archives@tulane.edu / Hispanic older adults are burdened by obesity, and Body Mass Index (BMI) - a common measure of obesity, has limitations with aging. Further, Food Insecurity (FI) is linked to adverse health outcomes, including obesity. Yet, there is limited knowledge on obesity-related health risk disparities on account of place of birth among Hispanic older adults and the effect of FI. This study examines: 1) the prevalence of obesity {BMI/Waist Circumference (WC) classification} by place of birth and their associations to health risks- cardiometabolic risk factors (CRF) and physical performance (PP), and 2) the impact of FI. First, a cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) III with sample population of n= 4,584 participants aged 50 years and older {Non-Hispanic whites (NHW), n=3059; United States born Hispanics (USB-H), n=1170; Foreign-born Hispanics (FB-H), n=355} was done. Measurements include body types created from BMI/WC cut off values; CRFs as defined by the American heart association; PP-time tandem stand, time to complete five-stand and time to complete 8ft walk; sociodemographic (SDF) and behavioral factors (BF). Weighted multivariable logistic regression analyzed associations between body types and health risks controlling for SDF and BF. Second, NHANES 2005-2014 with sample population of (n=5,772; NHW, n=3869; USB, n=613; FBH, n=1,290) was analyzed. Food security status was defined as suggested by the United States Department of Agriculture (food secure-FS, food insecure-FI). Multivariable logistic regressions examined relationships between FI, obesity, and having at least one CRF. The proportion of body types varied across ethnicity-place of birth. NHW and FBH were more likely to have normal BMI/WC, while USB-H were more likely to have high BMI/WC. Body types with high BMI/WC were more likely to have CRFs and poorer PP when compared to those with normal BMI/WC. Stratifying by ethnicity-place of birth, FI persons had 1.60-1.80 odds of having at least one CRF when compared to persons who are FS. This study suggests that regardless of place of birth, Hispanic older adults are at obesity-related health risks. The concurrent use of BMI and WC measures in clinic settings and population-based research may encourage healthy aging. / 1 / Queendaleen Chukwurah

Background: Dyslipidemia is a modifiable risk factor for cardiovascular disease (CVD). We investigated the prevalence and associated risk factors of dyslipidemia- raised total cholesterol (TC), raised triglycerides (TG), raised low-density lipoprotein (LDL-C), low high-density lipoprotein (HDL-C), and raised non-high-density lipoprotein (non-HDL-C) in rural and urban China. Methods: We analyzed data from 136,945 participants aged 40-100 years of the CNSSPP project for 2014. Dyslipidemia was defined by the NCEP-ATP III and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Complete data on demographic, metabolic and lifestyle characteristics were used. Chi-square tests and multivariable logistic regression were used to obtain age- and sex-adjusted prevalence and risk factors for dyslipidemia among participants. Results: A total of 53.1% participants lived in rural areas. The prevalence of dyslipidemia was similar among rural and urban participants (43.2% vs. 43.3%). Regarding the components of dyslipidemia: urban compared with rural participants had a higher prevalence of low HDL-C (20.8% vs. 19.2%), whereas the prevalence of raised LDL-C (7.8% vs. 8.3%), raised TC (10.9% vs.11.8%) and raised non-HDL-C (10.0% vs. 10.9%) were lower in urban residents, (all p < 0.001). Women were more likely to have raised TC than men (adjusted OR [AOR] =1.83, 95% confidence interval [CI]:1.75-1.91), raised LDL-C (AOR = 1.55, 95% CI: 1.47-1.63) and high non-HDL-C (AOR = 1.52 95% CI: 1.45-1.59) (all p < 0.001). Compared with rural, urban participants had higher odds of dyslipidemia: low HDL-C (AOR = 1.04, 95% CI: 1.01-1.07), and raised TG (AOR = 1.06, 95% CI: 1.04-1.09). Hypertension and current drinker were less likely to get low HDL-C with AOR 0.93 (95% CI: 0.90-0.96) and AOR 0.73 (95% CI: 0.70-75), respectively. Overweight, obesity, central obesity and diabetes had higher odds of all dyslipidemias (p < 0.001). Conclusions: Low HDL-C was higher in urban areas, whereas the remaining dyslipidemia types were more common in rural areas. Dyslipidemia was more common in women in both areas of residence. Overweight, obesity, central obesity and diabetes were associated with dyslipidemias. The need to intensify intervention programs to manage dyslipidemia and risk factors should be prioritized.

Background: Hypertension is common, affecting over one billion people worldwide. Importantly, in Sub-Saharan Africa hypertensive disease not only affects the older population group, but is becoming increasingly prevalent in younger patients. In South Africa, over 30% of the adult population has hypertension, making it the single most common cardiovascular risk factor and the predominant contributor to cardiovascular disease and mortality. In non-cardiac surgical patients, elevated blood pressure is the most common perioperative comorbidity encountered with an overall prevalence of 20-25%, and it remains poorly controlled in low and middle-income countries. Furthermore, hypertension in the perioperative setting may adversely affect patient outcome. It thus not only flags possible perioperative challenges to anaesthesiologists, but also identifies patients at risk of long-term morbidity and mortality. Objectives: The primary objective of this study was to determine the prevalence and severity of hypertension in elective adult surgical patients in the Western Cape. Results: The study population included all non-cardiac, non-obstetric, elective surgical patients from seven hospitals in the Western Cape during a one-week period. Hypertension, defined as having had a previous diagnosis of hypertension or meeting the blood pressure criteria of more than 140/90 mmHg, was identified in 51.8% of patients during the preoperative assessment. Significantly, newly diagnosed hypertension was present in 9.6% of all patients presenting for elective surgery. Although 98.1% of the known hypertensive patients were on antihypertensive therapy, 36.9% were inadequately controlled. Numerous reasons exist for this but notably 32% of patients admitted to forgetting to take their medication, making patient factors the most common cause for treatment non-compliance. Conclusion: This study suggests that the perioperative period may be an important opportunity to identify undiagnosed hypertensive patient. The perioperative encounter may have a significant public health implication in facilitating appropriate referral and treatment of hypertension to decrease long-term cardiovascular complications in South Africa.

Introduction: The COVID-19 pandemic has increased the magnitude of mental illnesses such as depression, not only in the general population, but also in healthcare personnel. However, in Peru the prevalence, and the associated factors for developing depression in healthcare personnel, are not known. The objective was to determine the prevalence and identify the factors associated with depression in healthcare personnel, in the context of the SARS-CoV-2 pandemic. Methods: An analytical cross-sectional study was carried out from May to September, 2020 in healthcare establishments. A sample of 136 health workers were included and a survey was applied to collect the data. Depression as a dependent variable was measured using the Zung self-report scale. To identify the associated factors, the bivariate and multivariate analysis was performed by logistic regression with STATA v 14. Results: The prevalence of depression was 8.8% (95%CI, 4.64-14.90). Having a family member or friend who had died from COVID-19 was associated with depression (OR = 6.78; 95%CI, 1.39-32.90; P = 0.017). Whereas the use of personal protective equipment was found to be a protective factor against developing depression (OR = 0.03; 95%CI, 0.004-0.32; P = 0.003). Conclusions: Approximately 1 in 10 healthcare professionals and technicians developed depression during the COVID-19 pandemic in this study. In addition, having relatives or friends who had died from COVID-19 was negatively associated with depression and use of personal protective equipment was identified as a protective factor. / Revisión por pares

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Suicide is a leading cause of death in the United States, despite a wealth of research investigating suicide risk factors. Sleep disturbances are also rising, and continue to be an often undetected and untreated source of increased suicide risk. A growing body of literature has looked for connections between sleep disturbances and increased suicidality, but few studies have looked at differentiating between single and multiple suicide attempters. Further, when assessing nightmares, literature varies widely on defining and measuring symptoms of nightmares, and no known studies have compared frequency, distress/severity, and duration. Participants (n =225) were recruited via an online study conducted on Amazon Mechanical Turk who reported one or more prior suicide attempts. Results show that nightmare frequency independently predicted multiple suicide attempters when controlling for symptoms of depression, PTSD, insomnia, nightmare severity/distress, and nightmare duration. Clinical implications for findings include screening and treating nightmares as a potential suicide intervention.

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