Bullying Experiences of Child and Adolescent Mental Health Service-users: A Pilot Survey

Victims and perpetrators of bullying experience a variety of psychological problems. The aim of the current pilot study was to explore the bullying experiences of Child and Adolescent Mental Health (CAMHS) service-users. The investigation was conducted as a cross-sectional survey at a community-based specialist CAMH service. A modified version of the Revised Olweus Bully/Victim Questionnaire was used to assess bullying experiences. Participants comprised an opportunity sample of 26 adolescent male and female CAMH service-users. Results indicated that 61.5% of participants reported being bullied. Clear links were made between being bullied and the mental health of participants, with 62.5% of bullied participants reporting that being bullied was a ‘‘moderately importantvery important’’ reason for their attendance at the CAMH service. Therapists at the CAMH service made appropriate enquiries about young people being victims of bullying, but more enquiries could be made about young peoples’ experiences as perpetrators. Service-users favoured therapist-led bullying interventions such as assertiveness training, therapy and/or psychological coping strategies, and social skills training. These findings underline the need for ecological approaches to dealing with bullying, and suggest that CAMH services could play an important role in establishing and supporting such interventions.

Measuring healthcare integration: Operationalization of a framework for a systems evaluation of palliative care structures, processes, and outcomes

BACKGROUND: Healthcare integration is a priority in many countries, yet there remains little direction on how to systematically evaluate this construct to inform further development. The examination of community-based palliative care networks provides an ideal opportunity for the advancement of integration measures, in consideration of how fundamental provider cohesion is to effective care at end of life.

AIM: This article presents a variable-oriented analysis from a theory-based case study of a palliative care network to help bridge the knowledge gap in integration measurement.

DESIGN: Data from a mixed-methods case study were mapped to a conceptual framework for evaluating integrated palliative care and a visual array depicting the extent of key factors in the represented palliative care network was formulated.

SETTING/PARTICIPANTS: The study included data from 21 palliative care network administrators, 86 healthcare professionals, and 111 family caregivers, all from an established palliative care network in Ontario, Canada.

RESULTS: The framework used to guide this research proved useful in assessing qualities of integration and functioning in the palliative care network. The resulting visual array of elements illustrates that while this network performed relatively well at the multiple levels considered, room for improvement exists, particularly in terms of interventions that could facilitate the sharing of information.

CONCLUSION: This study, along with the other evaluative examples mentioned, represents important initial attempts at empirically and comprehensively examining network-integrated palliative care and healthcare integration in general.

Oral Bisphosphonate Exposure and the Risk of Upper Gastrointestinal Cancers

The association between oral bisphosphonate use and upper gastrointestinal cancer has been controversial. Therefore, we examined the association with esophageal and gastric cancer within the Kaiser Permanente, Northern California population. A total of 1,011 cases of esophageal (squamous cell carcinoma and adenocarcinoma) and 1,923 cases of gastric adenocarcinoma (cardia, non-cardia and other) diagnosed between 1997 and 2011 from the Kaiser Permanente, Northern California cancer registry were matched to 49,886 and 93,747 controls, respectively. Oral bisphosphonate prescription fills at least one year prior to the index date were extracted. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between prospectively evaluated oral bisphosphonate use with incident esophageal and gastric cancer diagnoses with adjustment for potential confounders. After adjustment for potential confounders, no significant associations were found for esophageal squamous cell carcinoma (OR 0.88; 95% CI: 0.51, 1.52), esophageal adenocarcinoma (OR 0.68; 95% CI: 0.37, 1.24), or gastric non-cardia adenocarcinoma (OR 0.83, 95% CI: 0.59, 1.18), but we observed an adverse association with gastric cardia adenocarcinoma (OR 1.64; 95% CI: 1.07, 2.50). In conclusion, we observed no association between oral bisphosphonate use and esophageal cancer risk within a large community-based population. A significant association was detected with gastric cardia and other adenocarcinoma risk, although this needs to be replicated.

Saúde mental e comportamentos de risco em estudantes universitários

A saúde dos estudantes do ensino superior é uma importante questão de saúde pública, com impacto não só a nível pessoal e social, como também institucional. Nesse sentido, a presente investigação teve como objectivos: 1) caracterizar a saúde mental dos estudantes universitários, ao nível de sintomas depressivos, stress e bem-estar; 2) identificar os seus padrões de consumo de álcool, em termos de quantidade e frequência de consumo, ingestão esporádica excessiva e tipos de bebidas mais ingeridas; 3) conhecer a prevalência de dois comportamentos de risco ligados ao álcool, os comportamentos sexuais de risco e a condução sob o efeito de álcool; 4) analisar a relação entre saúde mental e consumo de álcool no ensino superior. Para esse efeito, realizou-se um estudo transversal com 666 alunos do 1º ciclo da Universidade de Aveiro. Os instrumentos utilizados foram: Ficha de Caracterização Sociodemográfica e Académica; Medida de Saúde Comportamental-20; Inventário da Depressão em Estudantes Universitários; Inventário de Stress em Estudantes Universitários; Questionário de Comportamentos de Risco em Estudantes Universitários. Os resultados mostraram que 32% dos estudantes se encontravam num patamar disfuncional quanto à sua saúde mental, 15% apresentavam sintomatologia depressiva e 26% sofriam de níveis elevados de stress, mas que apenas uma minoria destes alunos estava a receber apoio psicológico profissional. Os níveis de saúde mental foram inferiores nas mulheres, nos alunos do 1º e do 3º ano, da área de Saúde e de estatuto socioeconómico baixo. Para além disso, a maioria dos estudantes consumia álcool e 41% tiveram episódios de ingestão excessiva no último mês. Durante as festas académicas, um quarto dos estudantes ingeriu cinco ou mais bebidas por noite. O consumo de álcool foi superior nos homens, nos estudantes da área de Engenharias, de estatuto socioeconómico elevado e nos deslocados. Quanto a problemas ligados ao álcool, 13% dos estudantes sexualmente activos admitiram ter tido relações sexuais decorrentes do consumo de álcool, no último ano, e 29% praticaram condução sob o efeito de álcool no último mês. Estes comportamentos foram mais frequentes em estudantes do sexo masculino e naqueles que tiveram episódios de ingestão excessiva. Não se encontrou, de um modo geral, uma relação entre saúde mental e consumo de álcool, tendo sido detectadas apenas correlações, fracas, do stress e do bem-estar com o consumo de álcool. Ao contrário do que era esperado, verificou-se que à medida que o consumo de álcool aumentava, o stress diminuía e o bem-estar aumentava ligeiramente. Estes dados salientam a necessidade de as instituições do ensino superior reforçarem a identificação e o tratamento de problemas existentes e apostarem na prevenção, tanto através de estratégias dirigidas a toda a comunidade, no âmbito da educação para a saúde e da literacia em saúde mental, como através de iniciativas destinadas aos grupos de risco aqui identificados.

Imagens das línguas e afectividade em contexto escolar

Enquadrado numa perspectiva sócio-construtivista em Didáctica de Línguas (DL), o presente trabalho propõe-se identificar e descrever as imagens face às línguas estrangeiras, em particular à língua Alemã, e sua aprendizagem, que se manifestam numa determinada comunidade escolar. Com base nas imagens identificadas, pretende-se compreender de que forma elas se relacionam com a dimensão afectiva presente no processo de ensinoaprendizagem, nomeadamente no que diz respeito à relação afectiva que o aprendente vai construindo com o alemão, objecto de estudo. Neste quadro, foram traçadas as seguintes questões de investigação para este trabalho: (1) Que imagens face às línguas escolares (inglês, francês, espanhol, português e, em particular, alemão), se manifestam numa determinada comunidade escolar (considerando os alunos, encarregados de educação, professores, administração da escola e funcionários)?; Como se (inter-) relacionam estas imagens nos diferentes públicos considerados?; (2) De que forma se manifestam as imagens face à língua alemã e sua aprendizagem na interacção em sala de aula de Alemão (LE)? Quais as marcas discursivas que as identificam e tecem?; De que forma estão estas imagens associadas às emoções e (3) Quais as emoções associadas às imagens do Alemão e sua aprendizagem em contexto de sala de aula? A investigação recente em DL sugere que as imagens que um determinado sujeito constrói face a uma dada língua permitem compreender as suas atitudes e comportamentos face à mesma, nomeadamente no que diz respeito à relação afectiva que vai construindo com a língua em causa e sua aprendizagem (cf. ARAÚJO E SÁ & SCHMIDT 2008, DE PIETRO & MÜLLER 1997, MÜLLER 1998, PERREFORT 2001). Estas imagens, enquanto constructos sociais, elaboram-se, revitalizam-se e cristalizam-se na e pela interacção verbal em sala de aula. Nesta perspectiva, o presente trabalho discute os conceitos de imagem/representação face às línguas, relacionandoos com a dimensão afectiva (inegavelmente) presente nos processos de ensino-aprendizagem das LE e à luz de uma abordagem interaccional em DL. A investigação desenrolou-se em duas fases. Numa primeira, aplicou-se um inquérito por questionário a toda uma comunidade escolar (incluindo todos os públicos anteriormente referidos), numa escola secundária com terceiro ciclo em Albergaria-a-Velha, no distrito de Aveiro. Os dados recolhidos foram analisados segundo uma abordagem mista (quantitativa e qualitativa). Os resultados apontam para imagens fortemente escolarizadas, na medida em que os inquiridos parecem considerar as línguas estrangeiras sobretudo enquanto objectos de apropriação em contextos escolares. Identificaram-se imagens homogéneas e consistentes das línguas estrangeiras, evidenciando-se, no que à língua alemã diz respeito, a sua dificuldade. Os resultados relacionam-se com os obtidos noutras investigações realizadas em terreno nacional em DL, corroborando alguns e complementando outros (ARAÚJO E SÁ 2008, SIMÕES 2006, PINTO 2005, MELO 2006 e Projecto Imagens das Línguas na comunicação intercultural: contributos para o desenvolvimento da competência plurilingue). Numa segunda fase, acompanhou-se uma turma de alemão (LE) ao longo de um ano lectivo completo, tendo-se procedido à vídeo-gravação das aulas e, posteriormente, à identificação do que designámos por ‘episódios significativos’, para constituição do corpus de análise. A análise interaccional destes episódios permitiu a identificação de diferentes marcas discursivas (verbais, para-verbais e não-verbais) que indiciam, por um lado, a circulação e (re)construção de imagens face ao alemão e sua aprendizagem e, por outro, a presença de um conjunto de emoções associadas a estas imagens, nos discursos dos aprendentes e da professora. No que diz respeito à imagem da dificuldade do alemão e da sua aprendizagem, cristalizaram-se seis indicadores: (1) a compreensão oral e a pronúncia, (2) o léxico e as palavras compostas (3) os números, (4) a leitura, (5) o sistema de regras gramaticais e, finalmente, (6) a auto-imagem dos alunos enquanto aprendentes de alemão. Os resultados sugerem ainda a associação destas imagens a emoções tendencialmente ‘negativas’ (por exemplo a arrelia e o embaraço), isto é, que se traduzem numa atitude de distanciamento e de evitamento linguístico. Face às conclusões obtidas, propõe-se um conjunto de princípios enquadradores para uma educação em línguas ‘afectivamente consciente’ e capaz de promover imagens mais positivas das línguas e das suas aprendizagens, designadamante do alemão. Considerando-se a diminuição acentuada dos aprendentes de alemão (LE) em contexto escolar nacional nos últimos dez anos, aponta-se para a necessidade de melhor compreender a relação entre a falta de popularidade escolar desta língua e a imagem da sua dificuldade (de aprendizagem).

Follow up on the local implementation of an MPA in the small fishing village of San Felipe, Yucatan

Dissertação mest., Biologia Marinha, Universidade do Algarve, 2007

Development and implementation of a new service delivery model for children with disabilities : implications for DCD

There is a general consensus that new service delivery models are needed for children with developmental coordination disorder (DCD). Emerging principles to guide service delivery include the use of graduated levels of intensity and evidence-based services that focus on function and participation. Interdisciplinary, community-based service delivery models based on best practice principles are needed. In this case report, we propose the Apollo model as an example of an innovative service delivery model for children with DCD. We describe the context that led to the creation of a program for children with DCD, describe the service delivery model and services, and share lessons learned through implementation. The Apollo model has 5 components: first contact, service delivery coordination, community-, group- and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups and individual interventions. Following implementation of the Apollo model, waiting times decreased and numbers of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD.

Comportamentos autolesivos em adolescentes : características epidemiológicas e análise de fatores psicopatológicos, temperamento efetivo e estratégias de coping

Tese de doutoramento, Medicina (Psiquiatria e Saúde Mental), Universidade de Lisboa, Faculdade de Medicina, 2014

Recursos Fandangueros

Thesis (Master's)--University of Washington, 2013

Best Practice for Providing Social Care and Support to People Living with Concurrent Sight Loss and Dementia: Professional Perspectives

Purpose-Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited. The purpose of this paper is to report on a research project that explored the provision of social care and support for older people with both conditions. Design/methodology/approach-The project was a collaboration between the universities of York, Worcester, Bournemouth and Cambridge, supported by the Thomas Pocklington Trust and the Housing and Dementia Research Consortium. Data for this paper were drawn from focus groups held in 2013 involving 47 professionals across the dementia, sight loss and housing sectors. Findings-Thematic analysis identified five main barriers to providing high-quality, cost-effective social care and support: time constraints; financial limitations; insufficient professional knowledge; a lack of joint working; and inconsistency of services. The requirements of dementia and sight loss often conflict, which can limit the usefulness of equipment, aids and adaptations. Support and information needs to address individual needs and preferences. Research limitations/implications-Unless professionals consider dementia and sight loss together, they are unlikely to think about the impact of both conditions and the potential of their own services to provide effective support for individuals and their informal carers. Failing to consider both conditions together can also limit the availability and accessibility of social care and support services. This paper is based on input from a small sample of self-selecting professionals across three geographical regions of England. More research is needed in this area. Practical implications-There are growing numbers of people living with concurrent dementia and sight loss, many of whom wish to remain living in their own homes. There is limited awareness of the experiences and needs of this group and limited provision of appropriate services aids/adaptations. A range of measures should be implemented in order to support independence and well-being for people living with both conditions and their family carers. These include increased awareness, improved assessment, more training and greater joint working. Social implications-People living with dementia or sight loss are at high risk of social isolation, increasingly so for those with both conditions. Services that take an inclusive approach to both conditions can provide crucial opportunities for social interaction. Extra care housing has the potential to provide a supportive, community-based environment that can help residents to maintain social contact. Originality/value-This paper adds much-needed evidence to the limited existing literature, and reflects the views of diverse professionals across housing, health and social care

Creating Local Institutional Arrangements for Sustainable Wetland Socio-ecological Systems: Lessons from the ‘Striking a Balance’ Project in Malawi

Wetland socio-ecological systems provide livelihood benefits for many poor people throughout the developing world, yet their sustainable development requires local utilisation strategies that balance both environmental and development outcomes. Community-based local institutional arrangements that mediate peoples’ relationships with their environment and facilitate adaptive co-management offer one means of achieving this, and increasingly many NGOs and development practitioners have sought to integrate local institutional capacity-building into development projects. In the context of wider academic debates surrounding the long-term sustainability of externally-facilitated local institutions, this paper draws on the experiences of the three-year Striking a Balance (SAB) project in Malawi which sought to embed sustainable wetland management practices within community-based local institutional arrangements. Drawing on field data collected through participatory methods at three project sites some five years after the cessation of project activities, we examine the extent to which SAB’s local institutional capacity-building has been successful, and from this draw some lessons for externally-driven project interventions which seek win-win outcomes for people and the environment. With reference to Elinor Ostrom’s design principles for long-enduring common property resource institutions, we suggest that the observed declining effectiveness of SAB’s local institutions can be attributed to issues of stakeholder inclusiveness and representations; their sustainability was arguably compromised from their inception on account of them being nested within pre-existing, externally-driven village ‘clubs’ whose membership and decision-making was not congruent with all the wetland stakeholders within the community.

Elos: trabalho de projecto

Trabalho de Projecto submetido à Escola Superior de Teatro e Cinema para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Teatro – especialização em Teatro e Comunidade.

How to increase and attract more tourists into Kenya throught experiental marketing

This marketing plan project is a culmination of extensive strategies with the use of experiential marketing to address issues confronting the Kenyan tourism industry in order to have a sustainable tourism sector. Following the terrorist attack carried out by Islamist militants’ belonging to al-Shabaab terrorist organization on Nairobi’s Westgate shopping mall in September 2013, tourist forecast has gone down sharply with an average of 20% fall in tourists’ arrivals which is likely to have an impact on the tourism sector in Kenya. Even before the deadly attack on Westgate, the most lethal attack by Islamist terrorists in 15 years in Kenya, the government through the Kenya tourist board had announced that in 2013 tourist arrivals were down by 12%, at 495,978, according to an October 2013 report by Bloomberg. Tourism revenues were also down by 7.4%, over FY12/13 (July-June) to reach KES96.24bn, according to a September 2013 report on the local Capital FM website. Beyond 2013, much will depend on how quickly the Kenya tourist board can regain control of the situation. The Kenyan government believes that the Westgate mall attack was a 'one-off' incident, with a low probability of a similar event happening again over the short term period. Germany, United States, United Kingdom, Australia, Italy, France and Canada continue to be the key source market however; the Kenya tourist board can make continued growth stronger from new emerging markets in order to increase new arrivals into the country. The marketing plan outlines the objectives to be implemented and provides the implementation strategy, activity plans, monitoring and evaluation plans, financial requirements projections and proposes a new structure of experiential marketing. A number of regional forces are identified that will impact tourism into the country including global, social and economic forces, emerging trends in visitor motivations and behavior, emerging forces in experiential marketing. A major component of the strategy identifies target markets for Kenya to commensurate with the level of resources that will be available for marketing and promotion, in keeping with the forces and trends identified and the nature of the Kenya tourism environment. The agreed upon target market segments are: generic/mass travel, experiential travel, creative travel, adventure seeking travel, senior/extended/long stay travel, and business related travel. The strategy phases the development of the target markets over the years of the marketing strategies in order to yield the best opportunity for results. A core activity in developing a marketing strategy is determining the nature of experiences Kenya offers in tourism. The strategy’s experience development process will continue to develop within the context of the products identified which will be promoted regionally: culture/heritage, nature, community-based. Each county in the country has a significant number of attractions and experiences and the challenge of the country is to bring these together in a creative and innovative way in order to encourage tourists to visit more than one county in Kenya.

Implementation progress of mental health services in Rwanda: Bugesera district case

RESUMO: O Ministério da Saúde do Governo do Ruanda identifica a saúde mental como uma área de prioridade estratégica para a intervenção em resposta à alta carga dos transtornos mentais no Ruanda. Ao longo dos últimos 20 anos após o genocídio, o sector público reconstruiu sua Resposta Nacional de Saúde Mental com base no acesso equitativo aos cuidados, através do desenvolvimento de uma Política Nacional de Saúde Mental e novas estruturas de saúde mental. A política de Saúde Mental do Ruanda, revista em 2010, prima pela descentralização e integração dos serviços de saúde mental em todas as estruturas nacionais do sistema de saúde e ao nível da comunidade. O presente estudo de caso tem como objetivo avaliar a situação do sistema de saúde mental de um distrito típico de uma área rural no Ruanda, e sugerir melhorias, incluindo algumas estratégias para monitoras as mudanças. Os resultados do estudo permitirão ao Ruanda reforçar a sua capacidade para implementar o Plano Nacional de Saúde Mental ao nível dos distritos. O relatório também será útil para monitorar o progresso da implementação de serviços de saúde mental nos distritos, incluindo a prestação de serviços de base comunitária e a participação dos usuários, suas famílias e outros interessados na promoção, prevenção, assistência e reabilitação em saúde mental. Este estudo também procurou avaliar o progresso da implementação dos cuidados de saúde mental a nível descentralizado, com vista a compreender as implicações em termos de recursos desses processos. Foi realizada uma análise situacional num local do distrito, baseado em entrevistas com as principais partes interessadas responsáveis, usando o Instrumento de Avaliação de Sistemas de Saúde Mental da Organização Mundial da Saúde (WHO-AIMS). Os resultados sugerem que os recursos humanos para a saúde mental e serviços de base comunitária de saúde mental no distrito continuam a ser extremamente limitados. Os profissionais de saúde mental são adicionalmente limitados na sua capacidade para oferecer intervenções de emergência a pacientes psiquiátricos e garantir a continuidade do tratamento farmacológico a pacientes com condições crônicas. Para planejar efetivamente, de acordo com as necessidades da comunidade, sugerimos que o sistema de saúde mental deve envolver também os representantes das famílias e dos usuários no processo de planificação de modo a melhorar a sua contribuição no processo de implementação das atividades de saúde mental. Este estudo de caso do Distrito de Bugesera oferece a primeira análise de nível distrital dos serviços de saúde mental no Ruanda, e pode servir como uma mais-valia para a melhoria do sistema de saúde mental, incluindo a advocacia para a melhoria da qualidade dos cuidados de saúde mental a este nível, aumentando o financiamento para a implementação de serviços clínicos de saúde mental e os recursos humanos disponíveis para a prestação de cuidados de saúde mental, principalmente a nível dos cuidados primários.--------------------- ABSTRACT: To deal with the high burden of mental health disorders resulting from consequences of the 1994 genocide against Tutsis, the Rwanda Ministry of Health (MoH) considers mental health as a priority intervention. For the last 20 years, Ministry of Health focused on rebuilding a national and equity-oriented mental health program responding to the population needs in mental health. Mental health services are now decentralized and integrated in the national health system, from the community level up to the referral level. This study assessed the situation of mental health services in one rural district in Rwanda. It was aimed at assessing the progress of implementation of mental health care at the decentralized level, focusing on resource implications and processes. This study is based on interviews conducted with key stakeholders, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS). Findings show that human resources for mental health care and community-based mental health services of the assessed district remain extremely limited. Mental health professionals face limitation regarding the ability to provide emergency management of psychiatric patients and to ensure continuity of psychopharmacological treatment of patients with chronic conditions. To improve the implementation process of mental health interventions and activities, a planning process based on community needs and the involvement of representatives of families and users in planning process should be considered. The Bugesera case study on the situation of mental health services can serve as a baseline for improvement of the mental health program in Rwanda, in terms of quality care services, infrastructure and equipment, human and financial resources.

Did Dumbo suffer a heart attack? independent association between earlobe crease and cardiovascular disease.

BACKGROUND: Earlobe crease (ELC) has been associated with cardiovascular diseases (CVD) or risk factors (CVRF) and could be a marker predisposing to CVD. However, most studies studied only a small number of CVRF and no complete assessment of the associations between ELC and CVRF has been performed in a single study. METHODS: Population-based study (n = 4635, 46.7 % men) conducted between 2009 and 2012 in Lausanne, Switzerland. RESULTS: Eight hundred six participants (17.4 %) had an ELC. Presence of ELC was associated with male gender and older age. After adjusting for age and gender (and medication whenever necessary), presence of ELC was significantly (p < 0.05) associated with higher levels of body mass index (BMI) [adjusted mean ± standard error: 27.0 ± 0.2 vs. 26.02 ± 0.07 kg/m(2)], triglycerides [1.40 ± 0.03 vs. 1.36 ± 0.01 mmol/L] and insulin [8.8 ± 0.2 vs. 8.3 ± 0.1 μIU/mL]; lower levels of HDL cholesterol [1.61 ± 0.02 vs. 1.64 ± 0.01 mmol/L]; higher frequency of abdominal obesity [odds ratio and (95 % confidence interval) 1.20 (1.02; 1.42)]; hypertension [1.41 (1.18; 1.67)]; diabetes [1.43 (1.15; 1.79)]; high HOMA-IR [1.19 (1.00; 1.42)]; metabolic syndrome [1.28 (1.08; 1.51)] and history of CVD [1.55 (1.21; 1.98)]. No associations were found between ELC and estimated cardiovascular risk, inflammatory or liver markers. After further adjustment on BMI, only the associations between ELC and hypertension [1.30 (1.08; 1.56)] and history of CVD [1.47 (1.14; 1.89)] remained significant. For history of CVD, further adjustment on diabetes, hypertension, total cholesterol and smoking led to similar results [1.36 (1.05; 1.77)]. CONCLUSION: In this community-based sample ELC was significantly and independently associated with hypertension and history of CVD.