Adjustment For Sociodemographic Variables Research Articles

Governmental programmes associated with food insecurity among communities of descendants of enslaved blacks in Brazil.

To assess the access to government programmes and their association with food insecurity (FI) in families from quilombolas communities in Brazil. An analysis of secondary data from the 2011 Quilombolas Census was performed in Brazilian territories. The Brazilian Household Food Insecurity Measurement Scale (Escala Brasileira de Insegurança Alimentar, EBIA) was used to assess the household FI status. The relationships of governmental programmes with the levels of FI were estimated using logistic regression models. Greater national survey census of food and nutritional security of the recognised Quilombolas Brazilian territories. Totally, 8743 quilombolas families. The prevalence of household FI was 86·1 % (moderate/severe FI: 55·9 %, 95 % CI 54·8, 56·9). After adjustment for socio-demographic variables, access to rural development programmes (Food Acquisition Program: OR: 0·6, 95 % CI 0·4, 0·8, P-value < 0·01) and health programmes (Center for Family Health Support: OR: 0·5, 95 % CI 0·5, 0·7, P-value < 0·001) is inversely and significantly associated with moderate/severe FI. The Brazilian conditional cash transfer programme (Bolsa Família) was associated with quilombolas families with moderate/severe levels of FI (OR: 3·3, 95 % CI 2·8, 4·0, P-value < 0·001). The prevalence of FI was high among quilombolas families. Despite reduced participation in governmental programmes, rural development, agriculture and conditional cash transfer programmes are fundamental to the autonomy of quilombolas communities. In spite of the low participation, when families are able to access these programmes, the study revealed the importance of these initiatives in reducing the likelihood of severe levels of FI.

Associations between social and intellectual activities with cognitive trajectories in Chinese middle-aged and older adults: a nationally representative cohort study

BackgroundAssociations between the frequency of social and intellectual activities and cognitive trajectories are understudied in Chinese middle-aged and older adults. We aimed to examine this association in a nationally representative longitudinal study.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative sample of Chinese middle-aged and older participants. The frequency of social and intellectual activities was measured at baseline. Interview-based cognitive assessments of orientation and attention, episodic memory, and visuospatial skills and the calculation of combined global scores were assessed every 2 years from 2011 to 2016. Cognitive aging trajectories over time were analyzed using group-based trajectory modeling, and the associations of the trajectory memberships with social and intellectual activities were analyzed using multinomial logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported.ResultsAmong 8204 participants aged 50–75 years at baseline, trajectory analysis identified three longitudinal patterns of cognitive function based on the global cognitive scores: “persistently low trajectory” (n = 1550, 18.9%), “persistently moderate trajectory” (n = 3194, 38.9%), and “persistently high trajectory” (n = 3460, 42.2%). After adjustment for sociodemographic variables, lifestyles, geriatric symptoms, and health conditions, more frequent intellectual activities (OR 0.54, 95% CI 0.38–0.77) and social activities (OR 0.79, 95% CI 0.65–0.95) were both associated with a lower likelihood of being in the “persistently low trajectory” for global cognitive function.ConclusionsThese findings suggested that more frequent social and intellectual activities were associated with more favorable cognitive aging trajectories.

Grandparenthood and risk of mortality: Findings from the Health and Retirement Study.

Grandparenthood constitutes a significant role for older adults and may have important health implications. Our study examines the grandparenthood-mortality nexus, controlling for an array of potentially confounding variables. Longitudinal survey data from the Health and Retirement Study (HRS) were used, comprising twelve biennial waves from 1992 to 2014 with linked data on vital status derived from the National Death Index. The sample included 27,463 participants aged ≥51 years with at least one child. Cox proportional hazard models tested the association between grandparenthood and mortality risk with adjustment for socio-demographic variables, for social variables including characteristics of and contact with children, and for health variables, including measures of general, functional and mental health. Grandparenthood overall was unassociated with mortality risk in both women and men. However, the subpopulation of younger, partnered grandmothers with a larger number of grandchildren tended to exhibit a substantial increase in mortality risk as compared to women without grandchildren.

Associations between primary health care strategies and outcomes of mental disorders.

Objective:To investigate associations between the percentage and severity of mental disorders (MD) and three different primary health care (PHC) strategies in Brazil: traditional care (TC), the Family Health Strategy (FHS), and FHS with shared mental health care (FHS+SC).Methods:Random samples were selected from three different areas of a Brazilian city. Each area was served by a different PHC strategy (TC, FHS, or FHS+SC). Five mental health professionals, blinded to the type of PHC strategy delivered in each area, conducted interviews using the Mini International Neuropsychiatric Interview (MINI) and other specific instruments to assess the prevalence and severity of MD.Results:530 subjects were interviewed. The TC strategy was significantly associated with a higher percentage of MD when compared to FHS and FHS+SC. These results were not affected by adjustment for sociodemographic variables. The difference in prevalence of MD between the two FHS areas (with and without SC) was not statistically significant. No significant differences in MD severity were observed across the three PHC strategies.Conclusion:Areas covered by FHS showed a lower percentage of MD than those covered by TC. Presence of SC did not influence the prevalence of MD, suggesting that mental-health training of FHS teams may have minimized the influence of SC.

Piloting an evidence-based intervention for HIV prevention among street youth in Eldoret, Kenya

ObjectivesThis study presents findings from piloting an adapted evidence-based intervention, Stepping Stones and Creating Futures, to change street-connected young people’s HIV knowledge, condom-use self-efficacy, and sexual practices.MethodsEighty street-connected young people participated in a pre- and post-test mixed methods design in Eldoret, Kenya. The primary outcome of interest was HIV knowledge. Secondary outcomes included condom-use self-efficacy and sexual practices. Multiple linear regression models for change scores with adjustment for socio-demographic variables were fitted. Qualitative and quantitative findings are presented together, where integration confirms, expands on, or uncovers discordant findings.ResultsParticipants had a significant increase in HIV knowledge from pre- to post-intervention. The median HIV knowledge score pre-intervention was 11 (IQR 8–13) and post-intervention 14 (IQR 12–16). Attendance was significantly associated with HIV knowledge change scores. Qualitatively participants reported increased HIV and condom-use knowledge and improved condom-use self-efficacy and health-seeking practices.ConclusionsOur findings support the potential for further testing with a rigorous study design to investigate how best to tailor the intervention, particularly by gender, and increase the overall effectiveness of the program.

Abstract P174: Adiposity Mediates the Association Between Gut Microbial Diversity and Hypertension: Cardia Study

Introduction: We have shown that gut microbial diversity is associated with hypertension in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Animal models have documented gut microbial effects on adiposity, a known risk factor for hypertension. The extent to which adiposity may mediate the association between the gut microbiome and hypertension has not been studied. Hypothesis: We hypothesize that adiposity is a mediator of the association between gut microbial diversity and hypertension. Methods: We analyzed data from the CARDIA Study (480 participants). Shotgun metagenomic sequencing was performed on DNA extracted from stool samples collected at the Year 30 exam (2015-2016). Taxonomic classification of sequenced reads was performed using Kraken2. Within-person gut microbial diversity was assessed at the genus level using the Shannon Diversity Index and richness (number of distinct genera); lower values indicate less diversity. Hypertension was defined as systolic BP ≥140, diastolic BP ≥90 mm Hg, or taking antihypertensive medication. We performed mediation analyses to quantify the percentage of the total estimated effect of gut microbial diversity on hypertension that is mediated by adiposity as assessed using body mass index (BMI). Results: Mean age of the participants was 55.1 (3.4) years, 47% were African American, and 53% were female. In multivariable-adjusted mediation analysis, BMI explained on average 26-34% of the association between gut microbiota diversity and hypertension (Table). Results were robust to adjustment for sociodemographic variables (Model 2) and health behaviors (Model 3). Conclusions: Approximately one-third of the total effect of gut microbial diversity on hypertension is mediated through adiposity.

Gender Differences in the Relationship Between Sleep Problems and Suicide Attempt in Adolescents.

There are few studies examining which types of sleep problems are independently associated with suicide attempt (SA) and gender difference in adolescents. The aim of the present study was to examine whether specific sleep problems were uniquely associated with suicide attempt in adolescents and explore gender differences in the association. A school-based health survey was conducted in four provinces within China from November 2014 to January 2015. A total of 15,132 students aged 10–21 years completed standard questionnaires assessing past 12 month suicide attempt in addition to measures of sleep quality, quantity and sleep beliefs. 5.4% of participants reported a suicide attempt within the last 12 months. After adjustment for sociodemographic variables and psychological symptoms, almost all sleep problems remained significantly associated with a greater endorsement of suicide attempt. Further adjustment for co-occurring sleep problems revealed that weekday sleep duration (<6, 8–10, and ≥10 h), insomnia (often), and nightmares (sometimes and often) remained independently associated with suicide attempt in boys (p < 0.05). However in girls, weekday sleep duration (<6 and ≥10 h), weekend sleep duration (<6 h), midday nap (0 or 1–2 d/week), insomnia (sometimes and often), nightmare (often) and sleep beliefs (high) were independently associated with suicide attempt (p < 0.05). Multiple sleep problems are associated with suicide attempt in adolescents, however the relationship varies by gender.

Self-Reported Health and Patterns of Romantic Love in Adolescents from Eight European Countries and Regions.

Purpose: Sexual minority youth (SMY) are at increased risk of poor health, but it remains unclear whether this phenomenon is universal. In this study, nationally representative samples of 15-year olds from eight European countries and regions were investigated to test if adolescents who have been in love with same- or both-gender partners report poorer health than those exclusively in love with opposite-gender partners or who have never been in love.Methods: A subsample of 13,674 adolescents participating in the 2014 Health Behaviour in School-aged Children (HBSC) study was used. We conducted binary logistic regression, adjusted for gender, region, and relative family affluence, to analyze associations between self-reported romantic love, multiple psychosomatic symptoms, and poor self-rated health.Results: Adolescents reporting same-gender love (adjusted odds ratio [aOR] = 1.50, 95% confidence interval [CI]: 1.11–2.02) and both-gender love (aOR = 3.57, 95% CI: 2.65–4.83) had significantly higher odds for multiple psychosomatic symptoms than those who reported opposite-gender love. Similarly, both SMY groups had higher odds of poor self-rated health (aOR = 2.95, 95% CI: 1.64–5.31 and aOR = 3.08, 95% CI: 1.79–5.31, respectively). Those who reported that they have never been in love had significantly lower odds for multiple symptoms. Adjustment for sociodemographic variables and stratifying by gender did not substantially change the odds ratios.Conclusion: Adolescents in love with same- and both-gender partners reported poorer subjective health outcomes than those in love with opposite-gender partners or who reported never being in love, suggesting that SMY health inequalities are found across various European countries and regions.

GRANDPARENTHOOD AND RISK OF MORTALITY: FINDINGS FROM THE HEALTH AND RETIREMENT STUDY

Grandparenthood is a significant social role for older adults and may have important health implications. Parenthood itself has been associated with some protective health effects, although findings have been mixed. Whether grandparenthood is associated with important long-term health effects such as mortality is largely unknown. This study examines the grandparenthood-mortality nexus, and whether it is modified by gender and education. Longitudinal data from the Health and Retirement Study (HRS) were used, comprising twelve biennial follow-up waves from 1992 to 2014 with linked data on vital status derived from the National Death Index. Submodules assessed participants’ family structure during follow-up. The sample included 24,325 participants aged > 51 years with at least one child. Cox proportional hazard models were used to test the association between grandparenthood and mortality risk with adjustment for socio-demographic variables, for social variables including characteristics of and contact with children, and for health variables, including measures of overall, functional and mental health. Stratified models assessed these associations separately by gender and education. Grandparenthood was associated with a substantially increased mortality risk in women (fully adjusted HR = 1.65; 95% CI 1.27-21.14), and increased with larger number of grandchildren. No significant association was found for men (fully adjusted HR=1.25; 95% CI 0.97-1.62). Mortality risks associated with grandparenthood were highest among grandparents with low levels of education. The findings are among the first to suggest a potential grandparenthood survival “penalty”, especially for grandmothers. Higher levels of education appear to mitigate this negative survival effect among grandparents.

The Association of Internet Use with Wellbeing, Mental Health and Health Behaviours of Persons with Disabilities.

Introduction: There is strong evidence that people with disabilities suffer from a significant digital divide. However, there are reports indicating that Internet use may result in many benefits for those with disabilities. The aim of the study was to assess the impact that the use of the Internet has on the wellbeing and health behaviours of persons with disabilities. Methods: An analysis was carried out using the dataset obtained from Social Diagnosis, a panel study undertaken on a nationally representative sample. The records of persons with disabilities were retrieved from the dataset which was established in 2015. An analysis of the association between Internet use and the wellbeing, mental health and health behaviours of the respondents was undertaken. The variables reflecting the self-assessment of their own life and experience of loneliness were treated as being indicators of their wellbeing and the prevalence of suicidal thoughts or making use of psychological help as indicators of mental health. The health behaviours analysed in the study included smoking, excessive consumption of alcohol and undertaking physical activity. For all these variables, multivariate logistic regression models were developed. The effect of Internet use was adjusted for sociodemographic variables and the degree of disability. An analysis was performed after applying post-stratification weights available from the Social Diagnosis study. Results: The weighted study group consisted of 2529 people having a mean age of 59.33 ± 16.89 years. The group included 20.71% (N = 524) respondents with a mild, 41.58% (N = 1052) with a moderate, and 26.54% (N = 671) with a severe disability. The proportion of Internet users was 37.07% (N = 937). In all the regression models, Internet use had a significant impact on the dependent variables. After adjustment for sociodemographic variables and the degree of disability, the Internet users more frequently assessed their lives as happy (odds ratio, 95% confidence interval: 1.86, 1.47–2.37) and less frequently experienced loneliness (0.63, 0.49–0.81) or suicidal thoughts (0.47, 0.35–0.65). In addition, they needed psychological help less frequently (0.50, 0.35–0.72). Interestingly, Internet users undertook some form of physical activity or sport more often (2.41, 1.87–3.13) and fewer smoked cigarettes (0.70, 0.54–0.91) or consumed alcohol excessively (0.32, 0.19–0.56). Conclusions: The use of the Internet by people with disabilities was associated with improved wellbeing, better mental health and more beneficial health behaviours. These findings support the development of intensive actions to reduce the digital divide for the population of people with disabilities.

Risk of childhood psychiatric disorders in children of refugee parents with post-traumatic stress disorder: a nationwide, register-based, cohort study

Children of refugees are often exposed to the consequences of parental post-traumatic stress disorder (PTSD), potentially leaving them vulnerable to intergenerational transmission of psychopathology. The present study aimed to determine whether parental PTSD is associated with childhood psychiatric morbidity among children of refugees. This study is a two-generation nationwide cohort study using the Danish Immigration Services database. We followed up children younger than 18 years with at least one refugee parent until psychiatric contact, end of the study, their 18th birthday, emigration, or death. We excluded children if their parents were diagnosed only with psychiatric diagnoses other than PTSD or if they had received a psychiatric contact before parental PTSD diagnosis. Information on parental PTSD and offspring psychiatric morbidity was obtained from the Danish Psychiatric Central Research Register. We used Cox proportional hazards regression models to assess the risk of psychiatric contacts among children of refugees with PTSD compared with children of refugees with no psychiatric diagnosis. Between Jan 1, 1995, and Dec 31, 2015, 102 010 refugees obtained residency permission in Denmark and 62 239 biological children of refugees were born in Denmark before Dec 31, 2015. 51 793 were eligible and included in the study (median follow-up 7·15 years [IQR 3·37-11·78]); of these, 1307 (2·5%) children had a psychiatric contact. 7486 (14·5%) children of refugees were exposed to parental PTSD. Parental PTSD significantly increased the risk of psychiatric contact in offspring (hazard ratio 1·49 [95% CI 1·17-1·89] for paternal PTSD, p=0·0011; 1·55 [1·20-2·01] for maternal PTSD, p=0·00084) after adjustment for sociodemographic variables. Children of refugees exposed to parental PTSD are at increased risk of psychiatric morbidity. Targeted screening and interventions are necessary to prevent psychiatric morbidity and ensure access to adequate care. Section for Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital Hvidovre.

Higher adiponectin concentrations are associated with reduced metabolic syndrome risk independently of weight status in Brazilian adolescents

ObjectiveTo evaluate the association between adiponectin concentrations and metabolic syndrome (MetS) risk and to investigate if this association is independent of weight status in adolescents.MethodsAdiponectin concentrations and MetS risk were assessed in 4546 Brazilian adolescents (12–17 years old) enrolled in The Study of Cardiovascular Risks in Adolescents (“ERICA”), a cross-sectional multicenter study in Brazil. For analyses, adiponectin was categorized in sex and age-specific quartiles and MetS risk was expressed as a continuous score, calculated as the average of the standardized values (z-score) of the five MetS components. Multiple linear regression models were used to investigate the association between the quartiles of adiponectin and MetS risk.ResultsAdiponectin was inversely associated with waist circumference and log-transformed triglycerides, and positively associated with HDL-c. We also observed an inverse association between adiponectin concentrations and MetS risk. After adjustment for sociodemographic variables, physical activity, skipping breakfast and body mass index (BMI), higher quartiles of adiponectin remained inversely associated with waist circumference and MetS risk. A direct association between adiponectin and HDL-c was also observed. In further analysis, the sample was stratified by weight status and an inverse association between quartiles of adiponectin and MetS risk was observed in both normal weight and overweight/obese adolescents.ConclusionHigher adiponectin concentrations were independently and inverse associated with MetS risk in Brazilian adolescents, even after adjusting for BMI. These results were similar in normal weight and overweight/obese adolescents, suggesting that adiponectin may play a role in early development of MetS.

The Relationship Between Serum 25-Hydroxyvitamin D Levels and Physical Performance in Community-Dwelling Older Adults.

BackgroundVitamin D deficiency is a risk factor for musculoskeletal health in older adults. While many studies have explored the relationship between vitamin D deficiency and fractures, few have examined the relationship between vitamin D and physical performance. We, therefore, sought to evaluate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and physical performance in community-dwelling older adults.MethodsA single-center, cross-sectional study was performed using data collected from 132 individuals aged 60 years or older who were living independently and who participated in the National Health Insurance Service health check-up between May and December 2016. Physical performance was assessed using a short physical performance battery (SPPB). Linear regression was used to examine the association between 25(OH)D levels and physical performance after adjustment for sociodemographic variables, behavioral characteristics, and body mass index.ResultsApproximately 36.5% of male and 50.7% of females had vitamin D levels indicative of deficiency (serum 25(OH)D <20.0 ng/mL). 25(OH)D levels were significantly associated with the chair stand SPPB scores in male and females but not with those of the walking and balance tests. After adjustment for potential confounders, there remained a linear association between 25(OH)D levels and the chair stand test for both sexes.ConclusionLower serum 25(OH)D levels were associated with poor physical performance (chair stand score) among community-dwelling older adults in Korea. Further prospective studies are needed to verify these results.

Associations between psychological factors and accelerometer-measured physical activity in urban Asian adults.

Examine the association between psychological variables and accelerometer-measured moderate-to-vigorous physical activity (MVPA) in urban Asians. A population-based cross-sectional study was conducted in Singapore. Participants wore an accelerometer for 7days to measure physical activity (PA). Demographic, anthropometric and psychological data were also collected. Psychological variables included PA guideline knowledge, motivational profile for PA self-regulation (5 subscales), perceived barriers to PA (4 subscales) and perceived social support for PA. Regression models with adjustment for socio-demographic variables were fitted. External regulation (b = - 13.03, 95% CI - 34.55; - 1.50) and perceived daily life barriers (b = - 12.63, 95% CI - 24.95; - 0.32) were significantly associated with fewer weekly MVPA minutes. A significant interaction between perceived social support and age (p = 0.046) was found. Social support was significantly negative associated with MVPA minutes in younger (< 28years), but not in older participants. Considering levels of self-determination to engage in PA and perceived daily life barriers may be important for planning PA interventions in urban Asian populations. Caution is required when promoting social support for PA as it was associated with lower MVPA in younger people.

Sociodemographic Pattern of Physical Activity in the Northwest of Iran: Results of the Pilot Phase of the Azar Cohort Study.

Background:Sedentary lifestyle plays a key role in the emergence of many noncommunicable diseases. Given the importance of physical activity (PA) in population-based studies, the present study was conducted to investigate the pattern of PA and its correlates in the pilot phase of Azar cohort study.Methods:In the pilot phase of Azar cohort study, 1236 individuals aged 35–70 years in Khameneh, a city in East Azarbaijan, Iran, were invited to participate in the study. A total of 952 individuals completed the overall and the PA questionnaire, a response rate of 82%. The PA level was evaluated using the classified PA questionnaire based on the equivalent metabolic activities. The general linear model was used to determine the factors affecting PA.Results:The overall mean score of PA was 36.54 (standard deviation = 5.3). In multivariate analysis, after adjustment for sociodemographic variables, total PA score was associated with gender (adjusted β = 0.014, confidence interval [CI] 95% = [0.01–0.82]), occupation (adjusted βs ranged over 0.015–0.059, (CI 95% = 0.01–0.079), level of education (adjusted βs ranged over 0.010–0.018, CI 95% = 0.001–0.026). In other word, sex (mean ranged over 35.49–36.81), educational level (mean ranged over 35.01–36.73) and occupation status (mean ranged over 34.62–39.62) were predictors of PA (all P < 0.05). This variable could also predict 20% of the variance of the PA.Conclusions:The current study identifies that gender, occupation and level of education could be factors that influence on PA level in the study population.

Tobacco Smoking and Psychotic-Like Experiences in a General Population Sample.

Recent findings suggest an association between tobacco and psychosis, but whether this association is mediated by confounding factors is unknown. Psychosis-like experiences (PLEs) are a subclinical expression of psychosis. To disentangle the association of tobacco with PLEs, we examined data from a large US population-based, nationally representative sample. Analysis was conducted on Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (N = 34,653 adults, conducted from 2004 to 2005). Participants were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV. Twenty-two PLEs previously described as observed indicators of psychosis were used. Participants were stratified according to their smoking status (never/former/current) for 5 different types of tobacco. There was a significant association (ie, with 95% CIs for which the lower value was ≥ 1) between smoking status and 14 of the 22 assessed PLEs. These associations remained significant after adjustment for sociodemographic variables (including urbanicity or ethnicity), lifetime drug use disorder, and past-year cannabis use. While 26.33% of nonsmokers reported at least 1 PLE, this prevalence was slightly higher in former smokers (27.48%) and rose as high as 39.09% in current smokers (for current smokers vs lifetime abstainers, adjusted OR = 1.33; 95% CI, 1.23-1.45). All 22 PLEs had higher prevalence in smokers than in former smokers or lifetime abstainers. A total of 8.56% of smokers reported at least 5 PLEs, compared to 3.42% in lifetime abstainers (aOR = 1.56; 95% CI, 1.32-1.84). In a large population-based, nationally representative sample, smoking status was associated with various PLEs. This association was not explained only by other known risk factors of PLEs or schizophrenia. There is a need to identify the potential neurobiological mechanisms by which smoking and PLEs are associated, for patients and from a public health perspective.

Associations of social support and alexithymia with psychological distress in Finnish young adults.

The positive influence of social support on psychological wellbeing is well documented but the research among young adults is scarce. Additionally, it is still unclear what type of social support explains the positive influence in this age group. Alexithymia has been linked to lacking social support and higher levels of psychological distress, but the underlying mechanisms are not well known. We aimed to assess the association of social support and alexithymia with psychological distress in a sample of young adults. The non-clinical sample comprised 316 young Finnish adults (mean age 23 years). Psychological distress was assessed using the 12-item General Health Questionnaire (GHQ-12), alexithymia was measured with the Toronto Alexithymia Scale (TAS-20) and social support with the Multidimensional Scale of Perceived Social Support (MSPSS). The associations were assessed using regression analyses. The TAS-20 (p = 0.002) and MSPSS (p = < 0.001) total scores were significantly associated with the GHQ-12 scores even after adjustment for sociodemographic variables. For the model with the TAS-20 and MSPSS subscales, the Difficulty Identifying Feelings subscale score of the TAS-20 scale (p < 0.001) and the Family subscale score of the MSPSS scale (p = 0.010) were significantly associated with the GHQ-12 scores. Our results show that low social support and high levels of alexithymia are associated with increased psychological distress both in females and males. Perceived social support from family explained the association between social support and psychological distress to a significant extent. Regarding alexithymia, the association with psychological distress was mainly related to difficulties identifying feelings.

Dairy products and obesity: pro and contra, Russian experience

The aim of the work was to study the association of overweight and obesity with the consumption of basic types of dairy products among the adult population of Russia. Data from the survey of the diet of adult members of 45,000 households, conducted in 2013 by the Federal Service of State Statistics in all regions of the country, have been used. The actual consumption of food among all members of the surveyed households was studied by 24-hour (daily) diet recall in April and September 2013. The body mass index was calculated on the basis of self-esteem by respondents of body weight and height. It was shown that average daily intake of kefir, yogurt and cottage cheese was higher in women, while consumption of drinking milk and cheeses was higher for men. Consumption of drinking milk and kefir in men and women was much higher in groups with overweight and obesity than with normal body weight. Consumption of yogurt, on the contrary, was much less in people of both sexes with overweight and obesity. Consumption of milk, kefir and cottage cheese increased with age, while consumption of yogurt and cheeses, on the contrary, decreased with age. The data of the variation statistics indicated the existence of a relationship between obesity and consumption of individual dairy products. However, the dependence of these same parameters on age reduced the reliability and evidentiary strength of the results of the variation analysis, since the prevalence of obesity increases significantly with age. To study the association of dairy consumption and the spread of obesity, a logistic regression model was used with the calculation of the odd ratio of the risk of obesity in the consumption of dairy products with adjustment for age, education level and per capita family income. The results of the association analysis, with adjustment for socio-demographic variables, unambiguously showed a significant reduction in the risk of obesity in persons of both sexes consuming yoghurt (OR mean 0.76; CI 0.71; 0.82; р<0.001), cottage cheese (OR mean 0.88; CI 0.85; 0.91; р<0.001), as well as in women with consumption of drinking milk (OR mean 0.87; CI 0.84; 0.91; р<0.001). The increase in the risk of obesity was observed only in men with consuming kefir (OR mean 1.08; CI 1.01; 1.16; р=0.023) or hard cheeses (OR mean 1.14; CI 1.08; 1.20; р<0.001) with adjustment for socio-demographic variables.

Gout prevalence and predictors of urate-lowering therapy use: results from a population-based study

BackgroundGout has an increasing global prevalence. Underutilization of urate-lowering therapy (ULT) is thought to be common, via both suboptimal dosing and poor medication adherence. The aims of this study were to determine the prevalence of self-reported gout and the key predictors of ULT use in those with gout in a representative population survey in South Australia.MethodsData were obtained from the Spring 2015 South Australian Health Omnibus Survey, a multilevel, systematic, survey in a representative population sample involving face-to-face interviews (n = 3005). This study analyzed responses from respondents aged ≥ 25 years (n = 2531) about self-reported gout, ULT use, sociodemographic factors, lifestyle factors, and comorbidities, using survey weighting. Univariate and subsequent adjusted logistic regression analyses on self-reported gout were performed. ULT use was divided into three categories (never use, prior use, and current use) and these data were analyzed using a multinomial logistic regression model.ResultsSelf-reported gout prevalence was 6.8% (95% CI 5.8, 7.9). The mean age of respondents with gout was 64 years (standard deviation 16) and 82% were male. As expected, older age, male gender, lower socioeconomic status (SES), and higher body mass index (BMI) were associated with gout, as were high alcohol consumption, current smoking, other forms of arthritis, and hypertension or hypercholesterolemia medication, after adjustment for sociodemographic variables. Two thirds of respondents with gout reported ULT use (36% current; 29% previous) with only 55% continuing treatment. Predictors of ULT use included male gender, low SES, and concomitant cholesterol-lowering therapy. Respondents with gout with a higher BMI were more likely to remain on ULT.ConclusionsDespite gout being a common, potentially disabling joint disease, only 55% of respondents with gout in this study adhered to ULT. Identification of key predictors of ULT use will provide guidance on prescribing strategy in clinical practice and on the quality of gout care in the community.

Religiousness is associated with lower levels of anxiety, but not depression, in medical and nursing students.

To evaluate the association between religious and spiritual beliefs, anxiety and depression in medical and nursing students. A cross-sectional study was carried out with medical and nursing students from a Brazilian university. Students were randomly selected and filled out a questionnaire that contained sociodemographic, religious (Duke Religion Index), spirituality (Self-spirituality rating scale) and mental health - depression and anxiety (Hospital Anxiety and Depression Scale) data. Linear regression models were used to evaluate the association of R/E with mental health, with adjustments for sociodemographic variables. A total of 187 students (90.7%) were included in the study, 56.1% female, an average of 23 years old, and 69% were enrolled in the medical program. Of the students, 29.4% attended religious services once a week or more often, 10.7% had private religious activities once a day or more often, and the indexes of intrinsic religiosity and spirituality were moderate. In the linear regression, adjusted for sociodemographic variables, the religious attendance was the only factor associated with lower levels of anxiety (Beta: -0.178, p=0.026). The other dimensions of religiousness or spirituality were not associated with levels of anxiety and depression. The present study showed that only the religious attendance was associated with the mental health of the medical and nursing students. These results demonstrate that some students use religious support in an attempt to minimize the negative effects of their university life. This support seems to be more effective when it involves participation in religious social activities in relation to private activities.