The purpose of this study was to compare the health profiles of women seeking residential treatment for substance abuse with women in the community. These 2 data sets consisted of a total of 621 participants. An additional aim of the present study was to examine whether these health profiles differ between the monosubstance abusing and polysubstance abusing women within the treatment group. There were a total of 257 participants in this group. All analyses controlled for the effects of age, insurance, marital status, employment and race/ethnicity. Binary logistic regressions were used to compare between and within the specified groups on the following variables: asthma, dyslipidemia, diabetes, Hepatitis B vaccination, HIV testing, hypertension, Pap smear testing, mental health problems, overweight/obesity and smoking. A follow-up analyses examined whether differences in the variables could be explained by the effects of specific control variables. Results suggested that differences in four outcomes might be explained by a single or smaller number of specific control variables. The overall results revealed that age was one of the strongest predictors of differences between the treatment and community group. When we controlled for age, marital status, low socioeconomic status (insurance, employment) and ethnicity we found that only two variables were significantly different. Women in residential showed significantly more smoking and mental health symptoms than were found in the community sample. There were no significant differences in the health profiles of polysubstance substance abusing than were found in monosubstance abusing women. The findings of the present study indicate that women seeking treatment are individuals with similar health disorders and health maintaining behaviors as the general population of women. However, women seeking treatment have significant increases in mental health disorders and smoking. Older age was related to increases in the odds of having dyslipidemia, diabetes, hypertension, and decreases in the odds of being immunized for Hepatitis B, tested for HIV, and having a Pap test in the last year. Due to anticipated-age related disorders, screening for dyslipidemia, diabetes, and hypertension should be provided for older women seeking admission to treatment. Substance abuse treatment centers for women should provide for mental health services and offer smoking cessation.

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Tyrimo problema – išeminės širdies ligos išsivystymui yra svarbūs keli faktoriai, kurių pavienė įtaka yra įrodoma, tačiau svarbu išsiaiškinti, ar egzistuoja šių rizikos veiksnių tarpusavio sąsajos. Tyrimo tikslas - nustatyti išemine širdies liga sergančiųjų pacientų psichologinės – elgesio rizikos veiksnių ypatumus stacionarinės reabilitacijos laikotarpiu. Tyrime dalyvavo 204 Abromiškių Reabilitacinės Ligoninės kardiologinio skyriaus pacientai (110 vyrų, 94 moterys; amžiaus vidurkis – 64,29m.). Tyrimo metodika: remiantis klausimynu, buvo įvertinti tiriamųjų demografiniai rodikliai – amžius, lytis, išsilavinimas. Iš pacientų ligų istorijų buvo surinkti duomenys apie išeminės širdies ligos formą ar kitą diagnozę, arterinį kraujo spaudimą bei antsvorį. Požiūris į rūkymą, alkoholio vartojimą, taip pat fizinio aktyvumo lygmuo bei subjektyvus sveikatos vertinimas buvo nustatyti pagal tiriamųjų atsakymus į atitinkamus klausimus. Stresogeninis elgesys įvertintas Rosenman‘o elgesio tipo interviu. Tyrimo metu buvo gauti tokie rezultatai: vyrai yra labiau linkę vartoti tabaką bei alkoholį, jų fizinio aktyvumo lygmuo aukštesnis, lyginant su moterimis. Jaunesnio amžiaus moterys buvo labiau linkusios vartoti alkoholį nei vyresnės, o jaunesnio amžiaus vyrai buvo fiziškai aktyvesni nei vyresni. Aukštesnio išsilavinimo pacientai buvo labiau fiziškai aktyvūs nei žemesnio išsilavinimo. Išeminės širdies ligos forma ir arterinis kraujo spaudimas nėra susiję nei su tabako, nei su alkoholio... [toliau žr. visą tekstą] / There are some factors, which are significant for ischemic heart disease development; their discrete influence is evidence – based, but it is important to ascertain if there are relationships among these factors. The purpose of the study is to evaluate ischemic heart disease patients‘ psychological – behavioral risk characteristics, during in - patients’ rehabilitation period. The subjects of this study were 204 ischemic heart disease patients from Abromiskes Rehabilitational Hospital, cardiological department (110 men, 94 women; mean age – 64,29m.). The demographical patients‘ indicators – age, gender, education, were gathered using a questionnaire. The data about ischemic heart disease form or other diagnosis, arterial blood pressure, overweight were taken from medical history. The attitude towards smoking, alcohol use also physical activity level, subjective health status was measured by using special questions. Stressogenic behavior was valuated by using Rosenman‘s behavior type‘s interview. The results of the study showed that men are more likely to use tobacco and alcohol, their physical activity level is higher, comparing with women. Younger women were more likely to use alcohol, comparing with older women. Younger men were more physically active, comparing with older men. Patients with higher education were more physically active, comparing with patients with lower education. Ischemic heart disease form and arterial blood pressure were not related with tobacco or... [to full text]

English Language Learners (ELLs) are considered to be at higher risk for developing emotional and behavioral difficulties due to their limited English proficiency. As a result, the present study examined the identification of emotional and behavioral risk (EBR) among ELLs and non-ELLs through the use of universal behavior screening measures. The study consisted of 395 students enrolled in kindergarten through 5th grades, ranging in age from 5 years, 6 months to 12 years, 4 months. Over half of participants (52.4%) were male and a majority (42.8%) identified as Hispanic/Latino(a). Approximately one-fifth (19.7%) of students were classified as ELLs. Teachers completed the electronic version of the BASC-2 Behavioral and Emotional Screening System-Teacher Form (BESS) for each student in their classroom. Demographic student data was provided by the school via the school’s electronic database. Results showed no relationship between ELL status and EBR. However, there was a relationship between gender and the identification of EBR among ELL students, where males demonstrated increased risk levels. In addition, students' reading ability, age, and gender predicted whether ELL and non-ELL students would be identified as at-risk for emotional and behavior problems. Although results did not show a relationship between language proficiency and EBR, ELLs remain a group vulnerable for being identified as at-risk for emotional and behavioral difficulties, due to academic and/or social-emotional problems that they may experience. In practice, schools may want to consider using an integrated approach to conducting universal screening, where schools screen for reading difficulties and behavior concerns, thus allowing them to address a broader range of concerns through early intervention programs.

Background: Screening rates for colorectal cancer (CRC) are increasing nationwide including Tennessee (TN); however, their up-to-date status is unknown. The objective of this study is to determine the trends and characteristics of TN adults who are up-to-date status with CRC screening during 2002-2008. Methods: We examined data from the TN Behavioral Risk Factor Surveillance System for 2002, 2004, 2006 and 2008 to estimate the proportion of respondents aged 50 years and above who were up-to-date status with CRC screening, defined as an annual home fecal occult blood test and/or sigmoidoscopy or colonoscopy in the past 5 years. We identified trends in up-to-status in all eligible respondents. Using multivariable logistic regression models, we delineated key characteristics of respondents who were up-to-date status. Results: During 2002-2008, the proportion of respondents with up-to-date status for CRC screening increased from 49% in 2002- 55% in 2006 and then decreased to 46% in 2008. The screening rates were higher among adults aged 65-74 years, those with some college education, those with annual household income ≥$35,000 and those with health-care access. In 2008, the respondents who were not up-to-date status with CRC screening included those with no health-care coverage (adjusted odds ratio [OR] 0.46, 95% confidence interval [CI] 0.33-0.63), those aged 50-54 years (OR 0.62, 95% CI 0.46-0.82) and those with annual household income <$25,000 (OR 0.65, 95% CI 0.52- 0.82). Conclusions: TN adults who are up-to-date status with CRC screening are increasing, but not across all socio-demographic subgroups. The results identified specific subgroups to be targeted by screening programs, along with continued efforts to educate public and providers about the importance of CRC screening.

BACKGROUND: Behavioral risk factors are known to co-occur among youth, and to increase risks of chronic diseases morbidity and mortality later in life. However, little is known about determinants of multiple chronic disease behavioral risk factors, particularly among youth. Previous studies have been cross-sectional and carried out without a sound theoretical framework. METHODS: Using longitudinal data (n = 1135) from Cycle 4 (2000-2001), Cycle 5 (2002-2003) and Cycle 6 (2004-2005) of the National Longitudinal Survey of Children and Youth, a nationally representative sample of Canadian children who are followed biennially, the present study examines the influence of a set of conceptually-related individual/social distal variables (variables situated at an intermediate distance from behaviors), and individual/social ultimate variables (variables situated at an utmost distance from behaviors) on the rate of occurrence of multiple behavioral risk factors (physical inactivity, sedentary behavior, tobacco smoking, alcohol drinking, and high body mass index) in a sample of children aged 10-11 years at baseline. Multiple behavioral risk factors were assessed using a multiple risk factor score. All statistical analyses were performed using SAS, version 9.1, and SUDAAN, version 9.01. RESULTS: Multivariate longitudinal Poisson models showed that social distal variables including parental/peer smoking and peer drinking (Log-likelihood ratio (LLR) = 187.86, degrees of freedom (DF) = 8, p < .001), as well as individual distal variables including low self-esteem (LLR = 76.94, DF = 4, p < .001) increased the rate of occurrence of multiple behavioral risk factors. Individual ultimate variables including age, sex, and anxiety (LLR = 9.34, DF = 3, p < .05), as well as social ultimate variables including family socioeconomic status, and family structure (LLR = 10.93, DF = 5, p = .05) contributed minimally to the rate of co-occurrence of behavioral risk factors. CONCLUSIONS: The results suggest targeting individual/social distal variables in prevention programs of multiple chronic disease behavioral risk factors among youth.

This study discusses the traditional way of understanding behavioral risk at adolescence, proposing a psychosocial perspective of the concept of risk. It is known that the biomedical approach of health is centered in consequences and damage, but adolescence health and risk are related with a complex web of causation that acts before the risk involvement, supporting it. This study shows that it is necessary to analyze not only the behavioral consequences bur the antecedents and the function that these behaviors have in their lives and in solve the developmental tasks present in each society. Then it will be possible to design appropriate and effective prevention programs. / Se presenta una discusión acerca del modo tradicional como se suele aproximar a la comprensión de los comportamientos de riesgo en adolescentes, planteando la necesidad de incorporar una perspectiva psicosocial del riesgo. Se encuentra que la aproximación biomédica está centrada en las consecuencias y en el daño, pero la salud y las situaciones de riesgo en adolescentes están relacionadas con una compleja telaraña psicosocial que las promueve. Se muestra la necesidad de analizar no solamente las consecuencias de las conductas sino los antecedentes de las mismas y las posibles funciones que estas conductas tienen en sus vidas y en el logro de las tareas del desarrollo presentes en cada sociedad. De esta manera será posible diseñar programas de prevención adecuados y eficaces.

Type 2 diabetes mellitus (T2DM) is one of the leading causes of death from worldwide non-communicable diseases. The prevalence of diabetes in the Mexico (MX)-United States border states exceeds the national rate in both countries. The economic burden of diabetes, due to decreased productivity, disability, and medical costs, is staggering and increases significantly when T2DM-related complications occur. The purpose of this study was to use a modified behavioral risk factor surveillance system (BRFSS) to describe the T2DM self-management behaviors, diabetes care, and health perception of a convenience sample of adults with T2DM in Monterrey, MX. This cross-sectional study design, with convenience sampling, was conducted with a convenience sample (n = 351) of adults in the metropolitan area of Monterrey, MX who self-reported a diagnosis of T2DM. Potential participants were recruited from local supermarkets. Twenty-six diabetes and health-related items were selected from the BRFSS and administered in face-to-face interviews by trained data collectors. Data analysis was conducted using descriptive statistics. The mean age was 47 years, and the mean length of time with T2DM was 12 years. The majority was taking oral medication and 34% required insulin. Daily self-monitoring of feet was performed by 56% of the participants; however, only 8.8% engaged in blood glucose self-monitoring. The mean number of health-care provider visits was 9.09 per year, and glycated hemoglobin level (HbA1c) was assessed 2.6 times per year. Finally, only 40.5% of the participants recalled having a dilated eye exam. We conclude the modified BRFSS survey administered in a face-to-face interview format is an appropriate tool for assessing engagement in T2DM self-management behaviors, diabetes care, and health perception. Extension of the use of this survey in a more rigorous design with a larger scale survey is encouraged.

The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States. Currently more than 1 in 3 children aged 2-19 are overweight or obese. This is of major concern because childhood overweight and obesity leads to chronic conditions such as type II diabetes and tracks into adulthood, where more severe adverse health outcomes arise. In this study I used the premise of the social ecological model (SEM) to analyze the common levels that a child is exposed to daily; the intrapersonal level, the interpersonal level, the school level, and the community level to better understand what risk factors are significantly associated with child weight status. Data came from the 2012 National Survey of Children's Health (NSCH) (n=41,361). Frequencies and confidence intervals were used to describe risk factors at each level. Bivariate analyses were conducted between each risk factor and the outcome variable. Using all risk factors that were significantly associated with overweight and obesity in the bivariate analyses, multinomial logistic regressions were performed for each SEM level. The 4 SEM levels were then analyzed together using stagewise multinomial logistic regression. A significance level cutoff of 0.05 was applied to all analyses. Thirty-three percent of participants were overweight or obese. Child sex, race, age, child physical activity participation, mother’s education and health, the child’s family structure, the child’s participation in extracurricular activities, frequency of family meals at home, safety and engagement in school, the number of amenities and the safety and support within their communities were found to be significantly associated with child weight status. The odds ratios of the covariates in the final stagewise model were similar to those in each individual model. Understanding both the risk factors associated with child overweight and obesity in each individual level and in the complete socio-ecological perspective is important when working toward more effective policy and program creation and the reduction of childhood obesity. Recognizing that all levels of a child's SEM influence his or her likelihood of being overweight or obese can lead to more effective strategies that tackle multiple SEM levels collectively instead of each level independently.

BACKGROUND: Screening rates for colorectal cancer (CRC) are increasing nationwide including Tennessee (TN); however, their up-to-date status is unknown. The objective of this study is to determine the trends and characteristics of TN adults who are up-to-date status with CRC screening during 2002-2008. METHODS: We examined data from the TN Behavioral Risk Factor Surveillance System for 2002, 2004, 2006 and 2008 to estimate the proportion of respondents aged 50 years and above who were up-to-date status with CRC screening, defined as an annual home fecal occult blood test and/or sigmoidoscopy or colonoscopy in the past 5 years. We identified trends in up-to-status in all eligible respondents. Using multivariable logistic regression models, we delineated key characteristics of respondents who were up-to-date status. RESULTS: During 2002-2008, the proportion of respondents with up-to-date status for CRC screening increased from 49% in 2002- 55% in 2006 and then decreased to 46% in 2008. The screening rates were higher among adults aged 65-74 years, those with some college education, those with annual household income ≥$35,000 and those with health-care access. In 2008, the respondents who were not up-to-date status with CRC screening included those with no health-care coverage (adjusted odds ratio [OR] 0.46, 95% confidence interval [CI] 0.33-0.63), those aged 50-54 years (OR 0.62, 95% CI 0.46-0.82) and those with annual household income CONCLUSIONS: TN adults who are up-to-date status with CRC screening are increasing, but not across all socio-demographic subgroups. The results identified specific subgroups to be targeted by screening programs, along with continued efforts to educate public and providers about the importance of CRC screening.