Male Circumcision and STI Acquisition in Britain: Evidence from a National Probability Sample Survey

Background

It is well-established that male circumcision reduces acquisition of HIV, herpes simplex virus 2, chancroid, and syphilis. However, the effect on the acquisition of non-ulcerative sexually transmitted infections (STIs) remains unclear. We examined the relationship between circumcision and biological measures of three STIs: human papillomavirus (HPV), Chlamydia trachomatis and Mycoplasma genitalium.

Methods

A probability sample survey of 15,162 men and women aged 16-74 years (including 4,060 men aged 16-44 years) was carried out in Britain between 2010 and 2012. Participants completed a computer-assisted personal interview, including a computer-assisted self-interview, which asked about experience of STI diagnoses, and circumcision. Additionally, 1,850 urine samples from sexually-experienced men aged 16-44 years were collected and tested for STIs. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR) to quantify associations between circumcision and i) self-reporting any STI diagnosis and ii) presence of STIs in urine, in men aged 16-44 years, adjusting for key socio-demographic and sexual behavioural factors.

Results

The prevalence of circumcision in sexually-experienced men aged 16-44 years was 17.4% (95%CI 16.0-19.0). There was no association between circumcision and reporting any previous STI diagnoses, and specifically previous chlamydia or genital warts. However, circumcised men were less likely to have any HPV type (AOR 0.26, 95% confidence interval (CI) 0.13-0.50) including high-risk HPV types (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and/or 68) (AOR 0.14, 95% CI 0.05-0.40) detected in urine.

Conclusions

Circumcised men had reduced odds of HPV detection in urine. These findings have implications for improving the precision of models of STI transmission in populations with different circumcision prevalence and in designing interventions to reduce STI acquisition.     

Association between Childhood Obesity and Metabolic Syndrome: Evidence from a Large Sample of Chinese Children and Adolescents

Data about metabolic syndrome (MetS) in children is limited in China. We aimed to assess the prevalence of MetS related components, and their association with obesity. Data were collected as part of a representative study on MetS among 19593 children, aged 6–18 years old in Beijing. General obesity was assessed by body mass index (BMI) and central obesity by waist circumference. Finger capillary blood tests were used to assess triglyceride (TG), total cholesterol (TC) and impaired fasting glucose (IFG). Vein blood samples were collected from a subsample of 3814 children aged 10–18 years to classify MetS. MetS was defined according to the International Diabetes Federation 2007 definition. The associations between MetS related components and the degree and type of obesity were tested using logistic regression models. The prevalence of overweight, obesity, high blood pressure, elevated TG, TC and IFG were13.6%, 5.8%, 8.5%, 8.8%, 1.2% and 2.5%, respectively. Compared with normal weight children, overweight and obese children were more likely to have other MetS related components. In the subsample of 3814 children aged 10–18 years, the prevalence of MetS was much higher in obese subjects than in their normal weight counterparts (27.6% vs. 0.2%). Children with both general and central obesity had the highest prevalence of MetS. Compared with normal weight children, overweight and obese children were more likely to have MetS (overweight: OR = 67.33, 95%CI = 21.32–212.61; obesity: OR = 249.99, 95% CI = 79.51–785.98). Prevalence of MetS related components has reached high level among Beijing children who were overweight or obese. The association between metabolic disorders and obesity was strong.     

Substance Use Disorders and Adoption: Findings from a National Sample

Background

Prior research has shown that adoptees have a higher rate of substance use disorders (SUDs) than nonadoptees. But these findings have not been verified with a population-based sample of adult adoptees in the United States. Also, no previous adoption study has measured the prevalence of each specific substance use disorder (SUD). We aimed to compare lifetime prevalence rates and odds ratios of SUDs in adopted and nonadopted adults.

Methods and Findings

The data come from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The main outcome measure was the prevalence of lifetime SUDs in adopted (n = 378) and nonadopted adults (n = 42503). Adoptees and nonadoptees were compared to estimate the odds of lifetime SUDs using logistic regression analysis. Adoptees had higher prevalence rates of lifetime SUDs than nonadoptees. Overall, adoptees had a 1.87-fold increase (adjusted odds ratio [AOR] 1.87, 95% CI 1.51–2.31) in the odds of any lifetime SUD compared to nonadoptees. For each SUD, adoptees had higher odds for alcohol abuse/dependence (AOR 1.84), nicotine dependence (AOR 1.78), cannabis abuse/dependence (AOR 1.77), cocaine abuse/dependence (AOR 2.54), amphetamine abuse/dependence (AOR 3.14), hallucinogen abuse/dependence (AOR 2.85), opioid abuse/dependence (AOR 2.21), and other drug abuse/dependence (AOR 2.87) compared to nonadoptees. This study also identified two adoption-specific risk factors (Hispanic, never married) associated with any lifetime SUD.

Conclusions

This study demonstrated an increased risk of lifetime SUDs in adopted adults. The findings can be useful for clinicians and policy makers to provide education, prevention, and support for adoptees and their families.     

Advanced Maternal Age and Adverse Pregnancy Outcome: Evidence from a Large Contemporary Cohort

Background

Recent decades have witnessed an increase in mean maternal age at childbirth in most high-resourced countries. Advanced maternal age has been associated with several adverse maternal and perinatal outcomes. Although there are many studies on this topic, data from large contemporary population-based cohorts that controls for demographic variables known to influence perinatal outcomes is limited.

Methods

We performed a population-based cohort study using data on all singleton births in 2004–2008 from the North Western Perinatal Survey based at The University of Manchester, UK. We compared pregnancy outcomes in women aged 30–34, 35–39 and ≥40 years with women aged 20–29 years using log-linear binomial regression. Models were adjusted for parity, ethnicity, social deprivation score and body mass index.

Results

The final study cohort consisted of 215,344 births; 122,307 mothers (54.19%) were aged 20–29 years, 62,371(27.63%) were aged 30–34 years, 33,966(15.05%) were aged 35–39 years and 7,066(3.13%) were aged ≥40 years. Women aged 40+ at delivery were at increased risk of stillbirth (RR = 1.83, [95% CI 1.37–2.43]), pre-term (RR = 1.25, [95% CI: 1.14–1.36]) and very pre-term birth (RR = 1.29, [95% CI:1.08–1.55]), Macrosomia (RR = 1.31, [95% CI: 1.12–1.54]), extremely large for gestational age (RR = 1.40, [95% CI: 1.25–1.58]) and Caesarean delivery (RR = 1.83, [95% CI: 1.77–1.90]).

Conclusions

Advanced maternal age is associated with a range of adverse pregnancy outcomes. These risks are independent of parity and remain after adjusting for the ameliorating effects of higher socioeconomic status. The data from this large contemporary cohort will be of interest to healthcare providers and women and will facilitate evidence based counselling of older expectant mothers.     

Minimization of Childhood Maltreatment Is Common and Consequential: Results from a Large,Multinational Sample Using the Childhood Trauma Questionnaire

Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale—originally designed to assess a positive response bias—are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ’s MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ’s discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. Overall, results suggest that a minimizing response bias—as detected by the MD subscale—has a small but significant moderating effect on the CTQ’s discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables.     

Beliefs Underlying Dog Owners' Health Care Behaviors: Results from a Large,Self-Selected,Internet Sample

ABSTRACT

Various behaviors must be performed by owners to promote good health for their dogs. The aim in this study was to use the results of an online survey, completed by 1,016 self-selected, Australian dog owners, to investigate relationships between demographic factors, beliefs, dog–owner relationship variables, and the performance of health-promoting behaviors. Specific behaviors examined included the provision of annual vaccinations and health checkups by a veterinarian, regular grooming and exercise, and the provision of a nutritionally balanced diet. Reported compliance was high in the self-selected sample, ranging between 77.8% for annual vaccinations and 98.8% for the provision of a nutritious diet. Regression analyses revealed that all of the behaviors we measured could be predicted from beliefs relating to health care practices and dog–owner relationship variables independently of demographic factors. The extent of dog and owner interactions, as well as the extent to which owners perceived important others to be supportive of the behaviors, emerged as particularly important variables. These statistically robust findings have implications for campaigns encouraging pet health promotion by owners.     

Linking Sediment Biofilms, Hydrodynamics, and River Bed Clogging: Evidence from a Large River

Abstract We investigated possible effects of the hydrodynamics at the water/sediment interface on river bed biofilms within the reservoir Freudenau (Vienna, Austria) of the Danube River during the period 1996/97. Two study sites (OBB and SSF) that differed in the magnitude of surface/subsurface water exchange were selected and intersite comparisons revealed higher organic matter, bacterial cell numbers, and esterase activity in SSF with lower horizontal outflow. Concentrations of colloidal carbohydrates and uronic acids were unaffected by hydrodynamics. The relative contribution of uronic acids to bulk colloidal carbohydrates was higher in the low-flow site SSF. The distribution patterns of this relative contribution generally matched the subsurface flow pattern. Shortly after impoundment in March 1996 and along with decreased surface flow velocity, maximal biofilm carbohydrate exopolymers concurred with minimal esterase activity in OBB. We hypothesize that this inverse relationship is due to increased diffusional resistance within the exopolymer biofilm matrix that reduces mass transfer and hydrolytic activity. These results, to our knowledge, are the first evidence for microbial participation in the clogging of a large river bed. Biofilm-associated organic carbon increased significantly by a factor of ∼3.3 to 4.4 with progressive clogging as determined by the sediment leakage coefficient, which increased ∼3.8 times. Concomitantly, with ongoing clogging, esterase activity exhibited increasingly higher values at the interface relatively to deeper sediment layers, which translates into steeper depth gradients. Furthermore, minimal inflow from the surface water into the river bed along with steepest esterase gradients concurred with a senescent benthic algal bloom. This suggests an important role for algae in clogging. Either algae obstruct voids mechanically, or their exudates fuel heterotrophic bacteria that in turn are involved in clogging processes. However, our data do not allow unequivocal differentiation between biogenic and physical clogging mechanisms. Received: 14 September 1998; Accepted: 31 December 1998     

Blood Drunkenness and the Bloodthirsty Semai: Unmaking Another Anthropological Myth

The Senoi Semai of Malaysia have frequently been cited as examples in the debates over the wellsprings of human violence. Numerous writers have employed selected Semai ethnographic material to support assertions that, their apparent peacefulness notwithstanding, Semai are in reality bloodthirsty killers. This assertion has in turn been used as evidence in support of a variety of approaches whose common thread is a view of aggressiveness and violence as somehow innate in human beings. The authors of this article, whose publications form the basis of most anthropological knowledge of Semai life and culture, draw on their own published and unpublished work as well as on documentation from other sources to refute these interpretations. We hold that Semai life is, as first-hand observers have described it, notably free of interpersonal violence, and we argue that misrepresentations rooted in particular theoretical or philosophical a priori assumptions are scientifically untenable and culturally slanderous.     

Tolerance by Surprise: Evidence for a Generalized Reduction in Prejudice and Increased Egalitarianism through Novel Category Combination

Prejudices towards different groups are interrelated, but research has yet to find a way to promote tolerance towards multiple outgroups. We devise, develop and implement a new cognitive intervention for achieving generalized tolerance based on scientific studies of social categorization. In five laboratory experiments and one field study the intervention led to a reduction of prejudice towards multiple outgroups (elderly, disabled, asylum seekers, HIV patients, gay men), and fostered generalized tolerance and egalitarian beliefs. Importantly, these effects persisted outside the laboratory in a context marked by a history of violent ethnic conflict, increasing trust and reconciliatory tendencies towards multiple ethnic groups in the Former Yugoslav Republic of Macedonia. We discuss the implications of these findings for intervention strategies focused on reducing conflict and promoting peaceful intergroup relations.     

Association between Gestational Weight Gain and Postpartum Diabetes: Evidence from a Community Based Large Cohort Study

We have investigated the prospective association between excess gestational weight gain (GWG) and development of diabetes by 21 years post-partum using a community-based large prospective cohort study in Brisbane, Australia. There were 3386 mothers for whom complete data were available on GWG, pre-pregnancy BMI and self-reported diabetes 21 years post-partum. We used The Institute of Medicine (IOM) definition to categorize GWG as inadequate, adequate and excessive. We found 839 (25.78%) mothers gained inadequate weight, 1,353 (39.96%) had adequate weight gain and 1,194 (35.26%) had gained excessive weight during pregnancy. At 21 years post-partum, 8.40% of mothers self-reported a diagnosis of diabetes made by their doctor. In the age adjusted model, we found mothers who gained excess weight during pregnancy were 1.47(1.11,1.94) times more likely to experience diabetes at 21 years post-partum compared to the mothers who gained adequate weight. This association was not explained by the potential confounders including maternal age, parity, education, race, smoking, TV watching and exercise. However, this association was mediated by the current BMI. There was no association for the women who had normal BMI before pregnancy and gained excess weight during pregnancy. The findings of this study suggest that women who gain excess weight during pregnancy are at greater risk of being diagnosed with diabetes in later life. This relationship is likely mediated through the pathway of post-partum weight-retention and obesity. This study adds evidence to the argument that excessive GWG during pregnancy for overweight mothers has long term maternal health implications.     

Multimorbidity Patterns in a National Representative Sample of the Spanish Adult Population

Background

In the context of population aging, multimorbidity has emerged as a growing concern in public health. However, little is known about multimorbidity patterns and other issues surrounding chronic diseases. The aim of our study was to examine multimorbidity patterns, the relationship between physical and mental conditions and the distribution of multimorbidity in the Spanish adult population.

Methods

Data from this cross-sectional study was collected from the COURAGE study. A total of 4,583 participants from Spain were included, 3,625 aged over 50. An exploratory factor analysis was conducted to detect multimorbidity patterns in the population over 50 years of age. Crude and adjusted binary logistic regressions were performed to identify individual associations between physical and mental conditions.

Results

Three multimorbidity patterns rose: ‘cardio-respiratory’ (angina, asthma, chronic lung disease), ‘mental-arthritis’ (arthritis, depression, anxiety) and the ‘aggregated pattern’ (angina, hypertension, stroke, diabetes, cataracts, edentulism, arthritis). After adjusting for covariates, asthma, chronic lung disease, arthritis and the number of physical conditions were associated with depression. Angina and the number of physical conditions were associated with a higher risk of anxiety. With regard to multimorbidity distribution, women over 65 years suffered from the highest rate of multimorbidity (67.3%).

Conclusion

Multimorbidity prevalence occurs in a high percentage of the Spanish population, especially in the elderly. There are specific multimorbidity patterns and individual associations between physical and mental conditions, which bring new insights into the complexity of chronic patients. There is need to implement patient-centered care which involves these interactions rather than merely paying attention to individual diseases.     

Undressing Religion: Commitment and Conversion from a Cross-Cultural Perspective.

Undressing Religion: Commitment and Conversion from. Cross-Cultural Perspective. Linda B. Arthur. ed. New York: New York University Press, 2001. 224 pp.     

Muslims and evolution: a study of Pakistani physicians in the United States

This study investigated the views of Pakistani-American medical doctors regarding biological evolution. We used a mixed-methods approach, chiefly consisting of a short interview that presented evolution in the contexts of microbial, animal, and human evolution; evolution's acceptability or unacceptability to Muslims; and evolution's relevance to medicine. The participants were 23 doctors attending a convention in the United States. Fourteen participants accepted evolution, three rejected evolution, and six held other views. While a majority of participants indicated that they accepted evolution, a slightly smaller plurality accepted human evolution. A majority of participants, including some who did not wholly accept or reject evolution, thought that one could mutually accept evolution and also believe in Allah. Nearly every participant, including two who rejected evolution, thought that evolution was relevant to medicine. We find that participants assigned a plurality of meanings to the theory that depended on interactions between a participant’s perception of religion, science, medicine, and a host of other cultural influences. This study is the first of a collection of studies carried out by the authors, who collected data with the same instrument in five other countries with significant populations of Muslim doctors and medical students.     

Relationship between Television Viewing and Language Delay in Toddlers: Evidence from a Korea National Cross-Sectional Survey

Purpose

This study investigated the relationship between 2-year-old children’s exposure to TV and language delay.

Methods

The subjects of this study were 1,778 toddlers (906 males and 872 females) who participated in the Panel Study on Korean Children conducted in 2010. The linguistic ability of the toddlers was measured with the K-ASQ (Korean-Ages and Stages Questionnaire). The relationship between the amount of young children’s exposure to TV and language delay was analyzed with Poisson regression.

Results

The average daily TV watching time of 2-year-old Korean toddlers in this study was 1.21 hours. After all confounding variables were adjusted, toddlers with over 2 hours and less than 3 hours of TV watching time had 2.7 times more risk (RR = 2.74, 95% CI: 1.13–6.65) of language delay than those with less than 1 hour of TV watching time. Those with more than 3 hours of TV watching time had approximately 3 times (RR = 3.03, 95% CI: 1.12–8.21) more risk (p<0.05). In addition, the risk of language delay increased proportionately with the increase in toddlers’ TV watching time (p = 0.004).

Conclusion

Two-year-old Korean toddlers’ average daily TV watching time of more than 2 hours was related with language delay.