Excessive daytime sleepiness and metabolic syndrome: a cross-sectional study

Excessive daytime sleepiness (EDS) has been associated with singular independent symptoms of metabolic syndrome, such as insulin resistance and diabetes. The aim of this study was to assess whether this relationship is sustained among individuals who meet criteria for the whole syndrome.

Oxidative stress markers, cognitive functions, and psychosocial functioning in bipolar disorder: an empirical cross-sectional study

This study aimed to evaluate the relationship between oxidative stress markers and cognitive functions and domains of psychosocial functioning in bipolar disorder.

Improving chlamydia knowledge should lead to increased chlamydia testing among Australian general practitioners: a cross-sectional study of chlamydia testing uptake in general practice

Female general practitioners (GPs) have higher chlamydia testing rates than male GPs, yet it is unclear whether this is due to lack of knowledge among male GPs or because female GPs consult and test more female patients.

Association of serum leptin and ghrelin with depressive symptoms in a Japanese working population: a cross-sectional study

Leptin and ghrelin have been implicated in the pathogenesis of major depression. However, evidence is lacking among apparently healthy people. This study examined the relationship of these appetite hormones to depressive symptoms in a Japanese working population.

Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study

Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases.

Validation of patient health questionnaire (PHQ) for major depression in Chinese outpatients with multiple somatic symptoms: A multicenter cross-sectional study

Background: Despite the high co-morbidity of depressive symptoms in patients with multiple somatic symptoms, the validity of the 9-item Patient Health Questionnaire (PHQ-9) has not yet been investigated in Chinese patients with multiple somatic symptoms. Methods: The multicenter cross-sectional study was conducted in ten outpatient departments located in four cities in China. The psychometric properties of the PHQ-9 were examined by confirmative factor analysis (CFA). Criterion validation was undertaken by comparing results with depression diagnoses obtained from the Mini International Neuropsychiatric Interview (MINI) as the gold standard. Results: Overall, 491 patients were recruited of whom 237 had multiple somatic symptoms (SOM+ group, PHQ-15 ≥ 10). Cronbach's α of the PHQ-9 was 0.87, 0.87, and 0.90 for SOM+ patients, SOM- patients, and total sample respectively. All items and the total score were moderately correlated. The factor models of PHQ-9 tested by CFA yielded similar diagnostic performance when compared to sum score estimation. Multi-group confirmatory factor analysis based on unidimensional model showed similar psychometric properties over the groups with low and high somatic symptom burden. The optimal cut-off point to detect depression in Chinese outpatients was 10 for PHQ-9 (sensitivity=0.77, specificity=0.76) and 3 for PHQ-2 (sensitivity=0.77, specificity=0.74). Limitations: Potential selection bias and nonresponse bias with applied sampling method. Conclusions: PHQ-9 (cut-off point=10) and PHQ-2 (cut-off point=3) were reliable and valid to detect major depression in Chinese patients with multiple somatic symptoms.

Physical functioning, emotional, and behavioral problems in children with ADHD and comorbid ASD : a cross-sectional study

OBJECTIVE: To examine (a) physical and daily functioning in children with ADHD and autism spectrum disorder (ASD) compared with ADHD alone and (b) whether decreased physical quality of life (QoL) is associated with increased emotional and behavioral problems in children with ADHD-ASD. METHOD: Cross-sectional study comprising 392 children with confirmed ADHD (ADHD-ASD, n = 93; ADHD alone, n = 299) recruited from 21 pediatric practices in Victoria, Australia. Data were collected via parent and teacher surveys. Key measures included the Strengths and Difficulties Questionnaire (SDQ) and Pediatric Quality of Life Inventory (PedsQL). RESULTS: Children with ADHD-ASD had poorer QoL across both psychosocial and physical health domains, and also had greater parent-reported behavioral, emotional, and peer problems, compared with children with ADHD alone. Poorer physical QoL partially mediated the relationship between comorbid ASD status and poorer emotional and behavioral functioning. CONCLUSION: The comorbid overlay of ASD in ADHD appears to influence not only problems in physical functioning but also the severity of problems relating to areas of emotional and behavioral functioning.

Muscle strength and areal bone mineral density at the hip in women: a cross-sectional study

BACKGROUND: Muscle strengthening exercises are promoted for building and maintaining a healthy skeleton. We aimed to investigate the relationship between muscle strength and areal bone mineral density (BMD) at the hip in women aged 26-97 years.

METHODS: This cross-sectional study utilises data from 863 women assessed for the Geelong Osteoporosis Study. Measures of hip flexor and abductor strength were made using a hand-held dynamometer (Nicholas Manual Muscle Tester). The maximal measure from three trials on each leg was used for analyses. BMD was measured at the hip using dual energy x-ray absorptiometry (DXA; Lunar DPX-L). Total lean mass, body fat mass and appendicular lean mass were determined from whole body DXA scans. Linear regression techniques were used with muscle strength as the independent variable and BMD as the dependent variable. Models were adjusted for age and indices of body composition.

RESULTS: Measures of age-adjusted hip flexor strength and hip abductor strength were positively associated with total hip BMD. For each standard deviation (SD) increase in hip flexor strength, the increase in mean total hip BMD (SD) was 10.4 % (p = 0.009). A similar pattern was observed for hip abductor strength, with an increase in mean total hip BMD of 22.8 % (p = 0.025). All associations between hip muscle strength and total hip BMD were independent of height, but were nullified after adjusting for appendicular lean mass or total lean mass.

CONCLUSIONS: There was a positive association observed between muscle strength and BMD at the hip. However, this association was explained by measures of lean mass.

Cross-sectional study of 24-hour urinary electrolyte excretion and associated health outcomes in a convenience sample of Australian primary schoolchildren: the salt and other nutrients in children (SONIC) study protocol

BACKGROUND: Dietary sodium and potassium are involved in the pathogenesis of cardiovascular disease. Data exploring the cardiovascular outcomes associated with these electrolytes within Australian children is sparse. Furthermore, an objective measure of sodium and potassium intake within this group is lacking. OBJECTIVE: The primary aim of the Salt and Other Nutrient Intakes in Children ("SONIC") study was to measure sodium and potassium intakes in a sample of primary schoolchildren located in Victoria, Australia, using 24-hour urine collections. Secondary aims were to identify the dietary sources of sodium and potassium, examine the association between these electrolytes and cardiovascular risk factors, and assess children's taste preferences and saltiness perception of manufactured foods. METHODS: A cross-sectional study was conducted in a convenience sample of schoolchildren attending primary schools in Victoria, Australia. Participants completed one 24-hour urine collection, which was analyzed for sodium, potassium, and creatinine. Completeness of collections was assessed using collection time, total volume, and urinary creatinine. One 24-hour dietary recall was completed to assess dietary intake. Other data collected included blood pressure, body weight, height, waist and hip circumference. Children were also presented with high and low sodium variants of food products and asked to discriminate salt level and choose their preferred variant. Parents provided demographic information and information on use of discretionary salt. Descriptive statistics will be used to describe sodium and potassium intakes. Linear and logistic regression models with clustered robust standard errors will be used to assess the association between electrolyte intake and health outcomes (blood pressure and body mass index/BMI z-score and waist circumference) and to assess differences in taste preference and discrimination between high and low sodium foods, and correlations between preference, sodium intake, and covariates. RESULTS: A total of 780 children across 43 schools participated. The results from this study are expected at the end of 2015. CONCLUSIONS: This study will provide the first objective measure of sodium and potassium intake in Australian schoolchildren and improve our understanding of the relationship of these electrolytes to cardiovascular risk factors. Furthermore, this study will provide insight into child taste preferences and explore related factors. Given the cardiovascular implications of consuming too much sodium and too little potassium, monitoring of these nutrients during childhood is an important public health initiative.

Neighbourhood environment, sitting time and motorised transport in older adults: a cross-sectional study in Hong Kong

OBJECTIVES: Sitting time is a public health concern. This study examined associations of objectively measured neighbourhood environmental attributes with non-transport sitting time and motorised transport in 484 Hong Kong older adults. Neighbourhood attributes encouraging walking may help older adults replace some sitting time at home and on motorised transport with light-to-moderate-intensity activities such as strolling around the neighbourhood or walking to/from neighbourhood destinations. Thus, we hypothesised environmental attributes found to be related to walking would show associations with non-transport sitting time and motorised transport opposite to those seen for walking. DESIGN: Cross-sectional. SETTING: Hong Kong, an ultradense urban environment. PARTICIPANTS: 484 ethnic Chinese Hong Kong residents aged 65+ recruited from membership lists of four Hong Kong Elderly Health Centres representing catchment areas of low and high transport-related walkability stratified by socioeconomic status (response rate: 78%). PRIMARY AND SECONDARY OUTCOME MEASURES: Attributes of participants' neighbourhood environments were assessed by environmental audits, while non-transport sitting time and motorised transport were ascertained using the International Physical Activity Questionnaire-Long Form (Chinese version). RESULTS: Daily non-transport sitting minutes were 283 (SD=128) and motorised transport 23 (SD=28). Prevalence of signs of crime/disorder, streetlights, public facilities (toilets and benches) and pedestrian safety were independently negatively related, and sloping streets positively related, to sitting outcomes. Places of worship in the neighbourhood were predictive of more, and prevalence of public transit points of less, non-transport sitting. Associations of either or both sitting outcomes with prevalence of food/grocery stores and presence of parks were moderated by path obstructions and signs of crime/disorder. CONCLUSIONS: The findings suggest that access to specific destinations and relatively low-cost, minimal impact modifications to the urban form, such as street lighting, public toilets, benches and public transit points, could potentially reduce sitting time and associated negative health outcomes in Hong Kong older adults.

Associations between Australian early childhood educators’ mental health and working conditions: A cross-sectional study

© 2015, Early Childhood Australia Inc. All rights reserved. EARLY CHILDHOOD EDUCATION and care quality relies on educator capacity; however, working conditions may compromise educators’ mental health. This study examines associations between family day care (FDC) educators’ mental health and working conditions to inform workplace mental health promotion. Three hundred and sixty-six FDC educators completed an online or written survey. In addition to this, regression analyses were used to examine relationships between educator mental health and working conditions. Although many FDC educators had low psychological distress and moderate mental wellbeing, 41.7 per cent reported psychological distress. Most educators’ ‘efforts’ and ‘rewards’ were unbalanced (effort–reward imbalance [ERI] ratio) and showed high ‘overcommitment’ to work. Effort and overcommitment were significantly related to increased odds of psychological distress, whereas social support was associated with higher mental wellbeing. The ERI ratio had the strongest associations with educator psychological distress and mental wellbeing. As many working conditions associated with educator mental health are modifiable, this study highlights opportunities for workplace mental health promotion in FDC.

Maternal depressive and anxiety symptoms, self-esteem, body dissatisfaction and preschooler obesity: a cross-sectional study

The primary aim of the present study was to cross-sectionally examine the associations between maternal psychosocial variables, child feeding practices, and preschooler body mass index z-score (BMI-z) in children (aged 2–4 years). A secondary aim was to examine differences in child weight outcomes between mothers scoring above and below specified cut-offs on the psychosocial measures. Two hundred and ninety mother–child dyads were recruited from Melbourne, Australia, and completed questionnaires examining demographic information, mothers’ depressive and anxiety symptoms, self-esteem and body dissatisfaction, restrictive and pressure child feeding practices, and preschoolers’ BMI-z scores. Independent t-tests and hierarchical multiple regression were employed to analyse the data. In the final regression model, none of the maternal psychosocial measures or feeding practices predicted child BMI-z scores; maternal body mass index and employment status were the only predictors of preschooler BMI-z. However, independent t-tests revealed that children of mothers with elevated body dissatisfaction scores had significantly higher BMI-z scores than children of mothers without elevated scores. The results suggest that psychosocial variables are not related, cross-sectionally, to preschooler weight outcomes; however, further research is needed to replicate the group differences noted between mothers with and without body dissatisfaction, and to track these relationships longitudinally.