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1. Variations in healthcare utilization for mental health problems prior to suicide by socioeconomic status: a Norwegian register-based population study

Author: Carine Øien-Ødegaard, Solveig Tobie Glestad Christiansen, Lars Johan Hauge, Kim Stene-Larsen, Sissel Marguerite Bélanger, Espen Bjertness, and Anne Reneflot
Subjects: Suicide, Primary healthcare utilization, Mental healthcare utilization, SES, Educational attainment, Employment status, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Suicide poses a major public health challenge, claiming around 650 lives annually in Norway. There is limited understanding of mental healthcare utilization patterns preceding suicide, particularly relating to socioeconomic status (SES). This study analyzes mental health service use among Norwegian citizens aged 20–64 from 2009 to 2021, emphasizing disparities related to SES. Methods This is a population-wide registry-based study. We include mental health consultations with both primary and specialist healthcare services, and investigate patterns of service use regarding educational attainment, employment status and income and compare this to the population in general. All suicides in the period (N = 4731) are included in the study. The aim is to investigate potential discrepancies in service use the year and month preceding suicide, seeking to enhance targeted preventive interventions. Results Our results show significant variations in healthcare use for mental health problems the last year preceding suicide, according to the components of SES, for both men and women. Those with higher education utilize the mental healthcare services prior to suicide to a higher degree than men and women with high school education or less, whereas employed men and men with high income level have significantly lower mental healthcare usage prior to suicide both the last year and month compared to the non-employed men and men with low-income level. Employed women also had a lower mental healthcare usage, whereas the results regarding income are not significant for women. Conclusion Mental healthcare use prior to suicide varies across the SES components. Notably, the SES groups exhibit heterogeneity, with gendered patterns. Targeted interventions for low consultation rates among employed men, and men with high income and lower education are needed, while women, and men in at-risk groups, such as the non-employed and those with low income, demonstrate higher mental healthcare utilization, warranting comprehensive suicide prevention measures.
Published: 2024
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2. Educational inequalities and self-reported health among men and women aged 18–49 years in Yangon Region, Myanmar: analysis of a population-based, cross-sectional study

Author: Espen Bjertness, Unni Gopinathan, Win Thuzar Aye, Hein Stigum, Aung Soe Htet, and Sel Ki Baek
Subjects: Medicine
Abstract: Objectives To estimate the prevalence of good self-reported health (SRH) in subpopulations based on the social determinants of health and to investigate the association between education (measured in years of schooling) and good SRH among men and women aged 18–49 years in Yangon Region, Myanmar.Design Analysis of data from a population-based, cross-sectional study conducted in Yangon, Myanmar, from October to November 2016. A multistage sampling procedure was employed, and structured face-to-face interviews were conducted with standardised questions adapted from the Myanmar Demographic and Health Survey. Prevalence ratios (PRs) with 95% CIs were estimated using Poisson regression analyses by sex.Setting Urban and rural areas of Yangon Region, Myanmar.Participants The sample included 2,506 participants (91.8% response rate) aged 18–49 years and excluded nuns, monks, soldiers, institutionalised people and individuals deemed too ill physically and/or mentally to participate.Results The prevalence of good SRH was 61.2% (95% CI 59.3 to 63.1), with higher rates among men (72.0%, 95% CI 69.3 to 74.5), younger individuals (69.2%, 95% CI 66.2 to 72.1), urban residents (63.6%, 95% CI 60.8 to 66.3), extended family dwellers (66.6%, 95% CI 63.7 to 69.4) and those with a higher level of education (66.0%, 95% CI 61.3 to 70.5). After adjusting for confounders (age and area of residence), the association between years of schooling and SRH (PR) was 1.01 (95% CI 1.01 to 1.02, p=0.002) in men and 1.01 (95% CI 0.99 to 1.02, p=0.415) in women.Conclusions Good SRH was more prevalent among men than among women. Additionally, a 1-year increase in education was associated with a 1% increase in the prevalence of good SRH among men, whereas the association was not statistically significant among women. In order to enhance the educational benefits of health in Myanmar, we recommend a higher focus on the length of education and addressing gender inequalities in wage return from education.
Published: 2024
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3. Is the degree of religiosity related to community belonging and trust in society? A cross-sectional study among Muslims in Norway

Author: Bushra Ishaq, Espen Bjertness, Lars Østby, Asbjørn Johannessen, and Tatjana Schnell
Subjects: Muslim, Religion and medicine, Social determinants of health, Trust, Social cohesion, Community belonging, History of scholarship and learning. The humanities, AZ20-999, Social sciences (General), H1-99
Abstract: Introduction: It is unclear if the degree of religiosity within Muslim minority groups causes health inequality because of poor community belonging and lack of trust in society. We aimed to investigate the association of the degree of Muslim religiosity with community belonging and trust in society, including general trust and trust in political authorities, political power, media and monarchy. Methods: This study had a cross-sectional design, including a random sample of 1129 men and women aged 18–85 years, originating from Muslim countries and currently living in Norway. Data were retrieved from the Norwegian Central Population Register. Results: In logistic regression analyses, adjusted for confounders, the degree of Muslim religiosity was not associated with general trust (crude odds ratio [OR] = 1.00, 95% confidence interval [CI]: 0.91–1.10; p = 0.90) or trust in political authorities (OR = 0.96, 95% CI: 0.87–1.06; p = 0.40) and monarchy (OR = 0.92, 95% CI: 0.84–1.00; p = 0.08). However, the degree of Muslim religiosity showed a negative association with trust in political power (OR = 0.91, 95% CI 0.83–1.00; p = 0.04) and media (OR = 0.80, 95% CI: 0.73–0.87; p
Published: 2024
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4. Widening the knowledge of non-employment as a risk factor for suicide: a Norwegian register-based population study

Author: Carine Øien-Ødegaard, Lars Johan Hauge, Kim Stene-Larsen, Solveig Tobie Glestad Christiansen, Espen Bjertness, and Anne Reneflot
Subjects: Suicide risk, Non-employment, Unemployment, Welfare use, Health problems, Registry data, Public aspects of medicine, RA1-1270
Abstract: Abstract Background There is a known association between employment status and suicide risk. However, both reason for non-employment and the duration affects the relationship. These factors are investigated to a lesser extent. About one third of the Norwegian working age population are not currently employed. Due to the share size of this population even a small increase in suicide risk is of importance, and hence increased knowledge about this group is needed. Methods We used discrete time event history analysis to examine the relationship between suicide risk and non-employment due to either unemployment or health-problems, and the duration of these non-employment periods. We analyze data from the Norwegian population registry from 2004 to 2014, which includes all Norwegian residents in the ages 19–58 born between 1952 and 1989. In total the data consists of 1 063 052 men and 1 024 238 women, and 2 039 suicides. Results The suicide risk among the non-employed men and women is significantly higher than that of the employed. For the unemployed men, the suicide risk is significantly higher than the employed within the first 18 months. For the unemployed women we only find a significant association with suicide risk among those unemployed for six to twelve months. The suicide risk is especially increased among those with temporary health-related benefits. In the second year of health-related non-employment men have eightfold and women over twelvefold the OR for suicide, compared to the employed. Conclusion There is an association between non-employment and suicide risk. Compared to the employed both unemployed men and men and women with health-related non-employment have elevated suicide risk, and the duration of non-employment may be the driving force. Considering the large share of the working age population that are not employed, non-employment status should be considered in suicide risk assessment by health care professionals and welfare providers.
Published: 2023
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5. Childhood abuse and its association with adults’ mental health problems: a cross-sectional study among men and women in the Yangon Region of Myanmar

Author: Espen Bjertness, Lars Lien, Win Thuzar Aye, and Hein Stigum
Subjects: Medicine
Abstract: Objectives To estimate the prevalence of emotional, physical and sexual childhood abuse, and symptoms of post-traumatic stress disorder (PTSD) and to examine the association between childhood abuse and adult mental health problems, including mental distress and PTSD symptoms.Design A community-based cross-sectional study was conducted. Childhood abuse was assessed with the NorVold Abuse Questionnaire, and mental distress and symptoms of PTSD were measured using the Hopkins Symptom Checklist 10 and the Impact of Event Scale—Revised, respectively. The Wald test and multiple linear regression analysis were applied for testing differences between proportions and the association between childhood abuse and adult mental health outcomes, respectively.Setting Urban and rural areas of the Yangon Region, Myanmar.Participants A total of 2377 men and women aged 18–49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded.Results Overall, 21.1% (95% CI 18.8 to 23.6) reported any form of childhood abuse, 10.4% (95% CI 8.9 to 12.4) physical abuse, 10.4% (95% CI 8.8 to 12.2) emotional abuse and 7.3% (95% CI 5.7 to 9.3) sexual abuse. Childhood abuse was more common in women (29.8%) than in men (12.4%). The prevalence of PTSD symptoms in the total sample was 6.6%. After adjusting for confounding variables, positive associations were found between childhood abuse with adult mental distress and PTSD symptoms among women and older men.Conclusions Childhood abuse is prevalent among both men and women in the Yangon Region of Myanmar and associated with adult mental health problems. Approximately 7% of people report PTSD symptoms. It should prompt local health professionals and policy makers to establish prevention programmes to eliminate violence against children and to organise services for victims of childhood abuse. Care should be taken in generalising findings for less populated areas.
Published: 2021
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6. The prevalence of mental distress and the association with education: a cross-sectional study of 18-49-year-old citizens of Yangon Region, Myanmar

Author: Win Thuzar Aye, Lars Lien, Hein Stigum, Hla Hla Win, Tin Oo, and Espen Bjertness
Subjects: Prevalence, Mental distress, Myanmar, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Poor mental health is an important contributor to the global burden of disease. Mental health problems are often neglected in communities, and are scarcely studied in developing countries, including Myanmar. This study estimates the prevalence of mental distress by socio-demographic and health related factors, and the association between education and mental distress. As far as the authors are aware, this is the first population-based study in Myanmar estimating the prevalence of mental distress. Methods Between October and November 2016, a cross sectional study was conducted using a multi-stage sampling design with face-to-face interviews using the Hopkins Symptom Checklist (HSCL-10) for mental distress (symptoms of depression and anxiety). The multivariable analysis strategy was based on Directed Acyclic Graphs (DAGs), to identify confounders, mediators and colliders. Pearson’s chi-square was used for testing differences between proportions and multiple linear regression analysis was applied to explore the association between education (years at school) and mental distress (HSCL score). Results A random sample of 2391 (99.6% response) men and women aged 18–49 years participated in the study. The prevalence of mental distress was 18.0% (95% confidence interval (CI): 14.7–21.9), being higher among women (21.2%; 95% (CI): 16.6–26.6) than men (14.9%; 95% (CI): 11.4–19.2). Older-age, being separated or divorced and having a higher number of children were associated with increased mental distress. In linear regression analyses, adjusted for confounders (age, marital status and income), there was a significant negative association between years at school and mental distress among women and older men (> 30 years), but not among the youngest men. Conclusions The prevalence of mental distress is high, and there is an association between HSCL-10 score and education. Due to the scarcity of mental health services in Myanmar, the findings indicate a need for a mental health policy to handle the burden of mental health problems in Yangon, a burden which is probably high within the country.
Published: 2020
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7. The prevalence of selected risk factors for non-communicable diseases in Hargeisa, Somaliland: a cross-sectional study

Author: Soheir H. Ahmed, Haakon E. Meyer, Marte K. Kjøllesdal, Niki Marjerrison, Ibrahimu Mdala, Aung Soe Htet, Espen Bjertness, and Ahmed A. Madar
Subjects: STEPs survey, Prevalence, Non-communicable disease risk factors, Somaliland, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, respiratory conditions and cancers, are the most common causes of morbidity and mortality globally. Information on the prevalence estimates of NCD risk factors such as smoking, low fruit & vegetable intake, physical inactivity, raised blood pressure, overweight, obesity and abnormal blood lipid are scarce in Somaliland. The aim of this study was to determine the prevalence of these selected risk factors for NCDs among 20–69 year old women and men in Hargeisa, Somaliland. Methods A cross-sectional study was conducted in five districts of Hargeisa (Somaliland), using the STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) to collect data on demographic and behavioral characteristics and physical measurements (n = 1100). The STEPS approach is a standardized method for collecting, analysing and disseminating data on NCD risk factor burden. Fasting blood sugar, serum lipids (total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides) were collected in half of the participants. Results The vast majority of participants had ≤1 serving of fruits daily (97.7%) and ≤ 1 serving of vegetables daily (98.2%). The proportion of participants with low physical activity levels was 78.4%. The overall prevalence of high salt intake was 18.5%. The prevalence of smoking and khat chewing among men was 27 and 37% respectively, and negligible among women. In women, the prevalence of hypertension increased from 15% in the age group 20–34 years to 67% in the age group 50–69 years, the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) from 51 to 73%, and the prevalence of diabetes from 3 to 22%. Similar age-trends were seen in men. Conclusion Most of the selected risk factors for noncommunicable diseases were high and increased by age in both women and men. Overweight and obesity and low physical activity needs intervention in women, while hypertension and low fruit and vegetable consumption needs intervention in both men and women. Somaliland health authorities should develop and/or strengthen health services that can help in treating persons with hypertension and hyperlipidaemia, and prevent a future burden of NCDs resulting from a high prevalence of NCD risk factors.
Published: 2019
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8. Urban–rural differences in overweight and obesity among 25–64 years old Myanmar residents: a cross-sectional, nationwide survey

Author: Espen Bjertness, Rupa Thapa, Cecilie Dahl, and Wai Phyo Aung
Subjects: Medicine
Abstract: Objectives To investigate whether urban–rural location and socioeconomic factors (income, education and employment) are associated with body mass index (BMI) and waist–hip ratio (W/H-ratio), and to further explore if the associations between urban–rural location and BMI or W/H-ratio could be mediated through variations in socioeconomic factors.Design Cross-sectional, WHO STEPS survey of non-communicable disease risk factors.Setting Urban and rural areas of Myanmar.Participants A total of 8390 men and women aged 25 to 64 years included during the study period from September to December 2014. Institutionalised people (Buddhist monks and nuns, hospitalised patients) and temporary residents were excluded.Results The prevalence of overweight and obesity was higher in the urban areas and increased with increasing socioeconomic status (SES) score. Mean BMI was higher among urban residents (ß=2.49 kg/m2; 95% CI 2.28 to 2.70; p
Published: 2021
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9. Domestic violence victimisation and its association with mental distress: a cross-sectional study of the Yangon Region, Myanmar

Author: Johanne Sundby, Espen Bjertness, Lars Lien, Win Thuzar Aye, Hein Stigum, and Berit Schei
Subjects: Medicine
Abstract: Objectives To estimate the prevalence of domestic violence, with subgroups of physical, sexual and emotional violence, among men and women and to assess the association between any lifetime domestic violence (DV) and mental distress among ever-married men and women.Design We conducted a cross-sectional study from October to November 2016 using a multistage sampling design. DV questionnaire was adopted from the Demographic and Health Survey programme. Mental distress was estimated using the Hopkins Symptom Checklist-10 (HSCL-10). HSCL-score and DV were the outcome and exposure variables, respectively, in multiple linear regression. Prevalence estimates and associations were presented with a 95% CI and the Wald test.Setting Urban and rural areas of the Yangon region, Myanmar.Participants Men and women ages 18 to 49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded.Results A random sample of 2383 people was included in the analyses. Among ever-married participants, lifetime (LT) and past-12-month (12M) prevalence of any domestic violence victimisation was higher in women compared with men: LT women: 61.8% (95% CI: 54.3 to 68.9) versus LT men: 42.4% (95% CI: 37.5 to 47.5) and 12M women: 51.2% (95% CI: 44.9 to 57.5) versus 12M men: 37.7% (95% CI: 32.9 to 42.7). Among never-married participants, lifetime physical and sexual violence victimisation rates was higher in men (34.3% and 7.9%) compared with women (19.1% and 6.4%). Mental distress was significantly associated with lifetime DV in women who were afraid of their husbands and men who had wives who exhibited controlling behaviours.Conclusions Domestic violence is prevalent among both men and women and is associated with mental distress. The findings highlight an urgent need to prevent domestic violence in both sexes, including through legal and policy reform and improved mental health services for DV victims.
Published: 2020
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10. Course of depression symptoms between 3 and 8 months after delivery using two screening tools (EPDS and HSCL-10) on a sample of Sudanese women in Khartoum state

Author: Dina Sami Khalifa, Kari Glavin, Espen Bjertness, and Lars Lien
Subjects: Postnatal depression, Course of depression, Maternal distress, Screening, EPDS, HSCL-10, Gynecology and obstetrics, RG1-991
Abstract: Abstract Background Effects of depression on parenting and on cognitive development of newborns are augmented when symptoms continue throughout the first postnatal year. Current classification systems recognize maternal depression as postnatal if symptoms commence within four to six weeks. Traditional cultural rituals in Sudan offer new mothers adequate family support in the first 6–8 weeks postpartum. The course of postnatal depression symptoms beyond that period is not explored in such settings. We therefore aim to investigate the change in screening status and in severity of depression and distress symptoms between three and eight months postpartum among a sample of Sudanese women using the Edinburgh Postnatal Depression Scale (EPDS) and a locally used tool: the 10-items Hopkins Symptoms Checklist (HSCL-10). Methods Three hundred pregnant women in their 2nd or 3rd trimester were recruited from two clinics in Khartoum state. They were followed up and screened for depression symptoms eight months after delivery by EPDS at ≥12, and by HSCL-10 at ≥1.85. The same sample was previously screened for depression at three months after birth. Results Prevalence of postnatal depression symptoms by EPDS was lower at eight months compared to three months after birth (3.6% at eight months (8/223) compared to 9.2% at three months (22/238), p
Published: 2018
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11. Inequity in the utilization of antenatal and delivery care in Yangon region, Myanmar: a cross-sectional study

Author: Aye Nyein Moe Myint, Tippawan Liabsuetrakul, Thein Thein Htay, Myint Myint Wai, Johanne Sundby, and Espen Bjertness
Subjects: Inequity, Wealth index, Concentration index, Antenatal care, Delivery care, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Equity of access to and utilization of healthcare across socio-economic groups is important to achieve universal health coverage. Although the utilization of antenatal and delivery care has been increasing in low- and middle-income countries, inequities in the utilization of antenatal and delivery care have been reported in many countries, but have not yet been studied in Myanmar. This study aimed to determine whether inequities in the utilization of antenatal and delivery care existed in Yangon region, Myanmar. Methods A community-based cross-sectional survey using multistage sampling was conducted from October to November 2016. A wealth index was selected as the main socioeconomic parameter for measuring inequities with respect to early initiation of antenatal care (ANC), number of antenatal care visits, delivery by a skilled birth attendant (SBA) and delivery by cesarean section (CS). Inequities were evaluated using concentration curves and concentration indexes. Results Of the 762 women who gave birth within the 12-month survey period, there was no evidence of inequity in utilization of ANC; however, inequity of at least one antenatal visit among women aged less than 20 years was found with a concentration index of 0.04. The concentration indexes for delivery by SBA and CS were 0.05 and 0.14, respectively. Delivery by CS was disproportionately higher in adolescents and women with higher education than middle school. Conclusion There was no overall inequity in the utilization of ANC but substantial inequities in delivery by CS and SBA were shown. Social determinants of health, particularly age and education, were associated with inequities in the utilization of delivery care. Adolescent pregnant women were found to be particularly vulnerable, and thus should be a target group for strategic plans to reduce inequities in utilization of delivery care.
Published: 2018
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12. Changes in prevalence, awareness, treatment and control of hypertension from 2004 to 2014 among 25-74-year-old citizens in the Yangon Region, Myanmar

Author: Aung Soe Htet, Marius B. Bjertness, Win Myint Oo, Marte Karoline Kjøllesdal, Lhamo Y. Sherpa, Ko Ko Zaw, Ko Ko, Hein Stigum, Haakon E. Meyer, and Espen Bjertness
Subjects: Hypertension, Prevalence, Awareness, Treatment, Control, Yangon, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Hypertension is the leading risk factor for cardiovascular diseases, and little is known about trends in prevalence, awareness, treatment and the control of hypertension in Myanmar. This study aims at evaluating changes from 2004 to 2014 in the prevalence, awareness, treatment and control of hypertension in the Yangon Region, Myanmar, and to compare associations between hypertension and selected socio-demographic, behavioural- and metabolic risk factors in 2004 and 2014. Methods In 2004 and 2014, household-based cross-sectional studies were conducted in urban and rural areas of Yangon Region using the WHO STEPS protocol. Through a multi-stage cluster sampling method, a total of 4448 and 1486 participated in 2004 and 2014, respectively, with the response rates above 89%. Results From 2004 to 2014, there was a significant increase in the age-standardized prevalence of hypertension from 26.7% (95% CI:24.4-29.1) – 34.6% (32.2-37.1), as well as an awareness from 19.4% (17.2-21.9) to 27.8% (24.9-31.0), while treatment and control rates did not change. The age-standardized mean systolic blood pressure increased from 122.8 (SE) ± 0.82 mmHg in 2004 to 128.1 ± 0.53 mmHg in 2014, whereas diastolic blood pressure increased from 76.2 ± 0.35 mmHg to 80.9 ± 0.53 mmHg. In multivariate analyses, hypertension was significantly associated with age, alcohol consumption, overweight and diabetes in both 2004 and 2014, and additionally associated with low physical activity and hypercholesterolemia in 2004. Combining all data, a significant association between study-year and hypertension persisted in different models with an adjustment for socio-demographic variables and behavioural variables, but not when adjusting for a combination of socio-demographic variables, the metabolic variables, BMI and hypercholesterolemia. Conclusion The prevalence of hypertension has risen from 2004 to 2014 in both urban and rural areas of the Yangon Region, while, the awareness, treatment and control rate of hypertension remains low in urban and rural areas among both males and females. It is likely that changes in the metabolic variables, BMI and hypercholesterolemia have contributed to an increase in the prevalence of hypertension from 2004 to 2014. Factors associated with hypertension in both study years were age, alcohol consumption, overweight and diabetes. A national hypertension control programme should be implemented in order to reduce premature deaths in Myanmar.
Published: 2017
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13. Building a research registry for studying birth complications and outcomes in six Palestinian governmental hospitals

Author: Sahar Hassan, Ase Vikanes, Katariina Laine, Khaled Zimmo, Mohammad Zimmo, Espen Bjertness, and Erik Fosse
Subjects: Childbirth, e-health, Birth registries, Case registration form, District Health Information Software, Completeness, Gynecology and obstetrics, RG1-991
Abstract: Abstract Background Electronic-health (e-health) provides opportunities for quality improvement of healthcare, but implementation in low and middle income countries is still limited. Our aim was to describe the implementation of a registration (case record form; CRF) for obstetric interventions and childbirth events using e-health in a prospective birth cohort study in Palestine. We also report the completeness and the reliability of the data. Methods Data on maternal and fetal health was collected prospectively for all women admitted to give birth during the period from 1st March 2015 to 31st December 2015 in three governmental hospitals in Gaza and three in the West Bank. Essential indicators were noted in a case registration form (CRF) and subsequently entered into the District Health Information Software 2 (DHIS 2) system. Completeness of registered cases was checked against the monthly hospital birth registries. Reliability (correct information) of DHIS2 registration and entry were checked for 22 selected variables, collected during the first 10 months. In the West Bank, a comparison between our data registration and entry and data obtained from the Ministry of Health patient electronic records was conducted in the three hospitals. Results According to the hospital birth registries, a total of 34,482 births occurred in the six hospitals during the study period. Data on the mothers and children registered on CRF was almost complete in two hospitals (100% and 99.9%); in the other hospitals the completeness ranged from 72.1% to 98.7%. Eighty birth events were audited for 22 variables in the three hospitals in the West Bank. Out of 1760 registrations in each hospital, the rates of correct data registration ranged from 81% to 93.2% and data entry ranged from 84.5% to 93.1%. Conclusions The registered and entered data on birth events in six hospitals was almost complete in five out of six hospitals. The collected data is considered reliable for research purposes.
Published: 2017
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14. Time from dementia diagnosis to nursing-home admission and death among persons with dementia: A multistate survival analysis.

Author: Marit Mjørud, Geir Selbæk, Espen Bjertness, Trine Holt Edwin, Knut Engedal, Anne-Brita Knapskog, and Bjørn Heine Strand
Subjects: Medicine, Science
Abstract: ObjectivesTo estimate transition times from dementia diagnosis to nursing-home (NH) admission or death and to examine whether sex, education, marital status, level of cognitive impairment and dementia aetiology are associated with transition times.DesignMarkov multistate survival analysis and flexible parametric models.SettingParticipants were recruited from the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) in specialist healthcare between 2008 and 2017 and followed until August 2019, a maximum of 10.6 years follow-up time (mean 4.4 years, SD 2.2). Participants' address histories, emigration and vital status were retrieved from the National Population Registry from time of diagnosis and linked to NorCog clinical data.Participants2,938 home-dwelling persons with dementia, ages 40-97 years at time of diagnosis (mean 76.1, SD 8.5).ResultsDuring follow-up, 992 persons (34%) were admitted to nursing-homes (NHs) and 1,556 (53%) died. Approximately four years after diagnosis, the probability of living in a NH peaked at 19%; thereafter, the probability decreased due to mortality. Median elapsed time from dementia diagnosis to NH admission among those admitted to NHs was 2.28 years (IQR 2.32). The probability of NH admission was greater for women than men due to women´s lower mortality rate. Persons living alone, particularly men, had a higher probability of NH admission than cohabitants. Age, dementia aetiology and severity of cognitive impairment at time of diagnosis did not influence the probability of NH admission. Those with fewer than 10 years of education had a lower probability of NH admission than those with 10 years or more, and this was independent of the excess mortality in the less-educated group.ConclusionFour years after diagnosis, half of the participants still lived at home, while NH residency peaked at 19%. Those with fewer than 10 years of education were less often admitted to NH.
Published: 2020
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15. Dynamics of contraceptive use among married women in North and South Yangon, Myanmar: findings from a cross-sectional household survey

Author: Myint Myint Wai, Espen Bjertness, Thein Thein Htay, Tippawan Liabsuetrakul, Aye Nyein Moe Myint, Hein Stigum, and Johanne Sundby
Subjects: Contraceptive use, Duration, Older age, High parity, Periurban women, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract: Objective: The objective was to explore the sociodemographic factors associated with contraceptive use, the variation in prevalence and duration of contraceptive use across the age groups and parity among 18–49-year-old married women in North and South Yangon. Study design: We conducted a cross-sectional study regarding contraceptive use among married women aged 18–49 in North and South Yangon from September to November 2016. We used a questionnaire based on the Demographic and Health Surveys Program, with additional questions on the duration of contraception along the life-course. Associations between contraceptive prevalence and sociodemographic factors were tested by χ2. We describe the percentages of contraceptive use and nonuse across the age and parity subgroups, and the mean duration of contraception. We compared the contraceptive prevalence ratios across the parity using logistic regression. Results: The contraceptive prevalence of modern methods was 66% (95% confidence interval: 61.5%–69.9%) with better coverage in rural (69.6%) than in urban women (61.5%). Contraceptive use varied by age and parity, demonstrating lower prevalence in the oldest age group (45–49) and high parity (parity five and above). The mean duration of contraceptive use rose with increased age and parity, except in the oldest-age and high-parity groups. Conclusions: The findings called for greater attention to improve the contraceptive coverage of married women living in urban areas around Yangon city (periurban women). Implications: The study identified the pockets of low contraceptive coverage in a region with the highest contraceptive prevalence in Myanmar. Women above the age of 40 and women who had high parity had low contraceptive prevalence. Women living near the city showed lower contraceptive coverage compared to their rural counterparts.
Published: 2020
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16. Urban-rural differences in the prevalence of non-communicable diseases risk factors among 25–74 years old citizens in Yangon Region, Myanmar: a cross sectional study

Author: Aung Soe Htet, Marius B. Bjertness, Lhamo Y. Sherpa, Marte Karoline Kjøllesdal, Win Myint Oo, Haakon E. Meyer, Hein Stigum, and Espen Bjertness
Subjects: Risk factors, Non-communicable diseases, Urban-rural differences, Yangon, Myanmar, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Recent societal and political reforms in Myanmar may upturn the socio-economy and, thus, contribute to the country’s health transition. Baseline data on urban-rural disparities in non-communicable disease (NCD) risk factors are not thoroughly described in this country which has been relatively closed for more than five decades. We aim to investigate urban-rural differences in mean values and the prevalence of selected behavioral and metabolic risk factors for non-communicable diseases and 10-years risk in development of coronary heart diseases (CHD). Methods Two cross-sectional studies were conducted in urban and rural areas of Yangon Region in 2013 and 2014 respectively, using the WHO STEPwise approach to surveillance of risk factors of NCDs. Through a multi-stage cluster sampling method, 1486 participants were recruited. Results Age-standardized prevalence of the behavioral risk factors tended to be higher in the rural than urban areas for all included factors and significantly higher for alcohol drinking (19.9% vs. 13.9%; p = 0.040) and low fruit & vegetable consumption (96.7% vs. 85.1%; p = 0.001). For the metabolic risk factors, the tendency was opposite, with higher age-standardized prevalence estimates in urban than rural areas, significantly for overweight and obesity combined (40.9% vs. 31.2%; p = 0.023), obesity (12.3% vs.7.7%; p = 0.019) and diabetes (17.2% vs. 9.2%; p = 0.024). In sub-group analysis by gender, the prevalence of hypercholesterolemia and hypertriglyceridemia were significantly higher in urban than rural areas among males, 61.8% vs. 40.4%; p = 0.002 and 31.4% vs. 20.7%; p = 0.009, respectively. Mean values of age-standardized metabolic parameters showed higher values in urban than rural areas for both male and female. Based on WHO age-standardized Framingham risk scores, 33.0% (95% CI = 31.7–34.4) of urban dwellers and 27.0% (95% CI = 23.5–30.8) of rural dwellers had a moderate to high risk of developing CHD in the next 10 years. Conclusion The metabolic risk factors, as well as a moderate or high ten-year risk of CHD were more common among urban residents whereas behavioral risk factors levels were higher in among the rural people of Yangon Region. The high prevalences of NCD risk factors in both urban and rural areas call for preventive measures to reduce the future risk of NCDs in Myanmar.
Published: 2016
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17. Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study

Author: Marius B. Bjertness, Aung Soe Htet, Haakon E. Meyer, Maung Maung Than Htike, Ko Ko Zaw, Win Myint Oo, Tint Swe Latt, Lhamo Y. Sherpa, and Espen Bjertness
Subjects: Hypertension, NCD risk factors, Body-mass index, Waist circumference, Smoking, Alcohol, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Non-communicable diseases (NCDs), malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors. Methods A nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15–64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs) and 95 % confidence intervals (CIs) for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs). Results The prevalence of hypertension was 30.1 % (95 % CI: 28.4–31.8) in males and 29.8 % (28.5–31.1) in females. The mean BMI was 21.7 (SD 4.3) kg/m2 for males and 23.0 (5.1) kg/m2 for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1–3.3, females: OR = 2.3; 2.0–2.7) and high waist circumference (males: OR = 3.4; 1.8–6.8, females: OR = 2.7; 2.2–3.3). In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension. Conclusions The prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe trends in the risk factors, especially modifiable factors, which will most likely be on rise. Studies on effectiveness on interventions are needed, and policies to reduce the burden of NCD risk factors should be implemented if proven effective in similar settings.
Published: 2016
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18. Leisure-Time Physical Activity Is Associated With Reduced Risk of Dementia-Related Mortality in Adults With and Without Psychological Distress: The Cohort of Norway

Author: Ekaterina Zotcheva, Geir Selbæk, Espen Bjertness, Linda Ernstsen, and Bjørn H. Strand
Subjects: physical activity, depression, anxiety, cognitive health, brain health, dementia, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract: Background: Leisure-time physical activity (PA) has been proposed as a protective factor against dementia, whereas psychological distress is associated with an increased risk of dementia. We investigated the associations of leisure-time PA and psychological distress with dementia-related mortality, and whether the association between leisure-time PA and dementia-related mortality differs according to level of psychological distress.Methods: 36,945 individuals from the Cohort of Norway aged 50-74 years at baseline (1994–2002) were included and followed up until January 1st 2015. Leisure-time PA and psychological distress were assessed through questionnaires, whereas dementia-related mortality was obtained through the Norwegian Cause of Death Registry. Adjusted Cox regression analyses were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI).Results: Compared to inactivity, leisure-time PA was associated with a decreased risk of dementia-related mortality; low intensity leisure-time PA (HR = 0.73, 95% CI 0.59–0.89); high intensity leisure-time PA (HR = 0.61, 95%CI 0.49-0.77). A statistically significant difference in dementia-related mortality risk was observed between low and high intensity leisure-time PA (p < 0.05). Psychological distress was associated with an increased risk of dementia-related mortality (HR = 1.45, 95% CI 1.16–1.81). Among non-distressed, leisure-time PA was associated with a decreased dementia-related mortality risk; low intensity leisure-time PA (HR = 0.77, 95% CI 0.61–0.97); high intensity leisure-time PA (HR = 0.65, 95% CI 0.51–0.84). The same applied for those with psychological distress; low intensity leisure-time PA (HR = 0.57, 95% CI 0.35–0.94); high intensity leisure-time PA (HR = 0.42, 95% CI 0.22–0.82). The interaction between leisure-time PA and psychological distress on dementia-related mortality was not statistically significant (p = 0.38).Conclusions: Participating in leisure-time PA was associated with a reduced risk of dementia-related mortality, whereas psychological distress was associated with an increased risk of dementia-related mortality. Leisure-time PA appears to be equally strongly related with dementia-related mortality among those with and without psychological distress, underlining the importance of leisure-time PA for various groups of middle-aged and older adults.
Published: 2018
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19. Income in midlife and dementia related mortality over three decades: A Norwegian prospective study

Author: Bjørn Heine Strand, Vegard Skirbekk, Tor A. Rosness, Knut Engedal, and Espen Bjertness
Subjects: Dementia, Dementia related mortality, Midlife income, Socioeconomic status, Education, Risk factors, Neurology. Diseases of the nervous system, RC346-429
Abstract: Studies on midlife income and dementia are scarce, and our main aim was to investigate midlife with later risk of dementia related mortality, adjusting for education and dementia related risk factors. The study population consisted of Norwegian men, aged 40–59 years in 1980 at income assessment, which participated in Norwegian health examination studies in the period 1980–2002 where risk factors such as cholesterol level, hypertension, smoking, cardiovascular disease, and diabetes were assessed. Dementia related mortality was defined as a dementia diagnosis on the death certificate until 2012. Cox regression was used. The study included 45,944 participants and 1062 dementia related deaths. There was no association between midlife income and dementia mortality risk (HR = 1.04, 95% confidence interval (CI) 0.85, 1.28 for the lowest fifth of income compared to those in the highest fifth). For total mortality, there was a strong inverse association with income (HR = 1.61, 95% CI 1.53, 1.69), which was attenuated when adjusting for education and risk factors, but still significant (HR = 1.27, 95% CI 1.20, 1.34). Lower educational attainment was significantly associated with increased dementia mortality risk, also after adjustment for income and other known risk factors (HR = 1.30, 95% CI 1.03, 1.64 comparing low versus high education). Midlife income was not associated with dementia related mortality, but low education was independently linked to increased risk of dementia related mortality. Our results support the cognitive reserve hypothesis suggesting that mental activity and not material resources are related to dementia related mortality.
Published: 2015
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20. Childhood violence and mental health among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

Author: Astrid M. A. Eriksen, Ketil Lenert Hansen, Berit Schei, Tore Sørlie, Hein Stigum, Espen Bjertness, and Cecilie Javo
Subjects: Childhood violence, ethnicity, HSCL-10, indigenous, mental health, post-traumatic stress, psychological distress, Sami, SAMINOR, cross-cultural, Arctic medicine. Tropical medicine, RC955-962
Abstract: The main objectives of this study were to investigate the association between childhood violence and psychological distress and post-traumatic stress symptoms (PTS) among Sami and non-Sami adults, and to explore a possible mediating effect of childhood violence on any ethnic differences in mental health. This study is part of a larger questionnaire survey on health and living conditions in Mid- and Northern Norway (SAMINOR 2) which included 2116 Sami and 8674 non-Sami participants. A positive association between childhood violence and psychological distress and PTS in adulthood was found regardless of ethnicity. For women, childhood violence may have mediated some of the ethnic differences in psychological distress (53.2%) and PTS (31.4%). A similar pattern was found for men as to psychological distress (45.5%) and PTS (55.5%). The prevalence of psychological distress was significantly higher in the Sami than in the non-Sami group: 15.8% vs. 13.0% for women, and 11.4% vs. 8.0% for men. Likewise, PTS showed a higher prevalence in the Sami group, both for women (16.2% vs. 12.4%) and for men (12.2% vs. 9.1). Conclusion: A positive association between childhood violence and adult mental distress was found for both Sami and Norwegian adults. More mental problems were found among the Sami. Childhood violence may have mediated some of the ethnic differences.
Published: 2018
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21. Survival and years of life lost in various aetiologies of dementia, mild cognitive impairment (MCI) and subjective cognitive decline (SCD) in Norway.

Author: Bjørn Heine Strand, Anne-Brita Knapskog, Karin Persson, Trine Holt Edwin, Rachel Amland, Marit Mjørud, Espen Bjertness, Knut Engedal, and Geir Selbæk
Subjects: Medicine, Science
Abstract: INTRODUCTION:Alzheimer's disease patients are reported to have higher survival rate compared to patients with vascular dementia or dementia with Lewy bodies. There is a paucity of studies investigating survival including persons with cognitive decline and dementia of various aetiologies. OBJECTIVES:We aimed to compare survival for patients with subjective cognitive decline, mild cognitive impairment, Alzheimer's disease, vascular dementia, mixed Alzheimer's/vascular dementia, dementia with Lewy bodies/Parkinson's disease, and other dementias compared to the general Norwegian population, taking into account the role of gender, cognitive function, function in everyday activities, comorbidity and education. METHODS:Patients (N = 4682), ≥65 years, in the The Norwegian register of persons assessed for cognitive symptoms (NorCog) during 2009-2017 were followed for mortality in the National Registry until January 2018. Flexible parametric survival models were applied to estimate relative survival, life expectancy and years of life lost for diagnostic groups compared with the general population. RESULTS:Patients with vascular dementia or dementia with Lewy bodies/Parkinson's had the shortest survival, followed by mixed dementia, Alzheimer's disease, unspecified dementia, mild cognitive impairment and subjective cognitive decline. At age 70 years, men with vascular dementia or dementia with Lewy bodies/Parkinson's had life expectancy of 4.7 years, which corresponded to 10.3 years of life lost compared to the general population. Years of life lost for other diagnoses were 10.0 years for mixed dementia, 9.2 years for Alzheimer's disease, 9.3 years for other dementias, 5.2 years for mild cognitive impairment and 2.2 years for subjective cognitive decline. Corresponding years of life lost in women were: 12.7 years, 10.5 years, 9.8 years, 10.6 years, 7.8 years, and 2.6 years. Poor relative survival among dementia patients was associated with male gender, comorbidity, low cognitive function, and low function in activities of daily living. CONCLUSIONS:Compared with the general population, patients with subjective cognitive decline had no significant loss in life expectancy, while patients with mild cognitive impairment and all dementia subtypes had large losses, especially those with a diagnosis of vascular dementia or dementia with Lewy bodies/Parkinson's.
Published: 2018
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22. A longitudinal study on risk factors for neck and shoulder pain among young adults in the transition from technical school to working life

Author: Therese Nordberg Hanvold, Morten Wærsted, Anne Marit Mengshoel, Espen Bjertness, Jos Twisk, and Kaj Bo Veiersted
Subjects: musculoskeletal disorder, neck pain, longitudinal study, prospective study, electrician, young adult, pain, shoulder pain, hairdresser, young worker, working life, longitudinal, technical school, mechanical workload, Public aspects of medicine, RA1-1270
Abstract: OBJECTIVES: The study examined the course of neck and shoulder pain among a cohort of technical school students entering working life. We also aimed to identify work-related and individual risk factors for neck and shoulder pain during this transition period. METHODS: The study was designed as a prospective cohort study following 420 technical school students (167 student hairdressers, 118 student electricians, and 135 media/design students) from school, through their apprenticeship and into working life. Every 4^th month over a 6.5 year period (2002–2009), the participant`s neck and shoulder pain for the preceding four weeks was assessed. Mechanical and psychosocial workplace factors as well as individual factors were evaluated at baseline and/or during the follow-up period. Data were analyzed by generalized estimating equations (GEE). RESULTS: We found a significant increase in neck and shoulder pain over time in the transition from technical school to working life. High mechanical workload was associated with neck and shoulder pain among women, while a high level of shoulder muscle endurance capacity was associated with lower rates of neck and shoulder pain among men. Perceived muscle tension and ethnicity were the most consistent predictors for neck and shoulder pain, found among both women and men. CONCLUSION: Increased neck and shoulder pain was found in the transition from technical school to working life, and both work-related and individual factors were associated with pain development.
Published: 2014
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23. Associations between Physical Activity in Old Age and Dementia-Related Mortality: A Population-Based Cohort Study

Author: Tor Atle Rosness, Bjørn Heine Strand, Astrid Liv Mina Bergem, Knut Engedal, and Espen Bjertness
Subjects: Dementia, Physical activity, Epidemiology, Geriatric medicine, Longitudinal studies, Neurology. Diseases of the nervous system, RC346-429, Geriatrics, RC952-954.6
Abstract: Background: Findings from the literature vary in relation to whether physical activity brings about less cognitive decline in old age. The present study investigated self-reported levels of physical activity in old age and its association with the risk of dementia-related mortality. Methods: We included data from 31,086 subjects, between 65 and 80 years old, from the CONOR (Cohort of Norway) database. Cox regression analysis was used to estimate the risk of association. Results: Taking part in ‘light' (not causing perspiration or panting) activities of 3 h per week, with an HR of 0.61 and a 95% CI of 0.51-0.73. When taking part in ‘hard' (causing perspiration or panting) activities, a similar risk (HR = 0.56; 95% CI 0.43-0.72) was observed for >3 h per week. Interestingly, the highest reduction in risk was seen for ‘hard' activities of Conclusion: Physical activity during leisure time in old age was associated with a lower risk of dementia-related mortality when compared to inactive individuals.
Published: 2014
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24. The effect of work-related sustained trapezius muscle activity on the development of neck and shoulder pain among young adults

Author: Therese Nordberg Hanvold, Morten Wærsted, Anne Marit Mengshoel, Espen Bjertness, Hein Stigum, Jos Twisk, and Kaj Bo Veiersted
Subjects: musculoskeletal disorder, electromyography, trapezius muscle, young adult, workload, muscle activity, young worker, emg, sustained trapezius muscle activity, sustained muscle activity, Public aspects of medicine, RA1-1270
Abstract: OBJECTIVE: This study aimed to evaluate if sustained trapezius muscle activity predicts neck and shoulder pain over a 2.5-year period. METHODS: Forty young adults (15 hairdressers, 14 electricians, 5 students and 6 with various work) were followed during their first years of working life. Self-reported neck and shoulder pain during the last four weeks was assessed seven times over the observational period. Upper-trapezius muscle activity was measured during a full working day by bilateral surface electromyography (EMG) at baseline (winter 2006/7). Sustained trapezius muscle activity was defined as continuous muscle activity with amplitude >0.5% EMGmax lasting >4 minutes. The relative time of sustained muscle activity during the working day was calculated and further classified into low (0–29%), moderate (30–49%) and high (50–100%) level groups. RESULTS: Generalized estimating equations (GEE), adjusted for time, gender, mechanical workload, control-over-work intensity, physical activity, tobacco use, and prior neck and shoulder pain, showed that participants with a high level of sustained muscle activity had a rate of neck and shoulder pain three times higher than the low level group during a 2.5-year period. The association was strongest at the same time and shortly after the EMG measurement, indicating a time-lag of ≤6 months. CONCLUSION: The results support the hypothesis that sustained trapezius muscle activity is associated with neck and shoulder pain. This association was strongest analyzing cross-sectional and short-term effects.
Published: 2013
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25. Patterns of healthcare utilization prior to suicide according to educational attainment: a nationwide register-based population study

Author: Carine øien-ødegaard, Lars Hauge, Kim Stene-Larsen, Solveig Glestad Christiansen, Espen Bjertness, and Anne Reneflot
Subjects: Health (social science), Epidemiology, Health Policy, Public Health, Environmental and Occupational Health, Medicine (miscellaneous), Health Informatics
Published: 2023
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26. Dental caries in a Norwegian adult population, the HUNT4 oral health study; prevalence, distribution and 45-year trends

Author: Siri Christine Rødseth, Hedda Høvik, Annemarie A. Schuller, Espen Bjertness, and Rasa Skudutyte-Rysstad
Subjects: time trends, LIFE, 35-YEAR-OLD OSLO CITIZENS, Epidemiology, NORWAY, dental caries, HUNT, EXPERIENCE, COHORT, General Medicine, enamel caries, General Dentistry, TIME
Abstract: Objective To investigate dental caries prevalence amongst adults in Central Norway and assess changes over the last 45 years. Materials and methods The cross-sectional HUNT4 Oral Health Study was conducted in 2017-2019. A random sample of 4913 participants aged >= 19 years answered questionnaires and underwent clinical and radiographic examinations. Data were compared to findings from previous studies in the same region conducted from 1973 to 2006. Results Mean number of decayed, missing and filled teeth (D3-5MFT) was 14.9 (95% CI 14.7, 15.1), 56% of adults had one or more carious teeth (D3-5T) and 11.8% had >= 4 D3-5T, with the mean number of 1.4 (95% CI 1.32, 1.42). For initial caries, mean D1-2S was 3.8 (95% CI 3.7, 3.9), being the highest for 19-24-year-olds at 8.6 (95% CI 7.9, 9.3). Comparisons with earlier studies showed a decline in mean D3-5MFT for 35-45-year-olds from 26.5 in 1973 to 10.8 in 2019. In 1973, 4.8% of 35-45-year-olds were edentulous, while in present study edentulousness was found only in individuals >65 years. Conclusions Despite a substantial reduction in caries experience over the last 45 years, untreated dentine caries was common, evenly distributed across all age groups. Initial caries particularly affected younger individuals, indicating a need to evaluate prevention strategies and access to dental services.
Published: 2023

27. Prevalence of Intimate Partner Violence and Association with Wealth in Myanmar

Author: Win Thuzar Aye, Lise Wessel Larsen, and Espen Bjertness
Subjects: Sociology and Political Science, media_common.quotation_subject, 05 social sciences, Standard methods, Logistic regression, Confidence interval, 03 medical and health sciences, Clinical Psychology, 0302 clinical medicine, Domestic violence, Wife, Health survey, 0501 psychology and cognitive sciences, 030212 general & internal medicine, Psychology, Association (psychology), Law, Social Sciences (miscellaneous), 050104 developmental & child psychology, Demography, Quality of Life Research, media_common
Abstract: This study explores the prevalence of physical, sexual and emotional intimate partner violence in Myanmar, attitudes towards violence, and the association between wealth and intimate partner violence. We analysed a nationally representative sample of 3425 married women aged 15–49 years from Myanmar Demographic and Health survey 2015–2016. In this cross-sectional study, data was collected by in-person interviews using a standardized questionnaire. Wealth was operationalized into five groups depending on how much the household owns. Intimate partner violence was measured based on the standard methods of Demographic and Health Survey. The overall prevalence of intimate partner violence (physical, sexual and emotional) was 20.6% (95% confidence interval (95% CI) 18.9–22.3). Less severe physical intimate partner violence was reported by 14.8% (95% CI 13.5–16.3), while 4.4% (95% CI 3.8–5.2) reported severe physical violence. The prevalence of sexual and emotional violence were 2.8% (95% CI 2.2–3.6) and 13.1% (95% CI 11.7–14.6), respectively. Many women believed that a husband has the right to beat his wife if she acts inappropriate, with the highest prevalence at 43% of the women justifying beating if the wife neglects her children. In logistic regression analysis, low wealth as compared with higher wealth, was associated with a higher prevalence of intimate partner violence. The results reveals that intimate partner violence against ever-married women in Myanmar is present, that many women justify beating, and that wealth and intimate partner violence is associated.
Published: 2020
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28. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. Bojesen, Giuseppe Grosso, Seongjun Ha, Lauren Lissner, Mikhail Benet, Anastasia Markaki, Sanjay Rampal, Antônio Augusto Moura da Silva, Maria Lorenza Muiesan, Angelique Chan, Yvonne T. van der Schouw, Annamari Lundqvist, Philippe Amouyel, Kristyna Zejglicova, Charalambos Hadjigeorgiou, João Breda, Jørgen Meisfjord, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Vilma Irazola, Leng Huat Foo, Óscar Lopes, Dickman Gareta, Flavio Nervi, Imre Janszky, Ruzena Kubinova, Terho Lehtimäki, Mario V. Capanzana, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Shuohua Chen, Arvind Pandey, Luigi Palmieri, Roya Kelishadi, Srinivasan Kannan, Jie Mi, Robert Beaglehole, Liliana Dacica, Jyrki K. Virtanen, Mohan Deepa, Peter Ueda, Isti Ilmiati Fujiati, Hermann Pohlabeln, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, Mohsen Azimi-Nezhad, Henry Völzke, Karolina Milkowska, Zahra Mohammadi, Belgin Ünal, Magda Gasull, George S. Stergiou, Marshall K. Tulloch-Reid, Seppo Koskinen, James E. Bennett, Marcela González-Gross, Virginija Dulskiene, Idris Guessous, Assembekov Batyrbek, Kamarul Imran Musa, Jeannette Lee, Josep Redon, Bihungum Bista, Luisa M Macieira, Johan Sundström, Andres Metspalu, Lariane M Ono, Flora A. Ukoli, Salar Rahimikazerooni, Andrea Gualtieri, Trevor S. Ferguson, Félicité Tchibindat, Eliza Cinteza, Ha Tp Do, Tajana Zeljkovic Vrkic, Tuyen D Le, Alison J. Hayes, Abdul Basit, Chandini Nekkantti, Teresa Norat, Eunice Ugel, Gulmira Aitmurzaeva, Mariachiara Di Cesare, Abdul Hamid Zargar, Vincenzo Solfrizzi, Garry L. Jennings, Aline Meirhaeghe, Kaare Christensen, Päivi Mäki, Xu Lin, Ali Esmaeili, Joanna Baran, Aneta Grajda, Renata Cifkova, Alexandre C. Pereira, Martin Bobak, Iuliia A Rusakova, Keiu Nelis, Damian K Francis, Guansheng Ma, Axel C. Carlsson, Alejandro Diaz, Alireza Ansari-Moghaddam, N Capkova, Zumin Shi, Maria Turley, Imelda A. Agdeppa, Helena I. S. Nogueira, Marcia Scazufca, Katharina Maruszczak, Natascia Rinaldo, Paulo A. Lotufo, Nuno Lunet, Thor Aspelund, Caroline H.D. Fall, Antonio Cabrera de León, Ahmad Faudzi Yusoff, Holger Theobald, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Mihai Gafencu, Tandi E. Matsha, Ana B. Crujeiras, Ahmad Reza Dorosty, Alain Morejon, Weili Yan, Dominique Hange, Bekbolat Zholdin, Frédéric Gottrand, Jorge Mota, Jana Námešná, Stevo Popovic, Louise Eriksen, Line Lund Kårhus, Cihangir Erem, Juergen Breckenkamp, Mathilde Kersting, Yi Song, Martin McKee, Aleksandra Gomula, Rafaela Rosário, Enzo Manzato, S. Goya Wannamethee, Sounnia Mediene Benchekor, Azim Nejatizadeh, Krishna Kumar Aryal, Juan P. González-Rivas, Vedrana Sember, Stephen T. McGarvey, Jukka T. Salonen, Patrick Pasquet, Patricia Varona-Pérez, Amelia C. Crampin, Ramin Heshmat, Violeta Iotova, Juvenal Soares Dias-da-Costa, Oye Gureje, Aletta E. Schutte, João Luiz Bastos, Anelise Reis Gaya, Konrad Jamrozik, Dalia Luksiene, Amina Barkat, Maria Paula Santos, José Camolas, Azli Baharudin, Diego Vanuzzo, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, Albertino Damasceno, Davood Khalili, Simona Bo, Martina Müller-Nurasyid, Dominique Cottel, Markku Peltonen, Fikru Tullu, Ana Isabel Rito, Angélica Ochoa-Avilés, Annette J. Dobson, Christopher T. Cowell, Charumathi Sabanayagam, Rildo de Souza Wanderley Júnior, Oanh T. H. Trinh, Farahnaz Joukar, Mostafa K. Mohamed, Mostafa Qorbani, Jeongseon Kim, Helmut Schröder, Machi Suka, Natasja M. van Schoor, Jussi Kauhanen, Teresa Haugsgjerd, Goodarz Danaei, M. Fernanda Lima-Costa, Yong Tao, Elisabetta L. Romeo, Grazyna Jasienska, Victor Guillermo Sequera, Kazem Mohammad, Yanina Zócalo, Fernanda Cunha Soares, Jianfeng Wu, Mohammad Esmaeel Motlagh, María Elena Díaz-Sánchez, Monika Zuziak, Eldridge Ferrer, Anette Varbo, Leila Beltrami Moreira, Jeremy M. Jacobs, Kenneth James, Elena Sacchini, Pascal Bovet, Mahboubeh Parsaeian, Tania Lopez, Ya Xing Wang, Wojciech Drygas, Jody C Miller, Svetlana A. Shalnova, Maria Elisa Zapata, Chung T Nguyen, Nimmathota Arlappa, Edwige Landais, Thorkild I. A. Sørensen, Jeannette Klimont, Amirabbas Momenan, Erik J. Timmermans, Mari-Liis Tammesoo, Jost B. Jonas, Stefania Toselli, Maria Teresa Anselmo Olinto, Bahman Cheraghian, Kouamelan Doua, Esteban Carmuega, Marjeta Mišigoj-Duraković, Bo Werner, M. Arfan Ikram, Breige A. McNulty, Christa Meisinger, Clara Homs, Namuna Shrestha, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Alicia Matijasevich, Alison J Price, Ala'a Alkerwi, Kristine H. Allin, Lorenza Pilotto, Mohannad Al Nsour, Ingunn Holden Bergh, Marianna Noale, Heba Fouad, Vilnis Dzerve, Novie O. Younger-Coleman, Peter Willeit, Andrea R. V. R. Horimoto, Freda Pitakaka, Habiba Ben Romdhane, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Cristina Padez, Sarah P. Garnett, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tien Yin Wong, Rosa Haghshenas, Jonathan Giovannelli, Christina Howitt, Marleen E. Hendriks, Fadia AlBuhairan, Huashuai Chen, Gretchen A Stevens, Luís B. Sardinha, David Goltzman, Jenny M. Kindblom, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Rajendra Pradeepa, Yi-Ting Lin, Martin Neovius, Juan Francisco Miquel, Ellis Owusu-Dabo, Anil Poudyal, Marzieh Katibeh, Tanja Stocks, Veronica Mocanu, Ulla Roggenbuck, Robespierre Ribeiro, Gabriele Eiben, Mary Simon, Christine Cameron, Hamid Hakimi, Kamel Ajlouni, Jakub Stokwiszewski, Iulia Jurca Simina, Pietro Amedeo Modesti, Frederick C. W. Wu, Peter Kristensen, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Martijn Huisman, Betina H. Thuesen, Queenie Chan, Antonisamy Belavendra, Artur Mazur, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Marcos André Moura-dos-Santos, Jean Ferrières, Farhad Zamani, Shina Avi, Yves Kameli, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Thomas Meinertz Dantoft, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Azaliia M Tuliakova, Vera Lanska, Tint Swe Latt, Matthias Bopp, Abbas Rezaianzadeh, Rod Jackson, Johan Van der Heyden, Reecha Sofat, Koen Van Herck, Allan G. Hill, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Stela McLachlan, Ulrike Gehring, Ranko Stevanovic, Nagalla Balakrishna, Lekhraj Rampal, Marjolijn C. E. Bragt, Saeid Eslami, Napoleón Pérez-Farinós, G. K. Mini, Viktoria Anna Kovacs, Rosemarie Martin, Nahla Hwalla, Wei Zheng, Hoang Van Minh, Edward D Janus, Laetitia Huiart, Farhad Pourfarzi, Sudha Ramachandra Rao, Fred Paccaud, Marcia Makdisse, Aye Aye Sein, Enrique Gutiérrez-González, Yang Yang, Anneke Blokstra, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Wan Nazaimoon Wan Mohamud, Jesús Ibarluzea, Julio Zuñiga Cisneros, Laura Lauria, Argyro Karakosta, Dragana P Jovic, Jun Hata, Elio Riboli, Piotr Bandosz, Xun Tang, Parvina Mukhtorova, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Aleksandra Piwońska, Dusan Grafnetter, Mette Rasmussen, Daniel Weghuber, Sherali Rakhmatulloev, Martine Vrijheid, Johann Willeit, Motahareh Kheradmand, Małgorzata Mossakowska, Lechaba Tshepo, Dongfeng Gu, Hyeon Chang Kim, Vilmundur Gudnason, Maria Forsner, Peter Bjerregaard, Leon A. Simons, Rachael McLean, Japhet Killewo, Ramón Suárez-Medina, Y Nikitin, Eng Joo Tan, Jean Claude Mbanya, Aroor Bhagyalaxmi, Renata Kuciene, Kairat Davletov, Jose Eugenio Lozano, Afshin Ostovar, Niloofar Peykari, Guy De Backer, Soheir H Ahmed, Nicholas J. Wareham, Sai Yin Ho, Constanta Huidumac Petrescu, Maria Hassapidou, Iris Pigeot, Myriam Galfo, Susana Cararo Confortin, Blanca Sandra Ruiz-Betancourt, W. M. Monique Verschuren, Catterina Ferreccio, Fabio Galvano, Leila Houti, Daniel Bia, Annika Rosengren, Marcin Rutkowski, Biruta Velika, Joana Araújo, Fernando Rigo, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Marie Kunešová, Boban Mugoša, Sania Nishtar, Mangesh S. Pednekar, Shahla AlDhukair, Helle-Mai Loit, Antonis Zampelas, Altan Onat, Maciej Banach, Shohreh Naderimagham, Hajer Aounallah-Skhiri, Maja Bæksgaard Jørgensen, Yin Guo, Ewelina Czenczek-Lewandowska, Parasmani Dasgupta, Elvis Oa Wambiya, Inge Huybrechts, Raimund Erbel, Jari Jokelainen, Ana P. Ortiz, Stefan Kiechl, Emmanuel Cohen, Caleb Ochimana, Shynar Abdrakhmanova, Laura Censi, Iqbal Bata, Geetha R Menon, Snehalatha Chamukuttan, Pedro Plans-Rubio, Domenico Palli, Ana Azevedo, Slawomir Koziel, Benoît Salanave, Parinaz Mehdipour, Shu Ti Chiou, Lela Sturua, Lubica Ticha, Felipe Vogt Cureau, Jin Soo Moon, Ming-Hui Zhao, Urho M. Kujala, Nathalie Michels, Ertugrul Celikcan, Jaakko Tuomilehto, Judith Benedics, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, Andrea Rodriguez-Martinez, Tai Hing Lam, Yn-Tz Sung, Jürgen König, Kodavanti Mallikharjuna Rao, Hazzaa M. Al-Hazzaa, Karen Morgan, Bogdan Wojtyniak, Cynthia M. Pérez, Ilse Khouw, Manoli Garcia-de-la-Hera, Dong Wook Shin, Genc Burazeri, Ausra Petrauskiene, Charles Sossa Jérome, Kenisha Russell Jonsson, José Boggia, Daniela Galeone, Alice Bonilla-Vargas, Han Cg Kemper, Rahman Shiri, Stefaan Demarest, Else Karin Grøholt, San-Lin You, Adelheid Weber, Juha Auvinen, Aida Pilav, Sibel Gogen, Suzanne N Morin, Wan Mohamad Wan Bebakar, Viviane Cunha Cardoso, Kavumpurathu Raman Thankappan, Hana Zamrazilová, Frank Claessens, Karien Stronks, Helen Gonçalves, Tahir Aris, Luis Revilla, Sérgio Viana Peixoto, Zhamilya Battakova, Jing Liu, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Priscilla Duboz, Sandjaja, Tiina Laatikainen, Rafel Ramos, Sareh Eghtesad, Judith Simons, Orn Olafsson, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Aung Soe Htet, Bente Sparboe-Nilsen, Paul Elliott, Soon-Woo Park, Angel R. Gonzalez, Ying-Wei Wang, Rob M. van Dam, Ryutaro Ohtsuka, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Lynell V Maniego, Fariborz Mansour-Ghanaei, Maria Dorobantu, Giovanni Viegi, Xiaoguang Yang, Honor Bixby, Prakash C. Gupta, Ofra Kalter-Leibovici, Eugene Sobngwi, Ričardas Radišauskas, Jurate Medzioniene, Roy A Wong-McClure, Kim F. Michaelsen, Antonia Trichopoulou, Tania Tello, Francesco Branca, Johanna Gunnlaugsdottir, Els Clays, Wei-Yen Lim, Suzanne C. Ho, Toomas Veidebaum, Rebecca Goldsmith, Margot González-León, Matthias Nauck, Alibek Mereke, Marta Buoncristiano, Jakob Tarp, Rosalba Rojas-Martínez, Maya Tanrygulyyeva, Reza Malekzadeh, Abdonas Tamosiunas, Dimitrios Poulimeneas, Pedro Ordunez, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Anne Juolevi, Vassilis Zafiropulos, Emanuela Gualdi-Russo, Jordi Sunyer, Manu Raj, Chaoqiang Jiang, Sofia Malyutina, Efthymios Kapantais, Maria Lazo-Porras, Maung Maung Than Htike, Michael Hobbs, Ranjit Mohan Anjana, Merike Liivak, Johan G. Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. Santos, Marjeta Majer, Herman Schargrodsky, Bruna Gonçalves Cordeiro da Silva, Ebrahim Eftekhar, Jesús Vioque, Marisa K. Sophiea, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Stefan Söderberg, Isabel O. Oliveira, Joanne Katz, Xingwang Ye, Christophe Tzourio, Marie Zins, Aneta Weres, Ulrich Keil, Haiquan Xu, Akihiro Yoshihara, Rachel Dankner, Gabriella Gruden, Maroje Sorić, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Christa L. Lilly, Veikko Salomaa, Gilad Twig, Senthil K Vasan, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Wilma M. Hopman, Karl-Heinz Jöckel, Ari Voutilainen, Peter Schnohr, Jerzy Chudek, Katia Vergetti Bloch, Vincenzo Capuano, Jyh Eiin Wong, Torben Jørgensen, Anja Schienkiewitz, Nader Saki, Carolina Tarqui-Mamani, Maria Cecília Formoso Assunção, Kazi M. Jamil, Juraci Almeida Cesar, Pedro J Ortiz, Delphine De Smedt, Luciana Zaccagni, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Romana Roccaldo, Sara Magnacca, Peter Stehle, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Tabara Yasuharu, Ali Ghanbari, Gyulli M. Kazakbaeva, Takuro Furusawa, Felicia Cañete, Kari Kuulasmaa, Justina Vaitkeviciute, (NCD-RisC), NCD Risk Factor Collaboration, Imperial College London, Harvard T.H. Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut 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Chiara Donfrancesco , Silvana P Donoso , Angela Döring , Maria Dorobantu , Ahmad Reza Dorosty , Kouamelan Doua , Nico Dragano , Wojciech Drygas , Jia Li Duan , Charmaine A Duante , Priscilla Duboz , Rosemary B Duda , Vesselka Duleva , Virginija Dulskiene , Samuel C Dumith , Anar Dushpanova , Vilnis Dzerve , Elzbieta Dziankowska-Zaborszczyk , Ricky Eddie , Ebrahim Eftekhar , Eruke E Egbagbe , Robert Eggertsen , Sareh Eghtesad , Gabriele Eiben , Ulf Ekelund , Mohammad El-Khateeb , Jalila El Ati , Denise Eldemire-Shearer , Marie Eliasen , Paul Elliott , Reina Engle-Stone , Macia Enguerran , Rajiv T Erasmus , Raimund Erbel , Cihangir Erem , Louise Eriksen , Johan G Eriksson , Jorge Escobedo-de la Peña , Saeid Eslami , Ali Esmaeili , Alun Evans , David Faeh , Albina A Fakhretdinova , Caroline H Fall , Elnaz Faramarzi , Mojtaba Farjam , Victoria Farrugia Sant'Angelo , Farshad Farzadfar , Mohammad Reza Fattahi , Asher Fawwad , Francisco J Felix-Redondo , Trevor S Ferguson , Romulo A Fernandes , Daniel Fernández-Bergés , Daniel Ferrante , Thomas Ferrao , Marika Ferrari , Marco M Ferrario , Catterina Ferreccio , Eldridge Ferrer , Jean Ferrieres , Thamara Hubler Figueiró , Anna Fijalkowska , Günther Fink , Krista Fischer , Leng Huat Foo , Maria Forsner , Heba M Fouad , Damian K Francis , Maria do Carmo Franco , Ruth Frikke-Schmidt , Guillermo Frontera , Flavio D Fuchs , Sandra C Fuchs , Isti I Fujiati , Yuki Fujita , Matsuda Fumihiko , Takuro Furusawa , Zbigniew Gaciong , Mihai Gafencu , Andrzej Galbarczyk , Henrike Galenkamp , Daniela Galeone , Myriam Galfo , Fabio Galvano , Jingli Gao , Manoli Garcia-de-la-Hera , Marta García-Solano , Dickman Gareta , Sarah P Garnett , Jean-Michel Gaspoz , Magda Gasull , Adroaldo Cesar Araujo Gaya , Anelise Reis Gaya , Andrea Gazzinelli , Ulrike Gehring , Harald Geiger , Johanna M Geleijnse , Ali Ghanbari , Erfan Ghasemi , Oana-Florentina Gheorghe-Fronea , Simona Giampaoli , Francesco Gianfagna , Tiffany K Gill , Jonathan Giovannelli , Glen 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, Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , 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, Luxia Zhang , Zhen-Yu Zhang , Dong Zhao , Ming-Hui Zhao , Wenhua Zhao , Shiqi Zhen , Wei Zheng , Yingfeng Zheng , Bekbolat Zholdin , Maigeng Zhou , Dan Zhu , Marie Zins , Emanuel Zitt , Yanina Zocalo , Julio Zuñiga Cisneros , Monika Zuziak , Majid Ezzati , Sarah Filippi, Epidemiology, Iurilli, Maria LC, Zhou, Bin, Bennett, James E, Carrillo-Larco, Rodrigo M, Sophiea, Marisa K, Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D, Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A, Riley, Leanne M, Savin, Stefan, Cowan, Melanie J, Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J, Ikeda, Nayu, Jackson, Rod T, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J Jaime, Saidi, Olfa, Sebert, Sylvain, Sorić, Maroje, Starc, Gregor, Gregg, Edward W, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, 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Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021
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29. Urban–rural differences in overweight and obesity among 25–64 years old Myanmar residents: a cross-sectional, nationwide survey

Author: Cecilie Dahl, Rupa Thapa, Espen Bjertness, and Wai Phyo Aung
Subjects: Adult, Male, Rural Population, medicine.medical_specialty, Urban Population, Population, 030209 endocrinology & metabolism, Myanmar, Overweight, preventive medicine, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, Prevalence, medicine, Humans, Obesity, 030212 general & internal medicine, education, Socioeconomic status, education.field_of_study, business.industry, Public health, General Medicine, Middle Aged, medicine.disease, Cross-Sectional Studies, Socioeconomic Factors, Medicine, Female, epidemiology, Public Health, Rural area, medicine.symptom, business, Body mass index, Demography
Abstract: ObjectivesTo investigate whether urban–rural location and socioeconomic factors (income, education and employment) are associated with body mass index (BMI) and waist–hip ratio (W/H-ratio), and to further explore if the associations between urban–rural location and BMI or W/H-ratio could be mediated through variations in socioeconomic factors.DesignCross-sectional, WHO STEPS survey of non-communicable disease risk factors.SettingUrban and rural areas of Myanmar.ParticipantsA total of 8390 men and women aged 25 to 64 years included during the study period from September to December 2014. Institutionalised people (Buddhist monks and nuns, hospitalised patients) and temporary residents were excluded.ResultsThe prevalence of overweight and obesity was higher in the urban areas and increased with increasing socioeconomic status (SES) score. Mean BMI was higher among urban residents (ß=2.49 kg/m2; 95% CI 2.28 to 2.70; p2; 95% CI 0.43 to 1.05; p2; 95% CI 1.13 to 1.82; pConclusionResidents living in urban locations had higher BMI and greater W/H-ratio, partially explained by differences in socioeconomic indicators, indicating that socioeconomic factors should be emphasised in the management of overweight and obesity in the Myanmar population. Furthermore, new national or subnational STEPS surveys should be conducted in Myanmar to observe the disparity in trends of the urban–rural differential.
Published: 2021

30. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Author: Zhou, Bin Carrillo-Larco, Rodrigo M. Danaei, Goodarz Riley, Leanne M. Paciorek, Christopher J. Stevens, Gretchen A. and Gregg, Edward W. Bennett, James E. Solomon, Bethlehem and Singleton, Rosie K. Sophiea, Marisa K. Iurilli, Maria L. C. and Lhoste, Victor P. F. Cowan, Melanie J. Savin, Stefan and Woodward, Mark Balanova, Yulia Cifkova, Renata Damasceno, Albertino Elliott, Paul Farzadfar, Farshad He, Jiang and Ikeda, Nayu Kengne, Andre P. Khang, Young-Ho Kim, Hyeon Chang Laxmaiah, Avula Lin, Hsien-Ho Margozzini Maira, Paula and Miranda, J. Jaime Neuhauser, Hannelore Sundstrom, Johan and Varghese, Cherian Widyahening, Indah S. Zdrojewski, Tomasz and Ezzati, Majid Abarca-Gomez, Leandra Abdeen, Ziad A. Rahim, Hanan F. Abdul Abu-Rmeileh, Niveen M. Acosta-Cazares, Benjamin and Adams, Robert J. Aekplakorn, Wichai Afsana, Kaosar and Afzal, Shoaib Agdeppa, Imelda A. Aghazadeh-Attari, Javad and Aguilar-Salinas, Carlos A. Agyemang, Charles Ahmad, Noor Ani and Ahmadi, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadizar, Fariba and Ahmed, Soheir H. Ahrens, Wolfgang Ajlouni, Kamel and Al-Raddadi, Rajaa Alarouj, Monira AlBuhairan, Fadia and AlDhukair, Shahla Ali, Mohamed M. Alkandari, Abdullah and Alkerwi, Ala'a Allin, Kristine Aly, Eman Amarapurkar, Deepak N. Amougou, Norbert Amouyel, Philippe Andersen, Lars Bo and Anderssen, Sigmund A. Anjana, Ranjit Mohan Ansari-Moghaddam, Alireza Ansong, Daniel Aounallah-Skhiri, Hajer Araujo, Joana and Ariansen, Inger Aris, Tahir Arku, Raphael E. Arlappa, Nimmathota Aryal, Krishna K. Aspelund, Thor Assah, Felix K. and Assuncao, Maria Cecilia F. Auvinen, Juha Avdicova, Maria and Azevedo, Ana Azimi-Nezhad, Mohsen Azizi, Fereidoun Azmin, Mehrdad Babu, Bontha V. Bahijri, Suhad Balakrishna, Nagalla and Balanova, Yulia Bamoshmoosh, Mohamed Banach, Maciej and Banadinovic, Maja Bandosz, Piotr Banegas, Jose R. Baran, Joanna Barbagallo, Carlo M. Barcelo, Alberto Barkat, Amina and Barreto, Marta Barros, Aluisio J. D. Gomes Barros, Mauro Virgilio Bartosiewicz, Anna Basit, Abdul Bastos, Joao Luiz D. Bata, Iqbal Batieha, Anwar M. Batyrbek, Assembekov and Baur, Louise A. Beaglehole, Robert Belavendra, Antonisamy and Ben Romdhane, Habiba Benet, Mikhail Bennett, James E. and Benson, Lowell S. Berkinbayev, Salim Bernabe-Ortiz, Antonio and Bettiol, Heloisa Bezerra, Jorge Bhagyalaxmi, Aroor Bhargava, Santosh K. Bia, Daniel Biasch, Katia Lele, Elysee Claude Bika Bikbov, Mukharram M. Bista, Bihungum Bjerregaard, Peter and Bjertness, Espen Bjertness, Marius B. Bjorkelund, Cecilia and Bloch, Katia V. Blokstra, Anneke Bo, Simona Bobak, Martin Boeing, Heiner Boggia, Jose G. Boissonnet, Carlos P. and Bojesen, Stig E. Bongard, Vanina Bonilla-Vargas, Alice and Bopp, Matthias Borghs, Herman Bovet, Pascal Boyer, Christopher B. Braeckman, Lutgart Brajkovich, Imperia and Branca, Francesco Breckenkamp, Juergen Brenner, Hermann and Brewster, Lizzy M. Briceno, Yajaira Brito, Miguel Bruno, Graziella Bueno-de-Mesquita, H. Bas Bueno, Gloria Bugge, Anna Burns, Con Bursztyn, Michael Cabrera de Leon, Antonio and Cacciottolo, Joseph Cameron, Christine Can, Gunay and Candido, Ana Paula C. Capanzana, Mario V. Capkova, Nadezda and Capuano, Eduardo Capuano, Vincenzo Cardoso, Viviane C. and Carlsson, Axel C. Carvalho, Joana Casanueva, Felipe F. and Censi, Laura Cervantes-Loaiza, Marvin Chadjigeorgiou, Charalambos A. Chamukuttan, Snehalatha Chan, Angelique W. and Chan, Queenie Chaturvedi, Himanshu K. Chaturvedi, Nish Chee, Miao Li Chen, Chien-Jen Chen, Fangfang Chen, Huashuai and Chen, Shuohua Chen, Zhengming Cheng, Ching-Yu Cheraghian, Bahman Dekkaki, Imane Cherkaoui Chetrit, Angela Chien, Kuo-Liong Chiolero, Arnaud Chiou, Shu-Ti Chirita-Emandi, Adela Chirlaque, Maria-Dolores Cho, Belong Christensen, Kaare Christofaro, Diego G. Chudek, Jerzy Cifkova, Renata and Cinteza, Eliza Claessens, Frank Clarke, Janine Clays, Els Cohen, Emmanuel Concin, Hans Cooper, Cyrus and Coppinger, Tara C. Costanzo, Simona Cottel, Dominique and Cowell, Chris Craig, Cora L. Crampin, Amelia C. Crujeiras, Ana B. Cruz, Juan J. Csilla, Semanova Cui, Liufu Cureau, Felipe V. Cuschieri, Sarah D'Arrigo, Graziella d'Orsi, Eleonora Dallongeville, Jean Damasceno, Albertino Danaei, Goodarz Dankner, Rachel Dantoft, Thomas M. Dauchet, Luc and Davletov, Kairat De Backer, Guy De Bacquer, Dirk De Curtis, Amalia de Gaetano, Giovanni De Henauw, Stefaan de Oliveira, Paula Duarte De Ridder, David De Smedt, Delphine Deepa, Mohan Deev, Alexander D. DeGennaro, Vincent Jr Delisle, Helene Demarest, Stefaan Dennison, Elaine Deschamps, Valerie and Dhimal, Meghnath Di Castelnuovo, Augusto F. Dias-da-Costa, Juvenal Soares Diaz, Alejandro Dickerson, Ty T. Dika, Zivka and Djalalinia, Shirin Do, Ha T. P. Dobson, Annette J. and Donfrancesco, Chiara Donoso, Silvana P. Doering, Angela and Dorobantu, Maria Doerr, Marcus Doua, Kouamelan Dragano, Nico and Drygas, Wojciech Duante, Charmaine A. Duboz, Priscilla and Duda, Rosemary B. Dulskiene, Virginija Dushpanova, Anar and Dzakula, Aleksandar Dzerve, Vilnis Dziankowska-Zaborszczyk, Elzbieta Eddie, Ricky Eftekhar, Ebrahim Eggertsen, Robert and Eghtesad, Sareh Eiben, Gabriele Ekelund, Ulf El-Khateeb, Mohammad El Ati, Jalila Eldemire-Shearer, Denise Eliasen, Marie Elliott, Paul Elosua, Roberto Erasmus, Rajiv T. and Erbel, Raimund Erem, Cihangir Eriksen, Louise Eriksson, Johan G. Escobedo-de la Pena, Jorge Eslami, Saeid Esmaeili, Ali Evans, Alun Faeh, David Fakhretdinova, Albina A. and Fall, Caroline H. Faramarzi, Elnaz Farjam, Mojtaba and Farzadfar, Farshad Fattahi, Mohammad Reza Fawwad, Asher and Felix-Redondo, Francisco J. Felix, Stephan B. Ferguson, Trevor S. Fernandes, Romulo A. Fernandez-Berges, Daniel Ferrante, Daniel Ferrao, Thomas Ferrari, Marika Ferrario, Marco M. and Ferreccio, Catterina Ferreira, Haroldo S. Ferrer, Eldridge and Ferrieres, Jean Figueiro, Thamara Hubler Fink, Gunther and Fischer, Krista Foo, Leng Huat Forsner, Maria Fouad, Heba M. and Francis, Damian K. Franco, Maria do Carmo Frikke-Schmidt, Ruth Frontera, Guillermo Fuchs, Flavio D. Fuchs, Sandra C. and Fujita, Yuki Fumihiko, Matsuda Furdela, Viktoriya Furer, Ariel Furusawa, Takuro Gaciong, Zbigniew Galbarczyk, Andrzej and Galenkamp, Henrike Galvano, Fabio Gao, Jingli Gao, Pei and Garcia-de-la-Hera, Manoli Garcia, Pablo Gareta, Dickman and Garnett, Sarah P. Gaspoz, Jean-Michel Gasull, Magda and Gazzinelli, Andrea Gehring, Ulrike Geleijnse, Johanna M. and George, Ronnie Ghanbari, Ali Ghasemi, Erfan Gheorghe-Fronea, Oana-Florentina Ghimire, Anup Gialluisi, Alessandro and Giampaoli, Simona Gieger, Christian Gill, Tiffany K. and Giovannelli, Jonathan Gironella, Glen Giwercman, Aleksander and Gkiouras, Konstantinos Goldberg, Marcel Goldsmith, Rebecca A. and Gomez, Luis F. Gomula, Aleksandra Cordeiro da Silva, Bruna Goncalves Goncalves, Helen Goncalves, Mauer Gonzalez-Chica, David A. Gonzalez-Gross, Marcela Gonzalez-Rivas, Juan P. and Gonzalez-Villalpando, Clicerio Gonzalez-Villalpando, Maria-Elena and Gonzalez, Angel R. Bonet Gorbea, Mariano Gottrand, Frederic and Graff-Iversen, Sidsel Grafnetter, Dusan Grajda, Aneta and Grammatikopoulou, Maria G. Gregor, Ronald D. Grodzicki, Tomasz and Grosso, Giuseppe Gruden, Gabriella Gu, Dongfeng Guan, Ong Peng Gudmundsson, Elias F. Gudnason, Vilmundur Guerrero, Ramiro Guessous, Idris Guimaraes, Andre L. Gulliford, Martin C. Gunnlaugsdottir, Johanna Gunter, Marc J. Gupta, Prakash C. Gupta, Rajeev Gureje, Oye Gurzkowska, Beata and Gutierrez, Laura Gutzwiller, Felix Ha, Seongjun Hadaegh, Farzad Haghshenas, Rosa Hakimi, Hamid Halkjaer, Jytte and Hambleton, Ian R. Hamzeh, Behrooz Hange, Dominique Hanif, Abu A. M. Hantunen, Sari Hao, Jie Hardman, Carla Meneses and Kumar, Rachakulla Hari Hashemi-Shahri, Seyed Mohammad Hata, Jun and Haugsgjerd, Teresa Hayes, Alison J. He, Jiang He, Yuna and Heier, Margit Hendriks, Marleen Elisabeth Henrique, Rafael dos Santos Henriques, Ana Cadena, Leticia Hernandez Herrala, Sauli Heshmat, Ramin Hill, Allan G. Ho, Sai Yin Ho, Suzanne C. Hobbs, Michael Holdsworth, Michelle Homayounfar, Reza Dinc, Gonul Horasan Horimoto, Andrea R. V. R. Hormiga, Claudia M. Horta, Bernardo L. Houti, Leila Howitt, Christina and Htay, Thein Thein Htet, Aung Soe Htike, Maung Maung Than and Hu, Yonghua Huerta, Jose Maria Huhtaniemi, Ilpo Tapani and Huiart, Laetitia Huisman, Martijn Husseini, Abdullatif S. and Huybrechts, Inge Hwalla, Nahla Iacoviello, Licia Iannone, Anna G. Ibrahim, Mohsen M. Wong, Norazizah Ibrahim Ikeda, Nayu Ikram, M. Arfan Iotova, Violeta Irazola, Vilma E. and Ishida, Takafumi Isiguzo, Godsent C. Islam, Muhammad Islam, Sheikh Mohammed Shariful Iwasaki, Masanori Jackson, Rod T. and Jacobs, Jeremy M. Jaddou, Hashem Y. Jafar, Tazeen James, Kenneth Jamrozik, Konrad Janszky, Imre Janus, Edward and Jarvelin, Marjo-Riitta Jasienska, Grazyna Jelakovic, Ana and Jelakovic, Bojan Jennings, Garry Jha, Anjani Kumar Jiang, Chao Qiang Jimenez, Ramon O. Joeckel, Karl-Heinz Joffres, Michel Johansson, Mattias Jokelainen, Jari J. Jonas, Jost B. and Jorgensen, Torben Joshi, Pradeep Joukar, Farahnaz and Jozwiak, Jacek Juolevi, Anne Jurak, Gregor Juresa, Vesna and Kaaks, Rudolf Kafatos, Anthony Kajantie, Eero O. and Kalmatayeva, Zhanna Kalpourtzi, Natasa Kalter-Leibovici, Ofra and Kampmann, Freja B. Kannan, Srinivasan Karaglani, Eva and Karhus, Line L. Karki, Khem B. Katibeh, Marzieh Katz, Joanne and Kauhanen, Jussi Kaur, Prabhdeep Kavousi, Maryam and Kazakbaeva, Gyulli M. Keil, Ulrich Boker, Lital Keinan and Keinanen-Kiukaanniemi, Sirkka Kelishadi, Roya Kemper, Han C. G. and Kengne, Andre P. Keramati, Maryam Kerimkulova, Alina and Kersting, Mathilde Key, Timothy Khader, Yousef Saleh and Khalili, Davood Khang, Young-Ho Khaw, Kay-Tee Kheiri, Bahareh Kheradmand, Motahareh Khosravi, Alireza and Kiechl-Kohlendorfer, Ursula Kiechl, Stefan Killewo, Japhet and Kim, Dong Wook Kim, Hyeon Chang Kim, Jeongseon Klakk, Heidi and Klimek, Magdalena Klumbiene, Jurate Knoflach, Michael and Kolle, Elin Kolsteren, Patrick Kontto, Jukka P. Korpelainen, Raija Korrovits, Paul Kos, Jelena Koskinen, Seppo Kouda, Katsuyasu Kowlessur, Sudhir Koziel, Slawomir Kratenova, Jana and Kriaucioniene, Vilma Kristensen, Peter Lund Krokstad, Steiner Kromhout, Daan Kruger, Herculina S. Kubinova, Ruzena and Kuciene, Renata Kujala, Urho M. Kulaga, Zbigniew Kumar, R. Krishna Kurjata, Pawel Kusuma, Yadlapalli S. Kutsenko, Vladimir Kuulasmaa, Kari Kyobutungi, Catherine Laatikainen, Tiina Lachat, Carl Laid, Youcef Lam, Tai Hing Landrove, Orlando Lanska, Vera Lappas, Georg Larijani, Bagher and Latt, Tint Swe Laxmaiah, Avula Le Coroller, Gwenaelle Khanh Le Nguyen Bao Le, Tuyen D. Lee, Jeannette Lee, Jeonghee and Lehmann, Nils Lehtimaki, Terho Lemogoum, Daniel Levitt, Naomi S. Li, Yanping Lilly, Christa L. Lim, Wei-Yen and Lima-Costa, M. Fernanda Lin, Hsien-Ho Lin, Xu Lin, Yi-Ting and Lind, Lars Lingam, Vijaya Linneberg, Allan Lissner, Lauren Litwin, Mieczyslaw Lo, Wei-Cheng Loit, Helle-Mai and Lopez-Garcia, Esther Lopez, Tania Lotufo, Paulo A. Lozano, Jose Eugenio Lovrencic, Iva Lukacevic Lukrafka, Janice L. and Luksiene, Dalia Lundqvist, Annamari Lundqvist, Robert Lunet, Nuno Lustigova, Michala Luszczki, Edyta Ma, Guansheng and Ma, Jun Machado-Coelho, George L. L. Machado-Rodrigues, Aristides M. Macia, Enguerran Macieira, Luisa M. Madar, Ahmed A. Maggi, Stefania Magliano, Dianna J. Magriplis, Emmanuella Mahasampath, Gowri Maire, Bernard Majer, Marjeta and Makdisse, Marcia Malekzadeh, Fatemeh Malekzadeh, Reza and Malhotra, Rahul Mallikharjuna, Kodavanti Malyutina, Sofia K. and Maniego, Lynell V. Manios, Yannis Mann, Jim I. and Mansour-Ghanaei, Fariborz Manzato, Enzo Marcil, Anie and Margozzini, Paula Marild, Staffan B. Glavic, Mihalea Marinovic and Marques-Vidal, Pedro Marques, Larissa Pruner Marrugat, Jaume and Martorell, Reynaldo Mascarenhas, Luis P. Matasin, Marija and Mathiesen, Ellisiv B. Mathur, Prashant Matijasevich, Alicia and Matlosz, Piotr Matsha, Tandi E. Mavrogianni, Christina and Mbanya, Jean Claude N. Mc Donald Posso, Anselmo J. McFarlane, Shelly R. McGarvey, Stephen T. McLachlan, Stela McLean, Rachael M. McLean, Scott B. McNulty, Breige A. Benchekor, Sounnia Mediene Medzioniene, Jurate Mehdipour, Parinaz and Mehlig, Kirsten Mehrparvar, Amir Houshang Meirhaeghe, Aline and Meisinger, Christa Mendoza Montano, Carlos Menezes, Ana Maria B. and Menon, Geetha R. Mereke, Alibek Meshram, Indrapal I. and Metspalu, Andres Meyer, Haakon E. Mi, Jie Michels, Nathalie and Mikkel, Kairit Milkowska, Karolina Miller, Jody C. and Minderico, Claudia S. Mini, G. K. Miranda, J. Jaime and Mirjalili, Mohammad Reza Mirrakhimov, Erkin Misigoj-Durakovic, Marjeta Modesti, Pietro A. Moghaddam, Sahar Saeedi Mohajer, Bahram Mohamed, Mostafa K. Mohamed, Shukri F. Mohammad, Kazem Mohammadi, Mohammad Reza Mohammadi, Zahra and Mohammadifard, Noushin Mohammadpourhodki, Reza Mohan, Viswanathan Mohanna, Salim Yusoff, Muhammad Fadhli Mohd and Mohebbi, Iraj Mohebi, Farnam Moitry, Marie Mollehave, Line T. Molnar, Denes Momenan, Amirabbas Mondo, Charles K. and Monterrubio-Flores, Eric Monyeki, Kotsedi Daniel K. Moon, Jin Soo Moosazadeh, Mahmood Moreira, Leila B. Morejon, Alain and Moreno, Luis A. Morgan, Karen Moschonis, George Mossakowska, Malgorzata Mostafa, Aya Mostafavi, Seyed-Ali Mota, Jorge and Motlagh, Mohammad Esmaeel Motta, Jorge Andre Moura-dos-Santos, Marcos Mridha, Malay K. Msyamboza, Kelias P. Mu, Thet Thet and Muhihi, Alfa J. Muiesan, Maria L. Muller-Nurasyid, Martina and Murphy, Neil Mursu, Jaakko Musa, Kamarul Imran and Milanovic, Sanja Music Musil, Vera Mustafa, Norlaila and Nabipour, Iraj Naderimagham, Shohreh Nagel, Gabriele Naidu, Balkish M. Najafi, Farid Nakamura, Harunobu Namesna, Jana and Nang, Ei Ei K. Nangia, Vinay B. Narake, Sameer Ndiaye, Ndeye Coumba Neal, William A. Nejatizadeh, Azim Nenko, Ilona and Neovius, Martin Neuhauser, Hannelore K. Nguyen, Chung T. and Nguyen, Nguyen D. Nguyen, Quang V. Quang Ngoc Nguyen and Nieto-Martinez, Ramfis E. Niiranen, Teemu J. Nikitin, Yury P. and Ninomiya, Toshiharu Nishtar, Sania Njelekela, Marina A. and Noale, Marianna Noboa, Oscar A. Noorbala, Ahmad Ali Norat, Teresa Nordendahl, Maria Nordestgaard, Borge G. Noto, Davide and Nowak-Szczepanska, Natalia Al Nsour, Mohannad Nunes, Baltazar O'Neill, Terence W. O'Reilly, Dermot Ochimana, Caleb Oda, Eiji Odili, Augustine N. Oh, Kyungwon Ohara, Kumiko Ohtsuka, Ryutaro Olie, Valerie Olinto, Maria Teresa A. Oliveira, Isabel O. Omar, Mohd Azahadi Onat, Altan and Ong, Sok King Ono, Lariane M. Ordunez, Pedro Ornelas, Rui and Ortiz, Pedro J. Osmond, Clive Ostojic, Sergej M. and Ostovar, Afshin Otero, Johanna A. Overvad, Kim Owusu-Dabo, Ellis Paccaud, Fred Michel Padez, Cristina Pahomova, Elena and de Paiva, Karina Mary Pajak, Andrzej Palli, Domenico and Palmieri, Luigi Pan, Wen-Harn Panda-Jonas, Songhomitra and Panza, Francesco Paoli, Mariela Papandreou, Dimitrios Park, Soon-Woo Park, Suyeon Parnell, Winsome R. Parsaeian, Mahboubeh Pasquet, Patrick Patel, Nikhil D. Pavlyshyn, Halyna Pecin, Ivan Pednekar, Mangesh S. Pedro, Joao M. and Peer, Nasheeta Peixoto, Sergio Viana Peltonen, Markku and Pereira, Alexandre C. Peres, Karen G. D. A. Peres, Marco A. and Peters, Annette Petkeviciene, Janina Peykari, Niloofar Son Thai Pham Pichardo, Rafael N. Pigeot, Iris Pikhart, Hynek and Pilav, Aida Pilotto, Lorenza Pitakaka, Freda Piwonska, Aleksandra Pizarro, Andreia N. Plans-Rubio, Pedro Polasek, Ozren Porta, Miquel Poudyal, Anil Pourfarzi, Farhad and Pourshams, Akram Poustchi, Hossein Pradeepa, Rajendra Price, Alison J. Price, Jacqueline F. Providencia, Rui Puhakka, Soile E. Puiu, Maria Punab, Margus Qasrawi, Radwan F. and Qorbani, Mostafa Queiroz, Daniel Tran Quoc Bao Radic, Ivana and Radisauskas, Ricardas Rahimikazerooni, Salar Rahman, Mahfuzar Raitakari, Olli Raj, Manu Rakhimova, Ellina M. and Rao, Sudha Ramachandra Ramachandran, Ambady Ramos, Elisabete and Rampal, Lekhraj Rampal, Sanjay Rangel Reina, Daniel A. and Rarra, Vayia Rech, Cassiano Ricardo Redon, Josep Reganit, Paul Ferdinand M. Regecova, Valeria Revilla, Luis and Rezaianzadeh, Abbas Ribeiro, Robespierre Riboli, Elio and Richter, Adrian Rigo, Fernando de Wit, Tobias F. Rinke and Ritti-Dias, Raphael M. Robitaille, Cynthia Rodriguez-Artalejo, Fernando del Cristo Rodriguez-Perez, Maria Rodriguez-Villamizar, Laura A. Roggenbuck, Ulla Rojas-Martinez, Rosalba Romaguera, Dora Romeo, Elisabetta L. Rosengren, Annika Roy, Joel G. R. and Rubinstein, Adolfo Ruidavets, Jean-Bernard Sandra Ruiz-Betancourt, Blanca Ruiz-Castell, Maria Rusakova, Iuliia A. and Russo, Paola Rutkowski, Marcin Sabanayagam, Charumathi and Sabbaghi, Hamideh Sachdev, Harshpal S. Sadjadi, Alireza and Safarpour, Ali Reza Safi, Sare Safiri, Saeid Saidi, Olfa and Sakarya, Sibel Saki, Nader Salanave, Benoit Salazar Martinez, Eduardo Salmeron, Diego Salomaa, Veikko Salonen, Jukka T. Salvetti, Massimo Sanchez-Abanto, Jose Sans, Susana and Santos, Diana A. Santos, Ina S. Santos, Lelita C. and Santos, Maria Paula Santos, Rute Saramies, Jouko L. and Sardinha, Luis B. Sarganas, Giselle Sarrafzadegan, Nizal and Sathish, Thirunavukkarasu Saum, Kai-Uwe Savva, Savvas and Sawada, Norie Sbaraini, Mariana Scazufca, Marcia Schaan, Beatriz D. Schargrodsky, Herman Schipf, Sabine Schmidt, Carsten O. Schnohr, Peter Schoettker, Ben Schramm, Sara and Schultsz, Constance Schutte, Aletta E. Sebert, Sylvain Sein, Aye Aye Sen, Abhijit Senbanjo, Idowu O. Sepanlou, Sadaf G. and Servais, Jennifer Shalnova, Svetlana A. Shamah-Levy, Teresa and Shamshirgaran, Morteza Shanthirani, Coimbatore Subramaniam and Sharafkhah, Maryam Sharma, Sanjib K. Shaw, Jonathan E. and Shayanrad, Amaneh Shayesteh, Ali Akbar Shi, Zumin Shibuya, Kenji Shimizu-Furusawa, Hana Shin, Dong Wook Shirani, Majid and Shiri, Rahman Shrestha, Namuna Si-Ramlee, Khairil Siani, Alfonso Siantar, Rosalynn Sibai, Abla M. de Moura Silva, Caroline Ramos Santos Silva, Diego Augusto Simon, Mary and Simons, Judith Simons, Leon A. Sjostrom, Michael and Slowikowska-Hilczer, Jolanta Slusarczyk, Przemyslaw Smeeth, Liam and So, Hung-Kwan Soares, Fernanda Cunha Sobngwi, Eugene and Soderberg, Stefan Soemantri, Agustinus Sofat, Reecha and Solfrizzi, Vincenzo Somi, Mohammad Hossein Sonestedt, Emily and Song, Yi Sorensen, Thorkild I. A. Sorgjerd, Elin P. Soric, Maroje Jerome, Charles Sossa Soumare, Aicha Sparboe-Nilsen, Bente Sparrenberger, Karen Staessen, Jan A. Starc, Gregor and Stavreski, Bill Steene-Johannessen, Jostein Stehle, Peter and Stein, Aryeh D. Stergiou, George S. Stessman, Jochanan and Stieber, Jutta Stoeckl, Doris Stocks, Tanja Stokwiszewski, Jakub Stronks, Karien Strufaldi, Maria Wany Suka, Machi and Sun, Chien-An Sundstrom, Johan Sung, Yn-Tz Suriyawongpaisal, Paibul Sy, Rody G. Syddall, Holly E. Sylva, Rene Charles and Szklo, Moyses Tai, E. Shyong Tammesoo, Mari-Liis Tamosiunas, Abdonas Tan, Eng Joo Tang, Xun Tanser, Frank Tao, Yong and Tarawneh, Mohammed Rasoul Tarqui-Mamani, Carolina B. Taylor, Anne Taylor, Julie Tebar, William R. Tell, Grethe S. and Tello, Tania Tham, Yih Chung Thankappan, K. R. Theobald, Holger Theodoridis, Xenophon Thijs, Lutgarde Thinggaard, Mikael Thomas, Nihal Thorand, Barbara Thuesen, Betina H. and Timmermans, Erik J. Tjandrarini, Dwi H. Tjonneland, Anne and Toft, Ulla Tolonen, Hanna K. Tolstrup, Janne S. Topbas, Murat Topor-Madry, Roman Jose Tormo, Maria Tornaritis, Michael J. Torrent, Maties Torres-Collado, Laura Touloumi, Giota Traissac, Pierre Triantafyllou, Areti Trichopoulos, Dimitrios Trichopoulou, Antonia Trinh, Oanh T. H. Trivedi, Atul Tshepo, Lechaba Tsugane, Shoichiro Tuliakova, Azaliia M. Tulloch-Reid, Marshall K. Tullu, Fikru Tuomainen, Tomi-Pekka Tuomilehto, Jaakko Turley, Maria L. Twig, Gilad and Tynelius, Per Tzourio, Christophe Ueda, Peter Ugel, Eunice Ulmer, Hanno Uusitalo, Hannu M. T. Valdivia, Gonzalo and Valvi, Damaskini van Dam, Rob M. van den Born, Bert-Jan and Van der Heyden, Johan van der Schouw, Yvonne T. Van Herck, Koen and Hoang Van Minh Van Schoor, Natasja M. van Valkengoed, Irene G. M. van Zutphen, Elisabeth M. Vanderschueren, Dirk and Vanuzzo, Diego Varbo, Anette Vasan, Senthil K. Vega, Tomas and Veidebaum, Toomas Velasquez-Melendez, Gustavo Veronesi, Giovanni Verschuren, W. M. Monique Verstraeten, Roosmarijn and Victora, Cesar G. Viet, Lucie Villalpando, Salvador Vineis, Paolo Vioque, Jesus Virtanen, Jyrki K. Visvikis-Siest, Sophie Viswanathan, Bharathi Vlasoff, Tiina Vollenweider, Peter Voutilainen, Ari Wade, Alisha N. Walton, Janette and Wambiya, Elvis O. A. Bebakar, Wan Mohamad Wan Mohamud, Wan Nazaimoon Wan Wanderley Junior, Rildo de Souza Wang, Ming-Dong and Wang, Ningli Wang, Qian Wang, Xiangjun Wang, Ya Xing and Wang, Ying-Wei Wannamethee, S. Goya Wareham, Nicholas Wei, Wenbin Weres, Aneta Werner, Bo Whincup, Peter H. and Widhalm, Kurt Widyahening, Indah S. Wiecek, Andrzej Wilks, Rainford J. Willeit, Johann Willeit, Peter Williams, Emmanuel A. Wilsgaard, Tom Wojtyniak, Bogdan Wong-McClure, Roy A. Wong, Andrew Wong, Tien Yin Woo, Jean Woodward, Mark Wu, Frederick C. Wu, Shouling Wyszynska, Justyna and Xu, Haiquan Xu, Liang Yaacob, Nor Azwany Yan, Weili and Yang, Ling Yang, Xiaoguang Yang, Yang Yasuharu, Tabara and Ye, Xingwang Yiallouros, Panayiotis K. Yoosefi, Moein and Yoshihara, Akihiro You, San-Lin Younger-Coleman, Novie O. and Yusoff, Ahmad Faudzi Zainuddin, Ahmad A. Zakavi, Seyed Rasoul and Zamani, Farhad Zambon, Sabina Zampelas, Antonis Elisa Zapata, Maria Zaw, Ko Ko Zdrojewski, Tomasz Zejglicova, Kristyna Vrkic, Tajana Zeljkovic Zeng, Yi Zhang, Luxia and Zhang, Zhen-Yu Zhao, Dong Zhao, Ming-Hui Zhen, Shiqi and Zheng, Yingfeng Zholdin, Bekbolat Zhu, Dan Zins, Marie and Zitt, Emanuel Zocalo, Yanina Zoghlami, Nada Zuniga Cisneros, Julio NCD Risk Factor Collaboration
Abstract: Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier.
Published: 2021

31. Childhood abuse and its association with adults’ mental health problems: A cross-sectional study among men and women in the Yangon Region of Myanmar

Author: Lars Lien, Espen Bjertness, Win Thuzar Aye, and Hein Stigum
Subjects: Adult, Male, medicine.medical_specialty, Cross-sectional study, Myanmar, Stress Disorders, Post-Traumatic, Mental distress, Epidemiology, Prevalence, Humans, Medicine, Child Abuse, Child, Psychological abuse, Psychiatry, Aged, business.industry, Public health, General Medicine, Mental health, Cross-Sectional Studies, Mental Health, Physical abuse, Sexual abuse, epidemiology, Female, Public Health, adult psychiatry, business
Abstract: ObjectivesTo estimate the prevalence of emotional, physical and sexual childhood abuse, and symptoms of post-traumatic stress disorder (PTSD) and to examine the association between childhood abuse and adult mental health problems, including mental distress and PTSD symptoms.DesignA community-based cross-sectional study was conducted. Childhood abuse was assessed with the NorVold Abuse Questionnaire, and mental distress and symptoms of PTSD were measured using the Hopkins Symptom Checklist 10 and the Impact of Event Scale—Revised, respectively. The Wald test and multiple linear regression analysis were applied for testing differences between proportions and the association between childhood abuse and adult mental health outcomes, respectively.SettingUrban and rural areas of the Yangon Region, Myanmar.ParticipantsA total of 2377 men and women aged 18–49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded.ResultsOverall, 21.1% (95% CI 18.8 to 23.6) reported any form of childhood abuse, 10.4% (95% CI 8.9 to 12.4) physical abuse, 10.4% (95% CI 8.8 to 12.2) emotional abuse and 7.3% (95% CI 5.7 to 9.3) sexual abuse. Childhood abuse was more common in women (29.8%) than in men (12.4%). The prevalence of PTSD symptoms in the total sample was 6.6%. After adjusting for confounding variables, positive associations were found between childhood abuse with adult mental distress and PTSD symptoms among women and older men.ConclusionsChildhood abuse is prevalent among both men and women in the Yangon Region of Myanmar and associated with adult mental health problems. Approximately 7% of people report PTSD symptoms. It should prompt local health professionals and policy makers to establish prevention programmes to eliminate violence against children and to organise services for victims of childhood abuse. Care should be taken in generalising findings for less populated areas.
Published: 2021

32. Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Zahra Mohammadi, Abdul Basit, Helena I. S. Nogueira, Soile E. Puhakka, Hongsheng Bi, Ari Voutilainen, Davood Khalili, Bin Zhou, Dermot O'Reilly, Natascia Rinaldo, Paulo A. Lotufo, Bahareh Kheiri, Thein Thein Htay, Simona Giampaoli, Goodarz Danaei, M. Fernanda Lima-Costa, Simona Bo, Peter Schnohr, Jerzy Chudek, Francesco Panza, Ling Yang, Katia Vergetti Bloch, Vincenzo Capuano, Holly E. Syddall, Dong Zhao, Indah Suci Widyahening, Maria Lorenza Muiesan, Leng Huat Foo, Mohsen Azimi-Nezhad, Merete Osler, Laura Torres-Collado, Manu Raj, Adroaldo Cesar Araujo Gaya, Susi Kriemler, Ali Akbar Shayesteh, Aneta Grajda, Anette Varbo, Kazem Mohammad, Leila Beltrami Moreira, Shu Ti Chiou, Iuliia A Rusakova, Jyh Eiin Wong, Torben Jørgensen, Lela Sturua, Lubica Ticha, Hamid Hakimi, Hazzaa M. Al-Hazzaa, Yanina Zócalo, Freda Pitakaka, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Marie Kunešová, Johanna M. Geleijnse, Elysée Claude Bika Lele, Yannis Manios, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Sibel Gogen, Viviane Cunha Cardoso, Kristine H. Allin, Ana Azevedo, Line Tang Møllehave, Vincent Jr DeGennaro, Novie O. Younger-Coleman, Gretchen A Stevens, Dickman Gareta, Holger Theobald, Anja Schienkiewitz, Bekbolat Zholdin, Janice Luisa Lukrafka, Adela Chirita-Emandi, Ulla Roggenbuck, Kenisha Russell Jonsson, Robespierre Ribeiro, Gabriele Eiben, Eero Kajantie, Sounnia Mediene Benchekor, Fariborz Mansour-Ghanaei, Mary Simon, Prakash C. Gupta, Mohammad Esmaeel Motlagh, Emanuela Gualdi-Russo, María Elena Díaz-Sánchez, Pilar Guallar-Castillón, Bee Koon Poh, Cristina Padez, Azaliia M Tuliakova, Sarah P. Garnett, William R. Tebar, Yingfeng Zheng, Suhad Bahijri, Christina Mavrogianni, Mihaela Vladulescu, Jan A. Staessen, Paula Duarte de Oliveira, Rui Ornelas, Michael Sjöström, Charles Agyemang, Slawomir Koziel, Shohreh Naderimagham, Jari Jokelainen, Stephen T. McGarvey, Patrick Pasquet, Farnam Mohebi, Nader Saki, Aida Pilav, Azim Nejatizadeh, Marianna Noale, Habiba Ben Romdhane, Luís B. Sardinha, Laura Lauria, Jun Hata, Kodanda R Kanala, Gert B. M. Mensink, Nils Lehmann, Elio Riboli, Carolina Tarqui-Mamani, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Luis Serra-Majem, Martina Müller-Nurasyid, Felipe Vogt Cureau, Lekhraj Rampal, Zhamilya Battakova, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Fikru Tullu, Aung Soe Htet, Angel R. Gonzalez, Annette J. Dobson, Kavumpurathu Raman Thankappan, Hélène Delisle, Francisco J. Félix-Redondo, Ramón Suárez-Medina, Annika Rosengren, Sania Nishtar, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Maria Cecília Formoso Assunção, Kazi M. Jamil, Stefano Marventano, Wenbin Wei, Norsyamlina Che Abdul Rahim, Shukri F. Mohamed, Bente Sparboe-Nilsen, Soon-Woo Park, Ana Isabel Rito, David Goltzman, W. M. 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Capanzana, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Jonathan Giovannelli, Stela McLachlan, Ellis Owusu-Dabo, Stefania Toselli, Maria Teresa Anselmo Olinto, Senthil K Vasan, Sara Schramm, Xenophon Theodoridis, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Dongfeng Gu, Tomas Vega, Hynek Pikhart, Päivi Mäki, Heba Fouad, Vilnis Dzerve, Christina Howitt, Seyed Mohammad Hashemi-Shahri, Jenny M. Kindblom, Marjolijn C. E. Bragt, G. K. Mini, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Vilmundur Gudnason, Loreto Santa Marina, Kairat Davletov, Afshin Ostovar, Niloofar Peykari, Nicholas J. Wareham, Wilma M. Hopman, Karl-Heinz Jöckel, Jussi Kauhanen, Breige A. McNulty, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Stefan Kiechl, Alicia Matijasevich, Boban Mugoša, Srinivasan Kannan, Jyrki K. Virtanen, Mohan Deepa, Mangesh S. Pednekar, Shahla AlDhukair, Cynthia M. Pérez, Vera Lanska, Tint Swe Latt, Dominique Hange, João Luiz Bastos, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Maya Tanrygulyyeva, Reza Malekzadeh, Dimitrios Poulimeneas, Pedro Ordunez, Thomas Waldhör, Ioannis Pagkalos, Carlo M. Barbagallo, Abla M. Sibai, Peter Vollenweider, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Santosh K. Bhargava, Patrick Kolsteren, Aya Mostafa, Fangfang Chen, Flavio Nervi, Imre Janszky, Arvind Pandey, Renata Cifkova, Alexandre C. Pereira, Alejandro Diaz, Alireza Ansari-Moghaddam, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Rusidah Selamat, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paul Korrovits, Paola Nardone, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Alberto Barceló, Camilla T. Damsgaard, Constance Schultsz, Frank J Rühli, Santiago F. Gomez, Tara Coppinger, Muhammad Islam, Pierre Traissac, Eleonora d'Orsi, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Daniela Pierannunzio, Cristina Taddei, Wen-Harn Pan, Gregor Starc, Abdullah Alkandari, Saeed Dastgiri, Lien Braeckevelt, Gustavo Velasquez-Melendez, Sudhir Kowlessur, Bagher Larijani, Cynthia Robitaille, Mohamed M. Ali, Steiner Krokstad, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Abhijit Sen, Sergej M. Ostojic, Silvana Donoso, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Hanan F. Abdul Rahim, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Bethlehem D. Solomon, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Miquel Porta, Vesna Jureša, Alexander D. Deev, Son Thai Pham, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, David Faeh, Antonio Bernabe-Ortiz, Giota Touloumi, Maryam Kavousi, Sanja Musić Milanović, Jalila El Ati, Sauli Herrala, Liang Xu, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Yi Song, Jianfeng Wu, Jeannette Klimont, Jean Ferrières, Farhad Zamani, Shina Avi, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Reecha Sofat, Koen Van Herck, Hoang Van Minh, Enrique Gutiérrez-González, Martine Vrijheid, Susana Cararo Confortin, Antonis Zampelas, Bogdan Wojtyniak, Ausra Petrauskiene, Juha Auvinen, Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Young-Ho Khang, Ellina Rakhimova, Magdalena Klimek, Luís Lopes, Erkin M. Mirrakhimov, Maria Lc Iurilli, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Rainford J. Wilks, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Li Juan Wu, Adrian Richter, Licia Iacoviello, Hanno Ulmer, Deepak Amarapurkar, Mohsen Ibrahim, Hamed Pouraram, Massimo Salvetti, Hung-Kwan So, Yonghua Hu, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Sabina Zambon, Angelika Schaffrath Rosario, Lauren Lissner, Kamarul Imran Musa, Deepa Weerasekera, Bihungum Bista, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Irene G. M. van Valkengoed, Anna Fijałkowska, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Nasheeta Peer, Radka Taxová Braunerová, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Eliza Cinteza, Ha Tp Do, and Alison J. Hayes
Subjects: education.field_of_study, business.industry, Population, Distribution (economics), medicine.disease, Obesity, Geography, medicine, Underweight, medicine.symptom, education, business, Body mass index, Demography
Published: 2020
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33. Domestic violence victimisation and its association with mental distress: a cross-sectional study of the Yangon Region, Myanmar

Author: Hein Stigum, Lars Lien, Win Thuzar Aye, Berit Schei, Espen Bjertness, and Johanne Sundby
Subjects: Adult, Male, Domestic Violence, medicine.medical_specialty, Adolescent, Cross-sectional study, Poison control, sexual and gender disorders, Myanmar, Victimisation, Young Adult, Mental distress, Prevalence, Humans, Medicine, Crime Victims, Sexual violence, business.industry, Public health, Bullying, General Medicine, Middle Aged, Mental health, Cross-Sectional Studies, Domestic violence, epidemiology, Female, Public Health, adult psychiatry, business, Demography
Abstract: ObjectivesTo estimate the prevalence of domestic violence, with subgroups of physical, sexual and emotional violence, among men and women and to assess the association between any lifetime domestic violence (DV) and mental distress among ever-married men and women.DesignWe conducted a cross-sectional study from October to November 2016 using a multistage sampling design. DV questionnaire was adopted from the Demographic and Health Survey programme. Mental distress was estimated using the Hopkins Symptom Checklist-10 (HSCL-10). HSCL-score and DV were the outcome and exposure variables, respectively, in multiple linear regression. Prevalence estimates and associations were presented with a 95% CI and the Wald test.SettingUrban and rural areas of the Yangon region, Myanmar.ParticipantsMen and women ages 18 to 49 years were included. Institutionalised people, monks, nuns and individuals deemed too ill physically and/or mentally to participate were excluded.ResultsA random sample of 2383 people was included in the analyses. Among ever-married participants, lifetime (LT) and past-12-month (12M) prevalence of any domestic violence victimisation was higher in women compared with men: LT women: 61.8% (95% CI: 54.3 to 68.9) versus LT men: 42.4% (95% CI: 37.5 to 47.5) and 12M women: 51.2% (95% CI: 44.9 to 57.5) versus 12M men: 37.7% (95% CI: 32.9 to 42.7). Among never-married participants, lifetime physical and sexual violence victimisation rates was higher in men (34.3% and 7.9%) compared with women (19.1% and 6.4%). Mental distress was significantly associated with lifetime DV in women who were afraid of their husbands and men who had wives who exhibited controlling behaviours.ConclusionsDomestic violence is prevalent among both men and women and is associated with mental distress. The findings highlight an urgent need to prevent domestic violence in both sexes, including through legal and policy reform and improved mental health services for DV victims.
Published: 2020

34. The Loss in Expectation of Life due to Early-Onset Mild Cognitive Impairment and Early-Onset Dementia in Norway

Author: Anne-Brita Knapskog, Knut Engedal, Geir Selbæk, Espen Bjertness, Bjørn Heine Strand, Trine Holt Edwin, and Karin Persson
Subjects: Male, Pediatrics, medicine.medical_specialty, Cognitive Neuroscience, Population, Late onset, Norwegian, 03 medical and health sciences, Life Expectancy, 0302 clinical medicine, mental disorders, Humans, Medicine, Dementia, Cognitive Dysfunction, Age of Onset, education, Survival analysis, Aged, Aged, 80 and over, education.field_of_study, 030214 geriatrics, Life length, Norway, business.industry, Middle Aged, medicine.disease, Survival Analysis, language.human_language, Psychiatry and Mental health, Disease Progression, language, Life expectancy, Population study, Female, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: Introduction: Whether patients with early-onset dementia have poorer or improved survival compared with those with a late onset largely depends on the survival measure. Survival estimates for early-onset mild cognitive impairment (MCI) diagnosis are particularly scarce. We aimed to estimate life expectancy (LE) in patients with early-onset dementia or early MCI, and loss in expectation of life (LEL) for these groups. Comparisons were made with the general Norwegian population and a subgroup of patients with late-onset dementia. Methods: Early onset was defined as receiving a diagnosis of MCI or dementia before age 65 years. LE and LEL were predicted using flexible parametric survival models. Our study population was comprised of newly diagnosed (incident) cases (n = 4,906), aged 50–90 years at the time of diagnosis (672 were diagnosed before age 65 years, of which 291 were diagnosed with dementia), in the Norwegian register of persons assessed for cognitive symptoms (NorCog) between 2009 and 2017, and patients were followed up for mortality or censorship until January 2018. Results: Among the early-onset patients, 8 and 23% died during follow-up, in the MCI and dementia groups, respectively. Both early-onset MCI and especially early-onset dementia were associated with lower LE than in the general Norwegian population; LE for 60-year-old women in 2016 was 26 years in the general population, 20 years in MCI patients, and 7 years in dementia patients. The corresponding LE at 80 years was 10, 6, and 5 years. Thus, LEL were particularly pronounced for patients with early dementia. The diagnosis-specific LE pattern in men was similar to that in women. Discussion: Early-onset MCI was associated with substantial life years lost (5–6 years), but the loss was particularly pronounced for those with early-onset dementia, reducing the expected life length by 2 decades.
Published: 2019
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35. Shift work and job satisfaction among Palestinian nurses: a cross-sectional study

Author: Yousef Jaradat, Rita Bast-Pettersen, and Espen Bjertness
Subjects: General Medicine
Published: 2022
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36. Dynamics of contraceptive use among married women in North and South Yangon, Myanmar: findings from a cross-sectional household survey

Author: Espen Bjertness, Thein Thein Htay, Hein Stigum, Myint Myint Wai, Aye Nyein Moe Myint, Tippawan Liabsuetrakul, and Johanne Sundby
Subjects: business.industry, Periurban women, Older age, lcsh:Public aspects of medicine, Obstetrics and Gynecology, lcsh:RA1-1270, Logistic regression, Parity five, lcsh:Gynecology and obstetrics, Confidence interval, Article, Contraceptive use, Household survey, Duration, Reproductive Medicine, Age groups, Medicine, Parity (mathematics), business, High parity, lcsh:RG1-991, Demography
Abstract: Objective The objective was to explore the sociodemographic factors associated with contraceptive use, the variation in prevalence and duration of contraceptive use across the age groups and parity among 18-49-year-old married women in North and South Yangon. Study design We conducted a cross-sectional study regarding contraceptive use among married women aged 18-49 in North and South Yangon from September to November 2016. We used a questionnaire based on the Demographic and Health Surveys Program, with additional questions on the duration of contraception along the life-course. Associations between contraceptive prevalence and sociodemographic factors were tested by χ 2. We describe the percentages of contraceptive use and nonuse across the age and parity subgroups, and the mean duration of contraception. We compared the contraceptive prevalence ratios across the parity using logistic regression. Results The contraceptive prevalence of modern methods was 66% (95% confidence interval: 61.5%-69.9%) with better coverage in rural (69.6%) than in urban women (61.5%). Contraceptive use varied by age and parity, demonstrating lower prevalence in the oldest age group (45-49) and high parity (parity five and above). The mean duration of contraceptive use rose with increased age and parity, except in the oldest-age and high-parity groups. Conclusions The findings called for greater attention to improve the contraceptive coverage of married women living in urban areas around Yangon city (periurban women). Implications The study identified the pockets of low contraceptive coverage in a region with the highest contraceptive prevalence in Myanmar. Women above the age of 40 and women who had high parity had low contraceptive prevalence. Women living near the city showed lower contraceptive coverage compared to their rural counterparts.
Published: 2020

37. Association of anthropometry and weight change with risk of dementia and its major subtypes: A meta-analysis consisting 2.8 million adults with 57 294 cases of dementia

Author: Tomoyuki Ohara, Sudha Seshadri, John Gregson, Alexa S. Beiser, Willem A. van Gool, Teemu Palviainen, Bjørn Heine Strand, Robert Clarke, Anne Lee, Linda B. Hassing, Jaakko Kaprio, Mika Kivimäki, Emanuele Di Angelantonio, G. David Batty, Mary N. Haan, Steven Bell, Eero Vuoksimaa, Catherine Féart, Jean-François Dartigues, Kristine Yaffe, Stéphanie Debette, Crystal Man Ying Lee, Erin S. LeBlanc, Eric P. Moll van Charante, Espen Bjertness, Eric B. Larson, Kendra Davis-Plourde, Mark Woodward, Li Yung Lui, Marieke P. Hoevenaar-Blom, Karine Pérès, Toshiharu Ninomiya, Edo Richard, Georgios Lappas, Annika Rosengren, Rachel R. Huxley, Claudine Berr, Liv Tybjærg Nordestgaard, Archana Singh-Manoux, Nawab Qizilbash, Ruth Peters, Toshiaki Ohkuma, Martin J. Shipley, Kathleen M. Hayden, Ruth Frikke-Schmidt, John Chalmers, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Molecular Medicine Finland, Department of Public Health, University of Helsinki, Genetic Epidemiology, Cognitive and Brain Aging, HUS Helsinki and Uusimaa Hospital District, Lee, Crystal ManYing [0000-0001-6613-5491], and Apollo - University of Cambridge Repository
Subjects: Male, Aging, Endocrinology, Diabetes and Metabolism, Neurodegenerative, Cardiovascular, Weight Gain, Medical and Health Sciences, SEPIA, LEHA, Body Mass Index, 0302 clinical medicine, Weight loss, Risk Factors, 2.1 Biological and endogenous factors, Body Size, 030212 general & internal medicine, Aetiology, POPULATION, 2. Zero hunger, education.field_of_study, Anthropometry, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], 3. Good health, ALZHEIMERS-DISEASE, VINTAGE, Neurological, Female, medicine.symptom, Underweight, Waist Circumference, MIDLIFE, Adult, LATE-LIFE, Population, 030209 endocrinology & metabolism, Obesity Comorbidity, 03 medical and health sciences, Endocrinology & Metabolism, Rare Diseases, Thinness, Clinical Research, Vascular, Weight Loss, mental disorders, medicine, Acquired Cognitive Impairment, Dementia, Humans, Obesity, VASCULAR DEMENTIA, education, Vascular dementia, Nutrition, Aged, FUTURE RISK, business.industry, MORTALITY, Prevention, Dementia, Vascular, Weight change, Psychology and Cognitive Sciences, Body Weight, Public Health, Environmental and Occupational Health, Neurosciences, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), medicine.disease, Brain Disorders, BODY-MASS INDEX, 3121 General medicine, internal medicine and other clinical medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, FOLLOW-UP, business, Weight gain, Body mass index, Demography
Abstract: Contains fulltext : 218833.pdf (Publisher’s version ) (Open Access) Uncertainty exists regarding the relation of body size and weight change with dementia risk. As populations continue to age and the global obesity epidemic shows no sign of waning, reliable quantification of such associations is important. We examined the relationship of body mass index, waist circumference, and annual percent weight change with risk of dementia and its subtypes by pooling data from 19 prospective cohort studies and four clinical trials using meta-analysis. Compared with body mass index-defined lower-normal weight (18.5-22.4 kg/m(2) ), the risk of all-cause dementia was higher among underweight individuals but lower among those with upper-normal (22.5-24.9 kg/m(2) ) levels. Obesity was associated with higher risk in vascular dementia. Similarly, relative to the lowest fifth of waist circumference, those in the highest fifth had nonsignificant higher vascular dementia risk. Weight loss was associated with higher all-cause dementia risk relative to weight maintenance. Weight gain was weakly associated with higher vascular dementia risk. The relationship between body size, weight change, and dementia is complex and exhibits non-linear associations depending on dementia subtype under scrutiny. Weight loss was associated with an elevated risk most likely due to reverse causality and/or pathophysiological changes in the brain, although the latter remains speculative.
Published: 2020
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38. Trends in diabetes prevalence, awareness, treatment, control in Yangon, Myanmar between 2004-2014

Author: Aung Soe Htet, Hein Stigum, Wai Phyo Aung, Espen Bjertness, and Marte Karoline Råberg Kjøllesdal
Subjects: Plasma glucose, medicine.medical_specialty, Control treatment, Outcome variable, business.industry, Diabetes mellitus, Internal medicine, Linear regression, Public Health, Environmental and Occupational Health, medicine, Diabetes prevalence, medicine.disease, business
Abstract: Background In 2004, a survey in Yangon Region was conducted as the first STEP survey in Myanmar, which was repeated in 2014, assessing diabetes prevalence. Whether there have been any changes over time in the awareness, treatment and control status of diabetes is not known. The study aimed to assess changes in the prevalence, awareness, treatment and control of diabetes from 2004 to 2014, among adults in Yangon region. Methods The study was conducted in urban and rural areas of Yangon region, Myanmar, using two cross-sectional household based studies, in accordance with World Health Organization STEPS methodology. Men and women aged 25-74 years old participated in the studies (n = 4448 in 2004) and (n = 1372 in 2014). Logistic and linear regression were performed and outcome variables were diabetes and fasting plasma glucose. Results The overall age-standardized prevalence of diabetes were 8.3% (95% CI 6.5-10.6) in 2004 and 10.2% (7.6-13.6) in 2014 (p = 0.296). The diabetes prevalence increased from 2004 to 2014 only among participants aged ≥60 years, from 14.6% (11.7-18.1) to 31.9% (21.1-45.0) (p = 0.009). Awareness of having diabetes increased between 2004 and 2014 (44.3% (39.2, 49.6) to 69.4% (62.9-75.2)) (p < 0.001). Among participants who were aware of having diabetes, the proportion under treatment had increased between 2004 and 2014 from 55.1% (46.8-63.1) to 68.6% (61.5-74.8) (p = 0.015). There were no increase between 2004 and 2014 in the proportion of participants with controlled diabetes. After adjustments for age, sex and education, mean fasting plasma glucose levels in 2014 was 0.56 mmol/l (0.26-0.84) higher than in 2004. Conclusions The studies to monitor the development of diabetes prevalence in Myanmar are needed. Preventive measures to halt increases prevalence, to increase the detection rate of undiagnosed DM also treatment rate and to help people with diabetes to control their situation are needed. Key messages Mean plasma glucose levels were higher in 2014 than in 2004, but an increase in DM prevalence during this period was seen only among the oldest participants. The proportion of women being aware of having DM, as well as the proportion under treatment for most groups, had increased, however not the proportion under control.
Published: 2019
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39. Unmet Need for Family Planning among Urban and Rural Married Women in Yangon Region, Myanmar—a Cross-Sectional Study

Author: Hein Stigum, Tippawan Liabsuetrakul, Thein Thein Htay, Myint Myint Wai, Espen Bjertness, Aye Nyein Moe Myint, and Johanne Sundby
Subjects: Adult, Rural Population, Adolescent, Urban Population, Cross-sectional study, urban and rural women, Health, Toxicology and Mutagenesis, lcsh:Medicine, Myanmar, Sex Education, Abortion, Article, Odds, Unmet needs, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Humans, 030212 general & internal medicine, Contraception Behavior, Health Services Needs and Demand, 030219 obstetrics & reproductive medicine, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, satisfaction, demand, medicine.disease, Contraception, Cross-Sectional Studies, Family planning, Family Planning Services, contraceptives, Population study, Female, unmet need for family planning, Rural area, business, Demography
Abstract: Despite increasing contraceptive use and prevalence, many women who want to avoid or delay pregnancy are not using contraceptives. This results in unintended pregnancies, which increases the risk of unsafe abortions. This study aimed to explore the extent of the unmet need for family planning (FP) among urban and rural married women in Myanmar and their demand for and satisfaction with FP. A cross-sectional survey using adapted Demographic and Health surveys questions was conducted in south and north Yangon from September 2016 to November 2016. A total of 1100 currently married women of 18&ndash, 49 years participated. The contraceptive prevalence was 67.2% in total, 63% urban, and 70% rural. About 19.4% (95% CI: 16.7%&ndash, 22.4%) of the studied women had an unmet need for FP, significantly higher in urban than rural women (22.6% versus 16.6%). Rural women also showed significant lesser odds (adjusted OR: 0.63, 95% CI: 0.461&ndash, 0.849) of unmet need than the urban counterparts. About 86% of the women had demand for contraception and 77% of them satisfied their demand. The study population revealed a fairly good contraceptive coverage, however, a considerable proportion of women had an unmet need for FP, especially the urban women. The demand for contraception is increasing, and contraceptive services need to expand coverage to marginalized groups in order to reduce the risk of unsafe abortions.
Published: 2019

40. Trends in Diabetes Prevalence, Awareness, Treatment and Control in Yangon Region, Myanmar, Between 2004 and 2014, Two Cross-Sectional Studies

Author: Marte Karoline Råberg Kjøllesdal, Wai Phyo Aung, Aung Soe Htet, Hein Stigum, and Espen Bjertness
Subjects: Adult, Male, Health Knowledge, Attitudes, Practice, Cross-sectional study, Health, Toxicology and Mutagenesis, Who steps, prevalence, lcsh:Medicine, Yangon, 030209 endocrinology & metabolism, Myanmar, World health, Article, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Diabetes mellitus, Medicine, Humans, 030212 general & internal medicine, skin and connective tissue diseases, Aged, Plasma glucose, treatment, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, Diabetes prevalence, Awareness, Middle Aged, medicine.disease, Cross-Sectional Studies, diabetes mellitus, Female, sense organs, business, Stepwise approach, control
Abstract: Myanmar is currently facing the burden of non-communicable diseases due to changes in lifestyle and dietary patterns linked to socio-economic development. However, evidence is scarce about changes in the prevalence of diabetes mellitus (DM) over time. We aimed to investigate changes in the prevalence, awareness, treatment and control of DM from 2004 to 2014, among adults aged 25&ndash, 74 years, in the Yangon region. Two cross-sectional household-based studies, according to World Health Organization STEPwise approach to surveillance (WHO STEPS) methodology, were conducted in 2004 (n = 4448) and 2014 (n = 1372). The overall age-standardized prevalence of DM was 8.3% (95% CI 6.5&ndash, 10.6) in 2004 and 10.2% (7.6&ndash, 13.6) in 2014 (p = 0.296). The DM prevalence increased between the study years among elderly participants only, from 14.6% (11.7&ndash, 18.1) to 31.9% (21.1&ndash, 45.0) (p = 0.009). Awareness of having DM increased from 44.3% (39.2, 49.6) to 69.4% (62.9&ndash, 75.2) (p &lt, 0.001). Among participants who were aware of having DM, the proportion under treatment increased from 55.1% (46.8&ndash, 63.1) to 68.6% (61.5&ndash, 74.8) (p = 0.015). There was no change in proportion with controlled DM. Adjusted for age, sex and education, mean fasting plasma glucose levels in 2014 were 0.56 mmol/L (0.26&ndash, 0.84) higher than in 2004. Preventive measures to halt future increases in DM prevalence and to increase the detection of undiagnosed DM cases are needed.
Published: 2019

41. Associations between stressful working conditions and psychosomatic symptoms among Palestinian nurses: a cross-sectional survey

Author: Morten Birkeland Nielsen, Rita Bast-Pettersen, Espen Bjertness, and Yousef Jaradat
Subjects: Response rate (survey), medicine.medical_specialty, Cross-sectional study, business.industry, General Medicine, Norwegian, Affect (psychology), Mental health, Checklist, language.human_language, Informed consent, Family medicine, Epidemiology, language, medicine, business
Abstract: Background Stressful working conditions among nurses have adverse effects on their physical and mental health. We investigated associations between self-reported stressful working conditions and psychosomatic symptoms among nurses in the Hebron district, occupied Palestinian Territory, and whether there are differences the sexes in the perceptions of working conditions and psychosomatic symptoms. Methods We did a cross-sectional survey between Oct 7 and Dec 10, 2012, among registered nurses in all health sectors in Hebron district. A nine-point ordinal scale of working conditions was used to categorise perception of stress as low, medium, or high, and seven psychosomatic symptoms were recorded on a checklist coded as never (0), seldom (1), occasionally (2), or often (3), allowing for a total score between 0 and 21. All analyses were done with STATA (version 10). P values of less than 0·05 were significant. Participation in the study was voluntary, and written informed consent was obtained from each participant. The study was approved by the Regional Committee for Medical and Health Research Ethics, Norway. Permission to do the study was obtained from the Palestinian Ministry of Health. Findings Among 372 eligible nurses, ten were on extended leave from work, 16 declined to participate, and four had incomplete data, giving a final sample of 342 nurses (92% response rate). 212 (62%) were women and 130 (38%) were men. Low levels of stress were reported by 42 (12%) nurses, medium levels by 206 (60%), and high levels by 94 (28%). The mean score of psychosomatic symptoms for the group was 10·4 (SD 4·02, range 0–21). Scores did not differ significantly between men and women. Mean symptom scores differed between nurses with self-reported highly stressful working conditions and those with low levels of stress (12.6 vs 8.4, difference 4·1, 95% CI 2·7–5·5; p Interpretation We found that psychosomatic symptoms increased as self-reported perception of stressful working conditions increased, irrespective of sex. The study had a cross-sectional design and both exposure and outcomes were measured using self-report and, therefore, interpretation of the results should be made with caution. Longitudinal epidemiological studies are recommended. Future studies should investigate whether stressful working conditions affect the quality of patients’ care in health services. Funding Norwegian Programme for Development, Research and Education.
Published: 2021
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42. Workplace aggression, psychological distress, and job satisfaction among Palestinian nurses: A cross-sectional study

Author: Rita Bast-Pettersen, Morten Birkeland Nielsen, Khaldoun Nijem, Yousef Jaradat, Hein Stigum, Espen Bjertness, and Petter Kristensen
Subjects: Workplace bullying, Canada, medicine.medical_specialty, Cross-sectional study, Job Satisfaction, 03 medical and health sciences, 0302 clinical medicine, Workplace aggression, Surveys and Questionnaires, Health care, medicine, Humans, 030212 general & internal medicine, Israel, Workplace, Psychiatry, General Nursing, Response rate (survey), 030504 nursing, Aggression, business.industry, Arabs, Cross-Sectional Studies, Job satisfaction, medicine.symptom, General Health Questionnaire, 0305 other medical science, Psychology, business, Stress, Psychological
Abstract: Background Nurses can be exposed to aggressive behavior from patients, patient's relatives, colleagues and visitors. Purpose To determine the prevalence of workplace aggression among Palestinian nurses in the Hebron district and to examine cross-sectional associations between exposure to workplace aggression and the occurrence of psychological distress and job satisfaction. Methods Of 372 nurses eligible for the study, 343 were included (response rate of 92.2%). The sample comprised 62% females and 38% males. The participants responded to questions about their socio-demographic status, workplace aggression (WHO questionnaires), psychological distress (General Health Questionnaire, GHQ-30), and job satisfaction (Generic Job Satisfaction Scale). Results Ninety-three (27.1%) of the respondents reported exposure to workplace aggression of any kind. Seventeen (5%) reported exposure to physical aggression, 83 (24.2%) reported exposure to verbal aggression, and 25 (7.3%) reported exposure to bullying. The patients and the patients' relatives were the main sources of physical and verbal aggression, whereas colleagues were the main source of bullying. Males reported a higher prevalence of bullying than females. Younger nurses reported a higher prevalence of exposure to physical aggression, verbal aggression and bullying. Verbal aggression was associated with more psychological distress. Bullying was associated with lower job satisfaction. Conclusions More than a quarter of the nurses reported that they had been subject to some sort of aggression at the workplace. Verbal aggression was associated with higher psychological distress. Workplace bullying was associated with lower job satisfaction. Increased awareness and preventive measures to address this problem among health care workers are warranted.
Published: 2016
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43. Acne and dairy products in adolescence: results from a Norwegian longitudinal study

Author: M. Ulvestad, Jon Anders Halvorsen, Espen Bjertness, and Florence J Dalgard
Subjects: Male, Moderate to severe, Longitudinal study, Adolescent, Dermatology, Norwegian, Severity of Illness Index, Young Adult, 030207 dermatology & venereal diseases, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Environmental health, Acne Vulgaris, Severity of illness, Prevalence, Animals, Humans, Medicine, Longitudinal Studies, 030212 general & internal medicine, Young adult, Acne, Norway, business.industry, Odds ratio, medicine.disease, Dietary Fats, Health Surveys, language.human_language, Diet, Biotechnology, Milk, Infectious Diseases, language, Population study, Female, Dairy Products, Self Report, business
Abstract: Background Acne is a very common skin condition, and it is of great interest to elucidate lifestyle factors that may contribute to its occurrence. In the last decade, the acne-diet connection has been brought back to credibility. Objective To examine whether high intakes of dairy products in early adolescence is associated with moderate to severe acne in later adolescence. Methods The study is a longitudinal, questionnaire-based population study of Norwegian adolescents. Students attending the 10th grade (15–16 years old) of compulsory schooling in Oslo in 2000–2001 and the 13th grade (18–19 years old) 3 years later, in 2004, were invited. Dairy product consumption was self-reported at age 15–16 and acne severity was self-assessed and reported at age 18–19. Results The overall prevalence of moderate to severe acne was 13.9%. High intakes (≥2 glasses per day) of full-fat dairy products were associated with moderate to severe acne. In boys with exclusively high intakes of full-fat dairy products, the odds ratio for acne was 4.81 (1.59–14.56). A high total intake of dairy products was associated with acne in girls (OR 1.80, 1.02–3.16). No significant associations were found between acne and intake of semi-skimmed or skimmed dairy products, and not with moderate intakes of any fat variety of dairy products. Conclusion This study shows association between high intakes of dairy products and acne in adolescence. Our findings support a hypothesis suggesting that dairy consumption may be a factor contributing to acne. The study is based on multiple hypothesis testing, and the methodological limitations must be considered when interpreting the results.
Published: 2016
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44. Psychosomatic symptoms and stressful working conditions among Palestinian nurses: a cross-sectional study

Author: Rita Bast-Pettersen, Khaldoun Nijem, Lars Lien, Hein Stigum, Yousef Jaradat, and Espen Bjertness
Subjects: Adult, Employment, Male, medicine.medical_specialty, Cross-sectional study, Nurses, Article, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Sex factors, Occupational Exposure, Surveys and Questionnaires, Medicine, Humans, stressful working conditions, Palestine, Adverse effect, Psychiatry, General Nursing, Median score, 030504 nursing, business.industry, Articles, Middle Aged, 030210 environmental & occupational health, Mental health, Psychophysiologic Disorders, Checklist, Arabs, Cross-Sectional Studies, gender differences, Female, 0305 other medical science, business, Check List, psychosomatic symptoms, Stress, Psychological, Clinical psychology
Abstract: Background: High levels of perceived stressful working conditions have been found to have an adverse effect on physical and mental health. Objectives: To examine the associations between self-reported stressful working conditions and Psychosomatic Symptoms (PSS), and to investigate possible gender differences. Methods: The present cross-sectional study comprises 430 nurses employed in Hebron district, Palestine. Self-reported stressful working conditions were recorded, and a Psychosomatic Symptoms Check list was used to assess prevalence of PSS. Findings: Median score on the psychosomatic symptom checklist for the group was 11, (range 1–21). Women reported more symptoms than men, with medians 11.6 and 10.0, respectively (p = .0001). PSS were associated with more self-reported stressful working conditions for both men (p
Published: 2016

45. COVID-19 vaccines for Palestinians

Author: Khamis Elessi, Richard Sullivan, Harry S. Shannon, Yousef Khader, Espen Bjertness, John S Yudkin, Graham Watt, Iman Nuwayhid, Gerd Holmboe-Ottesen, Huda Zurayk, Hala Ghattas, Rita Giacaman, Jennifer Leaning, and Rima Afifi
Subjects: 2019-20 coronavirus outbreak, COVID-19 Vaccines, Human Rights, Human rights, Coronavirus disease 2019 (COVID-19), business.industry, Health Status, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), media_common.quotation_subject, Politics, MEDLINE, COVID-19, General Medicine, Virology, Health Services Accessibility, Arabs, Humans, Medicine, Israel, Prevention control, business, media_common
Published: 2021
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46. Impoverishment and catastrophic expenditures due to out-of-pocket payments for antenatal and delivery care in Yangon Region, Myanmar: a cross-sectional study

Author: Aye Nyein Moe Myint, Tippawan Liabsuetrakul, Myint Myint Wai, Thein Thein Htay, Johanne Sundby, and Espen Bjertness
Subjects: Adult, Adolescent, Cross-sectional study, media_common.quotation_subject, Prenatal care, Myanmar, 03 medical and health sciences, Young Adult, 0302 clinical medicine, antenatal care, Pregnancy, Environmental health, hemic and lymphatic diseases, Health care, Childbirth, Medicine, Humans, 030212 general & internal medicine, Socioeconomic status, Poverty, media_common, business.industry, catastrophic expenditure, 030503 health policy & services, Incidence (epidemiology), Health Policy, Research, delivery care, impoverishment, Prenatal Care, General Medicine, Health Care Costs, Middle Aged, Payment, Delivery, Obstetric, female genital diseases and pregnancy complications, Cross-Sectional Studies, out-of-pocket payment, Female, Health Expenditures, 0305 other medical science, business
Abstract: Objectives(1) To assess the levels of impoverishment and catastrophic expenditure due to out-of-pocket (OOP) payments for antenatal care (ANC) and delivery care in Yangon Region, Myanmar; and (2) to explore the determinants of impoverishment and catastrophic expenditure.Design, setting and participantsA community-based cross-sectional survey among women giving birth within the past 12 months in Yangon, Myanmar, was conducted during October to November 2016 using three-stage cluster sampling procedure.Outcome measuresPoverty headcount ratio, normalised poverty gap and catastrophic expenditure incidence due to OOP payments in the utilisation of ANC and delivery care as well as the determinants of impoverishment and catastrophic expenditure.ResultsOf 759 women, OOP payments were made by 75% of the women for ANC and 99.6% for delivery care. The poverty headcount ratios after payments increased to 4.3% among women using the ANC services, to 1.3% among those using delivery care and to 6.1% among those using both ANC and delivery care. The incidences of catastrophic expenditure after payments were found to be 12% for ANC, 9.1% for delivery care and 20.9% for both ANC and delivery care. The determinants of impoverishment and catastrophic expenditure were women’s occupation, number of household members, number of ANC visits and utilisation of skilled health personnel and health facilities. The associations of the outcomes with these variables bear both negative and positive signs.ConclusionsOOP payments for all ANC and delivery care services are a challenge to women, as one of fifteen women become impoverished and a further one-fifth incur catastrophic expenditures after visiting facilities that offer these services.
Published: 2018

47. Support for UNRWA’s survival

Author: Karl Blanchet, Abbas El-Zein, Ana Langer, Miho Sato, Sawsan Abdulrahim, Kim Abouchacra, Rima Afifi, Vittorio Agnoletto, Hidechika Akashi, Mohamad Alameddine, Éimhín Ansbro, Vera Araújo-Soares, Nassim Assefi, Matt Baillie Smith, Marco Bardus, Jacqueline Bhabha, Espen Bjertness, Josephine Borghi, Joanna Busza, Melani Cammett, Oona Campbell, Jad Chaaban, Iain Chalmers, Francesco Checchi, Goodarz Danaei, Hassan Dhaini, Karin Diaconu, Ishac Diwan, Paula Dominguez-Salas, Elizabeth Dubois, Faysal El Kak, Eugenia Eng, Nir Eyal, Wafaie Fawzi, Gene Feder, Rika Fujiya, Shota Furukawa, Kiyoko Furusawa, Akane Futami, Aline Germani, Hala Ghattas, Rita Giacaman, Ryunosuke Goto, Liz Grant, Paul Gregg Greenough, Rima Habib, Amy Hagopian, Shakoor Hajat, Fabienne Hariga, Ayako Hatano, Alastair Hay, Gerd Holmboe-Ottesen, Sayaka Horiuchi, William Hsiao, Daniela Huber, Darryl Humble, Taizo Imano, Yosuke Inoue, Aya Ishizuka, Ruba Ismail, Rumi Iwata, Samer Jabbour, Diana Jamal, Zeina Jamaluddine, Masamine Jimba, Tamar Kabakian, Yasuhiko Kamiya, Evangelos Karademas, Kenichi Kashiwagi, Yasushi Katsuma, Miyuki Kinjo, Junko Kiriya, Akiko Kitamura, Margaret E Kruk, Kazumi Kubota, Jennifer Leaning, Mhoira Leng, Lana Logam, Jihad Makhoul, Akihisa Matsuno, Yoshimi Matsuo, David McCoy, Terry McGovern, Martin McKee, Barbara McPake, Nada Melhem, Anne Merriman, Susan Michie, Christopher Millett, Chiaki Mishima, Takashi Miyachi, Hiroaki Miyata, Rob Moodie, Mariko Morioka, Kim Mulholland, Ghina Mumtaz, Adrianna Murphy, Eiji Nagasawa, Kenichiro Nagata, Martine Najem Kteily, Haruyo Nakamura, Rima Nakkash, Makiko Nambu, Mica Nava, Erica L Nelson, Aiko Nishikida, Shuhei Nomura, Sayumi Nozaki, Iman Nuwayhid, Kate O'Donnell, Masaaki Ohashi, Kelli O'Laughlin, Jennifer Palmer, Preeti Patel, Ronak Patel, Phuong Pham, Harumi Quezada-Yamamoto, Sami Ramia, Salman Rawaf, May Rihani, Bayard Roberts, Leslie Roberts, Tilman A Ruff, Nadine Sahyoun, Haruka Sakamoto, Nisreen Salti, Motoya Sato, Richard Sennett, Tim Shallice, Peter Shannon, Suhail Shiekh, Kiho Shin, Abla M Sibai, Maia Sieverding, Neha Singh, Richard Sullivan, Takao Takahara, Tomoyuki Tanigawa, Hiroko Taniguchi, Adrienne Testa, Alban Thomas, Atsuro Tsutsumi, Manami Uechi, Akira Usuki, Sara Valente de Almeida, Sue Wareham, Graham Watt, Robert West, Peter Wigg, Carol Wigg, Daniel Wikler, Sophie Witter, Nasser Yassin, Youseph Yazdi, Yasue Yoshino, Aisha Yousafzai, John S Yudkin, Mohammad H Zaman, and Huda Zurayk
Subjects: Right of return, L700, Economic growth, Refugees, L900, United Nations, L400, Humanitarian aid, business.industry, Refugee, Relief Work, Homeland, General Medicine, 11 Medical And Health Sciences, Arabs, B900, 159 signatories, Political science, Statelessness, General & Internal Medicine, Agency (sociology), Humans, business, Functional illiteracy
Abstract: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland.
Published: 2018

48. Childhood violence and mental health among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

Author: Ketil Lenert Hansen, Espen Bjertness, Astrid M. A. Eriksen, Cecilie Javo, Hein Stigum, Tore Sørlie, and Berit Schei
Subjects: Male, Health (social science), Epidemiology, Ethnic group, Stress Disorders, Post-Traumatic, 0302 clinical medicine, cross-cultural, psychological distress, Prevalence, Medicine, 030212 general & internal medicine, indigenous, SAMINOR, Arctic Regions, Norway, Age Factors, Questionnaire, General Medicine, VDP::Medical disciplines: 700::Health sciences: 800, Middle Aged, Mental Health, VDP::Medisinske Fag: 700::Helsefag: 800, Adult Survivors of Child Adverse Events, ethnicity, Female, post-traumatic stress, 0305 other medical science, Research Article, Adult, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, Violence, Childhood violence, Indigenous, 03 medical and health sciences, Young Adult, Sex Factors, Cross-cultural, Humans, Questionnaire study, Aged, 030505 public health, business.industry, Public Health, Environmental and Occupational Health, HSCL-10, Psychological distress, Sami, Mental health, Cross-Sectional Studies, business, Stress, Psychological, Demography
Abstract: This is the peer reviewed version of the following article: Eriksen, A., Hansen, K.L., Schei, B., Sørlie, T., Stigum, H., Bjertness, E. & Javo, C. (2018). Childhood violence and mental health among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study. International Journal of Circumpolar Health, 77(1). https://doi.org/10.1080/22423982.2018.1508320, which has been published in final form at https://doi.org/10.1080/22423982.2018.1508320. The main objectives of this study were to investigate the association between childhood violence and psychological distress and post-traumatic stress symptoms (PTS) among Sami and non-Sami adults, and to explore a possible mediating effect of childhood violence on any ethnic differences in mental health. This study is part of a larger questionnaire survey on health and living conditions in Mid- and Northern Norway (SAMINOR 2) which included 2116 Sami and 8674 non-Sami participants. A positive association between childhood violence and psychological distress and PTS in adulthood was found regardless of ethnicity. For women, childhood violence may have mediated some of the ethnic differences in psychological distress (53.2%) and PTS (31.4%). A similar pattern was found for men as to psychological distress (45.5%) and PTS (55.5%). The prevalence of psychological distress was significantly higher in the Sami than in the non-Sami group: 15.8% vs. 13.0% for women, and 11.4% vs. 8.0% for men. Likewise, PTS showed a higher prevalence in the Sami group, both for women (16.2% vs. 12.4%) and for men (12.2% vs. 9.1). Conclusion: A positive association between childhood violence and adult mental distress was found for both Sami and Norwegian adults. More mental problems were found among the Sami. Childhood violence may have mediated some of the ethnic differences.
Published: 2018

49. Survival and years of life lost in various aetiologies of dementia, mild cognitive impairment (MCI) and subjective cognitive decline (SCD) in Norway

Author: Karin Persson, Trine Holt Edwin, Geir Selbæk, Knut Engedal, Bjørn Heine Strand, Marit Mjørud, Rachel Amland, Espen Bjertness, and Anne-Brita Knapskog
Subjects: Male, Pediatrics, European People, Dementia with Lewy bodies, lcsh:Medicine, Comorbidity, Alzheimer's Disease, 0302 clinical medicine, Cognition, Activities of Daily Living, Medicine and Health Sciences, Ethnicities, Public and Occupational Health, 030212 general & internal medicine, Cognitive decline, Mild cognitive impairment (MCI), lcsh:Science, Aged, 80 and over, Cognitive Impairment, education.field_of_study, Multidisciplinary, Relative survival, Norway, Cognitive Neurology, Neurodegenerative Diseases, Neurology, Disease Progression, Female, Research Article, medicine.medical_specialty, Death Rates, Norwegian People, Cognitive Neuroscience, Cerebrovascular Diseases, Population, Vascular Dementia, Education, 03 medical and health sciences, Life Expectancy, Population Metrics, mental disorders, Mental Health and Psychiatry, medicine, Dementia, Humans, Cognitive Dysfunction, Vascular dementia, education, Aged, Population Biology, business.industry, lcsh:R, Biology and Life Sciences, medicine.disease, Survival Analysis, Years of potential life lost, People and Places, Cognitive Science, lcsh:Q, Population Groupings, business, 030217 neurology & neurosurgery, Neuroscience
Abstract: Research Article Abstract INTRODUCTION: Alzheimer's disease patients are reported to have higher survival rate compared to patients with vascular dementia or dementia with Lewy bodies. There is a paucity of studies investigating survival including persons with cognitive decline and dementia of various aetiologies. OBJECTIVES: We aimed to compare survival for patients with subjective cognitive decline, mild cognitive impairment, Alzheimer's disease, vascular dementia, mixed Alzheimer's/vascular dementia, dementia with Lewy bodies/Parkinson's disease, and other dementias compared to the general Norwegian population, taking into account the role of gender, cognitive function, function in everyday activities, comorbidity and education. METHODS: Patients (N = 4682), ≥65 years, in the The Norwegian register of persons assessed for cognitive symptoms (NorCog) during 2009-2017 were followed for mortality in the National Registry until January 2018. Flexible parametric survival models were applied to estimate relative survival, life expectancy and years of life lost for diagnostic groups compared with the general population. RESULTS: Patients with vascular dementia or dementia with Lewy bodies/Parkinson's had the shortest survival, followed by mixed dementia, Alzheimer's disease, unspecified dementia, mild cognitive impairment and subjective cognitive decline. At age 70 years, men with vascular dementia or dementia with Lewy bodies/Parkinson's had life expectancy of 4.7 years, which corresponded to 10.3 years of life lost compared to the general population. Years of life lost for other diagnoses were 10.0 years for mixed dementia, 9.2 years for Alzheimer's disease, 9.3 years for other dementias, 5.2 years for mild cognitive impairment and 2.2 years for subjective cognitive decline. Corresponding years of life lost in women were: 12.7 years, 10.5 years, 9.8 years, 10.6 years, 7.8 years, and 2.6 years. Poor relative survival among dementia patients was associated with male gender, comorbidity, low cognitive function, and low function in activities of daily living. CONCLUSIONS: Compared with the general population, patients with subjective cognitive decline had no significant loss in life expectancy, while patients with mild cognitive impairment and all dementia subtypes had large losses, especially those with a diagnosis of vascular dementia or dementia with Lewy bodies/Parkinson's. The funder, The Norwegian Association for Public Health, had no role in study design, data collection, data analysis, data interpretation, or writing of the manuscript. BHS had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Published: 2018

50. Association Between Random Measured Glucose Levels in Middle and Old Age and Risk of Dementia-Related Death

Author: Bjørn Heine Strand, Tor Atle Rosness, Espen Bjertness, and Knut Engedal
Subjects: Gerontology, medicine.medical_specialty, education.field_of_study, Proportional hazards model, business.industry, Population, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Cohort, medicine, 030212 general & internal medicine, Geriatrics and Gerontology, Risk factor, education, business, Body mass index, 030217 neurology & neurosurgery, Cause of death, Cohort study
Abstract: Objectives To investigate the association between random measured glucose levels in middle and old age and dementia-related death. Design Population-based cohort study. Setting Norwegian Counties Study (middle-aged individuals; 35–49) and Cohort of Norway participants (older individuals; 65–80). Participants Individuals without (n = 74,630) and with (n = 3,095) known diabetes mellitus (N = 77,725); 67,865 without and 2,341 with diabetes mellitus were included in the complete case analyses (nonmissing for all included covariates), of whom 1,580 without and 131 with diabetes mellitus died from dementia-related causes. Measurements Dementia-related death was ascertained according to the Norwegian Cause of Death Registry. Cox regression was used to assess the relationship between random glucose levels (nonfasting) in individuals without and with diabetes mellitus and dementia-related death. Education, smoking, cardiovascular disease, body mass index, cholesterol, blood pressure, and physical activity were adjusted for. Results Individuals without diabetes mellitus at midlife with glucose levels between 6.5 and 11.0 mmol/L had a significantly greater risk of dementia-related death than those with levels less than 5.1 mmol/L (hazard ratio = 1.32, 95% confidence interval = 1.04–1.67) in a fully adjusted model. A dose-response relationship (P = .02) was observed. No significant association between high glucose levels in individuals aged 65 to 80 and dementia-related death was detected. Conclusion High random glucose levels measured in middle-aged but not older age persons without known diabetes mellitus were associated with greater risk of dementia-related death up to four decades later.
Published: 2016
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