Behavioral Intention Scale for End-of-life DiscussionsReliability and Validity Using a Web-based Survey

Purpose: The purpose of this study was to examine the reliability and validity of the behavioral intention scale for end-of-life discussions. Methods: The scale items were developed according to the Theory of Planned Behavior. The drafts of the scale were created by Item-Level Content Validity Index (I-CVI) and a preliminary test. In the main study, we administered a cross-sectional questionnaire on the web to the participants 20–79 years of age (n=860), living in Tokyo and six surrounding prefectures, and a retest one week later (n=665). We examined item analysis, calculation of a reliability coefficient (intraclass correlation coefficient, Cronbach's alpha coefficient), construct validity, and concurrent validity of the scale. Results: Six factors identified by an exploratory factor analysis were; outcome evaluation, perceived power, control beliefs, motivation to comply, normative beliefs, and behavioral beliefs. The alpha coefficient of the overall scale was .96. The effect size that was determined based on known-groups validity and the correlation coefficient determined on the basis of concurrent validity were moderate. Conclusions: The reliability and validity of the scale were generally confirmed.

Relationship between awareness and fear about coronavirus disease infection among M.B.B.S. students studying at dedicated coronavirus disease hospital – A cross-sectional web-based survey

Background: News of havoc created by novel corona virus in infected regions of the world gave rise to fear and panic about coronavirus disease (COVID-19) infection among the people. Various news agencies, bringing mixed and variable information helped the spread of fear among the masses. Aims and Objectives: On literature search, few studies can be found analyzing fear and anxiety about COVID-19 infection among medical students, medical professionals, as well as general public. The present study is an attempt to fulfill these lacunae. Materials and Methods: The present study was carried out at tertiary care hospital and medical college. Design of the study was a cross-sectional, observational study and data collection was carried out using online means. Results: Mean score of All responses was 7.37 and with standard deviation of 1.36. Among individual questions, perfect score was achieved for question regarding common symptoms for COVID-19 infection while the lowest score was obtained for minimum hand washing time mentioned as per the WHO guidelines with only 15.6% of responders giving correct answer. Conclusion: Findings of this study demonstrated the level of fear and level of awareness and knowledge among the M.B.B.S. students. There was moderate amount of fear among the minds of students and their awareness and knowledge about COVID-19 infection was high. Although, difference in awareness score was statistically significant but no significant difference was obtained for fear levels among different batches of medical students.

School environment and adherence to school meals among Brazilian public-school adolescents

ABSTRACT Objective: To assess whether the school environment is associated with adherence to school meals among adolescent students in Brazilian public schools. Methods: Data from the 2015 National School Health Survey were analyzed. The provision of school meals was assessed according to student report and adherence through the frequency of weekly consumption, classified as adherence (≥3x/week), unsatisfactory adherence (≤2x/week), and non-adherence (none). The following characteristics of the school environment were considered: availability of a properly functioning kitchen and dining hall, cafeteria, and alternative outlets inside or outside schools, and sale of unhealthy food in the cafeteria and alternative outlets. Prevalence estimates were calculated considering the sample's complex design. Results: 86.5% of public schools offered school meals, to which 31.3% of students adhered, 37.9% had unsatisfactory adherence, and 30.8% did not adhere to school meals. Adherence to school meals was higher among schoolchildren in the Midwest Region, from non-capitals, and rural area, while less adherence was observed among students from schools with a cafeteria, an alternative food outlet, and a cafeteria selling soft drinks. Conclusions: Low adherence to school meals is associated with the school geography and food environment. These results can support the formulation of actions to improve the school environment and help the universality of participation in the School Nutrition and Food Policy.

RESUMEN Objetivo: Evaluar si el ambiente escolar está asociado con la adherencia a las comidas escolares entre los estudiantes adolescentes de las escuelas públicas brasileñas. Métodos: Se analizaron datos de la Encuesta Nacional de Salud Escolar de 2015. La provisión de comidas escolares se evaluó de acuerdo con el informe del estudiante y la adherencia a través de la frecuencia de consumo semanal, clasificada como adherencia (≥3x/semana), adherencia insatisfactoria (≤2x/semana) y no adherencia (ninguna). Las características del entorno escolar consideradas fueron: la disponibilidad de una cocina y comedor, quiosco y punto alternativo de venta de alimentos dentro o en la entrada de la escuela, y la venta de alimentos no saludables en el quiosco y en los locales alternativos. Las estimaciones de la prevalencia se calcularon considerando el complejo diseño de la muestra. Resultados: 86.5% de las escuelas públicas ofrecieron comidas escolares, a las cuales se adhirió 31.3% de los estudiantes, 37.9% tuvo adherencia insatisfactoria y 30.8% no se adhirió a las comidas escolares. La adherencia a las comidas escolares fue mayor entre los escolares de la Región Centro-Oeste, de las no capitales y del área rural, mientras que se observó una menor adherencia entre los estudiantes de las escuelas con cafetería, un punto de venta de comida alternativa y una cantina que vende refrescos. Conclusiones: La baja adherencia a las comidas escolares se asocia con variables geográficas de la escuela, así como con el entorno alimentario escolar. Por tanto, estos resultados pueden apoyar la formulación de acciones que tengan como objetivo mejorar el entorno escolar y ayudar a la universalidad de la asistencia a la Política de Nutrición y Alimentación Escolar.

Screening tool for restrictive and obstructive ventilatory abnormalities in a population-based survey

Abstract Background: A 6 s spirometry with an inexpensive pocket spirometer efficiently selects individuals for a diagnostic-quality spirometry for airflow limitation, but could also be useful to identify individuals with a restrictive pattern. Objectives: We evaluated an inexpensive simplified spirometer (chronic obstructive pulmonary disease [COPD]-6) as a screening tool to identify spirometric abnormalities. Methods: A population-based survey in Mexico City, with 742 participants performing pre- and post-BD spirometry and a three-maneuver 6 s spirometry (pre-BD) with a COPD-6. We evaluated forced expiratory volume in 1 s (FEV1), FEV6, and FEV1/FEV6 from the COPD-6, crude and expressed as the percentage of predicted (%P), to discriminate post-bronchodilator airflow obstruction (FEV1/forced vital capacity [FVC] <5th percentile) or restriction (FVC or FEV1 <5th percentile with normal FEV1/FVC) through receiver operating characteristics and their area under the curve (AUC). Results: FEV1%P was the best predictor to identify pre- and post-BD ventilatory abnormalities (best cutoff point 87%P, AUC 92% for restrictive pattern, 89% for obstructive pattern, and 91% for any spirometric abnormality). Deriving to clinical spirometry only those with <87%P (26% of the sample) missed only 12% of spirometric abnormalities most of the latter mild. Conclusions: An FEV1 <87%P from a pre-BD 6 s spirometry correctly identified individuals with spirometric ventilatory defects, either obstructive or restrictive.

Relationship between health risk behaviors, oral health-related behaviors, and experiences of oral symptoms in Korean adolescents: based on 2018 Korea Youth Risk Behavior Web-based Survey / 대한구강보건학회지

OBJECTIVES: This study investigates the relationship between risky health behaviors, occurrence of oral symptoms, and oral health-related behaviors. METHODS: The subjects were 60,040 adolescents selected from the web-based survey from the 2018 Korean Youth Health Behavior of Korean Center for Disease Control. The data were analyzed using a combined sample analysis method. The software SPSS version 12.0 was used to conduct the analyses. RESULTS: 1. Men were observed to partake in risky health behavior at significantly higher rates than were women in terms of smoking, drinking, drugs, and sexual intercourse. Our data showed the percentages of men taking part in these behaviors to be 21.1%, 46.4%, 1.3%, and 7.6%, respectively (P<0.01). 2. Of all subjects, 49.1% brushed their teeth more than three times a day, and 43.6% brushed more than twice a day. Further, a significantly higher number of men (46.0%) did not brush their teeth after lunch compared with women (29.1%) (P<0.01). 3. Of all subjects, 52.9% had developed oral symptoms in the previous year. The rate of women experiencing oral symptoms was significantly higher, at 58.1%, compared with men (48.1%, P<0.01). 4. Risky health behavior, such as smoking, drinking, drugs, and sexual intercourse, was significantly associated with occurrence of oral symptoms (P<0.01). Those that had not partaken in smoking, drinking, and sexual intercourse were significantly lower by 0.73, 0.87, and 0.89 times, respectively, compared with those that responded with “yes” (P<0.01). CONCLUSIONS: We have evaluated the rates of risky health and oral health-related behavior in Korean youth and identify their association with the oral symptoms. It is essential to understand the risks of oral diseases so that appropriate oral health education can be provided to adolescents for promoting behavioral changes.

Differences in smoking and tooth brushing habits among general high school and vocational high school students / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to investigate differences in smoking and toothbrushing habits between vocational and general high school students, using data from the 10th Korea Youth Risk Behavior Web-based Survey. METHODS: This study performed a complex samples cross-tabulation analysis and multivariate logistic regression analysis to identify differences in smoking and brushing habits according to the school type on 35,904 students from 400 sample high schools. The final model of logistic regression analysis was adjusted for gender, grade, subjective socioeconomic status, paternal education, and maternal education. RESULTS: The risks of having experienced smoking and current smoking among vocational high school students were 2.3 times and 2.8 times higher compared with general high school students, respectively (P < 0.001). The risks of brushing teeth less than 3 times a day and not brushing teeth after lunch were 1.4 times and 2.0 times higher compared with general high school students, respectively (P < 0.001). CONCLUSIONS: This study suggests the need for developing and implementing an oral health program that reflects the characteristics of vocational high schools to reduce the differences in smoking and toothbrushing habits between general and vocational high school students.

Sugar-sweetened beverage consumption and influencing factors in Korean adolescents: based on the 2017 Korea Youth Risk Behavior Web-based Survey / 한국영양학회지

PURPOSE: This study examined the frequency of sugar-sweetened beverage consumption in Korean adolescents and the major factors influencing the excessive consumption of sugar-sweetened beverages, such as sociodemographic characteristics, health-related behaviors, psychological characteristics, and dietary habits. METHODS: The analysis was performed using the data from the 2017 Korean Youth Risk Behavior Web-based Survey. The subjects included in the analysis were 30,885 middle school students and 31,391 high school students, totaling 62,276. The frequency of sugar-sweetened beverage consumption was calculated by summing the consumption frequencies of soda, high caffeine or energy drinks, and sweet beverages over the last 7 days. The Rao-Scott chi-square test, reflecting information on the sampling design, was used to test the differences in the rate of sugar-sweetened beverage consumption according to each factor. Logistic regression analysis was performed to examine the factors influencing the excessive consumption of sugar-sweetened beverages. RESULTS: The rate of sweetened beverage consumption was higher in boys than in girls, in high school students than in middle school students, in students whose father's education level was lower, in those whose subjective academic performance was lower, and in those who smoked or consumed alcohol. In addition, the rate of sugar-sweetened beverage consumption was higher in those who experienced severe stress, suicidal ideation, sadness, or a sense of despair. The rate of sugar-sweetened beverage consumption was also high in those who skipped breakfast; who frequently consumed fast foods, ramen, or snacks; and who frequently ate meals at convenience stores, supermarkets, or school stores. CONCLUSION: The rate of sugar-sweetened beverage consumption in Korean adolescents is related to various factors, such as sociodemographic characteristics, health-related behaviors, psychological characteristics, and dietary habits.

Social Desirability Bias in self-reported well-being Measures: Evidence from an online survey / Sesgo de deseabilidad social en las medidas de bienestar por autoinforme: evidencia de una encuesta en línea

Abstract Social desirability seems to enhance well-being measures because individuals tend to increase the degree of their satisfaction and happiness resulting in response artifacts and in a serious threat to the validity of self-reported data. This paper explores social desirability bias in self-reported subjective well-being, controlling for several socio-demographic variables such as gender, age, education, marital/relationship status, and employment status. This is in order to test whether social desirability has incremental validity in predicting some well-being measures. Three different facets of well-being are proposed which deal with subjective happiness, general life satisfaction, and gratitude and loneliness, respectively regarded as a positive and negative emotional response. Through a web-based survey a convenience sample of 170 participants completed an online questionnaire including measures of social desirability, subjective happiness, life satisfaction, gratitude, and loneliness. Correlation analyses and two-step hierarchical multiple regression analyses were conducted. All well-being measures show modest significant correlations with social desirability ranging from 0.235 to 0.309, except subjective happiness. Social desirability accounted for from about 3% to 6% of the variance of these measures, after controlling for socio-demographic variables. Social desirability seems thus to play little role in well-being self-report measures, as revealed by previous studies. Some limitations are discussed, as well as issues about social desirability bias in online investigation.

Resumen La deseabilidad social parece mejorar las medidas de bienestar, pues los individuos tienden a aumentar el grado de satisfacción y felicidad que resulta en artefactos de respuesta y en una seria amenaza para la validez de los datos por autoinforme. Este artículo explora el sesgo de deseabilidad social en el bienestar subjetivo autodeclarado, controlando variables sociodemográficas, como el género, la edad, la educación, el estado civil/familiar y la situación laboral, con el fin de probar si la deseabilidad social tiene un incremento en la validez para predecir algunas medidas de bienestar. Se proponen tres facetas del bienestar que tratan de la felicidad subjetiva: 1. la satisfacción general con la vida, 2. la gratitud y 3. la soledad, respectivamente, consideradas como una respuesta emocional positiva y negativa. A través de una encuesta en línea, una muestra de conveniencia de 170 participantes completó un cuestionario en línea que incluía medidas de deseabilidad social, felicidad subjetiva, satisfacción con la vida, gratitud y soledad. Se realizaron análisis de correlación y análisis de regresión jerárquica de dos etapas. Todas las medidas de bienestar muestran modestas correlaciones significativas con deseabilidad social que van desde 0.235 a 0.309, excepto la felicidad subjetiva. La deseabilidad social representó entre 3 y 6 % de la varianza de estas medidas, después de controlar las variables sociodemográficas. Por tanto, la deseabilidad social parece desempeñar un papel pequeño en las medidas de autorreporte de bienestar, como lo revelaron estudios previos. Se discuten algunas limitaciones y cuestiones sobre el sesgo de deseabilidad social en la investigación en en línea.

Alcohol Use And Associated Risk Behaviors Among Adolescents In Northern Thailand

Objectives: Alcohol use in adolescents is one of the major health problems in many countries.Understanding the extent of the problem andrelated health risk behaviors is necessary to help prevent the associated behaviors andprovide appropriate intervention. This study aimed to identify alcohol use in adolescents and its correlation with others health risk behaviors. Methods: A total of 4372 participants, aged 13-18 years old were enrolled. The data were collected using a two-stage stratified cluster sampling methods from secondary and vocational schools. A web-based questionnaire using the Thai Youth Risk Behavior Survey, modified from the Center for Disease Control and Prevention, was administered. Results: The prevalence of lifetime alcohol exposure was 28.32%, of which 815 participants (18.64%) reported current alcohol use. Adolescents with older age (odds ratio, OR=4.93, 95% confidence interval (CI) = 4.15-5.87), male gender (OR = 2.63, 95% CI = 2.23-3.09), and attendance at vocational schools (OR=7.87, 95% CI = 6.66-9.31) were associated with current alcohol use. When adjusted for confounding variables, health risk behaviors including interpersonal violence, cyber bullying, risky sexual behaviors, tobacco and marijuana use, and suicidal behaviors were associated with current alcohol use from the multiple logistic regression (p<0.001). Conclusions: This study shows that a number of adolescents in Northern Thailand are currently using alcohol, and this can influence other health risk behaviors. Efforts to prevent and control alcohol use needs to focus on high-risk groups and among those currently using alcohol.

The relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI) / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to review the relationship between pit and fissure sealant (PFS) experience and the socio-economic factors of adolescents before and after coverage by National Health Insurance (NHI). METHODS: Our sources were the Korea Youth Risk Behavior Web-based Surveys from 2008 and 2014. The variables used were PFS experience, demographic factors, socio-economic factors, and oral health-related behaviors. RESULTS: PFS experience was higher in 2014 than in 2008. The relationship between PFS experience and socio-economic factors was significant in both 2008 and 2014. Although the inequity of PFS experience among adolescents was reduced as PFS was included in NHI coverage, a disparity still exists. CONCLUSIONS: Even after NHI coverage included PFS, the policies to reduce the inequity of PFS experiences among adolescents should be further devised. In addition, a longitudinal study is recommended to determine the relationship between PFS experience and various socio-economic or behavioral factors.

A study on the reliability and validity of the Chinese revised version of Barratt Impulsiveness Scale in Chinese college student with a web-based survey / 预防医学

Objective TheaimofthestudywastoexaminethepsychometricpropertiesoftheChineserevisedversionof BarrattImpulsivenessScale11th(BIS-11)inChinesecollegestudentwithaweb-basedsurvey.Methods Atotalof 2 295 college students were enrolled in the survey,and were divided into two groups.The first group was used for item and factoranalysis,andthesecondgroupwasusedforconfirmatoryfactorsanalysis.Results ItemanalysisindicatedthatBIS-11 had satisfactory item discrimination,except the item 29.Three -factor model of BIS -11 was well documented with exploratory factor analysis (explained 45.526%of total variance)and confirmatory factor analysis (GFI,AGFI,TLI,CFI, RMSEA was 0.872,0.851,0.853,0.864,0.064,respectively).The internal consistency of the total scale and the three subscales using coefficient alpha was in the range of 0.833-0.913.The split-half reliability of the total scale and the three subscales using Spearman-Brown Coefficient was in the range of 0.827-0.907.Furthermore,the female college students in the present study had higher scores on the total scale,cognitive (attention)impulsiveness factor,and motor impulsiveness factor than the male college student (P <0.01 ).The individuals with GHQ -12 (the twelve -item General Health Questionnaire)screen-positive had higher scores on the total scale and the three factors than the subjects with GHQ-12 screen-negative(P<0.01).Conclusion TheresultsofpresentstudysuggestedthattheChineserevisedversionofthe Barratt Impulsiveness Scale 1 1 th could be used as a tool of impulsiveness assessment in web-based survey.

Study on Food-Intake and Atopic Dermatitis among Adolescents: Findings from the Korea Youth Risk Behavior Web-based Survey

The aim of this study was to explore the relationship between demographic characteristics and atopic dermatitis, along with adolescents' body mass index. Also, this study explored the association between dietary intakes (fruits, soda, caffeinated beverages, instant food, cracker, vegetables, and milk) of adolescents and atopic dermatitis. Korea Youth Risk Behavior Web-based Survey for 2014 was used for data analysis, in which a total of 3,532,149 middle and high school students participated. Data were analyzed by descriptive analysis and logistic regression based on the complex sample design using SPSS ver.20.0 statistics. The results showed that males had a higher prevalence rate of atopic dermatitis than females. The significant association between body mass index and atopic dermatitis was found (F=46.625, P<0.001). Students who have higher levels of body mass index showed a higher prevalence rate of atopic dermatitis. Finally, the findings showed that the intake of vegetable and milk had associations with atopic dermatitis (F=6.795, P<0.001). Greater vegetable intake was associated with less atopic dermatitis whereas greater milk intake was associated with more atopic dermatitis prevalence. Based on the above results, we found that demographic characteristics, body mass index, and some dietary food intakes of adolescents had influences on prevalence rate of atopic dermatitis.

Triagem sorológica para doença celíaca em adolescentes / Serologic screening of celiac disease in adolescents

OBJETIVO: Este estudo objetivou identificar a soroprevalência da doença celíaca em adolescentes de escolas públicas da cidade de Salvador, Bahia. MÉTODO: Trata-se de um estudo transversal com amostra probabilística de 1.213 adolescentes de 11 a 17 anos, de ambos os sexos. O índice de massa corporal foi utilizado para o diagnóstico do estado nutricional, adotando-se os percentis segundo idade e sexo, propostos pela World Health Organization. O anticorpo anti-transglutaminase humana da classe imunoglobulina A (anti-tTG-IgA) foi adotado como teste sorológico para triagem da doença celíaca e foi determinado pela técnica do ensaio imunoabsorvente ligado à enzima (ELISA). Foi realizada análise descritiva, utilizando-se a proporção e a média (desvio padrão). RESULTADOS: O sexo feminino predominou entre os adolescentes, e a maioria encontrava-se com adequado estado nutricional. O anticorpo anti-tTG-IgA foi positivo em 6/1.213 (0,49%) adolescentes. CONCLUSÃO: A soroprevalência de doença celíaca entre os adolescentes estudados foi 0,49%. Novas investigações são necessárias para confirmar a prevalência de doença celíaca nessa faixa etária. .

OBJECTIVE: This study aimed to identify the seroprevalence of celiac disease in adolescents from public schools in the city of Salvador, Bahia. METHODS: This was a cross-sectional study with probabilistic sample of 1,213 adolescents, aged 11 to 17 years old, of both genders. The body mass index was used to determine the participants' nutritional status based on the percentiles for age and gender recommended by the World Health Organization. Measurement of the anti-human transglutaminase immunoglobulin A (anti-tTG-IgA) antibody was established as the specific screening test for celiac disease, which involved an enzyme-linked immunosorbent assay (ELISA). Descriptive analysis was performed using proportions and means (standard deviation). RESULTS: The female gender prevailed in the sample, and most of the participants had normal weights. The anti-tTG-IgA antibody was positive in 6/1,213 (0.49%) adolescents. CONCLUSION: The seroprevalence of celiac disease was 0.49% in the investigated adolescents. Further studies are necessary to establish the prevalence of celiac disease in this age range. .

Prevalence of tuberculosis in Faridabad district, Haryana State, India.

Background & objectives: Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of bacillary tuberculosis in the district of Faridabad in Haryana State of India among persons aged older than 15 years. Methods: In this cross-sectional study, residents of Faridabad district were assessed for the prevalence of tuberculosis. Twelve rural and 24 urban clusters with estimated populations of 41,106 and 64,827 individuals were selected for the study. Two sputum samples were collected from individuals found eligible for inclusion. The samples were also cultured by modified Petroff’s method and were examined for growth of Mycobacterium tuberculosis once a week for eight weeks. A person found positive by smear and/or culture was identified as sputum-positive pulmonary TB positive. Results: A total of 105,202 subjects were enumerated in various clusters of the Faridabad district. There were 50,057 (47.58%) females and 55,145 (52.42%) males. Of these 98,599 (93.7%) were examined by the study group (47,976 females; 50,623 males). The overall prevalence of sputum smear or culture positive pulmonary tuberculosis in our study was found to be 101.4 per 100,000 population. Interpretation & conclusions: The present results showed that the prevalence of sputum positive pulmonary tuberculosis was higher in Faridabad district than the notification rates recorded by the World Health Organization for the contemporary period, a disparity that could be explained by a difference in case detection strategy employed for the study.

Ocular Trauma in a Rural Population of North China: The Handan Eye Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the prevalence of ocular trauma and the proportion of blindness and visual impairment due to trauma in a rural population in northern China.</p><p><b>METHODS</b>The Handan Eye Study is a population-based cross-sectional study that surveyed 6830 Chinese people aged 30+ years from 13 randomly selected villages in Yongnian County, city of Handan, Hebei Province, in July, 2006. All participants underwent a standardized interview and extensive examinations. A structured questionnaire was used to collect information on ocular trauma.</p><p><b>RESULTS</b>Of the 5837 participants who filled out the questionnaire, 124 subjects [2.1%; 95% confidence interval (CI), 1.8%-2.5%] reported a history of ocular trauma in either eye, including 19 (0.3%) persons reporting trauma in both eyes. Men were more likely to have an eye injury than women [odds ratio (OR), 3.3; 2.2-4.9]. In multiple logistic regression models, ocular trauma was significantly more frequent among normotensive participants when compared with hypertensive participants (hypertensive vs. normotensive: OR, 0.6; 0.4-0.9) and among participants who had a history of falls (OR, 2.4; 1.2-4.8). The proportion of unilateral visual impairment and unilateral blindness due to trauma were 10.5% (13 subjects) and 21.0% (26 subjects), respectively.</p><p><b>CONCLUSION</b>Our study reports the prevalence of severe ocular trauma among adults in rural China, revealing a high proportion of blindness and visual impairment due to trauma. These findings suggest the need for educational strategies to increase eye health awareness in this rural population with focus on providing at least appropriate first aid care to reduce blindness due to trauma.</p>

Sleep duration and school performance in Korean adolescents / Duración del sueño y desempeño escolar en adolescentes coreanos

Background This study investigated the relationship between sleep duration and school performance in Korean adolescents. Methods In 2012, 63 688 adolescents participated in the 8th Korea Youth Risk Behavior Web-Based Survey (KYRBWS-VIII) project. The relationship between sleep duration and school performance was evaluated by multivariate logistic regression analysis after adjustment for covariate variables, including body mass index, age, parental education, economic status, mental stress, smoking, alcohol consumption, breakfast patterns, and three measures of physical activity. Results For boys, but not for girls, 5-6 hours of sleep/night were related to average or better academic performance (OR: 1.094, 95% CI [1.011-1.182], p=0.025) compared to ≤4 hours/night. For both boys and girls, nine or more hours/night were negatively related to academic performance (boys: 0.657, [0.554-0.779; p<0.001]; girls: ≥9 hours/night, 0.664 [0.572-0.771], p<0.001) compared to ≤4 hours/night. Conclusion Whilst it may appear that five to six hours of sleep are necessary to maintain average or better than average school performance for boys, nine or more hours are detrimental to school performance for both groups. This study was limited by the following factors: data were collected only for weekdays and it is. Other sleep variables, such as quality of sleep and sleepiness, should be investigated for a further understanding of these results.

Antecedentes En este estudio se investigó la relación entre la duración del sueño y el desempeño escolar en adolescentes coreanos. Métodos En 2012, 63 688 adolescentes participaron en el octavo proyecto de Estudio de Conducta de Riesgo Juvenil Basado en la Red (KYRBWS-VIII, por sus siglas en inglés). La relación entre la duración del sueño y el desempeño escolar se evaluó mediante un análisis de regresión logística multivariada tras ajustar para las variables covariadas, incluyendo índice de masa corporal, edad, nivel educativo de los padres, posición económica, estrés mental, consumo de tabaco, consumo de alcohol, patrones en el desayuno y tres mediciones de actividad física. Resultados En el caso de los chicos, pero no así en el de las chicas, de cinco a seis horas de sueño por noche se relacionaron con un desempeño académico promedio o mejor que el promedio (R.M.: 1.094, 95% CI [1.011-1.182], p=0.025) en comparación con ≤ cuatro horas/ noche. Tanto para los chicos como para las chicas, nueve o más horas/noche se relacionaron de forma negativa con el desempeño académico (chicos: 0.657 [0.554-0.779; p<0.001]; chicas ≥9 horas/noche, 0.664 [0.572-0.771], p<0.001) en comparación con ≤4 horas/noche. Conclusión Para los chicos, de cinco a seis horas de sueño son necesarias para mantener un desempeño escolar promedio o mejor que el promedio, en tanto que nueve o más horas son perjudiciales para el desempeño escolar de tanto los chicos como las chicas. Otras variables del sueño, como la calidad del sueño y la somnolencia, deben investigarse para obtener una mejor comprensión de estos resultados.

An assessment of Pakistani pharmacy and medical students’ knowledge of black box warnings / Una evaluación del conocimiento de estudiantes de medicina y de farmacia en Pakistán sobre alertas de medicamentos / Uma avaliação sobre o acesso de estudantes paquistaneses de medicina e farmácia ao conhecimento das advertências das caixas de tarja preta

Food and Drug Administration delivers the black box warnings (BBW) which should appear on the leaflets of medicines for patient awareness and the prescription of drugs indicating its highly fatal adverse effects to human body. The aim of this study was to assess the knowledge of Pakistani pharmacy and medical students about BBW. A questionnaire containing contents about BBW was given to the 1st, 2nd and 3rd professional year pharmacy and medical students from different pharmacy and medical institutes. A 76 percent survey response rate was observed. It was observed that student’s knowledge about BBW improves in association with the promotion in professional years of pharmacy and medical education. The results indicate that student’s knowledge about black box increases with the study level. Training in black box warnings should be implemented in pharmacy and medical institutions influencing the meaningful ways to educate and train pharmacy and medical students, and help these students to get recent knowledge about black box warnings so that, in future, they may perform an ethical practice in their respective fields.

La Agencia Reguladora de Alimentos y Medicamentos comunica alertas sobre medicamentos (AM), que debieran aparecer en los prospectos de medicinas, para el conocimiento de los pacientes y la prescripción de medicamentos, indicando sus efectos adversos fatales para el cuerpo humano. El objetivo de este estudio es averiguar el conocimiento de estudiantes de medicina y de farmacia sobre AM. Se entregó un cuestionario con contenidos sobre AM a estudiantes de farmacia y de medicina de primero a tercer año de diferentes institutos médicos y farmacéuticos. Se obtuvo un 76 por ciento de respuesta. Se observó que el conocimiento de los estudiantes sobre AM mejora asociado a la promoción en años profesionales de medicina y farmacia. Los resultados indican que el conocimiento de los estudiantes sobre alerta de medicamentos aumenta con el nivel de estudio. Debería implementarse la formación sobre alerta de medicamentos en farmacia y medicina y ayudar a los estudiantes a tener conocimiento actual sobre alerta de medicamentos de forma que, en el futuro, puedan realizar prácticas éticas en sus campos respectivos.

A Food and Drug Administration disponibiliza as advertências das caixas de tarja preta (BBW) que devem aparecer em bulas de medicamentos para conscientização de pacientes e a prescrição de drogas, indicando seus efeitos adversos altamente fatais para o corpo humano. O propósito deste estudo foi o de de inteirar a cerca do conhecimento de estudantes de medicina e farmácia sobre BBW. Um questionário com conteúdos sobre BBW foi dado a estudantes de farmácia e medicina, do 1º, 2º e 3º ano de diferentes instituições de ensino em farmácia e medicina. Foi observada uma taxa de 76 por cento de resposta dos pesquisados. Observou-se que o conhecimento de estudantes sobre BBW melhora quando se associa à promoção para anos seguintes da educação nas faculdades de farmácia e medicina. Os resultados indicam que o conhecimento dos estudantes sobre as caixas de tarja preta aumenta com o nível de estudo. Treinamento com caixas de tarja preta pode ser implementado em instituições de ensino de farmácia e medicina, influenciando de modo significativo as formas de educação e treinamento de estudantes de farmácia e medicina, e,assim, ajudar estes estudantes a obter conhecimentos recentes sobre medicamentos de tarja preta de modo que, no futuro, elas possam exercer uma prática ética em seus respectivos campos de atuação profissional.

Factors Related to Increasing Trends in Cigarette Smoking of Adolescent Males in Rural Areas of Korea / 예방의학회지

OBJECTIVES: Cigarette smoking prevalence among adolescent males in rural areas of Korea has increased in recent years. The aim of this study was to explore the factors related to increasing trends in cigarette smoking among adolescent males living in rural areas. METHODS: The raw data from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Multiple logistic regression models were used to explore the factors affecting cigarette smoking. We evaluated the linear time trends in the prevalence of factors that were related to current smoking status and the linear time trends in cigarette smoking in groups stratified by the exposure to each factor using logistic regression models. Finally, we examined the contributions of the factors to the time trends in cigarette smoking by adjusting for each of those factors in the baseline regression models and changes in the adjusted odds ratio by survey year. RESULTS: A statistically significant increasing trend in smoking was observed after adjusting for the factors affecting cigarette smoking. Significant factors related to cigarette use were perceived stress, experience with depression, current alcohol drinking, exposure to secondhand smoke, and academic performance. The factor related to increasing trends in cigarette smoking was academic performance. CONCLUSIONS: Stress about academic performance is an important factor affecting the increase in cigarette smoking among adolescent males in a rural area of Korea.

Polifarmácia entre idosos do Município de São Paulo - Estudo SABE / Polypharmacy among the elderly in the city of São Paulo, Brazil - SABE Study

Foi avaliado o uso de cinco ou mais medicamentos (polifarmácia) e seus fatores associados por idosos do município de São Paulo. Realizou-se estudo transversal de base populacional: Estudo SABE - Saúde, Bem-estar e Envelhecimento, no ano de 2006. A amostra foi composta por 1.115 idosos com 65 anos e mais, que correspondiam a 422.377 indivíduos do Município de São Paulo. Utilizou-se regressão logística múltipla. A prevalência de polifarmácia foi de 36%. Sexo feminino (OR = 1,7; IC 95%: 1,0; 2,9), idade igual ou superior a 75 anos (OR = 1,9; IC 95%: 1,3; 2,7), maior renda (OR = 1,8; IC 95%: 1,2; 2,8), estar trabalhando (OR = 1,8; IC 95%: 1,1; 2,9), auto avaliação de saúde regular (OR = 1,6; IC 95%: 1,1; 2,3) ou ruim (OR = 2,6; IC 95%: 1,4; 4,9), hipertensão (OR = 2,0; IC 95%: 1,4; 2,9), diabetes (OR = 4,1; IC 95%: 2,2; 7,5), doença reumática (OR = 2,3; IC 95%: 1,5; 3,6) e problemas cardíacos (OR = 2,9; IC 95%: 1,9; 4,5) apresentaram associação positiva com polifarmácia. Usar apenas o sistema público de saúde (OR = 0,5; IC 95%: 0,3; 0,7) associou-se inversamente à polifarmácia. Os medicamentos mais utilizados foram os de ação no sistema cardiovascular e trato alimentar e metabolismo. No âmbito da farmacoepidemiologia, o conhecimento dos fatores associados a polifarmácia, como os identificados nesse estudo, pode ser útil para alertar os profissionais da saúde quanto à importância de identificar e monitorar os grupos de idosos mais vulneráveis a polifarmácia.

Polypharmacy for the elderly and associated factors were assessed. A cross-sectional study was conducted using data from the SABE Study (Health, Well-being and Aging), 2006. 1,115 individuals representing 422,377 elderly aged 65 or more, living in São Paulo City, were interviewed. Polypharmacy was defined as the use of five or more medications. A multivariate regression logistics was used. Polypharmacy prevalence was 36%. Female (OR = 1.7; IC 95%: 1.0; 2.9), age over 75 years (OR = 1.9; CI 95%: 1.3; 2.7), higher income (OR = 1.8; CI 95%: 1.2; 2.8), working (OR = 1.8; CI 95%: 1.1; 2.9), regular self assessed health (OR = 1.6; CI 95%: 1.1; 2.3) or poor (OR = 2.6; CI 95%: 1.4; 4.9), hypertension (OR = 2.0; CI 95%: 1.4; 2.9), diabetes (OR = 4.1; CI 95%: 2.2; 7.5), rheumatic diseases (OR = 2.3; CI 95%: 1.5; 3.6) and cardiac problems (OR = 2.9; CI 95%: 1.9; 4.5) were associated positively with polypharmacy. Using only the public health system (OR = 0.5, 95% CI: 0.3; 0.7) was inversely associated with polypharmacy. Medicines for the cardiovascular system and for the alimentary tract and metabolism were the most used. The knowledge of factors associated with polypharmacy, such as those identified in this study, may be useful to alert health professionals about the importance of identifying and monitoring the elderly groups most vulnerable to polypharmacy.

Comorbidities of Chronic Obstructive Pulmonary Disease in Koreans: A Population-Based Study

Chronic obstructive pulmonary disease (COPD) includes pulmonary components with increased comorbidity rates, as well as being a systemic disease. Comorbidities may frequently occur in COPD patients over 40 yr old. We report the comorbidities of patients with COPD, diagnosed by spirometry, in a population-based epidemiologic survey in Korea. Data were derived from the fourth Korean Health and Nutrition Examination Survey in 2008, a stratified multistage clustered probability design survey of a sample representing the entire population of Korea. Results of spirometry and various health-related questionnaires were analyzed in 2,177 subjects aged > or = 40 yr. The prevalence of COPD (FEV1/FVC or = 40 yr of age was 14.1%. Multivariate analysis showed that underweight (odds ratio [OR] 3.07, 95% confidence interval [CI] 1.05-8.98), coronary heart disease (OR, 0.43; 95% CI, 0.20-0.93) and dyslipidemia (OR, 0.61; 95% CI, 0.45-0.82) were significantly associated with COPD, whereas allergic rhinitis, anemia, arthritis, chronic renal failure, depression, diabetes mellitus, hypertension, gastrointestinal ulcer, and osteoporosis were not. Underweight might be more prevalent but coronary heart disease and dyslipidemia are less prevalent in Koreans with than without COPD in population setting.