Abstract

This study aims to establish a noninvasive scoring system to predict the risk of erosive esophagitis (EE). From 2002 to 2009, a total of 34, 346 consecutive adults who underwent health check-ups and upper gastrointestinal endoscopy were retrospectively enrolled. Of the participants, 22, 892 in the earlier two-thirds period of examination were defined as the training set and the remaining 11, 454 as the validation set. EE was diagnosed by upper gastrointestinal endoscopy. Independent risk factors associated with EE were analyzed by multivariate analysis using a logistic regression model with the forward stepwise selection procedure in the training set. Subsequently, an EE risk scoring system was established and weighted by β coefficient. This risk scoring system was further validated in the validation set. In the training set, older age, male gender, higher body mass index, higher waist circumference, higher serum triglyceride, and lower high-density lipid cholesterol levels were independent risk factors for predicting EE. According to the β coefficient value of each independent risk factor, the total score ranging from 0 to 10 was established, and then low- (0–3), moderate- (4–6), and high-risk (7–10) groups were identified. In the validation set, the prevalence rates of EE in the low-, moderate-, and high-risk groups were 5.15%, 15.76% and 26.11%, respectively (p < 0.001). This simple noninvasive risk scoring system, including factors of age, gender, body mass index, waist circumference, triglyceride, and high-density lipid cholesterol, effectively predicted EE and stratified its incidence.

Abstract

Despite revolutionary advancement in medicine over the past century, cardiovascular disease (CVD) remains the leading cause of death and disability in the world. Likewise, the morbidity and mortality of CVD in China are increasing persistently, although the government has taken an active part in the prevention and control of CVD. Here we present an overview regarding the current CVD status in China with respect to various disease phenotypes, as well as the anticipated future trend in accordance with the dynamics and distribution of pathogenesis in Chinese actual situations.

Abstract

Alcohol use is responsible for a high level of mortality and morbidity throughout the world. The WHO global strategy recommends that the detrimental effects of alcohol use be reduced. The objective of this paper was to investigate, using data from the 2010 Togo STEPS survey, alcohol use and other health-related factors in the general population of Togo. This epidemiological investigation using the STEPwise approach was undertaken from December 1st, 2010, to January 23rd, 2011, throughout the five regions of Togo. Togo is a low-income country (World Bank) located in West Africa. The study involved 4800 people aged 15 to 64 who were representative of the population of Togo and who were selected using the one-stage cluster sampling method. The sample was young and predominantly male. Approximately one-third of the respondents were alcohol abstainers, with the majority of these being women. Approximately the same proportion of current drinkers (daily consumption) by gender was observed. The reported daily average consumption of alcohol was 13 g of pure alcohol for men and 9 g for women. The mean number of heavy drinking days over the previous 30 days was higher for men (3 days), and this included 37.5% of the men who drink. We suggest a comparative analysis of the prevalence of harmful alcohol use in Togo and the WHO African region.

Abstract

  Dengue is a viral disease that depends on interactions between environment, agent, population of hosts and vector, as well as socioeconomic, political, technical and administrative determinants. The article aims to describe the prevalence of dengue for the period 2005 to 2015 in the Lagunillas parish of the municipality of Sucre, Mérida, Venezuela. Methodology: quantitative approach, descriptive type and non-experimental longitudinal design. Results: 2947 cases of dengue were found between the years under study. The presence of dengue with signs of alarm was recorded in the last three years of the study period and for severe dengue, the highest incidence occurred in 2010 with 1,085 cases / 100,000 inhabitants, the standardized prevalence rate: 2005 13/1000 inhabitants, by 2010 28/1000 inhabitants and 2015 of 8/1000 inhabitants and the projection (2016-2025) of the cases of dengue, a relation was obtained directly proportional in the time series, as Years increase the casuistry of the disease. Conclusions: The Lagunillas parish of Mérida state presents a high prevalence of dengue, being classified as an epidemic zone. It was determined that in the years 2013-2015 the dengue with signs of alarm, has suffered an increase in its incidence, although it has not been determined the cause, it is very probable that local environmental phenomena, such as the water deficit, as well as the social context , May translate into an increase in the density of the dengue transmitter vector and an increase in the reporting of dengue cases.  

Abstract

Introduction: Walking and cycling bring health and environmental benefits, but there is little robust evidence that changing the built environment promotes these activities in populations. This study evaluated the effects of new transport infrastructure on active commuting and physical activity. Study design: Quasi-experimental analysis nested within a cohort study. Setting/participants: Four hundred and sixty-nine adult commuters, recruited through a predominantly workplace-based strategy, who lived within 30 kilometers of Cambridge, United Kingdom and worked in areas of the city to be served by the new transport infrastructure. Intervention: The Cambridgeshire Guided Busway opened in 2011 and comprised a new bus network and a traffic-free walking and cycling route. Exposure to the intervention was defined using the shortest distance from each participant’s home to the busway. Main outcome measures: Change in weekly time spent in active commuting between 2009 and 2012, measured by validated 7-day recall instrument. Secondary outcomes were changes in total weekly time spent walking and cycling and in recreational and overall physical activity, measured using the validated Recent Physical Activity Questionnaire. Data were analyzed in 2014. Results: In multivariable multinomial regression models—adjusted for potential sociodemographic, geographic, health, and workplace confounders; baseline active commuting; and home or work relocation—exposure to the busway was associated with a significantly greater likelihood of an increase in weekly cycle commuting time (relative risk ratio=1.34, 95% CI=1.03, 1.76) and with an increase in overall time spent in active commuting among the least active commuters at baseline (relative risk ratio=1.76, 95% CI=1.16, 2.67). The study found no evidence of changes in recreational or overall physical activity. Conclusions: Providing new sustainable transport infrastructure was effective in promoting an increase in active commuting. These findings provide new evidence to support reconfiguring transport systems as part of public health improvement strategies. JP is supported by a National Institute for Health Research (NIHR) post-doctoral fellowship (PDF- 2012-05-157). EH is supported by an NIHR Public Health Research project grant (see below) and DO is supported by the Medical Research Council [Unit Programme number MC_UP_12015/6]. RM is funded by the Higher Education Funding Council for England. The Commuting and Health in Cambridge Study was initially funded under the auspices of the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, National Institute for Health Research and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The study is now funded by the National Institute for Health Research Public Health Research programme (project number 09/3001/06). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the NIHR PHR programme or the Department of Health This is the final version of the article. It was first available from Elsevier via http://dx.doi.org/10.1016/j.amepre.2015.09.021 Document type: Article

Abstract

Introduction: Only one-third of the European population meets the minimum recommended levels of physical activity (PA). Physical inactivity is a major risk factor for non-communicable diseases. Walking and cycling for transport (active mobility, AM) are well suited to provide regular PA. The European research project Physical Activity through Sustainable Transport Approaches (PASTA) pursues the following aims: (1) to investigate correlates and interrelations of AM, PA, air pollution and crash risk; (2) to evaluate the effectiveness of selected interventions to promote AM; (3) to improve health impact assessment (HIA) of AM; (4) to foster the exchange between the disciplines of public health and transport planning, and between research and practice. Methods and analysis: PASTA pursues a mixed-method and multilevel approach that is consistently applied in seven case study cities. Determinants of AM and the evaluation of measures to increase AM are investigated through a large scale longitudinal survey, with overall 14 000 respondents participating in Antwerp, Barcelona, London, Örebro, Rome, Vienna and Zurich. Contextual factors are systematically gathered in each city. PASTA generates empirical findings to improve HIA for AM, for example, with estimates of crash risks, factors on AM-PA substitution and carbon emissions savings from mode shifts. Findings from PASTA will inform WHO's online Health Economic Assessment Tool on the health benefits from cycling and/or walking. The study's wide scope, the combination of qualitative and quantitative methods and health and transport methods, the innovative survey design, the general and city-specific analyses, and the transdisciplinary composition of the consortium and the wider network of partners promise highly relevant insights for research and practice. Ethics and dissemination: Ethics approval has been obtained by the local ethics committees in the countries where the work is being conducted, and sent to the European Commission before the start of the survey. The PASTA website (http://www.pastaproject.eu) is at the core of all communication and dissemination activities. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (https://creativecommons.org/licenses/by-nc/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL. Document type: Article

Abstract

Background Active transport (i.e. walking and cycling for transport) can provide substantial health benefits by increasing levels of physical activity (PA) and help reduce transport-associated emissions. Our aim was to conduct a health impact assessment (HIA) of cycling networks expansions in seven diverse European cities (Antwerp, Barcelona, London, Orebro, Rome, Vienna, Zurich) that form part of the Physical Activity through Sustainable Transport Approaches (PASTA) project. We modeled the association between cycling network distance (km) and cycling mode share (%) and estimated health impacts of the expansion of cycling networks. Methods Cycling network distances were computed for 168 European cities using OpenStreetMap data for designated cycling ways. Cycling mode share was available through the European Platform on Mobility Management. We performed a non-linear least square regression to assess the relationship between cycling network and cycling mode share. We performed a quantitative HIA for five different scenarios (S) (10% (S1); 50% (S2); 100% (S3), Go-Orebro (S4) and All-streets (S5)) assessing how an expansion of the cycling network would lead to an increase in cycling mode share and estimated associated mortality impacts thereof. We quantified mortality impacts in terms of changes to PA levels, exposure to air pollution and traffic incidents for the cyclist. Results Our results suggest that the cycling network may contribute to a cycling mode share of up to 25% in European cities. A cycling network as that of Orebro (S4; 255 km/100,000 persons) produced greatest health benefits through increases in cycling for London with 646 (95% CI: 397;1012) annual deaths avoided, followed by Rome (224; 95% CI: 133;359), Barcelona (162; 95% CI: 103;248), Vienna (82; 95% CI: 47;133), Zurich (27; 95% CI: 16;42) and Antwerp (3; 95% CI: 2;6). If all 168 European cities achieved a cycling mode share of 25% over 16,000 deaths (95% CI: 9,861;25,763) could be avoided each year. The largest cost-benefit ratios were found for the 10% increase in cycling network (S1) suggesting it to be most cost-effective (Rome € 40:1; Barcelona € 20:1; Zurich € 16:1; Vienna € 11:1, London € 3:1). Conclusions Especially in cities with a currently low cycling mode share, expansion of cycling networks may promote increases in cycling mode share. Increases in cycling mode share were estimated to provide considerable health benefits in European cities.

Abstract

Background The number of trips of the average urban inhabitant per year has grown steadily in recent years – but we are actually moving (our bodies) less. Every day, millions of trips are made by car (where 50% of these are less than 5 km) or other motorised private vehicles as well as with public transport, while only a small percentage of trips are made by active modes, such as cycling and walking. This lack of physical activity causes major health problems for individuals and great economic costs for society as a whole. To reverse these negative impacts the World Health Organisation (WHO) recommends a minimum of 150 minutes of moderate physical activity per week (e.g. 30 minutes 5 times per week). Replacing short motorized trips can feasibly increase physical activity in everyday life. Methods PASTA “Physical Activity trough sustainable transport approaches” collected data in a longitudinal web-based survey with a cohort design to study the effects of active mobility on overall physical activity and health. The target population for the survey was the entire adult population in 7 European Cities. In total, more than 12.000 people participated in the survey with half of them filling in valid travel diaries on actual trips on a regular basis. Results Differences in sociodemographics and travel behaviour of cyclists in the seven cities will be shown in the paper. Preliminary results reveal that more than 2.000 participants from the total sample can be identified as regular cyclists (reported in their trip diaries) with an average age of 40 years. Most of them are highly educated and full time employed. In comparison to non-regular cyclists, the share of female is lower; however the share of people who have a driving licence and who have at least sometimes access to a car is higher within the group of cyclists. About 85% of regular cyclists reach at least 30 cycling-minutes per reported day. This indicates that a high share of regular cyclists can reach the WHO´s recommended level only by routine cycling trips. Further the threshold of reaching the minimum recommendation by cycling will be analysed between the cities. Conclusions In this study, we compare cyclists and their travel behaviour in seven European cities. Our first results indicate, that cycling as a mean of transport can help reach the WHO’s physical activity recommendations and including physical activity into daily life without much of extra effort. Document type: Article