Prevalence and determinants of hepatitis B co-infection among a United States Veterans Administration cohort with hepatitis C

Background and aim. Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection is associated with increased risk of cirrhosis, decompensation, hepatocellular carcinoma, and death. Yet, there is sparse epidemiologic data on co-infection in the United States. Therefore, the aim of this study was to determine the prevalence and determinants of HBV co-infection in a large United States population of HCV patients. ^ Methods. The National Veterans Affairs HCV Clinical Case Registry was used to identify patients tested for HCV during 1997–2005. HCV exposure was defined as two positive HCV tests (antibody, RNA or genotype) or one positive test combined with an ICD-9 code for HCV. HCV infection was defined as only a positive HCV RNA or genotype. HBV exposure was defined as a positive test for hepatitis B core antibodies, hepatitis B surface antigen, HBV DNA, hepatitis Be antigen, or hepatitis Be antibody. HBV infection was defined as only a positive test for hepatitis B surface antigen, HBV DNA, or hepatitis Be antigen within one year before or after the HCV index date. The prevalence of exposure to HBV in patients with HCV exposure and the prevalence of HBV infection in patients with HCV infection were determined. Multivariable logistic regression was used to identify demographic and clinical determinants of co-infection. ^ Results. Among 168,239 patients with HCV exposure, 58,415 patients had HBV exposure for a prevalence of 34.7% (95% CI 34.5–35.0). Among 102,971 patients with HCV infection, 1,431 patients had HBV co-infection for a prevalence of 1.4% (95% CI 1.3–1.5). The independent determinants for an increased risk of HBV co-infection were male sex, positive HIV status, a history of hemophilia, sickle cell anemia or thalassemia, history of blood transfusion, cocaine and other drug use. Age >50 years and Hispanic ethnicity were associated with a decreased risk of HBV co-infection. ^ Conclusions. This is the largest cohort study in the United States on the prevalence of HBV co-infection. Among veterans with HCV, exposure to HBV is common (∼35%), but HBV co-infection is relatively low (1.4%). There is an increased risk of co-infection with younger age, male sex, HIV, and drug use, with decreased risk in Hispanics.^

Occupational health and safety among commercial sex workers in Ghana

The topic of occupational health and safety (OHS) has been investigated for many years and continues to be a concept often researched today. Generally speaking OHS research has been centered around food safety, construction safety, transportation safety, fire safety, drug and alcohol testing, health and medical management, and industrial hygiene to name a few. However, the concept of OHS concerning female commercial sex workers (FCSWs) has rarely been investigated, often neglected, seldom discussed and is lacking in sound research. Although regarded as the "oldest profession", commercial sex work (CSW) has consistently been ignored, disregarded and under-researched due to the illegality and stigmatization of prostitution. This paper reviews occupational safety and health issues faced by FCSWs in Tema and Accra, Ghana, through in-depth interviews, visits to women's homes, field work, informal conversations and participant observations with FCSWs over a period of two months. Facets of OHS that emerged among FCSWs included sexually transmissible infections, risks associated with harassment and violence from police and clients, alcohol and drug use, irregular hospital visits and/or lack of hospital visits, immigration issues, legal and policing risks. We argue that CSW be viewed as an occupation in great need of interventions to reduce workplace risks and improve the health and safety of FCSWs^

The association between academic achievement and health status among eighth -grade Hispanic students in Houston

This cross-sectional study examines the association between health and academic achievement among Hispanic eighth-grade students in the Houston Independent School District. As part of the district's 3 year Safe Schools/Healthy Students Initiative to enhance comprehensive educational programs, a brief anonymous questionnaire was administered in the classroom to 359 students in two schools during a one-month period in the early part of the 2001 school year. ^ The primary study questions are: Among this sample of Hispanic adolescents, is there a significant association between academic achievement and health status? and in this same population, is there a significant association between health risk behavior and health status? The specific aims of this research are: (1) to describe the association between academic achievement and health status; (2) to describe the association between health risk behaviors and health status; and (3) to describe the relative contribution of health risk behaviors and academic achievement to adolescent health status among this sample of Hispanic adolescents. ^ The survey instrument was a 32-item questionnaire that incorporated: several academic achievement questions measuring usual grades, school-related performance, attendance, student and perceived parental satisfaction with academic achievement, and educational aspirations; two health and quality of life scales measuring adolescent self-reported health; and specific measures of health risk behavior, e.g., frequency of tobacco cigarette smoking, alcohol and other drug use, aggression, and suicidal ideation and behavior that were incorporated from the national Youth Risk Behavior Survey. Questions pertaining to sexual behavior and pregnancy were omitted to comply with school district guidelines. ^ Analysis revealed that strong associations between academic achievement and health status and between health risk behaviors and health status were observed after controlling for the covariates. Eight factors were found to be significantly associated with poor health status: usual grades (low), academic performance (low), academic achievement beliefs (low), classroom and homework performance satisfaction (low), ever drinking alcohol (6 or more times), suicidality (ever thought about, planned for, or sought medical help after attempting suicide), gender (female), and age (15 years and older). (Abstract shortened by UMI.) ^

Riesgo del consumo de cannabis para la práctica físico-deportiva

El consumo de cannabis es uno de los principales problemas de salud pública, especialmente entre los jóvenes, dadas sus prevalencias de consumo. Esta droga puede provocar alteraciones psicomotrices en el individuo, por ello, el presente trabajo de investigación tiene como objetivo principal comprobar si el consumo de cannabis supone un riesgo añadido a la práctica físico-deportiva. Para alcanzar dicho objetivo, se dividió el trabajo en dos estudios interrelacionados entre sí. En el primer estudio o Estudio 1, “Repercusión del consumo de cannabis en las clases de Educación Física”, se realizó un cuestionario autoadministrado, dirigido al profesorado de Educación Física de la Comunidad de Madrid, con el fin de recoger su opinión sobre la posible presencia de consumidores de cannabis en sus aulas. El segundo estudio o Estudio 2, “Influencia del cannabis en el equilibrio, la coordinación, el tiempo de respuesta y la percepción temporal”, consistió en la realización de una serie de pruebas por parte de un grupo control y un grupo de consumidores de cannabis, para así cuantificar y cualificar los efectos de la inhalación de esta droga en la condición motriz. La encuesta que se utilizó para el Estudio 1, “El cannabis, los adolescentes y la práctica físico-deportiva”, pasó primero por una fase de elaboración, corrección y validación, y después, utilizándose la técnica de muestreo aleatorio por conglomerados, fue distribuido por los centros públicos de enseñanzas secundarias de la Comunidad de Madrid seleccionados. Se obtuvo respuesta de 93 profesores de Educación Física pertenecientes a 76 centros, es decir el 22,35% de los centros de la comunidad. Por último, se procedió al análisis, discusión y difusión de los resultados. En el Estudio 2, primero se procedió al diseño de la batería de pruebas a realizar, compuesta por 7 tests con 16 variables que valoraron el equilibrio, la coordinación, el tiempo de respuesta y la percepción temporal de los sujetos. Después se procedió a la selección de la muestra, formada por dos grupos de voluntarios de entre 18 y 30 años: un grupo control de 52 participantes, y un grupo de consumidores de cannabis, de 28 participantes con un hábito de consumo diferente. Los sujetos del grupo de consumidores realizaron las pruebas 20 minutos después de la inhalación de cannabis. Tras la realización de las pruebas por parte de todos los sujetos se procedió al análisis de los resultados obtenidos, segmentándolos por sexo y apareando las variables para evitar posibles efectos confundidores. Los resultados del primer estudio indicaron que el 75,27% del profesorado ha pensado alguna vez que sus alumnos consumían cannabis antes del inicio de su clase, hecho asociado a alteraciones psicológicas (90,63%) y cognitivo-conductuales (68,75%); no siendo factores influyentes el sexo o la experiencia docente de los encuestados (p>0,05). El segundo estudio aportó como principal resultado el empeoramiento de la percepción temporal y la conducta motriz de los sujetos que consumieron cannabis, en especial de su equilibrio y su coordinación (p<0,05). También indicó que hubo ligeras diferencias en función del hábito de consumo de esta droga, si bien los resultados se vieron influenciados por el tamaño de la muestra. Las conclusiones extraídas mostraron que el profesorado de Educación Física percibe la presencia de consumidores de cannabis en sus aulas, utiliza el diálogo con el alumnado como herramienta de actuación, y conoce la influencia negativa que tiene el consumo de esta droga en el rendimiento motor. También demuestran que el cannabis supone un riesgo añadido a la práctica físico-deportiva, debido al empeoramiento de la conducta motriz, en especial de la coordinación y el equilibrio. Además, las diferencias surgidas en base al hábito de consumo no son concluyentes pero si apuntan a que el consumo esporádico puede conllevar un peor rendimiento motor que el consumo habitual. ABSTRACT Cannabis use is one of the most important concerns of public health, particularly among young people, given their use prevalence. This drug can produce psychomotor alterations in the subject; therefore, this research work has as main aim to check if cannabis use is an added risk for physical and sporting practices. In order to achieve the objectives pursued, work was divided in two interrelated studies. First study or Study 1, “Cannabis use impact in Physical Education lessons”, a self-managed questionnaire addressed to Physical Education teachers in Community of Madrid was carried out, in order to gather the opinion about the possible existence of Cannabis users in their classes. Second Study or Study 2, “Cannabis influence in balance, coordination, reaction time and temporal perception”, consisted in a series of tests performed by a control group and a cannabis users group, in order to quantify and qualify the effects of inhalation of this drug in the motor skills. The questionnaire used for Study 1, “Cannabis, teenagers, and physical and sporting practices”, firstly went through an elaboration y correction phase, and then, using cluster sampling technique, was distributed within selected Secondary Education Centres from Community of Madrid. Response from 93 Physical Education teachers from 76 High Schools were obtained, this is 22,35% of total High Schools in Madrid. Finally, analysis, discussion and dissemination of results were held. In Study 2, first of all design of tests to be made was done, consisting on 7 different test with 16 variables that measured balance, coordination, response time and temporal perception in subjects. After that, sample selection was performed, comprised of 2 volunteers groups of ages between 18-30 years: a control group of 52 participants, and a Cannabis Users Group of 28 participants with different consumption habits. Users group subjects carried out tests 20 minutes after cannabis inhalation. After tests were performed by all subjects, results were analyzed and segmented by sex and matching variables in order to avoid confusion effects. First study results brought out that 75,27% of teachers have ever thought that their pupils used cannabis before getting into class, this fact is linked to psychological alterations (90,63%) and cognitive-behavioral (68,75%); not being influencing factors sex or teaching experience of the surveyed (p>0,05). Second study provided as most significant result the worsening of temporal perception and motor tasks behavior in subjects that had used cannabis, especially in regards of their balance and coordination (p<0,05). Also resulted that there were slight differences in consumption habits, although results were influenced by the sample size. Conclusions drawn showed that Physical Education teachers notice the presence of cannabis users in lessons, use dialogue with pupils as an action tool and acknowledge the negative influence this drug has in motor tasks performance. Also, it is shown that cannabis is an additional risk for physical and sporting practices due to deteriorating in motor skills, particularly in coordination and balance. In addition, the differences that may arise depending on the consumption habits are not conclusive, but they suggest that the sporadic drug use may be related to a worse motor performance than usual consumption.