Number Of Behavioral Risk Factors Research Articles

AWARENESS OF THE POPULATION ABOUT CARDIOVASCULAR FACTORS OF THE DEVELOPMENT OF DISEASES AS A RESULT OF THE APPLICATION OF A POPULATION STRATEGY

At the state level, measures have been carried out in different years to form a sustainable understanding of the importance of health as a personal value by the population. This is due to the global strategic interests of the Russian Federation in preserving and strengthening the health of the population.
 In our study, the awareness of working-age patients of primary health care about the risk factors for the development of cardiovascular diseases and their frequency of occurrence was analyzed, taking into account the standardization of statistical indicators for 5 years (2014-2018) in the office of prevention of hypertension.
 Materials and methods. The study was conducted on the basis of urban clinics of the Krasnoselsky district of St. Petersburg in two stages. At the first stage, a sociological survey was conducted using a specially designed questionnaire. At the second stage, an analysis of 807 cases of patients aged 18 to 65 years in the office of prevention of arterial hypertension was carried out.
 As a result of the sociological survey, respondents among both men and women are well informed about the influence of a number of behavioral risk factors on the occurrence and development of cardiovascular diseases.
 Conclusion. There is a high awareness of risk factors for the development of non-communicable diseases, including cardiovascular diseases, in patients of working age, which is a positive result of the implementation of a population and high-risk strategy.
 But there are significant reserves for improving behavior for those who are ready to change it in favor of choosing a healthy lifestyle.
 Within the framework of primary health care, medical examinations and preventive medical examinations are aimed at increasing the awareness of the population about risk factors for the development of non-communicable, including cardiovascular diseases through medical consultations. The work of Health Centers, prevention offices, Health Schools should be aimed at low-informed patients, examine and determine the functional reserves of their body with the possibility of subsequent correction of the identified disorders.
 In our work, low awareness was noted in 13% of respondents. Low awareness of patients creates a high risk of unfavorable outcomes of diseases. If the patient understands the essence of his illness and the importance of following the doctor’s recommendations, then the situation may change for the better.

Behavioural risk factors and healthy life expectancy: evidence from two longitudinal studies of ageing in England and the US

We examined whether the co-occurrence of four behavioural risk factors (alcohol consumption, smoking, physical inactivity and obesity) is associated with disability-free and chronic disease-free life expectancy similarly in two longitudinal studies of ageing in England and the United States. Data were from 17,351 individuals aged 50+ from the US Health and Retirement Study (HRS) and, 10,388 from the English Longitudinal Study of Ageing (ELSA), from 2002 to 2013. Disability-free life expectancy was estimated using repeat measures of limitations with instrumental activities and activities of daily living and, chronic disease-free life expectancy was based on chronic health conditions. Multistate life table models were used to estimate sex-specific health expectancy at the ages of 50, 60 and 70. In both countries and at all ages, there was a clear gradient towards shorter health expectancy with increasing number of behavioural risk factors. Compared to people with 2+ behavioural risk factors, in both countries, those with no behavioural risk factors could expect to live up to 11 years longer without disability and, up to 12 years longer without chronic conditions. Individual and co-occurring behavioural risk factors were strongly associated with shorter healthy life expectancy in both countries, attesting to the robustness of the contribution of lifestyle factors on health expectancy.

Clustering of cardiovascular behavioral risk factors and blood pressure among people diagnosed with hypertension: a nationally representative survey in China.

This study aimed to examine association between the number of behavioral risk factors and blood pressure (BP) level among a nationally representative sample of Chinese people diagnosed with hypertension. A total of 31,694 respondents aged 18+ years with diagnosed hypertension were extracted from the 2013–2014 China Chronic Disease and Risk Factor Surveillance. BP of each respondent was classified into six levels according to criteria in 2007 Guidelines for the Management of Arterial Hypertension. Information for smoking, alcohol drinking, fruit and vegetables consumption, physical inactivity, and overweight and obesity were obtained. The average number of risk factors was determined by BP level to explore potential risk factor clustering. Ten generalized proportional odds models were used to examine association between clustering of behavioral risk factors and BP level. A clear gradient between the number of behavioral risk factors and BP level was observed for men and women (P < 0.05 for both genders). BP level for men and women was much likely to upgrade as number of risk factors accumulated (P < 0.01 for 10 models). Behavioral modifications may decrease BP, and combinations of two or more behavioral interventions could potentially result in even better BP management among people diagnosed with hypertension.

Adolescent social isolation does not lead to persistent increases in anxiety- like behavior or ethanol intake in female long-evans rats.

Clinically, early life stress and anxiety disorders are associated with increased vulnerability for alcohol use disorders. In male rats, early life stress, imparted by adolescent social isolation, results in long-lasting increases in a number of behavioral risk factors for alcoholism, including greater anxiety-like behaviors and ethanol (EtOH) intake. Several recent studies have begun to use this model to gain insight into the relationships among anxiety measures, stress, EtOH intake, and neurobiological correlates driving these behaviors. As prior research has noted significant sex differences in the impact of adolescent stress on anxiety measures and EtOH drinking, the current study was conducted to determine if this same model produces an "addiction vulnerable" phenotype in female rodents. Female Long Evans rats were socially isolated (SI; 1/cage) or group housed (GH; 4/cage) for 6weeks during adolescence. After this housing manipulation, behavioral assessment was conducted using the elevated plus maze, response to novelty in an open field environment, and the light/dark box. After behavioral testing, home cage EtOH drinking was assessed across an 8-week period. No group differences were detected in any of the behavioral measures of unconditioned anxiety-like behavior. Greater EtOH intake and preference were observed in SI females but these differences did not persist. The SI/GH model, which results in robust and enduring increases in anxiety measures and EtOH self-administration in male Long Evans rats, did not result in similar behavioral changes in female rats. These data, and that of others, suggest that adolescent social isolation is not a useful model with which to study neurobiological substrates linking antecedent anxiety and addiction vulnerability in female rats. Given the compelling epidemiological evidence that the relationship between chronic adolescent stress and alcohol addiction is particularly strong in women, there is clearly an urgent need to identify a more effective model with which to study these clinically important relationships in female rodents.

Discrimination, Affect, and Cancer Risk Factors among African Americans

To examine whether stress or depressive symptoms mediated associations between perceived discrimination and multiple modifiable behavioral risk factors for cancer among 1363 African American adults. Nonparametric bootstrapping procedures, adjusted for sociodemographics, were used to assess mediation. Stress and depressive symptoms each mediated associations between discrimination and current smoking, and discrimination and the total number of behavioral risk factors for cancer. Depressive symptoms also mediated the association between discrimination and overweight/obesity (p values < .05). Discrimination may influence certain behavioral risk factors for cancer through heightened levels of stress and depressive symptoms. Interventions to reduce cancer risk may need to address experiences of discrimination, as well as the stress and depression they engender.

Abstract B40: The mediating role of perceived stress and depression in relations between perceived discrimination and cancer risk behaviors and outcomes among African American adults.

Abstract Background: Several modifiable risk behaviors (smoking, heavy alcohol use, inadequate physical activity, poor diet) and associated outcomes (overweight/obesity) have been causally linked to cancer incidence and related mortality. Research indicates that African Americans suffer disproportionately from the adverse consequences of these risk factors relative to other ethnic groups, even after accounting for differences in risk behavior prevalence. In addition, some studies suggest that African Americans may be more likely than other ethnic groups to engage in multiple risk behaviors. Purpose: A better understanding of factors associated with cancer risk behaviors/outcomes is needed to inform interventions to reduce cancer risk among African Americans. Discrimination has been linked to risk behaviors in the literature, but the mechanisms underlying these associations are not well understood. Because perceived discrimination has been associated with elevated stress and depression, and because stress and depression have been implicated in cancer risk behavior engagement, these psychosocial factors may help to explain relations between discrimination and cancer risk behaviors/outcomes. The current study examined the mediating role of stress and depression in the association between perceived discrimination and smoking status, alcohol use, physical activity, fruit and vegetable consumption, and body mass index, as well as the total number of behavioral risk factors among 1363 African American adults (age=45+13, 75% female). Methods: A nonparametric bootstrapping procedure was used to assess whether stress and/or depression mediated relations of discrimination and behavioral risk factors in single mediator models. All analyses controlled for age, sex, marital status, income, education, and employment status. Analyses involving body mass index were additionally adjusted for physical activity and fruit and vegetable consumption. Results: Associations between discrimination and cancer risk factors were non-significant; however, there were several significant indirect effects. Specifically, discrimination had an indirect effect on smoking (CIs.95= .0012, .0109; .0003, .0096), physical activity (CIs.95= .0007, .0073; .0003, .0065), and number of risk factors (CIs.95= .0008, .0029; .0005, .0024) through stress and depressive symptoms. Greater discrimination was associated with greater stress and depression, which were each associated with a higher likelihood of current smoking, higher odds of low physical activity, and a greater number of behavioral risk factors. Additionally, discrimination had an indirect effect on body mass index (CIs.95= .0015, .0115) through depressive symptoms. Greater discrimination was associated with greater depressive symptoms, which were associated with higher odds of overweight/obesity. No indirect effects emerged for at-risk drinking or fruit and vegetable consumption. Conclusions: Results suggest that perceived discrimination may influence certain behavioral risk factors for cancer through heightened levels of stress and depression. Interventions to reduce cancer risk among African Americans may need to address experiences of discrimination, as well as the stress and depression that these may engender. Citation Format: Adolfo G. Cuevas, Lorraine R. Reitzel, Adams CE Claire, Yumei Cao, Nga NT Nguyen, David W. Wetter, Kellie L. Watkins, Seann D. Regan. The mediating role of perceived stress and depression in relations between perceived discrimination and cancer risk behaviors and outcomes among African American adults. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr B40.

Behavioral risk factors for overweight in early childhood; the ‘Be active, eat right’ study

BackgroundThe lifestyle-related behaviors having breakfast, drinking sweet beverages, playing outside and watching TV have been indicated to have an association with childhood overweight, but research among young children (below 6 years old) is limited. The aim of the present study was to assess the associations between these four behaviors and overweight among young children.MethodsThis cross-sectional study used baseline data on 5-year-old children (n = 7505) collected for the study ‘Be active, eat right’. Age and sex-specific cut-off points for body mass index of the International Obesity Task Force were used to assess overweight/obesity. Multivariable logistic regression analyses were applied.ResultsFor children whom had breakfast <7 days/week and watched TV >2 hours/day, the odds ratio (OR) for having overweight (obesity included) was, respectively, 1.49 (95% confidence interval (CI): 1.13-1.95), and 1.25 (95% CI: 1.03-1.51). There was a positive association between the number of risk behaviors present and the risk for having overweight. For children with 3 or all of the risk behaviors having breakfast <7 days/week, drinking sweet beverages >2 glasses/day, playing outside <1 h/day, watching TV >2 hs/day, the OR for overweight was 1.73 (95% CI: 1.11-2.71) (all models adjusted for children’s sex and sociodemographic characteristics).ConclusionGiven the positive association between the number of behavioral risk factors and overweight, further studies are needed to evaluate the effectiveness of behavioral counseling of parents of toddlers in preventing childhood overweight. In the meantime we recommend physicians to target all four behaviors for counseling during well-child visits.

A study of the prevalence and risk factors leading to HIV infection among a sample of street children and youth of Kathmandu

BackgroundThe true prevalence of HIV and other sexually transmitted diseases among street children in Nepal is virtually unknown while information on related behavioural risk factors in this population is non-existent. The risk of HIV infection among street children and adolescents may be especially high due to their marginalized social and economic conditions. This study was conducted to determine the prevalence of HIV infection among a sample of street children and youth of Kathmandu and to identify risk factors associated with HIV infection in this group.A sample of street children and youth was recruited based on the purposive sampling of ten streets in Kathmandu, Nepal, known to have a high density of street children and youth. A total of 251 street children (aged 11–16 years) and youth (aged 17–24 years) were enrolled, with informed consent, from November, 2008 through June, 2009. Most of the participants (95%) were male. Case status was determined by serological assessment of HIV status; data on risk factors were obtained using structured survey interviews. HIV prevalence and rates of a number of behavioural risk factors suspected to play a role in HIV transmission among street children and youth were determined, including unprotected sex, intravenous drug use, and other risky sex and substance use behaviours.ResultsAmong the 251 children and youth, we found an overall HIV prevalence of 7.6%. As the sample size of females was small (n = 13) and the behavioural risk factors are likely to be quite different for boys and girls, we conducted separate analyses by gender. As our small sample of females is unlikely to be representative and lacks power for statistical testing, our report focuses on the results for the males surveyed.The strongest behavioural risk factor to emerge from this study was intravenous drug use; 30% of the male subjects were injecting drug users and 20% of those were HIV positive. Furthermore, frequency of drug injection was a highly significant predictor with a dose–response relationship; males reporting occasional injection drug use were nearly 9 times more likely to be HIV positive than never users, while weekly drug injectors had over 46 times the risk of non-users, controlling for exposure to group sex, the only other significant risk factor in the multivariate model.ConclusionsThis sample of street children and youth of Kathmandu has a nearly 20-fold higher prevalence of HIV infection than the general population of Nepal (0.39%). The children and youth engage in number of high risk behaviours, including intravenous drug use, putting them at significant risk of contracting HIV and other sexually transmitted infections.

1 Introduction

1 Introduction Obesity arises from a complex interplay between genetic susceptibility and behaviour, primarily relating to dietary habits and physical activity (Foresight, 2007). Evidence for specific behavioural factors that promote or protect against excess weight gain have been usefully reviewed (Wareham, 2007); (Jebb, 2007), and is more limited in children compared with adults (Rennie et al., 2005). A number of behavioural risk factors have been postulated, including TV viewing, diets with a high energy density, and fast foods. Most evidence is derived from cross sectional studies which can frequently produce conflicting results. Prospective studies with accurate measure of diet and physical activity exposures, and outcomes in terms of body fatness, are deemed to provide the more robust evidence on which to base interventions to achieve long-term behavioural change and prevent excess weight gain. The question to be answered by this comprehensive systematic review of the epidemiological evidence was ‘What is the association between food, food groups, nutrition and physical activity and subsequent excess weight gain and obesity in humans?’ Relevant exposures include patterns of diet; breastfeeding; food and drink; food preparation; dietary constituents; physical activity and inactivity; energy intake; energy density of diet; energy expenditure. Outcomes in adulthood and childhood have reported separately. Outcomes of interest included markers of weight gain; overweight; obesity; markers of body composition; markers of distribution of fat. The results of this review will provide evidence of association, but not causes, of subsequent excess weight gain and obesity. There is a degree of uncertainty inherent in epidemiological evidence, given that it is impossible to determine if there are uncontrolled variables, including genetic variations. The well known association between relatively high non caloric sweetner usage and subsequent weight gain is a useful reminder that, whilst an evidence based approach is critical to the process of scientific enquiry, consideration of evidence from other types of studies (mechanistic studies, intervention studies) and understanding the context of the evidence reviewed is essential if we are to provide policy makers, industry, service providers and the public with sensible recommendations.

Duchas vaginales y otros riesgos de vaginosis bacteriana

Bacterial vaginosis (BV) is an infection characterized by a change in the micro flora of the vagina. BV has been associated with adverse pregnancy outcomes and increased risk of acquiring sexually transmitted infections (STI). Objective. To identifiy the association of douching and other behavioral risk factors in relation to BV. Material and methods. This cross-sectional study was carried out among 1252 women attending in 3 public hospitals and one specialized institute in Lima, Peru in 1997. A structured questionnaire was used to collect information on socio-demographic and lifestyle characteristics of women. BV was diagnosed by the Nugent’s score. Logistic regression procedures were employed to estimate adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Results. Mean age of participants was 25.1 ± 4.7 and 23.4% had more than 11 years of formal education. The prevalence of BV was 20.1% and significantly associated with a number of behavioral risk factors. Women who practice douching (OR: 2.28; 95% CI: 1.0-5.0), having two or more sexual partners (OR: 2.0; 95% CI: 1.2-3.5) and who started sexual intercourse at a younger age (OR:1.4; 95% CI: 1.0-1.9) have more risk to get BV. Conclusion. Vaginal douching is a risk factor associated with BV among Peruvian women. Programs aimed at women’s health must address the adverse health outcomes associated with douching.

Chronic non-communicable diseases

Chronic non-communicable diseases (NCD) account for almost 60% of global mortality, and 80% of deaths from NCD occur in low- and middle-income countries. One quarter of these deaths--almost 9 million in 2005--are in men and women aged <60 years. Taken together, NCD represent globally the single largest cause of mortality in people of working age, and their incidences in younger adults are substantially higher in the poor countries of the world than in the rich. The major causes of NCD-attributable mortality are cardiovascular disease (30% of total global mortality), cancers (13%), chronic respiratory disease (7%) and diabetes (2%). These conditions share a small number of behavioural risk factors, which include a diet high in saturated fat and low in fresh fruit and vegetables, physical inactivity, tobacco smoking, and alcohol excess. In low- and middle-income countries such risk factors tend to be concentrated in urban areas and their prevalences are increasing as a result of rapid urbanization and the increasing globalisation of the food, tobacco and alcohol industries. Because NCD have a major impact on men and women of working age and their elderly dependents, they result in lost income, lost opportunities for investment, and overall lower levels of economic development. Reductions in the incidences of many NCD and their complications are, however, already possible. Up to 80% of all cases of cardiovascular disease or type-2 diabetes and 40% of all cases of cancer, for example, are probably preventable based on current knowledge. In addition, highly cost-effective measures exist for the prevention of some of the complications of established cardiovascular disease and diabetes. Achieving these gains will require a broad range of integrated, population-based interventions as well as measures focused on the individuals at high risk. At present, the international-assistance community provides scant resources for the control of NCD in poor countries, partly, at least, because NCD continue to be wrongly perceived as predominantly diseases of the better off. As urbanization continues apace and populations age, investment in the prevention and control of NCD in low-and middle-income countries can no longer be ignored.

Clustering of behavioural risk factors and compliance with clinical preventive recommendations in Spain

Objetive. To examine the relationship between the clustering of behavioural risk factors and compliance with clinical preventive practices. Method. Cross-sectional study using a telephone interview of a sample of 16043 persons, representative of the population aged 18–64 years in the Madrid Region (Spain). The criteria for providing clinical preventive services were based on recommendations issued by the Spanish Society for Family and Community Medicine. Analyses were performed using logistic regression with adjustment for age, education, social class and year of interview. Results. A positive dose–response association was observed between the number of behavioural risk factors (tobacco smoking, hazardous alcohol drinking, leisure-time sedentariness and unbalanced diet) and non-compliance of recommendations for blood-pressure and cholesterol testing, and for cytology and mammography screening ( P < 0.001). Compared to subjects with no behavioural risk factors, those with all four risk factors showed a higher frequency of non-compliance of blood pressure assessment: OR = 2.5 (95% CI: 1.6, 3.8) in men and 2.7 (1.5, 4.8) in women, and cholesterolaemia testing: OR = 2.6 (1.8, 3.9) in men and 2.7 (1.5, 5.1) in women. Furthermore, among women, the presence of these four risk factors was also associated with a higher frequency of non-performance of cytology: OR = 6.4 (2.8, 14.8) and mammography screening: OR = 10.2 (2.1, 49.8). However, as it is a cross-sectional study, we do not know the direction of this relationship, therefore, any causal inference should be made with caution. Conclusions. Clustering of behavioural risk factors is associated with greater non-compliance with recommendations for both blood pressure and cholesterolaemia testing, and for cytology and mammography screening.

Behavioural determinants of obesity

Obesity in children arises from a complex interplay between genetic susceptibility and behaviour, primarily relating to dietary habits and physical activity. Evidence for specific behavioural factors that promote or protect against excess weight gain in children is more limited than in adults, and the effects of growth and development are not clear. A number of behavioural risk factors has been postulated, including diets with a high energy density, high consumption of sugar-sweetened beverages, large portion sizes, eating patterns, high levels of sedentary behaviour and low levels of physical activity. However, most evidence is derived from cross-sectional studies which frequently yield conflicting results. More prospective studies with accurate measures of exposures and outcomes in terms of body composition are needed to provide more robust evidence on which to base interventions to achieve long-term behavioural change and prevent excess weight gains in children.

Sleep duration and mortality: the effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women

Background: There is evidence to suggest that insufficient sleep may have an adverse effect on physical and psychological health. Previous studies have reported that when adjusting for major risk factors for cardiovascular disease and a number of demographic and social variables, sleeping 7–8 h each night is associated with lower mortality. These studies, however, have excluded any consideration of stress, which is known to be related to a number of behavioural risk factors for disease and, like sleep, may influence neurochemical, hormonal and immunological functioning. Methods: This study revisits the associations between sleep duration, cardiovascular disease risk factors and mortality, taking into account the perceived stress of individuals. The data come from a cohort of working Scottish men and women recruited between 1970 and 1973; approximately half of the cohort was screened for a second time, 4–7 years after the baseline examination. Results: For both men and women, higher self-perceived stress was associated with a reduction in the hours of sleep reported. The pattern of mortality from all causes and the pattern of mortality from cardiovascular disease were consistent for both men and women. When sleep was measured on one occasion only, the risk of dying was reduced for men sleeping more than 8 h in every 24 h compared with those sleeping 7–8 h over the same period. This was after adjustment had been made for age, marital status, social class, cardiovascular risk factors and stress. The risk of dying was increased for women sleeping less than 7 h in every 24 h compared with those sleeping 7–8 h over the same period, after similar adjustments. When the data from the 1st and 2nd screening were considered longitudinally, both men and women who reported that they slept less than 7 h on both occasions that they were questioned, had a greater risk of dying from any cause than those who had reported sleeping 7–8 h at both screenings, after adjusting for age, marital status, social class and stress. Conclusions: Short sleep over a prolonged period may be associated with an increased risk of mortality: men and women who reported sleeping fewer than 7 h in 24 on two occasions between 4 and 7 years apart, had greater risk of dying from any cause over a 25 year period than those who reported sleeping 7–8 h on both occasions that they were questioned.