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Almevall A, Almevall AD, Öhlin J, Gustafson Y, Zingmark K, Niklasson J, Nordström P, Rosendahl E, Söderberg S, Olofsson B. Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort. Arch Gerontol Geriatr 2024; 122:105392. [PMID: 38492492 DOI: 10.1016/j.archger.2024.105392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population. AIM To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival. METHODS All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests. FINDINGS Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05). CONCLUSION This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.
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Affiliation(s)
- Ariel Almevall
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden.
| | | | - Jerry Öhlin
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Yngve Gustafson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Karin Zingmark
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Johan Niklasson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Section of Medicine Umeå University, Umeå, Sweden
| | - Birgitta Olofsson
- Department of Nursing, Department of Diagnostics and Intervention, Orthopedics, Umeå University, Umeå, Sweden
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Jonsson F, Olofsson B, Söderberg S, Niklasson J. Association between the COVID-19 pandemic and mental health in very old people in Sweden. PLoS One 2024; 19:e0299098. [PMID: 38564616 PMCID: PMC10986980 DOI: 10.1371/journal.pone.0299098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, Sweden implemented social distancing measures to reduce infection rates. However, the recommendation meant to protect individuals particularly at risk may have had negative consequences. The aim of this study was to investigate the impact of the COVID-19 pandemic on very old Swedish peoples' mental health and factors associated with a decline in mental health. METHODS We conducted a cross-sectional study among previous participants of the SilverMONICA (MONItoring of Trends and Determinants of CArdiovascular disease) study. Of 394 eligible participants, 257 (65.2%) agreed to participate. Of these, 250 individuals reported mental health impact from COVID-19. Structured telephone interviews were carried out during the spring of 2021. Data were analysed using the χ2 test, t-test, and binary logistic regression. RESULTS Of 250 individuals (mean age: 85.5 ± 3.3 years, 54.0% women), 75 (30.0%) reported a negative impact on mental health, while 175 (70.0%) reported either a positive impact (n = 4) or no impact at all (n = 171). In the binary logistic regression model, factors associated with a decline in mental health included loneliness (odds ratio [95% confidence interval]) (3.87 [1.83-8.17]) and difficulty adhering to social distancing recommendations (5.10 [1.92-13.53]). High morale was associated with positive or no impact on mental health (0.37 [0.17-0.82]). CONCLUSIONS A high percentage of very old people reported a negative impact on mental health from the COVID-19 pandemic, primarily from loneliness and difficulty adhering to social distancing measures, while high morale seemed to be a protective factor.
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Affiliation(s)
- Fanny Jonsson
- Community Medicine and Rehabilitation, Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Birgitta Olofsson
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Surgical and Perioperative Science, Orthopedics, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Johan Niklasson
- Community Medicine and Rehabilitation, Sunderby Research Unit, Umeå University, Umeå, Sweden
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Lee PN, Coombs KJ, Hamling JS. Evidence relating cigarettes, cigars and pipes to cardiovascular disease and stroke: Meta-analysis of recent data from three regions. World J Meta-Anal 2023; 11:290-312. [DOI: 10.13105/wjma.v11.i6.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND More recent data are required relating to disease risk for use of various smoked products and of other products containing nicotine. Earlier we published meta-analyses of recent results for chronic obstructive pulmonary disease and lung cancer on the relative risk (RR) of current compared to never product use for cigarettes, cigars and pipes based on evidence from North America, Europe and Japan. We now report corresponding up-to-date evidence for acute myocardial infarction (AMI), ischaemic heart disease (IHD) and stroke.
AIM To estimate, using recent data, AMI, IHD and stroke RRs by region for current smoking of cigarettes, cigars and pipes.
METHODS Publications in English from 2015 to 2020 were considered that, based on epidemiological studies in the three regions, estimated the current smoking RR of AMI, IHD or stroke for one or more of the three products. The studies should involve at least 100 cases of stroke or cardiovascular disease (CVD), not be restricted to populations with specific medical conditions, and should be of cohort or nested case-control study design or randomized controlled trials. A literature search was conducted on MEDLINE, examining titles and abstracts initially, and then full texts. Additional papers were sought from reference lists of selected papers, reviews and meta-analyses. For each study identified, we entered the most recent available data on current smoking of each product, as well as the characteristics of the study and the RR estimates. Combined RR estimates were derived using random-effects meta-analysis for stroke and, in the case of CVD, separately for IHD and AMI. For cigarette smoking, where far more data were available, heterogeneity was studied by a wide range of factors. For cigar and pipe smoking, a more limited heterogeneity analysis was carried out. A more limited assessment of variation in risk by daily number of cigarettes smoked was also conducted. Results were compared with those from previous meta-analyses published since 2000.
RESULTS Current cigarette smoking: Ten studies gave a random-effects RR for AMI of 2.72 [95% confidence interval (CI): 2.40-3.08], derived from 13 estimates between 1.47 and 4.72. Twenty-three studies gave an IHD RR of 2.01 (95%CI: 1.84-2.21), using 28 estimates between 0.81 and 4.30. Thirty-one studies gave a stroke RR of 1.62 (95%CI: 1.48-1.77), using 37 estimates from 0.66 to 2.91. Though heterogeneous, only two of the overall 78 RRs were below 1.0, 71 significantly (P < 0.05) exceeding 1.0. The heterogeneity was only partly explicable by the factors studied. Estimates were generally higher for females and for later-starting studies. They were significantly higher for North America than Europe for AMI, but not the other diseases. For stroke, the only endpoint with multiple Japanese studies, RRs were lower there than for Western studies. Adjustment for multiple factors tended to increase RRs. Our RR estimates and the variations by sex and region are consistent with earlier meta-analyses. RRs generally increased with amount smoked. Current cigar and pipe smoking: No AMI data were available. One North American study reported reduced IHD risk for non-exclusive cigar or pipe smoking, but considered few cases. Two North American studies found no increased stroke risk with exclusive cigar smoking, one reporting reduced risk for exclusive pipe smoking (RR 0.24, 95%CI: 0.06-0.91). The cigar results agree with an earlier review showing no clear risk increase for IHD or stroke.
CONCLUSION Current cigarette smoking increases risk of AMI, IHD and stroke, RRs being 2.72, 2.01 and 1.62. The stroke risk is lower in Japan, no increase was seen for cigars/pipes.
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Affiliation(s)
- Peter Nicholas Lee
- Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
| | - Katharine J Coombs
- Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
| | - Jan S Hamling
- Medical Statistics and Epidemiology, P.N.Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
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Association of the number of teeth and self-rated mastication with self-rated health in community-dwelling Japanese aged 40 years and older: the Yamagata cohort study. Sci Rep 2022; 12:21025. [PMID: 36471165 PMCID: PMC9722922 DOI: 10.1038/s41598-022-25690-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Self-rated health (SRH) is a predictive factor for health-related prognoses such as mortality. This study aimed to comprehensively investigate the risk factors for poor SRH in the general population of Japan, focusing on the combination of the number of teeth and self-rated mastication. Individuals aged at least 40 years in Yamagata Prefecture, Japan, were surveyed from 2017 to 2021. The participants answered a self-administered postal survey on lifestyle factors, medical history, physical and mental conditions, oral health, and dietary intake, and 6739 participants were included. Multivariate logistic regression analysis showed that individuals with less than 20 teeth and who bite tightly on one side or neither side were at a 1.422- and 1.952-fold significantly higher risk, respectively, of poor SRH than individuals with at least 20 teeth and who bite tightly on both sides. Moreover, individuals who had less than 20 teeth but could bite tightly on both sides did not have a significant risk compared to those who had at least 20 teeth and could bite tightly on both sides. Regarding individuals with more than 20 teeth, there was no difference between those who could and could not bite tightly on both sides, although the odds ratios for poor SRH tended to increase for those who could bite on one side or neither side. Our results emphasize the importance of having at least 20 teeth without periodontal disease and oral rehabilitation using a type of prosthesis for SRH, even with less than 20 teeth.
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Jordan AN, Anning C, Wilkes L, Ball C, Pamphilon N, Clark CE, Bellenger NG, Shore AC, Sharp ASP, Valderas JM. Cross-cultural adaptation of the Spanish MINICHAL instrument into English for use in the United Kingdom. Health Qual Life Outcomes 2022; 20:39. [PMID: 35246164 PMCID: PMC8895672 DOI: 10.1186/s12955-022-01943-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/20/2022] [Indexed: 12/12/2022] Open
Abstract
Background Hypertension is a highly prevalent condition, with optimal treatment to BP targets conferring significant gains in terms of cardiovascular outcomes. Understanding why some patients do not achieve BP targets would be enhanced through greater understanding of their health-related quality of life (HRQoL). However, the only English language disease-specific instruments for measurement of HRQoL in hypertension have not been validated in accordance with accepted standards. It is proposed that the Spanish MINICHAL instrument for the assessment of HRQoL in hypertension could be translated, adapted and validated for use in the United Kingdom. The aim of the study was therefore to complete this process. Methods The MINICHAL authors were contacted and the original instrument obtained. This was then translated into English by two independent English-speakers, with these versions then reconciled, before back-translation and subsequent production of a 2nd reconciled version. Thereafter, a final version was produced after cognitive debriefing, for administration and psychometric analysis in the target population of patients living in the Exeter area (Southwest UK) aged 18–80 years with treatment-naïve grade II-III hypertension, before, during and after 18 weeks’ intensive treatment. Results The English-language instrument was administered to 30 individuals (median age: 58.5 years, 53% male). Psychometric analysis demonstrated a floor effect, though no ceiling effect. Internal consistency for both state of mind (StM) and somatic manifestations (SM) dimensions of the instrument were acceptable (Cronbach’s alpha = 0.81 and 0.75), as was test–retest reliability (ICC = 0.717 and 0.961) and construct validity, which was measured through co-administration with the EQ-5D-5L and Bulpitt-Fletcher instruments. No significant associations were found between scores and patient characteristics known to affect HRQoL. The EQ-5D-5L instrument found an improvement in HRQoL following treatment, with the StM and SM dimensions of the English language MINICHAL trending to support this (d = 0.32 and 0.02 respectively). Conclusions The present study details the successful English translation and validation of the MINICHAL instrument for use in individuals with hypertension. The data reported also supports an improvement in HRQoL with rapid treatment of grade II-III hypertension, a strategy which has been recommended by contemporaneous European guidelines. Trial registration ISRCTN registry number: 57475376 (assigned 25/06/2015).
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Affiliation(s)
- Andrew N Jordan
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK. .,Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.
| | - Christine Anning
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Lindsay Wilkes
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Claire Ball
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Nicola Pamphilon
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Christopher E Clark
- Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care (APEx), NIHR School for Primary Care Research, University of Exeter, Smeall Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
| | - Nicholas G Bellenger
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.,Department of Cardiology, Royal Devon and Exeter Hospital, Exeter, UK
| | - Angela C Shore
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK.,Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK
| | - Andrew S P Sharp
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.,Department of Cardiology, Royal Devon and Exeter Hospital, Exeter, UK
| | - Jose M Valderas
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.,Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care (APEx), NIHR School for Primary Care Research, University of Exeter, Smeall Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
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Guan A, Kim-Mozeleski JE, Vyas P, Stewart SL, Gildengorin G, Burke NJ, Ma K, Pham AT, Tan J, Lu Q, McPhee SJ, Tsoh JY. Neighborhood Ethnic Composition and Self-rated Health Among Chinese and Vietnamese American Immigrants. J Immigr Minor Health 2021; 23:574-582. [PMID: 32617753 PMCID: PMC8208464 DOI: 10.1007/s10903-020-01041-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Immigrants tend to live in areas with higher co-ethnic density, and the effect of neighborhood ethnic composition could be particularly salient for health. This study explored associations between neighborhood ethnic composition and self-rated health among Asian immigrants. We analyzed data collected at baseline from 670 Chinese and Vietnamese immigrants enrolled in a lifestyle intervention trial. Residential addresses were geocoded and combined with neighborhood socio-demographic profiles based on census data. We used generalized estimating equations to examine neighborhood ethnic composition and self-rated health. Independent of individual-level factors, living in neighborhoods more densely populated by whites was associated with poor/fair self-rated health. Neighborhood household income and density of participants' own ethnic group were not associated with poor/fair self-rated health. More research is warranted to disentangle reasons why Chinese and Vietnamese immigrants living in white-concentrated neighborhoods reported poorer self-rated health, including investigating effects of discrimination, relative deprivation, and availability of social resources.
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Affiliation(s)
- Alice Guan
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Jin E Kim-Mozeleski
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Priyanka Vyas
- Center for Tobacco Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Susan L Stewart
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Nancy J Burke
- Department of Public Health, University of California Merced, Merced, CA, USA.,Asian American Research Center on Health, San Francisco, CA, USA
| | - Kris Ma
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Amber T Pham
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Judy Tan
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen J McPhee
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Janice Y Tsoh
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA. .,Asian American Research Center on Health, San Francisco, CA, USA.
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Beasley J, Sardina P, Johnston E, Ganguzza L, Padikkala J, Bagheri A, Jones S, Gianos E. Integrating a diet quality screener into a cardiology practice: assessment of nutrition counseling, cardiometabolic risk factors and patient/provider satisfaction. BMJ Nutr Prev Health 2020; 3:24-30. [PMID: 33235968 PMCID: PMC7664487 DOI: 10.1136/bmjnph-2019-000046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/23/2022] Open
Abstract
Objective We assessed factors related to the integration of an office-based diet quality screener: nutrition counselling, cardiometabolic risk factors and patient/physician satisfaction. Methods We evaluated the impact of a 10-item diet quality measure (self-rated diet quality question and a 9-item Mediterranean Diet Score (MDS)) prior to the cardiology visit on assessment of nutrition counselling, cardiometabolic risk factors and patient/provider satisfaction. Study staff trained the nine participating physicians on the purpose and use of the screener. To assess physician uptake of the diet quality screener, we reviewed all charts having a documented dietitian referral or visit and a 20% random sample of remaining participants that completed the screener at least once to determine the proportion of notes that referenced the diet quality screener and documented specific counselling based on the screener. Results Between December 2017 and August 2018, 865 patients completed the diet quality screener. Mean age was 59 (SD 16) years, 54% were male and mean body mass index was 27.4 (SD 6.0) kg/m2. Almost one-fifth (18.5%) of participants rated their diet as fair or poor, and mean MDS (range 0–9) was moderate (mean 5.6±1.8 SD). Physicians referred 22 patients (2.5%) to a dietitian. Conclusion Integrating the screener into the electronic health record did not increase dietitian referrals, and improvements in screener scores were modest among the subset of patients completing multiple screeners. Future work could develop best practices for physicians in using diet quality screeners to allow for some degree of standardisation of nutrition referral and counselling received by the patients.
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Affiliation(s)
- Jeannette Beasley
- Department of Medicine, NYU Langone Health, New York City, New York, USA
| | - Paloma Sardina
- Department of Medicine, NYU Langone Health, New York City, New York, USA
| | - Emily Johnston
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lisa Ganguzza
- Department of Population Health, NYU Langone Health, New York City, New York, USA
| | - Jane Padikkala
- Department of Population Health, NYU Langone Health, New York City, New York, USA
| | - Ashley Bagheri
- Department of Population Health, NYU Langone Health, New York City, New York, USA
| | - Simon Jones
- Department of Population Health, NYU Langone Health, New York City, New York, USA
| | - Eugenia Gianos
- Department of Medicine, NYU Langone Health, New York City, New York, USA
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Zhang L, Ding D, Neubeck L, Gallagher R. Health literacy as a predictor of emergency department visits and self-rated health among Chinese immigrants: findings from an Australian survey. PATIENT EDUCATION AND COUNSELING 2020; 103:2353-2360. [PMID: 32456982 DOI: 10.1016/j.pec.2020.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 04/09/2020] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Our objectives were to examine health literacy among first-generation Chinese immigrants living in Australia, identifying health literacy domains associated with emergency department (ED) visits and self-rated health (SRH). METHODS Chinese immigrants (n = 362, mean age = 59) were recruited from communities across New South Wales and surveyed for health literacy, ED visits in the past 12 months, and SRH using the Health Literacy Questionnaire (simplified Chinese version). RESULTS More than 70% of participants experienced health literacy difficulties. Health literacy was significantly lower among the following participants: older, migration at older age, recent immigrants, and those without university level education or proficient English. ED visits were independently associated with the health literacy domains lacking 'social support for health' (OR: 1.80; p = .031) and 'ability to appraise health information' (OR: 2.22; p = .005). Poor SRH was associated with the health literacy domains 'insufficient health information' (OR: 1.81; p = .025), 'inactively managing health' (OR: 1.72; p = .048), and 'lacking ability to appraise health information' (OR: 1.70; p = .048). CONCLUSIONS Inadequate health literacy was identified in the majority of first-generation Chinese immigrants and it had significantly association with higher prevalence of ED use and poorer SRH. PRACTICE IMPLICATIONS Early screening and support for health literacy is critical in Chinese immigrants.
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Affiliation(s)
- Ling Zhang
- Susan Wakil School of Nursing and Midwifery / Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; The Charles Perkins Centre, The University of Sydney, Camperdown, Australia.
| | - Ding Ding
- The Charles Perkins Centre, The University of Sydney, Camperdown, Australia; Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Lis Neubeck
- Susan Wakil School of Nursing and Midwifery / Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; The Charles Perkins Centre, The University of Sydney, Camperdown, Australia; School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Robyn Gallagher
- Susan Wakil School of Nursing and Midwifery / Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia; The Charles Perkins Centre, The University of Sydney, Camperdown, Australia
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Self-Rated Health and Age-Related Differences in Ambulatory Blood Pressure: The Mediating Role of Behavioral and Affective Factors. Psychosom Med 2020; 82:402-408. [PMID: 32150013 PMCID: PMC7196491 DOI: 10.1097/psy.0000000000000795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Despite the well-established association between self-rated health (SRH) and health, little is known about the potential psychobiological mechanisms responsible for such links and if these associations differ by age. The main goals of this study were to investigate the links between SRH and ambulatory blood pressure (ABP), if age moderated the risk, and the health behavior/affective mechanisms responsible for such links. METHODS A total of 188 men and women (94 married couples; ages, 18-63 years) completed a standard measure of SRH and a 1-day ABP assessment. Multilevel models were run to examine whether SRH was associated with daily ABP and whether these links were moderated by age. The Monte Carlo method was used to construct confidence intervals for mediation analyses. RESULTS Results indicated that poor SRH was associated with higher ambulatory systolic blood pressure (SBP; b = 3.14, SE = 0.68, p < .001) and diastolic blood pressure (DBP; b = 1.34, SE = 0.43, p = .002) levels. Age also moderated the links between SRH and ambulatory SBP (b = 0.19, SE = 0.08, p = .011) and DBP (b = 0.14, SE = 0.05, p = .004), with links being stronger in relatively older individuals. However, only daily life negative affect significantly mediated the age by SRH interaction for both ambulatory SBP and DBP. CONCLUSIONS These results highlight the potential psychobiological mechanisms linking SRH to longer-term health outcomes. Such work can inform basic theory in the area as well as intervention approaches that target such pathways.
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Diurlin S, Eriksson MCM, Daka B, Lindblad U, Hellgren M. Men with impaired glucose tolerance have lower self-rated health than men with impaired fasting glucose. Prim Care Diabetes 2020; 14:40-46. [PMID: 31204262 DOI: 10.1016/j.pcd.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 05/08/2019] [Accepted: 05/12/2019] [Indexed: 11/15/2022]
Abstract
AIM Previous studies have shown that individuals with impaired glucose tolerance (IGT) have lower self-rated health than normoglycaemic individuals. The aim of this study was to examine differences in self-rated health between individuals with IGT and those with impaired fasting glucose (IFG) and to consider the potentially mediating effect of physical activity. METHODS In 2002-2005, a total of 2816 individuals were randomly selected for a population-based study in Sweden. All participants performed an oral glucose tolerance test (OGTT). Fasting venous blood samples were drawn, and questionnaires concerning lifestyles were completed. Self-rated health (SRH) and leisure time physical activity (LTPA) were reported on a five-graded and four-graded scale, respectively. A total of 213 individuals with IGT and 129 with IFG were detected. RESULTS IGT, but not IFG, was associated with low self-rated health. The difference in self-rated health was seen particularly in men when adjusted for age and BMI (OR = 2.13, CI: 1.13-4.02, p = 0.020). The results became insignificant when including physical activity in the model (OR = 1.8, CI: 0.91-3.58, p = 0.094). CONCLUSION The low self-rated health adds further weight to the risk profile in men with IGT and stresses the importance of early detection and lifestyle interventions.
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Affiliation(s)
- Sven Diurlin
- Department of Primary Health Care, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Maria C M Eriksson
- Department of Primary Health Care, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Bledar Daka
- Department of Primary Health Care, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ulf Lindblad
- Department of Primary Health Care, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Margareta Hellgren
- Department of Primary Health Care, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sweden.
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Bao X, Borné Y, Yin S, Niu K, Orho-Melander M, Nilsson J, Melander O, Engström G. The associations of self-rated health with cardiovascular risk proteins: a proteomics approach. Clin Proteomics 2019; 16:40. [PMID: 31832026 PMCID: PMC6859604 DOI: 10.1186/s12014-019-9258-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/25/2019] [Indexed: 12/26/2022] Open
Abstract
Background Though subjective, poor self-rated health (SRH) has consistently been shown to predict cardiovascular disease (CVD). The underlying mechanism is unclear. This study evaluates the associations of SRH with biomarkers for CVD, aiming to explore potential pathways between poor SRH and CVD. Methods Based on the Malmö Diet and Cancer Cardiovascular Cohort study, a targeted proteomics approach was used to assess the associations of SRH with 88 cardiovascular risk proteins, measured in plasma from 4521 participants without CVD. The false discovery rate (FDR) was controlled using the Benjamini and Hochberg method. Covariates taken into consideration were age, sex, traditional CVD risk factors (low-density lipoprotein cholesterol, systolic blood pressure, anti-hypertensive medication, diabetes, body mass index, smoking), comorbidity, life-style and psycho-social factors (education level, living alone, alcohol consumption, low physical activity, psychiatric medication, sleep duration, and unemployment). Results Age and sex-adjusted associations with SRH was found for 34 plasma proteins. Nine of them remained significant after adjustments for traditional CVD risk factors. After further adjustment for comorbidity, life-style and psycho-social factors, only leptin (β = − 0.035, corrected p = 0.016) and C–C motif chemokine 20 (CCL20; β = − 0.054, corrected p = 0.016) were significantly associated with SRH. Conclusions Poor SRH was associated with raised concentrations of many plasma proteins. However, the relationships were largely attenuated by adjustments for CVD risk factors, comorbidity and psycho-social factors. Leptin and CCL20 were associated with poor SRH in the present study and could potentially be involved in the SRH–CVD link.
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Affiliation(s)
- Xue Bao
- 1Department of Cardiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,2Department of Clinical Sciences, Lund University, CRC 60:13, Jan Waldenströms gata 35, 20502 Malmö, Sweden.,3Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yan Borné
- 2Department of Clinical Sciences, Lund University, CRC 60:13, Jan Waldenströms gata 35, 20502 Malmö, Sweden
| | - Songjiang Yin
- 2Department of Clinical Sciences, Lund University, CRC 60:13, Jan Waldenströms gata 35, 20502 Malmö, Sweden.,4Department of Orthopedics, Jiangsu Province Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Kaijun Niu
- 3Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Marju Orho-Melander
- 2Department of Clinical Sciences, Lund University, CRC 60:13, Jan Waldenströms gata 35, 20502 Malmö, Sweden
| | - Jan Nilsson
- 2Department of Clinical Sciences, Lund University, CRC 60:13, Jan Waldenströms gata 35, 20502 Malmö, Sweden
| | - Olle Melander
- 2Department of Clinical Sciences, Lund University, CRC 60:13, Jan Waldenströms gata 35, 20502 Malmö, Sweden
| | - Gunnar Engström
- 2Department of Clinical Sciences, Lund University, CRC 60:13, Jan Waldenströms gata 35, 20502 Malmö, Sweden
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Aftyka A, Rosa W, Taczała J. Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study. Scand J Caring Sci 2019; 34:698-709. [PMID: 31657048 DOI: 10.1111/scs.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality. AIM The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. METHODS We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. RESULTS The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. RELEVANCE TO CLINICAL PRACTICE In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.
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Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Wojciech Rosa
- Department of Applied Mathematics, Faculty of Technology Fundamentals, Lublin University of Technology, Lublin, Poland
| | - Jolanta Taczała
- Department of Rehabilitation and Physiotherapy, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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microRNA-212-induced protection of the heart against myocardial infarction occurs via the interplay between AQP9 and PI3K/Akt signaling pathway. Exp Cell Res 2018; 370:531-541. [DOI: 10.1016/j.yexcr.2018.07.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 01/09/2023]
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14
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Willadsen TG, Siersma V, Nielsen ABS, Køster-Rasmussen R, Guassora AD, Jarbøl DE, Eusebi P, Malterud K, Reventlow S, de Fine Olivarius N. The effect of structured personal care on diabetes symptoms and self-rated health over 14 years after diabetes diagnosis. Prim Care Diabetes 2018; 12:354-363. [PMID: 29705674 DOI: 10.1016/j.pcd.2018.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/23/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Abstract
AIMS To explore the effect of structured personal care on diabetes symptoms and self-rated health over 14 years after diabetes diagnosis while patients are gradually diagnosed with other chronic conditions (multimorbidity). METHODS Post hoc analysis of the Danish randomized controlled trial Diabetes Care in General Practice including 1381 patients newly diagnosed with type 2 diabetes. The effect of structured personal care compared with routine care on diabetes symptoms and self-rated health was analysed 6 and 14 years after diagnosis with a generalized multilevel Rasch model. RESULTS Structured personal care reduced the overall likelihood of reporting diabetes symptoms at the end of the intervention (OR 0.79; 95% CI: 0.64-0.97), but this effect was not explained by glycaemic control or multimorbidity. There was no effect of the intervention on diabetes symptoms after 14 years or on self-rated health after 6 years or 14 years. CONCLUSIONS Structured personal care had a beneficial effect on diabetes symptoms 6 years after diagnosis, but not on self-rated health at either follow up point. To optimally manage patients over time it is important to supplement clinical information by information provided by the patients.
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Affiliation(s)
- Tora Grauers Willadsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anni Brit Sternhagen Nielsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Køster-Rasmussen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ann Dorrit Guassora
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Paolo Eusebi
- Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy; Health Planning Service, Department of Epidemiology, Regional Health Authority of Umbria, Perugia, Italy
| | - Kirsti Malterud
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Research Unit for General Practice, Uni Research Health, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Susanne Reventlow
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Niels de Fine Olivarius
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Time trends of comparative self-rated health in adults aged 25-34 in the Northern Sweden MONICA study, 1990-2014. PLoS One 2017; 12:e0187896. [PMID: 29155858 PMCID: PMC5695772 DOI: 10.1371/journal.pone.0187896] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/27/2017] [Indexed: 12/16/2022] Open
Abstract
Self-rated health (SRH) accounts comprehensively for many health domains. The aim of this paper was to investigate time trends and associations between age-comparative self-rated health and some known determinants in a general population aged 24-34 years. Population-based cross-sectional surveys were performed in 1990, 1994, 1999, 2004, 2009 and 2014 in Northern Sweden. Out of 3500 invited persons, 1811 responded. Comparative SRH was measured on a three-grade ordinal scale by the question: "How would you assess your general health condition compared to persons of your own age?" with the alternatives "better/worse/similar". Over the period 1990 to 2014, the percentage of women rating comparative SRH as "worse" increased steadily, from 8.5% in 1990 reaching 20% in 2014 (p for trend 0.007). Among men, this pattern was almost the opposite, with increasing proportions rating "better" (p for trend <0.000). Time trends for physical activity in leisure time; length of education; Body Mass Index; anxiety; depressive emotions and satisfaction with economy showed a similar pattern for men and women. Factors that might contribute to the development of time trends for comparative SRH are discussed.
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16
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Saleh ZT, Connell A, Lennie TA, Bailey AL, Elshatarat RA, Yousef K, Moser DK. Cardiovascular Disease Risk Predicts Health Perception in Prison Inmates. Clin Nurs Res 2017; 28:235-251. [DOI: 10.1177/1054773817740534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We hypothesized that risk factors for cardiovascular disease (CVD) would be associated with worse health perceptions in prison inmates. This study included 362 inmates recruited from four medium security prisons in Kentucky. Framingham Risk Score was used to estimate the risk of developing CVD within the next 10 years. A single item on self-rated health from the Medical Outcomes Survey–Short Form 36 was used to measure health perception. Multinomial logistic regression showed that for every 1-unit increase in Framingham Risk Score, inmates were 23% more likely to have rated their health as fair/poor and 11% more likely to rate their health as good rather than very good/excellent. These findings demonstrate that worse health perceptions may serve as a starting point for discussing cardiovascular risk factors and prevention with inmates.
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17
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Feldman AL, Griffin SJ, Fhärm E, Norberg M, Wennberg P, Weinehall L, Rolandsson O. Screening for type 2 diabetes: do screen-detected cases fare better? Diabetologia 2017; 60:2200-2209. [PMID: 28831538 PMCID: PMC6086324 DOI: 10.1007/s00125-017-4402-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 07/27/2017] [Indexed: 12/31/2022]
Abstract
AIMS/HYPOTHESIS We aimed to investigate whether diabetes cases detected through screening have better health outcomes than clinically detected cases in a population-based cohort of adults who were eligible to be screened for diabetes at 10 year intervals. METHODS The Västerbotten Intervention Programme is a community- and individual-based public health programme in Västerbotten County, Sweden. Residents are invited to clinical examinations that include screening for diabetes by OGTTs at age 30, 40, 50 and 60 years (individuals eligible for screening, n = 142,037). Between 1992 and 2013, we identified 1024 screen-detected cases and 8642 clinically detected cases of diabetes using registry data. Clinically detected individuals were either prior screening participants (n = 4506) or people who did not participate in screening (non-participants, n = 4136). Study individuals with diabetes were followed from date of detection until end of follow-up, emigration, death or incident cardiovascular disease (CVD), renal disease or retinopathy event, and compared using Cox proportional hazard regression adjusted for calendar time, age at detection, year of detection, sex and socioeconomic status. RESULTS The average age at diabetes diagnosis was 4.6 years lower for screen-detected individuals compared with clinically detected individuals. Overall, those who were clinically detected had worse health outcomes than those who were screen-detected (HR for all-cause mortality 2.07 [95% CI 1.63, 2.62]). Compared with screen-detected study individuals, all-cause mortality was higher for clinically detected individuals who were screening non-participants (HR 2.31 [95% CI 1.82, 2.94]) than for those clinically detected who were prior screening participants (HR 1.70 [95% CI 1.32, 2.18]). Estimates followed a similar pattern for CVD, renal disease and retinopathy. CONCLUSIONS/INTERPRETATION Individuals with screen-detected diabetes were diagnosed earlier and appeared to fare better than those who were clinically detected with regard to all-cause mortality, CVD, renal disease and retinopathy. How much of these associations can be explained by earlier treatment because of screening rather than healthy user bias, lead time bias and length time bias warrants further investigation.
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Affiliation(s)
- Adina L Feldman
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
| | - Simon J Griffin
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- The Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Eva Fhärm
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Margareta Norberg
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 87, Umeå, Sweden
| | - Lars Weinehall
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 901 87, Umeå, Sweden.
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18
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Stewart RAH, Hagström E, Held C, Wang TKM, Armstrong PW, Aylward PE, Cannon CP, Koenig W, López-Sendón JL, Mohler ER, Hadziosmanovic N, Krug-Gourley S, Ramos Corrales MA, Siddique S, Steg PG, White HD, Wallentin L. Self-Reported Health and Outcomes in Patients With Stable Coronary Heart Disease. J Am Heart Assoc 2017; 6:JAHA.117.006096. [PMID: 28862971 PMCID: PMC5586450 DOI: 10.1161/jaha.117.006096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The major determinants and prognostic importance of self‐reported health in patients with stable coronary heart disease are uncertain. Methods and Results The STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial randomized 15 828 patients with stable coronary heart disease to treatment with darapladib or placebo. At baseline, 98% of participants completed a questionnaire that included the question, “Overall, how do you feel your general health is now?” Possible responses were excellent, very good, good, average, and poor. Adjudicated major adverse cardiac events, which included cardiovascular death, myocardial infarction, and stroke, were evaluated by Cox regression during 3.7 years of follow‐up for participants who reported excellent or very good health (n=2304), good health (n=6863), and average or poor health (n=6361), before and after adjusting for 38 covariates. Self‐reported health was most strongly associated with geographic region, depressive symptoms, and low physical activity (P<0.0001 for all). Poor/average compared with very good/excellent self‐reported health was independently associated with major adverse cardiac events (hazard ratio [HR]: 2.30 [95% confidence interval (CI), 1.92–2.76]; adjusted HR: 1.83 [95% CI, 1.51–2.22]), cardiovascular mortality (HR: 4.36 [95% CI, 3.09–6.16]; adjusted HR: 2.15 [95% CI, 1.45–3.19]), and myocardial infarction (HR: 1.87 [95% CI, 1.46–2.39]; adjusted HR: 1.68 [95% CI, 1.25–2.27]; P<0.0002 for all). Conclusions Self‐reported health is strongly associated with geographical region, mood, and physical activity. In a global coronary heart disease population, self‐reported health was independently associated with major cardiovascular events and mortality beyond what is measurable by established risk indicators. Clinical Trial Registration URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00799903.
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Affiliation(s)
| | - Emil Hagström
- Department of Medical Sciences Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Claes Held
- Department of Medical Sciences Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | | | | | - Philip E Aylward
- South Australian Health and Medical Research Institute, Flinders University and Medical Centre, Adelaide, Australia
| | | | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,DZHK (German Centre for Cardiovascular Research) partner site Munich Heart Alliance, Munich, Germany.,Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
| | | | - Emile R Mohler
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Nermin Hadziosmanovic
- Department of Medical Sciences Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Susan Krug-Gourley
- Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline, King of Prussia, PA
| | | | | | - Philippe Gabriel Steg
- Département Hospitalo-Universitaire FIRE, AP-HP Hôpital Bichat, Paris, France.,Sorbonne Paris Cité Diderot University, Paris, France.,NHLI Imperial College, ICMS, Royal Brompton Hospital, London, United Kingdom.,FACT (French Alliance for Cardiovascular Trials), an F-CRIN Network, INSERM U1148, Paris, France
| | | | - Lars Wallentin
- Department of Medical Sciences Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
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Liu F, Zhang C, Liang Y, Deng Q, Hang D, Pan Y, Li X, He Z, Liu M, Liu Y, Li J, Ning T, Guo C, Xu R, Zhang L, Cai H, Ke Y. Epidemiology of self-rated health in rural China: a population-based cross-sectional study. Sci Rep 2017; 7:4459. [PMID: 28667261 PMCID: PMC5493681 DOI: 10.1038/s41598-017-04381-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/16/2017] [Indexed: 11/09/2022] Open
Abstract
Self-rated health (SRH) has been shown to be a good predictor of mortality. Data on SRH and its associated factors in the Chinese general population are limited. This study aims to assess the epidemiology of SRH in rural Anyang, China. SRH (categorized as "healthy", "fair" or "unhealthy") was measured in a population-based study of 2,814 adults (including 697 couples) aged 25 to 69 who were recruited from rural Anyang in 2014. Of 2,814 subjects, 63.1% rated their health as "healthy", whereas 28.1% and 8.8% rated their health as "fair" and "unhealthy". Compared to males, females had a higher likelihood of reporting a better SRH. Health ratings declined with increasing age, unmarried status, lower education levels. Poor SRH was positively correlated with medical history as well as high levels of fasting plasma glucose and total cholesterol, but not with unhealthy lifestyle indicators including smoking, drinking, and obesity. High household income was predictive of better SRH in men but not in women. Among couples, a positive spousal SRH concordance was observed, although the strength of this concordance was low. These findings will be useful for formulation of appropriate strategies for improving risk perception and promoting general health in economically developing regions.
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Affiliation(s)
- Fangfang Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Chaoting Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yongmei Liang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Qiuju Deng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Dong Hang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Yaqi Pan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Xiang Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Zhonghu He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Mengfei Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Ying Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Jingjing Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Tao Ning
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Chuanhai Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China
| | - Ruiping Xu
- Anyang Cancer Hospital, No. 1 Binhebei Rd, Anyang, Henan Province, 455000, China
| | - Lixin Zhang
- Anyang Cancer Hospital, No. 1 Binhebei Rd, Anyang, Henan Province, 455000, China
| | - Hong Cai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China.
| | - Yang Ke
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China.
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20
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Nagai M, Ohira T, Zhang W, Nakano H, Maeda M, Yasumura S, Abe M. Lifestyle-related factors that explain disaster-induced changes in socioeconomic status and poor subjective health: a cross-sectional study from the Fukushima health management survey. BMC Public Health 2017; 17:340. [PMID: 28427361 PMCID: PMC5397819 DOI: 10.1186/s12889-017-4247-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/08/2017] [Indexed: 11/25/2022] Open
Abstract
Background Socioeconomic status (SES) and lifestyle-related factors are determinants of subjective health. However, changes in SES are inevitable in times of natural disaster, while lifestyle-related factors remain modifiable. The aim of this study was to use a cross-sectional approach to examine lifestyle-related factors that may attenuate the negative impact of disaster-induced changes in SES on poor subjective health. Methods We analyzed 33,350 men and women aged 20–64 years who were living in evacuation zones due to the radiation accident in Fukushima, Japan. Disaster-induced changes in SES were defined by living arrangements and working conditions. Using Poisson regression analysis adjusted for confounders (model 1) and lifestyle-related factors as intermediate variables (model 2), we compared the prevalence ratios (PRs) of poor subjective health of participants who did not undergo disaster-induced changes in SES (did not become unemployed, income did not decrease, and living in relative’s home/own home) with that of participants who did undergo disaster-induced changes in SES (became unemployed, decreased income, or lived in an evacuation shelter, temporary housing, or rental housing/apartment). We calculated the percentage of excess risks explained by lifestyle-related factors as follows: ((PRmodel 1 − PRmodel 2)/(PRmodel 1–1)) × 100. Results Disaster-induced changes in SES were significantly associated with poor subjective health. The PRs (95% CIs) among participants who underwent disaster-induced changes in SES were 2.02 (1.81–2.24) for men and 1.80 (1.65–1.97) for women. After adjusting for lifestyle-related factors, we found that the PRs in men and women were remarkably attenuated, decreasing to 1.56 (1.40–1.73) and 1.43 (1.31–1.55), respectively. Controlling for lifestyle-related factors resulted in PR attenuation by 45.1% (men) and 46.3% (women). Satisfaction of sleep and participation in recreation and community activity particularly contributed to this attenuation. Conclusions While disaster-induced changes in SES are unavoidable, lifestyle-related factors have the potential to attenuate the impact of these changes on poor subjective health. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4247-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masato Nagai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan. .,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Wen Zhang
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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Ylikoski A, Martikainen K, Sieminski M, Partinen M. Sleeping difficulties and health-related quality of life in Parkinson's disease. Acta Neurol Scand 2017; 135:459-468. [PMID: 27282092 DOI: 10.1111/ane.12620] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Various sleep-related symptoms occur in Parkinson's disease (PD). Their occurrence with health-related quality of life (HRQL), comorbid sleep disorders, and other comorbidities was studied. METHODS Altogether, 1447 randomly selected patients with Parkinson's disease, aged 43-89 years, participated in a questionnaire study. A structured questionnaire with 207 items was based on the Basic Nordic Sleep Questionnaire. Questions on demographics, PD, sleep disorders, and comorbidities were included. RESULTS The response rate was 59.0%, and of these, 80% had answered to all questions that were used in the analyses (N=684). Occurrence of long sleep was found in 26.2% of the subjects, short sleep in 32.5%, poor sleep in 21.2%, sleep deprivation in 33.8%, disrupted sleep in 47.4%, and difficulties to fall asleep in 12.2%, respectively. Poor self-rated health and poor quality of life occurred in 44.4% and in 43.3% of all participants. In the logistic regression, age and gender differentially predicted long sleep and sleep deprivation, such that older age and being male were positively associated with long sleep but negatively associated with the report of sleep deprivation. Depression, subjective negative stress, and fatigue occurred with long sleep. On the other hand, poor sleep and excessive daytime sleepiness occurred with short sleep and sleep deprivation. CONCLUSIONS The sleep difficulties in PD are frequent. The long sleeping patients have depression, stress, and fatigue.
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Affiliation(s)
- A. Ylikoski
- Vitalmed Research Center; Helsinki Sleep Clinic; Helsinki Finland
- Department of Neurology; Hospital of Laakso; Helsinki Finland
| | | | - M. Sieminski
- Department of Adult Neurology; Medical University of Gdansk; Gdansk Poland
| | - M. Partinen
- Vitalmed Research Center; Helsinki Sleep Clinic; Helsinki Finland
- Department of Clinical Neurosciences; Institute of Clinical Medicine; University of Helsinki; Helsinki Finland
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Stadin M, Nordin M, Broström A, Magnusson Hanson LL, Westerlund H, Fransson EI. Information and communication technology demands at work: the association with job strain, effort-reward imbalance and self-rated health in different socio-economic strata. Int Arch Occup Environ Health 2016; 89:1049-58. [PMID: 27193569 PMCID: PMC5005402 DOI: 10.1007/s00420-016-1140-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 05/02/2016] [Indexed: 12/03/2022]
Abstract
Purpose The use of information and communication technology (ICT) is common in modern working life. ICT demands may give rise to experience of work-related stress. Knowledge about ICT demands in relation to other types of work-related stress and to self-rated health is limited. Consequently, the aim of this study was to examine the association between ICT demands and two types of work-related stress [job strain and effort-reward imbalance (ERI)] and to evaluate the association between these work-related stress measures and self-rated health, in general and in different SES strata. Methods This study is based on cross-sectional data from the Swedish Longitudinal Occupational Survey of Health collected in 2014, from 14,873 gainfully employed people. ICT demands, job strain, ERI and self-rated health were analysed as the main measures. Sex, age, SES, lifestyle factors and BMI were used as covariates. Results ICT demands correlated significantly with the dimensions of the job strain and ERI models, especially with the demands (r = 0.42; p < 0.01) and effort (r = 0.51; p < 0.01) dimensions. ICT demands were associated with suboptimal self-rated health, also after adjustment for age, sex, SES, lifestyle and BMI (OR 1.49 [95 % CI 1.36–1.63]), but job strain (OR 1.93 [95 % CI 1.74–2.14) and ERI (OR 2.15 [95 % CI 1.95–2.35]) showed somewhat stronger associations with suboptimal self-rated health. Conclusion ICT demands are common among people with intermediate and high SES and associated with job strain, ERI and suboptimal self-rated health. ICT demands should thus be acknowledged as a potential stressor of work-related stress in modern working life.
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Affiliation(s)
- Magdalena Stadin
- School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11, Jönköping, Sweden.
| | - Maria Nordin
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Anders Broström
- School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | | | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Eleonor I Fransson
- School of Health and Welfare, Jönköping University, P.O. Box 1026, 551 11, Jönköping, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Olson KL, Stiefel M, Ross C, Stadler S, Hornak R, Sandhoff B, Merenich JA. Self-Rated Health Among Patients with Coronary Artery Disease Enrolled in a Cardiovascular Risk Reduction Service. Popul Health Manag 2015; 19:24-30. [PMID: 26237495 DOI: 10.1089/pop.2014.0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Little is known about the use of the single self-rated health (SRH) status item measuring health-related quality of life among people with coronary artery disease (CAD). The objective of this study was to assess relationships between SRH and recurrent coronary events, mortality, health care utilization, and intermediate clinical outcomes and to assess predictors of fair/poor SRH. A total of 5573 patients enrolled in a comprehensive cardiac risk reduction service managed by clinical pharmacy specialists were evaluated over a 2-year period. Regression modeling explored relationships among variables, modeling SRH separately as an independent and a dependent variable. The 1374 (24.7%) respondents reporting fair/poor SRH differed statistically from 4199 (75.3%) respondents reporting good/very good/excellent SRH in terms of age, sex, ethnicity, number of comorbid conditions, DxCG scores, lifestyle behaviors, blood pressure control, and inpatient and emergency department (ED) utilization. Respondents reporting fair/poor health were more likely to have recurrent major coronary events (MCE), including death. Fair/poor SRH was consistently statistically significant when it was included as a predictor in regression modeling for poor blood pressure control, health care utilization, MCE, and all-cause mortality. Variables associated with fair/poor SRH in regression modeling included females, Hispanic ethnicity, ≥1 baseline ED visit, and DxCG score. Exercising <30 minutes per week was strongly associated with fair/poor SRH. Single-item SRH status may help identify patients with CAD at higher risk of poor blood pressure control, recurrent MCE, and death and those who may benefit from interventions to increase physical activity.
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Affiliation(s)
- Kari L Olson
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Matt Stiefel
- 2 Center for Population Health, Care Management Institute , Kaiser Permanente, Oakland, California
| | - Colleen Ross
- 3 Institute for Health Research , Kaiser Permanente Colorado, Denver, Colorado
| | - Sheila Stadler
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Roseanne Hornak
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Brian Sandhoff
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
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