Morbid obesity in women on the rise : an observational, population-based study

Background The obesity epidemic is generally monitored by the proportion of the population whose body mass index (BMI) exceeds 30 kg/m2 but this masks the growing proportion of those who are morbidly obese. This issue is important as the adverse health risks amplify as the level of obesity increases. The aim of this study was to determine how the prevalence of morbid obesity (BMI &gt;= 40.0 kg/m2) has changed over a decade among women living in south-eastern Australia.Methods BMI was determined for women in the Geelong Osteoporosis study (GOS) during two time periods, a decade apart. Height and weight were measured for 1,494 women (aged 20--94 years) during 1993--7 and for 1,076 women (aged 20--93 years), 2004--8, and the BMI calculated as weight in kilograms divided by the square of the height in metres (kg/m2). Prevalence estimates were age-standardised to enable direct comparisons.Results Mean BMI increased from 26.0 kg/m2 (95%CI 25.7-26.3) in 1993--7, to 27.1 kg/m2 (95%CI 26.8-27.4) in 2004--8. During this period, the prevalence of morbid obesity increased from 2.5% to 4.2% and the standardised morbidity ratio for morbid obesity was 1.69 (95%CI 1.26-2.27). Increases in mean BMI and prevalence of morbid obesity were observed for all ages and across the socioeconomic spectrum.Conclusions These findings reveal that over a decade, there has been an increase in mean BMI among women residing in south-eastern Australia, resulting in a measurable increase in the prevalence of morbid obesity.<br /

The epidemiology of the first wave of H1N1 influenza pandemic in Australia : a population-based study

Objectives: Following the recent H1N1 influenza pandemic we were able to describe seropositivity in a repre-sentative sample of adults prior to the availability of a specific vaccine.Methods: This cross-sectional serological study is set in the Barwon Statistical Division, Australia. Blood samples were collected from September 2009 through to May 2010, from 1184 individuals (569 men, 615 women; median age 61.7 years), randomly selected from electoral rolls. Serum was analysed for specific H1N1 immunity using a haemagglutina-tion inhibition test. A self-report provided information about symptoms, demographics and healthcare. Associations be-tween H1N1 infection, gender, households and occupation were determined using logistic regression, adjusting for age.Results: Of 1184 individuals, 129 (58 men, 71 women) were seropositive. Gender-adjusted age-specific prevalence was: 8.3% 20-29 years, 13.5% 30-39, 10.4% 40-49, 6.5% 50-59, 9.7% 60-69, 10.3% 70-79, 18.8% 80+. Standardised preva-lence was 10.3% (95%CI 9.6-11.0). No associations were detected between seropositivity and gender (OR=0.82, 95%CI 0.57-1.19) or being a healthcare worker (OR=1.43, 95%CI 0.62-3.29). Smokers (OR=1.86, 95%CI 1.09-3.15) and those socioeconomically disadvantaged (OR=2.52, 95%CI 1.24-5.13) were at increased risk. Among 129 seropositive individu-als, 31 reported symptoms that were either mild (n = 13) or moderate (time off work, doctor visit, n = 18). For age &lt;60, 39.6% of seropositive individuals reported symptoms, whereas the proportion was 13.2% for age 60+.Conclusions: Following the pandemic, the proportion of seropositive adults was low, but significant subclinical infection was found. Social disadvantage increased the likelihood of infection. The low symptom rate for older ages may relate to pre-existing immunity.<br /

Sex-differences in reasons for non-participation at recruitment : Geelong Osteoporosis Study

Background : Understanding reasons for non-participation in health studies can help guide recruitment strategies and inform researchers about potential sources of bias in their study sample. Whilst there is a paucity of literature regarding this issue, it remains highly plausible that men and women may have varied reasons for declining an invitation to participate in research. We aimed to investigate sex-differences in the reasons for non-participation at baseline of the Geelong Osteoporosis Study (GOS). Methods : The GOS, a prospective cohort study, randomly recruited men and women aged 20 years and over from a region in south-eastern Australia using Commonwealth electoral rolls (2001&ndash;06 and 1993&ndash;97, respectively). Reasons for non-participation (n=1,200) were documented during the two recruitment periods. We used the Pearson&rsquo;s chi squared test to explore differences in the reasons for non-participation between men and women. Results : Non-participation in the male cohort was greater than in the female cohort (32.9% vs. 22.9%; p&lt;0.001). Overall, there were sex-differences in the reasons provided for non-participation (p&lt;0.001); apparent differences related to time constraints (men 26.3% vs. women 10.4%), frailty/inability to cope with or understand the study (men 18.7% vs. women 30.6%), and reluctance over medical testing (men 1.1% vs women 9.9%). No sex-differences were observed for non-participation related to personal reason/disinterest, and language- or travel-related reasons. Conclusions : Improving participation rates in epidemiological studies may require different recruitment strategies for men and women in order to address sex-specific concerns about participating in research

Employed Parents of Children With Mental Health Disorders: Achieving Work–Family Fit, Flexibility, and Role Quality

Extensive interviews with 60 employed parents of school-age children treated for mental health problems explored work–family fit, flexibility, family support, and work–life strategies in relation to role quality. Role quality was measured as employment and parenting rewards and concerns. Work–family fit was positively related to family flexibility but not work flexibility. Higher flexibility in work and family predicted lower job concerns, and work flexibility and work–family fit were predictors of job rewards. Parental concerns were dependent on flexibility and work–family strategies. Single parents had significantly fewer sources of family support and used fewer work–family strategies than caregivers with partners. Human services providers should collaborate with families by jointly exploring new flexibility and support strategies in work and family domains

Socioeconomic status, obesity and lifestyle in men : the Geelong Osteoporosis Study

Background : Although the association between lower socioeconomic status (SES) and obesity in women in developed countries is well-documented, current evidence regarding the relationship between obesity in men and area-based SES (equivalised for advantage and disadvantage) is inconsistent. Therefore, we aimed to examine obesity, lifestyle behaviours, physical activity in different domains and demographics in men using area-based SES.Methods : We performed a descriptive cross-sectional study of 1467 randomly selected white men (mean age 56 year (inter-quartile range (IQR) = 39&ndash;73 year)) recruited from the Barwon Statistical Division, South Western Victoria, Australia between 2001&ndash;06.Results : Age-adjusted BMI, waist circumference, % fat and lean mass and blood pressure were inversely associated with SES, with differences between low and upper SES (P for difference &lt;0.05), independent of country of birth. Age-adjusted lifestyle behaviours associated with obesity and/or adverse health (especially cardiovascular disease), were also associated with lower SES.Conclusions : Subjects from lower SES had greater measures of obesity despite being more physically active at work, but were less likely to be physically active in the domains of sports and/or leisure. These findings suggest the possible influence of lifestyle behaviours and occupation upon obesity in men and should be investigated further.<br /

Rheumatoid arthritis and incident fracture in women: a case-control study

Background: To examine fracture incidence in women with rheumatoid arthritis (RA) for an entire geographical&nbsp;region of south-eastern Australia.Methods: Women aged 35 years and older, resident in the Barwon Statistical Division (BSD) and clinically&nbsp;diagnosed with RA 1994&ndash;2001 were eligible for inclusion as cases (n =1,008). The control population (n = 172,422)&nbsp;comprised the entire female BSD population aged 35 years and older, excluding those individuals identified as&nbsp;cases. Incident fractures were extracted from the prospective Geelong Osteoporosis Study Fracture Grid. We&nbsp;calculated rate ratios (RR) and 95% confidence intervals (CI) to compare the age- adjusted rate of fracture between&nbsp;the RA and non-RA populations, and used a chi-square test to compare proportions of fractures between women&nbsp;with and without RA, and a two-sided Mann&ndash;Whitney U-test to examine age-differences.Results: Among 1,008 women with RA, 19 (1.9%) sustained a fracture, compared to 1,981 fractures sustained by the&nbsp;172,422 women without RA (1.2%). Fracture rates showed a trend for being greater among women diagnosed with&nbsp;RA (age-adjusted RR 1.43, 95%CI 0.98-2.09, p= 0.08). Women with RA sustained vertebral fractures at twice the&nbsp;expected frequency, whereas hip fractures were underrepresented in the RA population (p&lt; 0.001). RA status was&nbsp;not associated with the likelihood of sustaining a fracture at sites adjacent to joints most commonly affected by RA&nbsp;(p= 0.22).Conclusion: Given that women with RA have a greater risk of fracture compared to women without RA, these&nbsp;patients may be a suitable target population for anti-resorptive agents; however, larger studies are warranted

Excessive daytime sleepiness and falls among older men and women: cross-sectional examination of a population-based sample

Background: Excessive daytime sleepiness (EDS) has been associated with an increased risk for falls among clinical samples of older adults. However, there is little detailed information among population-representative samples. The current study aimed to assess the relationship between EDS and falls among a cohort of population-based older adults. Methods: This study assessed 367 women aged 60-93years (median 72, interquartile range 65-79) and 451 men aged 60-92years (median 73, interquartile range 66-80) who participated in the Geelong Osteoporosis Study between the years 2001 and 2008. Falls during the prior year were documented via self-report, and for men, falls risk score was obtained using an Elderly Fall Screening Test (EFST). Sleepiness was assessed using the Epworth Sleepiness Scale (ESS), and scores of&ge;10 indicated EDS. Differences among those with and without EDS in regard to falls were tested using logistic regression models. Results: Among women, 50 (13.6 %) individuals reported EDS. Women with EDS were more likely to report a fall, and were more likely to report the fall occurring outside. EDS was similarly associated with an increased risk of a fall following adjustment for use of a walking aid, cases of nocturia and antidepressant medication use (adjusted OR&isin;=&isin;2.54, 95 % CI 1.24-5.21). Multivariate modelling revealed antidepressant use (current) as an effect modifier (p&isin;&lt;&isin;.001 for the interaction term). After stratifying the data by antidepressant medication use, the association between EDS and falls was sustained following adjustment for nocturia among antidepressant non-users (adjusted OR&isin;=&isin;2.63, 95 % CI 1.31-5.30). Among men, 72 (16.0 %) individuals reported EDS. No differences were detected for men with and without EDS in regard to reported falls, and a trend towards significance was noted between EDS and a high falls risk as assessed by the EFST (p&isin;=&isin;0.06), however, age explained this relationship (age adjusted OR&isin;=&isin;2.20, 95 % CI 1.03-1.10). Conclusions: For women, EDS is independently associated with at least one fall during the previous year, and this is more likely to occur whilst located outside. Amelioration of EDS may assist in improving functional outcomes among these individuals by reducing the risk for falls

Characteristics of female nonagenarian participants in an observational health study

Abstract Background: Inclusion of very elderly participants in health studies is limited, despite the increasing longevity in the population. We aimed to describe characteristics of female nonagenarians who had been retained for a decade in an ongoing, population-based cohort study