National Probability Sample Survey Research Articles

Violence against older people and associations with mental health: A national probability sample survey of the general population in England

BackgroundOfficial estimates of violence prevalence in England exclude older people. There are few studies of elder abuse and these excluded violence from acquaintances and strangers and lack comparability with younger adults. ObjectivesTo estimate prevalence of past-year violence victimisation in older people, identify factors associated with violence in older age, quantify the extent to which experience of violence in older people was associated with common mental disorder (CMD). Study design/methodsAnalysis of a 2014 general population probability sample survey of 2570 adults aged 60+ and 4484 16–59 year olds. Modified version of the Conflict Tactics Scale measured domestic violence and List of Threatening Experiences captured bullying and serious assault. CMD were assessed using the revised Clinical Interview Schedule. Associations were examined using regression models adjusted for childhood victimisation and other adversities. Results2.0 % (n = 52,CI:1.4–2.6) of older people experienced violence in the past year, with intimate partner violence the most prevalent form. Older people of non-white ethnicity, those who were socially isolated or lonely, and the formerly married were more likely to experience violence. Violence was associated with CMD in older people (adjusted odds ratio 2.2, CI:1.0–4.8), controlling for impairments, adversities and other factors. ConclusionViolence, especially from an intimate partner, is evident in later life and strongly associated with poor mental health. Better instruments for the identification of violence and abuse in older people in research and safe enquiry in practice settings are needed, with recognition of and attention to ethnic and other inequalities among older people in exposure.

National Trends in Mental Health–Related Emergency Department Visits Among Youth, 2011-2020

There has been increasing concern about the burden of mental health problems among youth, especially since the COVID-19 pandemic. Trends in mental health-related emergency department (ED) visits are an important indicator of unmet outpatient mental health needs. To estimate annual trends in mental health-related ED visits among US children, adolescents, and young adults between 2011 and 2020. Data from 2011 to 2020 in the National Hospital Ambulatory Medical Care Survey, an annual cross-sectional national probability sample survey of EDs, was used to examine mental health-related visits for youths aged 6 to 24 years (unweighted = 49 515). Mental health-related ED visits included visits associated with psychiatric or substance use disorders and were identified by International Classification of Diseases-Ninth Revision, Clinical Modification (ICD-9-CM; 2011-2015) and ICD-10-CM (2016-2020) discharge diagnosis codes or by reason-for-visit (RFV) codes. We estimated the annual proportion of mental health-related pediatric ED visits from 2011 to 2020. Subgroup analyses were performed by demographics and broad psychiatric diagnoses. Multivariable-adjusted logistic regression analyses estimated factors independently associated with mental health-related ED visits controlling for period effects. From 2011 to 2020, the weighted number of pediatric mental health-related visits increased from 4.8 million (7.7% of all pediatric ED visits) to 7.5 million (13.1% of all ED visits) with an average annual percent change of 8.0% (95% CI, 6.1%-10.1%; P < .001). Significant linearly increasing trends were seen among children, adolescents, and young adults, with the greatest increase among adolescents and across sex and race and ethnicity. While all types of mental health-related visits significantly increased, suicide-related visits demonstrated the greatest increase from 0.9% to 4.2% of all pediatric ED visits (average annual percent change, 23.1% [95% CI, 19.0%-27.5%]; P < .001). Over the last 10 years, the proportion of pediatric ED visits for mental health reasons has approximately doubled, including a 5-fold increase in suicide-related visits. These findings underscore an urgent need to improve crisis and emergency mental health service capacity for young people, especially for children experiencing suicidal symptoms.

The European Union Statistics on Income and Living Conditions after 15 Years

AbstractThis data brief describes the European Union Statistics on Income and Living Conditions (EU-SILC). Detailed data on income and taxes are collected, as well as information on material deprivation, labour, housing, childcare, health, access to and use of services, and education. Although primarily a social policy instrument that addresses the information needs of policymakers and is used for social monitoring at the European level, EU-SILC is also closely geared to the needs of researchers and provides an excellent database for evidence-based research on a wide variety of aspects of income, income poverty, material poverty, health, and well-being in Europe. EU-SILC is composed of national probability sample surveys and is conducted annually. The target population comprises private households. Observation units are households and all current household members. EU-SILC provides cross-sectional and longitudinal data. The data are composed of a fixed core module, and annually changing ad-hoc modules. Launched in 2003 and revised with effect from 2021, EU-SILC is currently implemented in all EU Member States and in 11 non-EU countries. During the revision process, many suggestions from the research community were incorporated.

How does the sexual, physical and mental health of young adults not in education, employment or training (NEET) compare to workers and students?

BackgroundSyndemic theory highlights the potential for health problems to interact synergistically, compounding impact. Young adults not in education, employment or training (NEET) are more likely to experience disadvantage and poorer general health outcomes. However, there is little research on their sexual health, or the extent to which this clusters with mental and physical health outcomes.MethodsAnalysis of data from 16 to 24 year olds (1729 men, 2140 women) interviewed 2010–12 for Britain’s third National Survey of Sexual Attitudes and Lifestyles. Natsal-3 is a national probability sample survey using computer-assisted personal interviewing with computer-assisted self-interviewing. Participants were classified as workers, students or NEET. We used multivariable logistic regression to examine associations between being NEET (relative to worker or student) and risk behaviours and outcomes in physical, sexual and mental health domains. We then examined how risk behaviours and poor health outcomes cluster within and across domains.Results15% men and 20% women were NEET; 36% men and 32% women were workers; and 49% men and 48% women were students. Young people who were NEET were more likely to report smoking and drug use (men) than other young people. There were few differences in sexual health, although NEETs were more likely to report condomless sex, and NEET women, unplanned pregnancy (past year). Risk behaviours clustered more within and across domains for NEET men. Among NEET women, poor health outcomes clustered across mental, physical and sexual health domains.ConclusionsHarmful health behaviours (men) and poor health outcomes (women) clustered more in those who are NEET. This points to a possible syndemic effect of NEET status on general ill health, especially for women. Our paper is novel in highlighting that elevated risk pertains to sexual as well as mental and physical health.

Highlighting Similarities between Political Parties Reduced Perceived Disagreement on Global Warming

ABSTRACT This paper explores how an alternative media narrative of general partisan agreement can spill over onto individuals’ perceptions of how much partisan groups agree on specific issues. Consistent with the idea that a media narrative emphasizing partisan differences leads individuals to hold inaccurate views of what partisans think, recent national probability sample surveys showed that Americans inaccurately perceived that most Democrats and most Republicans held opposing beliefs about whether global warming has been occurring when, in fact, the majorities of both parties agree that the world is warming. To determine if an alternative narrative can rectify this misperception, experiments that exposed some participants to a message highlighting areas in which Democrats and Republicans agree were embedded in a series of non-probability sample surveys (Study 1, N =1,000; Study 2, N = 3,007). Study 1 demonstrates that this alternative narrative, compared to a narrative highlighting disagreement, leads people to perceive more Republicans to think that the world has been warming and, in turn, a decreased partisan gap on the issue. Study 2 replicates these findings and provides evidence that respondents enter the study already exposed to a narrative emphasizing disagreement. Mediation analyses of both studies suggest that the alternative narrative can indirectly lead Republican respondents to express the belief that global warming exists via updating their perceptions of what co-partisans think. Thus, a narrative emphasizing the ways in which partisans agree rather than disagree can help address the misperception that Republicans and Democrats hold opposing beliefs on global warming.

Problem gambling and suicidality in England: secondary analysis of a representative cross-sectional survey

ObjectivesProblem gamblers in treatment are known to be at high risk for suicidality, but few studies have examined if this is evident in community samples. Evidence is mixed on the extent to which an association between problem gambling and suicidality may be explained by psychiatric comorbidity. We tested whether they are associated after adjustment for co-occurring mental disorders and other factors. Study designSecondary analysis of the Adult Psychiatric Morbidity Survey 2007, a cross-sectional national probability sample survey of 7403 adults living in households in England. MethodsRates of suicidality in problem gamblers and the rest of the population were compared. A series of logistic regression models assessed the impact of adjustment on the relationship between problem gambling and suicidality. ResultsPast year suicidality was reported in 19.2% of problem gamblers, compared with 4.4% in the rest of the population. Their unadjusted odds ratios (OR) of suicidality were 5.3 times higher. Odds attenuated but remained significant when depression and anxiety disorders, substance dependences, attention-deficit/hyperactivity disorder, and other factors were accounted for (adjusted OR = 2.9, 95% confidence interval = 1. 1, 8.1 P = 0.023). ConclusionsProblem gamblers are a high-risk group for suicidality. This should be recognised in individual suicide prevention plans and local and national suicide prevention strategies. While some of this relationship is explained by other factors, a significant and substantial association between problem gambling and suicidality remains.

Suicidal behavior among substance users: data from the Second Brazilian National Alcohol and Drug Survey (II BNADS)

Objective:To investigate the prevalence rates of suicidal ideation (SI) and suicide attempts (SA) and their association with substance use in a nationally representative sample of Brazilians.Methods:The Second Brazilian National Alcohol and Drug Survey (II BNADS) is a household cross-sectional survey that investigated the consumption of psychotropic drugs and associated risk factors. This national probability sample survey used a multistage cluster design to select 4,607 participants aged 14 or older and had a total response rate of 77%. Illegal drug use, SI and SA were obtained by confidential self-report assessment.Results:SI and SA were reported by 9.9 and 5.4% of the sample, respectively. This prevalence was 20.8 and 12.4% among individuals with alcohol use disorders (AUD), 31.5 and 16.5% among cannabis users and 40.0 and 20.8% among cocaine users. After adjusting for demographic characteristics, tobacco use, family history of suicide and depression, both SI and SA were positively associated with AUD, cannabis and cocaine use.Conclusion:AUD, cannabis and cocaine use were significantly associated with SI and SA, even after the adjustments. Public health initiatives targeting suicide prevention should consider including assessment and management of substance misuse, and therapeutic approaches to substance misuse should include assessment of suicidality.

Placing sexually transmitted infection surveillance data in perspective by using national probability sample surveys.

Many European countries do not have comprehensive sexually transmitted infection (STI) surveillance in place. The objective was to investigate whether national probability sample surveys are useful in placing STI surveillance into perspective. We used data from the Dutch national cross-sectional probability sample survey on sexual health 2016 (18-34-year-old sexually active individuals). Descriptive analyses were performed regarding STI testing (last year). Test numbers were extrapolated from the survey and compared with surveillance data from sexual health centres (SHCs) (complete) and general practitioners (GPs) (representative estimates from 7% of all GPs). Statistical differences in characteristics between SHC attendees and general population (according to weighted survey participants) were determined using χ2 statistic. Predictors of recent testing at GPs or SHCs were determined using multinomial multivariable logistic regression. Of the 17 222 survey invitees, 3217 (19%) were eligible for analyses. Testing uptake was higher in women (17.2%, 14.8-20.0%) than men (11.5%, 9.1-14.3%). The majority of tests were conducted by GPs followed by SHCs and hospitals. Number of tests extrapolated from the survey was similar to SHC surveillance data, but higher than GP surveillance data (women only). Testing at SHCs was associated with high-risk behaviour and with living in highly urbanized areas. Low education level and older age were, next to high-risk behaviour factors, determinants of testing at GPs. National probability sample surveys are useful for placing STI surveillance data into perspective by providing insights in testing patterns in the general population and identifying strengths and weaknesses of national surveillance systems.

The 5-HTTLPR rs25531 LALA-genotype increases the risk of insomnia symptoms among shift workers

BackgroundPrevious studies indicate that shift work tolerance may be associated with individual factors including genetic variability in the gene encoding the serotonin transporter 5-HTT (SLC6A4). The present study aimed to explore the interaction between work schedule (shift work versus non-shift work), genetic variability in SLC6A4 and insomnia symptoms. MethodsThe study was based on a national probability sample survey of 987 Norwegian employees drawn from The Norwegian Central Employee Register by Statistics Norway. Insomnia symptoms were assessed by three items reflecting problems with sleep onset, sleep maintenance, and early morning awakenings. Genotyping concerning SLC6A4 (the 5-HTTLPR S versus L and the SNP rs25531 A versus G) was carried out using a combination of gel-electrophoresis and TaqMan assay. ResultsUsing the LALA genotype as a reference a main effect of the SS genotype (B = 0.179; 95% CI = 0.027–0.330) was found. In addition, a main effect of work schedule (0 = non shift, 1 = shift work) was found (B = 0.504; 95% CI = 0.185–0.823). The genotype x work schedule interaction was significant for all genotypes; SLA (B = −0.590; 95% CI = −0.954–0.216), LALG (B = −0.879; 95% CI = −1.342–0.415), SLG (B = −0.705; 95% CI = −1.293–0.117) and SS (B = −0.773; 95% CI = −1.177–0.369) indicating higher insomnia symptom scores among LALA-participants compared to participants with other genotypes when working shifts. ConclusionsThe ability to cope with shift work is associated with the combination of the SLC6A4 variants 5-HTTLPR and SNP rs25531. Our findings demonstrated that the LALA-genotype increases the risk of insomnia symptoms among shift workers.

National prevalence estimates of chlamydia and gonorrhoea in the Netherlands

ObjectivesNational prevalence estimates of Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhoea) are important for providing insights in the occurrence and control of these STIs. The aim was to obtain national...

Trends in atrial fibrillation hospitalizations in the United States: A report using data from the National Hospital Discharge Survey

AimsAtrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice. Patients presenting with AF are often admitted to hospital for rhythm or rate control, symptom management, and/or anticoagulation. We investigated temporal trends in AF hospitalizations in United States from 1996 to 2010. MethodsData were obtained from the National Hospital Discharge Survey (NHDS), a national probability sample survey of discharges conducted annually by National Center for Health Statistics. Because of the survey design, sampling weights were applied to the raw NHDS data to produce national estimates. Hospitalizations with a primary diagnosis of AF were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code of 427.31. Weighted least squares regression was used to test for linear trends in the number of AF admissions, length of stay, and inpatient mortality. We further stratified AF admissions based on patients' age, gender, and race. ResultsAdmissions for a primary diagnosis of AF increased from approximately 286,000 in 1996 to about 410,000 in 2010 with a significant linear trend (β = 9470 additional admissions per year, p < 0.001). The trend of increased AF admissions was uniform across patient sub-groups. Overall, mean length of stay for AF admissions was 3.75 days, and this remained relatively stable over time (β = 0.002 days, p = 0.884). Inpatient mortality was 0.96% and also remained stable over time (β = 0.031%, p = 0.181). ConclusionOur data demonstrate an increase in the number of AF admissions but constant length of stay and mortality over time.

Can psychosocial and socio-demographic questions help identify sexual risk among heterosexually-active women of reproductive age? Evidence from Britain\u2019s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

BackgroundContraceptive advice and supply (CAS) and sexually transmitted infection (STI) testing are increasingly provided in primary care. Most risk assessment tools are based on sexual risk behaviours and socio-demographics, for use online or in specialist services. Combining socio-demographic and psychosocial questions (e.g. religious belief and formative experience) may generate an acceptable tool for targeting women in primary care who would benefit from intervention. We aimed to identify psychosocial and socio-demographic factors associated with reporting key sexual risk behaviours among women in the British general population.MethodsWe undertook complex survey analysis of data from 4911 hetero-sexually active women aged 16–44 years, who participated in Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a national probability sample survey undertaken 2010–2012. We used multivariable regression to examine associations between the available psychosocial and socio-demographic variables in Natsal-3 and reports of three key sexual behaviours: a) 2+ partners in the last year (2PP); b) non-use of condoms with 2+ partners in the last year (2PPNC); c) non-use of condoms at first sex with most recent sexual partner (FSNC). We adjusted for key socio-demographic factors: age, ethnicity and socio-economic status (measured by housing tenure).ResultsWeekly binge drinking (6+ units on one occasion), and first sex before age 16 were each positively associated with all three sexual behaviours after adjustment. Current relationship status, reporting drug use (ever), younger age and living in rented accommodation were also associated with 2+ partners and 2 + partners without condoms after adjustment. Currently being a smoker, older age and respondent ethnicity were associated with FSNC after adjustment for all other variables. Current smoking status, treatment for depression (last year), and living at home with both parents until the age of 14 were each associated with one or more of the behaviours.ConclusionsReported weekly binge drinking, early sexual debut, and age group may help target STI testing and/or CAS among women. Further research is needed to examine the proportion of sexual risk explained by these factors, the acceptability of these questions to women in primary care and the need to customise them for community and other settings.

Trends in hospitalization for congestive heart failure, 1996-2009.

Although heart failure (HF) is a common cause of hospital admissions, few data describe temporal trends in HF hospitalization. We present data on number of HF admissions, length of stay (LOS), and inpatient mortality in the United States, 1996-2009. To assess HF hospitalizations in a national sample of United States population. Data were obtained from the National Hospital Discharge Survey (NHDS), a national probability sample survey of discharges conducted annually by the National Center for Health Statistics. Sampling weights are applied to raw NHDS data to produce national estimates. Hospitalizations with a primary diagnosis of HF were identified using ICD-9-CM codes. We excluded hospitalizations where HF was a secondary diagnosis. Weighted least squares regression was used to test for linear trends in HF hospitalizations. Approximately 15.5 million weighted primary HF hospitalizations were included. The number of total primary HF hospitalizations increased from 1 000 766 in 1996 to about 1 173 832 in 2009 (β = 7371 hospitalizations per year; 95% confidence interval (CI): 552 to 14 190, P = 0.036). Mean LOS per hospitalization decreased from 6.07 days in 1996 to about 5.26 days in 2009 (β = -0.059 days per year; 95% CI: -0.079 to -0.039, P < 0.001). Inpatient mortality rates declined from 4.92% in 1996 to 3.41% in 2009 (β = -0.17% per year; 95% CI: -0.23 to -0.10, P < 0.001). In a nationally representative sample of HF hospitalizations, mean LOS and inpatient mortality rates declined over the past 2 decades. HF management cost is most likely to be reduced by decreasing the number of HF admissions.

Abstract 11225: Trends in Atrial Fibrillation Hospitalizations From 1996 to 2010 Using Data From National Hospital Discharge Survey

Aims: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Patients presenting with AF are often admitted to the hospital for rhythm or rate control, symptom management, and/or anticoagulation. We investigated temporal trends in AF hospitalizations in the United States from 1996 to 2010. Methods: Data were obtained from the National Hospital Discharge Survey (NHDS), a national probability sample survey of discharges conducted annually by the National Center for Health Statistics. Because of the survey design, sampling weights are applied to the raw NHDS data to produce national estimates. Hospitalizations with a primary diagnosis of AF were identified using ICD-9 code. Weighted least squares regression was used to test for linear trends in the number of AF admissions, length of stay, and inpatient mortality. Results: AF admissions increased from approximately 286,000 in 1996 to about 410,000 in 2010 with a significant linear trend (β=9460 additional admissions per year, p&lt;0.001). Overall, mean length of stay for AF admissions was 3.75 days, and this remained relatively stable over time (β=0.002 days, p=0.884; see Figure). Inpatient mortality was 0.96% and also remained stable over time (β=0.031%, p=0.181; see Figure). Conclusion: Our data demonstrate an increase in the number of AF admissions but constant length of stay and mortality over time. Opportunities to decrease the cost of inpatient AF management should therefore target reducing both the number of admissions as well as the length of stay.

Abstract 11158: Trends in Heart Failure Hospitalizations Using Data From National Hospital Discharge Survey

Aims: Heart failure (HF) is a common cause of hospital admission. However, relatively little data have described temporal trends in HF hospitalization. We present data on the number of HF admissions, length of stay and inpatient mortality from 1996-2010. Methods: Data were obtained from the National Hospital Discharge Survey (NHDS), a national probability sample survey of discharges conducted annually by the National Center for Health Statistics. Because of the survey design, sampling weights are applied to the raw NHDS data to produce national estimates. Hospitalizations with a primary diagnosis of HF were identified using ICD-9 codes. Weighted least squares regression was used to test for linear trends in the number of HF admissions, length of stay, and inpatient mortality. Results: The raw data contained 130,079 HF hospitalizations, translating to an estimated 16.7 million hospitalizations from 1996-2010 after application of sample weights. The total number of hospitalizations increased over time (p=0.05; see Figure); however, mean length of stay per hospitalization declined (p&lt;0.001; see Figure). Inpatient mortality rate has also declined (p&lt;0.001; see Figure). Conclusion: In a nationally representative sample of HF hospitalizations, mean length of stay and inpatient mortality rates have been declining over the past two decades. These trends reflect improvement in HF management over time, and have important implications in the cost of managing HF patients.

Urgent Care Needs Among Nonurgent Visits to the Emergency Department.

Urgent Care Needs Among Nonurgent Visits to the Emergency Department.

The consequences of parental labor migration in China for children's emotional wellbeing

Using data from the 2010 wave of the China Family Panel Studies (CFPS), we study the effects of internal migration in China on the emotional wellbeing of children age 10–15. The 2010 CFPS, a national probability sample survey of the Chinese population, includes 3464 children within this age range. We compare five groups: rural children with local registration living with both parents; urban children with local registration living with both parents; children accompanying their migrant parent(s), children left behind with one parent when the other parent goes out to work; and children left behind or sent to live with others when both parents go out to work. We expect the last three groups to be at risk of increased emotional difficulties compared to children living with both parents. We test these expectations using both conventional regression models and community fixed-effects models. The evidence supporting our expectations is very weak and inconsistent, leading us to conclude that in the Chinese context family arrangements have little impact on the emotional wellbeing of children. We conclude by offering some conjectures as to why this is so.

ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration--2014.

The results of the 2014 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are described. A stratified random sample of pharmacy directors at 1435 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 29.7%. Ninety-seven percent of hospitals used automated dispensing cabinets in their medication distribution systems, 65.7% of which used individually secured lidded pockets as the predominant configuration. Overall, 44.8% of hospitals used some form of machine-readable coding to verify doses before dispensing in the pharmacy. Overall, 65% of hospital pharmacy departments reported having a cleanroom compliant with United States Pharmacopeia chapter 797. Pharmacists reviewed and approved all medication orders before the first dose was administered, either onsite or by remote order view, except in procedure areas and emergency situations, in 81.2% of hospitals. Adoption rates of electronic health information have rapidly increased, with the widespread use of electronic health records, computer prescriber order entry, barcodes, and smart pumps. Overall, 31.4% of hospitals had pharmacists practicing in ambulatory or primary care clinics. Transitions-of-care services offered by the pharmacy department have generally increased since 2012. Discharge prescription services increased from 11.8% of hospitals in 2012 to 21.5% in 2014. Approximately 15% of hospitals outsourced pharmacy management operations to a contract pharmacy services provider, an increase from 8% in 2011. Health-system pharmacists continue to have a positive impact on improving healthcare through programs that improve the efficiency, safety, and clinical outcomes of medication use in health systems.

Male Circumcision and STI Acquisition in Britain: Evidence from a National Probability Sample Survey.

BackgroundIt is well-established that male circumcision reduces acquisition of HIV, herpes simplex virus 2, chancroid, and syphilis. However, the effect on the acquisition of non-ulcerative sexually transmitted infections (STIs) remains unclear. We examined the relationship between circumcision and biological measures of three STIs: human papillomavirus (HPV), Chlamydia trachomatis and Mycoplasma genitalium.MethodsA probability sample survey of 15,162 men and women aged 16-74 years (including 4,060 men aged 16-44 years) was carried out in Britain between 2010 and 2012. Participants completed a computer-assisted personal interview, including a computer-assisted self-interview, which asked about experience of STI diagnoses, and circumcision. Additionally, 1,850 urine samples from sexually-experienced men aged 16-44 years were collected and tested for STIs. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR) to quantify associations between circumcision and i) self-reporting any STI diagnosis and ii) presence of STIs in urine, in men aged 16-44 years, adjusting for key socio-demographic and sexual behavioural factors.ResultsThe prevalence of circumcision in sexually-experienced men aged 16-44 years was 17.4% (95%CI 16.0-19.0). There was no association between circumcision and reporting any previous STI diagnoses, and specifically previous chlamydia or genital warts. However, circumcised men were less likely to have any HPV type (AOR 0.26, 95% confidence interval (CI) 0.13-0.50) including high-risk HPV types (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and/or 68) (AOR 0.14, 95% CI 0.05-0.40) detected in urine.ConclusionsCircumcised men had reduced odds of HPV detection in urine. These findings have implications for improving the precision of models of STI transmission in populations with different circumcision prevalence and in designing interventions to reduce STI acquisition.

Living Arrangements of the Elderly in China and Consequences for Their Emotional Well-being

:We study the living arrangements and consequences for emotional well-being of the elderly in China using data from a national probability sample survey conducted in 2010, part of the China Family Panel Studies: 14,960 households were included and information was collected for each family member. We study 7,015 people in the sample age sixty and older. We find that, compared to living independently with one’s spouse, elderly respondents living with grown children are less happy, have less life satisfaction, and are more depressed, especially when the spouse is not sharing the household. The negative effects largely disappear when there also are grandchildren in the household although widows and widowers remain more prone to depression. Elderly people living in “generation-skipping” families suffer the same fate as living with adult children but no grandchildren—they are less happy and more depressed and, when not sharing responsibilities with a spouse, less satisfied with life than independent elderly couples. Finally, living alone or living with other relatives results in a significant degradation of emotional health. But the very small fraction of elderly respondents living with non-relatives enjoys the greatest happiness and the least depression.