, Parker & Baker, 2001). HIV risk was determined using an interview questionnaire developed by the research group (Belcher, Deming, Hunter & Wallace, 2005) which allowed participants to self-report recent alcohol and drug use, sexual behavior, sexually transmitted disease (STD) history and exposure to abuse and sexual coercion. Open-ended response questions regarding readability, understanding, main message, and importance for each brochure provided the qualitative data. This analysis confirms previous work showing accessibility, readability, cultural sensitivity and user-friendly formatting are important when attempting to engage at-risk adults with varying levels of functional health literacy in an HIV testing message. The visual aspects of the brochure can be essential in capturing the reader's attention and should be relevant to the target audience (Wallace, Deming, Hunter, Belcher & Choi, 2006). Mono-colored graphics may be perceived as dated and irrelevant or worse yet, threatening to some readers. Whenever possible culturally appropriate color photos of people depicting relevant content should replace excess text and difficult medical terms should be eliminated. Wording on the cover and within the brochure should be used to

Assessment of the risk factors for hearing loss in adult Nigerian ...

African Journals Online (AJOL)

Conclusion: It was concluded that the RFs for SNHL in adult Nigerians were multifactorial while some of the RFs may be amenable to primary prevention. Legislation and public health education could facilitate reduction of SNHL in our community. Keywords: Adults, elderly, hearing loss, Nigerians, risk factors. Nigerian ...

Polygenic risk predicts obesity in both white and black young adults.

Directory of Open Access Journals (Sweden)

Benjamin W Domingue

Full Text Available To test transethnic replication of a genetic risk score for obesity in white and black young adults using a national sample with longitudinal data.A prospective longitudinal study using the National Longitudinal Study of Adolescent Health Sibling Pairs (n = 1,303. Obesity phenotypes were measured from anthropometric assessments when study members were aged 18-26 and again when they were 24-32. Genetic risk scores were computed based on published genome-wide association study discoveries for obesity. Analyses tested genetic associations with body-mass index (BMI, waist-height ratio, obesity, and change in BMI over time.White and black young adults with higher genetic risk scores had higher BMI and waist-height ratio and were more likely to be obese compared to lower genetic risk age-peers. Sibling analyses revealed that the genetic risk score was predictive of BMI net of risk factors shared by siblings. In white young adults only, higher genetic risk predicted increased risk of becoming obese during the study period. In black young adults, genetic risk scores constructed using loci identified in European and African American samples had similar predictive power.Cumulative information across the human genome can be used to characterize individual level risk for obesity. Measured genetic risk accounts for only a small amount of total variation in BMI among white and black young adults. Future research is needed to identify modifiable environmental exposures that amplify or mitigate genetic risk for elevated BMI.

Polygenic risk predicts obesity in both white and black young adults.

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Domingue, Benjamin W; Belsky, Daniel W; Harris, Kathleen Mullan; Smolen, Andrew; McQueen, Matthew B; Boardman, Jason D

2014-01-01

To test transethnic replication of a genetic risk score for obesity in white and black young adults using a national sample with longitudinal data. A prospective longitudinal study using the National Longitudinal Study of Adolescent Health Sibling Pairs (n = 1,303). Obesity phenotypes were measured from anthropometric assessments when study members were aged 18-26 and again when they were 24-32. Genetic risk scores were computed based on published genome-wide association study discoveries for obesity. Analyses tested genetic associations with body-mass index (BMI), waist-height ratio, obesity, and change in BMI over time. White and black young adults with higher genetic risk scores had higher BMI and waist-height ratio and were more likely to be obese compared to lower genetic risk age-peers. Sibling analyses revealed that the genetic risk score was predictive of BMI net of risk factors shared by siblings. In white young adults only, higher genetic risk predicted increased risk of becoming obese during the study period. In black young adults, genetic risk scores constructed using loci identified in European and African American samples had similar predictive power. Cumulative information across the human genome can be used to characterize individual level risk for obesity. Measured genetic risk accounts for only a small amount of total variation in BMI among white and black young adults. Future research is needed to identify modifiable environmental exposures that amplify or mitigate genetic risk for elevated BMI.

Enhancing Key Competencies of Health Professionals in the Assessment and Care of Adults at Risk of Suicide Through Education and Technology.

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Ryan, Kathryn; Tindall, Claudia; Strudwick, Gillian

This article describes efforts undertaken to improve the clinical competencies of health professionals in the area of suicide risk assessment, documentation, and care planning. Best practices that fit the mental health and addictions setting were identified from the Registered Nurses' Association of Ontario Best Practice Guideline on Assessment and Care of Adults at Risk for Suicidal Ideation and Behaviour. A variety of methods were used to implement the guidelines at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada. These included 3 in-person educational modules, an e-learning module, and the creation of an electronic health record suicide risk assessment documentation form. Results showed that interprofessional team members improved their suicide awareness and increased their confidence and knowledge in suicide risk assessment and the identification of interventions for clients at risk. Organizational level performance and quality improvement activities after implementation of the education and the electronic suicide risk assessment documentation form are being implemented through a collaboration between performance improvement, clinical education and informatics, and professional practice. The success of an interprofessional educational program of this nature is dependent on the collaboration of a number of stakeholders from a variety of areas of the organization.

Maternal Risk Exposure and Adult Daughters’ Health, Schooling, and Employment: A Constructed Cohort Analysis of 50 Developing Countries

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Li, Qingfeng; Tsui, Amy O.

2016-01-01

This study analyzes the relationships between maternal risk factors present at the time of daughters’ births—namely, young mother, high parity, and short preceding birth interval—and their subsequent adult developmental, reproductive, and socioeconomic outcomes. Pseudo-cohorts are constructed using female respondent data from 189 cross-sectional rounds of Demographic and Health Surveys conducted in 50 developing countries between 1986 and 2013. Generalized linear models are estimated to test the relationships and calculate cohort-level outcome proportions with the systematic elimination of the three maternal risk factors. The simulation exercise for the full sample of 2,546 pseudo-cohorts shows that the combined elimination of risk exposures is associated with lower mean proportions of adult daughters experiencing child mortality, having a small infant at birth, and having a low body mass index. Among sub-Saharan African cohorts, the estimated changes are larger, particularly for years of schooling. The pseudo-cohort approach can enable longitudinal testing of life course hypotheses using large-scale, standardized, repeated cross-sectional data and with considerable resource efficiency. PMID:27154342

Maternal Risk Exposure and Adult Daughters' Health, Schooling, and Employment: A Constructed Cohort Analysis of 50 Developing Countries.

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Li, Qingfeng; Tsui, Amy O

2016-06-01

This study analyzes the relationships between maternal risk factors present at the time of daughters' births-namely, young mother, high parity, and short preceding birth interval-and their subsequent adult developmental, reproductive, and socioeconomic outcomes. Pseudo-cohorts are constructed using female respondent data from 189 cross-sectional rounds of Demographic and Health Surveys conducted in 50 developing countries between 1986 and 2013. Generalized linear models are estimated to test the relationships and calculate cohort-level outcome proportions with the systematic elimination of the three maternal risk factors. The simulation exercise for the full sample of 2,546 pseudo-cohorts shows that the combined elimination of risk exposures is associated with lower mean proportions of adult daughters experiencing child mortality, having a small infant at birth, and having a low body mass index. Among sub-Saharan African cohorts, the estimated changes are larger, particularly for years of schooling. The pseudo-cohort approach can enable longitudinal testing of life course hypotheses using large-scale, standardized, repeated cross-sectional data and with considerable resource efficiency.

The prevalence of and factors associated with high-risk alcohol consumption in Korean adults: The 2009-2011 Korea National Health and Nutrition Examination Survey.

Directory of Open Access Journals (Sweden)

Jae Won Hong

Full Text Available The consequences of alcohol consumption on health outcomes are largely determined by two separate, but related, dimensions of drinking: the total volume of alcohol consumed and the pattern of drinking. Most epidemiological studies focus on the amount of alcohol consumed and do not consider the pattern of drinking.This study evaluated the prevalence of and factors associated with high-risk and heavy alcohol drinking in Korean adults.This study analyzed 15,215 of the 28,009 participants in the 2009-2011 Korea National Health and Nutrition Examination Survey (KNHANES. High-risk alcohol drinking was defined as Alcohol Use Disorders Identification Test (AUDIT scores ≥16, which provides a framework for intervention to identify hazardous and harmful drinking patterns as the cause of alcohol-use disorders, according to World Health Organization guidelines.The prevalence of high-risk drinking was 15.1%, with the highest prevalence of 17.2% in middle-aged adults (45-64 years. In men, the prevalence of high-risk alcohol drinking was 23.7%, with the highest prevalence found in middle-aged adults. In women, the prevalence of high-risk alcohol drinking was 4.2%, with the highest prevalence found in younger adults. Men had higher weighted mean AUDIT scores than women (10.0 vs. 4.0, P<0.001, and age was negatively associated with the AUDIT score (P<0.001. Elementary school graduates had higher mean AUDIT scores than senior high school (P = 0.003 or college (P<0.001 graduates. Regarding occupation, clerical support workers (P = 0.002 and service and sales workers (P<0.001 had higher mean AUDIT scores than managers and professionals. Logistic regression analyses of high-risk alcohol drinking using sex, age, education level, number of family members, household income, and occupation as covariates was performed. Women had a lower risk of high-risk alcohol drinking (odds ratio (OR 0.14, 95% CI: 0.13-0.16, P<0.001 than men. Regarding age, compared to control

Exposure to child abuse and risk for mental health problems in women.

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Schneider, Renee; Baumrind, Nikki; Kimerling, Rachel

2007-01-01

Risk for adult mental health problems associated with child sexual, physical, or emotional abuse and multiple types of child abuse was examined. Logistic regression analyses were used to test study hypotheses in a population-based sample of women (N = 3,936). As expected, child sexual, physical, and emotional abuse were independently associated with increased risk for mental health problems. History of multiple types of child abuse was also associated with elevated risk for mental health problems. In particular, exposure to all three types of child abuse was linked to a 23-fold increase in risk for probable posttraumatic stress disorder (PTSD). Findings underscore relations between child emotional abuse and adult mental health problems and highlight the need for mental health services for survivors of multiple types of child abuse.

Sports and energy drink consumption are linked to health-risk behaviours among young adults.

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Larson, Nicole; Laska, Melissa N; Story, Mary; Neumark-Sztainer, Dianne

2015-10-01

National data for the USA show increases in sports and energy drink consumption over the past decade with the largest increases among young adults aged 20-34 years. The present study aimed to identify sociodemographic factors and health-risk behaviours associated with sports and energy drink consumption among young adults. Cross-sectional analysis of survey data from the third wave of a cohort study (Project EAT-III: Eating and Activity in Teens and Young Adults). Regression models stratified on gender and adjusted for sociodemographic characteristics were used to examine associations of sports and energy drink consumption with eating behaviours, physical activity, media use, weight-control behaviours, sleep patterns and substance use. Participants completed baseline surveys in 1998-1999 as students at public secondary schools in Minneapolis/St. Paul, Minnesota, USA and the EAT-III surveys online or by mail in 2008-2009. The sample consisted of 2287 participants (55% female, mean age 25·3 years). Results showed 31·0% of young adults consumed sports drinks and 18·8% consumed energy drinks at least weekly. Among men and women, sports drink consumption was associated with higher sugar-sweetened soda and fruit juice intake, video game use and use of muscle-enhancing substances like creatine (P≤0·01). Energy drink consumption was associated with lower breakfast frequency and higher sugar-sweetened soda intake, video game use, use of unhealthy weight-control behaviours, trouble sleeping and substance use among men and women (Psports and energy drink consumption with other unhealthy behaviours in the design of programmes and services for young adults.

Childhood Violence Exposure: Cumulative and Specific Effects on Adult Mental Health

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Hooven, Carole; Nurius, Paula S.; Logan-Greene, Patricia; Thompson, Elaine A.

2012-01-01

Childhood exposure to violence and victimization is a significant public health problem, with potentially long-lasting, deleterious effects on adult mental health. Using a longitudinal study design, 123 young adults—identified in adolescence as at-risk for high school dropout—were examined for the effects of multi-domain childhood victimization on emotional distress and suicide risk, net of adolescent risk and protective factors, including family dysfunction. The hypothesis that higher levels...

Bioaccessibility and human health risk assessment of lead in soil from Daye City

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Li, Q.; Li, F.; Xiao, M. S.; Cai, Y.; Xiong, L.; Huang, J. B.; Fu, J. T.

2018-01-01

Lead (Pb) in soil from 4 sampling sites of Daye City was studied. Bioaccessibilities of Pb in soil were determined by the method of simplified bioaccessible extraction test (SBET). Since traditional health risk assessment was built on the basis of metal total content, the risk may be overestimated. Modified human health risk assessment model considering bioaccessibility was built in this study. Health risk of adults and children exposure to Pb based on total contents and bioaccessible contents were evaluated. The results showed that bioaccessible content of Pb in soil was much lower than its total content, and the average bioaccessible factor (BF) was only 25.37%. The hazard indexes (HIs) for adults and children calculated by two methods were all lower than 1. It indicated that there were no no-carcinogenic risks of Pb for human in Daye. By comparing with the results, the average bioaccessible HIs for adults and children were lower than the total one, which was due to the lower hazard quotient (HQ). Proportions of non-carcinogenic risk exposure to Pb via different pathways have also changed. Particularly, the most main risk exposure pathway for adults turned from the oral ingestion to the inhalation.

Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study.

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Strotmeyer, Elsa S; Cauley, Jane A; Schwartz, Ann V; Nevitt, Michael C; Resnick, Helaine E; Bauer, Douglas C; Tylavsky, Frances A; de Rekeneire, Nathalie; Harris, Tamara B; Newman, Anne B

2005-07-25

Diabetes mellitus (DM) and related complications may increase clinical fracture risk in older adults. Our objectives were to determine if type 2 diabetes mellitus or impaired fasting glucose was associated with higher fracture rates in older adults and to evaluate how diabetic individuals with fractures differed from those without fractures. The Health, Aging, and Body Composition Study participants were well-functioning, community-dwelling men and women aged 70 to 79 years (N = 2979; 42% black), of whom 19% had DM and 6% had impaired fasting glucose at baseline. Incident nontraumatic clinical fractures were verified by radiology reports for a mean +/- SD of 4.5 +/- 1.1 years. Cox proportional hazards regression models determined how DM and impaired fasting glucose affected subsequent risk of fracture. Diabetes mellitus was associated with elevated fracture risk (relative risk, 1.64; 95% confidence interval, 1.07-2.51) after adjustment for a hip bone mineral density (BMD) and fracture risk factors. Impaired fasting glucose was not significantly associated with fractures (relative risk, 1.34; 95% confidence interval, 0.67-2.67). Diabetic participants with fractures had lower hip BMD (0.818 g/cm(2) vs 0.967 g/cm(2); Pbattery score (5.0 vs 7.0), and falls (37% vs 21%) compared with diabetic participants without fractures (P<.05). These results indicate that older white and black adults with DM are at higher fracture risk compared with nondiabetic adults with a similar BMD since a higher risk of nontraumatic fractures was found after adjustment for hip BMD. Fracture prevention needs to target specific risk factors found in older adults with DM.

Sleep Disturbances in Adults With Arthritis: Prevalence, Mediators, and Subgroups at Greatest Risk. Data From the 2007 National Health Interview Survey

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LOUIE, GRANT H.; TEKTONIDOU, MARIA G.; CABAN-MARTINEZ, ALBERTO J.; WARD, MICHAEL M.

2012-01-01

Objective To examine the prevalence of sleep disturbances in adults with arthritis in a nationally representative sample, mediators of sleep difficulties, and subgroups of individuals with arthritis at greatest risk. Methods Using data on US adults ages ≥18 years participating in the 2007 National Health Interview Survey, we computed the prevalence of 3 measures of sleep disturbance (insomnia, excessive daytime sleepiness, and sleep duration arthritis. We used logistic regression analysis to examine if the association of arthritis and sleep disturbances was independent of sociodemographic characteristics and comorbidities, and to identify potential mediators. We used classification trees to identify subgroups at higher risk. Results The adjusted prevalence of insomnia was higher among adults with arthritis than those without arthritis (23.1% versus 16.4%; P arthritis were more likely than those without arthritis to report insomnia (unadjusted odds ratio 2.92, 95% confidence interval 2.68 –3.17), but adjustment for sociodemographic characteristics and comorbidities attenuated this association. Joint pain and limitation due to pain mediated the association between arthritis and insomnia. Among adults with arthritis, those with depression and anxiety were at highest risk for sleep disturbance. Results for excessive daytime sleepiness and sleep duration arthritis, and is mediated by joint pain and limitation due to pain. Among individuals with arthritis, those with depression and anxiety are at greatest risk. PMID:20890980

Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department.

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Arias, Sarah A; Boudreaux, Edwin D; Segal, Daniel L; Miller, Ivan; Camargo, Carlos A; Betz, Marian E

2017-10-01

We described characteristics and treatment received for older (≥60 years) vs younger (adult emergency department (ED) patients with suicide risk. Retrospective chart review. An ED with universal screening for suicide risk. Eligible charts included a random sample of adults (≥18 years) who screened positive for suicidal ideation (SI) in past 2 weeks and/or a suicide attempt (SA) within the past 6 months. Visit dates were from May 2014 to September 2016. A total of 800 charts were reviewed, with oversampling of older adults. Of the 200 older adults sampled, fewer older adults compared to younger adults (n = 600) had a chief complaint involving psychiatric behavior (53% vs 70%) or self-harm behavior (26% vs 36%). Although a higher number of older adults (93%) had documentation of current SI compared to younger adults (79%), fewer older adults (17%) reported SA in the past 2 weeks compared to younger adults (23%). Of those with a positive suicide screen who were discharged home, less than half of older adults received a mental health evaluation during their visit (42%, 95% CI 34-52) compared to 66% (95% CI 61-70) of younger adults who met the same criteria. Similarly, fewer older, than younger, adult patients with current SI/SA received referral resources (34%; 95% CI 26-43; vs 60%; 95% CI 55-65). Significantly fewer suicidal older adult patients who were discharged home received a mental health evaluation when compared to similar younger adults. These findings highlight an important area for improvement in the treatment of older adults at risk for suicide. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Sleep duration and risk of stroke mortality among Chinese adults: the Singapore Chinese Health Study

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Pan, An; De Silva, Deidre Anne; Yuan, Jian-Min; Koh, Woon-Puay

2014-01-01

Background and Purpose Prospective relation between sleep duration and stroke risk is less studied, particularly in Asians. We examined the association between sleep duration and stroke mortality among Chinese adults. Methods The Singapore Chinese Health Study is a population-based cohort of 63,257 Chinese adults aged 45-74 years enrolled during 1993 through 1998. Sleep duration at baseline was assessed via in-person interview, and death information during follow-up was ascertained via record linkage with the death registry up to December 31, 2011. Cox proportional hazard models were used to calculate hazard ratios (HRs) with adjustment for other comorbidities and lifestyle risk factors of stroke mortality. Results During 926,752 person-years of follow-up, we documented 1,381 stroke deaths (322 from hemorrhagic and 1,059 from ischemic or non-specified strokes). Compared to individuals with 7 hours/day of sleep, the multivariate-adjusted HR (95% confidence interval) of total stroke mortality was 1.25 (1.05-1.50) for ≤5 hours/day (short duration), 1.01 (0.87-1.18) for 6 hours/day, 1.09 (0.95-1.26) for 8 hours/day, and 1.54 (1.28-1.85) for ≥9 hours/day (long duration). The increased risk of stroke death with short (1.54; 1.16-2.03) and long duration of sleep (1.95; 1.48-2.57) was seen among subjects with a history of hypertension, but not in those without hypertension. These findings were limited to risk of death from ischemic or non-specified stroke, but not observed for hemorrhagic stroke. Conclusions Both short and long sleep durations are associated with increased risk of stroke mortality in a Chinese population, particularly among those with a history of hypertension. PMID:24743442

Perceived risk of mental health problems in primary care.

LENUS (Irish Health Repository)

2015-01-01

In the face of limited resources and an aging population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalization, hospitalization and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care (PC). We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community to rank perceived risk of mental health concerns (including neurocognitive and mood disorders) from 1 (mild) to 3 (severe). The mean age of the 4499 people assessed was 76.3 years (SD = 7.3) and 2645 (58.8%) were female. According to the PC team 1616 (35.9%) were perceived to have mental health concerns of whom 847 (52.4%) were mild, 559 (34.6%) were moderate and 210 (13%) were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR = 2.22, 95% CI 1.83-2.69 for institutionalization; OR = 1.66, 95% CI 1.41-1.94 for hospitalization; OR = 1.69, 95% CI 1.42-2.01 for death). These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.

Perceived risk of mental health problems in primary care

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Constança ePaúl

2015-11-01

Full Text Available In the face of limited resources and an ageing population with increasingly care needs, healthcare systems must identify community-dwelling older adults with mental health problems at higher risk of adverse outcomes such as institutionalisation, hospitalisation and death, in order to deliver timely and efficient care. The objectives of this study were to assess the prevalence of mental health concerns and the associated perceived risk of adverse outcomes in a large sample of older patients in primary care. We trained general practitioners and nurses to use the Risk Instrument for Screening in the Community (RISC to rank perceived risk of mental health concerns (including neurocognitive and mood disorders from 1 (mild to 3 (Severe. The mean age of the 4499 people assessed was 76.3 years (sd=7.3 and 2645 (58.8% were female. According to the primary care team 1616 (35.9% were perceived to have mental health concerns of whom 847 (52.4% were mild, 559 (34.6% were moderate and 210 (13% were severe. Patients with mental health concerns had higher odds of perceived risk of adverse outcomes (OR=2.22, 95% CI 1.83-2.69 for institutionalisation; OR=1.66, 95% CI 1.41-1.94 for hospitalisation; OR=1.69, 95% CI 1.42-2.01 for death. These results suggest a high prevalence of mental health concerns among older adults and supports the need for early identification of patients at high-risk of adverse healthcare outcomes.

Q-methodology to identify young adult renal transplant recipients at risk for nonadherence

NARCIS (Netherlands)

M. Moors-Tielen (Mirjam); A.L. van Staa (AnneLoes); S. Jedeloo (Susan); N.J.A. van Exel (Job); W. Weimar (Willem)

2008-01-01

textabstractBACKGROUND. Young adult renal transplant recipients may display patterns of behavior that affect graft survival. The present study aimed to identify young adults at risk for nonadherent behavior by investigating their attitudes about posttransplant health lifestyle. METHOD. A

Young adults’ risk perceptions of various tobacco products relative to cigarettes – results from the National Young Adult Health Survey

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Delnevo, Cristine D.

2015-01-01

Objectives Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Methods We examined risk perception responses among a nationally representative sample of young adults (ages 18–34)(n=2871)(including tobacco and non-tobacco users) from the 2011 National Young Adult Health Survey. Results Most (57.8%) respondents believed that e-cigarettes were less risky than cigarettes. Respondents were more likely to rate combustible products hookah (24.5%) and cigars (13.9%) as being less risky compared to non-combustible snus (10%) and other smokeless tobacco (SLT) products (7.1%) relative to cigarettes. Few (2.5%) rated menthol cigarettes as less risky. For e-cigarettes, hookah, and SLT, less risky beliefs were significantly higher among ever or current versus never product users. Between 22–33% of all respondents believed that SLT, snus, menthol cigarettes and cigars were more risky than cigarettes, but differences in this belief between current and non-users of these products were small and insignificant. Younger young adults were more likely to rate e-cigarettes and hookah as being “less risky” and rate cigars and SLT as being “more risky” than older young adults. Conclusion The public’s views of comparative tobacco risk perceptions vary widely by tobacco product type, and age group. While “less risky” perceptions may be associated with product use, perceptions that products are “more risky” than cigarettes may not necessarily dissuade people from their use. PMID:26304709

Intake of paracetamol and risk of asthma in adults

DEFF Research Database (Denmark)

Thomsen, Simon Francis; Kyvik, Kirsten Ohm; Skadhauge, Lars

2008-01-01

Intake of paracetamol has been associated with development of asthma. The aim of this study was to address a possible association between intake of paracetamol and risk of adult-onset asthma. Using a multidisciplinary postal questionnaire survey concerning health and lifestyle we prospectively...... studied 19,349 adult twins enrolled in the nationwide Danish Twin Registry. There was a higher prevalence of new-onset asthma in subjects who reported frequent intake of paracetamol at baseline compared with subjects without this determinant (12.0% vs. 4.3%), OR = 3.03 (1.51-6.11), p = 0.005. The result...... remained significant after adjusting for sex, age, smoking, BMI, hay fever, eczema, and intake of medications other than paracetamol, OR = 2.16 (1.03-4.53), p = 0.041. Frequent intake of paracetamol is an independent risk factor for adult-onset asthma....

Audit of Cardiovascular Disease Risk Factors among Supported Adults with Intellectual Disability Attending an Ageing Clinic

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Wallace, Robyn A.; Schluter, Philip

2008-01-01

Background: Little is known about the cardiovascular disease (CVD) risk factor profile for older adults with intellectual disability (ID). As many CVD risk factors are treatable by lifestyle changes, confirmation of the risk factor profile for older adults with ID could substantially impact upon preventive health practices for this group. Method:…

Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults

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Dao Thi Minh An

2013-01-01

Full Text Available Background: Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS revealed that the proportion of male adults currently smoking remains high at 47.4%. Objectives: To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. Design: GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc. and knowledge on health risks. Results: General knowledge on the health risks of active smoking (AS and exposure to second hand smoke (SHS was good (90% and 83%, respectively. However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer appeared to be lower (51.5%. Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6 and SHS (OR 1.7 than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively. Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively. Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. Conclusions: It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to

Risk Profiles for Falls among Older Adults: New Directions for Prevention

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William A. Satariano

2017-08-01

Full Text Available ObjectiveTo address whether neighborhood factors, together with older adults’ levels of health and functioning, suggest new combinations of risk factors for falls and new directions for prevention. To explore the utility of Grade-of-Membership (GoM analysis to conduct this descriptive analysis.MethodThis is a cross-sectional, descriptive study of 884 people aged ≥65 years from Alameda County, CA, Cook County, IL, Allegheny County, PA, and Wake and Durham counties, NC. Interviews focused on neighborhood characteristics, physical and cognitive function, walking, and falls and injuries. Four risk profiles (higher order interactions of individual and neighborhood factors were derived from GoM analysis.ResultsProfiles 1 and 2 reflect previous results showing that frail older adults are likely to fall indoors (Profile 1; healthy older adults are likely to fall outdoors (Profile 2. Profile 3 identifies the falls risk for older with mild cognitive impairment living in moderately walkable neighborhoods. Profile 4 identifies the risk found for healthy older adults living in neighborhoods with low walkability.DiscussionNeighborhood walkability, in combination with levels of health and functioning, is associated with both indoor and outdoor falls. Descriptive results suggest possible research hypotheses and new directions for prevention, based on individual and neighborhood factors.

Predicting influenza vaccination intent among at-risk chinese older adults in Hong Kong.

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Yu, Doris S F; Low, Lisa P L; Lee, Iris F K; Lee, Diana T F; Ng, Wai Man

2014-01-01

Older adults with major chronic illnesses are very susceptible to influenza and its serious complications, but many do not obtain vaccinations. Little is known about factors associated with intention to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. The aim of this study was to identify factors associated with intent to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. This multicenter descriptive correlational study recruited a convenience sample of 306 Chinese older adults with medical risk factors for influenza and its serious complications from the general outpatient clinics in Hong Kong. Interviews were conducted to assess intent to obtain influenza vaccination for the coming year, health beliefs about influenza, and discomfort following past vaccinations. The current influenza vaccination rate was 58.5%; only 36.3% intended to get vaccinated the following year. After controlling for clinical and demographic factors in a logistic regression model, perceived susceptibility predicted intention to obtain future vaccination (OR = 1.42, 95% CI [1.14, 1.78]), whereas postvaccination discomfort was negatively associated with intention (OR = 0.063, 95% CI [0.006, 0.63]). Intention to obtain influenza vaccination was low among at-risk Chinese older adults. Strengthening health beliefs and creating strategies to provide positive influenza vaccination experiences are possible approaches to interventions to improve uptake of influenza vaccination rates.

High Framingham risk score decreases quality of life in adults

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Christian Yosaputra

2010-04-01

Full Text Available Cardiovascular disease (CVD risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment (p=0.000. Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults.

Connection between competence, usability, environment and risk of falls in elderly adults

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José Alex Leiva-Caro

2015-12-01

Full Text Available Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.

Older adults' health and late-life drinking patterns: a 20-year perspective.

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Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S

2010-01-01

This study focused on the associations between older adults' health-related problems and their late-life alcohol consumption and drinking problems. A sample of 719 late-middle-aged community residents (55-65 years old at baseline) participated in a survey of health and alcohol consumption and this survey was followed 10 years and 20 years later. Health-related problems increased and alcohol consumption and drinking problems declined over the 20-year interval. Medical conditions, depressive symptoms, medication use, and acute health events were associated with a higher likelihood of abstinence; acute health events were also associated with less alcohol consumption. In contrast, reliance on alcohol to reduce pain was linked to more alcohol consumption. Moreover, an individual's overall health burden and reliance on alcohol to reduce pain were associated with more drinking problems. Reliance on alcohol to reduce pain potentiated the association between health burden, alcohol consumption and drinking problems. Older adults who have more health problems and rely on alcohol to manage pain are at elevated risk for drinking problems. Health care providers should target high-risk older adults, such as those who drink to reduce pain, for screening and brief interventions to help them identify new ways to cope with pain and curtail their drinking.

Prevalence of Falls and Risk Factors in Adults with Intellectual Disability

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Hsieh, Kelly; Rimmer, James; Heller, Tamar

2012-01-01

The purpose of this study was to examine the prevalence of falls and risk factors for falls in 1,515 adults (greater than or equal to 18 years) with intellectual disability using baseline data from the Longitudinal Health and Intellectual Disability Study. Nearly 25% of adults from the study were reported to have had one or more falls in the past…

Anomaly in the education–health gradient: Biomarker profiles among adults with subbaccalaureate attainment levels

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Anna Zajacova

2016-12-01

Full Text Available This Short Communication builds on recent findings that documented an anomaly in the education–health gradient: adults who attended college but did not earn a BA (the subbaccalaureate group reported an equal or higher level of health problems than adults with high school (HS diploma. Our aim is to test whether this anomaly holds when we eliminate potential reporting differences, by examining biomarker levels in the subbaccalaureate vs HS groups.Using the restricted 1999–2012 NHANES, we estimate models of biomarkers for cardiovascular and metabolic diseases as a function of educational attainment, including three subbaccalaureate levels: “some college”, vocational associate degree (AA, and academic AA.The data show that adults with “some college” or vocational AA have no systematic advantage over HS graduates in most biomarker indices while academic AA is associated with a significantly better risk profile compared to HS. The findings indicate that the adults with some college and vocational AA degrees do not benefit from their college experience in terms of improved physiological risk profile.This pattern underscores the need to understand and explain the anomalous health pattern that concerns 28% of American adults in the subbaccalaureate group among whom many reap little health payoffs to postsecondary schooling. Keywords: Education, Subbaccalaureate, Biomarkers, Health, Gradient, US adults

Cardiovascular risk-factor knowledge and risk perception among HIV-infected adults.

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Cioe, Patricia A; Crawford, Sybil L; Stein, Michael D

2014-01-01

Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age = 48 years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk [F(1, 117) = 0.13, p > .05]. Estimated risk and perceived risk were weakly but significantly correlated; r (126) = .24, p = .01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk-factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Suicide Risks among Adolescents and Young Adults in Rural China

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Sibo Zhao

2014-12-01

Full Text Available Background: In China, suicide is one of the major causes of death among adolescents and young adults aged 15 to 34 years. Aim: The current study examines how risk factors vary by age groups in rural China, referring to those aged 15 to 24 years and those aged 25 to 34 years. Method: A case-control psychological autopsy (PA study is conducted in sixteen counties from three Chinese provinces, including 392 suicide cases and 416 community living controls in the sample. Results: In China, young adults aged 25 to 34 years have a higher risk for suicide than adolescents aged 15 to 24 years, and it holds true even controlling for relevant social factors. In addition, age-related factors such as education, marital status, whether having children, status in the family, physical health, and personal income all have varying degrees of impact on suicide risks for rural youth. Conclusions: This study shows that there are some age-related risk factors for suicide at certain life stages and emphasizes that young adults in rural China aged 25 to 34 years have an increased risk of suicide as a result of experiencing more psychological strains with age.

Race/Ethnicity and Health-Related Quality of Life Among LGBT Older Adults

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Kim, Hyun-Jun; Jen, Sarah; Fredriksen-Goldsen, Karen I.

2017-01-01

Purpose of the Study: Few existing studies have addressed racial/ethnic differences in the health and quality of life of lesbian, gay, bisexual, and transgender (LGBT) older adults. Guided by the Health Equity Promotion Model, this study examines health-promoting and health risk factors that contribute to racial/ethnic health disparities among LGBT adults aged 50 and older. Design and Methods: We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. By applying multiple mediator models, we analyzed the indirect effects of race/ethnicity on health-related quality of life (HRQOL) via demographics, lifetime LGBT-related discrimination, and victimization, and socioeconomic, identity-related, spiritual, and social resources. Results: Although African Americans and Hispanics, compared with non-Hispanic Whites, reported lower physical HRQOL and comparable psychological HRQOL, indirect pathways between race/ethnicity and HRQOL were observed. African Americans and Hispanics had lower income, educational attainment, identity affirmation, and social support, which were associated with a decrease in physical and psychological HRQOL. African Americans had higher lifetime LGBT-related discrimination, which was linked to a decrease in their physical and psychological HRQOL. African Americans and Hispanics had higher spirituality, which was associated with an increase in psychological HRQOL. Implications: Findings illustrate the importance of identifying both health-promoting and health risk factors to understand ways to maximize the health potential of racially and ethnically diverse LGBT older adults. Interventions aimed at health equity should be tailored to bolster identity affirmation and social networks of LGBT older adults of color and to support strengths, including spiritual resources. PMID:28087793

Comparison of Health Risk Assessments of Heavy Metals and As in Sewage Sludge from Wastewater Treatment Plants (WWTPs) for Adults and Children in the Urban District of Taiyuan, China.

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Duan, Baoling; Zhang, Wuping; Zheng, Haixia; Wu, Chunyan; Zhang, Qiang; Bu, Yushan

2017-10-08

Abstract : To compare the human health risk of heavy metals and As in sewage sludge between adults and children, samples were collected from five wastewater treatment plants (WWTPs) located in the urban district of Taiyuan, the capital of Shanxi. Heavy metals and As in sewage sludge can be ranked according to the mean concentration in the following order: Cu > Cr > Zn > Pb > As > Hg > Cd. Compared with the concentration limit set by different countries, the heavy metals contents in sewage sludge were all within the standard limits, except for the content of As, which was higher than the threshold limit established by Canada. A health risk assessment recommended by the United States Environmental Protection Agency (USEPA) was used to compare the non-cancer risk and cancer risk between adults and children. Based on the mean and 95% upper confidence limit (UCL) of the average daily dose (ADD), heavy metals and As can be ranked in the order of Cu > Cr > Zn > Pb > As > Hg > Cd for adults, and Cu > Cr > Zn > Pb > Hg > As > Cd for children. Moreover, results of ADD ingest and ADD inhale indicated that ingestion was the main pathway for heavy metals and As exposure for both adults and children, and the sum of ADD implied that the exposure to all heavy metals and As for children was 8.65 and 9.93 times higher, respectively, than that for adults according to the mean and 95% UCL. For the non-carcinogenic risk, according to the hazard quotient (HQ), the risk of Cu, Hg and Cr was higher than the risk of Zn and Pb. The hazard index (HI) for adults was 0.144 and 0.208 for the mean and 95% UCL, which was less than the limit value of 1; for children, the HI was 1.26 and 2.25, which is higher than the limit value of 1. This result indicated that children had non-carcinogenic risk, but adults did not. Furthermore, ingestion was the main pathway for non-carcinogenic risk exposure by the HQ ingest and HQ inhale . For the carcinogenic risk, Cd and As were classified as carcinogenic

Assessment of Interpersonal Risk (AIR) in Adults with Learning Disabilities and Challenging Behaviour--Piloting a New Risk Assessment Tool

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Campbell, Martin; McCue, Michael

2013-01-01

A new risk assessment tool, "Assessment of Interpersonal Risk" (AIR), was piloted and evaluated to measure risk factors and compatibility between individuals living in an assessment and treatment unit in one NHS area. The adults with learning disabilities in this unit had severe and enduring mental health problems and/or behaviour that is severely…

Type 1 diabetes: addressing the transition from pediatric to adult-oriented health care

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Monaghan M

2016-04-01

Full Text Available Maureen Monaghan,1,2 Katherine Baumann2 1Center for Translational Science, Children's National Health System, 2George Washington University School of Medicine, Washington, DC, USA Abstract: Adolescents and young adults with type 1 diabetes are at risk for poor health outcomes, including poor glycemic control, acute and chronic complications, and emergency department admissions. During this developmental period, adolescent and young adult patients also experience significant changes in living situation, education, and/or health care delivery, including transferring from pediatric to adult health care. In recent years, professional and advocacy organizations have proposed expert guidelines to improve the process of preparation for and transition to adult-oriented health care. However, challenges remain and evidence-based practices for preparing youth for adult health care are still emerging. Qualitative research suggests that adolescent and young adult patients rely on health care providers to guide them through the transition process and appreciate a gradual approach to preparing for adult-oriented health care, keeping parents in supportive roles into young adulthood. Patients also benefit from specific referrals and contact information for adult care providers. Promising models of transition care include provision of transition navigators, attendance at a young adult bridge clinic, or joint visits with pediatric and adult care providers. However, much of this research is in its early stages, and more rigorous trials need to be conducted to evaluate health outcomes during transition into adult health care. The purpose of this review is to provide an overview of the transition process, patient and health care provider perceptions of transition care, and emerging evidence of successful models of care for engagement in adult-oriented health care. Recommendations and resources for health care providers are also presented. Keywords: type 1 diabetes

Risks of Metabolic Syndrome in Students of the Faculty of Health Sciences

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Ersin Öğüş

2013-09-01

Full Text Available Background: Metabolic syndrome is highly prevalent in the adult population worldwide. Education may play an important role in preventing metabolic syndrome in young adults, especially those who are attending university. Such adults are at a critical point in their lives and make their own lifestyle choices that can affect their future health. Aims: The aims of this study were to determine the metabolic syndrome risk levels of students from the Faculty of Health Sciences. Study Design: Survey design study. Methods: In a questionnaire developed by the researchers to collect data in accordance with the relevant literature, the scale of the risk of metabolic syndrome was assessed. A stepwise logistic regression analysis was performed to determine the risks. Results: Important risk factors for metabolic syndrome were found to be gender, weight gain, “stress eating” excessive amounts of food, sleeping for more than 8 hours a day, feeling tired after sleep, belonging to a divided family, and eating whilst working on the computer. Conclusion: The students from the Faculty of Health Sciences, particularly because they are trained in the health sector, are expected to have more information about the risk factors of metabolic syndrome, and take necessary precautions to prevent it.

Comparing young adults to older adults in e-cigarette perceptions and motivations for use: implications for health communication.

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Cooper, Maria; Harrell, Melissa B; Perry, Cheryl L

2016-08-01

Use of electronic cigarettes ('e-cigarettes' is rapidly rising, and is especially prevalent among young adults. A better understanding of e-cigarette perceptions and motivations for use is needed to inform health communication and educational efforts. This study aims to explore these aspects of use with a focus on comparing young adults to older adults. In this qualitative study, the investigator conducted semi-structured interviews among a purposive sample of e-cigarette users. Thematic content analysis was used to analyze qualitative data and document themes. e-cigarettes were most commonly used for smoking cessation among both age groups. Young adults described other motivations for use including doing smoke tricks, being able to consume a wide variety of flavors, and helping them study. Some interviewees (11%) believed e-cigarettes were a healthy alternative to conventional cigarettes, while many other users (30%) expressed concerns about the unknown risks of e-cigarettes. Findings were generally consistent across both age groups in their perceptions of harm from e-cigarettes and in subjective effects such as perceived addictiveness. However, individuals under 30 described unique motivations for e-cigarette use. Health messaging targeted to young adults should emphasize the potential health risks of e-cigarette use and recognize their distinct motivational aspects. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association.

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Gorelick, Philip B; Furie, Karen L; Iadecola, Costantino; Smith, Eric E; Waddy, Salina P; Lloyd-Jones, Donald M; Bae, Hee-Joon; Bauman, Mary Ann; Dichgans, Martin; Duncan, Pamela W; Girgus, Meighan; Howard, Virginia J; Lazar, Ronald M; Seshadri, Sudha; Testai, Fernando D; van Gaal, Stephen; Yaffe, Kristine; Wasiak, Hank; Zerna, Charlotte

2017-10-01

Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health. We identify metrics to define optimal brain health in adults based on inclusion of factors that could be measured, monitored, and modified. From these practical considerations, we identified 7 metrics to define optimal brain health in adults that originated from AHA's Life's Simple 7: 4 ideal health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent with current guideline levels, and body mass index brain health but recognize that the truly ideal circumstance may be uncommon because there is a continuum of brain health as demonstrated by AHA's Life's Simple 7. Therefore, there is opportunity to improve brain health through primordial prevention and other interventions. Furthermore, although cardiovascular risks align well with brain health, we acknowledge that other factors differing from those related to cardiovascular health may drive cognitive health. Defining optimal brain health in adults and its maintenance is consistent with the AHA's Strategic Impact Goal to improve cardiovascular health of all Americans by 20% and to reduce deaths resulting from cardiovascular disease and stroke by 20% by the year 2020. This work in defining optimal brain health in adults serves to provide the AHA/American Stroke Association with a foundation for a new strategic direction going forward in cardiovascular health

Associations of food consumption, serum vitamins and metabolic syndrome risk with physical activity level in middle-aged adults: the National Health and Nutrition Examination Survey (NHANES) 2005-2006.

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Choi, Jihyun E; Ainsworth, Barbara E

2016-06-01

To examine the associations of food consumption, serum vitamins and metabolic syndrome risk with physical activity level in middle-aged adults. Cross-sectional. National Health and Nutrition Examination Survey (NHANES) 2005-2006. Adults aged 40-70 years were divided into three groups by tertile of accelerometer-determined steps/d (in men and women, respectively): tertile 1 (sedentary), active), ≥10699, ≥9226. The active men consumed more grain products, fruits and vegetables, whereas the active women consumed more legumes and vegetables, compared with the sedentary group. Serum vitamin concentrations were associated with daily steps in both men and women. Vitamin C, α-carotene, trans-β-carotene, cis-β-carotene, β-cryptoxanthin, lutein+zeaxanthin, lycopene, γ-tocopherol and vitamin D were significantly associated with daily steps. OR (Pmen and women, respectively. Those with the highest steps taken showed a more healthful eating profile and a better serum vitamin profile compared with less active adults. Those with the lowest steps taken had greater odds of having metabolic syndrome and its risk components. Probably, daily walking is a marker of a healthful eating profile and increasing daily walking is one of the healthful ways to decrease the metabolic syndrome and its risk components.

Health Promotion for Young Adults With Serious Mental Illness.

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Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A; Pratt, Sarah I; Bartels, Stephen J

2017-02-01

Young adulthood represents a critical time to address elevated obesity rates and the risk of early mortality, particularly among people with serious mental illness. Few studies have assessed the benefits of lifestyle interventions targeting weight loss among these young adults. This study examined the impact of the 12-month In SHAPE lifestyle intervention on weight loss and fitness among overweight and obese young adults with serious mental illness (ages 21-30) compared with participants over age 30. Data were combined from three trials of the 12-month In SHAPE program delivered through community mental health centers. In SHAPE includes weekly fitness trainer meetings, a gym membership, and nutrition education. Primary outcomes were weight loss and change in fitness at 12 months. Participants (N=194) had a schizophrenia spectrum disorder (53%) or a mood disorder (47%). The overall sample achieved significant weight loss and improved fitness; differences between young adults (N=29) and participants over age 30 (N=165) were not significant. An important finding was that 42% of young adults achieved clinically significant reductions in cardiovascular risk, defined as ≥5% weight loss or improved fitness (>50-m increase on the 6-Minute Walk Test), compared with 54% of adults over age 30 (a nonsignificant difference between age groups). Among persons enrolled in a lifestyle intervention, overweight and obese young adults experienced benefits comparable with those of adults over age 30. Young adults with serious mental illness face high risk of gaining weight, but a meaningful proportion of these individuals can achieve clinically significant cardiovascular risk reduction, thus highlighting the need to promote lifestyle intervention participation in this group.

Comparison of Health Risk Assessments of Heavy Metals and As in Sewage Sludge from Wastewater Treatment Plants (WWTPs for Adults and Children in the Urban District of Taiyuan, China

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Baoling Duan

2017-10-01

Full Text Available Abstract: To compare the human health risk of heavy metals and As in sewage sludge between adults and children, samples were collected from five wastewater treatment plants (WWTPs located in the urban district of Taiyuan, the capital of Shanxi. Heavy metals and As in sewage sludge can be ranked according to the mean concentration in the following order: Cu > Cr > Zn > Pb > As > Hg > Cd. Compared with the concentration limit set by different countries, the heavy metals contents in sewage sludge were all within the standard limits, except for the content of As, which was higher than the threshold limit established by Canada. A health risk assessment recommended by the United States Environmental Protection Agency (USEPA was used to compare the non-cancer risk and cancer risk between adults and children. Based on the mean and 95% upper confidence limit (UCL of the average daily dose (ADD, heavy metals and As can be ranked in the order of Cu > Cr > Zn > Pb > As > Hg > Cd for adults, and Cu > Cr > Zn > Pb > Hg > As > Cd for children. Moreover, results of ADDingest and ADDinhale indicated that ingestion was the main pathway for heavy metals and As exposure for both adults and children, and the sum of ADD implied that the exposure to all heavy metals and As for children was 8.65 and 9.93 times higher, respectively, than that for adults according to the mean and 95% UCL. For the non-carcinogenic risk, according to the hazard quotient (HQ, the risk of Cu, Hg and Cr was higher than the risk of Zn and Pb. The hazard index (HI for adults was 0.144 and 0.208 for the mean and 95% UCL, which was less than the limit value of 1; for children, the HI was 1.26 and 2.25, which is higher than the limit value of 1. This result indicated that children had non-carcinogenic risk, but adults did not. Furthermore, ingestion was the main pathway for non-carcinogenic risk exposure by the HQingest and HQinhale. For the carcinogenic risk, Cd and As were classified as

Public health economics of chlamydia and other STIs : aspects of risk, prevention and resources

OpenAIRE

Deogan, Charlotte

2013-01-01

The overall aim of this thesis was to increase the knowledge of the public health economic aspects of chlamydia and other STIs, in terms of risk, prevention and resources. In Study I, we examined the association between demographic, socioeconomic and lifestyle factors and the risk of self-reported chlamydial infection among young adults in the Stockholm public health cohort. We found that the risk of self-reported chlamydia infection among young adults in Sweden was associated with lowe...

Food Insecurity in Older Adults in an Integrated Health Care System.

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Steiner, John F; Stenmark, Sandra H; Sterrett, Andrew T; Paolino, Andrea R; Stiefel, Matthew; Gozansky, Wendolyn S; Zeng, Chan

2018-05-01

To estimate food insecurity prevalence and develop a statistical prediction model for food insecurity. Retrospective cohort study. Kaiser Permanente Colorado. Adult members who completed a pre-Medicare Annual Wellness Visit survey. Food insecurity was assessed using a single screening question. Sociodemographic and clinical characteristics from electronic health records and self-reported characteristics from the survey were used to develop the prediction model. Of 130,208 older adult members between January 2012 and December 2015, 50,097 (38.5%) completed food insecurity screening, 2,859 of whom (5.7% of respondents) reported food insecurity. The prevalence of food insecurity was 10.0% or greater among individuals who were black or Hispanic, had less than high school education, had Medicaid insurance, were extremely obese, had poor health status or quality of life, had depression or anxiety, had impairments in specific activities of daily living, had other nutritional risk factors, or were socially isolated (all pinsecurity and those without and 14.3% of individuals in the highest quintile of risk reported food insecurity. Food insecurity is prevalent even in older adults with private-sector healthcare coverage. Specific individual characteristics, and a model based on those characteristics, can identify older adults at higher risk of food insecurity. System-level interventions will be necessary to connect older adults with community-based food resources. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Alcohol's Collateral Damage: Childhood Exposure to Problem Drinkers and Subsequent Adult Mortality Risk.

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Rogers, Richard G; Lawrence, Elizabeth M; Montez, Jennifer Karas

2016-12-07

The importance of childhood circumstances, broadly defined, for shaping adult health and longevity is well-established. But the significance of one of the most prevalent childhood adversities-exposure to problem drinkers-has been understudied from a sociological perspective and remains poorly understood. We address this gap by drawing on cumulative inequality theory, using data from the 1988-2011 National Health Interview Survey-Linked Mortality Files, and estimating Cox proportional hazards models to examine the relationship between exposure to problem drinkers in childhood and adult mortality risk. Childhood exposure to problem drinkers is common (nearly 1 in 5 individuals were exposed) and elevates adult overall and cause-specific mortality risk. Compared to individuals who had not lived with a problem drinker during childhood, those who had done so suffered 17 percent higher risk of death (prisk. Favorable socioeconomic status in adulthood does not ameliorate the consequences of childhood exposure to problem drinkers. The primary intervening mechanisms are risky behaviors, including adult drinking and smoking. The findings-which reveal that the influence of problem drinking is far-reaching and long-term-should inform policies to improve childhood circumstances, reduce detrimental effects of problem drinking, and increase life expectancy.

The Cascading Effects of Marginalization and Pathways of Resilience in Attaining Good Health Among LGBT Older Adults

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Fredriksen-Goldsen, Karen I.; Kim, Hyun-Jun; Bryan, Amanda E. B.; Shiu, Chengshi; Emlet, Charles A.

2017-01-01

Purpose of the Study: Lesbian, gay, bisexual, and transgender (LGBT) older adults comprise a diverse and growing health disparate population. In the present study, using the Health Equity Promotion Model, we investigated pathways by which LGBT older adults experience resilience, risk, and marginalization and their relationship to attaining positive health outcomes. Design and Methods: Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) is the first longitudinal research project designed to examine the health, aging, and well-being of LGBT adults aged 50 and older. Using data from 2014 (N = 2,415), we tested a structural equation model linking lifetime marginalization, identity affirmation and management, social and psychological resources, and health behaviors to positive health outcomes. Results: Identity affirmation positively predicted social resources and mental health, and social resources positively predicted mental health. Marginalization was associated with fewer social resources for LGBT older adults with an open identity management style, lower identity affirmation for LGBT older adults who strategically concealed their sexual identity, and poorer mental health. Mental health was associated with better health behaviors, which in turn predicted positive physical health outcomes. Implications: Although a health disparate population, good health among LGBT older adults appears to be attained via multiple resilience and risk pathways. Providers must remain aware of the historical contexts in which LGBT older adults lived and the strengths they developed in order to understand their health and to develop tailored and targeted prevention and intervention services. PMID:28087797

Adapting interpersonal psychotherapy for older adults at risk for suicide.

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Heisel, Marnin J; Talbot, Nancy L; King, Deborah A; Tu, Xin M; Duberstein, Paul R

2015-01-01

To pilot a psychological intervention adapted for older adults at risk for suicide. A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Outpatient mental health care provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Seventeen English-speaking adults 60 years or older, at risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation) and secondary study outcomes (depressive symptom severity, social adjustment and support, psychological well-being), and psychotherapy process measures. Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Religion, Alcohol Use and Risk Drinking Among Canadian Adults Living in Ontario.

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Tuck, Andrew; Robinson, Margaret; Agic, Branka; Ialomiteanu, Anca R; Mann, Robert E

2017-12-01

This research examines (1) the association between risk drinking and religious affiliation and (2) differences between religions for risk drinking among adults living in Ontario, Canada, for Christians, Buddhists, Sikhs, Muslims, Hindus, Jews, other religious groups and the non-religious. Data are based on telephone interviews with 16,596 respondents and are derived from multiple cycles (2005-2011) of the Centre for Addiction and Mental Health's (CAMH) Monitor survey, an ongoing cross-sectional survey of adults in Ontario, Canada, aged 18 years and older. Data were analysed using bivariate cross-tabulations, Mann-Whitney U nonparametric test and logistic regression. Alcohol use and risk drinking occur among members of all religious groups; however, the rate of drinking ranges widely. Risk drinking is significantly associated with religion. When compared to the No religion/Atheist group, several religious groups (Baptist, Christian, Hindu, Jehovah's Witness, Jewish, Muslim/Islam, Non-denominational, Pentecostal, Sikh and Other religion) in our sample have significantly lower odds of risk drinking. Risk drinkers also attended significantly fewer services among several religions. Results suggest that there are differences in the risk drinking rates among Canadian adults, living in Ontario, by religion. It appears that religious traditions of prohibition and abstention do hold sway among Canadian adults for some religious groups.

Risk of High Dietary Calcium for Arterial Calcification in Older Adults

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Philip J. Klemmer

2013-09-01

Full Text Available Concern has recently arisen about the potential adverse effects of excessive calcium intakes, i.e., calcium loading from supplements, on arterial calcification and risks of cardiovascular diseases (CVD in older adults. Published reports that high calcium intakes in free-living adults have relatively little or no beneficial impact on bone mineral density (BMD and fracture rates suggest that current recommendations of calcium for adults may be set too high. Because even healthy kidneys have limited capability of eliminating excessive calcium in the diet, the likelihood of soft-tissue calcification may increase in older adults who take calcium supplements, particularly in those with age or disease-related reduction in renal function. The maintenance of BMD and bone health continues to be an important goal of adequate dietary calcium consumption, but eliminating potential risks of CVDs from excessive calcium intakes needs to be factored into policy recommendations for calcium by adults.

The Effect of a Patient-Provider Educational Intervention to Reduce At-Risk Drinking on Changes in Health and Health-Related Quality of Life Among Older Adults: The Project SHARE Study.

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Barnes, Andrew J; Xu, Haiyong; Tseng, Chi-Hong; Ang, Alfonso; Tallen, Louise; Moore, Alison A; Marshall, Deborah C; Mirkin, Michelle; Ransohoff, Kurt; Duru, O Kenrik; Ettner, Susan L

2016-01-01

At-risk drinking, defined as alcohol use that is excessive or potentially harmful in combination with select comorbidities or medications, affects about 10% of older adults in the United States and is associated with higher mortality. The Project SHARE intervention, which uses patient and provider educational materials, physician counseling, and health educator support, was designed to reduce at-risk drinking among this vulnerable population. Although an earlier study showed that this intervention was successful in reducing rates of at-risk drinking, it is unknown whether these reductions translate into improved health and health-related quality of life (HRQL). The aim of this study was to examine changes in health and HRQL of older adult at-risk drinkers resulting from a patient-provider educational intervention. A randomized controlled trial to compare the health and HRQL outcomes of patients assigned to the Project SHARE intervention vs. care as usual at baseline, 6- and 12-months post assignment. Control patients received usual care, which may or may not have included alcohol counseling. Intervention group patients received a personalized patient report, educational materials on alcohol and aging, a brief provider intervention, and a telephone health educator intervention. Current drinkers 60years and older accessing primary care clinics around Santa Barbara, California (N=1049). Data were collected from patients using baseline, 6- and 12-month mail surveys. Health and HRQL measures included mental and physical component scores (MCS and PCS) based on the Short Form-12v2 (SF-12v2), the SF-6D, which is also based on the SF-12, and the Geriatric Depression Scale (GDS). Adjusted associations of treatment assignment with these outcomes were estimated using generalized least squares regressions with random provider effects. Regressions controlled for age group, sex, race/ethnicity, marital status, education, household income, home ownership and the baseline value of

Fall-risk prediction in older adults with cancer: an unmet need.

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Wildes, Tanya M; Depp, Brittany; Colditz, Graham; Stark, Susan

2016-09-01

Falls in older adults with cancer are more common than in noncancer controls, yet no fall-risk screening tool has been validated in this population. We undertook a cross-sectional pilot study of the Falls Risk Questionnaire (FRQ) in 21 adults aged ≥65 receiving systemic cancer therapy. Participants completed the FRQ, geriatric assessment measures, and a measure of fear-of-falling. The recruitment rate was 87.5 %, with 95.2 % completion of the FRQ and additional geriatric assessment and quality of life measures. The FRQ correlated significantly with the Timed Up and Go test (Pearson r 0.479, p = 0.028). In addition, the FRQ score correlated directly with fear-of-falling and inversely with QOL, particularly physical health and neurotoxicity subscales. In conclusion, the FRQ was feasible in older adults receiving cancer therapy and correlates with measures of physical performance, functional status, and fear-of-falling. The FRQ may prove to be a valuable fall-risk screening tool to implement fall-prevention interventions in this vulnerable population of older adults with cancer.

Poor mental health among low-income women in the U.S.: The roles of adverse childhood and adult experiences.

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Mersky, Joshua P; Janczewski, Colleen E; Nitkowski, Jenna C

2018-06-01

It is well established that exposure to a greater number of adverse childhood experiences (ACEs) increases the risk of poor physical and mental health outcomes. Given the predictive validity of ACE scores and other cumulative risk metrics, a similar measurement approach may advance the study of risk in adulthood. We examined the prevalence and interrelations of 10 adverse adult experiences, including household events such as intimate partner violence and extrafamilial events such as crime victimization. We also tested the relation between cumulative adult adversity and later mental health problems, and we examined whether adult adversity mediates the link between childhood adversity and mental health. Data were collected from 501 women in the Families and Children Thriving Study, a longitudinal investigation of low-income families that received home visiting services in Wisconsin. We conducted correlation analyses to assess interrelations among study measures along with multivariate analyses to test the effects of childhood and adult adversity on three outcomes: depression, anxiety, and posttraumatic stress disorder (PTSD). We then fit a structural equation model to test whether the effects of childhood adversity on mental health are mediated by adult adversity. Over 80% of participants endorsed at least one adverse adult experience. Adult adversities correlated with each other and with the mental health outcomes. Controlling for ACEs and model covariates, adult adversity scores were positively associated with depression, anxiety, and PTSD scores. Path analyses revealed that the ACE-mental health connection was mediated by adult adversity. Our findings indicate that mental health problems may be better understood by accounting for processes through which early adversity leads to later adversity. Pending replication, this line of research has the potential to improve the identification of populations that are at risk of poor health outcomes. Copyright © 2018

Young Adults' Risk Perceptions of Various Tobacco Products Relative to Cigarettes: Results from the National Young Adult Health Survey

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Wackowski, Olivia A.; Delnevo, Cristine D.

2016-01-01

Objectives: Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method: We examined risk…

Prevalence of coronary heart disease risk factors and screening for high cholesterol levels among young adults, United States, 1999-2006.

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Kuklina, Elena V; Yoon, Paula W; Keenan, Nora L

2010-01-01

Previous studies have reported low rates of screening for high cholesterol levels among young adults in the United States. Although recommendations for screening young adults without risk factors for coronary heart disease (CHD) differ, all guidelines recommend screening adults with CHD, CHD equivalents, or 1 or more CHD risk factors. This study examined national prevalence of CHD risk factors and compliance with the cholesterol screening guidelines among young adults. National estimates were obtained using results for 2,587 young adults (men aged 20 to 35 years; women aged 20 to 45 years) from the 1999-2006 National Health and Nutrition Examination Surveys. We defined high low-density lipoprotein cholesterol (LDL-C) as levels higher than the goal specific for each CHD risk category outlined in the National Cholesterol Education Program Adult Treatment Panel III guidelines. About 59% of young adults had CHD or CHD equivalents, or 1 or more of the following CHD risk factors: family history of early CHD, smoking, hypertension, or obesity. In our study, the overall screening rate in this population was less than 50%. Moreover, no significant difference in screening rates between young adults with no risk factors and their counterparts with 1 or more risk factors was found even after adjustment for sociodemographic and health care factors. Approximately 65% of young adults with CHD or CHD equivalents, 26% of young adults with 2 or more risk factors, 12% of young adults with 1 risk factor, and 7% with no risk factor had a high level of LDL-C. CHD risk factors are common in young adults but do not appear to alter screening rates. Improvement of risk assessment and management for cardiovascular disease among young adults is warranted.

Use of the Internet to Meet Sexual Partners, Sexual Risk Behavior, and Mental Health in Transgender Adults.

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Benotsch, Eric G; Zimmerman, Rick S; Cathers, Laurie; Heck, Ted; McNulty, Shawn; Pierce, Juan; Perrin, Paul B; Snipes, Daniel J

2016-04-01

The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.

The Cascading Effects of Marginalization and Pathways of Resilience in Attaining Good Health Among LGBT Older Adults.

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Fredriksen-Goldsen, Karen I; Kim, Hyun-Jun; Bryan, Amanda E B; Shiu, Chengshi; Emlet, Charles A

2017-02-01

Lesbian, gay, bisexual, and transgender (LGBT) older adults comprise a diverse and growing health disparate population. In the present study, using the Health Equity Promotion Model, we investigated pathways by which LGBT older adults experience resilience, risk, and marginalization and their relationship to attaining positive health outcomes. Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) is the first longitudinal research project designed to examine the health, aging, and well-being of LGBT adults aged 50 and older. Using data from 2014 (N = 2,415), we tested a structural equation model linking lifetime marginalization, identity affirmation and management, social and psychological resources, and health behaviors to positive health outcomes. Identity affirmation positively predicted social resources and mental health, and social resources positively predicted mental health. Marginalization was associated with fewer social resources for LGBT older adults with an open identity management style, lower identity affirmation for LGBT older adults who strategically concealed their sexual identity, and poorer mental health. Mental health was associated with better health behaviors, which in turn predicted positive physical health outcomes. Although a health disparate population, good health among LGBT older adults appears to be attained via multiple resilience and risk pathways. Providers must remain aware of the historical contexts in which LGBT older adults lived and the strengths they developed in order to understand their health and to develop tailored and targeted prevention and intervention services. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Prediction of pneumonia hospitalization in adults using health checkup data.

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Uematsu, Hironori; Yamashita, Kazuto; Kunisawa, Susumu; Otsubo, Tetsuya; Imanaka, Yuichi

2017-01-01

Community-acquired pneumonia is a common cause of hospitalization, and pneumococcal vaccinations are recommended for high-risk individuals. Although risk factors for pneumonia have been identified, there are currently no pneumonia hospitalization prediction models based on the risk profiles of healthy subjects. This study aimed to develop a predictive model for pneumonia hospitalization in adults to accurately identify high-risk individuals to facilitate the efficient prevention of pneumonia. We conducted a retrospective database analysis using health checkup data and health insurance claims data for residents of Kyoto prefecture, Japan, between April 2010 and March 2015. We chose adults who had undergone health checkups in the first year of the study period, and tracked pneumonia hospitalizations over the next 5 years. Subjects were randomly divided into training and test sets. The outcome measure was pneumonia hospitalization, and candidate predictors were obtained from the health checkup data. The prediction model was developed and internally validated using a LASSO logistic regression analysis. Lastly, we compared the new model with comparative models. The study sample comprised 54,907 people who had undergone health checkups. Among these, 921 were hospitalized for pneumonia during the study period. The c-statistic for the prediction model in the test set was 0.71 (95% confidence interval: 0.69-0.73). In contrast, a comparative model with only age and comorbidities as predictors had a lower c-statistic of 0.55 (95% confidence interval: 0.54-0.56). Our predictive model for pneumonia hospitalization performed better than comparative models, and may be useful for supporting the development of pneumonia prevention measures.

Associations between adult attachment and: oral health-related quality of life, oral health behaviour, and self-rated oral health.

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Meredith, Pamela; Strong, Jenny; Ford, Pauline; Branjerdporn, Grace

2016-02-01

Although adult attachment theory has been revealed as a useful theoretical framework for understanding a range of health parameters, the associations between adult attachment patterns and a range of oral health parameters have not yet been examined. The aim of this study was to examine potential associations between attachment insecurity and: (1) oral health-related quality of life (OHRQoL), (2) oral health behaviours, and (3) self-rated oral health. In association with this aim, sample characteristics were compared with normative data. The sample in this cross-sectional study was comprised of 265 healthy adults, recruited via convenience sampling. Data were collected on attachment patterns (Experiences in Close Relationships Scale-Short Form, ECR-S), OHRQoL (Oral Health Impact Profile-14, OHIP-14), oral health behaviours (modified Dental Neglect Scale, m-DNS), and self-rated oral health (one-item global rating of oral health). Multivariate regression models were performed. Both dimensions of attachment insecurity were associated with lowered use of favourable dental visiting behaviours, as well as decreased OHRQoL for both overall well-being and specific aspects of OHRQoL. Attachment avoidance was linked with diminished self-rated oral health. This study supports the potential value of an adult attachment framework for understanding a range of oral health parameters. The assessment of a client's attachment pattern may assist in the identification of people who are at risk of diminished OHRQoL, less adaptive dental visiting behaviours, or poorer oral health. Further research in this field may inform ways in which attachment approaches can enhance oral health-related interventions.

Cost-effectiveness and public health impact of alternative influenza vaccination strategies in high-risk adults.

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Raviotta, Jonathan M; Smith, Kenneth J; DePasse, Jay; Brown, Shawn T; Shim, Eunha; Nowalk, Mary Patricia; Wateska, Angela; France, Glenson S; Zimmerman, Richard K

2017-10-09

High-dose trivalent inactivated influenza vaccine (HD-IIV3) or recombinant trivalent influenza vaccine (RIV) may increase influenza vaccine effectiveness (VE) in adults with conditions that place them at high risk for influenza complications. This analysis models the public health impact and cost-effectiveness (CE) of these vaccines for 50-64year-olds. Markov model CE analysis compared 5 strategies in 50-64year-olds: no vaccination; only standard-dose IIV3 offered (SD-IIV3 only), only quadrivalent influenza vaccine offered (SD-IIV4 only); high-risk patients receiving HD-IIV3, others receiving SD-IIV3 (HD-IIV3 & SD-IIV3); and high-risk patients receiving HD-IIV3, others receiving SD-IIV4 (HD-IIV3 & SD-IIV4). In a secondary analysis, RIV replaced HD-IIV3. Parameters were obtained from U.S. databases, the medical literature and extrapolations from VE estimates. Effectiveness was measured as 3%/year discounted quality adjusted life year (QALY) losses avoided. The least expensive strategy was SD-IIV3 only, with total costs of $99.84/person. The SD-IIV4 only strategy cost an additional $0.91/person, or $37,700/QALY gained. The HD-IIV3 & SD-IIV4 strategy cost $1.06 more than SD-IIV4 only, or $71,500/QALY gained. No vaccination and HD-IIV3 & SD-IIV3 strategies were dominated. Results were sensitive to influenza incidence, vaccine cost, standard-dose VE in the entire population and high-dose VE in high-risk patients. The CE of RIV for high-risk patients was dependent on as yet unknown parameter values. Based on available data, using high-dose influenza vaccine or RIV in middle-aged, high-risk patients may be an economically favorable vaccination strategy with public health benefits. Clinical trials of these vaccines in this population may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

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Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

2014-01-01

Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

A culture of future planning: perceptions of sexual risk among educated young adults.

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Cheney, Ann M; Ostrach, Bayla; Marcus, Ruthanne; Frank, Cynthia; Ball, Cassandra; Erickson, Pamela I

2014-10-01

In this study we examined how social processes, specifically the acquisition of postsecondary education and capital, shaped perceptions of sexual risk and impacted sexual practices and sexual health among young adults. Using qualitative research methods we collected and analyzed data among students attending a 4-year university in the northeastern region of the United States over a 1-year period. By analyzing participants' narratives, we found that the reproduction of shared norms and values encouraged educated young adults to focus on educational and professional success, pressing many of them to be concerned about preventing pregnancy rather than preventing disease transmission, and increasing their risk for sexually transmitted infections, including HIV/AIDS. Sexual-health educators need to address how social processes shape sexual practices, encourage educated young adults to challenge unequal gender expectations, and consider how sexually transmitted infections might also interfere with life plans. © The Author(s) 2014.

Multifactorial screening for fall risk in community-dwelling older adults in the primary care office: development of the fall risk assessment & screening tool.

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Renfro, Mindy Oxman; Fehrer, Steven

2011-01-01

Unintentional falls is an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur. This article describes the content selection and development of a simple-to-administer, multifactorial, Fall Risk Assessment & Screening Tool (FRAST), designed specifically for use in primary care settings to identify those older adults with high fall risk. Fall Risk Assessment & Screening Tool incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention. Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. Fall Risk Assessment & Screening Tool has been developed to assess fall risk in the target population of older adults (older than 65 years) living and ambulating independently in the community. Many fall risk factors have been considered and 15 items selected for inclusion. Fall Risk Assessment & Screening Tool includes 4 previously validated measures to assess balance, depression, falls efficacy, and home safety. Reliability and validity studies of FRAST are under way. Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing primary care practitioners (PCPs) with a very simple screening tool is imperative. Fall Risk Assessment & Screening Tool was created to allow for safe, quick, and low-cost administration by minimally trained office staff with interpretation and

The utility of childhood and adolescent obesity assessment in relation to adult health.

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Goldhaber-Fiebert, Jeremy D; Rubinfeld, Rachel E; Bhattacharya, Jay; Robinson, Thomas N; Wise, Paul H

2013-02-01

High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children. To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults. Longitudinal statistical analyses; microsimulations combining multiple data sets. National Longitudinal Survey of Youth, Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys. The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, 10-, and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race. Twelve percent of 18-year-olds were obese. While screening at age 5 would miss 50% of those who become obese adults, screening at age 15 would miss 9%. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age 15. For example, the relative risk of developing diabetes as adults for obese white male 15-year-olds was 4.5 versus otherwise similar nonobese 15-year-olds. For obese 5-year-olds, the relative risk was 1.6. Main results do not include Hispanics due to sample size. Past relationships between childhood and adult obesity and health may change in the future. Early childhood obesity assessment adds limited information to later childhood assessment. Targeted later childhood approaches or universal strategies to prevent unhealthy weight gain should be considered.

Environmental Health and Aging: Activity, Exposure and Biological Models to Improve Risk Assessment and Health Promotion

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The US Environmental Protection Agency (EPA) and other public health agencies are concerned that the environmental health of America’s growing population of older adults has not been taken into consideration in current approaches to risk assessment. The reduced capacity to respo...

Race/Ethnicity and Health-Related Quality of Life Among LGBT Older Adults.

Science.gov (United States)

Kim, Hyun-Jun; Jen, Sarah; Fredriksen-Goldsen, Karen I

2017-02-01

Few existing studies have addressed racial/ethnic differences in the health and quality of life of lesbian, gay, bisexual, and transgender (LGBT) older adults. Guided by the Health Equity Promotion Model, this study examines health-promoting and health risk factors that contribute to racial/ethnic health disparities among LGBT adults aged 50 and older. We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. By applying multiple mediator models, we analyzed the indirect effects of race/ethnicity on health-related quality of life (HRQOL) via demographics, lifetime LGBT-related discrimination, and victimization, and socioeconomic, identity-related, spiritual, and social resources. Although African Americans and Hispanics, compared with non-Hispanic Whites, reported lower physical HRQOL and comparable psychological HRQOL, indirect pathways between race/ethnicity and HRQOL were observed. African Americans and Hispanics had lower income, educational attainment, identity affirmation, and social support, which were associated with a decrease in physical and psychological HRQOL. African Americans had higher lifetime LGBT-related discrimination, which was linked to a decrease in their physical and psychological HRQOL. African Americans and Hispanics had higher spirituality, which was associated with an increase in psychological HRQOL. Findings illustrate the importance of identifying both health-promoting and health risk factors to understand ways to maximize the health potential of racially and ethnically diverse LGBT older adults. Interventions aimed at health equity should be tailored to bolster identity affirmation and social networks of LGBT older adults of color and to support strengths, including spiritual resources. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Awareness of Cardiovascular Risk Factors in U.S. Young Adults Aged 18–39 Years

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Bucholz, Emily M.; Gooding, Holly C.; de Ferranti, Sarah D.

2018-01-01

Introduction Young adults with hyperlipidemia, hypertension, and diabetes are at increased risk of developing heart disease later in life. Despite emphasis on early screening, little is known about awareness of these risk factors in young adulthood. Methods Data from the nationally representative cross-sectional survey National Health and Nutrition Examination Survey 2011–2014 were analyzed in 2017 to estimate the prevalence of self-reported awareness of hypercholesterolemia, hypertension, and diabetes in U.S. young adults aged 18–39 years (n=11,083). Prevalence estimates were weighted to population estimates using survey procedures, and predictors of awareness were identified using weighted logistic regression. Results Among U.S. young adults, the prevalence of hypercholesterolemia, hypertension, and diabetes was 8.8% (SE=0.4%), 7.3% (SE=0.3%), and 2.6% (SE=0.2%), respectively. The prevalence of borderline high cholesterol, blood pressure, and blood glucose were substantially higher (21.6% [SE= 0.6%], 26.9% [SE=0.7%], and 18.9% [SE=0.6%], respectively). Awareness was low for hypercholesterolemia (56.9% [SE=2.4%]) and moderate for hypertension and diabetes (62.7% [SE=2.4%] and 70.0% [SE=2.7%]); young adults with borderline levels of these risk factors were aware of their risk. Correlates of risk factor awareness included older age, insurance status, family income above the poverty line, U.S. origin, having a usual source of health care, and the presence of comorbid conditions. Conclusions Despite the high prevalence of cardiovascular risk factors in U.S. young adults, awareness remains less than ideal. Interventions that target access may increase awareness and facilitate achieving treatment goals in young adults. PMID:29433955

Gender Differences in Risk for Intimate Partner Violence Among South African Adults

OpenAIRE

Gass, Jesse D.; Stein, Dan J.; Williams, David R.; Seedat, Soraya

2010-01-01

Despite a high prevalence of intimate partner violence in South Africa, few epidemiological studies have assessed individual risk factors and differential vulnerability by gender. This study sought to analyze gender differences in risk for intimate partner violence victimization and perpetration according to childhood and adult risk factors in a national sample of South African men and women. Using data from the cross-sectional, nationally representative South Africa Stress and Health Study, ...

Anomaly in the education-health gradient: Biomarker profiles among adults with subbaccalaureate attainment levels.

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Zajacova, Anna; Johnson-Lawrence, Vicki

2016-12-01

This Short Communication builds on recent findings that documented an anomaly in the education-health gradient: adults who attended college but did not earn a BA (the subbaccalaureate group) reported an equal or higher level of health problems than adults with high school (HS) diploma. Our aim is to test whether this anomaly holds when we eliminate potential reporting differences, by examining biomarker levels in the subbaccalaureate vs HS groups. Using the restricted 1999-2012 NHANES, we estimate models of biomarkers for cardiovascular and metabolic diseases as a function of educational attainment, including three subbaccalaureate levels: "some college", vocational associate degree (AA), and academic AA. The data show that adults with "some college" or vocational AA have no systematic advantage over HS graduates in most biomarker indices while academic AA is associated with a significantly better risk profile compared to HS. The findings indicate that the adults with some college and vocational AA degrees do not benefit from their college experience in terms of improved physiological risk profile. This pattern underscores the need to understand and explain the anomalous health pattern that concerns 28% of American adults in the subbaccalaureate group among whom many reap little health payoffs to postsecondary schooling.

Chronic Disease Risk Typologies among Young Adults in Community College.

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Jeffries, Jayne K; Lytle, Leslie; Sotres-Alvarez, Daniela; Golden, Shelley; Aiello, Allison E; Linnan, Laura

2018-03-01

To address chronic disease risk holistically from a behavioral perspective, insights are needed to refine understanding of the covariance of key health behaviors. This study aims to identify distinct typologies of young adults based on 4 modifiable risk factors of chronic disease using a latent class analysis approach, and to describe patterns of class membership based on demographic characteristics, living arrangements, and weight. Overall, 441 young adults aged 18-35 attending community colleges in the Minnesota Twin Cities area completed a baseline questionnaire for the Choosing Healthy Options in College Environments and Settings study, a RCT. Behavioral items were used to create indicators for latent classes, and individuals were classified using maximum-probability assignment. Three latent classes were identified: 'active, binge-drinkers with a healthy dietary intake' (13.1%); 'non-active, moderate-smokers and non-drinkers with poor dietary intake' (38.2%); 'moderately active, non-smokers and non-drinkers with moderately healthy dietary intake' (48.7%). Classes exhibited unique demographic and weight-related profiles. This study may contribute to the literature on health behaviors among young adults and provides evidence that there are weight and age differences among subgroups. Understanding how behaviors cluster is important for identifying groups for targeted interventions in community colleges.

Differences in the Effects of the Great Recession on Health Outcomes among Minority Working-Age Adults.

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Towne, Samuel D; Probst, Janice C; Hardin, James W; Bell, Bethany A; Glover, Saundra

2015-03-01

We examined the effects of the Great Recession (December 2007-June 2009) among vulnerable adults who may be at high risk of poor health and low access to health care. Our primary outcomes of interest were self-reported health status (fair/poor versus good/very good/excellent), and foregoing needed health care due to cost in the past 12 months. Racial and ethnic minorities, except Asians, experienced higher rates of poor/fair health and higher rates of forgone medical care than did White adults. Hispanic and AIAN adults experienced differential effects of the Great Recession, as compared to White adults. Understanding how vulnerable populations react in times of economic flux will enable policy makers to identify strategies/policies to lessen the burden experienced by vulnerable adults.

Genetic moderation of multiple pathways linking early cumulative socioeconomic adversity and young adults' cardiometabolic disease risk.

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Wickrama, Kandauda A S; Lee, Tae Kyoung; O'Neal, Catherine Walker

2018-02-01

Recent research suggests that psychosocial resources and life stressors are mediating pathways explaining socioeconomic variation in young adults' health risks. However, less research has examined both these pathways simultaneously and their genetic moderation. A nationally representative sample of 11,030 respondents with prospective data collected over 13 years from the National Study of Adolescent to Adult Health was examined. First, the association between early cumulative socioeconomic adversity and young adults' (ages 25-34) cardiometabolic disease risk, as measured by 10 biomarkers, through psychosocial resources (educational attainment) and life stressors (accelerated transition to adulthood) was examined. Second, moderation of these pathways by the serotonin transporter linked polymorphic region gene (5-HTTLPR) was examined. There was evidence for the association between early socioeconomic adversity and young adults' cardiometabolic disease risk directly and indirectly through educational attainment and accelerated transitions. These direct and mediating pathways were amplified by the 5-HTTLPR polymorphism. These findings elucidate how early adversity can have an enduring influence on young adults' cardiometabolic disease risk directly and indirectly through psychosocial resources and life stressors and their genetic moderation. This information suggests that effective intervention and prevention programs should focus on early adversity, youth educational attainment, and their transition to young adulthood.

Oral health literacy and oral health outcomes in an adult population in Brazil.

Science.gov (United States)

Batista, Marília Jesus; Lawrence, Herenia Procopio; Sousa, Maria da Luz Rosário de

2017-07-26

To investigate the association between critical and communicative oral health literacy (OHL) and oral health outcomes (status, oral health-related quality of life and practices) in adults. This cross-sectional study examined a household probability sample of 248 adults, representing 149,635 residents (20-64 years old) in Piracicaba-SP, Brazil. Clinical oral health and socioeconomic and demographic data, as well as data on oral health-related quality of life (OHIP-14) and health practices were collected. The oral examinations were carried out in the participants' homes, using the World Health Organization criteria for oral diseases. The critical and communicative OHL instrument was the primary independent variable, and it was measured using five Likert items that were dichotomized as 'high' ('agree' and 'strongly agree' responses for the 5 items) and 'low' OHL. Binary and multinomial logistic regressions were performed on each outcome (oral health status and practices), controlling for age, sex and socioeconomic status (SES). Approximately 71.5% presented low OHL. When adjusted for age and sex (first model) low OHL was associated with untreated caries (Odds Ratio = 1.92, 95% Confidence Interval = 1.07-3.45), tooth brushing oral health impact on quality of life (OR = 2.06, 1.15-3.69). Adjusting for age, sex and SES, OHL is related to a risk factor (biofilm) and a consequence of poor oral health (emergency dental visits) and can interfere with the impact of oral diseases on quality of life. As low OHL can be modified, the results support oral health promotion strategies directed at improving critical and communicative oral health literacy in adult populations.

Risky music-listening behaviors and associated health-risk behaviors.

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Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

2012-06-01

To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

Health Literacy and Older Adults

Science.gov (United States)

Chesser, Amy K.; Keene Woods, Nikki; Smothers, Kyle; Rogers, Nicole

2016-01-01

Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults. PMID:28138488

Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

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Burks, Collin E; Jones, Christopher W; Braz, Valerie A; Swor, Robert A; Richmond, Natalie L; Hwang, Kay S; Hollowell, Allison G; Weaver, Mark A; Platts-Mills, Timothy F

2017-08-01

Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury. To identify modifiable risk factors associated with malnutrition in older patients. Prospective cross-sectional multicenter study. 3 EDs in the South, Northeast, and Midwest. Non-critically ill, English-speaking adults aged ≥65 years. Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor. In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%). Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Effect of Area-Level Socioeconomic Deprivation on Risk of Cognitive Dysfunction in Older Adults.

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McCann, Adrian; McNulty, Helene; Rigby, Jan; Hughes, Catherine F; Hoey, Leane; Molloy, Anne M; Cunningham, Conal J; Casey, Miriam C; Tracey, Fergal; O'Kane, Maurice J; McCarroll, Kevin; Ward, Mary; Moore, Katie; Strain, J J; Moore, Adrian

2018-02-12

To investigate the relationship between area-level deprivation and risk of cognitive dysfunction. Cross-sectional analysis. The Trinity, Ulster, and Department of Agriculture (TUDA) study from 2008 to 2012. Community-dwelling adults aged 74.0 ± 8.3 without dementia (N = 5,186; 67% female). Adopting a cross-jurisdictional approach, geo-referenced address-based information was used to map and link participants to official socioeconomic indicators of deprivation within the United Kingdom and the Republic of Ireland. Participants were assigned an individual deprivation score related to the smallest administrative area in which they lived. These scores were categorized into comparable quintiles, that were then used to integrate the datasets from both countries. Cognitive health was assessed using the Mini-Mental State Examination (MMSE); cognitive dysfunction was defined as a MMSE score of 24 or less. Approximately one-quarter of the cohort resided within the most-deprived districts in both countries. Greater area-level deprivation was associated with significantly lower MMSE scores; fewer years of formal education; greater anxiety, depression, smoking and alcohol use, and obesity; and more adverse outcomes, including higher blood pressure and diabetes risk. After adjustment for relevant covariates, area deprivation was associated with significantly higher risk of cognitive dysfunction (odds ratio =1.40, 95% confidence interval = 1.05-1.87, P = .02, for most vs least deprived). This analysis combining data from two health systems shows that area deprivation is an independent risk factor for cognitive dysfunction in older adults. Adults living in areas of greatest socioeconomic deprivation may benefit from targeted strategies aimed at improving modifiable risk factors for dementia. Further cross-national analysis investigating the impact of area-level deprivation is needed to address socioeconomic disparities and shape future policy to improve health outcomes in older

The Effect of Childhood Health Status on Adult Health in China.

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Wang, Qing; Zhang, Huyang; Rizzo, John A; Fang, Hai

2018-01-26

Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects' fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13-18%), 13% (95% CI: 10-15%), and 14% (95% CI: 12-17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote

Relations of behavioral autonomy to health outcomes among emerging adults with and without type 1 diabetes.

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Helgeson, Vicki S; Reynolds, Kerry A; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

2014-01-01

To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Perspectives of Puerto Rican Adults about Heart Health and a Potential Community Program

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Todorova, Irina L. G.; Tejada, Shirley; Castaneda-Sceppa, Carmen

2014-01-01

Background: Puerto Ricans are the second largest Hispanic group in the United States, and older adults have significant health disparities. Educational programs that address heart disease risk for this population have rarely been developed and implemented. Purpose: To address this gap, the Heart Healthy Initiative for Puerto Rican adults is being…

Health Literacy, Health Disparities, and Sources of Health Information in U.S. Older Adults.

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Cutilli, Carolyn Crane; Simko, Lynn C; Colbert, Alison M; Bennett, Ian M

Low health literacy in older adults has been associated with poor health outcomes (i.e., mortality, decreased physical and cognitive functioning, and less preventive care utilization). Many factors associated with low health literacy are also associated with health disparities. Interaction with healthcare providers and sources of health information are influenced by an individual's health literacy and can impact health outcomes. This study examined the relationships between health literacy, sources of health information, and demographic/background characteristics in older adults (aged 65 years and older) related to health literacy and disparities. This descriptive, correlational study is a secondary analysis of the 2003 National Assessment of Adult Literacy, a large-scale national assessment. Older adults with lower health literacy have less income and education, rate their health as poor or fair, have visual or auditory difficulties, need help filling out forms, reading newspaper, or writing notes, and use each source of health information less (print and nonprint). Many of these characteristics and skills are predictive of health literacy and associated with health disparities. The results expand our knowledge of characteristics associated with health literacy and sources of health information used by older adults. Interventions to improve health outcomes including health disparities can focus on recognizing and meeting the health literacy demands of older adults.

Motives for volunteering are associated with mortality risk in older adults.

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Konrath, Sara; Fuhrel-Forbis, Andrea; Lou, Alina; Brown, Stephanie

2012-01-01

The purpose of this study is to examine the effects of motives for volunteering on respondents' mortality risk 4 years later. Logistic regression analysis was used to examine whether motives for volunteering predicted later mortality risk, above and beyond volunteering itself, in older adults from the Wisconsin Longitudinal Study. Covariates included age, gender, socioeconomic variables, physical, mental, and cognitive health, health risk behaviors, personality traits, received social support, and actual volunteering behavior. Replicating prior work, respondents who volunteered were at lower risk for mortality 4 years later, especially those who volunteered more regularly and frequently. However, volunteering behavior was not always beneficially related to mortality risk: Those who volunteered for self-oriented reasons had a mortality risk similar to nonvolunteers. Those who volunteered for other-oriented reasons had a decreased mortality risk, even in adjusted models. This study adds to the existing literature on the powerful effects of social interactions on health and is the first study to our knowledge to examine the effect of motives on volunteers' subsequent mortality. Volunteers live longer than nonvolunteers, but this is only true if they volunteer for other-oriented reasons.

Sexting, substance use, and sexual risk behavior in young adults.

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Benotsch, Eric G; Snipes, Daniel J; Martin, Aaron M; Bull, Sheana S

2013-03-01

Cell phone use has become more widespread over the past decade. Young adults are frequently early adopters of new technologies, including cell phones. Most previous research examining sexting, the act of sending sexually explicit or suggestive images via text message, has focused on the legal or social consequences of this behavior. The current study focused on the public health implications of sexting by examining associations between sexting, substance use, and sexual risk behavior in youth. Young adults (N = 763) completed online questionnaires assessing demographics, cell phone use (e.g., texting, sexting), substance use, and sexual risk behaviors. Sexting was reported by a substantial minority of participants (44%). Compared with their nonsexting counterparts, participants who engaged in sexting were more likely to report recent substance use and high-risk sexual behaviors, including unprotected sex and sex with multiple partners. Of those who engaged in sexting, a considerable percentage (31.8%) reported having sex with a new partner for the first time after sexting with that person. In multivariate analyses, sexting was associated with high-risk sexual behavior, after accounting for demographic factors, total texting behaviors, and substance use. Results suggest that sexting is robustly associated with high-risk sexual behavior. Many individuals exchange explicit or provocative photos with long-term sexual partners, but at least some participants in this study were incurring new sexual risks after sexting. Additional research is needed to understand the contexts in which sexting occurs, motivations for sexting, and relationship of sexting to risk behavior. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Problems and fall risk determinants of quality of life in older adults with increased risk of falling.

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Lin, Sang-I; Chang, Ku-Chou; Lee, Hsuei-Chen; Yang, Yi-Ching; Tsauo, Jau-Yih

2015-05-01

Determine quality of life and its association with fall risk factors in older adults with increased risk of falling. A total of 597 community-dwelling Taiwanese older adults who were screened to have increased risk of falling participated in the present study. The fall risk factors included sociodemographics, physical and psychological function, Timed Up and Go, past fall/medical histories, fear of falling and medications. The Euro QOL EQ-5D was used to measure health-related quality of life. Pain/discomfort was the EQ-5D dimension most frequently reported to be impaired (35%), regardless of the level of fall risk or age groups, followed by mobility (25%). Hierarchical regression analysis showed that Geriatric Depression Scale, Mini-Mental State Examination, physiological function, up-and-go, fear of falling and psychotropic medication were independent predictors for total EQ-5D, explaining 68.37% of the variance. Logistic regression analysis showed that for the five EQ-5D dimensions, Geriatric Depression Scale and Up and Go time were the most common determinants. Pain/discomfort was the leading impairment, and greater Geriatric Depression Scale and longer up-and-go time were the main contributing factors in declines in quality of life in older adults with increased risk of falling. These factors are often modifiable, and their management might be considered a priority in falls prevention. © 2014 Japan Geriatrics Society.

Cross-cultural differences and sexual risk behavior of emerging adults.

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Thomas, Tami L; Yarandi, Hossein N; Dalmida, Safiya George; Frados, Andrew; Klienert, Kathleen

2015-01-01

The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV). A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic. Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies. Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly. By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV. © The Author(s) 2014.

Risky music-listening behaviors and associated health-risk behaviors

NARCIS (Netherlands)

I. Vogel (Ineke); P.M. van de Looij-Jansen (Petra); C.L. Mieloo (Cathelijne); A. Burdorf (Alex); F. de Waart (Frouwkje)

2012-01-01

textabstractOBJECTIVE: To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes,

Risk Factors of Falls in Community-Dwelling Older Adults: Logistic Regression Tree Analysis

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Yamashita, Takashi; Noe, Douglas A.; Bailer, A. John

2012-01-01

Purpose of the Study: A novel logistic regression tree-based method was applied to identify fall risk factors and possible interaction effects of those risk factors. Design and Methods: A nationally representative sample of American older adults aged 65 years and older (N = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used.…

Prevalence of Mental Health Illness Among Patients with Adult-onset Strabismus

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Hassan, Mohamed Basil; Hodge, David O.

2016-01-01

Background Children diagnosed with some forms of strabismus were recently found to have an increased risk of developing mental illness by early adulthood. The purpose of this case-controlled study was to determine if adults with non-paralytic forms of strabismus are similarly at an elevated risk for developing mental illness. Methods The medical records of all patients diagnosed as adults (≥ 19 years of age) with convergence insufficiency (CI, n=118), divergence insufficiency (DI, n=80), and small angle hypertropia (HT, n=99) from January 1, 1985, through December 31, 2004, were retrospectively reviewed. Each case was compared with a sex- and birthdate-matched non-strabismic control. The medical records were reviewed for mental health diagnoses, including inpatient and outpatient encounters, psychiatric ER visits, and medication use. Results Mental health disorders were diagnosed in 65 (55.1%) patients with CI compared to 54 (45.8%) controls (p=0.15), in 51 (63.8%) patients with DI compared to 42 (52.5%) controls (p=0.15), and in 63 (63.6%) patients with HT compared to 57 (57.6%) controls (p=0.38). CI patients were not more likely to have mental health disorders than their controls (p=0.15). Mental health hospitalizations (p=0.02), psychiatric medication use (p=0.04), and unspecified anxiety disorders (p=0.03) were higher in DI patients compared to controls. HT patients were found to have more generalized anxiety disorders (p=0.003) than controls. Conclusions Adults with some forms of strabismus (DI and HT) appear to have an increased risk of mental illness and its comorbidities, compared to age- and gender-matched non-strabismic controls. PMID:26559866

Metabolic syndrome among urban Indian young adults: prevalence and associated risk factors.

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Manjunath, Dinaker; Uthappa, Chengapp Kechamada; Kattula, Sri Rama; Allam, Ramesh Reddy; Chava, Nalini; Oruganti, Ganesh

2014-09-01

We estimated the prevalence of metabolic syndrome among urban Indian young adults (18-25 years) as defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), Internation Diabetes Federation (IDF), and Indian consensus statement criteria. We included 473 urban young adults through simple random sampling methodology to estimate the prevalence and associated risk factors for metabolic syndrome. Prevalence of metabolic syndrome was estimated to be 3.6 [95% confidence interval (CI) 2.2-5.8], 6.6% (95% CI 4.6-9.1), and 8.7% (95% CI 6.4-11.6) using the NCEP ATP III, IDF, and Indian consensus statement criteria, respectively. Men had significantly higher waist circumference, systolic blood pressure, fasting blood glucose, and triglycerides, whereas mean concentrations of both high-density lipoprotein cholesterol (HDL-C) and total cholesterol were significantly higher among women. Low HDL-C (38.9%), high blood pressure (26%), and central obesity (16.1%) were the most common component risk factors. Although less than 4% of normal weight adults met the criteria for metabolic syndrome, rates increased in overweight individuals and reached a prevalence of 87% in the obese participants. In all, 61.3% of the total population had one or more risk factors for metabolic syndrome. The prevalence of metabolic syndrome is high among urban young adults in India, and it increased with increase in body mass index (BMI). Each component risk factor in isolated form-increased BMI, smoking, and history of hypertension--is an associated risk factor for metabolic syndrome. Although it is unclear whether metabolic syndrome screening in young Indians as a means to prevent adverse cardiovascular health outcomes is appropriate, healthy lifestyles should nevertheless be encouraged, and young adults should be considered as an important group for cardiovascular risk reduction programs.

Coping and health in older adults.

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Yancura, Loriena A; Aldwin, Carolyn M

2008-02-01

Although coping has been shown to influence physical health in younger populations, whether coping affects health in older adults appears to depend upon how coping and health are conceptualized. This article reviews recent literature on coping and health in older adults in three areas. First, we discuss coping's distinct relevance to health in older adults. Second, we describe ways in which coping may differ between older and younger populations. Third, we detail recent and notable findings of coping's specific effects on biomedical health and health in general. The recent literature suggests that coping may be a developmental and multifaceted process. Positive coping strategies may have positive and even protective effects on health, whereas negative strategies may have negative effects.

Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.

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Hoffman, Geoffrey J; Hays, Ron D; Wallace, Steven P; Shapiro, Martin F; Yakusheva, Olga; Ettner, Susan L

2017-04-01

Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk. Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (≥14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (≥3 activities of daily living) or cognitive limitations moderated this relationship. Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (Pfall risk relative to low levels of informal care. Among individuals with ≥3 activities of daily living, fall risks were reduced by 21% for those receiving high levels of informal care; additionally, FRIs were reduced by 42% and 58% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54% FRI risk reduction among the cognitively impaired. Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

Adult height, nutrition, and population health

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Perkins, Jessica M.; Subramanian, S.V.; Davey Smith, George

2016-01-01

In this review, the potential causes and consequences of adult height, a measure of cumulative net nutrition, in modern populations are summarized. The mechanisms linking adult height and health are examined, with a focus on the role of potential confounders. Evidence across studies indicates that short adult height (reflecting growth retardation) in low- and middle-income countries is driven by environmental conditions, especially net nutrition during early years. Some of the associations of height with health and social outcomes potentially reflect the association between these environmental factors and such outcomes. These conditions are manifested in the substantial differences in adult height that exist between and within countries and over time. This review suggests that adult height is a useful marker of variation in cumulative net nutrition, biological deprivation, and standard of living between and within populations and should be routinely measured. Linkages between adult height and health, within and across generations, suggest that adult height may be a potential tool for monitoring health conditions and that programs focused on offspring outcomes may consider maternal height as a potentially important influence. PMID:26928678

Associations of a social network typology with physical and mental health risks among older adults in South Korea.

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Park, N S; Jang, Y; Lee, B S; Chiriboga, D A; Chang, S; Kim, S Y

2018-05-01

The objectives of this study were to (1) develop an empirical typology of social networks in older Koreans; and (2) examine its effect on physical and mental health. A sample of 6900 community-dwelling older adults in South Korea was drawn from the 2014 Korean National Elderly Survey. Latent profile analysis (LPA) was conducted to derive social network types using eight common social network characteristics (marital status, living arrangement, the number and frequency of contact with close family/relatives, the number and frequency of contact with close friends, frequency of participation in social activities, and frequency of having visitors at home). The identified typologies were then regressed on self-rated health and depressive symptoms to explore the health risks posed by the group membership. The LPA identified a model with five types of social network as being most optimal (BIC = 153,848.34, entropy = .90). The groups were named diverse/family (enriched networks with more engagement with family), diverse/friend (enriched networks with more engagement with friends), friend-focused (high engagement with friends), distant (structurally disengaged), and restricted (structurally engaged but disengaged in family/friends networks). A series of regression analyses showed that membership in the restricted type was associated with more health and mental health risks than all types of social networks except the distant type. Findings demonstrate the importance of family and friends as a source of social network and call attention to not only structural but also non-structural aspects of social isolation. Findings and implications are discussed in cultural contexts.

Family Communication, Risk Perception and Cancer Knowledge of Young Adults from BRCA1/2 Families: a Systematic Review.

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Young, Alison L; Butow, Phyllis N; Vetsch, Janine; Quinn, Veronica F; Patenaude, Andrea F; Tucker, Katherine M; Wakefield, Claire E

2017-12-01

Understanding challenges in familial communication of cancer risk has informed genetic service delivery. Parent-child interactions have received considerable attention, but few studies focus on young adulthood experiences within BRCA1/2 families. Young adults are approaching, or at a life stage where awareness of hereditary cancer risk is vital for informed choice of risk management options. This review assesses family communication, risk perception and cancer knowledge held by 18-40 year old individuals who have a parent with a BRCA1/2 gene mutation or carry the gene mutation themselves. Thirteen papers met the inclusion criteria. One utilized a 'mixed methods' methodology and the remaining used a qualitative approach. Findings were synthesized into themes and reported narratively. In general, parents are communicating openly about genetic risk with young adult offspring, but there is evidence that some young adults are withholding information from their parents about their own test results. Risk perception is influenced by a family history of cancer, childbearing plans and health providers' advice. Misconceptions about genetic risk appear to be common and gaps in hereditary cancer knowledge are evident. It is unclear whether incorrect knowledge was passed from parents to offspring. Health providers need to provide developmentally appropriate services for emerging adults (18-25 years old), with particular support in navigating through risk management options.

Health risk assessment of heavy metals and metalloid in drinking water from communities near gold mines in Tarkwa, Ghana.

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Bortey-Sam, Nesta; Nakayama, Shouta M M; Ikenaka, Yoshinori; Akoto, Osei; Baidoo, Elvis; Mizukawa, Hazuki; Ishizuka, Mayumi

2015-07-01

Concentrations of heavy metals and metalloid in borehole drinking water from 18 communities in Tarkwa, Ghana, were measured to assess the health risk associated with its consumption. Mean concentrations of heavy metals (μg/L) exceeded recommended values in some communities. If we take into consideration the additive effect of heavy metals and metalloid, then oral hazard index (HI) results raise concerns about the noncarcinogenic adverse health effects of drinking groundwater in Huniso. According to the US Environmental Protection Agency's (USEPA) guidelines, HI values indicating noncarcinogenic health risk for adults and children in Huniso were 0.781 (low risk) and 1.08 (medium risk), respectively. The cancer risk due to cadmium (Cd) exposure in adults and children in the sampled communities was very low. However, the average risk values of arsenic (As) for adults and children through drinking borehole water in the communities indicated medium cancer risk, but high cancer risk in some communities such as Samahu and Mile 7. Based on the USEPA assessment, the average cancer risk values of As for adults (3.65E-05) and children (5.08E-05) indicated three (adults) and five (children) cases of neoplasm in a hundred thousand inhabitants. The results of this study showed that residents in Tarkwa who use and drink water from boreholes could be at serious risk from exposure to these heavy metals and metalloid.

Drinking patterns and adherence to "low-risk" guidelines among community-residing older adults.

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Lewis, Ben; Garcia, Christian C; Nixon, Sara Jo

2018-06-01

Older adults constitute a rapidly expanding proportion of the U.S. Contemporary studies note the increasing prevalence of alcohol consumption in this group. Thus, understanding alcohol effects, consumption patterns, and associated risks in aging populations constitute critical areas of study with increasing public health relevance. Participants (n = 643; 292 women; ages 21-70) were community residing adult volunteers. Primary measures of interest included four patterns of alcohol consumption (average [oz./day]; typical quantity [oz./occasion]; frequency [% drinking days]; and maximal quantity [oz.]). Regression analyses explored associations between these measures, age, and relevant covariates. Subsequent between-group analyses investigated differences between two groups of older adults and a comparator group of younger adults, their adherance to "low-risk" guidelines, and whether alcohol-associated risks differed by age and adherence pattern. Average consumption did not vary by age or differ between age groups. In contrast, markedly higher frequencies and lower quantities of consumption were observed with increasing age. These differences persisted across adherence categories and were evident even in the oldest age group. Exceeding "low-risk" guidelines was associated with greater risk for alcohol-related problems among the older groups. These results emphasize the utility of considering underlying constituent patterns of consumption in older drinkers. Findings highlight difficulties in identifying problem drinking among older adults and contribute to the few characterizations of "risky" drinking patterns in this group. Taken together, our data contribute to literatures of import for the design and enhancement of screening, prevention, and education initiatives directed toward aging adults. Copyright © 2018. Published by Elsevier B.V.

Mortality among older adults with opioid use disorders in the Veteran's Health Administration, 2000-2011.

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Larney, Sarah; Bohnert, Amy S B; Ganoczy, Dara; Ilgen, Mark A; Hickman, Matthew; Blow, Fred C; Degenhardt, Louisa

2015-02-01

The population of people with opioid use disorders (OUD) is aging. There has been little research on the effects of aging on mortality rates and causes of death in this group. We aimed to compare mortality in older (≥ 50 years of age) adults with OUD to that in younger (OUD and older adults with no history of OUD. We also examined risk factors for specific causes of death in older adults with OUD. Using data from the Veteran's Health Administration National Patient Care Database (2000-2011), we compared all-cause and cause-specific mortality rates in older adults with OUD to those in younger adults with OUD and older adults without OUD. We then generated a Cox regression model with specific causes of death treated as competing risks. Older adults with OUD were more likely to die from any cause than younger adults with OUD. The drug-related mortality rate did not decline with age. HIV-related and liver-related deaths were higher among older OUD compared to same-age peers without OUD. There were very few clinically important predictors of specific causes of death. Considerable drug-related mortality in people with OUD suggests a need for greater access to overdose prevention and opioid substitution therapy across the lifespan. Elevated risk of liver-related death in older adults may be addressed through antiviral therapy for hepatitis C virus infection. There is an urgent need to explore models of care that address the complex health needs of older adults with OUD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Gender disparities in the association between socio-demographics and non-communicable disease risk factors among adults with disabilities in Shanghai, China

Directory of Open Access Journals (Sweden)

Youran Zhang

2018-03-01

Full Text Available Background Non-communicable disease (NCD risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China. Methods We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and logistic regression models were conducted to estimate gender disparities in the association between socio-demographics, disability characteristics, and four selected NCD risk factors among adults with disabilities—including high blood pressure, high blood glucose, high blood lipids, and being overweight. We estimated marginal effects (MEs on NCD risk factors between gender and other confounders. Results Women with disabilities were about 11.6 percentage points more likely to suffer from high blood lipids and less likely to develop the other three risk factors than men were. The association of age group, residence permit, education level, marital status, and disability type with health outcomes varied by gender among adults with disabilities. The difference in age effects between men and women was more pronounced in older age groups. Urban residence was associated with less risk of high blood pressure risk among women (ΔME =  − 0.035, p < 0.01, but no significant difference in other NCD risk factors. Education remained a major protective factor against high blood pressure, high blood glucose and being overweight among women with disabilities (MEs < 0, p < 0.05; however, this did not hold for men. The difference in marriage effects between men and women was observed in

Psychosocial risk factors and asthma among adults in Puerto Rico.

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Han, Yueh-Ying; Forno, Erick; Canino, Glorisa; Celedón, Juan C

2018-05-08

Asthma and psychosocial stressors are common among Puerto Rican adults living in the United States. We estimated the prevalence of current asthma, and examined potential psychosocial risk factors and current asthma, among adults in Puerto Rico. Cross-sectional study of 3,049 Puerto Ricans aged 18-64 years living in Puerto Rico between May 2014 and June 2016. A structured interview was conducted to obtain information on demographics, lifestyles, mental disorders, and respiratory health. Current asthma was defined as self-reported physician-diagnosed asthma and still having asthma. Two-sample t tests (for continuous variables) or chi-square tests (for categorical variables) were used in bivariate analyses. Multivariable logistic regression was used to examine psychosocial risk factors and current asthma. The estimated prevalence of current asthma was 10.2%. In a multivariable analysis, exposure to violence (odds ratio [OR] for each 1-point increment in a validated scale = 1.14, 95% confidence interval [CI] = 1.07 to 1.21) and a lifetime history of at least one suicide attempt (OR = 3.01, 95% CI = 1.80 to 5.01) were significantly associated with current asthma, independently of major depressive disorder. Moreover, a lifetime history of at least one suicide attempt was associated with co-existing asthma and chronic obstructive pulmonary disease (i.e. asthma-COPD overlap syndrome or ACOS (OR = 9.05, 95% CI = 3.32-24.67). Our findings suggest that asthma is a major health problem among adults in Puerto Rico, with psychosocial risk factors playing a significant role on asthma and ACOS. Addressing chronic stressors and mental illness should be part of comprehensive strategies to reduce asthma burden in this population.

Dying in their prime: determinants and space-time risk of adult mortality in rural South Africa

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Sartorius, Benn; Kahn, Kathleen; Collinson, Mark A.; Sartorius, Kurt; Tollman, Stephen M.

2013-01-01

A longitudinal dataset was used to investigate adult mortality in rural South Africa in order to determine location, trends, high impact determinants and policy implications. Adult (15-59 years) mortality data for the period 1993-2010 were extracted from the health and socio-demographic surveillance system (HDSS) in the rural sub-district of Agincourt. A Bayesian geostatistical frailty survival model was used to quantify significant associations between adult mortality and various multilevel (individual, household and community) variables. It was found that adult mortality significantly increased over time with a reduction observed late in the study period. Non-communicable disease mortality appeared to increase and decrease in parallel with communicable mortality, whilst deaths due to external causes remained constant. Male gender, unemployment, circular (labour) migrant status, age and gender of household heads, partner and/or other household death, low education and low household socioeconomic status (SES) were identified as significant and highly attributable determinants of adult mortality. Health facility remoteness was also a risk for adult mortality and households falling outside a critical buffering zone were identified. Spatial foci of higher adult mortality risk were observed indicating a strong non-random pattern. Communicable diseases differed from non-communicable diseases with respect to spatial distribution of mortality. Areas with significant excess mortality risk (hotspots) were found to be part of a complex interaction of highly attributable factors that continues to drive differential space-time risk patterns of communicable (HIV/AIDS and Tuberculosis) mortality in Agincourt. The impact of HIV mortality and its subsequent lowering due to the introduction of antiretroviral therapy (ART) was found to be clearly evident in this rural population. PMID:23733287

Health Literacy, Social Support, and Health Status among Older Adults

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Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel

2009-01-01

The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…

Cardiometabolic Risks and Severity of Obesity in Children and Young Adults.

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Skinner, Asheley C; Perrin, Eliana M; Moss, Leslie A; Skelton, Joseph A

2015-10-01

The prevalence of severe obesity among children and young adults has increased over the past decade. Although the prevalence of cardiometabolic risk factors is relatively low among children and young adults who are overweight or obese, those with more severe forms of obesity may be at greater risk. We performed a cross-sectional analysis of data from overweight or obese children and young adults 3 to 19 years of age who were included in the National Health and Nutrition Examination Survey from 1999 through 2012 to assess the prevalence of multiple cardiometabolic risk factors according to the severity of obesity. Weight status was classified on the basis of measured height and weight. We used standard definitions of abnormal values for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, glycated hemoglobin, and fasting glucose and report the prevalence of abnormal values in children and young adults according to weight status. Among 8579 children and young adults with a body-mass index at the 85th percentile or higher (according to the Centers for Disease Control and Prevention growth charts), 46.9% were overweight, 36.4% had class I obesity, 11.9% had class II obesity, and 4.8% had class III obesity. Mean values for some, but not all, cardiometabolic variables were higher with greater severity of obesity in both male and female participants, and the values were higher in male participants than in female participants; for HDL cholesterol, the mean values were lower with greater severity of obesity. Multivariable models that controlled for age, race or ethnic group, and sex showed that the greater the severity of obesity, the higher the risks of a low HDL cholesterol level, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels. Severe obesity in children and young adults was associated with an increased prevalence of cardiometabolic risk factors

Body mass index in childhood and adult risk of primary liver cancer

DEFF Research Database (Denmark)

Berentzen, Tina Landsvig; Gamborg, Michael; Holst, Claus

2014-01-01

BACKGROUND & AIMS: Childhood overweight increases the risk of early development of non-alcoholic fatty liver disease, which may predispose to carcinogenesis. We investigated if childhood body size during school ages was associated with the risk of primary liver cancer in adults. METHODS: A cohort......-specific reference. Information on liver cancer was obtained from the National Cancer Registry. Hazard ratios and 95% confidence intervals (95% CI) of liver cancer were estimated by Cox regression. RESULTS: During 6,963,105 person-years of follow-up, 438 cases of primary liver cancer were recorded. The hazard ratio...... hepatitis, alcohol-related disorders, and biliary cirrhosis. CONCLUSIONS: Higher BMI in childhood increases the risk of primary liver cancer in adults. In view of the high case fatality of primary liver cancer, this result adds to the future negative health outcomes of the epidemic of childhood overweight...

Zero-Inflated Poisson Modeling of Fall Risk Factors in Community-Dwelling Older Adults.

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Jung, Dukyoo; Kang, Younhee; Kim, Mi Young; Ma, Rye-Won; Bhandari, Pratibha

2016-02-01

The aim of this study was to identify risk factors for falls among community-dwelling older adults. The study used a cross-sectional descriptive design. Self-report questionnaires were used to collect data from 658 community-dwelling older adults and were analyzed using logistic and zero-inflated Poisson (ZIP) regression. Perceived health status was a significant factor in the count model, and fall efficacy emerged as a significant predictor in the logistic models. The findings suggest that fall efficacy is important for predicting not only faller and nonfaller status but also fall counts in older adults who may or may not have experienced a previous fall. The fall predictors identified in this study--perceived health status and fall efficacy--indicate the need for fall-prevention programs tailored to address both the physical and psychological issues unique to older adults. © The Author(s) 2014.

Applying the reasoned action approach to understanding health protection and health risk behaviors.

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Conner, Mark; McEachan, Rosemary; Lawton, Rebecca; Gardner, Peter

2017-12-01

The Reasoned Action Approach (RAA) developed out of the Theory of Reasoned Action and Theory of Planned Behavior but has not yet been widely applied to understanding health behaviors. The present research employed the RAA in a prospective design to test predictions of intention and action for groups of protection and risk behaviors separately in the same sample. To test the RAA for health protection and risk behaviors. Measures of RAA components plus past behavior were taken in relation to eight protection and six risk behaviors in 385 adults. Self-reported behavior was assessed one month later. Multi-level modelling showed instrumental attitude, experiential attitude, descriptive norms, capacity and past behavior were significant positive predictors of intentions to engage in protection or risk behaviors. Injunctive norms were only significant predictors of intention in protection behaviors. Autonomy was a significant positive predictor of intentions in protection behaviors and a negative predictor in risk behaviors (the latter relationship became non-significant when controlling for past behavior). Multi-level modelling showed that intention, capacity, and past behavior were significant positive predictors of action for both protection and risk behaviors. Experiential attitude and descriptive norm were additional significant positive predictors of risk behaviors. The RAA has utility in predicting both protection and risk health behaviors although the power of predictors may vary across these types of health behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Social Network Types and Mental Health Among LGBT Older Adults

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Kim, Hyun-Jun; Fredriksen-Goldsen, Karen I.; Bryan, Amanda E. B.; Muraco, Anna

2017-01-01

Purpose of the Study: This study was designed to identify social network types among lesbian, gay, bisexual, and transgender (LGBT) older adults and examine the relationship between social network type and mental health. Design and Methods: We analyzed the 2014 survey data of LGBT adults aged 50 and older (N = 2,450) from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. Latent profile analyses were conducted to identify clusters of social network ties based on 11 indicators. Multiple regression analysis was performed to examine the association between social network types and mental health. Results: We found five social network types. Ordered from greatest to least access to family, friend, and other non-family network ties, they were diverse, diverse/no children, immediate family-focused, friend-centered/restricted, and fully restricted. The friend-centered/restricted (33%) and diverse/no children network types (31%) were the most prevalent. Among individuals with the friend-centered/restricted type, access to social networks was limited to friends, and across both types children were not present. The least prevalent type was the fully restricted network type (6%). Social network type was significantly associated with mental health, after controlling for background characteristics and total social network size; those with the fully restricted type showed the poorest mental health. Implications: Unique social network types (diverse/no children and friend-centered/restricted) emerge among LGBT older adults. Moreover, individuals with fully restricted social networks are at particular risk due to heightened health needs and limited social resources. This study highlights the importance of understanding heterogeneous social relations and developing tailored interventions to promote social connectedness and mental health in LGBT older adults. PMID:28087798

Volunteering by older adults and risk of mortality: a meta-analysis.

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Okun, Morris A; Yeung, Ellen WanHeung; Brown, Stephanie

2013-06-01

Organizational volunteering has been touted as an effective strategy for older adults to help themselves while helping others. Extending previous reviews, we carried out a meta-analysis of the relation between organizational volunteering by late-middle-aged and older adults (minimum age = 55 years old) and risk of mortality. We focused on unadjusted effect sizes (i.e., bivariate relations), adjusted effect sizes (i.e., controlling for other variables such as health), and interaction effect sizes (e.g., the joint effect of volunteering and religiosity). For unadjusted effect sizes, on average, volunteering reduced mortality risk by 47%, with a 95% confidence interval ranging from 38% to 55%. For adjusted effect sizes, on average, volunteering reduced mortality risk by 24%, with a 95% confidence interval ranging from 16% to 31%. For interaction effect sizes, we found preliminary support that as public religiosity increases, the inverse relation between volunteering and mortality risk becomes stronger. The discussion identifies several unresolved issues and directions for future research. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Health risk indicators in NPP - a continuous discussion

International Nuclear Information System (INIS)

Bliznakov, V.

1999-01-01

An evaluation of the costs connected with the health consequences due to occupational exposure for the personnel in the NPP 'Kozloduy' is made. The methods used are WTP (willingness to pay) and COI (cost of illness). The estimations in USD are as follows: for chronic bronchitis in adults 126 000 - 3336 000 (WTP); visit to medical unit - 265 - 795 (COI); asthma attacks per day - 12 - 55 (WTP); acute respiratory syndrome - 5 - 15 (WTP). Health - demographic data are used for the risk assesment. The weighted mean value for personnel irradiation is 2.5 - 8.7 mSv/year. Determination of individual dose limit, individual radiation risk, and individual annual dose limit is discussed

The negative impact of attention-deficit/hyperactivity disorder on occupational health in adults and adolescents.

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Küpper, Thomas; Haavik, Jan; Drexler, Hans; Ramos-Quiroga, Josep Antoni; Wermelskirchen, Detlef; Prutz, Christin; Schauble, Barbara

2012-11-01

To review the negative effects of attention-deficit/hyperactivity disorder (ADHD) in adolescence and adulthood on work productivity and occupational health. A review of the MEDLINE database was carried out to identify direct and indirect effects of ADHD on work, employment and occupational health. ADHD is associated with higher levels of unemployment versus controls. Adults with ADHD who are employed experience workplace impairment and reduced productivity, as well as behavioural issues such as irritability and low frustration tolerance. Adults with ADHD are also at increased risk of accidents, trauma and workplace injuries, particularly traffic accidents. Indirect effects of ADHD on occupational health include reduced educational achievement and increased rates of substance abuse and criminality. Overall, ADHD in adults has a substantial economic impact as a result of absenteeism and lost productivity. Psychoeducation, combined with stimulant medications if necessary, is recommended as first-line treatment for adults with ADHD. Limited data available suggest that stimulant treatment can improve work productivity and efficacy, and reduce the risks associated with driving, although further studies are necessary. ADHD can affect the ability to gain and maintain employment and to work safely and productively. As ADHD is a treatable condition, patients, employers and physicians have a role to play in ensuring optimal occupational health.

Health Insurance Status as a Barrier to Ideal Cardiovascular Health for U.S. Adults: Data from the National Health and Nutrition Examination Survey (NHANES.

Directory of Open Access Journals (Sweden)

Michael A McClurkin

Full Text Available Little is known about the association between cardiovascular (CV health and health insurance status. We hypothesized that U.S. adults without health insurance coverage would have a lower likelihood of ideal cardiovascular health.Using National Health and Nutrition Examination Survey (NHANES data from 2007-2010, we examined the relationship between health insurance status and ideal CV health in U.S. adults aged ≥19 years and <65 (N = 3304. Ideal CV health was defined by the American Heart Association (AHA as the absence of clinically manifested CV disease and the simultaneous presence of 6-7 "ideal" CV health factors and behaviors. Logistic regression modeling was used to determine the relationship between health insurance status and the odds of ideal CV health. Of the U.S. adult population, 5.4% attained ideal CV health, and 23.5% were without health insurance coverage. Those without health insurance coverage were more likely to be young (p<0.0001, male (p<0.0001, non-white (p<0.0001, with less than a high school degree (p<0.0001, have a poverty-to-income ratio less than 1 (p<0.0001 and unemployed (p<0.0001 compared to those with coverage. Lack of health insurance coverage was associated with a lower likelihood of ideal CV health; however, this relationship was attenuated by socioeconomic status.U.S. adults without health insurance coverage are less likely to have ideal CV health. Population-based strategies and interventions directed at the community-level may be one way to improve overall CV health and reach this at-risk group.

Relationships among veteran status, gender, and key health indicators in a national young adult sample.

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Grossbard, Joel R; Lehavot, Keren; Hoerster, Katherine D; Jakupcak, Matthew; Seal, Karen H; Simpson, Tracy L

2013-06-01

Although many risk behaviors peak during young adulthood, little is known about health risk factors and access to care. This study assessed health indicators and health care access in a national sample of young adult veterans and civilians. Data were from the 2010 Behavioral Risk Factor Surveillance System, a national telephone survey. Of 27,471 participants, ages 19-30 years, 2.2% were veterans (74.6% were male) and 97.7% were civilians (37.6% were male). Gender-stratified comparisons assessed health indicators and health care access by veteran status. Multivariate logistic regression was used to examine health indicators and health care access as a function of gender and veteran status. In the overall sample, women were more likely than men to have insurance, to have a regular physician, and to have had a routine checkup and yet were more likely to report financial barriers to care. Women also were more likely than men to report general medical and mental distress and higher lifetime anxiety and depressive disorders, whereas men were more likely to be overweight or obese and to report tobacco use and high-risk drinking. Adjusted analyses revealed a higher likelihood of general medical distress and higher rates of lifetime anxiety disorders among veterans compared with civilians, although there were no differences between veterans and civilians regarding health care utilization and hazardous drinking. Findings extend the literature on health care status and modifiable risk factors for young adults by identifying differences between men and women and between veterans and civilians. Interventions may need to be tailored on the bases of gender and veteran status because of several differences in mental health and general health needs.

Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1.

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Wu, Fan; Guo, Yanfei; Chatterji, Somnath; Zheng, Yang; Naidoo, Nirmala; Jiang, Yong; Biritwum, Richard; Yawson, Alfred; Minicuci, Nadia; Salinas-Rodriguez, Aaron; Manrique-Espinoza, Betty; Maximova, Tamara; Peltzer, Karl; Phaswanamafuya, Nancy; Snodgrass, James J; Thiele, Elizabeth; Ng, Nawi; Kowal, Paul

2015-02-06

Behavioral risk factors such as tobacco use, unhealthy diet, insufficient physical activity and the harmful use of alcohol are known and modifiable contributors to a number of NCDs and health mediators. The purpose of this paper is to describe the distribution of main risk factors for NCDs by socioeconomic status (SES) among adults aged 50 years and older within a country and compare these risk factors across six lower- and upper-middle income countries. The study population in this paper draw from SAGE Wave 1 and consisted of adults aged 50-plus from China (N=13,157), Ghana (N=4,305), India (N=6,560), Mexico (N=2,318), the Russian Federation (N=3,938) and South Africa (N=3,836). Seven main common risk factors for NCDs were identified: daily tobacco use, frequent heavy drinking, low level physical activity, insufficient vegetable and fruit intake, high risk waist-hip ratio, obesity and hypertension. Multiple risk factors were also calculated by summing all these risk factors. The prevalence of daily tobacco use ranged from 7.7% (Ghana) to 46.9% (India), frequent heavy drinker was the highest in China (6.3%) and lowest in India (0.2%), and the highest prevalence of low physical activity was in South Africa (59.7%). The highest prevalence of respondents with high waist-to-hip ratio risk was 84.5% in Mexico, and the prevalence of self-reported hypertension ranging from 33% (India) to 78% (South Africa). Obesity was more common in South Africa, the Russia Federation and Mexico (45.2%, 36% and 28.6%, respectively) compared with China, India and Ghana (15.3%, 9.7% and 6.4%, respectively). China, Ghana and India had a higher prevalence of respondents with multiple risk factors than Mexico, the Russia Federation and South Africa. The occurrence of three and four risk factors was more prevalent in Mexico, the Russia Federation and South Africa. There were substantial variations across countries and settings, even between upper-middle income countries and lower-middle income

Control beliefs and risk for 4-year mortality in older adults: a prospective cohort study.

Science.gov (United States)

Duan-Porter, Wei; Hastings, Susan Nicole; Neelon, Brian; Van Houtven, Courtney Harold

2017-01-11

Control beliefs are important psychological factors that likely contribute to heterogeneity in health outcomes for older adults. We evaluated whether control beliefs are associated with risk for 4-year mortality, after accounting for established "classic" biomedical risk factors. We also determined if an enhanced risk model with control beliefs improved identification of individuals with low vs. high mortality risk. We used nationally representative data from the Health and Retirement Study (2006-2012) for adults 50 years or older in 2006 (n = 7313) or 2008 (n = 6301). We assessed baseline perceived global control (measured as 2 dimensions-"constraints" and "mastery"), and health-specific control. We also obtained baseline data for 12 established biomedical risk factors of 4-year mortality: age, sex, 4 medical conditions (diabetes mellitus, cancer, lung disease and heart failure), body mass index less than 25 kg/m 2 , smoking, and 4 functional difficulties (with bathing, managing finances, walking several blocks and pushing or pulling heavy objects). Deaths within 4 years of follow-up were determined through interviews with respondents' family and the National Death Index. After accounting for classic biomedical risk factors, perceived constraints were significantly associated with higher mortality risk (third quartile scores odds ratio [OR] 1.37, 95% CI 1.03-1.81; fourth quartile scores OR 1.45, 95% CI, 1.09-1.92), while health-specific control was significantly associated with lower risk (OR 0.69-0.78 for scores above first quartile). Higher perceived mastery scores were not consistently associated with decreased risk. The enhanced model with control beliefs found an additional 3.5% of participants (n = 222) with low predicted risk of 4-year mortality (i.e., 4% or less); observed mortality for these individuals was 1.8% during follow-up. Compared with participants predicted to have low mortality risk only by the classic biomedical model

Health Risks to Children and Adults Residing in Riverine Environments where Surficial Sediments Contain Metals Generated by Active Gold Mining in Ghana.

Science.gov (United States)

Armah, Frederick Ato; Gyeabour, Elvis Kyere

2013-03-01

The purpose of this study was to investigate the current status of metal pollution in the sediment from rivers, lakes, and streams in active gold mining districts in Ghana. Two hundred and fifty surface sediment samples from 99 locations were collected and analyzed for concentrations of As, Hg, Cr, Co, Cu, Fe, Zn, Pb, Cd, Ni, and Mn using inductively coupled plasma-mass spectroscopy (ICP-MS). Metal concentrations were then used to assess the human health risks to resident children and adults in central tendency exposure (CTE) and reasonable maximum exposure (RME) scenarios. The concentrations of Pb, Cd, and As were almost twice the threshold values established by the Hong Kong Interim Sediment Quality Guidelines (ISQG). Hg, Cu, and Cr concentrations in sediment were 14, 20, and 26 times higher than the Canadian Freshwater Sediment Guidelines for these elements. Also, the concentrations of Pb, Cu, Cr, and Hg were 3, 11, 12, and 16 times more than the Australian and New Zealand Environment and Conservation Council (ANZECC) sediment guideline values. The results of the human health risk assessment indicate that for ingestion of sediment under the central tendency exposure (CTE) scenario, the cancer risks for child and adult residents from exposure to As were 4.18 × 10(-6) and 1.84 × 10(-7), respectively. This suggests that up to 4 children out of one million equally exposed children would contract cancer if exposed continuously to As over 70 years (the assumed lifetime). The hazard index for child residents following exposure to Cr(VI) in the RME scenario was 4.2. This is greater than the United States Environmental Protection Agency (USEPA) threshold of 1, indicating that adverse health effects to children from exposure to Cr(VI) are possible. This study demonstrates the urgent need to control industrial emissions and the severe heavy metal pollution in gold mining environments.

Trajectories of Depressive Symptoms in Older Adults and Risk of Dementia.

Science.gov (United States)

Kaup, Allison R; Byers, Amy L; Falvey, Cherie; Simonsick, Eleanor M; Satterfield, Suzanne; Ayonayon, Hilsa N; Smagula, Stephen F; Rubin, Susan M; Yaffe, Kristine

2016-05-01

Depression has been identified as a risk factor for dementia. However, most studies have measured depressive symptoms at only one time point, and older adults may show different patterns of depressive symptoms over time. To investigate the association between trajectories of depressive symptoms and risk of dementia in older adults. This was a prospective cohort investigation of black and white community-dwelling older adults in the Health, Aging, and Body Composition study. Participants were enrolled between May 1997 and June 1998 and followed up through 2001-2002. The dates of this analysis were September 2014 to December 2015. The setting was community research centers in Memphis, Tennessee, and Pittsburgh, Pennsylvania. Trajectories of depressive symptoms were assessed from baseline to year 5. Symptoms were measured with the Center for Epidemiologic Studies Depression Scale Short Form, and trajectories were calculated using latent class growth curve analysis. Incident dementia through year 11, determined by dementia medication use, hospital records, or significant cognitive decline (≥1.5 SD race-specific decline on the Modified Mini-Mental State Examination). We examined the association between depressive symptom trajectories and dementia incidence using Cox proportional hazards regression models adjusted for demographics, health factors that differed between groups, and cognition during the depressive symptom assessment period (baseline to year 5). The analytic cohort included 2488 black and white older adults with repeated depressive symptom assessments from baseline to year 5 who were free of dementia throughout that period. Their mean (SD) age at baseline was 74.0 (2.8) years, and 53.1% (n = 1322) were female. The following 3 depressive symptom trajectories were identified: consistently minimal symptoms (62.0% [n = 1542] of participants), moderate and increasing symptoms (32.2% [n = 801] of participants), and high and increasing symptoms (5

Lifestyle and health conditions of adults with spinal cord injury.

Science.gov (United States)

Xavier de França, Inacia Sátiro; Cruz Enders, Bertha; Silva Coura, Alexsandro; Pereira Cruz, Giovanna Karinny; da Silva Aragão, Jamilly; Carvalho de Oliveira, Déborah Raquel

2014-01-01

. To describe the lifestyle of adults with spinal cord injury and explore its relation with some health conditions. Cross sectional study, in which a questionnaire containing sociodemographic, habits and health conditions variables was used. Forty-seven people with spinal cord injury participated and answered the self-report questionnaire. The group under study was predominantly male (92%), under 40 years of age (47%), and had low educational level (76%). The most frequent risk factors related to the lifestyle were: smoking (28%), alcohol consumption (36%), coffee consumption (92%) and being physically inactive (64%). Association was found between having four or more risk factors related to lifestyle and the loss of appetite, as well as constipation. . The actual inadequate lifestyle is associated with the health conditions of patients, and the nursing team should pay special attention to the education and promotion of health related to people with spinal cord injury.

Health system strategies supporting transition to adult care.

Science.gov (United States)

Hepburn, Charlotte Moore; Cohen, Eyal; Bhawra, Jasmin; Weiser, Natalie; Hayeems, Robin Z; Guttmann, Astrid

2015-06-01

The transition from paediatric to adult care is associated with poor clinical outcomes, increased costs and low patient and family satisfaction. However, little is known about health system strategies to streamline and safeguard care for youth transitioning to adult services. Moreover, the needs of children and youth are often excluded from broader health system reform discussions, leaving this population especially vulnerable to system 'disintegration'. (1) To explore the international policy profile of paediatric-to-adult care transitions, and (2) to document policy objectives, initiatives and outcomes for jurisdictions publicly committed to addressing transition issues. An international policy scoping review of all publicly available government documents detailing transition-related strategies was completed using a web-based search. Our analysis included a comparable cohort of nine wealthy Organisation for Economic Co-operation and Development (OECD) jurisdictions with Beveridge-style healthcare systems (deemed those most likely to benefit from system-level transition strategies). Few jurisdictions address transition of care issues in either health or broader social policy documents. While many jurisdictions refer to standardised practice guidelines, a few report the intention to use powerful policy levers (including physician remuneration and non-physician investments) to facilitate the uptake of best practice. Most jurisdictions do not address the policy infrastructure required to support successful transitions, and rigorous evaluations of transition strategies are rare. Despite the well-documented risks and costs associated with a poor transition from paediatric to adult care, little policy attention has been paid to this issue. We recommend that healthcare providers engage health system planners in the design and evaluation of system-level, policy-sensitive transition strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not

Why target sedentary adults in primary health care? Baseline results from the Waikato Heart, Health, and Activity Study.

Science.gov (United States)

Elley, C Raina; Kerse, Ngaire M; Arroll, Bruce

2003-10-01

The question of whether the public health issue of physical inactivity should be addressed in primary health care is a controversial matter. Baseline cross-sectional analysis of a physician-based physical activity intervention trial involving sedentary adults was undertaken within 42 rural and urban family practices in New Zealand to examine self-reported levels of physical activity and cardiovascular risk factors. A self-administered single question about physical activity was used to screen 40- to 79-year-old patients from waiting rooms for physical inactivity. The positive predictive value of the screening question was 81%. Participation rates for the study were high, including 74% of family physicians (n = 117) in the region. Eighty-eight percent of consecutive patients in the age group agreed to be screened and 46% were identified as sedentary. Of those eligible, 66% (n = 878) agreed to participate in a study involving a lifestyle intervention from their family physician. Blood pressure and BMI were significantly greater than that in the general population. There were high rates of hypertension (52%), diabetes (10.5%), obesity (43%), previous cardiovascular disease (19%), and risk factors for cardiovascular disease (93%). Decreasing total energy expenditure was associated with increasing cardiovascular risk (P = 0.001). Sedentary adults in primary care represent a high cardiovascular risk population. Screening for inactivity in primary care is effective and efficient. Two-thirds of sedentary adults agreed to receive a lifestyle intervention from their family physician.

Differences in Risk Aversion between Young and Older Adults.

Science.gov (United States)

Albert, Steven M; Duffy, John

2012-01-15

Research on decision-making strategies among younger and older adults suggests that older adults may be more risk averse than younger people in the case of potential losses. These results mostly come from experimental studies involving gambling paradigms. Since these paradigms involve substantial demands on memory and learning, differences in risk aversion or other features of decision-making attributed to age may in fact reflect age-related declines in cognitive abilities. In the current study, older and younger adults completed a simpler, paired lottery choice task used in the experimental economics literature to elicit risk aversion. A similar approach was used to elicit participants' discount rates. The older adult group was more risk averse than younger adults (p Risk aversion and implied discount rates were weakly correlated. It may be valuable to investigate developmental changes in neural correlates of decision-making across the lifespan.

Associations of Health-Risk Behaviors and Health Cognition With Sexual Orientation Among Adolescents in School

Science.gov (United States)

Lee, Dong-Yun; Kim, Seo-Hee; Woo, Sook Young; Yoon, Byung-Koo; Choi, DooSeok

2016-01-01

Abstract Homosexual adolescents may face significant health disparities. We examined health-risk behaviors and health cognition related to homosexual behavior in a representative sample of adolescents. Data were obtained from 129,900 adolescents between 2008 and 2012 over 5 cycles of the Korean Youth Risk Behavior Survey, a national survey of students in grades 7 to 12. Various health-risk behaviors and aspects of health cognition were compared between homosexual and heterosexual adolescents and analyzed with multiple logistic regression models. Compared with heterosexual adolescents (n = 127,594), homosexual adolescents (n = 2306) were more likely to engage in various health-risk behaviors and to have poor health cognition. In multiple logistic regression analysis, not living with parents, alcohol experience (adjusted odds ratio, 1.50; 95% confidence interval, 1.26–1.78 for males and 1.66; 1.33–2.07 for females), smoking experience (1.80; 1.54–2.10 for males and 3.15; 2.61–3.79 for females), and drug experience (3.65; 2.81–4.80 for males and 3.23; 2.35–4.46 for females) were associated with homosexual behavior. Homosexual adolescents were more likely to use adult internet content (2.82; 2.27–3.50 for males and 7.42; 4.19–13.15 for females), and to be depressed (1.21; 1.03–1.43 for males and 1.32; 1.06–1.64 for females). In addition, suicide ideation (1.51; 1.26–1.81 for males and 1.47; 1.16–1.86 for females) and attempts (1.67; 1.37–2.05 for males and 1.65; 1.34–2.03 for females) were significantly more prevalent among homosexual adolescents. Homosexual adolescents report disparities in various aspects of health-risk behavior and health cognition, including use of multiple substances, adult internet content and inappropriate weight loss methods, suicide ideation and attempts, and depressive mood. These factors should be addressed relevantly to develop specific interventions regarding sexual minorities. PMID:27227939

Prevalence of Low Cardiovascular Risk Profile Among Diverse Hispanic/Latino Adults in the United States by Age, Sex, and Level of Acculturation: The Hispanic Community Health Study/Study of Latinos.

Science.gov (United States)

Daviglus, Martha L; Pirzada, Amber; Durazo-Arvizu, Ramon; Chen, Jinsong; Allison, Matthew; Avilés-Santa, Larissa; Cai, Jianwen; González, Hector M; Kaplan, Robert C; Schneiderman, Neil; Sorlie, Paul D; Talavera, Gregory A; Wassertheil-Smoller, Sylvia; Stamler, Jeremiah

2016-08-20

Favorable levels of all readily measurable major cardiovascular disease risk factors (ie, low risk [LR]) are associated with lower risks of cardiovascular disease morbidity and mortality. Data are not available on LR prevalence among Hispanic/Latino adults of diverse ethnic backgrounds. This study aimed to describe the prevalence of a low cardiovascular disease risk profile among Hispanic/Latino adults in the United States and to examine cross-sectional associations of LR with measures of acculturation. The multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos examined 16 415 men and women aged 18 to 74 years at baseline (2008-2011) with diverse Hispanic/Latino backgrounds. Analyses involved 14 757 adults (mean age 41.3 years; 60.6% women). LR was defined using national guidelines for favorable levels of serum cholesterol, blood pressure, and body mass index and by not having diabetes mellitus and not currently smoking. Age-adjusted LR prevalence was low (8.4% overall; 5.1% for men, 11.2% for women) and varied by background (4.2% in men of Mexican heritage versus 15.0% in women of Cuban heritage). Lower acculturation (assessed using proxy measures) was significantly associated with higher odds of a LR profile among women only: Age-adjusted odds ratios of having LR were 1.64 (95% CI 1.24-2.17) for foreign-born versus US-born women and 1.96 (95% CI 1.49-2.58) for women residing in the United States profile is low. Lower acculturation is associated with higher odds of a LR profile among women but not men. Comprehensive public health strategies are needed to improve the cardiovascular health of US Hispanic/Latino adults. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact

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Nora Hajarsjah

2018-04-01

Full Text Available Background Children in household contact of adults with smear-positive tuberculosis (TB are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB. Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients. Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests. Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%] or the control group [TB score <6; 84 subjects (58.0%]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively. Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.

Everyday life innovation potential: when technology has to make sense. Citizens living in high-risk areas for health, using health-promoting technologies

DEFF Research Database (Denmark)

Madsen, Jacob Østergaard

2014-01-01

) to contribute, along with other health professionals, in dealing with the problem of inequality in health. In this study health promoting technologies for adult citizens living in high risk areas of health, is chosen as one particular area of interest for occupational therapists within the field of health...

Metabolic syndrome and cardiovascular risk among adults

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Reem Hunain

2018-03-01

Full Text Available Background: Mortality and morbidity due cardiovascular diseases in India is on the rise. Metabolic Syndrome which is a collection of risk factors of metabolic origin, can greatly contribute to its rising burden. Aims & Objectives: The present study was conducted with the objective of estimating the prevalence of metabolic syndrome and 10-year cardiovascular risk among adults. Material & Methods: This hospital-based study included 260 adults aged 20-60 years. Metabolic Syndrome was defined using National Cholesterol Education Program –Adult Treatment Panel -3 criteria. The 10 year cardiovascular risk was estimated using Framingham risk scoring. Results: The overall prevalence of metabolic syndrome among the study participants was 38.8%. Age (41-60yrs, male gender and daily consumption of high salt items were positively associated with metabolic syndrome whereas consumption of occasional high sugar items showed an inverse association with metabolic syndrome. According to Framingham Risk Scoring, 14.3% of the participants belonged to intermediate/high risk category. Conclusion: With a high prevalence of metabolic syndrome and a considerable proportion of individuals with intermediate to high 10 yr CVD risk, there is a need to design strategies to prevent future cardiovascular events.

"That was grown folks' business": narrative reflection and response in older adults' family health history communication.

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Yamasaki, Jill; Hovick, Shelly R

2015-01-01

Given the importance of family health history and the pivotal role of older adults in communicating it, this study examines how African American older adults (a) characterize their understandings of health-related conditions in their family histories and (b) rationalize their motivations and constraints for sharing this information with current family members. Using narrative theory as a framework, we illustrate how the participants reflect on prior health-related experiences within the family to respond to moral and practical calls for communicating family health information to current relatives. Specifically, our analysis highlights how storied family secrets--as constructed by 28 participants in group and individual interviews--reveal and inform shifting cultural and generational practices that shape the lived health behaviors and communication of older adults at greater risk for health disparities.

Investigating Married Adults' Communal Coping with Genetic Health Risk and Perceived Discrimination

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Smith, Rachel A.; Sillars, Alan; Chesnut, Ryan P.; Zhu, Xun

2017-01-01

Increased genetic testing in personalized medicine presents unique challenges for couples, including managing disease risk and potential discrimination as a couple. This study investigated couples' conflicts and support gaps as they coped with perceived genetic discrimination. We also explored the degree to which communal coping was beneficial in reducing support gaps, and ultimately stress. Dyadic analysis of married adults (N = 266, 133 couples), in which one person had the genetic risk for serious illness, showed that perceived discrimination predicted more frequent conflicts about AATD-related treatment, privacy boundaries, and finances, which, in turn, predicted wider gaps in emotion and esteem support, and greater stress for both spouses. Communal coping predicted lower support gaps for both partners and marginally lower stress. PMID:29731540

Investigating Married Adults' Communal Coping with Genetic Health Risk and Perceived Discrimination.

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Smith, Rachel A; Sillars, Alan; Chesnut, Ryan P; Zhu, Xun

2018-01-01

Increased genetic testing in personalized medicine presents unique challenges for couples, including managing disease risk and potential discrimination as a couple. This study investigated couples' conflicts and support gaps as they coped with perceived genetic discrimination. We also explored the degree to which communal coping was beneficial in reducing support gaps, and ultimately stress. Dyadic analysis of married adults ( N = 266, 133 couples), in which one person had the genetic risk for serious illness, showed that perceived discrimination predicted more frequent conflicts about AATD-related treatment, privacy boundaries, and finances, which, in turn, predicted wider gaps in emotion and esteem support, and greater stress for both spouses. Communal coping predicted lower support gaps for both partners and marginally lower stress.

Self-stigma and its associations with stress, physical health, and health care satisfaction in adults who stutter.

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Boyle, Michael P; Fearon, Alison N

2018-06-01

The aim of this study was to identify potential relationships between self-stigma (stigma awareness and stigma application) and stress, physical health, and health care satisfaction among a large sample of adults who stutter. It was hypothesized that both stigma awareness and stigma application would be inversely related to measures of physical health and health care satisfaction, and positively related to stress. Furthermore, it was anticipated that stress mediated the relationship between self-stigma and physical health. A sample of adults who stutter in the United States (n=397) completed a web survey that assessed levels of stigma awareness and stigma application, stress, physical health, and health care satisfaction. Correlational analyses were conducted to determine the relationships between these variables. Higher levels of stigma awareness and stigma application were associated with increased stress, decreased overall physical health, and decreased health care satisfaction (i.e., discomfort obtaining health care due to stuttering, and adverse health care outcomes due to stuttering), and these relationships were statistically significant. Stress was identified as a mediator between stigma application and physical health. Because adults who stutter with higher levels of self-stigma are at risk for decreased physical health through increased stress, and lower satisfaction with their health care experiences as a result of stuttering, it is important for professionals to assess and manage self-stigma in clients who stutter. Self-stigma has implications for not only psychological well-being, but stress, physical health, and health care satisfaction as well. Copyright © 2017 Elsevier Inc. All rights reserved.

Adolescent and young adult health in the United States in the past decade: little improvement and young adults remain worse off than adolescents.

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Park, M Jane; Scott, Jazmyn T; Adams, Sally H; Brindis, Claire D; Irwin, Charles E

2014-07-01

Adolescence and young adulthood are unique developmental periods that present opportunities and challenges for improving health. Health at this age can affect health throughout the lifespan. This review has two aims: (1) to examine trends in key indicators in outcomes, behaviors, and health care over the past decade for U.S. adolescents and young adults; and (2) to compare U.S. adolescents and young adults on these indicators. The review also assesses sociodemographic differences in trends and current indicators. Guided by our aims, previous reviews, and national priorities, the present review identified 21 sources of nationally representative data to examine trends in 53 areas and comparisons of adolescents and young adults in 42 areas. Most health and health care indicators have changed little over the past decade. Encouraging exceptions were found for adolescents and young adults in unintentional injury, assault, and tobacco use, and, for adolescents, in sexual/reproductive health. Trends in violence and chronic disease and related behaviors were mixed. Review of current indicators demonstrates that young adulthood continues to entail greater risk and worse outcomes than adolescence. Young adults fared worse on about two-thirds of the indicators examined. Differences among sociodemographic subgroups persisted for both trends and current indicators. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Risk aversion, time preference and health production: theory and empirical evidence from Cambodia.

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Rieger, Matthias

2015-04-01

This paper quantifies the relationship between risk aversion and discount rates on the one hand and height and weight on the other. It studies this link in the context of poor households in Cambodia. Evidence is based on an original dataset that contains both experimental measures of risk taking and impatience along with anthropometric measurements of children and adults. The aim of the paper is to (i) explore the importance of risk and time preferences in explaining undernutrition and (ii) compare the evidence stemming from poor households to strikingly similar findings from industrialized countries. It uses an inter-generational approach to explain observed correlations in adults and children that is inspired by the height premium on labor markets. Parents can invest in the health capital of their child to increase future earnings and their consumption when old: better nutrition during infancy translates into better human capital and better wages, and ultimately better financial means to take care of elderly parents. However this investment is subject to considerable uncertainty, since parents neither perfectly foresee economic conditions when the child starts earning nor fully observe the ability to transform nutritional investments into long-term health capital. As a result, risk taking households have taller and heavier children. Conversely, impatience does not affect child health. In the case of adults, only weight and the body mass index (BMI), but not height, are positively and moderately correlated with risk taking and impatience. Copyright © 2014 Elsevier B.V. All rights reserved.

Risk factor profile for atherosclerosis among young adults in Israel--results of a large-scale survey from the young adult periodic examinations in Israel (YAPEIS) database.

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Sharabi, Y; Grotto, I; Huerta, M; Eldad, A; Green, M S

2001-01-01

Assessing the prevalence of relevant risk factors among young adults is a critical step in the process of preventing atherosclerotic cardiovascular diseases (ASCVD) later in life. The Israel Defense Force Periodic Health Examination Center performs a routine check-up for subjects aged 25-45 years. Medical history, physical examination notes, laboratory results and ECG tracings are recorded, computerized and processed to form the Young Adults Periodic Examinations in Israel (YAPEIS) database. Data representing 31,640 subjects (27,769 males and 3871 females) examined between the years 1991-1999 were analyzed. The prevalence of documented risk factors for ASCVD were evaluated. The results of all parameters were graded categorically as low, moderate or high and the Framingham risk score was calculated. Fifty-one percent of the study participants were found to be overweight (body mass index > or = 25 kg/m2), 8.5% had high systolic blood pressure and 14.6% had high diastolic blood pressure. The prevalence of hypercholesterolemia and hyperglycemia was found to be 44.7 and 9.7%, respectively. Thirty-two percent of the subjects smoked cigarettes, and 76.7% reported not performing any routine physical activity. Furthermore, 31.8% had a Framingham score indicating a greater than 5% risk for developing a coronary event within the next 10 years. As expected, the prevalence of these risk factors increased with age and were found to be less frequent among females. Thus we conclude that many young Israeli adults hold significant risk factors for future ASCVD. Many of these risk factors are modifiable, and risk behavior is often amenable to alteration. Awareness to the high prevalence of risk factors among young adults should spark vigorous health-promotion programs as well as screening, education, and interventional measures aimed at altering the expected outcome of future ASCVD.

Health promotion and disease prevention strategies in older adults with Intellectual and Developmental Disabilities

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Eli eCarmeli

2014-04-01

Full Text Available The rapid growth in the number of individuals living with Intellectual and Developmental Disabilities (IDD along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD. This is considered to be challenging given the continued shrinkage in the overall health care and welfare system services due to the cut in the governmental budget in some of the western countries. The ideal health promotion and disease prevention strategies for older adults with IDD should be tailored to the individuals’ health risks, address primary and secondary disease prevention and prevent avoidable impairments that cause premature institutionalization. Domains of intervention should include cognitive, mental and physical health, accommodations, workplace considerations, assistive technology, recreational activities and nutrition.

Food security and cardiovascular disease risk among adults in the United States: findings from the National Health and Nutrition Examination Survey, 2003-2008.

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Ford, Earl S

2013-12-05

Little is known about the relationship between food security status and predicted 10-year cardiovascular disease risk. The objective of this study was to examine the associations between food security status and cardiovascular disease risk factors and predicted 10-year risk in a national sample of US adults. A cross-sectional analysis using data from 10,455 adults aged 20 years or older from the National Health and Nutrition Examination Survey 2003-2008 was conducted. Four levels of food security status were defined by using 10 questions. Among all participants, 83.9% had full food security, 6.7% had marginal food security, 5.8% had low food security, and 3.6% had very low food security. After adjustment, mean hemoglobin A1c was 0.15% greater and mean concentration of C-reactive protein was 0.8 mg/L greater among participants with very low food security than among those with full food security. The adjusted mean concentration of cotinine among participants with very low food security was almost double that of participants with full food security (112.8 vs 62.0 ng/mL, P security status and systolic blood pressure or concentrations of total cholesterol, high-density lipoprotein cholesterol, or non-high-density lipoprotein cholesterol were observed. Participants aged 30 to 59 years with very low food security were more likely to have a predicted 10-year cardiovascular disease risk greater than 20% than fully food secure participants (adjusted prevalence ratio, 2.38; 95% CI, 1.31-4.31). Adults aged 30 to 59 years with very low food security showed evidence of increased predicted 10-year cardiovascular disease risk.

Factors of health in the protection against death and cardiovascular disease among adults with subclinical atherosclerosis

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While cardiovascular disease (CVD) prevention traditionally emphasizes risk-factor control, recent evidence also supports the promotion of "health-factors" associated with cardiovascular wellness. However, whether such health-factors exist among adults with advanced subclinical atherosclerosis is un...

Health Literacy, Cognitive Ability, and Functional Health Status among Older Adults

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Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S

2014-01-01

Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068

Parents' Traditional Cultural Values and Mexican-Origin Young Adults' Routine Health and Dental Care.

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Updegraff, Kimberly A; Kuo, Sally I-Chun; McHale, Susan M; Umaña-Taylor, Adriana J; Wheeler, Lorey A

2017-05-01

To investigate the prospective associations between Mexican-origin mothers' and fathers' traditional cultural values and young adults' health and dental care utilization and to test the moderating role of youth gender. Mexican-origin parents and youth (N = 246 families) participated in home interviews and provided self-reports of parents' cultural values (time 1) and young adults' health status and routine health and dental care (time 2; 5 years later). Logistic regressions tested parents' traditional cultural values as predictors of routine health and dental care, accounting for parent nativity, parent acculturation, family socioeconomic status, youth gender, youth age, and youth physical health status. We also tested whether youth gender moderated the associations between parents' cultural values and young adults' routine care. Young adults whose mothers endorsed strong familism values when they were in mid-to-late adolescence were more likely to report at least one routine physician visit in the past year as young adults (odds ratio [OR] = 3.47, 95% confidence interval [CI]: 1.23-9.83, p = .019). Furthermore, for females only, mothers' more traditional gender role attitudes predicted reduced odds of receiving routine health (OR = .22; 95% CI: .08-.64, p = .005) and dental care (OR = .26; 95% CI: .09-.75, p culturally specific mechanisms to identify targets for addressing ethnic/racial disparities in health care utilization among Mexican-origin young adults, during a period of increased risk for health-compromising behaviors and reduced access to care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Social Network Types and Mental Health Among LGBT Older Adults.

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Kim, Hyun-Jun; Fredriksen-Goldsen, Karen I; Bryan, Amanda E B; Muraco, Anna

2017-02-01

This study was designed to identify social network types among lesbian, gay, bisexual, and transgender (LGBT) older adults and examine the relationship between social network type and mental health. We analyzed the 2014 survey data of LGBT adults aged 50 and older (N = 2,450) from Aging with Pride: National Health, Aging, and Sexuality/Gender Study. Latent profile analyses were conducted to identify clusters of social network ties based on 11 indicators. Multiple regression analysis was performed to examine the association between social network types and mental health. We found five social network types. Ordered from greatest to least access to family, friend, and other non-family network ties, they were diverse, diverse/no children, immediate family-focused, friend-centered/restricted, and fully restricted. The friend-centered/restricted (33%) and diverse/no children network types (31%) were the most prevalent. Among individuals with the friend-centered/restricted type, access to social networks was limited to friends, and across both types children were not present. The least prevalent type was the fully restricted network type (6%). Social network type was significantly associated with mental health, after controlling for background characteristics and total social network size; those with the fully restricted type showed the poorest mental health. Unique social network types (diverse/no children and friend-centered/restricted) emerge among LGBT older adults. Moreover, individuals with fully restricted social networks are at particular risk due to heightened health needs and limited social resources. This study highlights the importance of understanding heterogeneous social relations and developing tailored interventions to promote social connectedness and mental health in LGBT older adults. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Diabetes and risk of hospitalized fall injury among older adults.

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Yau, Rebecca K; Strotmeyer, Elsa S; Resnick, Helaine E; Sellmeyer, Deborah E; Feingold, Kenneth R; Cauley, Jane A; Vittinghoff, Eric; De Rekeneire, Nathalie; Harris, Tamara B; Nevitt, Michael C; Cummings, Steven R; Shorr, Ronald I; Schwartz, Ann V

2013-12-01

To determine whether older adults with diabetes are at increased risk of an injurious fall requiring hospitalization. The longitudinal Health, Aging, and Body Composition Study included 3,075 adults aged 70-79 years at baseline. Hospitalizations that included ICD-9-Clinical Modification codes for a fall and an injury were identified. The effect of diabetes with and without insulin use on the rate of first fall-related injury hospitalization was assessed using proportional hazards models. At baseline, 719 participants had diabetes, and 117 of them were using insulin. Of the 293 participants who were hospitalized for a fall-related injury, 71 had diabetes, and 16 were using insulin. Diabetes was associated with a higher rate of injurious fall requiring hospitalization (hazard ratio [HR] 1.48 [95% CI 1.12-1.95]) in models adjusted for age, race, sex, BMI, and education. In those participants using insulin, compared with participants without diabetes, the HR was 3.00 (1.78-5.07). Additional adjustment for potential intermediaries, such as fainting in the past year, standing balance score, cystatin C level, and number of prescription medications, accounted for some of the increased risk associated with diabetes (1.41 [1.05-1.88]) and insulin-treated diabetes (2.24 [1.24-4.03]). Among participants with diabetes, a history of falling, poor standing balance score, and A1C level ≥8% were risk factors for an injurious fall requiring hospitalization. Older adults with diabetes, in particular those using insulin, are at greater risk of an injurious fall requiring hospitalization than those without diabetes. Among those with diabetes, poor glycemic control may increase the risk of an injurious fall.

Quick Guide to Health Literacy and Older Adults

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... Health Promotion Quick Guide to Health Literacy and Older Adults skip to content ODPHP Health Communication Healthy People ... and Patient e-Health Resources Health Literacy and Older Adults Who is this guide for? Why are health ...

Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults.

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Guo, Fangjian; Garvey, W Timothy

2016-02-01

To assess the stability of metabolic status and body mass index (BMI) status and their relative contribution to risk of diabetes, cardiovascular events, and mortality. A total of 14,685 participants from the Atherosclerosis Risk in Communities Study and 4,990 from the Coronary Artery Risk Development in Young Adults Study were included. People with healthy obesity (HO) are defined as those meeting all three indices of blood pressure, blood glucose, and blood lipids. People with unhealthy obesity crossed the risk threshold for all three criteria. In both healthy and unhealthy subgroups, risks for coronary heart disease (CHD), stroke, and mortality were comparable among BMI status during a mean 18.7-year follow-up. When compared with HO, hazard ratios were increased for diabetes (5.56, 95% confidence interval [CI] 4.12-7.48), CHD (5.60, 95% CI 3.14-9.98), stroke (4.84, 95% CI 2.13-10.97), and mortality (2.6, 95% CI 1.88-3.61) in people with unhealthy obesity. BMI only moderately increased the risks for diabetes among healthy subjects. In the Coronary Artery Risk Development in Young Adults Study over 20 years, 17.5% of lean subjects and 67.3% of overweight subjects at baseline developed obesity during follow-up. Despite rising BMI, metabolic status remained relatively stable. Metabolic status is relatively stable despite rising BMI. HO had lower risks for diabetes, CHD, stroke, and mortality than unhealthy subjects but increased diabetes risks than healthy lean people. Cardiometabolic risk factors confer much higher risk than obesity per se. © 2015 The Obesity Society.

Ecological and human health risks associated with abandoned gold mine tailings contaminated soil.

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Veronica Mpode Ngole-Jeme

Full Text Available Gold mining is a major source of metal and metalloid emissions into the environment. Studies were carried out in Krugersdorp, South Africa, to evaluate the ecological and human health risks associated with exposure to metals and metalloids in mine tailings contaminated soils. Concentrations of arsenic (As, cadmium (Cd, chromium (Cr, cobalt (Co, copper (Cu, lead (Pb, manganese (Mn, nickel (Ni, and zinc (Zn in soil samples from the area varied with the highest contamination factors (expressed as ratio of metal or metalloid concentration in the tailings contaminated soil to that of the control site observed for As (3.5x102, Co (2.8x102 and Ni (1.1x102. Potential ecological risk index values for metals and metalloids determined from soil metal and metalloid concentrations and their respective risk factors were correspondingly highest for As (3.5x103 and Co (1.4x103, whereas Mn (0.6 presented the lowest ecological risk. Human health risk was assessed using Hazard Quotient (HQ, Chronic Hazard Index (CHI and carcinogenic risk levels, where values of HQ > 1, CHI > 1 and carcinogenic risk values > 1×10-4 represent elevated risks. Values for HQ indicated high exposure-related risk for As (53.7, Cr (14.8, Ni (2.2, Zn (2.64 and Mn (1.67. Children were more at risk from heavy metal and metalloid exposure than adults. Cancer-related risks associated with metal and metalloid exposure among children were also higher than in adults with cancer risk values of 3×10-2 and 4×10-2 for As and Ni respectively among children, and 5×10-3 and 4×10-3 for As and Ni respectively among adults. There is significant potential ecological and human health risk associated with metal and metalloid exposure from contaminated soils around gold mine tailings dumps. This could be a potential contributing factor to a setback in the health of residents in informal settlements dominating this mining area as the immune systems of some of these residents are already compromised by high

Lifestyle and health conditions of adults with spinal cord injury

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Inacia Sátiro Xavier de França

2014-07-01

Full Text Available Objective. To describe the lifestyle of adults with spinal cord injury and explore its relation with some health conditions. Methodology. Cross sectional study, in which a questionnaire containing sociodemographic, habits and health conditions variables was used. Forty-seven people with spinal cord injury participated and answered the self-report questionnaire. Results. The group under study was predominantly male (92%, under 40 years of age (47%, and had low educational level (76%. The most frequent risk factors related to the lifestyle were: smoking (28%, alcohol consumption (36%, coffee consumption (92% and being physically inactive (64%. Association was found between having four or more risk factors related to lifestyle and the loss of appetite, as well as constipation. Conclusion. The actual inadequate lifestyle is associated with the health conditions of patients, and the nursing team should pay special attention to the education and promotion of health related to people with spinal cord injury.

Barriers to contraceptive access after health care reform: experiences of young adults in Massachusetts.

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Bessett, Danielle; Prager, Joanna; Havard, Julia; Murphy, Danielle J; Agénor, Madina; Foster, Angel M

2015-01-01

To explore how Massachusetts' 2006 health insurance reforms affected access to sexual and reproductive health (SRH) services for young adults. We conducted 11 focus group discussions across Massachusetts with 89 women and men aged 18 to 26 in 2009. Most young adults' primary interaction with the health system was for contraceptive and other SRH services, although they knew little about these services. Overall, health insurance literacy was low. Parents were primary decision makers in health insurance choices or assisted their adult children in choosing a plan. Ten percent of our sample was uninsured at the time of the discussion; a lack of knowledge about provisions in Chapter 58 rather than calculated risk analysis characterized periods of uninsurance. The dynamics of being transitionally uninsured, moving between health plans, and moving from a location defined by insurance companies as the coverage area limited consistent access to contraception. Notably, staying on parents' insurance through extended dependency, a provision unique to the post-reform context, had implications for confidentiality and access. Young adults' access to and utilization of contraceptive services in the post-reform period were challenged by unanticipated barriers related to information and privacy. The experience in Massachusetts offers instructive lessons for the implementation of national health care reform. Young adult-targeted efforts should address the challenges of health service utilization unique to this population. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Socio-ecological risk factors for prime-age adult death in two coastal areas of Vietnam.

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Kim, Deok Ryun; Ali, Mohammad; Thiem, Vu Dinh; Wierzba, Thomas F

2014-01-01

Hierarchical spatial models enable the geographic and ecological analysis of health data thereby providing useful information for designing effective health interventions. In this study, we used a Bayesian hierarchical spatial model to evaluate mortality data in Vietnam. The model enabled identification of socio-ecological risk factors and generation of risk maps to better understand the causes and geographic implications of prime-age (15 to less than 45 years) adult death. The study was conducted in two sites: Nha Trang and Hue in Vietnam. The study areas were split into 500×500 meter cells to define neighborhoods. We first extracted socio-demographic data from population databases of the two sites, and then aggregated the data by neighborhood. We used spatial hierarchical model that borrows strength from neighbors for evaluating risk factors and for creating spatially smoothed risk map after adjusting for neighborhood level covariates. The Markov chain Monte Carlo procedure was used to estimate the parameters. Male mortality was more than twice the female mortality. The rates also varied by age and sex. The most frequent cause of mortality was traffic accidents and drowning for men and traffic accidents and suicide for women. Lower education of household heads in the neighborhood was an important risk factor for increased mortality. The mortality was highly variable in space and the socio-ecological risk factors are sensitive to study site and sex. Our study suggests that lower education of the household head is an important predictor for prime age adult mortality. Variability in socio-ecological risk factors and in risk areas by sex make it challenging to design appropriate intervention strategies aimed at decreasing prime-age adult deaths in Vietnam.

Giving voice to older adults living with frailty and their family caregivers: engagement of older adults living with frailty in research, health care decision making, and in health policy.

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Holroyd-Leduc, Jayna; Resin, Joyce; Ashley, Lisa; Barwich, Doris; Elliott, Jacobi; Huras, Paul; Légaré, France; Mahoney, Megan; Maybee, Alies; McNeil, Heather; Pullman, Daryl; Sawatzky, Richard; Stolee, Paul; Muscedere, John

2016-01-01

The paper discusses engaging older adults living with frailty and their family caregivers. Frailty is a state that puts an individual at a higher risk for poor health outcomes and death. Understanding whether a person is frail is important because treatment and health care choices for someone living with frailty may be different from someone who is not (i.e., who is fit). In this review, we discuss strategies and hurdles for engaging older adults living with frailty across three settings: research, health and social care, and policy. We developed this review using published literature, expert opinion, and stakeholder input (including citizens). Engaging frail older individuals will be challenging because of their vulnerable health state - but it can be done. Points of consideration specific to engaging this vulnerable population include:In any setting, family caregivers (defined to include family, friends, and other social support systems) play an important role in engaging and empowering older adults living with frailtyEngagement opportunities need to be flexible (e.g., location, time, type)Incentivizing engagement for researchers and citizens (financial and otherwise) may be necessaryThe education and training of citizens, health and social care providers, and researchers on engagement practicesPatient-centered care approaches should consider the specific needs of individuals living with frailty including end-of-life care and advanced care planningInfluencing policy can occur in many ways including participating at institutional, regional, provincial or national committees that relate to health and social care. Older adults are the fastest growing segment of Canada's population resulting in an increased number of individuals living with frailty. Although aging and frailty are not synonymous the proportion of those who are frail increases with age. Frailty is not defined by a single condition, but rather a health state characterized by an increased risk of

Perceived and actual obesity in childhood and adolescence and risk of adult depression.

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Sanchez-Villegas, Almudena; Field, Alison E; O'Reilly, Eilis J; Fava, Maurizio; Gortmaker, Steven; Kawachi, Ichiro; Ascherio, Alberto

2013-01-01

Obesity in childhood and adolescence has important health consequences, but its relation to risk of adult depression remains uncertain. To examine the effect of perceived and actual obesity during childhood and adolescence on prevalence and incidence of adult depression risk. Cohort study of 91,798 female registered nurses followed longitudinally for 12 years. As compared with lean women of the same age, women in the two highest categories of body shape at age 10 had both higher prevalence (OR=2.59, 95% CI 1.46 to 4.61) and incidence (OR=2.01, 95% CI 1.08 to 3.71) of depression. Similar results were obtained for body shape at age 20 (OR=3.43 for prevalence and OR=2.03 for incidence) and for body mass index (BMI) at age 18 (OR=2.92 for BMI ≥ 40 kg/m(2)). These associations remained significant after adjustment for multiple confounders. These results indicate that childhood-adolescence obesity is a strong and independent risk factor for adult depression.

LGBTQ+ Latinx young adults' health autonomy in resisting cultural stigma.

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Schmitz, Rachel M; Sanchez, Julissa; Lopez, Bianca

2018-03-20

Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) young people of colour are exposed to intersecting dynamics of social prejudice and discrimination related to sexuality and gender as well as race/ethnicity. In particular, Latinx-identifying LGBTQ+ young people face unique challenges in their lives, due to cultural stressors that stigmatise expansive gender and sexual identities. While it is crucial to examine the effects of multiple stressors on the well-being of LGBTQ+ young people of colour, this risk-based focus can overshadow the resilient capacities of multiply marginalised groups. Guided by an intersectional minority stress resilience framework, we asked: how do self-identified LGBTQ+ Latinx young adults manage cultural messages of prejudice and discrimination in relation to their health? Findings underscore how LGBTQ+ Latinx young adults established a strong sense of health autonomy to resist cultural stigma related to their intersecting identities. Young people actively educated themselves on health-related concerns, engaged in health-promoting tactics, and practised cultural negativity management to effectively navigate exposure to prejudice and discrimination.

Independent older adults perspectives on oral health.

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Khabra, K K; Compton, S M; Keenan, L P

2017-11-01

The purpose of this study was to explore oral health experiences from the perspective of older adults' living in community dwellings. The two objectives of this study were to identify facilitators and barriers to oral health care, and to determine how utilization of oral health services compares to utilization of other healthcare services. An interpretive descriptive methodology was employed with a purposive sample of 12 adults, aged 70 years or older. The inclusion criterion was English-speaking seniors residing in community dwellings. Community dwellings were defined as any housing outside of long-term care or other supportive living facilities. Semi-structured interviews were 30-80 min, audio-recorded and transcribed verbatim. Three researchers participated in the comparative analysis process to develop codes, generate categories, interpret patterns and construct themes. Three central themes surfacing from the data were as follows: life course influences on oral health, transparency in delivery of oral health services and interrelationships between oral health and overall health. Older adults in this study emphasized the value of establishing collaborative and trusting relationships between oral health practitioners and older adults. Oral health practitioners should be clear and transparent when communicating information about oral health costs and be cognizant of different circumstances from childhood to older adulthood that inhibit or promote routine utilization of oral health services. Including oral health services as part of interdisciplinary care teams could help promote understandings of the reciprocal relationship between oral health and general health and improve oral health status for older adults. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Relation between Childhood Obesity and Adult Cardiovascular Risk

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Darren M. Allcock

2009-01-01

Full Text Available The incidence of overweight and obesity is rising at an alarming pace in the pediatric population, just as in the adult population. The adult comorbidities associated with this risk factor are well-recognized and are being further elucidated continually. Additionally, we are gradually developing a better understanding of the risks of overweight and obesity among children while they are still young. However, there is now a growing body of evidence showing that childhood obesity not only leads all too frequently to adult obesity, but is in itself a risk factor for cardiometabolic syndrome and resultant cardiovascular risk in adulthood. If current trends continue, the problem of pediatric overweight and obesity will become of unmanageable proportions once these individuals reach adulthood. Future research efforts toward understanding this complex problem will need to focus on those overweight and obese children who later went on to change their metabolic course and become normal-weight adults.

Health Care Transition in Young Adults With Type 1 Diabetes: Perspectives of Adult Endocrinologists in the U.S.

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Garvey, Katharine C; Telo, Gabriela H; Needleman, Joseph S; Forbes, Peter; Finkelstein, Jonathan A; Laffel, Lori M

2016-02-01

Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. Our objective was to describe experiences, resources, and barriers reported by a national sample of adult endocrinologists receiving and caring for young adults with type 1 diabetes. We fielded an electronic survey to adult endocrinologists with a valid e-mail address identified through the American Medical Association Physician Masterfile. We received responses from 536 of 4,214 endocrinologists (response rate 13%); 418 surveys met the eligibility criteria. Respondents (57% male, 79% Caucasian) represented 47 states; 64% had been practicing >10 years and 42% worked at an academic center. Only 36% of respondents reported often/always reviewing pediatric records and 11% reported receiving summaries for transitioning young adults with type 1 diabetes, although >70% felt that these activities were important for patient care. While most respondents reported easy access to diabetes educators (94%) and dietitians (95%), fewer (42%) reported access to mental health professionals, especially in nonacademic settings. Controlling for practice setting and experience, endocrinologists without easy access to mental health professionals were more likely to report barriers to diabetes management for young adults with depression (odds ratio [OR] 5.3; 95% CI 3.4, 8.2), substance abuse (OR 3.5; 95% CI 2.2, 5.6), and eating disorders (OR 2.5; 95% CI 1.6, 3.8). Our findings underscore the need for enhanced information transfer between pediatric and adult providers and increased mental health referral access for young adults with diabetes post-transition. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older

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Colonvega Makasha; Rupert Ronald; Hyland John K; Hawk Cheryl; Hall Stephanie

2006-01-01

Abstract Background Falls are a major health concern for older adults and their impact is a significant public health problem. The chief modifiable risk factors for falls in community-dwellers are psychotropic drugs, polypharmacy, environmental hazards, poor vision, lower extremity impairments, and balance impairments. This study focused on balance impairments. Its purpose was to assess the feasibility of recruiting older adults with possible balance problems for research conducted at a chiro...

Childhood circumstances, psychosocial factors and the social impact of adult oral health.

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Sanders, Anne E; Spencer, A John

2005-10-01

The aim of this study was to determine whether childhood familial conditions are associated with the social impact of adult oral health and to investigate the role of psychosocial attributes as potential mechanisms by which risk might be conveyed from childhood to adulthood. Using a cross-sectional design, self-report data were obtained from a representative sample of adults in Australia with a telephonic interview and a self-completed questionnaire. The dependent variable was the sum of impacts on the short-form Oral Health Impact Profile (OHIP-14). Childhood familial conditions included socioeconomic position assessed by paternal occupation group, family structure and quality of rearing. Current adult sense of control, perceived stress and satisfaction with life were assessed with standard scales and social support was evaluated with four items. Data were obtained for 3678 dentate adults aged 18-91 years. In bivariate analysis controlling for sex, age and household income in adulthood, parenting style was significantly associated with OHIP-14 scores (anova, P parental rearing style was significantly associated with social impact after adjusting for sex, age and household income in adulthood, but was no longer significant in the presence of the psychosocial factors. The importance of parental rearing to adult oral health may be mediated through the quality and nature of psychosocial attributes.

Mental health implications for older adults after natural disasters--a systematic review and meta-analysis.

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Parker, Georgina; Lie, David; Siskind, Dan J; Martin-Khan, Melinda; Raphael, Beverly; Crompton, David; Kisely, Steve

2016-01-01

Natural disasters affect the health and well-being of adults throughout the world. There is some debate in the literature as to whether older persons have increased risk of mental health outcomes after exposure to natural disasters when compared with younger adults. To date, no systematic review has evaluated this. We aimed to synthesize the available evidence on the impact of natural disasters on the mental health and psychological distress experienced by older adults. A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress. We identified six papers with sufficient data for a random effects meta-analysis. Older adults were 2.11 times more likely to experience PTSD symptoms and 1.73 more likely to develop adjustment disorder when exposed to natural disasters when compared with younger adults. Given the global rise in the number of older adults affected by natural disasters, mental health services need to be prepared to meet their needs following natural disasters, particularly around the early detection and management of PTSD.

Physical health and wellbeing of emerging and young adults with mental illness: an integrative review of international literature.

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McCloughen, Andrea; Foster, Kim; Huws-Thomas, Michelle; Delgado, Cynthia

2012-06-01

Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Examination of Oral Microbiota Diversity in Adults and Older Adults as an Approach to Prevent Spread of Risk Factors for Human Infections.

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Zawadzki, Paweł J; Perkowski, Konrad; Padzik, Marcin; Mierzwińska-Nastalska, Elżbieta; Szaflik, Jacek P; Conn, David Bruce; Chomicz, Lidia

2017-01-01

The oral cavity environment may be colonized by polymicrobial communities with complex, poorly known interrelations. The aim of this study was to determine oral microbiota diversity in order to prevent the spread of infectious microorganisms that are risk factors for human health complications in patients requiring treatment due to various disabilities. The study examined Polish adults aged between 40 and 70 years; parasitological, microbiological, and mycological data collected before treatment were analyzed. The diversity of oral microbiota, including relatively high prevalences of some opportunistic, potentially pathogenic strains of bacteria, protozoans, and fungi detected in the patients analyzed, may result in increasing risk of disseminated infections from the oral cavity to neighboring structures and other organs. Increasing ageing of human populations is noted in recent decades in many countries, including Poland. The growing number of older adults with different oral health disabilities, who are more prone to development of oral and systemic pathology, is an increasing medical problem. Results of this retrospective study showed the urgent need to pay more attention to the pretreatment examination of components of the oral microbiome, especially to the strains, which are etiological agents of human opportunistic infections and are particularly dangerous for older adults.

Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis

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Amna Umer

2017-08-01

Full Text Available Abstract Background Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Methods Studies were included if they met the following criteria: (1 longitudinal and cohort studies (including case-cohort, (2 childhood exposure and adult outcomes collected on the same individual over time, (3 childhood obesity, as defined by the original study authors, (4 English-language articles, (5 studies published up to June, 2015, (6 one or more of the following CVD risk factors [systolic blood pressure (SBP, diastolic blood pressure (DBP, total cholesterol (TC, high-density lipoprotein cholesterol (HDL, low-density lipoprotein cholesterol (LDL, non-high-density lipoprotein cholesterol (non-HDL, and triglycerides (TG], (7 outcome(s not self-reported, and (8 exposure measurements (child’s adiposity assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher’s r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Results Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and

Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis.

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Umer, Amna; Kelley, George A; Cottrell, Lesley E; Giacobbi, Peter; Innes, Kim E; Lilly, Christa L

2017-08-29

Overweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap. Studies were included if they met the following criteria: (1) longitudinal and cohort studies (including case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity, as defined by the original study authors, (4) English-language articles, (5) studies published up to June, 2015, (6) one or more of the following CVD risk factors [systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG)], (7) outcome(s) not self-reported, and (8) exposure measurements (child's adiposity) assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher's r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed. Of the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr

Trends in Prehypertension and Hypertension Risk Factors in US Adults: 1999-2012.

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Booth, John N; Li, Jiexiang; Zhang, Lu; Chen, Liwei; Muntner, Paul; Egan, Brent

2017-08-01

Prehypertension is associated with increased risk for hypertension and cardiovascular disease. Data are limited on the temporal changes in the prevalence of prehypertension and risk factors for hypertension and cardiovascular disease among US adults with prehypertension. We analyzed data from 30 958 US adults ≥20 years of age who participated in the National Health and Nutrition Examination Surveys between 1999 and 2012. Using the mean of 3 blood pressure (BP) measurements from a study examination, prehypertension was defined as systolic BP of 120 to 139 mm Hg and diastolic BP hypertension increased among US adults with prehypertension, including prediabetes (9.6% to 21.6%), diabetes mellitus (6.0% to 8.5%), overweight (33.5% to 37.3%), and obesity (30.6% to 35.2%). There was a nonstatistically significant increase in no weekly leisure-time physical activity (40.0% to 43.9%). Also, the prevalence of adhering to the Dietary Approaches to Stop Hypertension eating pattern decreased (18.4% to 11.9%). In contrast, there was a nonstatistically significant decline in current smoking (25.9% to 23.2%). In conclusion, the prevalence of prehypertension has decreased modestly since 1999-2000. Population-level approaches directed at adults with prehypertension are needed to improve risk factors to prevent hypertension and cardiovascular disease. © 2017 American Heart Association, Inc.

Associations of APOE ε4 With Health and Financial Literacy Among Community-Based Older Adults Without Dementia.

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Stewart, Christopher C; Boyle, Patricia A; James, Bryan D; Yu, Lei; Han, S Duke; Bennett, David A

2016-05-12

Older adults often exhibit low health and financial literacy, but the reasons why remain unclear. One possibility is that those older adults at high risk for developing dementia demonstrate low literacy even in the absence of marked cognitive impairment. We therefore examined associations of health and financial literacy with the APOE ε4 allele, the chief genetic risk factor for Alzheimer's disease, among older adults without dementia. Participants were 487 older adults without dementia enrolled in the Rush Memory and Aging Project (mean age = 83, mean years of education = 15, 77% female, 91% non-Hispanic White). Participants underwent APOE genotyping and assessments of cognition, health literacy, and financial literacy. Health and financial literacy scores were also averaged into a total literacy score. ε4 was associated with lower total and health literacy, with a trend toward an association with lower financial literacy, after adjustment for age, sex, and education. Associations of ε4 with lower total and health literacy persisted after further adjustment for global cognitive function and 5 specific cognitive domains. ε4 affects literacy even in the absence of clinical dementia and does so relatively independent of performance on traditional cognitive tests. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Psychological well-being among US adults with arthritis and the unmet need for mental health care.

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Straub, Laura E; Cisternas, Miriam G

2017-01-01

Mental health conditions can increase the risk of disability among adults with arthritis. The objective of this analysis was to compare the prevalence of serious psychological distress (SPD), depression, and anxiety among US adults with arthritis vs. those without; characterize adults with arthritis with and without SPD; and determine correlates of seeing a mental health professional during the year for adults with arthritis and SPD. Cross-sectional analysis of adults in the 2011-2013 National Health Interview Survey. Higher proportions of adults with arthritis had SPD (6.8% vs. 2.4%), depression (19.4% vs. 7.3%), and anxiety (29.3% vs. 16.3%) compared to those without. Of the estimated 3.5 million adults with arthritis and SPD, only 39% saw a mental health professional during the year. Adjusted analyses identified the following statistically significant relationships: those who were older (45-64 and ≥65 [vs.18-44], prevalence ratio [PR]=0.8 and 0.4, respectively), less educated (PR=0.5 and 0.7 for high school or less vs. college degree, respectively), and without health insurance coverage (vs. any private, PR=0.7), were less likely to see a mental health professional, whereas the disabled or unemployed (vs. employed, PR=1.6 and 1.5, respectively), and those unable to afford mental health care throughout the year (PR=1.3) were more likely. The high prevalence of SPD, anxiety, and depression in adults with arthritis suggests the need for increased mental health screening, with subsequent referral to mental health professionals or other treatment programs, in that population.

Gardening is beneficial for adult mental health: Scottish Health Survey, 2012-2013.

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Shiue, Ivy

2016-07-01

Gardening has been reported as being beneficial for mental well-being for vulnerable populations since 2000. However, little is known concerning its role in the general population. Therefore, the aim of the present study was to investigate the relationship of gardening and mental health in adults in a countrywide and population-based setting. Data was retrieved from and analysed in the Scottish Health Survey, 2012-2013. Information on demographics, lifestyle factors, gardening engagement, and adult mental health by General Health Questionnaire was obtained by household interview. Statistical analyses including chi-square test, t-test and survey-weighted logistic and multi-nominal regression modelling were performed. Of 9709 Scottish adults aged 16-99, 5 531 (57.0%) people did not do any gardening or building work in the last four weeks. A total of 888 (9.2%) people reported poor self-rated health. Gardening was associated with adult mental health in people both with or without heart conditions including ability to concentrate, feeling playing a useful part in things, feeling capable of making decisions, thinking of self as worthless, feeling reasonably happy, etc. General adults with or without heart conditions could benefit from engaging with gardening or building work. Future public health programmes promoting such activity should be encouraged in order to optimise adult mental health.

Clustering of health behaviours in adult survivors of childhood cancer and the general population.

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Rebholz, C E; Rueegg, C S; Michel, G; Ammann, R A; von der Weid, N X; Kuehni, C E; Spycher, B D

2012-07-10

Little is known about engagement in multiple health behaviours in childhood cancer survivors. Using latent class analysis, we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20-35 years) and 1670 age- and sex-matched controls from the general population. Behaviour groups were determined from replies to questions on smoking, drinking, cannabis use, sporting activities, diet, sun protection and skin examination. The model identified four health behaviour patterns: 'risk-avoidance', with a generally healthy behaviour; 'moderate drinking', with higher levels of sporting activities, but moderate alcohol-consumption; 'risk-taking', engaging in several risk behaviours; and 'smoking', smoking but not drinking. Similar proportions of survivors and controls fell into the 'risk-avoiding' (42% vs 44%) and the 'risk-taking' cluster (14% vs 12%), but more survivors were in the 'moderate drinking' (39% vs 28%) and fewer in the 'smoking' cluster (5% vs 16%). Determinants of health behaviour clusters were gender, migration background, income and therapy. A comparable proportion of childhood cancer survivors as in the general population engage in multiple health-compromising behaviours. Because of increased vulnerability of survivors, multiple risk behaviours should be addressed in targeted health interventions.

Performance and Health Benefits of Dietary Nitrate Supplementation in Older Adults: A Systematic Review

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Luke Stanaway

2017-10-01

Full Text Available Supplementation with nitrate (NO3−-rich beetroot juice has been shown to improve exercise performance and cardiovascular (CV responses, due to an increased nitric oxide (NO availability. However, it is unclear whether these benefits are greater in older adults who have an age-related decrease in NO and higher risk of disease. This systematic review examines 12 randomised, crossover, control trials, investigating food-based NO3− supplementation in older adults and its potential benefits on physiological and cognitive performances, and CV, cerebrovascular and metabolic health. Four studies found improvements in physiological performance (time to exhaustion following dietary NO3− supplementation in older adults. Benefits on cognitive performance were unclear. Six studies reported improvements in CV health (blood pressure and blood flow, while six found no improvement. One study showed improvements in cerebrovascular health and two found no improvement in metabolic health. The current literature indicates positive effects of dietary NO3− supplementation in older adults on physiological performance, with some evidence indicating benefits on cardiovascular and cerebrovascular health. Effects on cognitive performance were mixed and studies on metabolic health indicated no benefit. However, there has been limited research conducted on the effects of dietary NO3− supplementation in older adults, thus, further study, utilising a randomised, double-blind, control trial design, is warranted.

Motives and perceptions regarding electronic nicotine delivery systems (ENDS) use among adults with mental health conditions.

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Spears, Claire Adams; Jones, Dina M; Weaver, Scott R; Pechacek, Terry F; Eriksen, Michael P

2018-05-01

Smoking rates are disproportionately high among adults with mental health conditions (MHC), and recent research suggests that among former smokers, those with MHC are more likely to use electronic nicotine delivery systems (ENDS). This study investigated reasons for ENDS use and related risk perceptions among individuals with versus without MHC. Among adult current ENDS users (n=550), associations between self-reported MHC diagnoses and motives for ENDS use and ENDS risk perceptions were examined, stratified by smoking status. There were no significant associations between MHC status and ENDS motives or perceptions in the overall sample. However, current smokers with MHC indicated thinking more about how ENDS might improve their health, and former smokers with MHC reported thinking less about how ENDS might harm their health, compared to their counterparts without MHC. Former smokers with MHC rated several reasons for ENDS use (e.g., less harmful than regular cigarettes; to quit smoking; appealing flavors) as more important than did those without MHC. Current and former smokers with MHC may be especially optimistic about health benefits of ENDS. However, they might also be prone to health risks of continued ENDS use or concurrent use with traditional cigarettes. It will be important for public health messaging to provide this population with accurate information about benefits and risks of ENDS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Patterns of justice involvement among adults with schizophrenia and bipolar disorder: key risk factors.

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Robertson, Allison G; Swanson, Jeffrey W; Frisman, Linda K; Lin, Hsiuju; Swartz, Marvin S

2014-07-01

Adults with serious mental illness have a relatively high risk of criminal justice involvement. Some risk factors for justice involvement are known, but the specific interaction of these risk factors has not been examined. This study explored the interaction of gender, substance use disorder, and psychiatric diagnosis among patients with schizophrenia or bipolar disorder to identify subgroups at higher risk of justice involvement. Administrative service records of 25,133 adults with schizophrenia or bipolar disorder who were clients of Connecticut's public behavioral health system during 2005-2007 were merged with state records of criminal convictions, incarceration, and other measures of justice involvement. The main effects and the effects of interactions of gender, substance use disorder, and psychiatric diagnosis on risk of justice involvement ("offending") were estimated by using multivariable logistic regression. Men with bipolar disorder and co-occurring substance use disorder had the highest absolute risk of offending in every category of justice involvement. For both men and women, bipolar disorder was associated with an increased risk of offending versus schizophrenia, but the increase was significantly greater for women. Substance use disorder also increased risk of offending more among women than men, especially among those with schizophrenia. Men and women with bipolar disorder and substance use disorders have much higher risk of justice involvement than those with schizophrenia, especially those without a substance use disorder. Research is needed to validate these effects in other populations and specify risk factors for justice involvement among adults with mental illness.

A public health and budget impact analysis of vaccinating the elderly and at-risk adults with the 23-valent pneumococcal polysaccharide vaccine or 13-valent pneumococcal conjugate vaccine in the UK.

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Jiang, Yiling; Gauthier, Aline; Keeping, Sam; Carroll, Stuart

2014-12-01

Since the introduction of the routine childhood immunization, a change in epidemiology of pneumococcal disease has been seen in both children and adults. This study aimed to quantify the public health and budget impact of pneumococcal vaccination of the elderly and those in at risk groups in the UK. The model was adapted from a previous population-based Markov model. At-risk adults and the elderly were assumed to receive PPV23 or PCV13 vaccination or no vaccination. Over the study period (2012-2016), PPV23 vaccination led to a reduction in the number of invasive pneumococcal disease cases in most scenarios. The net budget impact ranged between £15 and £39 million (vs no vaccination) or between -£116 and -£93 million (vs PCV13). PPV23 vaccination program remains the optimal strategy from public health and budgetary perspectives despite epidemiological changes. PCV13 is likely to impose a significant budget with limited health benefits.

High nutrition risk is associated with higher risk of dysphagia in advanced age adults newly admitted to hospital.

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Popman, Amy; Richter, Marilize; Allen, Jacqueline; Wham, Carol

2018-02-01

To establish the prevalence of nutrition risk and associated risk factors among adults of advanced age newly admitted to hospital. A cross-sectional study was undertaken in adults aged over 85 years admitted to one of two hospital wards in Auckland within the previous 5 days. An interviewer-administered questionnaire was used to establish participant's socio-demographic and health characteristics. Markers of body composition and muscle strength were collected. Nutrition risk was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF), dysphagia risk using the 10-Item Eating Assessment Tool (EAT-10) and level of cognition using the Montreal Cognitive Assessment. A total of 88 participants with a mean age of 90.0 ± 3.7 years completed the assessments. A third (28.4%) of the participants were categorised by the MNA-SF as malnourished and 43.2% were classified at risk of malnutrition. A third (29.5%) were at risk of dysphagia as assessed by EAT-10. Malnourished participants were more likely to be at risk of dysphagia (P = 0.015). The MNA-SF score was positively correlated with body mass index (r = 0.484, P strength (r = 0.250, P = 0.026) and negatively correlated with risk of dysphagia (r = -0.383, P strength and negatively correlated with dysphagia risk. Findings highlight the importance of screening for dysphagia risk, especially in those identified to be malnourished or at nutrition risk. © 2017 Dietitians Association of Australia.

Oral health literacy and oral health outcomes in an adult population in Brazil

Directory of Open Access Journals (Sweden)

Marília Jesus Batista

2017-07-01

Full Text Available Abstract Background To investigate the association between critical and communicative oral health literacy (OHL and oral health outcomes (status, oral health-related quality of life and practices in adults. Methods This cross-sectional study examined a household probability sample of 248 adults, representing 149,635 residents (20–64 years old in Piracicaba-SP, Brazil. Clinical oral health and socioeconomic and demographic data, as well as data on oral health-related quality of life (OHIP-14 and health practices were collected. The oral examinations were carried out in the participants’ homes, using the World Health Organization criteria for oral diseases. The critical and communicative OHL instrument was the primary independent variable, and it was measured using five Likert items that were dichotomized as ‘high’ (‘agree’ and ‘strongly agree’ responses for the 5 items and ‘low’ OHL. Binary and multinomial logistic regressions were performed on each outcome (oral health status and practices, controlling for age, sex and socioeconomic status (SES. Results Approximately 71.5% presented low OHL. When adjusted for age and sex (first model low OHL was associated with untreated caries (Odds Ratio = 1.92, 95% Confidence Interval = 1.07–3.45, tooth brushing <3 times a day (OR = 2.00, 1.11–3.62 and irregular tooth flossing (OR = 2.17, 1.24–3.80. After SES inclusion in the first model, significant associations were found for low OHL when the outcomes were: presence of biofilm (OR = 1.83, 1.08–3.33, dental care for emergency only (OR = 2.24, 1.24–4.04 and prevalence of oral health impact on quality of life (OR = 2.06, 1.15–3.69. Conclusion Adjusting for age, sex and SES, OHL is related to a risk factor (biofilm and a consequence of poor oral health (emergency dental visits and can interfere with the impact of oral diseases on quality of life. As low OHL can be modified, the results support oral health promotion

EFFECTS OF AIR POLLUTION ON RESPIRATORY HEALTH OF ADULTS IN THREE CHINESE CITIES.

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The authors examined potential associations between air-pollution exposures and respiratory symptoms and illnesses of 4,108 adults who resided in 4 districts of 3 large, distinct Chinese cities. Data on respiratory health outcomes and relevant risk factors for parents and childre...

Sexting, substance use, and sexual risk behavior in young adults

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Benotsch, Eric G.; Snipes, Daniel J.; Martin, Aaron M.; Bull, Sheana S.

2012-01-01

Purpose Cell phone use has become more widespread over the past decade. Young adults are frequently early adopters of new technologies, including cell phones. Most prior research examining sexting, the act of sending sexually explicit or suggestive images via text message, has focused on the legal or social consequences of this behavior. The current study focused on the public health implications of sexting by examining associations between sexting, substance use, and sexual risk behavior in youth. Methods Young adults (N=763) completed online questionnaires assessing demographics, cell phone use (e.g., texting, sexting), substance use, and sexual risk behaviors. Results Sexting was reported by a substantial minority of participants (44%). Compared to their non-sexting counterparts, participants who engaged in sexting were more likely to report recent substance use and high-risk sexual behaviors, including unprotected sex and sex with multiple partners. Of those who engaged in sexting, a considerable percentage (31.8%) reported having sex with a new partner for the first time after sexting with that person. In multivariate analyses, sexting was associated with high-risk sexual behavior after accounting for demographic factors, total texting behaviors, and substance use. Conclusions Results suggest that sexting is robustly associated with high-risk sexual behavior. Many individuals exchange explicit or provocative photos with long-term sexual partners, but at least some participants in this study were incurring new sexual risks subsequent to sexting. Additional research is needed to understand the contexts in which sexting occurs, motivations for sexting, and relationship of sexting to risk behavior. PMID:23299017

Sexual orientation and health among U.S. adults: national health interview survey, 2013.

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Ward, Brian W; Dahlhamer, James M; Galinsky, Adena M; Joestl, Sarah S

2014-07-15

To provide national estimates for indicators of health-related behaviors, health status, health care service utilization, and health care access by sexual orientation using data from the 2013 National Health Interview Survey (NHIS). NHIS is an annual multipurpose health survey conducted continuously throughout the year. Analyses were based on data collected in 2013 from 34,557 adults aged 18 and over. Sampling weights were used to produce national estimates that are representative of the civilian noninstitutionalized U.S. adult population. Differences in health-related behaviors, health status, health care service utilization, and health care access by sexual orientation were examined for adults aged 18-64, and separately for men and women. Based on the 2013 NHIS data, 96.6% of adults identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual. The remaining 1.1% of adults identified as ''something else,'' stated ''I don't know the answer,'' or refused to provide an answer. Significant differences were found in health-related behaviors, health status, health care service utilization, and health care access among U.S. adults aged 18-64 who identified as straight, gay or lesbian, or bisexual. NHIS sexual orientation data can be used to track progress toward meeting the Healthy People 2020 goals and objectives related to the health of lesbian, gay, and bisexual persons. In addition, the data can be used to examine a wide range of health disparities among adults identifying as straight, gay or lesbian, or bisexual. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Spatial risk for gender-specific adult mortality in an area of southern China

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Ochiai Rion

2007-07-01

Full Text Available Abstract Background Although economic reforms have brought significant benefits, including improved health care to many Chinese people, accessibility to improved care has not been distributed evenly throughout Chinese society. Also, the effects of the uneven distribution of improved healthcare are not clearly understood. Evidence suggests that mortality is an indicator for evaluating accessibility to improved health care services. We constructed spatially smoothed risk maps for gender-specific adult mortality in an area of southern China comprising both urban and rural areas and identified ecological factors of gender-specific mortality across societies. Results The study analyzed the data of the Hechi Prefecture in southern in China. An average of 124,204 people lived in the area during the study period (2002–2004. Individual level data for 2002–2004 were grouped using identical rectangular cells (regular lattice of 0.25 km2. Poisson regression was fitted to the group level data to identify gender-specific ecological factors of adult (ages 15– Conclusion We found a disparity in mortality rates between rural and urban areas in the study area in southern China, especially for adult men. There were also differences in mortality rates between poorer and wealthy populations in both rural and urban areas, which may in part reflect differences in health care quality. Spatial influences upon adult male versus adult female mortality difference underscore the need for more research on gender-related influences on adult mortality in China.

Youth with special health care needs: transition to adult health care services.

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Oswald, Donald P; Gilles, Donna L; Cannady, Mariel S; Wenzel, Donna B; Willis, Janet H; Bodurtha, Joann N

2013-12-01

Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.

Socio-ecological risk factors for prime-age adult death in two coastal areas of Vietnam.

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Deok Ryun Kim

Full Text Available Hierarchical spatial models enable the geographic and ecological analysis of health data thereby providing useful information for designing effective health interventions. In this study, we used a Bayesian hierarchical spatial model to evaluate mortality data in Vietnam. The model enabled identification of socio-ecological risk factors and generation of risk maps to better understand the causes and geographic implications of prime-age (15 to less than 45 years adult death.The study was conducted in two sites: Nha Trang and Hue in Vietnam. The study areas were split into 500×500 meter cells to define neighborhoods. We first extracted socio-demographic data from population databases of the two sites, and then aggregated the data by neighborhood. We used spatial hierarchical model that borrows strength from neighbors for evaluating risk factors and for creating spatially smoothed risk map after adjusting for neighborhood level covariates. The Markov chain Monte Carlo procedure was used to estimate the parameters. Male mortality was more than twice the female mortality. The rates also varied by age and sex. The most frequent cause of mortality was traffic accidents and drowning for men and traffic accidents and suicide for women. Lower education of household heads in the neighborhood was an important risk factor for increased mortality. The mortality was highly variable in space and the socio-ecological risk factors are sensitive to study site and sex.Our study suggests that lower education of the household head is an important predictor for prime age adult mortality. Variability in socio-ecological risk factors and in risk areas by sex make it challenging to design appropriate intervention strategies aimed at decreasing prime-age adult deaths in Vietnam.

Effects of early life factors on the health and quality of life of older adults.

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Yilmaz, Fikriye; N Tekin, Rukiye

2018-01-01

Few studies on the effects of early life factors on the health and quality of life of adults have been conducted in Turkey. We aimed to investigate the effects of early life factors on the health and quality of life of older adults. We administered a questionnaire to 350 adults, aged 50-89 years, living in Cankaya, Ankara. The questionnaire covered sociodemographic characteristics, early life characteristics, health status, and the World Health Organization Quality of Life-Ageing scale. Data were analyzed using χ 2 tests, independent samples t-tests, one-way anova, and binary logistic regression analysis. The analyses showed that the most important risk factors for chronic disease were being ≥65 years (odds ratio (OR) = 2.34), having a chronic health problem before 18 years of age (OR = 2.48), experiencing prolonged hospitalization or bed rest before 18 years of age (OR = 2.65), and experiencing parental unconcern during early life (OR = 2.13) (P quality of life (P life factors are among the important determinants of the health and quality of life of older adults in Turkey. © 2017 Japanese Psychogeriatric Society.

Effectiveness of personalized and interactive health risk calculators: a randomized trial.

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Harle, Christopher A; Downs, Julie S; Padman, Rema

2012-01-01

Risk calculators are popular websites that provide individualized disease risk assessments to the public. Little is known about their effect on risk perceptions and health behavior. This study sought to test whether risk calculator features-namely, personalized estimates of one's disease risk and feedback about the effects of risk-mitigating behaviors-improve risk perceptions and motivate healthy behavior. A web-based experimental study using simple randomization was conducted to compare the effects of 3 prediabetes risk communication websites. Setting The study was conducted in the context of ongoing health promotion activities sponsored by a university's human resources office. Patients Participants were adult university employees. Intervention The control website presented nonindividualized risk information. The personalized noninteractive website presented individualized risk calculations. The personalized interactive website presented individualized risk calculations and feedback about the effects of hypothetical risk-mitigating behaviors. Measurements Pre- and postintervention risk perceptions were measured in absolute and relative terms. Health behavior was measured by assessing participant interest in follow-up preventive health services. On average, risk perceptions decreased by 2%. There was no general effect of personalization or interactivity in aligning subjective risk perceptions with objective risk calculations or in increasing healthy behaviors. However, participants who previously overestimated their risk reduced their perceptions by 16%. This was a significantly larger change than the 2% increase by participants who underestimated their risk. Limitations Results may not generalize to different populations, different diseases, or longer-term outcomes. Compared to nonpersonalized information, individualized risk calculators had little positive effect on prediabetes risk perception accuracy or health behavior. Risk perception accuracy was improved in

Life course socioeconomic position and C-reactive protein: mediating role of health-risk behaviors and metabolic alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil.

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Lidyane V Camelo

Full Text Available BACKGROUND: Chronic inflammation has been postulated to be one mediating mechanism explaining the association between low socioeconomic position (SEP and cardiovascular disease (CVD. We sought to examine the association between life course SEP and C-reactive protein (CRP levels in adulthood, and to evaluate the extent to which health-risk behaviors and metabolic alterations mediate this association. Additionally, we explored the possible modifying influence of gender. METHODS AND FINDINGS: Our analytical sample comprised 13,371 participants from ELSA-Brasil baseline, a multicenter prospective cohort study of civil servants. SEP during childhood, young adulthood, and adulthood were considered. The potential mediators between life course SEP and CRP included clusters of health-risk behaviors (smoking, low leisure time physical activity, excessive alcohol consumption, and metabolic alterations (obesity, hypertension, low HDL, hypertriglyceridemia, and diabetes. Linear regression models were performed and structural equation modeling was used to evaluate mediation. Although lower childhood SEP was associated with higher levels of CRP in adult life, this association was not independent of adulthood SEP. However, CRP increased linearly with increasing number of unfavorable social circumstances during the life course (p trend <0.001. The metabolic alterations were the most important mediator between cumulative SEP and CRP. This mediation path accounted for 49.5% of the total effect of cumulative SEP on CRP among women, but only 20.2% among men. In consequence, the portion of the total effect of cumulative SEP on CRP that was mediated by risk behaviors and metabolic alterations was higher among women (55.4% than among men (36.8%. CONCLUSIONS: Cumulative SEP across life span was associated with elevated systemic inflammation in adulthood. Although health-risk behaviors and metabolic alterations were important mediators of this association, a sizable

The Health Literacy and ESL study: a community-based intervention for Spanish-speaking adults.

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Soto Mas, Francisco; Ji, Ming; Fuentes, Brenda O; Tinajero, Josefina

2015-04-01

Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits.

The Health Literacy and ESL Study: A Community-Based Intervention for Spanish-Speaking Adults

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MAS, FRANCISCO SOTO; JI, MING; FUENTES, BRENDA O.; TINAJERO, JOSEFINA

2015-01-01

Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits. PMID:25602615

Health Risk Assessment of Heavy Metals in Soils from Witwatersrand Gold Mining Basin, South Africa

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Caspah Kamunda

2016-06-01

Full Text Available The study evaluates the health risk caused by heavy metals to the inhabitants of a gold mining area. In this study, 56 soil samples from five mine tailings and 17 from two mine villages were collected and analyzed for Asernic (As, Lead (Pb, Mercury (Hg, Cadmium (Cd, Chromium (Cr, Cobalt (Co, Nickel (Ni, Copper (Cu and Zinc (Zn using ICP-MS. Measured concentrations of these heavy metals were then used to calculate the health risk for adults and children. Their concentrations were such that Cr > Ni > As > Zn > Cu > Co > Pb > Hg > Cd, with As, Cr and Ni higher than permissible levels. For the adult population, the Hazard Index value for all pathways was found to be 2.13, making non-carcinogenic effects significant to the adult population. For children, the Hazard Index value was 43.80, a value >>1, which poses serious non-carcinogenic effect to children living in the gold mining area. The carcinogenic risk was found to be 1.7 × 10−4 implying that 1 person in every 5882 adults may be affected. In addition, for children, in every 2725 individuals, 1 child may be affected (3.67 × 10−4. These carcinogenic risk values were both higher than acceptable values.

Healthy lifestyle behaviour among Ghanaian adults in the phase of a health policy change

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Dake Fidelia AA

2011-04-01

Full Text Available Abstract Background Many countries have adopted health policies that are targeted at reducing the risk factors for chronic non-communicable diseases. These policies promote a healthy population by encouraging people to adopt healthy lifestyle behaviours. This paper examines healthy lifestyle behaviour among Ghanaian adults by comparing behaviours before and after the introduction of a national health policy. The paper also explores the socio-economic and demographic factors associated with healthy lifestyle behaviour. Method Descriptive, bivariate and multivariate regression techniques were employed on two nationally representative surveys (2003 World Health Survey (Ghana and 2008 Ghana Demographic and Health Survey to arrive at the results. Results While the prevalence of some negative lifestyle behaviours like smoking has reduced others like alcohol consumption has increased. Relatively fewer people adhered to consuming the recommended amount of fruit and vegetable servings per day in 2008 compared to 2003. While more females (7.0% exhibited healthier lifestyles, more males (9.0% exhibited risky lifestyle behaviours after the introduction of the policy. Conclusion The improvement in healthy lifestyle behaviours among female adult Ghanaians will help promote healthy living and potentially lead to a reduction in the prevalence of obesity among Ghanaian women. The increase in risky lifestyle behaviour among adult male Ghanaians even after the introduction of the health policy could lead to an increase in the risk of non-communicable diseases among men and the resultant burden of disease on them and their families will push more people into poverty.

Fetal and infant exposure to severe Chinese famine increases the risk of adult dyslipidemia: Results from the China health and retirement longitudinal study.

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Wang, Zhenghe; Li, Changwei; Yang, Zhongping; Ma, Jun; Zou, Zhiyong

2017-06-14

To explore the associations between the Chinese famine exposure in early life and the dyslipidemia in adulthood. We selected 2752 participants from the baseline survey of China Health and Retirement Longitudinal Study (CHARLS) 2011-2012 to evaluate the associations of early life the Chinese famine exposure with risk of dyslipidemia in adulthood. Dyslipidemia was defined as TC (Total Cholesterol): HDL-C (High-Density Lipoprotein Cholesterol) ratio ≥ 5.0 or use cholesterol lowering drugs. Famine exposure cohorts were categorized by birthdates of participants. Binary logistics regression model was used to examine the associations of early-life famine exposure with the risk of dyslipidemia. The dyslipidemia prevalence of the non-exposed cohort, fetal stage-, infant stage-, and preschool stage-exposed cohorts in adulthood was 15.7%, 23.1%, 22.0%, and 18.6%, respectively. Early-life exposure to the Chinese famine significantly increased LDL cholesterol concentrations in adulthood after adjusted for age. The risks of dyslipidemia in fetal (OR = 1.58; 95% CI: 1.23-2.03; P dyslipidemia in female adults. However, the similar association was not observed for male adults. Early-life exposure to severe Chinese famine could link with the higher dyslipidemia risk in female adulthood, but not in male adulthood. This gender-specific effect might be associated with the hypothesis that parents in China prefer boys to girls traditionally or survivors' bias.

Novel sensing technology in fall risk assessment in older adults: a systematic review.

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Sun, Ruopeng; Sosnoff, Jacob J

2018-01-16

Falls are a major health problem for older adults with significant physical and psychological consequences. A first step of successful fall prevention is to identify those at risk of falling. Recent advancement in sensing technology offers the possibility of objective, low-cost and easy-to-implement fall risk assessment. The objective of this systematic review is to assess the current state of sensing technology on providing objective fall risk assessment in older adults. A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). Twenty-two studies out of 855 articles were systematically identified and included in this review. Pertinent methodological features (sensing technique, assessment activities, outcome variables, and fall discrimination/prediction models) were extracted from each article. Four major sensing technologies (inertial sensors, video/depth camera, pressure sensing platform and laser sensing) were reported to provide accurate fall risk diagnostic in older adults. Steady state walking, static/dynamic balance, and functional mobility were used as the assessment activity. A diverse range of diagnostic accuracy across studies (47.9% - 100%) were reported, due to variation in measured kinematic/kinetic parameters and modelling techniques. A wide range of sensor technologies have been utilized in fall risk assessment in older adults. Overall, these devices have the potential to provide an accurate, inexpensive, and easy-to-implement fall risk assessment. However, the variation in measured parameters, assessment tools, sensor sites, movement tasks, and modelling techniques, precludes a firm conclusion on their ability to predict future falls. Future work is needed to determine a clinical meaningful and easy to interpret fall risk diagnosis utilizing sensing technology. Additionally, the gap between functional evaluation and user experience to technology should be addressed.

Prayer Attendance and General Health in the Iranian Adult Urban Population.

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Sotodehasl, Nemat; Ghorbani, Raheb; Mahdavi-Nejad, Gholamhosein; Haji-Aghajani, Saeed; Mehdizadeh, Jamileh

2016-02-01

This study was conducted to determine the relationship between prayer attendance and general health among adult urban population in Iran. A total of 470 males older than 17 years, chosen by multistage sampling, were investigated. The results showed that people who did not perform prayers compared to those who said prayers on time and performed Nafilahs (supererogatory prayers) were 2.87 (OR 2.87, 95 % CI 1.23-6.70, p = 0.015) times at risk of general health problems. In conclusion, the findings show that increasing the degree of people's belief in prayer can lead to improve general health.

100% orange juice consumption is associated with better diet quality, improved nutrient adequacy, decreased risk for obesity, and improved biomarkers of health in adults: National Health and Nutrition Examination Survey, 2003-2006.

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O'Neil, Carol E; Nicklas, Theresa A; Rampersaud, Gail C; Fulgoni, Victor L

2012-12-12

Consumption of 100% orange juice (OJ) has been positively associated with nutrient adequacy and diet quality, with no increased risk of overweight/obesity in children; however, no one has examined these factors in adults. The purpose of this study was to examine the association of 100% OJ consumption with nutrient adequacy, diet quality, and risk factors for metabolic syndrome (MetS) in a nationally representative sample of adults. Data from adults 19+ years of age (n = 8,861) participating in the National Health and Nutrition Examination Survey 2003-2006 were used. The National Cancer Institute method was used to estimate the usual intake (UI) of 100% OJ consumption, selected nutrients, and food groups. Percentages of the population below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was measured by the Healthy Eating Index-2005 (HEI-2005). Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese or having risk factors of MetS or MetS. Usual per capita intake of 100% OJ was 50.3 ml/d. Among consumers (n = 2,310; 23.8%), UI was 210.0 ml/d. Compared to non-consumers, consumers had a higher (p juice, whole fruit, and whole grain. Consumers had a lower (p diet.

The impact of health claims and food deprivation levels on health risk perceptions of fast-food restaurants.

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Cadario, Romain

2016-01-01

We examined the effect of health claims and food deprivation levels on the health risk perceptions of fast-food restaurants. Consistent with previous research, we used a within-subjects experimental design to manipulate the health claims of fast-food restaurants using real brands: Subway, expressing strong health claims vs. McDonald's, expressing weak health claims. Participants who did not have access to nutrition information were asked to estimate the health risk associated with food items that were slightly more caloric for Subway than McDonald's (640 kcal vs. 600 kcal). We collected data through a web survey with a sample consisting of 414 American adults. Based on the USDA Food Insufficiency Indicator, participants were classified into two categorical food deprivation levels: food sufficiency and food insufficiency. We find that risk perceptions for obesity, diabetes and cardiac illnesses are lower (higher) for the restaurant with stronger (lower) health claims, i.e., Subway (McDonald's). Moreover, we also find that food deprivation levels moderate this effect, such that health risk underestimation is aggravated for individuals who suffer from food insufficiency. More precisely, we find that food insufficient individuals are more responsive to health claims, such that they perceive less health risk than food sufficient individuals for the restaurant with stronger health claims (Subway). Exploring the underlying mechanism of the latter effect, we found that dietary involvement mediates the relationship between food deprivation levels and health risk perceptions for the restaurant with stronger health claims (Subway). These results provide an interdisciplinary contribution in consumer psychology and public health. Copyright © 2015 Elsevier Ltd. All rights reserved.

Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas
- Behavioral Risk Factor Surveillance System, United States, 2012.

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Chowdhury, Pranesh P; Mawokomatanda, Tebitha; Xu, Fang; Gamble, Sonya; Flegel, David; Pierannunzi, Carol; Garvin, William; Town, Machell

2016-04-29

Chronic diseases (e.g., heart diseases, cancer, chronic lower respiratory disease, stroke, diabetes, and arthritis) and unintentional injuries are the leading causes of morbidity and mortality in the United States. Behavioral risk factors (e.g., tobacco use, poor diet, physical inactivity, excessive alcohol consumption, failure to use seat belts, and insufficient sleep) are linked to the leading causes of death. Modifying these behavioral risk factors and using preventive health services (e.g., cancer screenings and influenza and pneumococcal vaccination of adults aged ≥65 years) can substantially reduce morbidity and mortality in the U.S. Continuous monitoring of these health-risk behaviors, chronic conditions, and use of preventive services are essential to the development of health promotion strategies, intervention programs, and health policies at the state, city, and county level. January-December 2012. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. BRFSS collects data on health-risk behaviors, chronic diseases and conditions, access to health care, and use of preventive health services related to the leading causes of death and disability. This report presents results for all 50 states, the District of Columbia, participating U.S. territories that include the Commonwealth of Puerto Rico (Puerto Rico) and Guam, 187 Metropolitan/Micropolitan Statistical Areas (MMSAs), and 210 counties (n = 475,687 survey respondents) for the year 2012. In 2012, the estimated prevalence of health-risk behaviors, chronic diseases or conditions, access to health care, and use of preventive health services substantially varied by state and territory, MMSA, and county. The following portion of the abstract lists a summary of results by selected BRFSS measures. Each set of proportions refers to the range of

Depression and health behaviors in Brazilian adults – PNS 2013

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Marilisa Berti de Azevedo Barros

Full Text Available ABSTRACT OBJECTIVE To evaluate the prevalence of health-related behaviors according to presence and type of depression in Brazilian adults. METHODS Based on a sample of 49,025 adults (18 to 59 years from the National Survey on Health 2013 (PNS 2013, we estimated the prevalence of health-related behaviors (smoking; passive smoking; frequent or risky alcohol consumption; leisure time physical activity; time watching TV; and eating pattern indicators, according to the presence of depression (minor and major, evaluated by the Patient Health Questionnaire – 9 (PHQ-9, and the report of depressive mood (in up to seven days or more than seven days over a two-week period. Prevalence ratios were estimated by Poisson regression. RESULTS Evaluated by the PHQ-9 scale, 9.7% of the Brazilian adults had depression and 3.9% presented major depression. About 21.0% reported depressive mood and, in 34.9% of them, that feeling has been present for more than seven days. In individuals with major depression (PHQ-9, higher prevalence was found in almost all unhealthy behaviors analyzed, in particular, smoking (PR = 1.65, passive smoking (PR = 1.55, risk alcohol consumption (PR = 1.72, TV for ≥ 5 hours/day (PR = 2.13, consumption of fat meat (PR = 1.43 and soft drink (PR = 1.42. The prevalence ratios tended to be lower in those with minor depression. Similar results were observed in adults with depressive mood. CONCLUSIONS This study detected relevant association between depression and health behaviors, in particular for smoking and physical activity. The associations found with the PHQ were similar to those observed with the application of a single question about depressive mood. Our results indicate the importance of assessing the presence of depression and the frequency and severity of symptoms when implementing actions for the promotion of healthy behaviors.

Dental Caries and General Health in Children and Adults

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Twetman, Svante

2016-01-01

in society with caries risk due to age- and medication-induced salivary reduction. However, a general disease may not always have a negative influence on dental health. Therefore, a regular individual caries risk assessment is of utmost importance for clinical decision-making and tailoring of recall......Caries is a biofilm-mediated noncommunicable disease fueled by dietary sugar, neglected oral hygiene, and reduced saliva flow. General diseases may influence the oral environment through its pathogenesis, medication, and/or the caring of the condition. Associations between caries and chronic...... diseases are mainly derived from case–control studies with various sample sizes and quality of matching. Few observational studies are available and the majority of all research is conducted in childhood and among older adults. There is an increased caries risk for subjects with obesity, severe asthma...

Social isolation, health literacy, and mortality risk: Findings from the English Longitudinal Study of Ageing.

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Smith, Samuel G; Jackson, Sarah E; Kobayashi, Lindsay C; Steptoe, Andrew

2018-02-01

To investigate the relationships between social isolation, health literacy, and all-cause mortality, and the modifying effect of social isolation on the latter relationship. Data were from 7731 adults aged ≥50 years participating in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing. Social isolation was defined according to marital/cohabiting status and contact with children, relatives, and friends, and participation in social organizations. Scores were split at the median to indicate social isolation (yes vs. no). Health literacy was assessed as comprehension of a medicine label and classified as "high" (≥75% correct) or "low" (socially isolated versus nonisolated groups. Low health literacy (adj. HR = 1.22, 95% CI 1.02-1.45 vs. high) and social isolation (adj. HR = 1.28, 95% CI 1.10-1.50) were independently associated with increased mortality risk. The multiplicative interaction term for health literacy and social isolation was not statistically significant (p = .81). Low health literacy and high social isolation are risk factors for mortality. Social isolation does not modify the relationship between health literacy and mortality. Clinicians should be aware of the health risks faced by socially isolated adults and those with low health literacy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Committee Opinion No. 653: Concerns Regarding Social Media and Health Issues in Adolescents and Young Adults.

Science.gov (United States)

2016-02-01

Although there are many positive aspects of social media for adolescents and young adults, there are also risks. Adolescence is a time of significant developmental changes, during which adolescents exhibit a limited capacity for self-regulation and an increased risk of susceptibility to peer pressure and experimentation. Social media can be harmful, and obstetrician-gynecologists may screen their adolescent and young adult patients for high-risk sexual behaviors, especially if sexualized text communication (sexting), exposure to pornography, online dating, or other risk-taking behaviors are present. Victims of cyberbullying and those who engage in sexting are at increased risk of sexually transmitted infections and pregnancy. The effect of social media may be considered in the differential diagnosis of myriad health problems during adolescence. Referrals to mental health care providers or providing outside resources may be indicated. A multidisciplinary approach to address these issues can include the obstetrician-gynecologist, guardians, and school officials and personnel. Knowledge of resources, including those within the schools and community, allows the obstetrician-gynecologist to provide support to adolescents facing these issues.

Assessing Health Risk due to Exposure to Arsenic in Drinking Water in Hanam Province, Vietnam

Directory of Open Access Journals (Sweden)

Tung Bui Huy

2014-07-01

Full Text Available We assessed health risks related to Arsenic (As in contaminated drinking water in Hanam, applying the Australian Environmental Health Risk Assessment Framework, which promotes stakeholder involvement in risk assessments. As concentrations in 300 tube-well water samples, before and after filtration, were analyzed and the water consumption levels in 150 households were estimated. Skin cancer risk was characterized using Cancer Slope Factor index and lifetime average daily dose with a probabilistic approach. The results showed that arsenic concentrations in tube-well water ranged from 8–579 ppb (mean 301 ppb before filtration and current sand filters used by the households did not meet the standard for As removal. Arsenic daily consumption of 40% of the adults exceeded the level of TDI (Tolerable Daily Intake at 1 µg/kg/day. The average skin cancer risk in adults due to consuming filtered tube-well water for drinking purpose were 25.3 × 10−5 (using only well water and 7.6 × 10−5 (using both well and rain water. The skin cancer risk would be 11.5 times higher if the water was not filtered. Improvement of filtration measures or the replacement of the current drinking water sources to minimize the health risks to the local population is urgently needed.

Assessing Health Risk due to Exposure to Arsenic in Drinking Water in Hanam Province, Vietnam

Science.gov (United States)

Bui Huy, Tung; Tuyet-Hanh, Tran Thi; Johnston, Richard; Nguyen-Viet, Hung

2014-01-01

We assessed health risks related to Arsenic (As) in contaminated drinking water in Hanam, applying the Australian Environmental Health Risk Assessment Framework, which promotes stakeholder involvement in risk assessments. As concentrations in 300 tube-well water samples, before and after filtration, were analyzed and the water consumption levels in 150 households were estimated. Skin cancer risk was characterized using Cancer Slope Factor index and lifetime average daily dose with a probabilistic approach. The results showed that arsenic concentrations in tube-well water ranged from 8–579 ppb (mean 301 ppb) before filtration and current sand filters used by the households did not meet the standard for As removal. Arsenic daily consumption of 40% of the adults exceeded the level of TDI (Tolerable Daily Intake) at 1 µg/kg/day. The average skin cancer risk in adults due to consuming filtered tube-well water for drinking purpose were 25.3 × 10−5 (using only well water) and 7.6 × 10−5 (using both well and rain water). The skin cancer risk would be 11.5 times higher if the water was not filtered. Improvement of filtration measures or the replacement of the current drinking water sources to minimize the health risks to the local population is urgently needed. PMID:25062276

Examination of Oral Microbiota Diversity in Adults and Older Adults as an Approach to Prevent Spread of Risk Factors for Human Infections

Directory of Open Access Journals (Sweden)

Paweł J. Zawadzki

2017-01-01

Full Text Available The oral cavity environment may be colonized by polymicrobial communities with complex, poorly known interrelations. The aim of this study was to determine oral microbiota diversity in order to prevent the spread of infectious microorganisms that are risk factors for human health complications in patients requiring treatment due to various disabilities. The study examined Polish adults aged between 40 and 70 years; parasitological, microbiological, and mycological data collected before treatment were analyzed. The diversity of oral microbiota, including relatively high prevalences of some opportunistic, potentially pathogenic strains of bacteria, protozoans, and fungi detected in the patients analyzed, may result in increasing risk of disseminated infections from the oral cavity to neighboring structures and other organs. Increasing ageing of human populations is noted in recent decades in many countries, including Poland. The growing number of older adults with different oral health disabilities, who are more prone to development of oral and systemic pathology, is an increasing medical problem. Results of this retrospective study showed the urgent need to pay more attention to the pretreatment examination of components of the oral microbiome, especially to the strains, which are etiological agents of human opportunistic infections and are particularly dangerous for older adults.

Seeing Health Insurance and HealthCare.gov Through the Eyes of Young Adults.

Science.gov (United States)

Wong, Charlene A; Asch, David A; Vinoya, Cjloe M; Ford, Carol A; Baker, Tom; Town, Robert; Merchant, Raina M

2015-08-01

We describe young adults' perspectives on health insurance and HealthCare.gov, including their attitudes toward health insurance, health insurance literacy, and benefit and plan preferences. We observed young adults aged 19-30 years in Philadelphia from January to March 2014 as they shopped for health insurance on HealthCare.gov. Participants were then interviewed to elicit their perceived advantages and disadvantages of insurance and factors considered important for plan selection. A 1-month follow-up interview assessed participants' plan enrollment decisions and intended use of health insurance. Data were analyzed using qualitative methodology, and salience scores were calculated for free-listing responses. We enrolled 33 highly educated young adults; 27 completed the follow-up interview. The most salient advantages of health insurance for young adults were access to preventive or primary care (salience score .28) and peace of mind (.27). The most salient disadvantage was the financial strain of paying for health insurance (.72). Participants revealed poor health insurance literacy with 48% incorrectly defining deductible and 78% incorrectly defining coinsurance. The most salient factors reported to influence plan selection were deductible (.48) and premium (.45) amounts as well as preventive care (.21) coverage. The most common intended health insurance use was primary care. Eight participants enrolled in HealthCare.gov plans: six selected silver plans, and three qualified for tax credits. Young adults' perspective on health insurance and enrollment via HealthCare.gov can inform strategies to design health insurance plans and communication about these plans in a way that engages and meets the needs of young adult populations. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Long-Term Effects of Parental Divorce on the Mental Health of Young Adults: A Developmental Perspective.

Science.gov (United States)

Chase-Lansdale, P. Lindsay; And Others

1995-01-01

Examined effects on young adults (23 years) of parental divorce during childhood and adolescence using data from Britain's longitudinal National Child Development study. Found that divorce had a moderate, long-term negative impact on young adults' mental health; the relative risk of serious emotional disorders increased in the aftermath of…

Food Security and Cardiovascular Disease Risk Among Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2003–2008

Science.gov (United States)

2013-01-01

Introduction Little is known about the relationship between food security status and predicted 10-year cardiovascular disease risk. The objective of this study was to examine the associations between food security status and cardiovascular disease risk factors and predicted 10-year risk in a national sample of US adults. Methods A cross-sectional analysis using data from 10,455 adults aged 20 years or older from the National Health and Nutrition Examination Survey 2003–2008 was conducted. Four levels of food security status were defined by using 10 questions. Results Among all participants, 83.9% had full food security, 6.7% had marginal food security, 5.8% had low food security, and 3.6% had very low food security. After adjustment, mean hemoglobin A1c was 0.15% greater and mean concentration of C-reactive protein was 0.8 mg/L greater among participants with very low food security than among those with full food security. The adjusted mean concentration of cotinine among participants with very low food security was almost double that of participants with full food security (112.8 vs 62.0 ng/mL, P security status and systolic blood pressure or concentrations of total cholesterol, high-density lipoprotein cholesterol, or non-high-density lipoprotein cholesterol were observed. Participants aged 30 to 59 years with very low food security were more likely to have a predicted 10-year cardiovascular disease risk greater than 20% than fully food secure participants (adjusted prevalence ratio, 2.38; 95% CI, 1.31–4.31). Conclusion Adults aged 30 to 59 years with very low food security showed evidence of increased predicted 10-year cardiovascular disease risk. PMID:24309090

A prospective study of the impact of floods on the mental and physical health of older adults.

Science.gov (United States)

Bei, Bei; Bryant, Christina; Gilson, Kim-Michelle; Koh, Juliana; Gibson, Penelope; Komiti, Angela; Jackson, Henry; Judd, Fiona

2013-01-01

With a longitudinal prospective design, we examined the impact of floods on the mental and physical health of older adults and explored risk and protective factors. Two hundred and seventy four older adults (age ≥60) completed surveys before and after a flood event. Both the surveys included measures of anxiety, depression, self-reported health, and satisfaction with life; the post-flood survey also included questionnaires on flood experience, symptoms of post-traumatic stress disorder (PTSD), stoicism, and psychological coping with floods. Compared to those not personally affected (78.8%), personally affected individuals (21.2%) reported significantly higher PTSD symptoms, with about one in six reporting PTSD symptoms that might require clinical attention. Personally affected individuals also reported a greater increase in anxiety post-flood, but changes in their depressive symptoms and self-reported health were not significantly different from those not personally affected. Greater flood exposure and the lack of social support were the risk factors for poorer mental and physical health. Higher stoicism was associated with higher post-flood depression and poorer self-reported mental health. The use of maladaptive coping, such as venting and distraction, was associated with greater deterioration in mental health after floods, whilst emotion-focused coping such as acceptance, positive reframing, and humour, was protective against such deterioration. Floods had adverse psychological impacts on some older adults who were personally affected. Despite the evidence of resilience, a small proportion of older adults experienced significant difficulties after the floods. The findings in this study help understand older adults' psychological responses to disasters and have practical implications for service planning and delivery.

Oral Health and Older Adults

Centers for Disease Control (CDC) Podcasts

2008-10-27

This podcast discusses the importance of older adults maintaing good oral health habits. It is primarily targeted to public health and aging services professionals.  Created: 10/27/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/27/2008.

A path analysis of a randomized promotora de salud cardiovascular disease-prevention trial among at-risk Hispanic adults.

Science.gov (United States)

de Heer, Hendrik Dirk; Balcazar, Hector G; Castro, Felipe; Schulz, Leslie

2012-02-01

This study assessed effectiveness of an educational community intervention taught by promotoras de salud in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of protective health behaviors, health beliefs, contextual and social factors. Participants were 328 Hispanic adults with at least one CVD risk factor. SEM analyses assessed direct and indirect effects of intervention participation on CVD risk (Framingham score) and latent variables nutrition intake and health beliefs. The model fit was adequate (root mean square error of approximation = .056 [90% confidence interval = .040, .072], comparative fit index = .967, normed fit index = .938, nonnormed fit index = .947). Intervention participation was associated with improved nutritional consumption, but not lower CVD risk. Stronger health beliefs predicted healthier nutritional habits. This project provided evidence for the adequacy of a conceptual framework that can be used to elicit new pathways toward CVD risk reduction among at-risk Hispanic populations.

Metal Exposure and Associated Health Risk to Human Beings by Street Dust in a Heavily Industrialized City of Hunan Province, Central China

Directory of Open Access Journals (Sweden)

Guangyi Sun

2017-03-01

Full Text Available Fifty-five urban street dust samples were collected from Zhuzhou, an industrial city in central China and analyzed for a range of toxic elements. Potential carcinogenic and non-carcinogenic health effects on children and adults due to exposure to street dust were assessed. Concerning the two subgroups, the child cohort is confronted with considerably greater health risks than adults. According to the Hazard Quotient (HQ method, ingestion of dust particles poses primary risk to children and adults, followed by dermal contact and inhalation for all of the metals investigated except Hg, for which inhalation of its elemental vapor constitute a slightly higher risk than ingestion. For children, Pb, As, Cd, Cr, Hg and Sb exposure were deemed as the highest contributors to non-cancer health risks, while As and Cr represent an enhanced cancer risk for children. For adults, risk indicator values for both cancer and non-cancer effects obtained were within the safety threshold. In a comparison with other locations within and outside mainland China, exposure to arsenic is prominent for the population of Zhuzhou, indicating more attention and preventive actions should been taken.

Attitudes towards mental health, mental health research and digital interventions by young adults with type 1 diabetes: A qualitative analysis.

Science.gov (United States)

Clarke, Janine; Proudfoot, Judy; Vatiliotis, Veronica; Verge, Charles; Holmes-Walker, Deborah J; Campbell, Lesley; Wilhelm, Kay; Moravac, Catherine; Indu, Pillaveetil S; Bridgett, Madeleine

2018-06-01

Young people with type 1 diabetes are at increased risk of mental disorders. Whereas treatment need is high, difficulty recruiting young people with type 1 diabetes into psychosocial studies complicates development, testing and dissemination of these interventions. Interviews with young adults with type 1 diabetes were conducted to examine attitudes towards mental health and mental health research, including barriers and motivators to participation in mental health studies and preferred sources of mental health support. The interviews were audio-taped, transcribed and evaluated via thematic analysis. Young adults with type 1 diabetes were recruited via social media channels of 3 advocacy organizations. A total of 31 young adults (26 females and 5 males) with an average age of 22 years were interviewed between October 2015 and January 2016. Participants were largely unaware of their increased vulnerability to common mental health problems and knew little about mental health research. Major barriers to participation included perceived stigma and lifestyle issues and low levels of trust in researchers. Opportunities to connect with peers and help others were described as key motivators. Psychological distress was considered normal within the context of diabetes. A need for some level of human contact in receiving psychosocial support was expressed. Findings provide valuable insights into the complex dynamics of engaging young adults with type 1 diabetes in mental health studies. Interviewees provided practical suggestions to assist investigation and delivery of psychosocial interventions for this vulnerable group. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Health effects of protein intake in healthy adults

DEFF Research Database (Denmark)

Pedersen, Agnes N.; Kondrup, Jens; Børsheim, Elisabet

2013-01-01

The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy adults. The literature search covered the years 2000-2011. Prospective cohort, case-control, and intervention studies were......: probable for an estimated average requirement of 0.66 g good-quality protein/kg body weight (BW)/day based on nitrogen balance studies, suggestive for a relationship between increased all-cause mortality risk and long-term low-carbohydrate-high-protein (LCHP) diets; but inconclusive for a relationship...... between all-cause mortality risk and protein intake per se; suggestive for an inverse relationship between cardiovascular mortality and vegetable protein intake; inconclusive for relationships between cancer mortality and cancer diseases, respectively, and protein intake; inconclusive for a relationship...

Self-esteem, propensity for sensation seeking, and risk behaviour among adults with tattoos and piercings.

Science.gov (United States)

Hong, Bo-Kyung; Lee, Hyo Young

2017-12-13

Background: In recent years, increasing numbers of adults and adolescents have opted to undergo tattoo and piercing procedures. Studies among adolescents with tattoo and piercing have usually explored the relationship between one factor and the decision to have tattoos and/or piercings. The aim of this study was to determine relationships between body cosmetic procedures and selfesteem, propensity for sensation seeking, and risk behaviours among adults. Materials and Methods: The subjects were divided into two groups, i.e. , those with (n=429) and those without tattoos/piercings (n=237), and self-esteem, propensity for sensation seeking, and risk behaviour were compared between the two groups using self-report questionnaires. To analyse differences in self-esteem and the propensity for sensation seeking, general characteristics were statistically adjusted. In addition, general characteristics, self-esteem, and propensity for sensation seeking were statistically adjusted to determine differences in the propensity for risk behaviour between the two groups. Results: Significant differences were observed in age, marital status, income level, occupation, values or sensitivity to fashion, and educational level between the group with and that without tattoos/ piercings. There was no significant difference in self-esteem, whereas there were significant differences in the propensity for sensation seeking and risk behaviour between the two groups. Conclusions: Continuous attention to, and interest in, the increased incidence of tattooing and piercing are necessary, especially in terms of public interventions for health education and health promotion, as these forms of self-adornment are associated with behaviours that pose a risk to health.

Self-esteem, propensity for sensation seeking, and risk behaviour among adults with tattoos and piercings

Directory of Open Access Journals (Sweden)

Bo-Kyung Hong

2017-12-01

Full Text Available Background: In recent years, increasing numbers of adults and adolescents have opted to undergo tattoo and piercing procedures. Studies among adolescents with tattoo and piercing have usually explored the relationship between one factor and the decision to have tattoos and/or piercings. The aim of this study was to determine relationships between body cosmetic procedures and selfesteem, propensity for sensation seeking, and risk behaviours among adults. Materials and Methods: The subjects were divided into two groups, i.e., those with (n=429 and those without tattoos/piercings (n=237, and self-esteem, propensity for sensation seeking, and risk behaviour were compared between the two groups using self-report questionnaires. To analyse differences in self-esteem and the propensity for sensation seeking, general characteristics were statistically adjusted. In addition, general characteristics, self-esteem, and propensity for sensation seeking were statistically adjusted to determine differences in the propensity for risk behaviour between the two groups. Results: Significant differences were observed in age, marital status, income level, occupation, values or sensitivity to fashion, and educational level between the group with and that without tattoos/ piercings. There was no significant difference in self-esteem, whereas there were significant differences in the propensity for sensation seeking and risk behaviour between the two groups. Conclusions: Continuous attention to, and interest in, the increased incidence of tattooing and piercing are necessary, especially in terms of public interventions for health education and health promotion, as these forms of self-adornment are associated with behaviours that pose a risk to health.

Exploring Older Adults' Health Information Seeking Behaviors

Science.gov (United States)

Manafo, Elizabeth; Wong, Sharon

2012-01-01

Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…

The other 23 hours: a qualitative study of fitness provider perspectives on social support for health promotion for adults with mental illness.

Science.gov (United States)

Aschbrenner, Kelly; Mueser, Kim; Bartels, Stephen; Carpenter-Song, Elizabeth; Pratt, Sarah; Barre, Laura; Naslund, John; Kinney, Allison

2015-05-01

Current efforts to reduce the increased risk of premature death from preventable cardiovascular disease among adults with serious mental illness (SMI) through lifestyle change have had limited success. Engaging informal support systems to promote healthy behaviors in everyday life may increase the effectiveness of health promotion interventions targeting this at-risk population. In-depth semistructured interviews were conducted with 10 fitness trainers serving adults with SMI in a health promotion program at community mental health centers to explore their perspectives on the potential of enlisting support from significant others for health behavior change. Trainers reported that the majority of participants had a relative or significant other who influenced their health behaviors, and they saw potential value in involving them in efforts to improve health outcomes by extending support into participants' daily lives. They did not feel qualified to work with families of individuals with mental illness, but they were willing to partner with providers who had experience in this area. Social workers who practice with families could play a critical role on health promotion teams addressing cardiovascular risk in adults with SMI by using their skills and experiences to engage families in supporting a relative through the process of health behavior change.

Factors Associated With High-Risk Alcohol Consumption Among LGB Older Adults: The Roles of Gender, Social Support, Perceived Stress, Discrimination, and Stigma.

Science.gov (United States)

Bryan, Amanda E B; Kim, Hyun-Jun; Fredriksen-Goldsen, Karen I

2017-02-01

Lesbian, gay, and bisexual (LGB) adults have elevated rates of high-risk alcohol consumption compared with heterosexual adults. Although drinking tends to decline with age in the general population, we know little about LGB older adults' drinking. Using 2014 data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), we aimed to identify factors associated with high-risk drinking in LGB older adults. A U.S. sample of 2,351 LGB adults aged 50-98 years completed a survey about personal and social experiences, substance use, and health. Multinomial logistic regression was conducted to identify predictors of past-month high-risk alcohol consumption. Approximately one fifth (20.6%) of LGB older adults reported high-risk drinking, with nonsignificantly different rates between men (22.4%) and women (18.4%). For women, current smoking and greater social support were associated with greater likelihood of high-risk drinking; older age, higher income, recovery from addiction, and greater perceived stress were associated with lower likelihood. For men, higher income, current smoking, and greater day-to-day discrimination were associated with greater likelihood of high-risk drinking; transgender identity and recovery from addiction were associated with lower likelihood. Social contexts and perceived drinking norms may encourage higher levels of alcohol consumption in LGB older women, whereas men's drinking may be linked with discrimination-related stress. Prevention and intervention with this population should take into account gender differences and sexual minority-specific risk factors. With future waves of data, we will be able to examine LGB older adults' drinking trajectories over time. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

"Friending" teens: systematic review of social media in adolescent and young adult health care.

Science.gov (United States)

Yonker, Lael M; Zan, Shiyi; Scirica, Christina V; Jethwani, Kamal; Kinane, T Bernard

2015-01-05

Social media has emerged as a potentially powerful medium for communication with adolescents and young adults around their health choices. The goal of this systematic review is to identify research on the use of social media for interacting with adolescents and young adults in order to achieve positive health outcomes. A MEDLINE/PubMed electronic database search was performed between January 1, 2002 and October 1, 2013, using terms to identify peer-reviewed research in which social media and other Web 2.0 technologies were an important feature. We used a systematic approach to retrieve papers and extract relevant data. We identified 288 studies involving social media, of which 87 met criteria for inclusion; 75 studies were purely observational and 12 were interventional. The ways in which social media was leveraged by these studies included (1) observing adolescent and young adult behavior (n=77), (2) providing health information (n=13), (3) engaging the adolescent and young adult community (n=17), and (4) recruiting research participants (n=23). Common health topics addressed included high-risk sexual behaviors (n=23), alcohol, tobacco, and other drug use (n=19), Internet safety (n=8), mental health issues (n=18), medical conditions (n=11), or other specified issues (n=12). Several studies used more than one social media platform and addressed more than one health-related topic. Social media technologies offer an exciting new means for engaging and communicating with adolescents and young adults; it has been successfully used to engage this age group, identify behaviors, and provide appropriate intervention and education. Nevertheless, the majority of studies to date have been preliminary and limited in their methodologies, and mostly center around evaluating how adolescents and young adults use social media and the resulting implications on their health. Although these explorations are essential, further exploration and development of these strategies into

Effects of exercise on fitness and health of adults with spinal cord injury: A systematic review.

Science.gov (United States)

van der Scheer, Jan W; Martin Ginis, Kathleen A; Ditor, David S; Goosey-Tolfrey, Victoria L; Hicks, Audrey L; West, Christopher R; Wolfe, Dalton L

2017-08-15

To synthesize and appraise research testing the effects of exercise interventions on fitness, cardiometabolic health, and bone health among adults with spinal cord injury (SCI). Electronic databases were searched (1980-2016). Included studies employed exercise interventions for a period ≥2 weeks, involved adults with acute or chronic SCI, and measured fitness (cardiorespiratory fitness, power output, or muscle strength), cardiometabolic health (body composition or cardiovascular risk factors), or bone health outcomes. Evidence was synthesized and appraised using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). A total of 211 studies met the inclusion criteria (22 acute, 189 chronic). For chronic SCI, GRADE confidence ratings were moderate to high for evidence showing exercise can improve all of the reviewed outcomes except bone health. For acute SCI, GRADE ratings were very low for all outcomes. For chronic SCI, there was low to moderate confidence in the evidence showing that 2-3 sessions/week of upper body aerobic exercise at a moderate to vigorous intensity for 20-40 minutes, plus upper body strength exercise (3 sets of 10 repetitions at 50%-80% 1-repetition maximum for all large muscle groups), can improve cardiorespiratory fitness, power output, and muscle strength. For chronic SCI, there was low to moderate confidence in the evidence showing that 3-5 sessions per week of upper body aerobic exercise at a moderate to vigorous intensity for 20-44 minutes can improve cardiorespiratory fitness, muscle strength, body composition, and cardiovascular risk. Exercise improves fitness and cardiometabolic health of adults with chronic SCI. The evidence on effective exercise types, frequencies, intensities, and durations should be used to formulate exercise guidelines for adults with SCI. © 2017 American Academy of Neurology.

Estimating young Australian adults' risk of hearing damage from selected leisure activities.

Science.gov (United States)

Beach, Elizabeth; Williams, Warwick; Gilliver, Megan

2013-01-01

, display warnings, and provide earplugs for patrons and employees. Health promoters should focus their attention on those young adults who are most at risk and provide them with targeted practical advice about reducing their leisure-noise exposure and avoiding hearing loss.

Perceived extrinsic mortality risk and reported effort in looking after health: testing a behavioral ecological prediction.

Science.gov (United States)

Pepper, Gillian V; Nettle, Daniel

2014-09-01

Socioeconomic gradients in health behavior are pervasive and well documented. Yet, there is little consensus on their causes. Behavioral ecological theory predicts that, if people of lower socioeconomic position (SEP) perceive greater personal extrinsic mortality risk than those of higher SEP, they should disinvest in their future health. We surveyed North American adults for reported effort in looking after health, perceived extrinsic and intrinsic mortality risks, and measures of SEP. We examined the relationships between these variables and found that lower subjective SEP predicted lower reported health effort. Lower subjective SEP was also associated with higher perceived extrinsic mortality risk, which in turn predicted lower reported health effort. The effect of subjective SEP on reported health effort was completely mediated by perceived extrinsic mortality risk. Our findings indicate that perceived extrinsic mortality risk may be a key factor underlying SEP gradients in motivation to invest in future health.

A score for measuring health risk perception in environmental surveys.

Science.gov (United States)

Marcon, Alessandro; Nguyen, Giang; Rava, Marta; Braggion, Marco; Grassi, Mario; Zanolin, Maria Elisabetta

2015-09-15

In environmental surveys, risk perception may be a source of bias when information on health outcomes is reported using questionnaires. Using the data from a survey carried out in the largest chipboard industrial district in Italy (Viadana, Mantova), we devised a score of health risk perception and described its determinants in an adult population. In 2006, 3697 parents of children were administered a questionnaire that included ratings on 7 environmental issues. Items dimensionality was studied by factor analysis. After testing equidistance across response options by homogeneity analysis, a risk perception score was devised by summing up item ratings. Factor analysis identified one latent factor, which we interpreted as health risk perception, that explained 65.4% of the variance of five items retained after scaling. The scale (range 0-10, mean ± SD 9.3 ± 1.9) had a good internal consistency (Cronbach's alpha 0.87). Most subjects (80.6%) expressed maximum risk perception (score = 10). Italian mothers showed significantly higher risk perception than foreign fathers. Risk perception was higher for parents of young children, and for older parents with a higher education, than for their counterparts. Actual distance to major roads was not associated with the score, while self-reported intense traffic and frequent air refreshing at home predicted higher risk perception. When investigating health effects of environmental hazards using questionnaires, care should be taken to reduce the possibility of awareness bias at the stage of study planning and data analysis. Including appropriate items in study questionnaires can be useful to derive a measure of health risk perception, which can help to identify confounding of association estimates by risk perception. Copyright © 2015 Elsevier B.V. All rights reserved.

Clinical implications of treating depressed older adults with SSRIs: possible risk of hyponatremia.

Science.gov (United States)

Smith, Judith M

2010-04-01

Depression is a serious mental health problem in older adults. Some of the symptoms of depression include depressed mood, significant change in weight or appetite, changes in sleep patterns, a decrease in concentration and energy, and possible suicide. However, depression is a treatable illness, especially with the newer class of antidepressant agents, the selective serotonin reuptake inhibitors (SSRIs). One side effect of SSRI use includes hyponatremia, which is becoming an increasingly serious complication that may have harmful clinical ramifications. Older adults are especially at risk for hyponatremia and could experience serious consequences if left untreated. The purpose of this article is to use an individual example to demonstrate the clinical importance of detecting hyponatremia in older adults receiving SSRI treatment. Copyright 2010, SLACK Incorporated.

The digital health divide: evaluating online health information access and use among older adults.

Science.gov (United States)

Hall, Amanda K; Bernhardt, Jay M; Dodd, Virginia; Vollrath, Morgan W

2015-04-01

Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide debate. This study evaluated the potential digital health divide in relation to characteristic and belief differences between older adult users and nonusers of online health information sources. A cross-sectional survey design was conducted using a random sample of older adults. A total of 225 older adults (age range = 50-92 years, M = 68.9 years, SD = 10.4) participated in the study. Seventy-six percent of all respondents had Internet access. Users and nonusers of online health information differed significantly on age (M = 66.29 vs. M = 71.13), education, and previous experience with the health care system. Users and nonusers of online health information also differed significantly on Internet and technology access, however, a large percentage of nonusers had Internet access (56.3%), desktop computers (55.9%), and laptop computers or netbooks (43.2%). Users of online health information had higher mean scores on the Computer Self-Efficacy Measure than nonusers, t(159) = -7.29, p information. Findings suggest strategies for reducing this divide and implications for health education programs to promote HIT use among older adults. © 2014 Society for Public Health Education.

Health inequalities among sexual minority adults: evidence from ten U.S. states, 2010.

Science.gov (United States)

Blosnich, John R; Farmer, Grant W; Lee, Joseph G L; Silenzio, Vincent M B; Bowen, Deborah J

2014-04-01

Improving the health of lesbian, gay, and bisexual (LGB) individuals is a Healthy People 2020 goal; however, the IOM highlighted the paucity of information currently available about LGB populations. To compare health indicators by gender and sexual orientation statuses. Data are from Behavioral Risk Factor Surveillance System surveys conducted January-December of 2010 with population-based samples of non-institutionalized U.S. adults aged over 18 years (N=93,414) in ten states that asked about respondents' sexual orientation (response rates=41.1%-65.6%). Analyses were stratified by gender and sexual orientation to compare indicators of mental health, physical health, risk behaviors, preventive health behaviors, screening tests, health care utilization, and medical diagnoses. Analyses were conducted in March 2013. Overall, 2.4% (95% CI=2.2, 2.7) of the sample identified as LGB. All sexual minority groups were more likely to be current smokers than their heterosexual peers. Compared with heterosexual women, lesbian women had more than 30% decreased odds of having an annual routine physical exam, and bisexual women had more than 2.5 times the odds of not seeking medical care owing to cost. Compared with heterosexual men, gay men were less likely to be overweight or obese, and bisexual men were twice as likely to report a lifetime asthma diagnosis. This study represents one of the largest samples of LGB adults and finds important health inequalities, including that bisexual women bear particularly high burdens of health disparities. Further work is needed to identify causes of and intervention for these disparities. Published by Elsevier Inc.

Indicators of choking risk in adults with learning disabilities: a questionnaire survey and interview study.

Science.gov (United States)

Thacker, Alice; Abdelnoor, Adam; Anderson, Claire; White, Sarah; Hollins, Sheila

2008-01-01

Feeding and swallowing impairments are key predictors of increased morbidity and mortality in adults with learning disabilities. This postal survey and interview study sought to identify risk factors in adults with learning disabilities who have histories of choking. A total of 2000 questionnaires were sent to carers of all adults with learning disabilities registered as service users by three local health authorities. (A 'service user' may be using any specialist learning disability health or social care facility with day, residential or therapeutic services). Of the 674 service users for whom surveys were returned, 47 were living in hospital, 396 were living in residential or group homes and 208 were living with relatives, or in their own homes. Eighteen subjects who had reported serious or repeated episodes of choking were interviewed in depth in their residences or workplaces. Responses were subjected to frequency analyses. Personal characteristics were analysed. Choking patterns were differentiated by food texture. A total of 34% of questionnaires on 674 service users were returned; 42% of respondents reported one or more choking episodes. There was a significantly greater occurrence of choking among people with more severe learning disability, with Down syndrome, people who had an incomplete dentition or were taking a greater number of psychotropic drugs. Antisocial eating habits learnt in institutional settings presented an additional choking hazard for some individuals. Choking is a serious hazard for many adults with learning disabilities. This study establishes many of the characteristics associated with swallowing problems in this population. Clinicians and carers should benefit from awareness of these predictors, leading to better management of eating behaviours and habits. A choking and swallowing risk assessment should be included in routine health assessments of adults with learning disability, paying especial attention to the condition of a person

Committee Opinion No 653 Summary: Concerns Regarding Social Media and Health Issues in Adolescents and Young Adults.

Science.gov (United States)

2016-02-01

Although there are many positive aspects of social media for adolescents and young adults, there are also risks. Adolescence is a time of significant developmental changes, during which adolescents exhibit a limited capacity for self-regulation and an increased risk of susceptibility to peer pressure and experimentation. Social media can be harmful, and obstetrician-gynecologists may screen their adolescent and young adult patients for high-risk sexual behaviors, especially if sexualized text communication (sexting), exposure to pornography, online dating, or other risk-taking behaviors are present. Victims of cyberbullying and those who engage in sexting are at increased risk of sexually transmitted infections and pregnancy. The effect of social media may be considered in the differential diagnosis of myriad health problems during adolescence. Referrals to mental health care providers or providing outside resources may be indicated. A multidisciplinary approach to address these issues can include the obstetrician-gynecologist, guardians, and school officials and personnel. Knowledge of resources, including those within the schools and community, allows the obstetrician-gynecologist to provide support to adolescents facing these issues.

Childhood cardiovascular risk factors in South Asians: A cause of concern for adult cardiovascular disease epidemic

International Nuclear Information System (INIS)

Prasad, Duggirala Sivaram; Kabir, Zubair; Dash, Ashok Kumar; Das, Bhagabati Charan

2011-01-01

Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnormalities, high blood pressure, hyperglycemia, tobacco use, obesity, physical inactivity, and unhealthy dietary practices. Atherosclerotic CVD processes begin early in childhood and are influenced over the life course by genetic and potentially modifiable risk factors and environmental exposure. 80% of adult CVD burden will fall on the developing nations by 2020. The concept of primordial prevention is fast emerging as a necessary prevention tool to curb adult CVD epidemic. Established guidelines and proven preventive strategies on cardiovascular health exist; however, are always implemented half-heartedly. Composite screening and prediction tools for adults can be adapted and validated in children tailored to South Asian population. South Asian children could be at a greater risk of developing cardiovascular risk factors at an earlier stage, thus, timely interventions are imperative

What are we missing? Risk behaviors among Arab-American adolescents and emerging adults.

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Munro-Kramer, Michelle L; Fava, Nicole M; Saftner, Melissa A; Darling-Fisher, Cynthia S; Tate, Nutrena H; Stoddard, Sarah A; Martyn, Kristy K

2016-09-01

Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. ©2016 American Association of Nurse Practitioners.

A longitudinal study of structural risk factors for obesity and diabetes among American Indian young adults, 1994-2008.

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Marley, Tennille L; Metzger, Molly W

2015-05-07

American Indian young adults have higher rates of obesity and type 2 diabetes than the general US population. They are also more likely than the general population to have higher rates of structural risk factors for obesity and diabetes, such as poverty, frequent changes of residence, and stress. The objective of this study was to investigate possible links between these 2 sets of problems. Data from the American Indian subsample of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were used to examine potential links between obesity and type 2 diabetes and structural risk factors such as neighborhood poverty, housing mobility, and stress. We used logistic regression to explore explanatory factors. American Indians in the subsample had higher rates of poor health, such as elevated hemoglobin A1c levels, self-reported high blood glucose, self-reported diabetes, and overweight or obesity. They also had higher rates of structural risk factors than non-Hispanic whites, such as residing in poorer and more transient neighborhoods and having greater levels of stress. Self-reported stress partially mediated the increased likelihood of high blood glucose or diabetes among American Indians, whereas neighborhood poverty partially mediated their increased likelihood of obesity. Neighborhood poverty and stress may partially explain the higher rates of overweight, obesity, and type 2 diabetes among American Indian young adults than among non-Hispanic white young adults. Future research should explore additional neighborhood factors such as access to grocery stores selling healthy foods, proximity and safety of playgrounds or other recreational space, and adequate housing.

Falls' problematization and risk factors identification through older adults' narrative.

Science.gov (United States)

Morsch, Patricia; Myskiw, Mauro; Myskiw, Jociane de Carvalho

2016-11-01

Falling is an important event for older adults as they might cause physical and psychological impairment, institutionalization and increased mortality risk. Adherence in falls prevention programs depends on older adults' perceptions in relation to falling. The current study aims to investigate the fall problematization and older adults' perception about the risk factors for falls. This is an exploratory qualitative research, conducted through content analysis approach. The sample consisted of older adults aged 60 years and older who participate in community groups in Porto Alegre (Brazil), and professors from two local universities. Final sample consisted of 22 participants, mean age was 70.2 ± 7.1. Coding and interpretation of data resulted in two thematic categories, named: falls' problematization and the perception of the risk factors for falling. The first category highlights that many older adults do not realize falling as a potential problem, which suggests that current preventive measures may not be reaching the target population. The second category shows that older adults' perceptions in relation to the risk factors exist, but often they are not avoided, because older adults consider their ability to "take care" as the main method of prevention, and due to the multifactorial nature of falls, this cannot be considered an efficient solution.

Dietary fat and cholesterol and risk of cardiovascular disease in older adults: The Health ABC Study

NARCIS (Netherlands)

Houston, D.K.; Ding, J.; Lee, J.S.; Garcia, M.; Kanaya, A.; Tylavsky, F.A.; Newman, A.B.; Visser, M.; Kritchevsky, S.B.

2011-01-01

Background and aims: Although dietary fats and cholesterol have previously been associated with risk of cardiovascular disease (CVD) in middle-aged populations, less is known among older adults. The purpose of this study was to determine the association between dietary fats, cholesterol, and eggs

Childhood family wealth and mental health in a national cohort of young adults

Directory of Open Access Journals (Sweden)

Félice Lê-Scherban

2016-12-01

Full Text Available Purpose: Mental health is critical to young adult health, as the onset of 75% of psychiatric disorders occurs by age 24 and psychiatric disorders early in life predict later behavioral health problems. Wealth may serve as a buffer against economic stressors. Family wealth may be particularly relevant for young adults by providing them with economic resources as they make educational decisions and move towards financial and social independence. Methods: We used prospectively collected data from 2060 young adults aged 18–27 in 2005–2011 from the Panel Study of Income Dynamics, a national cohort of US families. We examined associations between nonspecific psychological distress (measured with the K-6 scale and childhood average household wealth during ages 0–18 years (net worth in 2010 dollars. Results: In demographics-adjusted generalized estimating equation models, higher childhood wealth percentile was related to a lower prevalence of serious psychological distress: compared to lowest-quartile wealth, prevalence ratio (PR=0.52 (0.32–0.85 for 3rd quartile and PR=0.41 (0.24–0.68 for 4th quartile. The associations were attenuated slightly by adjustment for parent education and more so by adjustment for childhood household income percentile. Conclusions: Understanding the lifelong processes through which distinct aspects of socioeconomic status affect mental health can help us identify high-risk populations and take steps to minimize future disparities in mental illness. Keywords: USA, Mental health, Health disparities, Socioeconomic status, Young adults, Life course, Wealth, Multigenerational

Sedentary time in older adults: a critical review of measurement, associations with health, and interventions.

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Copeland, Jennifer L; Ashe, Maureen C; Biddle, Stuart Jh; Brown, Wendy J; Buman, Matthew P; Chastin, Sebastien; Gardiner, Paul A; Inoue, Shigeru; Jefferis, Barbara J; Oka, Koichiro; Owen, Neville; Sardinha, Luís B; Skelton, Dawn A; Sugiyama, Takemi; Dogra, Shilpa

2017-11-01

Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults. A trained librarian created a search strategy that was peer reviewed for completeness. Self-report assessment of the context and type of ST is important but the tools tend to underestimate total ST. There appears to be an association between ST and geriatric-relevant health outcomes, although there is insufficient longitudinal evidence to determine a dose-response relationship or a threshold for clinically relevant risk. The type of ST may also affect health; some cognitively engaging sedentary behaviours appear to benefit health, while time spent in more passive activities may be detrimental. Short-term feasibility studies of individual-level ST interventions have been conducted; however, few studies have appropriately assessed the impact of these interventions on geriatric-relevant health outcomes, nor have they addressed organisation or environment level changes. Research is specifically needed to inform evidence-based interventions that help maintain functional autonomy among older adults.This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine. �

Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis.

Science.gov (United States)

Kwan, M Y; Arbour-Nicitopoulos, K P; Duku, E; Faulkner, G

2016-08-01

University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Undergraduate students (n = 837; mean age = 21 years) from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep). A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671) = 7.26, p Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.

Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis

Directory of Open Access Journals (Sweden)

M. Y. Kwan

2016-08-01

Full Text Available University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Methods: Undergraduate students (n = 837; mean age = 21 years from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep. Results: A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671 = 7.26, p < .01. Conclusion: Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.

Adolescent and Young Adult Male Mental Health: Transforming System Failures Into Proactive Models of Engagement.

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Rice, Simon M; Purcell, Rosemary; McGorry, Patrick D

2018-03-01

Adolescent and young adult men do poorly on indicators of mental health evidenced by elevated rates of suicide, conduct disorder, substance use, and interpersonal violence relative to their female peers. Data on global health burden clearly demonstrate that young men have a markedly distinct health risk profile from young women, underscoring different prevention and intervention needs. Evidence indicates that boys disconnect from health-care services during adolescence, marking the beginning of a progression of health-care disengagement and associated barriers to care, including presenting to services differently, experiencing an inadequate or poorly attuned clinical response, and needing to overcome pervasive societal attitudes and self-stigma to access available services. This review synthesizes key themes related to mental ill health in adolescent boys and in young adult men. Key social determinants are discussed, including mental health literacy, self-stigma and shame, masculinity, nosology and diagnosis, and service acceptability. A call is made for focused development of policy, theory, and evaluation of targeted interventions for this population, including gender-synchronized service model reform and training of staff, including the e-health domain. Such progress is expected to yield significant social and economic benefits, including reduction to mental ill health and interpersonal violence displayed by adolescent boys and young adult men. Copyright © 2018. Published by Elsevier Inc.

Health risk assessment of heavy metals in rice to the population in Zhejiang, China.

Science.gov (United States)

Huang, Zhu; Pan, Xiao-Dong; Wu, Ping-Gu; Han, Jian-Long; Chen, Qing

2013-01-01

Environmental pollution with toxic heavy metals can lead to the possible contamination of the rice. Selected metals (As, Cd, Hg and Pb) and their accumulation in rice collected from Zhejiang, China were analyzed to evaluate the potential health risk to the local adults and children. The mean levels found in rice were as follows: As, 0.080 mg/kg; Cd, 0.037 mg/kg; Hg, 0.005 mg/kg; Pb, 0.060 mg/kg. The estimated daily intakes (EDIs) were calculated in combination of the rice consumption data. The mean intakes of As, Cd, Hg and Pb through rice were estimated to be 0.49, 0.23, 0.03 and 0.37 µg/kg bw/day for adults, and 0.34, 0.29, 0.04 and 0.47 µg/kg bw/day for children. The 97.5th percentile (P97.5) daily intakes of As, Cd, Hg and Pb were 1.02, 0.64, 0.37 and 1.26 µg/kg bw/day for adults, and 0.63, 0.83, 0.47 and 1.63 µg/kg bw/day for children. The risk assessment in mean levels showed that health risk associated with these elements through consumption of rice was absent. However, estimates in P97.5 level of Cd and Pb for children, and Hg for adults have exceeded the respective safe limits.

Investigating Adult Health Literacy in Tuyserkan City

Directory of Open Access Journals (Sweden)

Maryam Afshari

2014-09-01

Full Text Available Introduction: Health literacy is the capacity of individuals to obtain, process and understand basic health information and services needed to make healthy decisions. Therefore, this study was designed to determine health literacy of adults Tuyserkan district. Materials and Methods: This cross-sectional descriptive-analytical study was performed on 285 subjects aged 20-60 years attending Tuyserkan health centers through convenience sampling method in 2014. Iranian health literacy questionnaire was used to collect data. Data was analyzed using Stata-11 by Independent T-test and one way ANOVA. Results: Most participants aged 20 to 30 years (52.3% and 53.7 % were males. Most participants had postgraduate diploma level (55.8 % and were students (31.9 %. Participants had a weak level to access information (42.1%, weak level to perceive data (54.4%, moderate in judgment and assessment (64.9% and moderate in use of information (88.8%. Conclusion: Overall, there was a poor health literacy in adults. This indicates the need for more attention to health education and health promotion programs. It seems necessary to design and implement comprehensive plans using media and simple training methods for adults with a low level of health literacy.

The association between loneliness and health - a survey-based study among middle-aged and older adults in Denmark

DEFF Research Database (Denmark)

Jessen, Mathilde Amalie Buchwald; Pallesen, Anna Vera Jørring; Kriegbaum, Margit

2017-01-01

. We analysed the association between loneliness and health in 9154 Danish adults through multi-variate regression analyses adjusting for the year of birth, gender, marital status, cohabitation status, employment status and home ownership. RESULTS: We found that loneliness was associated with increased...... risks of poor self-rated health (OR, 2.58; 95% Cl, 1.20-3.35), limited physical abilities (OR, 1.91; 95% Cl, 1.58-2.32) and multiple diagnoses (OR, 1.77; 95% Cl, 1.48-2.12). Lonely middle-aged adults (52-62 years of age) had an increased risk of having limited physical abilities. CONCLUSION: Among...

Physical activity level and fall risk among community-dwelling older adults.

Science.gov (United States)

Low, Sok Teng; Balaraman, Thirumalaya

2017-07-01

[Purpose] To find the physical activity level and fall risk among the community-dwelling Malaysian older adults and determine the correlation between them. [Subjects and Methods] A cross-sectional study was conducted in which, the physical activity level was evaluated using the Rapid Assessment of Physical Activity questionnaire and fall risk with Fall Risk Assessment Tool. Subjects recruited were 132 community-dwelling Malaysian older adults using the convenience sampling method. [Results] The majority of the participants were under the category of under-active regular light-activities and most of them reported low fall risk. The statistical analysis using Fisher's exact test did not show a significant correlation between physical activity level and fall risk. [Conclusion] The majority of community-dwelling Malaysian older adults are performing some form of physical activity and in low fall risk category. But this study did not find any significant correlation between physical activity level and fall risk among community-dwelling older adults in Malaysia.

Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection.

Science.gov (United States)

Brown, J; McGowan, J A; Chouial, H; Capocci, S; Smith, C; Ivens, D; Johnson, M; Sathia, L; Shah, R; Lampe, F C; Rodger, A; Lipman, M

2017-09-01

We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life. © 2017 The Authors HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

A population-based study of sexual orientation identity and gender differences in adult health.

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Conron, Kerith J; Mimiaga, Matthew J; Landers, Stewart J

2010-10-01

We provide estimates of several leading US adult health indicators by sexual orientation identity and gender to fill gaps in the current literature. We aggregated data from the 2001-2008 Massachusetts Behavioral Risk Factor Surveillance surveys (N = 67,359) to examine patterns in self-reported health by sexual orientation identity and gender, using multivariable logistic regression. Compared with heterosexuals, sexual minorities (i.e., gays/lesbians, 2% of sample; bisexuals, 1%) were more likely to report activity limitation, tension or worry, smoking, drug use, asthma, lifetime sexual victimization, and HIV testing, but did not differ on 3-year Papanicolaou tests, lifetime mammography, diabetes, or heart disease. Compared with heterosexuals, bisexuals reported more barriers to health care, current sadness, past-year suicidal ideation, and cardiovascular disease risk. Gay men were less likely to be overweight or obese and to obtain prostate-specific antigen tests, and lesbians were more likely to be obese and to report multiple risks for cardiovascular disease. Binge drinking and lifetime physical intimate partner victimization were more common among bisexual women. Sexual orientation disparities in chronic disease risk, victimization, health care access, mental health, and smoking merit increased attention. More research on heterogeneity in health and health determinants among sexual minorities is needed.

Using a multifactorial approach to determine fall risk profiles in portuguese older adults.

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Moniz-Pereira, Vera; Carnide, Filomena; Ramalho, Fátima; André, Helô; Machado, Maria; Santos-Rocha, Rita; Veloso, António P

2013-01-01

The aim of this study was to use a multifactorial approach to characterize episodic and recurrent fallers risk profiles in Portuguese older adults. To accomplish the mentioned purpose, 1416 Portuguese older adults above 65 years were tested with three different field measurements: 1) health and falls questionnaire; 2) Physical Activity questionnaire and 3) a set of functional fitness tests. The subjects were divided in three different groups according to fall prevalence: non-fallers, subjects who did not report any falls during the previous year, episodic fallers, those who reported to have fallen only once during the previous year, and recurrent fallers, the ones that fell twice or more times during the previous year. Episodic and Recurrent fallers risk profiles were established using multifactorial logistic regression models in order to avoid confounding effects between the variables. The results showed that age was not a risk factor for either episodic or recurrent falling. In addition, health parameters were shown to be the factors distinguishing recurrent from episodic fallers. This may imply that, comparing with episodic falls, recurrent falls are more associated with higher presence of chronic conditions and are less likely to occur due to external factors. Furthermore, being a woman, having fear of falling and lower functional fitness levels were determinant factors for both episodic and recurrent falls. It is also important to note that, although total physical activity was only related with episodic falling, promoting physical activity and exercise may be the easiest and cheapest way to improve functional fitness and health levels and therefore, its role in fall prevention should not be underestimated. The results of this study reinforce the importance of using a multifactorial approach, not only focusing on cognitive-behavioral factors, but also on promoting physical activity and healthy lifestyles, when assessing fall risk or planning an intervention

Psychological well-being among US adults with arthritis and the unmet need for mental health care

Directory of Open Access Journals (Sweden)

Straub LE

2017-05-01

Full Text Available Laura E Straub,1,2 Miriam G Cisternas3 1Emory University, Atlanta, GA, 2Immune Tolerance Network, San Francisco, CA, 3MGC Data Services, Carlsbad, CA, USA Purpose: Mental health conditions can increase the risk of disability among adults with arthritis. The objective of this analysis was to compare the prevalence of serious psychological distress (SPD, depression, and anxiety among US adults with arthritis vs. those without; characterize adults with arthritis with and without SPD; and determine correlates of seeing a mental health professional during the year for adults with arthritis and SPD.Materials and methods: Cross-sectional analysis of adults in the 2011–2013 National Health Interview Survey.Results: Higher proportions of adults with arthritis had SPD (6.8% vs. 2.4%, depression (19.4% vs. 7.3%, and anxiety (29.3% vs. 16.3% compared to those without. Of the estimated 3.5 million adults with arthritis and SPD, only 39% saw a mental health professional during the year. Adjusted analyses identified the following statistically significant relationships: those who were older (45–64 and ≥65 [vs.18–44], prevalence ratio [PR]=0.8 and 0.4, respectively, less educated (PR=0.5 and 0.7 for high school or less vs. college degree, respectively, and without health insurance coverage (vs. any private, PR=0.7, were less likely to see a mental health professional, whereas the disabled or unemployed (vs. employed, PR=1.6 and 1.5, respectively, and those unable to afford mental health care throughout the year (PR=1.3 were more likely.Conclusion: The high prevalence of SPD, anxiety, and depression in adults with arthritis suggests the need for increased mental health screening, with subsequent referral to mental health professionals or other treatment programs, in that population. Keywords: serious psychological distress, anxiety, depression, access to mental health care, rheumatoid arthritis 

Gender Differences in Adult Health: An International Comparison.

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Rahman, Omar; And Others

1994-01-01

Used data from United States, Jamaica, Malaysia, and Bangladesh to explore gender differences in adult health. Found that women fared worse than men across variety of self-reported health measures in all four countries. Data from Jamaica indicated that gender disparities in adult health arose early and persisted throughout the life cycle, with…

Physical therapy approaches to reduce fall and fracture risk among older adults.

Science.gov (United States)

Karinkanta, Saija; Piirtola, Maarit; Sievänen, Harri; Uusi-Rasi, Kirsti; Kannus, Pekka

2010-07-01

Falls and fall-related injuries, such as fractures, are a growing problem among older adults, often causing longstanding pain, functional impairments, reduced quality of life and excess health-care costs and mortality. These problems have led to a variety of single component or multicomponent intervention strategies to prevent falls and subsequent injuries. The most effective physical therapy approach for the prevention of falls and fractures in community-dwelling older adults is regular multicomponent exercise; a combination of balance and strength training has shown the most success. Home-hazard assessment and modification, as well as assistive devices, such as canes and walkers, might be useful for older people at a high risk of falls. Hip protectors are effective in nursing home residents and potentially among other high-risk individuals. In addition, use of anti-slip shoe devices in icy conditions seems beneficial for older people walking outdoors. To be effective, multifactorial preventive programs should include an exercise component accompanied by individually tailored measures focused on high-risk populations. In this Review, we focus on evidence-based physical therapy approaches, including exercise, vibration training and improvements of safety at home and during periods of mobility. Additionally, the benefits of multifaceted interventions, which include risk factor assessment, dietary supplements, elements of physical therapy and exercise, are addressed.

Risk Factors for 30-Day Readmission in Adults with Sickle Cell Disease.

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Brodsky, Max A; Rodeghier, Mark; Sanger, Maureen; Byrd, Jeannie; McClain, Brandi; Covert, Brittany; Roberts, Dionna O; Wilkerson, Karina; DeBaun, Michael R; Kassim, Adetola A

2017-05-01

Readmission to the hospital within 30 days is a measure of quality care; however, only few modifiable risk factors for 30-day readmission in adults with sickle cell disease are known. We performed a retrospective review of the medical records of adults with sickle cell disease at a tertiary care center, to identify potentially modifiable risk factors for 30-day readmission due to vasoocclusive pain episodes. A total of 88 patients ≥18 years of age were followed for 3.5 years between 2010 and 2013, for 158 first admissions for vasoocclusive pain episodes. Of these, those subsequently readmitted (cases) or not readmitted (controls) within 30 days of their index admissions were identified. Seven risk factors were included in a multivariable model to predict readmission: age, sex, hemoglobin phenotype, median oxygen saturation level, listing of primary care provider, type of health insurance, and number of hospitalized vasoocclusive pain episodes in the prior year. Mean age at admission was 31.7 (18-59) years; median time to readmission was 11 days (interquartile range 20 days). Absence of a primary care provider listed in the electronic medical record (odds ratio 0.38; 95% confidence interval, 0.16-0.91; P = .030) and the number of vasoocclusive pain episodes requiring hospitalization in the prior year were significant risk factors for 30-day readmission (odds ratio 1.30; 95% confidence interval, 1.16-1.44; P readmission rate in adults with sickle cell disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Potential human health risk assessment of trace metals via the consumption of marine fish in Persian Gulf

DEFF Research Database (Denmark)

Naji, Abolfazl; Khan, Farhan; Hashemi, Seyed Hassan

2016-01-01

This study was carried out to evaluate the concentration of trace metals (Cd, Cu, Ni, Pb and Zn) in the muscle of four fish species from the Persian Gulf. Trace metals were analyzed using atomic absorption spectroscopy and consumption rates advisory for minimizing chronic systemic effects in chil...... health risks resulting from human consumption....... in children and adults were estimated. The metals concentrations in analyzed fish samples were lower than legal limits. Cadmium target hazard quotient values suggested that the threshold to avoid the potential risk for children health is an exposure level lower than 3 meals per week. Hazard index values based...... on four metals (not including Pb) for the child age class were higher than those of the adult age class, suggesting that children may suffer from a higher health risk. This study provides information about the consumption limits of certain metals, in particular Cd, necessary for minimizing potential...

How Persuasive are Serious Games, Social Media and mHealth Technologies for Vulnerable Young Adults? Design Factors for Health Behavior and Lifestyle Change Support: Sexual Health Case. Proceedings Third International Workshop on Behavior Change Support Systems (BCSS 2015)

NARCIS (Netherlands)

Kulyk, Olga Anatoliyivna; van Gemert-Pijnen, Julia E.W.C.; den Daas, Chantal; David, Silke; Kelders, Saskia; Kulyk, Olga; van Gemert-Pijnen, Lisette; Oinas-Kukkonen, Harri

2015-01-01

Modern eHealth technologies, such as serious games, social media and mobile applications addressing health behavior support are evolving rapidly. High-risk young adults with low educational background and of foreign origin could especially benefit from personalized health technologies, designed for

Risk assessment for adult butterflies exposed to the mosquito control pesticide naled

Science.gov (United States)

Bargar, Timothy A.

2012-01-01

A prospective risk assessment was conducted for adult butterflies potentially exposed to the mosquito control insecticide naled. Published acute mortality data, exposure data collected during field studies, and morphometric data (total surface area and fresh body weight) for adult butterflies were combined in a probabilistic estimate of the likelihood that adult butterfly exposure to naled following aerial applications would exceed levels associated with acute mortality. Adult butterfly exposure was estimated based on the product of (1) naled residues on samplers and (2) an exposure metric that normalized total surface area for adult butterflies to their fresh weight. The likelihood that the 10th percentile refined effect estimate for adult butterflies exposed to naled would be exceeded following aerial naled applications was 67 to 80%. The greatest risk would be for butterflies in the family Lycaenidae, and the lowest risk would be for those in the family Hesperidae, assuming equivalent sensitivity to naled. A range of potential guideline naled deposition levels is presented that, if not exceeded, would reduce the risk of adult butterfly mortality. The results for this risk assessment were compared with other risk estimates for butterflies, and the implications for adult butterflies in areas targeted by aerial naled applications are discussed.

Risk assessment for adult butterflies exposed to the mosquito control pesticide naled.

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Bargar, Timothy A

2012-04-01

A prospective risk assessment was conducted for adult butterflies potentially exposed to the mosquito control insecticide naled. Published acute mortality data, exposure data collected during field studies, and morphometric data (total surface area and fresh body weight) for adult butterflies were combined in a probabilistic estimate of the likelihood that adult butterfly exposure to naled following aerial applications would exceed levels associated with acute mortality. Adult butterfly exposure was estimated based on the product of (1) naled residues on samplers and (2) an exposure metric that normalized total surface area for adult butterflies to their fresh weight. The likelihood that the 10th percentile refined effect estimate for adult butterflies exposed to naled would be exceeded following aerial naled applications was 67 to 80%. The greatest risk would be for butterflies in the family Lycaenidae, and the lowest risk would be for those in the family Hesperidae, assuming equivalent sensitivity to naled. A range of potential guideline naled deposition levels is presented that, if not exceeded, would reduce the risk of adult butterfly mortality. The results for this risk assessment were compared with other risk estimates for butterflies, and the implications for adult butterflies in areas targeted by aerial naled applications are discussed. Copyright © 2012 SETAC.

Dietary sodium content, mortality, and risk for cardiovascular events in older adults: the Health, Aging, and Body Composition (Health ABC) Study.

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Kalogeropoulos, Andreas P; Georgiopoulou, Vasiliki V; Murphy, Rachel A; Newman, Anne B; Bauer, Douglas C; Harris, Tamara B; Yang, Zhou; Applegate, William B; Kritchevsky, Stephen B

2015-03-01

Additional information is needed about the role of dietary sodium on health outcomes in older adults. To examine the association between dietary sodium intake and mortality, incident cardiovascular disease (CVD), and incident heart failure (HF) in older adults. We analyzed 10-year follow-up data from 2642 older adults (age range, 71-80 years) participating in a community-based, prospective cohort study (inception between April 1, 1997, and July 31, 1998). Dietary sodium intake at baseline was assessed by a food frequency questionnaire. We examined sodium intake as a continuous variable and as a categorical variable at the following levels: less than 1500 mg/d (291 participants [11.0%]), 1500 to 2300 mg/d (779 participants [29.5%]), and greater than 2300 mg/d (1572 participants [59.5%]). Adjudicated death, incident CVD, and incident HF during 10 follow-up years. Analysis of incident CVD was restricted to 1981 participants without prevalent CVD at baseline. The mean (SD) age of participants was 73.6 (2.9) years, 51.2% were female, 61.7% were of white race, and 38.3% were black. After 10 years, 881 participants had died, 572 had developed CVD, and 398 had developed HF. In adjusted Cox proportional hazards regression models, sodium intake was not associated with mortality (hazard ratio [HR] per 1 g, 1.03; 95% CI, 0.98-1.09; P = .27). Ten-year mortality was nonsignificantly lower in the group receiving 1500 to 2300 mg/d (30.7%) than in the group receiving less than 1500 mg/d (33.8%) and the group receiving greater than 2300 mg/d (35.2%) (P = .07). Sodium intake of greater than 2300 mg/d was associated with nonsignificantly higher mortality in adjusted models (HR vs 1500-2300 mg/d, 1.15; 95% CI, 0.99-1.35; P = .07). Indexing sodium intake for caloric intake and body mass index did not materially affect the results. Adjusted HRs for mortality were 1.20 (95% CI, 0.93-1.54; P = .16) per milligram per kilocalorie and 1.11 (95% CI, 0.96-1.28; P = .17) per

The Digital Health Divide: Evaluating Online Health Information Access and Use among Older Adults

Science.gov (United States)

Hall, Amanda K.; Bernhardt, Jay M.; Dodd, Virginia; Vollrath, Morgan W.

2015-01-01

Objective: Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide…

Walking, body mass index, and self-rated health in a representative sample of Spanish adults

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Vicente Romo-Perez

2016-01-01

Full Text Available Abstract Obesity and physical inactivity (PI are risk factors for chronic diseases and are associated with lifestyle and environmental factors. The study tested the association between PI, body mass index (BMI, and self-rated health in a representative sample of the Spanish adult population (N = 21,486. The sample included 41.5% men, with mean age 52.3 years (± 18.03, and age range 20-82 years. Prevalence of overweight/obesity was 34.2%/12.7% in women and 52.1%/12.7% in men (p < 0.001 for obesity in both sexes. 53% of women and 57.5% of men met recommended levels of physical activity by walking (≥ 150 minutes/week. According to logistic regression analysis, individuals that walked less had higher risk of overweight or obesity. Data from the population-based surveillance study support suggestions that regular walking by adults is associated with positive self-rated health and better BMI profile. Obesity and low/very low self-rated health have low prevalence rates to meet the recommendations.

MARRIAGE AND MENTAL HEALTH AMONG YOUNG ADULTS

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Uecker, Jeremy E.

2012-01-01

Marriage is widely thought to confer mental health benefits, but little is known about how this relationship may vary across the life course. Early marriage—which is non-normative—could have no, or even negative, mental health consequences for young adults. Using survey data from Waves 1 and 3 of the National Longitudinal Study of Adolescent Health (N = 11,743), I find that married young adults exhibit similar levels of psychological distress as young adults who are in any kind of romantic relationship. Married and engaged young adults report lower rates of drunkenness than others. Married young adults—especially those who first married at age 22–26—report higher life satisfaction than those in other types of relationships or no relationship at all, as well as those who married at younger ages. Explanations for these findings are examined, and their implications are discussed. PMID:22328171

Leukocyte count, systemic inflammation, and health status in older adults: a narrative review

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Chmielewski Piotr

2018-03-01

Full Text Available Epidemiological and clinical studies suggest that elevated leukocyte count within the normal range can predict cardiovascular and total mortality in older adults. These findings are remarkable because this simple and common laboratory test is included in routine medical check-ups. It is well known that chronic systemic inflammation (inflammaging is one of the hallmarks of aging and an important component of obesity-associated insulin resistance that can lead to type 2 diabetes and other health problems in both overweight individuals and elderly people. To understand the molecular mechanisms linking increased systemic inflammation with aging-associated diseases and elevated leukocyte counts in the elderly is to unravel the multiplicity of molecular factors and mechanisms involved in chronic low-grade systemic inflammation, the gradual accumulation of random molecular damage, age-related diseases, and the process of leukopoiesis. There are several possible mechanisms through which chronic low-grade systemic inflammation is associated with both higher leukocyte count and a greater risk of aging-associated conditions in older adults. For example, the IL-6 centric model predicts that this biomediator is involved in chronic systemic inflammation and leukopoiesis, thereby suggesting that elevated leukocyte count is a signal of poor health in older adults. Alternatively, an increase in neutrophil and monocyte counts can be a direct cause of cardiovascular events in the elderly. Interestingly, some authors assert that the predictive ability of elevated leukocyte counts with regard to cardiovascular and allcause mortality among older adults surpass the predictive value of total cholesterol. This review reports the recent findings on the links between elevated but normal leukocyte counts and the increased risks of all-cause, cardiovascular, and cancer mortality. The possible molecular mechanisms linking higher but normal leukocyte counts with increased

Vaccination rates among the general adult population and high-risk groups in the United States.

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Kathy Annunziata

Full Text Available BACKGROUND: In order to adequately assess the effectiveness of vaccination in helping to control vaccine-preventable infectious disease, it is important to identify the adherence and uptake of risk-based recommendations. METHODS: The current project includes data from five consecutive datasets of the National Health and Wellness Survey (NHWS: 2007 through 2011. The NHWS is an annual, Internet-based health questionnaire, administered to a nationwide sample of adults (aged 18 or older which included items on vaccination history as well as high-risk group status. Vaccination rates and characteristics of vaccinees were reported descriptively. Logistic regressions were conducted to predict vaccination behavior from sociodemographics and risk-related variables. RESULTS: The influenza vaccination rate for all adults 18 years and older has increased significantly from 28.0% to 36.2% from 2007 to 2011 (ps<.05. Compared with those not at high risk (25.1%, all high-risk groups were vaccinated at a higher rate, from 36.8% (pregnant women to 69.7% (those with renal/kidney disease; however, considerable variability among high-risk groups was observed. Vaccination rates among high-risk groups for other vaccines varied considerably though all were below 50%, with the exception of immunocompromised respondents (57.5% for the hepatitis B vaccine and 52.5% for the pneumococcal vaccine and the elderly (50.4% for the pneumococcal. Multiple risk factors were associated with increased rate of vaccination for most vaccines. Significant racial/ethnic differences with influenza, hepatitis, and herpes zoster vaccination rates were also observed (ps<.05. CONCLUSIONS: Rates of influenza vaccination have increased over time. Rates varied by high-risk status, demographics, and vaccine. There was a pattern of modest vaccination rate increases for individuals with multiple risk factors. However, there were relatively low rates of vaccination for most risk-based recommendations

Adult atopic dermatitis and the risk of type 2 diabetes

DEFF Research Database (Denmark)

Andersen, Yuki M.F.; Egeberg, Alexander; Gislason, Gunnar H.

2017-01-01

While AD is not an independent risk factor for T2D in adjusted analysis, age, smoking, alcohol abuse and use of systemic and topical corticosteroids may increase the risk of T2D in adults with AD.......While AD is not an independent risk factor for T2D in adjusted analysis, age, smoking, alcohol abuse and use of systemic and topical corticosteroids may increase the risk of T2D in adults with AD....

The risk factors for impulsivity-related falls among hospitalized older adults.

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Ferrari, Marisa; Harrison, Barbara; Lewis, Doresea

2012-01-01

Falls among older adults are a common, preventable problem associated with increased morbidity and mortality. Impulsivity is a known risk factor for older adult falls; however, there is a gap in evidence demonstrating the unique risk factors associated with impulsivity related falls (IRF). The research explored the association between seven fall risk factors and impulsivity related falls in hospitalized older adults in a community hospital. This retrospective descriptive study analyzed the association between seven fall risk factors and IRF in hospitalized older adults. The sample (N = 233) included patients age 65 years and older who had a documented in-patient fall in 2008. Of the falls, 29.7% were classified as IRF. The mean age of patients with IRF was 78 years, with the median day of fall being Day 5 of hospitalization/rehabilitation admission. Logistic regression demonstrated that only inattention and cognitive impairment were significant risk factors for IRF. The incidence of IRF was 29.7%. Our findings also indicate that cognitive impairment and inattention are strongest predictors for IRF among usual risk factors. Early identification of the unique risk factors associated with IRF could improve identification and reduce fall rates among hospitalized older adults. © 2012 Association of Rehabilitation Nurses.

100% Orange juice consumption is associated with better diet quality, improved nutrient adequacy, decreased risk for obesity, and improved biomarkers of health in adults: National Health and Nutrition Examination Survey, 2003-2006

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O’Neil Carol E

2012-12-01

Full Text Available Abstract Background Consumption of 100% orange juice (OJ has been positively associated with nutrient adequacy and diet quality, with no increased risk of overweight/obesity in children; however, no one has examined these factors in adults. The purpose of this study was to examine the association of 100% OJ consumption with nutrient adequacy, diet quality, and risk factors for metabolic syndrome (MetS in a nationally representative sample of adults. Methods Data from adults 19+ years of age (n = 8,861 participating in the National Health and Nutrition Examination Survey 2003-2006 were used. The National Cancer Institute method was used to estimate the usual intake (UI of 100% OJ consumption, selected nutrients, and food groups. Percentages of the population below the Estimated Average Requirement (EAR or above the Adequate Intake (AI were determined. Diet quality was measured by the Healthy Eating Index-2005 (HEI-2005. Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese or having risk factors of MetS or MetS. Results Usual per capita intake of 100% OJ was 50.3 ml/d. Among consumers (n = 2,310; 23.8%, UI was 210.0 ml/d. Compared to non-consumers, consumers had a higher (p  Conclusion The results suggest that moderate consumption of 100% OJ should be encouraged to help individuals meet the USDA daily recommendation for fruit intake and as a component of a healthy diet.

NIHSeniorHealth: a free tool for online health information for older adults.

Science.gov (United States)

Linares, Brenda M

2013-01-01

NIHSeniorHealth is a free, consumer health website that covers health topics affecting older adults. The website was created and is maintained by the National Library of Medicine (NLM) and features more than 55 health topics and nearly 150 videos. The easy-to-use navigational and visual tools create a user-friendly experience for older adults, their families, and caregivers who seek senior-specific information on the web. This column will include an overview of the website, a simple search, and a review of the features of NIHSeniorHealth.

Investing in the health and well-being of young adults.

Science.gov (United States)

Stroud, Clare; Walker, Leslie R; Davis, Maryann; Irwin, Charles E

2015-02-01

Contrary to popular perception, young adults-ages approximately 18-26 years-are surprisingly unhealthy. They are less healthy than adolescents, and they also show a worse health profile than those in their late 20s and 30s. The Affordable Care Act provisions to extend coverage for young adults are well known, and some states had already been pursuing similar efforts before the Affordable Care Act was enacted. These initiatives have resulted in important gains in young adults' heath care coverage. However, too little attention has been paid to the care that young adults receive once they are in the system. Given young adults' health problems, this is a critical omission. The Institute of Medicine and National Research Council recently released a report titled Investing in the Health and Well-Being of Young Adults. The report concludes that young adulthood is a critical developmental period and recommends that young adults ages 18-26 years be treated as a distinct subpopulation in policy, planning, programming, and research. The report also recommends action in three priority areas to improve health care for young adults: improving the transition from pediatric to adult medical and behavioral health care, enhancing preventive care for young adults, and developing evidence-based practices. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Snacking patterns, diet quality, and cardiovascular risk factors in adults

Science.gov (United States)

The relationship of snacking patterns on nutrient intake and cardiovascular risk factors in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of cardiovascular risk factors in adults participating in the ...

Potential human health risk assessment of trace metals via the consumption of marine fish in Persian Gulf

International Nuclear Information System (INIS)

Naji, Abolfazl; Khan, Farhan R.; Hashemi, Seyed Hassan

2016-01-01

This study was carried out to evaluate the concentration of trace metals (Cd, Cu, Ni, Pb and Zn) in the muscle of four fish species from the Persian Gulf. Trace metals were analyzed using atomic absorption spectroscopy and consumption rates advisory for minimizing chronic systemic effects in children and adults were estimated. The metals concentrations in analyzed fish samples were lower than legal limits. Cadmium target hazard quotient values suggested that the threshold to avoid the potential risk for children health is an exposure level lower than 3 meals per week. Hazard index values based on four metals (not including Pb) for the child age class were higher than those of the adult age class, suggesting that children may suffer from a higher health risk. This study provides information about the consumption limits of certain metals, in particular Cd, necessary for minimizing potential health risks resulting from human consumption. - Highlights: • Trace metals in wild marine fish from the Persian Gulf were investigated. • Metal concentrations descended in the following order: Zn > Cu > Pb ≈ Ni > Cd > . • The Cd and Pb may be potential risk to human. • No obvious health risk from the intake of trace elements through fish consumption.