Current use of smokeless tobacco among adolescents in the Republic of Congo

<p>Abstract</p> <p>Background</p> <p>Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT).</p> <p>Methods</p> <p>Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS) of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking). Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) were used to measure magnitudes of associations.</p> <p>Results</p> <p>Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females) reported having used smokeless tobacco (chewing tobacco, sniff or dip) in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]). Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes). Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]). Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]).</p> <p>Conclusions</p> <p>Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and at leisure must also be factored in order to prevent their uptake or maintenance of tobacco use.</p

Desigualdades socioeconomicas e demograficas como fatores de risco para a artrite autorreferida: estudo de base populacional em adultos no Sul do Brasil

Abstract published in English and Portuguese English title: Socioeconomic and demographic inequalities as risk factors for self-reported arthritis: a population-based study in southern BrazilThe study aimed to estimate prevalence of self-reported arthritis or rheumatism and associated factors. This was a cross-sectional population-based study in Florianopolis, Santa Catarina State, Brazil, with 1,720 adults ranging from 20 to 59 years of age. Presence of self-reported arthritis or rheumatism was analyzed with a hierarchical approach, considering demographic, socioeconomic, and behavioral variables and use of health services. Logistic regression was used to evaluate the association between the outcome and independent variables. Prevalence of self-reported arthritis or rheumatism was 7.7% (95%CI: 6.4-8.9). The odds of self-reported arthritis were twice as high in women, and increased self-reported arthritis was directly associated with BMI > 30kg/m2 and increasing age and inversely proportional to schooling. Self-reported arthritis or rheumatism was higher in this sample than in Brazilian adults in general in 2008. The results suggest the need to plan public health policies to address this problem. = Estimar a prevalência de artrite ou reumatismo autorreferido e os fatores associados. Realizou-se um estudo transversal de base populacional em Florianópolis, Santa Catarina, Brasil, com 1.720 adultos entre 20 e 59 anos. A presença de artrite ou reumatismo autorreferido foi analisada por meio do modelo hierárquico de determinação no nível demográfico, socioeconômico, comportamental e uso de serviços de saúde. Utilizou-se análise de regressão logística para avaliar a associação entre as variáveis. A prevalência de artrite ou reumatismo autorreferido foi de 7,7% (IC95%: 6,4-8,9). A chance de artrite ou reumatismo autorreferido foi duas vezes maior entre as mulheres, maior entre aqueles com índice de massa corporal (IMC) > 30kg/m2,diretamente proporcional à idade e inversamente proporcional à escolaridade. A prevalência de artrite ou reumatismo autorreferido foi maior do que a estimativa nacional no ano de 2008. Essa realidade sugere a necessidade de um planejamento de políticas públicas voltado para esse agravo de saúde.Rafael Santos Gomes, Karen Glazer Pere

Health-related quality of life in adults reporting arthritis: analysis from the National Health Measurement Study

BackgroundArthritis is the leading cause of disability in the United States. We assess the generic health-related quality-of-life (HRQOL) among a nationally representative sample of U.S. adults with and without self-reported arthritis.MethodsThe NHMS, a cross-sectional survey of 3,844 adults (35-89 years) administered EuroQol-5D (EQ-5D), Health Utilities Index Mark 2 (HUI2) and 3 (HUI3), SF-36v2™, Quality of Well-being Scale self-administered form (QWB-SA), and the Health and Activities Limitations index (HALex) to each respondent via a telephone interview. Weighted multiple linear regression was used to generate age-gender-arthritis-stratified unadjusted HRQOL means and means adjusted for sociodemographic, socioeconomic covariates and comorbidities by arthritis-age category.ResultsThe estimated population prevalence of self-reported arthritis was 31%. People with arthritis were more likely to be woman, older, of lower socioeconomic status, and had more self-reported comorbidities than were those not reporting arthritis. Adults with arthritis had lower HRQOL on six different indexes compared with adults without arthritis, with overall differences ranging from 0.03 (QWB-SA, age-group 65-74) to 0.17 (HUI3, age-group 35-44; all P-value &lt; .05).ConclusionArthritis in adults is associated with poorer HRQOL. We provide age-related reference values for six generic HRQOL measures in people with arthritis

Genome-wide sequencing in acutely ill infants: genomic medicine's critical application?

Diagnostic genome-wide sequencing (exome or genome sequencing and data analysis for high-penetrance disease-causing variants) in acutely ill infants appears to be clinically useful, but the value of this diagnostic test should be rigorously demonstrated before it is accepted as a standard of care. This white paper was developed by the Paediatric Task Team of the Global Alliance for Genomics and Health's Regulatory and Ethics Work Stream to address the question of how we can determine the clinical value of genome-wide sequencing in infants in an intensive care setting. After reviewing available clinical and ethics literature on this question, we conclude that evaluating diagnostic genome-wide sequencing as a comprehensive scan for major genetic disease (rather than as a large panel of single-gene tests) provides a practical approach to assessing its clinical value in acutely ill infants. Comparing the clinical value of diagnostic genome-wide sequencing to chromosomal microarray analysis, the current evidence-based standard of care, per case of serious genetic disease diagnosed provides a practical means of assessing clinical value. Scientifically rigorous studies of this kind are needed to determine if clinical genome-wide sequencing should be established as a standard of care supported by healthcare systems and insurers for diagnosis of genetic disease in seriously ill newborn infants