bluuebunny/crossref_metadata_2025 huggingface dataset:
Minor mental disorders among undergraduate students: Prevalence and associated factors
Authors: Ferreira Júnior V , de Sousa Gomes E , Pereira Lima M , Maura Mascarini L
Published: October 2020

Although it is recognized that mental disorders are more likely to occur in adulthood, especially in university period, and result in damage to health and incapacity for work, researches with university population are scarce in Brazil. We aimed to evaluate the prevalence of Minor Mental Disorders (MMD) among undergraduate students of a public university of São Paulo state, and investigate its association with social and economic conditions, sexuality and gender. This is a cross-sectional study conducted in 2018 with 376 undergraduate students who were halfway through the course. Data were collected from an anonymously and self-administered questionnaire, and MMD was evaluated from Self Report Questionnaire (SRQ-20). Associations were estimated through logistic regression, and odds ration calculated. We found prevalence of 53.9% of MMD among the students, and associated with gender (OR, 3.66; 95% CI, 2.37-5.67), being LGBT + (e.g Bisexuals OR, 2.92; 95% CI, 1.56-5.50), not receiving necessary family support (OR, 5.6; 95% CI, 2.00 - 15.68), not being satisfied with the course (OR, 23.69 95% CI, 2.95 - 190,03) and not practicing physical activities regularly (OR, 2.05; 95% IC, 1.33 - 3.17). Minor mental disorders prevalence found was high, reaching more than 70% in some courses (e.g 77.8% among Biomedicine students), mainly associated with gender, sexual orientation and emotional support. Our study draws attention to the urgency of monitoring the mental health status of undergraduate students, and implementing mental health centers at universities, as well as facilitating access and improve existing centers.

Key messages

The high prevalence of minor mental disorders found among undergraduate students indicates the urgent need for interventions in this populations. Women and LGBT+ students are groups at higher risk for the development of minor mental disorders at university. Strategies must be created to reduce the higher prevalence in this populations.
Psychiatric morbidity among patients attending a rural non-communicable disease clinic
Authors: Sangwan G , Mehra A , Grover S , Avasthi A
Published: October 2020

Background

The presence of psychiatric illness among patients with physical illnesses leads to poor treatment adherence, poor lifestyle, increased cost of treatment, poor quality of life, worsening of physical illness, work absenteeism, increased hospital visits, poor self-care and higher mortality. The study evaluated the prevalence of cognitive impairment and psychiatric morbidity in non-communicable disease patients. The study highlights that NCD patients should be provided information about the development of cognitive impairment in order to prevent it.

Methods

It was a cross-sectional study conducted among the patients attending the non-communicable disease clinic of a rural community health centre run in collaboration with the Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh. We registered 124 patients after obtaining written informed consent. Instruments: Hindi Mental Status Examination (HMSE), Patient Health Questionnaire-9, Generalized anxiety disorder-7 (GAD-7) scale. Analysis of covariance was applied to see the relationship between the domain of the HMSE and NCDs.

Results

The mean age of the participants was 55.5 years (SD-11.9, Range-26-90). A little more than one third (N = 48, 38.7%) were diagnosed with hypertension only, one-sixth (N = 22; 17.7%) were diagnosed with diabetes mellitus only, and 54 (43.5%) patients were diagnosed with both hypertension and diabetes mellitus. A slightly more than one-third of the study participants were diagnosed with depressive disorder (N = 44, 35.5%), and 29% (N = 36) of the participants were diagnosed with an anxiety disorder. About one-fourth of patients with NCD have cognitive impairment and 39.51% have psychiatric morbidity.

Conclusions

The prevalence of cognitive impairment is higher among patients of NCD with psychiatric morbidity. Patients with NCDs should be routinely screened for cognitive functioning and provided information about the development of cognitive impairment.

Key messages

Because of high prevalence of cognitive impairment and psychiatric morbidity in NCD patients, patients should be provided information to prevent it. There is a need to screen NCD patients routinely for cognitive functioning, and provide them information to prevent cognitive impairment.
Loneliness, social isolation, and chronic disease outcomes
Authors: Christiansen J , Lund R , Qualter P , Andersen C M , Pedersen S S , Lasgaard M
Published: October 2020

Background

Research suggests that loneliness and social isolation are serious public health concerns. However, our knowledge of the associations of loneliness and social isolation with specific chronic diseases is limited. The present prospective cohort study investigated (a) the longitudinal associations of loneliness and social isolation with four chronic diseases (cardiovascular disease [CVD], chronic obstructive pulmonary disease [COPD], diabetes mellitus Type 2 [T2D], and cancer), (b) the synergistic association of loneliness and social isolation with chronic disease, and (c) baseline psychological and behavioral explanatory factors.

Methods

Self-reported data from the 2013 Danish “How are you?” survey (N = 24,607) were combined with individual-level data from the National Danish Patient Registry on diagnoses in a 5 year follow-up period (2013-2018).

Results

Cox proportional hazard regression analyses showed that loneliness and social isolation were independently associated with CVD (loneliness: adjusted hazard ratio (AHR) = 1.20, 95% confidence interval [CI; 1.03, 1.40]; SI: AHR = 1.23, 95% CI [1.04, 146]) and T2D (loneliness: AHR =1.90, 95% CI [1.42, 2.55]; SI: AHR = 1.59, 95% CI [1.15, 2.21]). No significant associations were found between loneliness or social isolation and COPD and cancer, respectively. Likewise, loneliness and social isolation did not demonstrate a synergistic effect on chronic disease. Multiple mediation analysis indicated that loneliness and social isolation had an indirect effect on CVD and T2D through both baseline psychological and behavioral factors.

Conclusions

Loneliness and social isolation were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period. The associations of loneliness and social isolation with CVD and T2D were fully explained by baseline psychological and behavioral factors.

Key messages

Individuals exposed to loneliness and social isolation constitute vulnerable groups in risk of chronic disease. Psychological and behavioural factors explain the associations with chronic disease.
Does seeing a psychologist reduce sickness absence due to mental disorders? A quasi-experiment
Authors: Lahti J , Harkko J , Sumanen H , Piha K , Pietiläinen O , Mänty M , Rahkonen O , Lallukka T , Kouvonen A
Published: October 2020

Background

Mental ill-health in young adults is a major public health and work-life problem. We examined in a quasi-experimental design whether occupational psychologist appointment can reduce subsequent sickness absence due to mental disorders among young Finnish employees.

Methods

The present study was conducted among 18-39-year-old employees of the City of Helsinki using register data from the City of Helsinki and the Social lnsurance Institution of Finland. We used Wald test to compare the differences in sickness absence days due to mental disorders (ICD-10, F-diagnosed) between those treated (occupational psychologist appointment for work ability support) and the non-treated (no psychologist appointment) during a one year follow-up. The full sample (n = 2156, 84% women) consisted of employees with mental disorder diagnosed sickness absence during 2009-2014. To account for the systematic differences between the treated and non-treated, the participants were matched according to their characteristics (age, sex, occupational class, education, previous sickness absence and psychotropic medication). The matched sample included 886 participants. We excluded those with treatment before the treatment screening time (± 3 months to the end of sickness absence period), non-treated with treatment during the follow-up and those that could not be matched (lack of common support).

Results

In the full sample, the mean of sickness absence days due to mental disorders was 17.7 (95% CI, 11.4, 24.1) days for those treated (n = 240) and 23.2 (95% CI, 20.5, 25.9) days for non-treated (n = 1916), difference being non-significant. The corresponding figures in the matched sample were (16.8, 95% CI, 9.5-24.1) for those treated (n = 195) and (27.8, 95% CI, 22.6-32.9) for non-treated (n = 691), difference being statistically significant (p = 0.02).

Conclusions

This quasi-experiment suggests that seeing an occupational psychologist to support work ability may be reduce mental health related sickness absence.

Key messages

We showed that supporting work ability at an early stage may prevent sickness absence due to mental disorders. More efforts to provide early stage support for maintaining work ability may prove useful in reducing sickness absence rates in younger employees.
Disparities in prevalence of metabolic syndrome: A cross-sectional analysis of Indian adults
Authors: Joshi C , Thanikachalam M , OI Bermudez  , Chui K K H
Published: October 2020

Background

Metabolic syndrome (MS) is a cluster of risk factors: central obesity, a low level of high-density lipoprotein cholesterol, high levels of triglyceride, fasting glucose, and blood pressure. Individuals with MS have an increased risk for cardiovascular disease and diabetes. South Asians, including Indians, generally have higher rates, earlier onset, and severe forms of cardiovascular diseases and the associated risk factors compared to other ethnic groups. This study assessed the prevalence of MS in an adult South Indian population, and further examined socioeconomic, gender and rurality disparities.

Methods

We analyzed data from 7,697 adults aged between 20 and 76 years participating in the baseline PURSE-HIS study, a community-based cross-sectional study conducted in India in 2012. Socioeconomic status was derived from summary scores of three variables: family income, education and occupation. Univariate and multivariate logistic regressions were conducted to find the association between behavioral risk factors and metabolic syndrome, after adjusting for age, sex, rurality and socioeconomic status.

Results

The overall prevalence of metabolic syndrome was 36.3%, with significant gender difference (38.3% for women vs. 33.8% for men, P < 0.01). Women in semi-urban areas were twice as likely to have metabolic syndrome compared to men in urban areas (OR = 2.0, 95%CI:1.2 to 3.1, p < 0.01). Women in higher socioeconomic group were more than four times likely to have metabolic syndrome compared to men in lower socioeconomic group (OR = 4.2, 95%CI:2.3 to 7.6, p < 0.01).

Conclusions

The study emphasizes the need of preventative and curative interventions focused on low-socioeconomic populations, particularly women who reside in non-urban areas. The findings have important implications for the USA because there are 2.4 million foreign-born population from India, making it the second-largest immigrant group in the USA after Mexicans.

Key messages

Low socioeconmic population and women residing in non-urban areas are at higher risk for metabolic syndrome. Preventative and curative interventions focused on low-socioeconomic populations should be prioritized.
Illustrated Prescription – History of evolution at the School of Patients DF
Authors: Cubas-Rolim E , Yung F R , Marques L A , Souza B V , Gripp M R , Ribeiro L , Oliveira C L A , Gasperi C , Fagundes M C , Mendonça D L
Published: October 2020

Issue

There are challenges in PHC associated with low functional literacy in health. The Illustrated Prescription was developed aiming to reduce drug error and increase access to self-care, allowing better understanding and adherence to treatment; facilitate the safe use of medications; strengthen the support network.

Description of the Problem

In April 2016, systematization and preparation of pictorial prescriptions began in the service of origin, one of the researches with the highest participation of multiprofessional residents of pharmacy and medical interns. Optimization and complement of recipe was performed. Several models were systematized in the orientation of users in face-to-face care of prescription reviews. The proposed model has (1) written component, schedule of medicines and strategy organizing medicines according to time of administration and (2) strategy for organizing primary packaging of medicinal products using coloured elastic bands.

Results

The evolution of Illustrated Prescription components resulted in the progressive organization and understanding in the indication of schedules and drugs. There was development, improvement and validation of it as a self-care tool, especially for patients with CNDs. There was a social impact with media dissemination (6 TV stations and 2 radio stations) and national and international congresses; totaling 5 show-forums and 4 congress with participation of the service. Cash prizes were invested in the infrastructure of the FHS workplaces.

Lessons

The evolution of Illustrated Prescription allowed progressive gain of organization and clarity for patients with difficulty reading, which directed efforts to avoid drug errors, especially prescription.

Key messages

Illustrated Prescription allowed us to invest more time guiding the patient in accessible and understandable language. Illustrated Prescription is useful for empowering and training it in self-care, promoting, mainly, autonomy and citizenship.
Perfluoroalkyl substances and lipid profile in exposed pregnant women in the Veneto Region, Italy
Authors: Dalla Zuanna T , Barbieri G , Pitter G , Zare Jeddi M , Daprà F , Savitz D , Fabricio A , Russo F , Fletcher T , Canova C
Published: October 2020

Background

Perfluoroalkyl substances (PFASs) are persistent and widespread environmental pollutants. Residents of a large area of the Veneto Region (North-Eastern Italy) were exposed to high concentrations of PFASs through drinking water from the late-1970s to 2013. PFASs have been consistently associated with raised serum lipids, but only few studies have been conducted among pregnant women, and none has stratified analyses by trimesters of gestation. Our main objective was to evaluate the association between perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) levels and lipid profiles in high-exposed pregnant women.

Methods

A cross-sectional analysis was conducted in 319 pregnant women (age 14-48 years) recruited in the Regional health surveillance program. Serum PFASs were measured by HPLC-MS/MS. Non-fasting serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were measured by enzymatic assays in automated analysers, and low-density lipoprotein cholesterol (LDL-C) was calculated. The associations between ln-transformed PFASs (and categorized into quartiles) and lipids were assessed using generalized additive models. Analyses were adjusted for potential confounders and stratified according to pregnancy trimester.

Results

In the first trimester, plasma concentrations of both PFOA and PFOS were positively associated with TC. However in the third trimester PFOA levels were instead inversely significantly associated with TC and LDL-C levels. Overall, both PFOA and PFOS were positively associated with HDL-C, and PFOA negatively with LDL-C.

Conclusions

In a small highly exposed population of pregnant women, the associations between PFASs concentrations and lipid profile were modified by trimester of gestation. Patterns late in pregnancy were different to the positive associations with LDL-C generally found. Differential transfer and bioaccumulation of lipids and PFAS in the placenta across gestation might explain our findings.

Key messages

This study provides evidence of different patterns of PFAS associations with lipids in pregnant women across the trimesters of gestation. The different patterns of association from general population studies sheds light on the role of fetal nutrition during pregnancy affecting both lipids and PFAS in serum.
Association between menopausal hormone therapy and melanoma: a systematic review and meta-analysis
Authors: Naldini G , Chiavarini M , Giacchetta I , Fabiani R
Published: October 2020

Background

Age-specific incidence rates of cutaneous Malignant Melanoma (MM) are higher in women during their reproductive years, while the rate of increase slows after menopause, supporting the speculation that hormones might influence the risk of developing cutaneous MM. The aim of our systematic review and meta-analysis is to summarize the evidence on the association between Menopausal Hormone Therapy (MHT) and the risk of MM.

Methods

Medline and Web of Science were systematically searched for eligible publications until December 2019. Our review and meta-analysis follow the PRISMA guidelines. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using a random effect model.

Results

The pooled analysis of all 19 studies (9 cohort and 10 case-control) showed a significant positive association of MHT with risk of MM (OR 1.19; 95% CI 1.13-1.26; I2=41.93%, p = 0.029). Excluding Uveal and intraocular MM (3 studies), MHT increased the risk of cutaneous MM (OR 1.19; 95% CI 1.13-1.26; I2=35.73%, p = 0.077). No significant publication bias could be detected. Stratifying by study design, MHT significantly increased the risk of cutaneous MM (OR 1.19; 95% CI 1.12-1.27; I2=42.52%, p = 0.107) in the cohort studies; no significant association was found in case-control studies.

Conclusions

This meta-analysis of available literature resulted in an increased risk of MM in women used MHT. Further investigations are necessary to increase the reliability of the results and estimate the relationship of other characteristics of MHT, such as type (opposed and unopposed estrogens) and route of administration, with MM.

Key messages

Menopausal Hormone Therapy (MHT) significantly increases the risk of Malignant Melanoma (MM). Further awareness of clinical practitioners should be raised on the potential association of MHT with MM.
Differences in body composition and grip between Japanese and Thai older people living in Thailand
Authors: Yoda T , Saengrut B , Rattanasathien R , Ishimoto Y , Saito T , Miyamoto K , Chunjai K , Pudwan R , Sirimuengmoon K , Katsuyama H
Published: October 2020

Background

Age-related muscle mass loss is one of the main risk factors for osteoporosis and fractures among older people. Thus, prevention of muscle mass loss in older people is an important issue. We examined ethnic group-related differences in body composition and grip strength among older people living in the same area.

Methods

We measured body composition and grip strength among local Thai older people living in Chiang Mai Province, as well as in Japanese older people who emigrated to Chiang Mai Province in their retirement. A self-reported questionnaire regarding socio-demographic status was also administered. Measurement items were averaged and compared by sex and ethnic group. Questionnaire items were also categorized by sex and ethnic group.

Results

A total of 119 older people participated, including 47 Japanese participants (26 men, 21 women) and 72 Thai participants (16 men, 56 women). The average age of Japanese participants was 71.1 years (standard deviation: 4.89), and the average age of Thai participants was 68.8 years (standard deviation: 5.61). Significant differences between ethnic groups were found in percentage of body fat in women (Japanese average: 32.9% vs. Thai average: 37.6%, p < 0.05), skeletal muscle mass index (SMI) in men (Japanese average: 7.85 kg/m2 vs. Thai average: 7.31 kg/m2, p < 0.05) and average grip strength in men (Japanese: 35.1 kg vs. Thai: 30.7 kg, p < 0.05).

Conclusions

Our preliminary results suggest that Thai older people, particularly men, are weaker than Japanese older people. Decreased muscle mass is directly responsible for functional impairment, involving loss of strength, increased likelihood of falls, and loss of autonomy. Preventing muscle weakness among older people is important. In future studies, we plan to analyze and clarify the differences between Thai and Japanese older people to identify effective methods to prevent muscle mass decreases.

Key messages

There were significant differences in average % body fat between older Japanese and Thai women. There were significant differences in average SMI and grip strength between older Japanese and Thai men.
Factors associated with oral health inequalities in Korean adolescents
Authors: Shin B
Published: October 2020

Aim

The purpose of this study was to identify factors related to socioeconomic differences in oral health behavior and oral symptom experience in Korean adolescents using the 2017 Korea Youth Risk Behavior Web-Based Survey(KYRBS).

Methods

From the national 2017 KYRBS, which was approved by the Research Ethics Review Committee of the Korea Centers for Disease Control and Prevention, 61,874 adolescents aged 12-18 years were selected as participants of the present study. Toothbrushing, gum bleeding and toothache experience were selected as dependent variables, and subjective socioeconomic status (SES) was used as a measure of SES. For statistical analysis, complex samples logistic regression analysis was performed using SAS 9.3 (PROC SURVEYLOGISTIC).

Results

The Odds Ratio (OR) for toothbrushing variable in the highest SES group was 1.78 (95% CI: 1.68-1.88). The OR for the bleeding gums in the lowest SES group was 1.28 (95% CI: 1.21-1.36). Academic factors accounted for 19% of socioeconomic differences in toothbrushing, and psychological factors accounted for 36-49% of socioeconomic differences in oral symptoms.

Conclusions

Adolescent oral health inequalities were associated with a variety of factors including health behaviors, psychological factors, family and academic factors. Thus, oral health promotion of adolescents can be achieved by integrating relevant factors, which can be effective when based on schools.

Key messages

Social gradient in oral health behavior and oral symptoms of Korean adolescents persist when adjusted for behavioural, psychosocial and material factors. Because oral health in adolescents is linked to overall health, health promotion can be achieved when oral health inequalities are integrated and mediated within the overall health domain.
ECG abnormalities and arterial function by HIV status among high-risk populations in Rakai, Uganda
Authors: Enriquez R , Ekström A M , Gigante B , autiainen Lagerström S R , Kigozi G , Nalugoda F , Ssekubugu R , Nordenstedt H
Published: October 2020

Background

People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD). In Sub-Saharan Africa, where a majority of PLHIV live, population-based data on major CVD events such as stroke and myocardial infarction are difficult and expensive to collect. The use of proxy measures of future CVD events that are easier to collect, could be a feasible way to better study CVD in such settings. This study aimed to determine the acceptability of incorporating ECG and arterial function measurements into a population-based cohort study and to assess the prevalence of ECG abnormalities and arterial stiffness.

Methods

A pilot study was conducted within the Rakai community cohort study in Uganda on two high-risk CVD groups; one determined by age (35-49) and Framingham CVD risk scores and the other by age alone (50+). Data on ECG, arterial function, blood pressure, and HIV status were collected. The acceptability of incorporating ECG and arterial function measurements was established as an acceptance rate difference of no more than 5% to blood pressure measurements.

Results

A total of 118 participants were enrolled, 57 PLHIV and 61 HIV negative. Both arterial function and ECG measurements were well accepted (2% difference), but the completeness of arterial function measurements captured was suboptimal (63%). Left ventricular hypertrophy (LVH) and arterial stiffness (> 10 m/s) were common in both PLHIV and HIV negative participants across the two high-risk populations. Prevalence rates ranged from 30% to 53% for LVH and 25% to 58% for arterial stiffness.

Conclusions

The incorporation of ECG and arterial function measurements into routine activities of a population-based cohort was acceptable. LVH and arterial stiffness were common in these high-risk for CVD populations, indicating the need for future research. The use of these proxy measures might be recommended when data on CVD events cannot be collected.

Key messages

It is acceptable to incorporate ECG and arterial function measurements into a population-based cohort in Uganda. High prevalence rates of LVH and arterial stiffness were found in people with high risk for CVD.
Characterization of death from colorectal cancer in Mato Grosso State/Legal Amazon/Brazil, 2000-2016
Authors: Caló R S , Souza B S N , Galvão N D , Souza R A G , Oliveira J C S , Alves M R , Cabral J F , Atanaka M , Assis J V M , silva S M
Published: October 2020

Background

Colorectal cancer has been one of the cancers that most contributed to mortality, in both sexes in the world. In Brazil, cancer is among the top five causes of death and colorectal cancer is ranked on the fifth position. Of the Federative Units belonging to the Legal Amazon, Mato Grosso stands out for the higher adjusted incidence of colorectal cancer for both sexes. Thus, the objective is to characterize deaths from colorectal cancer, according to sociodemographic variables in Mato Grosso from 2000 to 2016.

Methods

A descriptive study was carried out, using data from the Mortality Information System, made available by the Department of Health of the Mato Grosso State. Deaths of all ages were selected, whose basic cause was identified by the codes from the International Classification of Diseases: (C.18) colon cancer, (C.19) rectosigmoid junction cancer, (C.20) rectal cancer or (C.21) anus cancer.

Results

Between 2000 and 2016, 31,607 deaths from cancer were registered. Of these, 1,750 (5.6%) were due to colorectal cancer. An increased number of deaths was observed at the end of the period, with a variation from 46 deaths in 2000 from 173 in 2016. Highest frequency was verified in men (51.3%), people aged 60 years or older (59.7%), black (54.6%), married (52.3%) and those with primary education (55.2%). According to Brazilian occupation classification options or those answers filled out on the death certificate, highest frequency were for “Retired” (26.2%), “Housewife” (23.1%), Agricultural/Forestry and Fisheries” (11.3%) and “Production of Industrial Goods and Services” (10.3%).

Conclusions

This study evidenced the increased number of deaths due to colorectal cancer in Mato Grosso State, and identified priority groups for interventions through public health policies which should include screening and early diagnosis to cope with the disease.

Key messages

Evidenced the increased number of deaths due to colorectal cancer in Mato Grosso State. Identified priority groups for interventions through public health policies.
Mortality trends for all causes of cancer in Mato Grosso State, Brazil
Authors: Vieira Gomes C , da Silva Nalin de Souza B , de Lima D V , de Souza Andrade A c , de Souza Oliveira J C , Gomes de Souza R A , Dreyer Galvão N , Aguilar L B , de Lima Neto G S , Ferreira Montenegro L H
Published: October 2020

Background

Cancer is the second leading cause of death in Brazil, being the most common breast, lung, colorectal, cervix and pancreas among women and lung, prostate, colorectal, stomach and esophagus among men. The mortality trends for all causes of cancer in Brazil have been increased, with variations between sexes and regions. The objective was to analyze standardized mortality trend rates for all causes of cancer in Mato Grosso State, Brazil, from 2000 to 2015.

Methods

This is a descriptive, ecological, time-series study using data from the Mortality Information System, made available by the Department of Health of the Mato Grosso State. Deaths from cancer of all ages were selected, whose basic cause was identified by the letter “C” from the 10th revision of International Classification of Diseases. The direct method of standardization was performed with the 1960 world population and expected deaths were estimated. To estimate the trend, the annual percentage variation (APV) was calculated using the ratio regression coefficient/2000 mortality rate, for the state and its five macroregions.

Results

From 2000 to 2015, 28.525 deaths from cancer occurred in the state residents. There was an increasing trend in the mortality rates for all causes of cancer, with APV of 0.81% (p = 0.001). Considering the macroregions, the south (APV = 1.12%; p = 0.01), north (APV = 1.51%; p = 0.01) and east (APV = 1.82%; p = 0.01) had an increasing trend and the west (APV = 0.51%; p = 0.44) and the center-north (APV = 0.46%; p = 0.12) had a stable trend.

Conclusions

Mato Grosso follows the Brazilian cancer mortality increased trend. Variation in mortality rates found among different macroregions of the state and no decreased rates reveal regional disparities and the importance of cancer control and prevention in the state.

Key messages

Mortality rate for all causes of cancer increased in Mato Grosso State, Brazil, from 2000 to 2015. Variation in mortality trends by macroregions of the Mato Grosso State reveals regional disparities and the importance of cancer control and prevention in the state.
Evaluation of sustainability of non-communicable diseases risk factor program in Malaysia
Authors: Shanmuganathan S , Mustapha F I , Wilson A
Published: October 2020

Background

Non-communicable diseases (NCDs) in Malaysia have risen substantially over the last two decades. We aimed to (i) evaluate the sustainability of the existing NCDs risk factor program implemented under the National Strategic Plan and (ii) identify challenges and factors impeding the sustainability of the NCDs program.

Methods

A mixed-method approach using a combination of the Program Sustainability Assessment Tool

with 40-item instrument assessing 8 domains (organizational capacity, program adaptation, program evaluation, communications, strategic planning, funding stability, environmental support and partnerships) and 5 open-ended questions were administered to 80 key managers from district directors of chronic disease programs in Malaysia. The mean score for each of the 8 sustainability domains and the overall mean sustainability score were determined. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25.

Results

Seven domains scored a mean of ≥ 4. The domains of communications (cross-site mean, 4.5 on a scale of 1-7) and organizational capacity (mean, 4.4) had the highest ratings. Funding stability had the lowest rating (mean, 3.8). The overall mean sustainability score was 4.2. Open-ended responses revealed challenges by program leaders, including implementation difficulties, factors impede planning for NCDs sustainability program, lack of financial, staff support and staff training which are largely consistent with the scaled domains.

Conclusions

Capacity issues affecting the sustainability of NCDs program in Malaysia are qualitatively similar to other countries. Future work should aim at improving funding stability and integrating evidence-based public health strategies to sustain implemented NCDs program.

Key messages

Researchers could utilize this tool to assess program design and strategies promoting sustainability during implementation process for long term program sustainment. Investments in leadership support for integrating program evaluation into implementation and greater funding flexibility may enhance sustainability of evidence-based public health program for NCDs.
Project on monitoring persistence of body mass index of school aged children
Authors: Majer M , Musil V , Sović S , Musić Milanović S , Jureša V , Kujundžić Tiljak M
Published: October 2020

Issue

Childhood obesity is one of the most important public health issues today. In Croatia every third school aged child are overweight. Monitoring of nutritional status of school aged children in Croatia is a part of routine health examinations provided by School health service, while Project on tracking BMI from early school aged to adolescence provided insight into the risk of overweight in adolescence. Risk assessment for overweight is important in planning interventions in Croatia, as well in other countries.

Description of the Problem

Objective of the project was to collect and analyze anthropometric data of representative sample of Croatian school aged children, to determine tracking of BMI from early school age to adolescence and to assess the risk for overweight in adolescence. Longitudinal follow up included period from first to eight grade of primary school. Data of date of birth, body weight and height were obtained from medical records, and BMI was evaluate according to the national reference values.

Results

Project included 641 participant (49.8% girls) with the data of three measurements within health examination in primary school. Normal weight in all free measurements were 226 (71%, CI95% 66-76%) girls, and 192 (60%, CI95% 54-65%) boys, while overweight were 18 (6%, CI95% 4-9%) girls and 26 boys (8%, CI95% 5-12%), respectively. Probabilities of being overweight in eight grade for girls and boys normal weight in first grade were 10% (CI95% 7-14%) and 13% (CI95% 10-18%), while for overweight in first grade probabilities were 63% (CI95% 46-78%) and 69% (CI95% 54-81%), respectively. Risk of being overweight in eighth grade started increasing at 75th BMI centile value in first grade.

Lessons

Project showed importance of monitoring persistence of BMI of school age children. Intervention should target normal weight children as well, in order to maintain normal weight during the lifespan.

Key messages

Monitoring of nutritional status and risk assessment for overweight is important in planning interventions. Intervention should target not only overweight children, but normal weight children as well.
Smoking abstinence 1 year after acute coronary syndrome in Tunisian adults
Authors: Abroug H , El Hraiech A , Ben Fredj M , Kacem M , Zemni I , Benasrallah C , Wafa Dhouib W , Rania Bannour R , Mehrez O , Sriha A
Published: October 2020

Background

In Tunisia, coronary heart disease(CHD) is the first cause of mortality, accounting one third (33.23%) of total deaths in 2017. Although smoking cessation is the most effective CHD prevention strategy, quitting smoking is difficult and two thirds of patients return to smoking within 1 year of their acute coronary syndrome (ACS). The present study aimed to evaluate the smoking cessation rate and to assess predictors of smoking abstinence in patients with ACS, one year after hospital discharge.

Methods

A prospective cohort study was conducted in the Cardiology Department and Smoking Cessation Service at University Hospital of Monastir, Tunisia from January 2015 to December 2017. During their hospitalization, all patients in the sample received individual therapeutic education including a motivational interview. The follow-up were carried out by clinic visits every two weeks. Logistic regression analysis was used to evaluate the independent predictors of smoking abstinence. The statistical analysis was conducted with SPSS software, version 21.0. A p value of < 0.05 was considered statistically significant.

Results

A total of 288 smoking patients were included in our study. All participants were male and the mean age was 55 ± 11 years. More than half (55.4%) of patients had a high level of nicotine dependence. Successful smoking cessation rate was 35.7 % [95% confidence interval (CI): 29.4-42.5%]. Independent predictors of smoking abstinence were: therapeutic adherence (odds ratio(OR): 13.8, p < 0.001), the level of nicotinic dependence (OR: 0.26, p = 0.02), the length of stay in the ICU (OR: 8.31, p = 0.001) and diabetic status (OR: 4.54, p = 0.01).

Conclusions

This study for smoking cessation highlights the importance to generalize our protocol for all Tunisian patient with cardiovascular risk.

Key messages

Smoking cessation is the most effective coronary heart disease prevention strategy. More efforts are required to improve smoking cessation in patients with cardiovascular risk.
Factors associated with diabetic foot among type 2 diabetes in the region of Monastir (Tunisia)
Authors: Abroug H , Ben Fredj M , Kacem M , Bennasrallah C , Dhouib W , Mehrez O , Zemni I , Bannour R , Sriha A
Published: October 2020

Background

The diabetic foot (DF) has actually a high rate of disability leading to impaired quality of life and even mortality. Glycemic control among Tunisian adults with diabetes mellitus remains poor. However the relationship between glycemic control and foot complication have not been clearly established. The aim of the present study was to assess the relationship between diabetic foot lesions and glycemic control and the diabetic duration in the people with DT2.

Methods

A cross-sectional survey was conducted in five Primary Health care Centers (PHC) in the region of Monastir (Tunisia) from March 2016 to April 2017. Data were collected using interviewer administered structured questionnaire. Validated questionnaire was used to assess diabetic foot diseases.nA multivariate logistic regression analysis was conducted to assess the relationship between glycemic control, diabetic duration and the DF lesions. A p-value of < 0.05 was considered statistically significant.

Results

In total 383 patients were recruited, of whom 258 (67.9%) were men. The mean age of participants was 60.7±11.3. Poor glycemic control (HbA1c ≥ 7.0%) increased the risk of abnormal patellar reflex (aOR=7.07; CI95% 1.65-30.1; p = 0.03) and calf claudication (aOR=7.07; CI95% 1.65-30.1). The long duration of diabetes (10 years and more) was a significant factor associated with an abnormal Achill reflex (aOR=2.31; CI95% 1.12-4.76; p = 0.02), a needle-stick perceptual disorder(aOR=2.08; CI95% 1.14-3.78; p = 0.01), a vibration sensibility perceptual disorder (aOR=2.02; CI95% 1.01-4.08; p = 0.04), a negative monofilament test (aOR=2.69; CI95% 1.04-5.16; p = 0.003), an absent dorsalis pedis artery pulsation(aOR=2.35; CI95% 1.09-5.05;p=0.02) and an absent posterior tibial artery pulsation (aOR=3.06; CI95% 1.28-7.28; p = 0.01).

Conclusions

This study identified that disease duration and poor glycemic control are significant risk factors related to DF development in the current T2DM population.

Key messages

Disease duration and poor glycemic control are significant risk factors related to DF development in the T2DM population in the region of Monastir. Prevention programs should be focused on patient education about modifiable risk factors in particular glycemic control and adequate and regular foot care.
Association of diverse musical experiences and well-being
Authors: Kyaw K
Published: October 2020

Background

Health is a state of complete physical, mental, and social well- being and not merely the absence of disease or infirmity as per the World Health Organization (WHO). Well-being is a subject aspect in one of the WHO “Health 2020: the European policy for health and well-being,” goals. Listening to music activates the neuronal cells in the frontotemporal lobe of the brain where memory, aggression, and emotions are regulated. Various types of musical exposures may help in dysregulating emotions and stress levels from mental and physical health. Advancing well-being is one of the public health issues to achieve a better quality of life and health and longevity. This study aims to identify an association between well-being and diverse musical experiences to explains public policy developments for advancing well-being.

Methods

This retrospective longitudinal study includes individuals age 24 and above from the English Longitudinal Study of Ageing (2008 to 2016). The outcome is subjective health. The predictor is a diverse musical experience (concert, opera, theater). Covariates are gender, age, marital status, objective health, and mental health. Bivariate, univariate, multiple logistic regression analysis was carried out in SAS software version 9.4, p-value (p) <0.05.

Results

This study shows that well-being is significantly associated (p < 0.0001) with musical experience at the yearly interval (OR: 2.34, 95% CI: 2.06, 2.79) and musical experience at the monthly interval (OR: 3.44, 95% CI: 2.85, 4.15). With adjustment for covariates, well-being is significantly associated (p < 0.0001) with musical experience, yearly interval (OR: 2.22, 95 % CI: 1.89, 2.60), and musical experience at the monthly interval (OR: 2.13, 95 % CI: 2.58, 3.80).

Conclusions

This study explains that well-being is associated with the diverse nature of musical experiences. Developing policy in the area of various types of musical programs in the community would achieve advancing well-being.

Key messages

Increase awareness of the importance of well-being and the impact of different musical experiences on wellbeing. Prioritize in developing public policy for well-bing with an option of various music programs in the community and conduct more research in the field of well-being with musical experiences.
Glyphosate: quantities a hundred times above the safe limit for human consumption in Brazil
Authors: Ribeiro Bizuti M , Inácio Andrioli A , Eneida de Almeida M , Roberto Barbato P , Savi Geremia D
Published: October 2020

Brazil is experiencing a situation never before seen in terms of environmental destruction. The expansion of monocultures has increasingly destroyed nature and this also has an impact on the increase in land concentration, rural exodus, poverty and hunger in the countryside. Transgenics allowed the expansion of areas to regions previously not suitable for monoculture production, requiring less labor and more pesticides. Just to produce 68.1 million tons of soybeans, exported last year, it required a quantity of water that could supply 2.03 billion people worldwide. This is the deficit of Brazilian agribusiness that cannot be calculated. If we calculate the expenditures of the public health system as a result of the use of pesticides, this will prove to be increasingly unsustainable. Recently, researchers found amounts of glyphosate a hundred times above the safe limit for human consumption in a stock of wheat stored in a silo in southern Brazil. The official speech of the Ministry of Agriculture, Livestock and Supply (MAPA) of Brazil is that the record release of pesticides is necessary due to the country's tropical climate. Universities and public research institutes have an important responsibility at this time: to investigate this type of problem and to allow its results to be available to an increasingly critical publicity. Brazil is experiencing a context of clear attacks on public institutions by the current federal government, either with cuts in the transfer of economic resources, or with the scrapping and attempts to destroy its image before public opinion. It is necessary to promote the training of citizen scientists in the field of Environmental Health, in order to be committed to the information to be produced and to the process of critical reflection on social development.

Key messages

To present an emerging issue in Brazil, related to Glyphosate, when researchers found amounts of glyphosate a hundred times above the safe limit for human consumption in southern Brazil. To present the concern in promoting the training of citizen scientists in the field of Environmental Health, as well as promoting the process of critical reflection and social development.
Social integration and its relationship with functional limitations in Chilean older adults
Authors: de Albuquerque Araújo L , Icaza Noguera G , Albala Brevis C
Published: October 2020

We are experiencing the highest levels of life expectancy and it poses challenges in the maintenance of the functional capacity in old age. This study seeks to determine the relation between social integration and functional limitation in Chilean older adults. Cross-sectional study with baseline of two cohort studies: the SABE cohort (born before 1940) and the Alexandros cohort (born between 1940 and 1948 from Primary Health Care centers), from Santiago. Were considered 1733 elderly. Performance variables were studied in seven Instrumental Activity of Daily Living (IADL): preparing food, managing money, leaving home alone, making purchases, making or receiving calls, doing light housework, organizing and taking medications, and six basic Activities of Daily Living (ADL): bathing, dressing, use of the bathroom, transfer, continence of urine and feeding. Having difficulties or inability to perform at least one activity was classified as having functional limitations. Social integration variables were: participation in community groups, clubs or organizations and in recreational activities. Adjustment variables were: sex, age, educational level, household income, depression, cognitive impairment and multimorbidity. Robust Poisson Regression was performed and prevalence ratios (PR) of functional limitation in ADL and IADL were reported. The level of significance was ≤0.5. Prevalence of functional limitations in ADL was 73.3% and in AIVD was 37.1%. Who participated in recreational activities have a lower prevalence of functional limitation in ADL (PR 0.85; 95%CI 0.80-0.90) and in IADL (PR 0.74; 95% CI0.63-0.86). Participation in community groups, clubs or organizations was associated with a lower prevalence of limitation in ADL (RP 0.78; 95%CI 0.71-0.87), although it was not significantly related to performance in IADL. Greater social integration in adulthood is a protective factor for limitation in ADL and IADL and should be the subject of public policies in Chile.

Key messages

Social integration seems to be a protective factor for functional limitation in Chilean older adults. Society and public policies should give greater opportunity for the elderly to participate in recreational activities and community groups.