Cross-sectional General Population Survey Research Articles

Prevalence, risks factors, and control of hypertension in Guinean older adults in 2021: a cross-sectional survey

BackgroundThe incidence of arterial hypertension increases with the aging of the population, but its magnitude remains insufficiently assessed. The aim of this study was to investigate the prevalence of hypertension and associated factors in elderly people in Guinea.MethodsData were obtained from a cross-sectional general population survey, conducted among people aged ≥ 60 years. A stratified enumeration area random sample survey was conducted in the four natural regions of Guinea from February to April 2021. This study included an interview on sociodemographic data, and a clinical examination. Hypertension was defined as systolic blood pressure ≥ 140mmHg and/or diastolic blood pressure ≥ 90mmHg or previous diagnosis of hypertension (with or without antihypertensive medication). Hypertension control was defined as blood pressure below 140/90 mmHg during treatment. Age-standardized prevalence was calculated, and logistic regression was used to examine factors associated with hypertension.ResultsA total of 1698 adults (1079 men, mean age: 71.6 ± 9.4 years) had at least two blood pressure measurements. The standardized prevalence of hypertension was 61.4% [95% CI: 61.3–61.6], ranging from 52% in Middle Guinea to 67% in Upper Guinea, and was higher in women (65.2%: 65.0-65.4) than in men (59.1%:58.9–59.3). Among those with hypertension, 46.7% were unaware of their condition before the survey and 49.6% were on treatment and only 18.5% had controlled hypertension. Whatever the residence (rural or urban), increasing age, being unmarried, working as a trader or functionary, jobless, living in upper Guinea, low monthly income, intake of extra salt, known diabetic, overweight, and obesity increased the risk of hypertension. In urban area, female sex (AOR: 1.14: 1.12–1.17), living in lower Guinea (AOR: 3.08: 2.97–3.20), being Maninka (AOR: 1.26: 1.21–1.31), being Nguerze (AOR: 1.71: 1.63–1.81) increased the risk of hypertension, but living in forest Guinea (AOR: 0.88: 0.83–0.93), being Soussou (AOR: 0.88: 0.85–0.92) decreased the risk. In rural area, living in forest Guinea (AOR: 2.14: 2.03–2.26), being Soussou (AOR: 1.14: 1.12–1.17) increased the risk of hypertension, but female sex (AOR: 0.96: 0.94–0.98), living in lower Guinea (AOR: 0.87: 0.85–0.89), being Maninka (AOR: 0.94: 0.92–0.97), being Nguerze (AOR: 0.50: 0.47–0.52) decreased the risk.ConclusionHypertension is a major problem in the elderly population in Guinea, and the level of treatment and control in elderly with known hypertension is inadequate. The place of hypertension among cardiovascular diseases and the identification of associated factors underlines the need to develop innovative approaches to control this major risk factor.

The Relationship between Alcohol Drinking Indicators and Self-Rated Mental Health (SRMH): Standardized European Alcohol Survey (SEAS)

Given that the self-perception of mental health is an important predictor of health outcomes and wellbeing, it is important to identify the indicators of mental health associated with alcohol consumption in order to reduce alcohol-related harms. This study used data from the cross-sectional RARHA SEAS survey (2015) in the Croatian general population, aged 18–64 years (n = 1500). Several aspects of drinking behaviors and alcohol-related harms were measured, as well as personal and sociodemographic factors. Logistic regression found a significant association between alcohol’s harm to others (AHTO) and poor self-rated mental health (SRMH) (OR = 0.752; 95% CI 0.601–0.941) in the total sample, as well as in the group of participants who rarely drank alcohol (OR = 0.504; 95% CI 0.322–0.787) in the last 12 months. More frequent consumers reported poor SRMH if they had at least one harmful effect from drinking (OR 0.538; 95% CI 0.295–0.980). Younger age, higher education, professional activity, and living with someone else in a household contributed to better SRMH. AHTO has been identified as a strong predictor of poor SRMH in the general population. Targeted public health and preventive measures are needed with specific approaches for different types of alcohol consumers.

Conducting General Social Surveys as Self-Administered Mixed-Mode Surveys

AbstractThis article discusses the current challenges of conducting a General Social Survey (GSS) in face-to-face mode and evaluates the alternative of fielding these surveys in self-administered mixed-mode (web, mail) instead. Based on data from Germany, it first illustrates the stark decline of participation in face-to-face surveys since 2002 and reports a strong increase in the cost of conducting these surveys over the same period. It then discusses the possibility of implementing GSS-type surveys in a self-administered design and reports results from a mode experiment implemented in the German part of the European Values Study (EVS) 2017/18. The results of the experiment indicate that self-administered mixed-mode surveys are a viable alternative for cross-sectional general population surveys in Germany; they shorten the fieldwork period and lead to higher response rates, while being more cost-efficient than face-to-face surveys. Despite the finding that the sample composition deviates from the general population in both modes, the face-to-face mode represents the population slightly better.

Elaborating the association of age at first drink with risky drinking: results from a cross-sectional survey

Objective An association between early drinking onset and subsequent heavy drinking has been established, but interpretation is problematic: is the onset of drinking or of intoxication important; is early onset a marker for vulnerability or a causal risk factor; what role does recall bias play? We (1) compare the associations of onset indicators with subsequent risky drinking, (2) assess whether drinking onset has a stronger association with subsequent risky drinking than relative onset (deviation from cohort’s median), and (3) study recall bias by examining within-cohort temporal changes in reported ages of drinking onset. Method The Finnish Drinking Habits Survey, a cross-sectional general population survey of 15–79-year-old Finns collected in 2016. Additionally, the four previous survey waves from 1984 to 2008 were used. Risky drinking was defined using the Alcohol Use Disorders Identification Test (AUDIT), and the age of first drink (AFD) and of intoxication (AFI) were obtained by retrospective recall. Results All three indicators showed statistically significant associations with AUDIT, but AFI had the strongest association. Absolute age of onset had a slightly stronger association with AUDIT than relative age of onset. Recall bias of AFD was found for each birth cohort, as the reported AFD within each cohort increased over time. Conclusions Onset of intoxication has stronger association with risky drinking than the onset of drinking. No gain was seen in measuring relative rather than absolute age of onset, which suggests that age of onset is not merely a marker of vulnerability to risky drinking.

Why and when do citizens support populist right-wing social movements? Development and test of an integrative theoretical model

ABSTRACT What are the microlevel mechanisms that explain citizens’ support of populist social movements? We address this question by focusing on the ‘PEGIDA’ (Patriotic Europeans against the Islamization of the Occident) protest groups in Germany, which became particularly prominent by attracting large numbers of attendees in street protests during the years 2015/16. We develop and test an integrative theoretical model that points to the key roles of anti-immigrant attitudes and political dissatisfaction as mediators linking subjective socioeconomic deprivation with citizens’ support of the ‘Pegida’-movement. Equally important, this model holds that citizens’ political dissatisfaction moderates the nexus between anti-immigrant attitudes and support for ‘Pegida’. The results based on data from seven cross-sectional general population surveys provide clear support for these predictions. Combined, these efforts help to advance scholarly understanding of not only why, but also how and under what conditions non-activist citizens support anti-immigrant collective action as exemplified by the ‘Pegida’ movement.

Police Violence among Adults Diagnosed with Mental Disorders.

Police violence is reportedly common among those diagnosed with mental disorders characterized by the presence of psychotic symptoms or pronounced emotional lability. Despite the perception that people with mental illness are disproportionately mistreated by the police, there is relatively little empirical research on this topic. A cross-sectional general population survey was administered online in 2017 to 1,000 adults in two eastern U.S. cities to examine the relationship between police violence exposure, mental disorders, and crime involvement. Results from hierarchical logistic regression and mediation analyses revealed that a range of mental health conditions are broadly associated with elevated risk for police violence exposure. Individuals with severe mental illness are more likely than the general population to be physically victimized by police, regardless of their involvement in criminal activities. Most of the excess risk of police violence exposure related to common psychiatric diagnoses was explained by confounding factors including crime involvement. However, crime involvement may necessitate more police contact, but does not necessarily justify victimization or excessive force (particularly sexual and psychological violence). Findings support the need for adequate training for police officers on how to safely interact with people with mental health conditions, particularly severe mental illness.

Alcohol Use and Harm to Children by Parents and Other Adults.

This study used mixed methods to examine parent-reported harm to children (lack of supervision or physical harm) due to alcohol use by themselves or someone else as well as parent beliefs about alcohol, parenting, and harms to children. We conducted a cross-sectional general population survey of 1,599 parents who were primary caregivers to a child aged 10 or younger and follow-up interviews with 23 parents who responded "yes" to one of the questions about alcohol use causing harm their child. Survey data were analyzed using multilevel logistic models. Compared to abstainers, parents who drank at least once a year were less likely to report that someone else's drinking caused a lack of supervision or physical harm to their child. Higher continued volumes of drinking were related to fewer reports of not watching a child closely enough. Social companionship support (having people to go out with) was related to greater odds that a parent's drinking would cause physical harm to his or her child(ren). In the qualitative analysis, four relevant themes emerged: perceived effects of alcohol use, tangible support and child supervision, immediate and distal harm, and turning points in drinking behaviors.

Association of Cohort and Individual Substance Use With Risk of Transitioning to Drug Use, Drug Use Disorder, and Remission From Disorder

Limited empirical research has examined the extent to which cohort-level prevalence of substance use is associated with the onset of drug use and transitioning into greater involvement with drug use. To use cross-national data to examine time-space variation in cohort-level drug use to assess its associations with onset and transitions across stages of drug use, abuse, dependence, and remission. The World Health Organization World Mental Health Surveys carried out cross-sectional general population surveys in 25 countries using a consistent research protocol and assessment instrument. Adults from representative household samples were interviewed face-to-face in the community in relation to drug use disorders. The surveys were conducted between 2001 and 2015. Data analysis was performed from July 2017 to July 2018. Data on timing of onset of lifetime drug use, DSM-IV drug use disorders, and remission from these disorders was assessed using the Composite International Diagnostic Interview. Associations of cohort-level alcohol prevalence and drug use prevalence were examined as factors associated with these transitions. Among the 90 027 respondents (48.1% [SE, 0.2%] men; mean [SE] age, 42.1 [0.1] years), 1 in 4 (24.8% [SE, 0.2%]) reported either illicit drug use or extramedical use of prescription drugs at some point in their lifetime, but with substantial time-space variation in this prevalence. Among users, 9.1% (SE, 0.2%) met lifetime criteria for abuse, and 5.0% (SE, 0.2%) met criteria for dependence. Individuals who used 2 or more drugs had an increased risk of both abuse (odds ratio, 5.17 [95% CI, 4.66-5.73]; P < .001) and dependence (odds ratio, 5.99 [95% CI, 5.02-7.16]; P < .001) and reduced probability of remission from abuse (odds ratio, 0.86 [95% CI, 0.76-0.98]; P = .02). Birth cohort prevalence of drug use was also significantly associated with both initiation and illicit drug use transitions; for example, after controlling for individuals' experience of substance use and demographics, for each additional 10% of an individual's cohort using alcohol, a person's odds of initiating drug use increased by 28% (odds ratio, 1.28 [95% CI, 1.26-1.31]). Each 10% increase in a cohort's use of drug increased individual risk by 12% (1.12 [95% CI, 1.11-1.14]). Birth cohort substance use is associated with drug use involvement beyond the outcomes of individual histories of alcohol and other drug use. This has important implications for understanding pathways into and out of problematic drug use.

Gender differences in psychiatric and medical comorbidity with post-traumatic stress disorder

BackgroundPost-traumatic stress disorder (PTSD) is associated with significant personal and societal burden. The present study examines the gender-specific differences in this burden in terms of the co-occurrence of psychiatric disorders and medical conditions with PTSD in the general population of France. MethodsThe study is based on a cross-sectional general population survey of 21,879 adults. Trained interviewers used a computer-assisted telephone interviewing system to administer the Composite International Diagnostic Interview-Short Form to screen for psychiatric disorders and medical conditions in the previous 12 months. ResultsOne third of those with moderately severe PTSD (35.3%) and half of those with severe PTSD (54.2%) suffered from comorbid depression. The prevalence of anxiety disorders and substance use disorders was also greater among severe cases of PTSD. Chronic back or neck problems, frequent or severe headaches, arthritis or rheumatism and hypertension were highly prevalent among adults with PTSD. Adjusting for gender, age, education, employment and marital status, moderately severe and severe PTSD diagnoses were associated with significantly greater odds of comorbid psychiatric disorders and medical conditions. With few exceptions, the pattern of gender differences in psychiatric and medical morbidity among those with moderate or severe PTSD were similar to differences observed among those without PTSD. ConclusionsThe findings highlight the burden of co-occurring psychiatric and medical conditions among PTSD sufferers in France and suggest the need for careful consideration of comorbidity in the assessment and service planning for PTSD.

Attitudes towards bystander cardiopulmonary resuscitation: Results from a cross-sectional general population survey.

Survival from out-of-hospital cardiac arrest (OHCA) varies across the developed world. Although not all OHCA are recoverable, the survival rate in Scotland is lower than in comparable countries, with higher average survival rates of 7.9% in England and 9% across Europe. The purpose of this paper is to explore the barriers, facilitators and public attitudes to administering bystander cardiopulmonary resuscitation (CPR) which could inform future policy and initiatives to improve the rate of bystander CPR. Data was collected via a cross-sectional general population survey of 1027 adults in Scotland. 52% of respondents had been trained in CPR. Of those who were not trained, two fifths (42%) expressed a willingness to receive CPR training. Fewer than half (49%) felt confident administering CPR, rising to 82% if they were talked through it by a call handler. Multivariate analyses identified that people in social grade C2DE were less likely than those in social grade ABC1 to be CPR trained and less confident to administer CPR if talked through by a call handler. The older a person was, the less likely they were to be CPR trained, show willingness to be CPR trained or be confident to administer bystander CPR with or without instruction from an emergency call handler. These findings are particularly relevant considering that most OHCA happen in the homes of older people. In a developed country such as Scotland with widely available CPR training, only half of the adult population reported feeling confident about administering bystander CPR. Further efforts tailored specifically for people who are older, unemployed and have a lower social grade are required to increase knowledge, confidence and uptake of training in bystander CPR.

A study in the general population about sadness to disentangle the continuum from well-being to depressive disorders

ObjectiveSadness is both a common experience in general population and one of the main criteria of major depressive disorder (MDD). We tested the hypothesis of a depressive continuum using sadness as an intermediate experience between well-being and disorder. MethodsA French cross-sectional Mental Health survey in General Population interviewed 38,694 individuals. We examined prevalences and compared sociodemographic correlates and psychiatric disorders of individuals in 3 independent groups 1) MDD, 2) sadness without MDD, and 3) controls. ResultsThe prevalence of sadness was of 29.8% in the whole sample and of 93% in subjects suffering from MDD (n = 4976). The “sadness” group shared the same sociodemographic patterns as the “MDD” group. All psychiatric disorders assessed (i.e. bipolar disorder, anxiety disorder, alcohol use disorder, psychotic disorder and suicide attempts) were significantly associated with both “sadness” and “MDD” groups compared to “controls”. Individuals with sadness, compared to those with MDD, were significantly less likely to meet the criteria for all psychiatric disorders. MDD's sensitivity of sadness was 94,2%. LimitationsEven though we used a quota sampling method, the sample was not strictly representative of the general population. ConclusionSadness validates the depressive continuum hypothesis, since it is more frequent in the general population than MDD itself and at the same time shares with MDD the same sociodemographic and clinical correlates. A gradual association from controls to MDD was observed for psychiatric comorbidities. Finally, the high sensitivity of sadness may suggest its use to screen at-risk individuals converting from well-being to full psychiatric disorders.

Differential Associations Between Excess Body Weight and Psychiatric Disorders in Men and Women

The current investigation is the first large-scale population-based study from France that documents the association between excess body weight and common psychiatric disorders, and examines the influence of gender on the association between excess body weight and these disorders. A recent plan has been implemented in France to treat the rising rate of those who are overweight or obese, and we seek to demonstrate whether integrated treatment of excess weight and psychiatric conditions appears as indicated. Data were drawn from a cross-sectional general population survey of 17,237 adults. Past-year psychiatric disorders were assessed using the Composite International Diagnostic Interview-Short Form. Body mass index was used to determine excess weight status. Overall, 3.7% of the sample were underweight, 57% were normal weight, 28% were overweight (35% of men, 22% of women), and 11% were obese (11% of men, 11% of women). Being overweight was more common in men than women, although obesity did not differ by gender. Sociodemographic variables significantly associated with weight status included, age, marital status, education, employment status, income level, and population density. Adjusting for these variables, being overweight was associated with major depression and other disorders among women and inversely associated with drug abuse and dependence among men. Obesity was associated with major depression, panic disorder, agoraphobia, social phobia, specific phobia, and obsessive-compulsive disorder among women. Only generalized anxiety was associated with obesity among men. Past year, mental disorders were more likely associated with being overweight or obese among women as compared with men. The prevalence of these co-occurring psychiatric disorders in the context of the rising rate of obesity in France indicates a clear need for psychiatric assessment and treatment in caring for those with excess weight, especially women. Preliminary reports suggest this need is unmet within the otherwise progressive move in France to assist those struggling with excess weight.

Cross-sectional Comparison of the Epidemiology of DSM-5 Generalized Anxiety Disorder Across the Globe

Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-5. To provide the first epidemiologic data on DSM-5 GAD and explore cross-national differences in its prevalence, course, correlates, and impact. Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016. The Composite International Diagnostic Interview was used to assess GAD along with comorbid disorders, role impairment, and help seeking. Respondents were 147 261 adults aged 18 to 99 years. The surveys had a weighted mean response rate of 69.5%. Across surveys, DSM-5 GAD had a combined lifetime prevalence (SE) of 3.7% (0.1%), 12-month prevalence of 1.8% (0.1%), and 30-day prevalence of 0.8% (0). Prevalence estimates varied widely across countries, with lifetime prevalence highest in high-income countries (5.0% [0.1%]), lower in middle-income countries (2.8% [0.1%]), and lowest in low-income countries (1.6% [0.1%]). Generalized anxiety disorder typically begins in adulthood and persists over time, although onset is later and clinical course is more persistent in lower-income countries. Lifetime comorbidity is high (81.9% [0.7%]), particularly with mood (63.0% [0.9%]) and other anxiety (51.7% [0.9%]) disorders. Severe role impairment is common across life domains (50.6% [1.2%]), particularly in high-income countries. Treatment is sought by approximately half of affected individuals (49.2% [1.2%]), especially those with severe role impairment (59.4% [1.8%]) or comorbid disorders (55.8% [1.4%]) and those living in high-income countries (59.0% [1.3%]). The findings of this study show that DSM-5 GAD is more prevalent than DSM-IV GAD and is associated with substantial role impairment. The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries. These results underscore the public health significance of GAD across the globe while uncovering cross-national differences in prevalence, course, and impairment that require further investigation.

Socioeconomic Correlates of Eating Disorder Symptoms in an Australian Population-Based Sample

BackgroundRecent research has challenged the stereotype that eating disorders are largely limited to young, White, upper-class females. This study investigated the association between indicators of socioeconomic status and eating disorder features.Methods and FindingsData were merged from cross-sectional general population surveys of adults in South Australia in 2008 (n = 3034) and 2009 (n = 3007) to give a total sample of 6041 participants. Multivariate logistic regressions were employed to test associations between indicators of socioeconomic status (household income, educational level, employment status, indigenous status and urbanicity) and current eating disorder features (objective binge eating, subjective binge eating, purging, strict dieting and overvaluation of weight/shape). Eating disorder features occurred at similar rates across all levels of income, education, indigenous status, and urbanicity (p > 0.05). However, compared to working full-time, not working due to disability was associated with an increased risk of objective binge eating (odds ratio (OR) = 2.30, p < 0.01) and purging (OR = 4.13, p < 0.05), engagement in home-duties with an increased risk of overvaluation of weight/shape (OR = 1.39, p < 0.05), and unemployment with an increased risk of objective binge eating (OR = 2.02, p < 0.05) and subjective binge eating (OR = 2.80, p < 0.05). Furthermore, participants with a trade or certificate qualification were at a significantly increased risk of reporting strict dieting compared to participants without a tertiary qualification (OR = 1.58, p <0.01). Limitations included the small numbers of indigenous participants (n = 115) and participants who reported purging (n = 54), exclusion of excessive exercise (which is associated with eating disorders, particularly in males), and the conduct of interviews by laypersons.ConclusionsOverall, symptoms of eating disorders are distributed equally across levels of socioeconomic status. This study highlights the need for universal access to specialised services, to train healthcare workers in the detection and diagnosis of eating disorders in diverse subgroups, and to combat barriers to help-seeking experienced by people who do not conform to the demographic stereotype of an eating disorder. The increased prevalence of various eating disorder features in those who are not working could be addressed by providing support to help sufferers join the workforce, or engage in meaningful social or community activities to improve resilience against the development of eating disorders.

Policy-Relevant Behaviors Predict Heavier Drinking in Both On and Off Premises and Mediate the Relationship Between Heavier Alcohol Consumption and Age, Gender, and Socioeconomic Status-Analysis from the International Alcohol Control Study.

Our goal was to investigate the role of behaviors amenable to policy change in mediating the relationship between alcohol consumption in off and on premises, age, and 2 measures of socioeconomic status (education and income). A cross-sectional general population survey was analyzed by using Bayesian path analysis to understand direct and mediating pathways. A total of 1,900 drinkers (past 6 months), aged 18 to 65 years, living in households with landline phones participated in the study. Measures were as follows: typical quantities of alcohol consumed per occasion, frequency of drinking, both off and on premise; gender, age groups; and years of education, personal income, prices paid, time of purchase, and liking for alcohol advertisements. Later times of purchase predicted larger quantities consumed (on and off premise) and more frequent drinking (on premise only). Younger people and males purchased later, and this mediated their heavier consumption. Lower prices paid predicted larger quantities consumed (on premise) and higher frequency of drinking (off premise). Younger and male respondents paid lower prices, and this mediated larger quantities consumed on premise and more frequent drinking off premise. Less well educated paid lower prices, and this mediated drinking more frequently off premise among this group. Liking for alcohol ads predicted drinking larger quantities and higher frequency both off and on premise. Younger and male respondents reported greater liking for ads, and this mediated their consumption of larger quantities and more frequent drinking both on and off premise. Those with higher income drank larger amounts on premise and more frequently on and off, but there were no mediating effects from the policy-relevant variables. Heavier drinking patterns by young people and those less well educated could be ameliorated by attention to alcohol policy.

P126 Breathlessness And Lung Function Predicts Future Work Disability In Older Workers: Detection, Intervention, Retention?

Economic pressures and the ageing population have increased the importance of maintaining fitness to work in older adults. Dyspnoea and airflow limitation are associated with disability particularly in individuals with diagnosed disease. A cross-sectional general population survey of 51–60 year olds demonstrated significant associations between breathlessness, airflow obstruction and work performance; a follow-up survey was completed 18 months later to examine changes in work. Participants from the first study were sent a postal questionnaire asking about job and employment changes. Questionnaire and spirometry results from the initial study were used to define breathlessness (modified MRC scale) and airflow obstruction (GOLD stage) respectively. Information from the follow up questionnaire was also used to identify cases, defined as those who had experienced a change in employment, and frequency matched controls of the same gender, who reported no change in work circumstances (with a ratio of two controls per case). Results from respondents to the follow up questionnaire (1663/1773 (94%)), all of whom had been in full time work at the time of the first study) showed that the majority (78.5%) continued in full time employment; however 10.6% were working part time and 10.9% were no longer in paid employment at follow up. Of the participants still in employment who reported changing their hours or activity at work, 9.3% stated that this change had been to their health. Prevalence of economic inactivity rose with increasing breathlessness and with increasing airflow obstruction in workers of both sexes; these relationships were statistically significant in all cases except for airflow obstruction in women (Figure). The odds of GOLD stage 1 or greater airflow obstruction was significantly higher in cases than in controls (unadjusted OR 1.71, 95% CI 1.10–2.77, p = 0.02). These findings suggest that breathlessness and airflow obstruction are associated with subsequent job instability and premature loss from the workforce in older workers. A focused surveillance programme could identify those at higher risk of employment problems with the intention of ameliorating them – providing that there are suitable interventions available to support continuing workforce activity in adults in their sixth decade of life and beyond.

The changing demographic profile of eating disorder behaviors in the community.

BackgroundThe perception that eating disorders occur predominantly in young white upper-class women has been challenged. This study examined temporal differences to the demographic correlates of eating disorder behaviors over a 10-year period.MethodsData from cross-sectional general population surveys in 1998 (n = 3010) and 2008 (n = 3034) were collected on demographics (sex, age, income, residency), current eating disorder behaviors (binge eating, extreme dieting, purging), and health-related quality of life (SF-36).ResultsBelow-median annual household income was associated with increased prevalence rates from 1998 to 2008 in binge eating, extreme dieting, and purging. Male sex was associated with increased prevalence rates in extreme dieting and purging. Age over 45 years was associated with increased prevalence rates in purging. In 2008 versus 1998, binge eating was associated with greater mental health-related quality of life impairment in males but not females; and greater physical health-related quality of life impairment in regional but not metropolitan areas. Extreme dieting was also associated with greater physical health-related quality of life impairment in 2008 versus 1998 in the lower but not the higher socioeconomic sector.ConclusionsFindings suggest the ‘democratization’ of disordered eating, with greatest levels of associated impairment being within marginalized demographic sectors. Implications include the need for broader intervention programs and recruitment of demographically representative samples in eating disorder research.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-943) contains supplementary material, which is available to authorized users.

Mental health and alcohol use: a cross-sectional study of the Finnish general population.

The connections between alcohol use, mental health problems and mental well-being have been under-researched. We examined the links between different aspects of alcohol use and positive and negative aspects of mental health, and the effect of protective social factors on these links. A cross-sectional general population survey of Finns aged 15-69 years was carried out in 2008 (n = 2725, response rate 74%). The included aspects of alcohol use were the frequency and volume of drinking, binge drinking and hazardous drinking using Alcohol Use Disorders Identification Test (AUDIT). The included aspects of mental health were subjective well-being (life satisfaction), self-efficacy (sense of mastery) and psychological distress using the General Health Questionnaire. The protective social factors examined were social support (loneliness, having a confidant) and socioeconomic status. Binge drinking and, particularly, hazardous drinking were associated with different aspects of mental health. The proportion of respondents with poor mental well-being increased when binge drinking was more frequent than monthly, and when respondents scored ≥6 on the AUDIT scale. Abstainers reported poor sense of mastery and former drinkers additionally reported poor satisfaction with life. Frequency and volume of drinking did not have a consistent connection with mental health. These associations between alcohol use and mental health did not depend on the protective social factors. Frequent binge drinking and alcohol problems are associated with poor mental health, especially with a lack of life satisfaction and psychological distress. This result applies equally to lower and higher social status groups.

Availability and use of home blood pressure measurement in the Czech general population

BackgroundHome blood pressure monitoring (HBPM) is recommended for hypertensive patients as a tool to improve both blood pressure (BP) control and compliance with treatment. MethodsWe evaluated the use of HBPM in hypertensive subjects examined during a cross-sectional general population survey (Czech post-MONICA). Models predicting the availability and use of HBPM were constructed using univariate and multivariate logistic regression. ResultsOf 449 treated hypertensive patients (mean age 63.2 years, 52.1% women), 250 (55.7%) reported that they had a device for BP monitoring available at home. The factors associated with HBPM availability were older age, university education, marital status, longer duration of hypertension and nonsmoking. Of the 250 subjects with HBPM available, 40% used HBPM regularly (at least once a week), and this ratio increased with the number of antihypertensive drugs taken (monotherapy 30%, dual combination 43%, combination of ≥3 drugs 48%; ptrend=0.028). BP control was similar in those using HBPM regularly and those who used HBPM irregularly or did not use it at all (54.5 vs. 49.7%; p=0.52). ConclusionHBPM is available to more than a half of treated hypertensive patients from the general population. However, only minority of the patients perform home blood pressure measurement regularly.

Connaissance et perception du risque dû au radon en France

PurposeRadon exposure is a major environmental risk in health. It remains badly known by the general population. It is the second cause of lung cancer, after tobacco smoking. The aim of this cross-sectional general population survey was to describe radon exposure risk knowledge and the socioeconomic factors related to this knowledge. Materials and methodsThe Cancer Barometer survey 2010 questioned the French population about its knowledge of radon as such and as health risk factor. This survey was a two-stage random sampling with computer-assisted telephone interview that was performed from April 3, 2010 to August 7, 2010 on a sample of 3,359 people aged 15 to 75 years old. ResultsAmong people aged 15 to 75 years old, only one in five knows that radon is a natural gas coming from the ground. This knowledge is more frequent among people living in an area that is directly concerned by radon, among men and increases with age, with the level of education and the level of income. Radon risk remains still widely underestimated by the general public, including in areas concerned by this risk. When people were confronted with radon exposure, few intended to remedy by improving their home. ConclusionThe success of prevention initiatives implies the support and the collaboration of various national and local actors. To improve their impact for the prevention of lung cancers, it could be more effective to couple these actions with prevention messages on tobacco.