Occupational risk of overweight and obesity: an analysis of the Australian Health Survey

<p>Abstract</p> <p>Background</p> <p>Adults spend about one third of their day at work and occupation may be a risk factor for obesity because of associated socioeconomic and behavioral factors such as physical activity and sedentary time. The aim of this study was to examine body mass index (BMI) and prevalence of overweight and obesity by occupation and explore the contributions of socioeconomic factors and lifestyle behaviors (including leisure time and commuting physical activity, diet, smoking, and alcohol) to occupational risk.</p> <p>Methods</p> <p>Secondary analyses of the National Health Survey in Australia (2005) were conducted for working age adults (20 to 64 years). Linear and logistic regression models using BMI as either dichotomous or continuous response were computed for occupation type. Model 1 was age-adjusted, Model 2 adjusted for age and socioeconomic variables and Model 3 adjusted for age, socioeconomic variables and lifestyle behaviours. All models were stratified by gender.</p> <p>Results</p> <p>Age-adjusted data indicated that men in associate professional (OR 1.34, 95% CI 1.10-1.63) and intermediate production and transport (OR 1.24 95% CI 1.03-1.50) occupations had a higher risk of BMI ≥ 25 kg/m²than those without occupation, and women in professional (OR 0.71, 95% CI 0.61-0.82), management (OR 0.72, 95% CI 0.56-0.92) and advanced clerical and service occupations (OR 0.73 95% CI 0.58-0.93) had a lower risk. After adjustment for socioeconomic factors no occupational group had an increased risk but for males, professionals, tradesmen, laborers and elementary clerical workers had a lower risk as did female associate professionals and intermediate clerical workers. Adjustment for lifestyle factors explained the lower risk in the female professional and associate professionals but failed to account for the lower odds ratios in the other occupations.</p> <p>Conclusions</p> <p>The pattern of overweight and obesity among occupations differs by gender. Healthy lifestyle behaviors appear to protect females in professional and associate professional occupations from overweight. For high-risk occupations lifestyle modification could be included in workplace health promotion programs. Further investigation of gender-specific occupational behaviors and additional lifestyle behaviors to those assessed in the current Australian Health Survey, is indicated.</p

Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study

Background Unanticipated control group improvements have been observed in intervention trials targeting various health behaviours. This phenomenon has not been studied in the context of behavioural weight loss intervention trials. The purpose of this study is to conduct a systematic review and meta-regression of behavioural weight loss interventions to quantify control group weight change, and relate the size of this effect to specific trial and sample characteristics. Methods Database searches identified reports of intervention trials meeting the inclusion criteria. Data on control group weight change and possible explanatory factors were abstracted and analysed descriptively and quantitatively. Results 85 trials were reviewed and 72 were included in the meta-regression. While there was no change in control group weight, control groups receiving usual care lost 1 kg more than control groups that received no intervention, beyond measurement. Conclusions There are several possible explanations why control group changes occur in intervention trials targeting other behaviours, but not for weight loss. Control group participation may prevent weight gain, although more research is needed to confirm this hypothesis

Trauma exposure, PTSD and psychotic-like symptoms in post-conflict Timor Leste: an epidemiological survey.

BACKGROUND: Studies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and PTSD. No comparable studies have been undertaken in low-income, post-conflict countries. This study aimed to assess the prevalence of psychotic-like symptoms in conflict-affected Timor Leste and to examine whether symptoms were associated with trauma and PTSD. METHODS: The Psychosis Screening Questionnaire and the Harvard Trauma Questionnaire (assessing trauma exposure and PTSD) were administered in an epidemiological survey of 1245 adults (response rate 80.6%) in a rural and an urban setting in Timor Leste. We defined PSQ screen-positive cases as those people reporting at least one psychotic-like symptom (paranoia, hallucinations, strange experiences, thought interference, hypomania). RESULTS: The prevalence of PSQ screen-positive cases was 12 percent and these persons were more disabled. PSQ cases were more likely to reside in the urban area, experienced higher levels of trauma exposure and a greater prevalence of PTSD. PTSD only partially mediated the relationship between trauma exposure and psychotic-like symptoms. CONCLUSIONS: Psychotic-like symptoms may be prevalent in countries exposed to mass conflict. The cultural and contextual meaning of psychotic-like symptoms requires further inquiry in low-income, post-conflict settings such as Timor Leste.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Eff ects of recurrent violence on post-traumatic stress disorder and severe distress in confl ict-aff ected Timor-Leste:a 6-year longitudinal study

Background Little is known about the eff ect of recurrent episodes of communal violence on mental health in countries recovering from mass confl ict. We report results of a 6-year longitudinal study in post-confl ict Timor-Leste assessing changes in mental health after a period of communal violence. Methods We assessed 1022 adults (600 from a rural village, 422 from an urban district) exposed to mass confl ict during the Indonesian occupation after independence in 2004, and again in 2010–11, following a period of internal confl ict. We took a census of all adults living at the two sites. The survey included measures of post-traumatic stress disorder, severe distress, traumatic events, poverty, ongoing confl ict, and injustice. Findings 1247 (80%) of 1554 invited adults participated in the baseline survey. 1038 (89% of those eligible) were followed up. The analysis included 1022 people who had suffi cient data at baseline and follow-up. The prevalence of post-traumatic stress disorder increased from 23 of 1022 (2∙3%) in 2004, to 171 of 1022 (16∙7%) in 2010. The prevalence of severe distress also increased, from 57 of 1022 (5∙6%) in 2004, to 162 of 1022 (15∙9%) in 2010. Both these outcomes were associated with disability at follow-up. Having post-traumatic stress at follow-up was associated with being a woman (odds ratio [OR] 1·63, 95% CI 1∙14–2∙32), experience of human rights trauma (OR 1∙25, 95% CI 1∙07–1∙47), or exposure to murder (OR 1∙71, 95% CI 1∙38–2∙10) during the Indonesian occupation (1975–99), human rights trauma during the period of internal violence in 2006–07 (OR 1∙46, 95% CI 1∙04–2∙03), and ongoing family or community confl ict (OR 1∙80, 95% CI 1∙15–2∙80) or preoccupations with injustice for two or three historical periods (OR 4∙06, 2∙63–6∙28). Severe distress at follow-up was associated with health stress (OR 1∙47, 1∙14–1∙90), exposure to murder (OR 1∙57, 1∙27–1∙95), and natural disaster (OR 1∙65, 1∙03–2∙64) during the Indonesian occupation, confl ict-related trauma during the internal violence (OR 1∙33, 1∙02–1∙74), and ongoing poverty (OR 1∙53, 1∙36–1∙72) or preoccupations with injustice for two or three historical periods (OR 2∙09, 1∙25–3∙50). Interpretation Recurrent violence resulted in a major increase in post-traumatic stress disorder and severe distress in a community previously exposed to mass confl ict. Poverty, ongoing community tensions, and persisting feelings of injustice contributed to mental disorders. The fi ndings underscore the importance of preventing recurrent violence, alleviating poverty, and addressing injustices in countries emerging from confl ict

The International Prevalence Study on Physical Activity: results from 20 countries

<p>Abstract</p> <p>Background</p> <p>Physical activity (PA) is one of the most important factors for improving population health, but no standardised systems exist for international surveillance. The International Physical Activity Questionnaire (IPAQ) was developed for international surveillance. The purpose of this study was a comparative international study of population physical activity prevalence across 20 countries.</p> <p>Methods</p> <p>Between 2002–2004, a standardised protocol using IPAQ was used to assess PA participation in 20 countries [total N = 52,746, aged 18–65 years]. The median survey response rate was 61%. Physical activity levels were categorised as "low", "moderate" and "high". Age-adjusted prevalence estimates are presented by sex.</p> <p>Results</p> <p>The prevalence of "high PA" varied from 21–63%; in eight countries high PA was reported for over half of the adult population. The prevalence of "low PA" varied from 9% to 43%. Males more frequently reported high PA than females in 17 of 20 countries. The prevalence of low PA ranged from 7–41% among males, and 6–49% among females. Gender differences were noted, especially for younger adults, with males more active than females in most countries. Markedly lower physical activity prevalence (10% difference) with increasing age was noted in 11 of 19 countries for males, but only in three countries for women. The ways populations accumulated PA differed, with some reporting mostly vigorous intensity activities and others mostly walking.</p> <p>Conclusion</p> <p>This study demonstrated the feasibility of international PA surveillance, and showed that IPAQ is an acceptable surveillance instrument, at least within countries. If assessment methods are used consistently over time, trend data will inform countries about the success of their efforts to promote physical activity.</p

Intentional injury reported by young people in the Federated States of Micronesia, Kingdom of Tonga and Vanuatu

<p>Abstract</p> <p>Background</p> <p>Intentional injury presents a threat to the physical and psychological well being of young people, especially in developing countries, which carry the greatest part of the global injury burden. While the importance of this problem is recognized, there are limited population data in low and middle income countries that can guide public health action. The present study investigates the prevalence and distribution of intentional injury among young people in three Pacific Island societies, and examines behavioural and psychosocial factors related to risk of intentional injury.</p> <p>Methods</p> <p>Population surveys were conducted with <b>s</b>tudents aged 11–17 years in Pohnpei State in the Federated States of Micronesia (n = 1495), the Kingdom of Tonga (n = 2808) and Vanuatu (n = 4474). Surveys measured self-reported injury and intentional injury, sources of intentional injury, and the range of behavioural, psychological, educational and social variables that may be related to injury risk.</p> <p>Results</p> <p>Among boys and girls aged 14–17 years the respective period prevalence of intentional injury was 62% and 56% in Pohnpei, 58% and 41% in Tonga, and 33% and 24% in Vanuatu. The prevalence of intentional injury declined with age in Tonga and Vanuatu, but there was little evidence of an age-trend in Pohnpei. Across the three societies, the major sources of intentional injury among boys were 'other persons' followed by boyfriends/girlfriends and fathers. Mothers, boyfriends/girlfriends and other persons were primary sources of injury among girls. An intentional injury was reported more often by those who had been bullied (OR 1.40–1.66, P < 0.05), by regular smokers in Tonga and Vanuatu (OR 1.52–2.21, P < 0.05), and illicit drug users in Pohnpei and Vanuatu (OR 1.87–1.92, P < 0.05).</p> <p>Conclusion</p> <p>Intentional injury was reported extensively in these three populations. Interventions directed towards the school environment and which take into account the role of bullying and drug use need to be considered.</p

Trends in prevalence of leisure time physical activity and inactivity: results from Australian National Health Surveys 1989 to 2011

Objective: To examine trends in leisure time physical activity and inactivity in Australians aged 15 years or older from 1989 to 2011. Method: We used data from six Australian National Health Surveys conducted from 1989/90 to 2011/12 in which physical activity was assessed using comparable questions. Analyses examined trends in the prevalence of sufficient physical activity (≥150 minutes/week moderate‐to‐vigorous physical activity) and of inactivity (\u3c30 minutes/week moderate‐to‐vigorous physical activity). Results: The proportion of sufficiently active adults was 39.2% in 1989 and 40.7% in 2011 with an overall declining trend of 0.2% per year (p=0.012). The prevalence of inactivity was 38.7% in 1989 and 37.3% in 2011; the overall time trend by year was stable (OR=0.999, p=0.242). In women, sufficient physical activity decreased by 0.3% per year from 35.5% in 1989 (p=0.025); inactivity increased from 39.5% by 0.3% per year (p=0.004). In men, sufficient physical activity prevalence was 43.1% in 1989 with a steady trend; inactivity decreased from 37.9% by 0.5% per year (p\u3c0.0001). Conclusions: The prevalence of sufficient physical activity remains low and inactivity high. Women appear to be a key target group for intervention. Public health efforts have been ineffective over two decades for improving physical activity among Australian adults. Implications for public health: This research supports calls for a national physical activity action plan given the multitude of benefits from sufficient physical activity. Maintenance of consistent physical activity questions in future National Health Surveys will facilitate long term tracking of physical activity levels in the Australian population