Implemeuting Health Impact Assessment Learning from the Theories and Experiences of Environmental Impact Assessment / 中国卫生经济

Objective:To learn from the experiences of environmental impact assessment,and explore the theories and practices of health impact assessment.Methods:With suitability analysis of reference to environmental impact assessment and literature research,the current situation,practices and problems of environmental impact assessment were summarized.Results and Conclusion:Drawing on experiences in environmental impact assessment,it needed to start the establishment and implementation of health impact assessment system with healthy cities,healthy towns and villages,improve relevant laws and regulations,strengthen supervision and management of health impact assessment.

Correlation between Knowledge on Cardiovascular Disease Prevention and Cardiovascular Health in Community Elderly / 中国康复理论与实践

@#Objective To analyze the relationship between knowledge on cardiovascular disease prevention and ideal cardiovascular health behaviors and factors in community elderly. Methods From December, 2015 to May, 2016, totally 400 elderly in communities with-out overt cardiovascular disease were conveniently sampled. The level of knowledge on cardiovascular disease prevention was measured by self-designed cardiovascular disease prevention questionnaire. And each of the ideal cardiovascular health components was collected. Re-sults A total of 390 responses were valid. 13.85%community elderly were with high level of the knowledge. There were significant differ-ences in the distribution of cardiovascular health indexes among various leves of the knowledge groups (χ2>9.974, P<0.05), except choles-terol (P>0.05). The level of the knowledge was positively correlated with the scores of cardiovascular health behaviors and health factors (r>0.354, P<0.01). The cardiovascular health score, health behaviors score, health factors score and number of ideal cardiovascular health in-dexes were significantly different among various levels of the knowledge groups (F>8.961, P<0.001). Conclusion The level of knowledge on cardiovascular disease prevention was positively correlated with cardiovascular health behavior and health factors. The scores of cardio-vascular health score, health behaviors score and health factors increased with the improvement of knowledge on cardiovascular disease pre-vention.

Risk Factors of Childhood Obesity and Overweight in Young Children and Adolescents Aged Between 5 to 15 Years in Urban Bangladesh: A Scoping Review

Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings. Risk factors for obesity in this context have not been explored. The objective of this study was to identify the risk factors associated with childhood obesity/overweight among young children and adolescents 5-15 years of age in urban Bangladesh. Methods: A scoping review based on York methodology was performed. This methodology involves a comprehensive search of published academic articles, conference proceedings and grey literature through PubMed, Bangla JOL, Google and Google scholar, limited to English-written papers. Results: Findings revealed that having at least one overweight parent and engaging in sedentary activities for more than 4 h a day were independent risk factors for childhood overweight and/or obesity.Children who spent ≥ 30 min each day in outdoor games at home that involved physical exercise had decreased odds (OR = 0.38, 95% CI: 0.1–0.8) of being overweight or obese compared to children who did not exercise at home. Conclusion: Spending much time seated or somewhat inactive were key risk factors for childhood obesity and overweight. More research, prevention and management of childhood obesity/overweight in young children and adolescents in urban Bangladesh should be a policy priority.

Queda e sua relação com fatores sociodemográficos e de saúde em idosos de uma comunidade brasileira: estudo de seguimento / Accidental falls related with sociodemographic and health factors in elderly people in a Brazilian community: a follow-up research

No decorrer do processo de envelhecimento há uma diminuição das habilidades físicas, psicológicas e sociais na pessoa o que aumenta o risco de sofrer de múltiplas síndromes, uma delas é a queda. O presente estudo é analítico, observacional de coorte retrospectivo com o objetivo de determinar a prevalência de queda em um seguimento de cinco anos em duas avaliações (2007/2008 - 2013) de idosos que vivem no domicílio e a sua relação com as variáveis sociodemográficas, doenças autorreferidas, número de medicamentos, estado cognitivo, síndrome da fragilidade e capacidade funcional. A pesquisa foi realizada na cidade de Ribeirão Preto, São Paulo, com população de idosos com 65 anos ou mais de idade. A amostra foi por conglomerado em duplo estágio sendo a amostra final de 515 idosos, sendo que a primeira etapa ocorreu de agosto de 2007 a março de 2008 e a segunda realizada de julho a dezembro de 2013. O instrumento utilizado para a coleta de dados foi composto por questões sociodemográficas; doenças autorreferidas e número de medicamentos; Mini Exame do Estado Mental (MEEM); avaliação da queda; Edmonton Frail Scale (EFS); Medida de Independência Funcional (MIF) e Escala de Lawton e Brody (AIVD). Foram pareadas as informações dos 262 idosos, sendo que houve predomínio do sexo feminino (66,4%), média da idade de 73,3 (dp=6,3) anos sendo que 56,9% foram categorizados como idoso mais jovem (70 - 79 anos), média de escolaridade de 5,0 (dp=4,9) anos e 49,2% eram casados. Verificou-se que em ambas as avaliações, o estado cognitivo diminuiu de 24,87 para 22,90 pontos com aumento do déficit cognitivo de 44,7 para 58,4%. Nas AIVD a média também diminuiu de 19,41 para 17,39 pontos, aumentando a dependência funcional de 44,7% para 66,1%. Quanto a MIF, a média diminui de 120,33 para 112,49 pontos com aumento da dependência de 4,2% para 15%. Verificou-se que a média da fragilidade aumentou de 4,16 para 6,53 pontos sendo que a categoria fragilidade aumentou de 17,5% para 50,4%. Por outro lado, a média das doenças autorreferidas diminuiu de 5,63 para 5,16 dos quais tanto na primeira como na segunda avaliação 5,7% não sofrem de doenças mas na primeira avaliação 46,2% sofrem mais de cinco doenças e na segunda 41,2%. Porém quanto ao consumo de medicamentos a média aumentou de 3,59 para 4,03, sendo que 22,5% na primeira avaliação consomem mais de cinco medicamentos e na segunda 28,6%. Em relação com o idoso que sofreu queda, na primeira avaliação 57 caíram e na segunda 99, a prevalência aumentou de 21,8% para 37,8%, sendo que em ambas as avaliações 82,5% e 73,7%, respectivamente, caíram da própria altura, trazendo consequências como fraturas, feridas e escoriações, além do medo de novas reincidências. Os idosos que sofreram queda apresentaram diminuição do estado cognitivo, maior fragilidade e incapacidade funcional com um aumento das doenças autorreferidas e número de medicamentos. Na associação da queda com as diferentes variáveis, verificou-se que no período do estudo, o número de doenças autorreferidas, o maior consumo de medicamentos e o aumento da fragilidade o idoso apresenta maior risco de queda. Conclui-se que a queda é uma síndrome que está relacionada com múltiplas causas (variáveis sociodemográficas e de saúde) o que leva a maior necessidade de implementar programas com planejamento para a prevenção de queda e suas consequências por meio da educação à população idosa e seus cuidadores

During the aging process there is a decrease in physical, psychological and social skills in the person which increases the risk of suffering from multiple syndromes, one of these are accidental fall. This study is analytical, observational retrospective cohort with the aim to determine the prevalence of accidental falls in a follow-up of five years in both assessments (2007/2008 - 2013) of elderly people living at home and their relationship to sociodemographic variables, self-reported diseases, number of medications, cognitive status, frailty syndrome and functional capacity. The research was conducted in the Ribeirão Preto city, São Paulo, in elderly people aged 65 or older. The sample by conglomerate in double stage with the final sample of 515 elderly people, on the first stage was from August 2007 to March 2008 and the second stage was from July to December 2013. The instrument used for data collection consists of sociodemographic questions; self-reported diseases and medications numbers; Mini Mental State Examination (MMSE); evaluation of the accidental fall; Edmonton Frail Scale (EFS); Functional Independence Measure (FIM) and Lawton and Brody Scale (IADL). They were matched information from 262 elderly, and there was a predominance of females (66.4%), mean of age 73.3 (sd = 6.3) years of which 56.9% were categorized as younger elderly (70-79 years), average schooling of 5.0 (sd = 4.9) years and 49.2% were married. It was found that in both assessments, the cognitive status declined from 24.87 to 22.90 points with increased cognitive deficit from 44.7 to 58.4%. IADL average also decreased from 19.41 to 17.39 points, increasing the functional dependence from 44.7% to 66.1%. The MIF average decreases from 120.33 to 112.49 points with increasing dependence from 4.2% to 15%. It was found that the frailty average increased from 4.16 to 6.53 points of which the category frailty increased from 17.5% to 50.4%. On the other hand, the average self-reported disease decreased from 5.63 to 5.16 which both the first and the second evaluation 5.7% did not suffer from diseases but in first evaluation suffered 46.2% over five diseases and second 41.2%. But with the consumption of drugs the average increased from 3.59 to 4.03, and 22.5% in the first evaluation consumed more than five drugs and the second 28.6%. In relation to the elderly who suffered fall, the first assessment fell 57 and the second 99, the prevalence increased from 21.8% to 37.8%, and in both evaluations 82.5% and 73.7%, respectively, fell from height, bringing consequences such as fractures, wounds and abrasions, and the fear of new falls. Elderly people who suffered falls had decreased cognitive status, increased frailty and functional impairment with an increase in self-reported diseases and number of medications. In the fall of association with different variables, it was found that during the study period, the number of self-reported diseases, the highest consumption of drugs and the increased frailty the elderly had a higher risk of falls. We conclude that the fall is a syndrome that is associated with multiple causes (socio-demographic and health variables) which leads to greater need to implement planning with programs for the prevention of fall and its consequences through education to the elderly and their caregivers

Characteristics of the Health Factors in 45~60 Year Old Korean Women related to Menopausal Stages: Based on 2008~2009 Korean National Health and Nutrition Examination Survey / 대한지역사회영양학회지

We analyzed data from the combined 2008~2009 Korean National Health and Nutrition Examination Survey (KNHANES) to compare the health factors related to menopausal stages in 45~60 year old Korean women. In this study, we classified the subjects into a premenopausal group (n = 439) and a postmenopausal group (n = 683). In the postmenopausal group, age was higher (p < 0.001), monthly income (p < 0.01) and education levels (p < 0.001) were significantly lower than in the premenopausal group. Body fat % and waist circumferences were also higher in the postmenopausal group than in the premenopausal group. The serum glucose (p < 0.05), total cholesterol (p < 0.001), LDL-cholesterol (p < 0.001), triglyceride (p < 0.001), GOT (p < 0.001), GPT (p < 0.001) in the postmenopausal group were higher than in the premenopausal group. The postmenopausal group showed a significantly lower quality of life compared to the premenopausal group (p < 0.01). With regard to dietary quality, nutrient adequacy ratio (NAR) of vitamin A, vitamin B1, vitamin B2 and niacin in the postmenopausal group were significantly lower than in the premenopausal group. The levels of glucose, total cholesterol, LDL-cholesterol, and triglyceride showed a significantly positive correlation with age, waist circumferences, body fat % and BMI. The 45~60 year old Korean women in this study showed high levels of obesity and serum lipids. Also, intakes of the vitamins and minerals of the women did not meet the level of Dietary reference intakes for Koreans. Therefore, nutritional risk may be high in the women, especially in postmenopausal women. In order to prevent the health risk, women's health care including the quality of the meal should be considered.

Factors affecting scholastic performances of adolescents.

Objective. Recognizing the social influence, study habits and health factors affecting scholastic performances of adolescents and to compare these factors among the adolescents between two categories of school. Methods. A total of 1230 adolescents (13-18 yrs) were screened. Data was collected by personal interview, using the teenage screening questionnaire (Trivandrum). Results. A total 615 students from corporation and private schools were studied. 39.76% (489) were high achievers, 13.5% (166) were low achievers with p < 0.001. In the low achievers, 12.03% were from the corporation schools and 1.46% from private schools. The incidence of poor study habits and social factors were increased in low achievers of corporation schools. On multivariate analysis, the predictor variables for poor scholastic performance were adolescent having refractory error, not having help for study at home, not doing home work regularly, not solving question bank papers and reading only before examinations. Conclusion. It is feasible and worthwhile to identify the determinants of scholastic performance and plan intervention strategies at each school. The results highlight the importance of implementing newer strategies, focusing on strict study patterns and creating the conducive school and home environment for study, so as to achive better scholastic performances.

Condicionantes epidemiológicos de salud y su relación con rendimiento escolar en el primer año de la carrera de medicina: estudio de dos generaciones / Epidemiological health factors and their relationship with academic performance during the first year of medical school: study of two generations

Antecedentes: El rezago escolar en la educación superior es preocupante. En la Facultad de Medicina de la UNAM la reprobación en el primer año rebasa 50%. Existen estrategias educativas y económicas para apoyar a estos alumnos. Las condicionantes de salud física, mental, estilo de vida y entorno social pueden influir en el rendimiento escolar. El objetivo de esta investigación fue identificar factores de riesgo para la salud integral y establecer un perfil predictivo del rendimiento escolar. Métodos: Se compararon condicionantes de salud del examen médico automatizado (EMA) y rendimiento escolar en dos generaciones. Se integraron cuatro grupos considerando el programa educativo, tradicional (TRAD) o alta exigencia académica (NUCE), y situación de regular o irregular. Resultados: Se incluyeron 1848 alumnos. Los factores que caracterizaron a los irregulares TRAD fueron alta prevalencia de depresión, ansiedad, ideación e intento suicida, embarazo previo, relaciones personales deficientes, escuela de procedencia pública, percepción económica baja, escolaridad de los padres inferior a bachillerato y tiempo prolongado de traslado. Los irregulares NUCE tuvieron los mayores factores protectores. Conclusiones: El EMA identifica factores de riesgo y protectores que influyen en el rendimiento escolar. Se estableció un perfil predictivo de fracaso escolar en el primer año del TRAD. Se recomiendan estrategias preventivas y continuar con el estudio de cohortes.

BACKGROUND: Academic drop outs at the university level is a serious problem. At the School of Medicine of the UNAM, over 50% of students enrolled in their first year do not graduate. In order to solve this problem, the UNAM has tutoring and financial aids to help students. One area of enquiry is to analyze factors such as health status (physical and mental), lifestyle and environmental factors that may influence student's performance. The objective in the present study was to identify risk factors for overall health and establish a scholastic performance forecasting profile. METHODS: Health variables included in the Examen Médico Automatizado (EMA) were correlated with the academic performance in a sample of students from two generations. Four groups were conformed and the variables that were analyzed included traditional academic program (TRAD), high academic demand and having a status as regular or irregular student. RESULTS: 1,848 students were included in the study. The risk factors that characterized students in the TRAD program and had an irregular status were: signs of depression, anxiety, suicidal ideation and suicidal intent, prior pregnancy, poor interpersonal relationships, public school education, low income, parents with less than college education and long commutes from home to school. Students with an irregular status belonging to the high academic demand, reported the strongest protective factors against school failure. CONCLUSIONS: The EMA test identifies risk and protective factors that have an influence on student's academic performance. A forecasting failure profile was established among first year of students enrolled in the TRAD program. We suggest strategies that should be implemented and to continue studying cohorts of graduating students.

Fundus Examination Rate in Diabetics and the Public Health Factors Associated With Fundus Examination Rate

PURPOSE: To investigate the fundus examination rate in diabetic patients and the public health factors associated with the fundus examination rate. METHODS: We analyzed the results of the third Korean National Health and Nutrition Examination Survey. We investigated the fundus examination rate in patients who had diabetes mellitus for more than 3 months during the previous year and determined the relationship of public health factors with the fundus examination rate. RESULTS: In all 547 patients (38.1%) received the fundus examination out of 1,437 total patients with diabetes mellitus. We found that many public health factors influenced the higher fundus examination rate, including patients who were residents in urban areas, women, office workers, university graduates, patients with a higher family income or more than 5 years duration of diabetes mellitus, patients with current insulin treatment, treatment of diabetes mellitus, education about diabetes mellitus, subjective visual problems or subjective health problems. However, age, marital status, health insurance and residential district did not influence the fundus examination rate. CONCLUSIONS: The Korean National Health and Nutrition Examination Survey is the largest health survey in Korea. This study is meaningful as a population-based study, not a clinic-based cross-sectional study and it suggests the basic data for improving the fundus examination rate in diabetes mellitus patients.

Prevalence of self-reported overweight-obesity and its association with socioeconomic and health factors among older Mexican adults

OBJECTIVE: To investigate the prevalence of obesity and its association with socioeconomic factors and comorbidities in a population-based study. MATERIAL AND METHODS: Data were examined from 4 605 persons ages 60 and older that participated in the 2001 Mexican Health and Aging Study, conducted in rural and urban communities in Mexico. The prevalence of obesity (according to self-reported weight and height) was obtained, stratified by age, and logistic regression was used to study cross-sectional associations between obesity and socioeconomic factors. RESULTS: Of the population studied, 20.9 percent were classified as obese and the prevalence diminishes with age. Overall, women were more likely than mentobe obese. Lower educational level was associated with lower risk of overweight. In both men and women, obesity was more common between subjects with hypertension (OR 1.38 and 1.71, respectively) and long-distance walk limitation (OR 2.08 and 2.21, respectively). CONCLUISON: In older Mexican adults, hypertension and long-distance walk limitation were independent associated factors for higher prevalence of obesity.

OBJETIVO: Estudiar la prevalencia de obesidad y su asociación con factores socioeconómicos y comorbilidades. MATERIAL Y MÉTODOS: Se analizaron los datos de 4 605 personas de 60 años y más que participaron en el Estudio Nacional sobre Salud y Envejecimiento en México 2001 (ENASEM 2001) en zonas rurales y urbanas. La prevalencia de obesidad (peso y talla autorreportados) se obtuvo estratificada por edad y mediante una regresión logística se asoció con factores socioeconómicos. RESULTADOS: 20.9 por ciento se clasificaron como obesos y la prevalencia disminuyó con la edad. En general las mujeres tuvieron mayor probabilidad de ser obesas. Una baja escolaridad se asoció con menor riesgo de sobrepeso. En hombres y mujeres la obesidad se asoció con hipertensión (RM 1.38 y 1.71 respectivamente) y con dificultad para caminar (RM 2.08 y 2.21 respectivamente). CONCLUSION: En la población de edad avanzada en México la hipertensión y la dificultad para caminar varias cuadras se asoció con mayor prevalencia de obesidad.