Background: The perception of barriers to exercise is an important correlate of exercise participation. However, only a limited number of studies—mostly from Western countries—have attempted to describe the perceptions of barriers to exercise in specific population groups. This study examined the associations between sociodemographic attributes and perceived barriers to exercise in Japanese adults. Methods: A population-based cross sectional study of 865 participants (age: 20–69 years old, men: 46.5%) was conducted in 4 cities in Japan. Nine sociodemographic attributes (sex, age, location of residence, educational attainment, marital status, employment status, presence of dependents in the household, self-rated health, body mass index), along with exercise frequency and perception of barriers to exercise (discomfort, lack of motivation, lack of time, lack of social support, poor environment) were assessed by self-administered questionnaire. Results: The most strongly perceived barrier was lack of time. Five of 9 sociodemographic attributes were significantly related to certain types of perceived barriers. Participants who more strongly perceived barriers were younger, more highly educated, more likely to be employed, and had relatively poor self-rated health and a high BMI. The specific types of barriers that were strongly perceived varied with the sociodemographic attributes of the participants. Conclusions: The results show that the perception of barriers to exercise varies among specific population groups, which indicates the importance of targeting exercise promotion strategies to specific populations.
Background: Taiwan has the highest incidence of end-stage renal disease (ESRD) in the world. The epidemiologic features of ESRD, however, have not been investigated. In this case–control study, we evaluated the risk of ESRD associated with a number of putative risk factors. Methods: We studied 200 patients among whom ESRD had been newly diagnosed between 1 January 2005 and 31 December 2005; 200 controls were selected from among relatives of patients treated in the general surgery unit. Using a structured questionnaire, we collected information related to socioeconomic factors, history of disease, regular blood or urine screening, lifestyle, environmental exposure, consumption of vitamin supplements, and regular drug use at 5 years before disease onset. Results: Our primary multivariate risk models indicated that low socioeconomic status was a strong predictor of ESRD (education: odds ratio [OR], 2.78; 95% confidence interval [CI], 1.49–5.19; income: OR, 2.86, 95% CI, 1.48–5.52), even after adjusting for other risk factors. Other significant predictors for ESRD were a history of hypertension (OR, 3.63–3.90), history of diabetes (OR, 3.85–5.50), and regular intake of folk remedies or over-the-counter Chinese herbs (OR, 10.84–12.51). Regular intake of a multivitamin supplement 5 years before diagnosis was associated with a decreased risk of ESRD (OR, 0.12–0.14). Conclusions: Our findings indicate that low socioeconomic status, history of hypertension, diabetes, and regular use of folk remedies or over-the-counter Chinese herbs were significant risk factors for ESRD, while regular intake of a multivitamin supplement was associated with a decreased risk of ESRD.
Background: Among African-Americans, and in southern US states, the rates of stroke are high but the reported prevalences of atrial fibrillation (AF) are low. We hypothesized that the reported ethnic and regional distributions of AF are affected by the sensitivity of the methods that were used to detect AF in previous reports. Methods: A total of 18 833 black and white participants from the US national REasons For Geographic And Racial Differences In Stroke (REGARDS) study were included in this analysis. Levels of sensitivity to detect AF, from least to most sensitive, were created for combinations of self-report (SR) and ECG methods, as follows: (1) SR plus ECG, (2) ECG alone, (3) SR alone, and (4) SR or ECG. Geographic regions were dichotomized as Stroke Belt (the southern US states) and non-Stroke Belt. Logistic regression analysis estimated the odd ratios of AF associated with the Stroke Belt and black ethnicity for each diagnostic combination. Results: Residence in the Stroke Belt was significantly associated with AF when diagnosed by SR plus ECG (multivariable-adjusted OR, 0.66; 95% CI, 0.47 to 0.92), but not when diagnosed with SR or ECG (OR, 0.95; 95% CI, 0.85 to 1.06). Similarly, for the 4 methods used to detect AF, the strength of the association between black ethnicity and AF progressively decreased with increasing test sensitivity (ORs: 0.20, 0.40, 0.70, 0.71, respectively). Conclusions: The association of AF with residence in the Stroke Belt and black ethnicity was inversely related to the sensitivity of the method used to detect AF: as test sensitivity increased, the association became attenuated. This may partially explain the lower reported prevalence of AF in populations and regions with higher stroke rates.
Background: The association between air pollution and cardiovascular diseases is well known, but previous studies only assessed mortality and hospital admissions in North America, Europe, and Northeast Asia. Few studies have been conducted in less-developed countries in regions with a tropical climate. This study evaluated whether short-term exposures to fine particulate matter (PM10) and ozone (O3) were associated with hospital visits for cardiovascular diseases (CVD; ICD-10th, I00–I99) in central Bangkok, Thailand. Methods: Data from hospital records were obtained from 3 major government hospitals. All hospital visits were stratified by age group and category of CVD. Daily PM10 and O3 levels reported by the Pollution Control Department from April 2002 to December 2006 (1736 days) were used in a time-series analysis with a generalized additive model procedure. Results: Exposure on the previous day to PM10 and O3 had a positive association with hospital visits for CVD among elderly (≥65 years) individuals. The increase in CVD hospital visits in this age group was 0.10% (95% CI, 0.03–0.19) with a 10 µg/m3 increase in PM10, and 0.50% (95% CI, 0.19–0.81) with an increase in O3. Conclusions: In central Bangkok, a short-term association was observed between increases in daily levels of PM10 and O3 and the number of daily emergency hospital visits for CVD, particularly among individuals aged ≥65 years.
Background: Hepatitis A vaccines have been highly effective in preventing hepatitis A. To investigate the epidemiology of hepatitis A in China after hepatitis A vaccine became available, we reviewed reported cases of hepatitis A and the use of hepatitis A vaccine in China during the period from 1990 through 2007. Methods: Data from the National Notifiable Disease Reporting System from 1990 to 2007 and the Emergency Events Reporting System from 2004 to 2007 were reviewed and epidemiologic characteristics analyzed. Hepatitis A vaccine distribution between 1992 and 2007 was also reviewed. Results: The incidence of hepatitis A has declined by 90% since 1990, from 56 to 5.9 per 105/year. Declines in age-specific incidence were seen in all age groups, most dramatically among children younger than 10 years. Disease incidence still varies substantially: poorer western provinces have had the highest incidences since 2000. In high-incidence provinces, children younger than 10 years continue to have a high disease incidence. Only 50% of cases were laboratory-confirmed, and only 3% occurred in reported local outbreaks. Over 156 million doses of hepatitis A vaccine have been distributed since 1992, and use has continued to increase since 2003. Conclusions: Incidence of hepatitis A has decreased in all age groups, likely due to changing socioeconomic conditions and increasing hepatitis A vaccine use. Nevertheless, western populations remain at high risk, with transmission predominantly occurring among children. The epidemiology of hepatitis A transmission is not well understood. Improved surveillance with better laboratory confirmation is needed to monitor the impact of universal hepatitis A vaccination of young children; this strategy began to be implemented in 2008.
Background: Records in Western countries reveal that adult height has been increasing over the last 250 years. These height gains have been biologically associated with healthier childhoods, less illness, and longer life spans—a health-risk transition. To measure such progress in Thailand we studied height change over the last 3 decades. Methods: We analyzed height records for 33 000 21-year-old male military recruits, sampling 1000 per year from 1972 through 2006. We compared the height trend in Thailand to those noted in Europe, and discuss the former in the context of improvements in living circumstances in Thailand. Results: Over 35 years, mean height increased from 164.4 to 169.2 cm, an increment of nearly 5 cm. The height increase was negligible in the first decade (1972–1981), but substantially accelerated after that. In the period after 1990 the increase exceeded 3 cm. A similar overall height gain in Britain occurred over a much longer period (1750–1886). Conclusions: The increase in height among Thai men is biological evidence that a Thai health-risk transition—defined by both changing risks and outcomes—is well underway for height. Military recruits born during the 1960s through the 1980s had progressively healthier childhoods. Over this period child nutrition improved, infection and mortality rates declined, and preventive health services expanded. The combined effect of these factors is indicated by the increased adult height of Thai military recruits.
Background: The aim of the present study was to determine subsites of gastric cancer in East Azerbaijan, Iran—a high incidence region for gastric cancer and Helicobacter pylori infection. Methods: Data were collected from 2002 through 2007 from patients who sought treatment for gastrointestinal symptoms or signs at a university clinic and subsequently underwent upper gastrointestinal endoscopy. Results: Cancer was diagnosed and histologically confirmed in 362 patients (352 adenocarcinomas). The mean age of the patients was 64.57 ± 11.32 (range, 16–94 years) and the male-to-female ratio was 2.8:1. The gastric cardia was involved in 40.3% of patients with gastric adenocarcinoma, while the gastric fundus was involved in 3.7%, the gastric body in 49.1%, and the gastric antrum in 24.1% of patients. Complete evaluation for metastasis was possible in 144 patients; 61 were free of metastasis, and most of these patients underwent surgical therapy. Cardia involvement was not associated with the sex or age of patients. Conclusions: Noncardia gastric cancer is still more frequent in East Azerbaijan, which is likely due to the very high prevalence of infection with Helicobacter pylori. The low rate of cancer involving the fundus is a target for further research on the etiology of gastric cancer.
Background: Consumption of Plantago ovata may protect against colorectal cancer. To test this hypothesis, an ecological study was performed to determine mortality rates and distribution of colorectal cancer, and the consumption and distribution of P ovata, in different provinces in Spain. The putative association between P ovata consumption and mortality from colorectal cancer was then evaluated. Methods: We conducted a comparative ecological study of Spanish provinces, with colorectal cancer mortality as the dependent variable and per capita consumption of P ovata by province and year as the independent variable. Associations were analyzed by calculating Spearman’s correlation coefficients and a Poisson multiple regression model. Results: Consumption of P ovata tended to be inversely correlated with mortality from colorectal cancer. In the Poisson regression analysis this tendency remained and reached statistical significance for the top quintile of P ovata consumption in the adjusted analysis (P = 0.042). Conclusions: Our results show an inverse trend between the consumption of P ovata and colorectal cancer mortality. We recommend additional observational studies of individuals, in order to better control confounding factors.