Health Study Questionnaire Research Articles

Association between maximal oxygen consumption and physical activity and sedentary lifestyle in metabolic syndrome. Usefulness of questionnaires.

To analyze whether variations in physical activity (PA) and sedentary behaviors are accompanied by differences in maximal oxygen consumption (VO2max). We conducted a prospective cross-sectional study of 243 participants (82 women), aged 65.0±4.9 years old, with metabolic syndrome and overweight/obesity who performed a maximal exercise test with expired gas analysis. PA was evaluated using subjective methods, the REGICOR and RAPA 1 self-reported questionnaires, and objective methods, the chair test and accelerometry. Sedentariness was analyzed with the Nurses' Health Study questionnaire and accelerometry. VO2max was higher in participants who reported they adhered to the recommendations of the PA guidelines in the REGICOR questionnaire (21.3±4.6 vs 18.0±4.4 mL/kg/min; P <.001) and was 18% higher in those who reported more PA in the RAPA 1 questionnaire than the less active group (P <.001). The chair test (> 15 vs ≤ 15 repetitions) also showed significant differences in VO2max (21.2±4.8 vs 18.7±4.5 ml/kg/min; P <.001). Correlations between PA variables and VO2max were significant but low (r: 0.2 to 0.4). Sedentary activities showed less relationship with VO2max. Participants with metabolic syndrome and overweight/obesity who reported adhering to PA recommendations achieved higher VO2max. The self-reported questionnaires and the chair test identified significant variations in VO2max. Sedentary activities do not appear to modify VO2max.

Asociación del consumo máximo de oxígeno con la actividad física y el sedentarismo en el síndrome metabólico. Utilidad de los cuestionarios

Introduction and objectivesTo analyze whether variations in physical activity (PA) and sedentary behaviors are accompanied by differences in maximal oxygen consumption (VO2max). MethodsWe conducted a prospective cross-sectional study of 243 participants (82 women), aged 65.0±4.9 years old, with metabolic syndrome and overweight/obesity who performed a maximal exercise test with expired gas analysis. PA was evaluated using subjective methods, the REGICOR and RAPA 1 self-reported questionnaires, and objective methods, the chair test and accelerometry. Sedentariness was analyzed with the Nurses’ Health Study questionnaire and accelerometry. ResultsVO2max was higher in participants who reported they adhered to the recommendations of the PA guidelines in the REGICOR questionnaire (21.3±4.6 vs 18.0±4.4 mL/kg/min; P <.001) and was 18% higher in those who reported more PA in the RAPA 1 questionnaire than the less active group (P <.001). The chair test (> 15 vs ≤ 15 repetitions) also showed significant differences in VO2max (21.2±4.8 vs 18.7±4.5 ml/Kg/min; P <.001). Correlations between PA variables and VO2max were significant but low (r: 0.2 to 0.4). Sedentary activities showed less relationship with VO2max. ConclusionsParticipants with metabolic syndrome and overweight/obesity who reported adhering to PA recommendations achieved higher VO2max. The self-reported questionnaires and the chair test identified significant variations in VO2max. Sedentary activities do not appear to modify VO2max.Full English text available from:www.revespcardiol.org/en

Assessment of dental health check-ups in Turkey between 0-14 years of age in 2014

Aim: Dental problems in children are important health problems all over the world as well as in our country. In this study, we aimed to determine the status of regular dental health checkups and some sociodemographic characteristics in 0-14 year old children in Turkey Material and Method: The study was conducted using data from the Turkish Statistical Institute Health Study Questionnaire 2014. Within the scope of the study, a total of 6946 individuals between 0-14 years of age were studied. Descriptive statistics were taken first in this study, which was conducted for dental control of children aged 0-6 and 7-14. In the second phase, the differences between age groups according to demographic characteristics of dental health related habits were examined. Results: It has been determined that 82.7% of children at the age group 0-6 and 41.7% of children at the age group 7-14 are not taken to the dental control until this age. The proportion of those who are taken to the dentist for control without complaints increases with age (0-6 years: 9.9%, 7-14 years: 21.9%). In both age groups, the rate of bringing children to the dentist increases by the higher monthly income level. The rate of children, who are taken to the healthy child follow-up, brought back to the dentist for control purposes are also escalating. Conclusion: Children are usually not brought to the dentist for dental control without having dental problems. The proportion of children brought to the dentist for routine control is as low as 1/10 of those who are taken to the dentist at the age group of 0-6. The rate of first-time dentist visit for children is increasing due to economic status of their families and the fact that they are followed up by sound child monitoring.

Romatoid Artrit Hastalarında Hastalık Aktivitesi ile Alerjik Hastalık Sıklığı İlişkisinin Değerlendirilmesi

Objectives: We aimed to assess the relationship between disease activity and frequency of allergic diseases in patients with rheumatoid arthritis who were admitted to a rheumatology outpatient clinic. Materials and methods: Socio-demographic data form and the European Community Respiratory Health Study (ECRHS) questionnaire were applied to the patients and the prevalence of allergic patients by applying ECHRS and the relationship between RA disease activity was assessed. Results: A total of 135 patients were included in the study (108 female and 27 male); average age 53,0 ± 11,1 years. Asthma-like symptoms were observed in 33,33% of women. Asthma-like symptoms in 33,33% of men and 33,33% are non-infectious rhinitis. A statistically significant difference was not found between DAS-28 scores and frequencies of the survey diagnoses (p = 0,75). Conclusion: We could not find a significant correlation between the diagnosis of RA activity score and ECHRS diagnoses in our study. We could not find a study which focused on the relationship between allergic diseases and DAS-28 in RA in the literature. Thus, we believe that these results are noteworthy

Accounting for individualized competing mortality risks in estimating postmenopausal breast cancer risk.

Accurate risk assessment is necessary for decision-making around breast cancer prevention. We aimed to develop a breast cancer prediction model for postmenopausal women that would take into account their individualized competing risk of non-breast cancer death. We included 73,066 women who completed the 2004 Nurses' Health Study (NHS) questionnaire (all≥57years) and followed participants until May 2014. We considered 17 breast cancer risk factors (health behaviors, demographics, family history, reproductive factors) and 7 risk factors for non-breast cancer death (comorbidities, functional dependency) and mammography use. We used competing risk regression to identify factors independently associated with breast cancer. We validated the final model by examining calibration (expected-to-observed ratio of breast cancer incidence, E/O) and discrimination (c-statistic) using 74,887 subjects from the Women's Health Initiative Extension Study (WHI-ES; all were≥55years and followed for 5years). Within 5years, 1.8% of NHS participants were diagnosed with breast cancer (vs. 2.0% in WHI-ES, p=0.02), and 6.6% experienced non-breast cancer death (vs. 5.2% in WHI-ES, p<0.001). Using a model selection procedure which incorporated the Akaike Information Criterion, c-statistic, statistical significance, and clinical judgement, our final model included 9 breast cancer risk factors, 5 comorbidities, functional dependency, and mammography use. The model's c-statistic was 0.61 (95% CI [0.60-0.63]) in NHS and 0.57 (0.55-0.58) in WHI-ES. On average, our model under predicted breast cancer in WHI-ES (E/O 0.92 [0.88-0.97]). We developed a novel prediction model that factors in postmenopausal women's individualized competing risks of non-breast cancer death when estimating breast cancer risk.

Pelvic pain and mode of delivery

We sought to determine the long-term effect of mode of delivery on the prevalence and severity of pelvic pain. Six to eleven years after a first delivery, pelvic pain (dysmenorrhea, dyspareunia, and pelvic pain not related to menses or intercourse) was measured using the Oxfordshire Women's Health Study Questionnaire. Obstetrical exposures were assessed by review of the hospital delivery record. The prevalence of moderate to severe pelvic pain was compared between the 577 women who delivered via cesarean for all births and the 538 who delivered at least 1 child vaginally. Other obstetrical exposures were also studied. Prevalence of pelvic pain was similar between women who delivered vaginally and by cesarean. Among women who delivered vaginally, those who experienced at least 1 forceps delivery and women who delivered at least 1 baby ≥4 kg vaginally reported a higher rate of dyspareunia. Perineal trauma was not associated with dyspareunia. Forceps delivery and a vaginal delivery of a baby ≥4 kg are associated with dyspareunia 6-11 years after vaginal birth. Vaginal birth is not associated with a higher rate of pelvic pain when compared to cesarean delivery.

Use of multivitamins, folic acid and herbal supplements among breast cancer survivors: the black women's health study.

BackgroundComplementary and alternative medicine (CAM) use, including herbals and multivitamin supplements, is quite common in the U.S., and has been shown to be highest in breast cancer survivors. However, limited data are currently available for CAM usage among African Americans. Thus, we sought to determine the prevalence of multivitamins, folic acid and herbal supplement usage in African American breast cancer survivors, and to compare the characteristics of users and nonusers.MethodsA cohort study of breast cancer survivors, who completed the 1999 Black Women's Health Study questionnaire and self-reported having been diagnosed with breast cancer between 1995 and 1999, comprised the study population. In this study, the intake of natural herbs, multivitamins and folic acid at least three days per week within the past two years was used as a proxy for typical usage of this complimentary alternative medicine (CAM) modality.ResultsA total of 998 breast cancer survivors were identified. Overall, 68.2% had used either herbals or multivitamin supplements or both. The three most frequently used herbals were garlic (21.2%), gingko (12.0%), and echinacea (9.4%). The multivariate analysis determined that single marital status (OR = 1.58; 95%CI: 1.04-2.41), and alcohol consumption of 1-3 drinks per week (OR = 1.86, 95%CI: 1.28-2.68) were significantly associated with increased herbal use. Multivitamin use was significantly lower among obese women (OR = 0.66, 95%CI: 0.46-0.94) and current smokers (OR = 0.53, 95%CI: 0.34-0.82).ConclusionsA significant number of African American breast cancer survivors are using herbals and multivitamins as CAM modality. Additional research is needed to understand the impact of herbals and multivitamins in African American breast cancer survivors.

Workplace bullying and subsequent sleep problems – the Helsinki Health Study

The associations between workplace bullying and subsequent sleep problems are poorly understood. This study aims to address this evidence gap. We used the Helsinki Health Study questionnaire survey data at baseline in 2000-2002 and follow-up in 2007 (N=7332). The 4-item Jenkins sleep questionnaire was used in both surveys. Two measures of workplace bullying asked whether the respondent had (i) reported being bullied and (ii) observed bullying. Logistic regression models were fitted, adjusting for age, childhood bullying, education, working conditions, obesity, common mental disorders, limiting long-standing illness, and baseline sleep problems. At baseline, 5% of women and men reported being currently bullied. Additionally, 9% of women and 7% of men had frequently observed bullying at their workplace. Adjusted for age, reporting bullying was associated with sleep problems at follow-up among women [odds ratio (OR) 1.69, 95% confidence interval (95% CI) 1.30-2.20) and men (OR 3.17, 95% CI 1.85-5.43). Also, reporting earlier bullying was associated with sleep problems among both women (OR 1.47, 95% CI 1.26-1.72) and men (OR 1.58, 95% CI 1.06-2.36). Separate adjustments for covariates had some effects on the associations. After full adjustment for childhood bullying and baseline sociodemographic factors, working conditions, health, and sleep problems, the associations reduced. Similarly, adjusted for age, observing bullying was associated with sleep problems among women (OR 2.00, 95% CI 1.61-2.48) and men (OR 2.04, 95% CI 1.23-3.39). Workplace bullying is associated with sleep problems, but associations attenuate after factors related to the social environment, work, and health are simultaneously taken into account.

Abstract B19: Complementary and alternative medicine use among postmenopausal breast cancer survivors: The Black Women's Health Study

Abstract Background: Complementary and alternative medicine (CAM) is widely used among women in the United States. However, there is limited knowledge about the use of CAM modalities in minority women despite the relationship of CAM use to cultural and health beliefs. We defined CAM use as the intake of natural herbs, vitamins and mineral products at least three days per week. The primary objectives of this study were to determine the prevalence of CAM usage in African American breast cancer survivors, and to compare the characteristics of users and nonusers. Design: A cross-sectional study of breast cancer survivors who completed the 1999 Black Women's Health Study questionnaire and reported having been diagnosed with breast cancer by 1999. A total of 436 women were included in the analysis. Results: Overall, 69% of breast cancer survivors compared to 59% noncases used one or more CAM products, including herbs, vitamins and minerals. Among breast cancer survivors the mean age for CAM users was 53.1 years compared to 51.3 years in nonusers. Among breast cancer survivor CAM users, garlic was the most widely used product (20.9%), followed by echinacea (12.6%) and gingko (11.7%). More CAM users chose a multivitamins supplement (53.9%) over a folic acid supplement alone (4.1%). Multivariate analysis determined that age (OR per year of age =1.05; 95% CI:1.02–1.08), and marital status (OR for single relative to married or living as married =0.33; 95% CI:0.15–0.70) were the factors significantly associated with CAM use among breast cancer survivors. Conclusions: CAM use is common in postmenopausal African American breast cancer survivors. Our results are consistent with prevalence rates of 60–70% reported in studies of CAM use by women with breast cancer following diagnosis. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B19.

Folate and Vitamin B6 Intake and Risk of Colon Cancer in Relation to p53 Expression

Considerable evidence suggests that a low-folate diet increases the risk of colorectal cancer, although the results of a recent randomized trial indicate that folate supplementation may not reduce the risk of adenoma recurrence. In laboratory models, folate deficiency appears to induce p53 mutation. We immunohistochemically assayed p53 expression in paraffin-fixed colon cancer specimens in a large prospective cohort of women with 22 years of follow-up to examine the relationship of folate intake and intake of other one-carbon nutrients to risks by tumor p53 expression. A total of 399 incident colon cancers accessible for p53 expression were available. The effect of folate differed significantly according to p53 expression (P(heterogeneity) = .01). Compared with women reporting folate intake <200 microg/day, the multivariate relative risks (RRs) for p53-overexpressing (mutated) cancers were 0.54 (95% confidence interval [CI], 0.36-0.81) for women who consumed 200-299 microg/day, 0.42 (95% CI, 0.24-0.76) for women who consumed 300-399 microg/day, and 0.54 (95% CI, 0.35-0.83) for women who consumed >or=400 microg/day. In contrast, total folate intake had no influence on wild-type tumors (RR, 1.05; 95% CI, 0.73-1.51; comparing >or=400 with <200 microg/day). Similarly, high vitamin B(6) intake conferred a protective effect on p53-overexpressing cancers (top versus bottom quintile: RR, 0.57; 95% CI, 0.35-0.94; P(heterogeneity) = .01) but had no effect on p53 wild-type tumors. We found that low folate and vitamin B(6) intake was associated with an increased risk of p53-overexpressing colon cancers but not wild-type tumors.

Risk Factors and Comorbidities in Primary Biliary Cirrhosis: A Controlled Interview-Based Study of 1032 Patients *

Primary biliary cirrhosis (PBC) is an autoimmune disease of unknown etiology, often associated with other autoimmune conditions. Controlled studies have so far provided conflicting data on risk factors and comorbidity rates in PBC. We enrolled patients with PBC (n = 1032) from 23 tertiary referral centers for liver diseases in the United States and random-digit-dialed controls (n = 1041) matched for sex, age, race, and geographical location. Patients and controls were administered a modified version of the US National Health and Nutrition Examination Study (NHANES III) questionnaire by trained personnel to evaluate associations between PBC and social, demographic, personal and family medical histories, lifestyle, and reproductive factors and the rates of comorbidity in affected individuals. Data indicate that having a first-degree relative with PBC (adjusted odds ratio [AOR] 10.736; 95% confidence interval 4.227-27.268), history of urinary tract infections (AOR 1.511, 95% CI 1.192-1.915), past smoking (AOR 1.569, 95% CI 1.292-1.905), or use of hormone replacement therapies (AOR 1.548, 95% CI 1.273-1.882) were significantly associated with increased risk of PBC. The frequent use of nail polish slightly increased the risk of having PBC. Other autoimmune diseases were found in 32% of cases and 13% of controls (P<0.0001). In conclusion, environmental factors, possibly including infectious agents through urinary tract infections or chemicals contained in cigarette smoke, may induce PBC in genetically susceptible individuals. Exogenous estrogens may also contribute to explain the female predominance of the disease.

Relation between cardiovascular risk factors at adult age, and physical activity during youth and adulthood: the Leuven Longitudinal Study on Lifestyle, Fitness and Health.

This study investigated the relationship between sports participation/physical activity during youth (13 - 18 years of age) and adulthood (30 - 40 years of age), and cardiovascular risk factors (body fat and fat distribution, blood pressure, lipoprotein levels and cardiorespiratory fitness) at 40 years of age. Subjects were 166 Flemish males from "The Leuven Longitudinal Study on Lifestyle, Fitness and Health". Physical activity was assessed by means of a sports participation inventory and the Tecumseh community Health Study Questionnaire. In addition to correlation and multiple stepwise regression analyses, different groups (at risk, not at risk) were contrasted on sports participation/physical activity parameters using ANOVA. Long-term exposure during adulthood to daily physical activity was slightly related to a low/high risk profile for waist circumference, percent body fatness, triglycerides and peak VO(2). Sports participation during adolescence was not related to levels of cardiovascular risk factors at 40 years of age.

Doubly labelled water validation of three physical activity questionnaires.

This study investigated the validity of the Baecke Questionnaire, the Five City Project Questionnaire, and the Tecumseh Community Health Study Questionnaire in 19 Flemish males, using correlation and multiple stepwise regression analyses. The three questionnaires are commonly used physical activity questionnaires in epidemiological studies. The physical activity level (PAL) as measured with the doubly labelled water method was used as the criterion. The Baecke total activity index showed the highest correlation coefficient with PAL (r = 0.69, p < 0.001). Also the sweat index from the Five City Project Questionnaire, and total daily energy expenditure from the Tecumseh Community Health Study Questionnaire showed significant associations with PAL, respectively 0.57 (p < 0.05) and 0.64 (p < 0.01). Multiple stepwise regression analyses supported the findings from the correlation study. The largest individual contribution in PAL was from the activity index (45%) for the Baecke Questionnaire, the sweat index (29%) for the Five City Project Questionnaire, and total daily energy expenditure (38%) for the Tecumseh Community Health Study Questionnaire. In conclusion, the questionnaires, and certainly the Baecke Questionnaire, can provide valid data about physical activity. Therefore they are useful in epidemiological studies.

Nurses' Health Study: Log-Incidence Mathematical Model of Breast Cancer Incidence

In 1983, Pike et al. developed a mathematical model to quantify the effects of reproductive risk factors on the incidence of breast cancer. In 1994, we modified that model to correct some deficiencies in the original model, including a lack of terms for spacing of births and an inability to easily accommodate births after age 40 years. Our extended Pike model, while improving on the original, still has serious disadvantages, such as difficulty in translating model parameters into relative risks (RRs) and an incomplete fit to data that slightly overestimated incidence for premenopausal women with an early age at first birth and that underestimated incidence for post-menopausal women with a late age at first birth. We undertook both the development of a new mathematical model to quantify the effects of reproductive risk factors on breast cancer incidence and validation of the model. A new log-incidence model of breast cancer incidence was developed using nonlinear regression methods, and a study population consisting of 89,132 women in the Nurses' Health Study from which a total of 2249 incident cases of breast cancer were identified. Subjects were followed from the return of the 1976 Nurses' Health Study questionnaire until June 1, 1990, or until the last questionnaire was returned, until the development of any cancer, or until death, yielding 1,148,593 person-years of follow-up. The log-incidence models were fitted using iteratively reweighted least squares analysis. The log-incidence model provided a better fit to that data than the extended Pike model, with parameter estimates interpretable in terms of RRs. This new model can be fitted using standard commercially available statistical software. In the model, younger parous women are generally at slightly higher risk than nulliparous women, which is true for both the observed and expected RRs, and older parous women, aged 55-64 years with an early age at first birth, are at lower risk than nulliparous women,while older women with a late age at first birth are at substantially higher risk than nulliparous women. Log-incidence models, such as this one, provide an efficient framework for modeling the effect of lifestyle risk factors on breast cancer incidence that may be specifically targeted to certain time periods of a woman's reproductive life.

A prospective assessment of moderate alcohol intake and major chronic diseases

In this paper the relation between alcohol intake assessed on the 1980 Nurses' Health Study questionnaire and subsequent risk of major chronic diseases in this cohort of middle-aged is reviewed. An increased risk of breast cancer among women consuming as little as 3 to 9 drinks per weeks is consistent with findings in other prospective studies. This same level of intake is inversely related to coronary heart disease and ischemic stroke; however, the risk of hemorrhagic stroke is increased. Alcohol intake is also inversely related to a risk of gall stones and noninsulin-dependent diabetes mellitus in this cohort.