Fecal and urinary incontinence are common disorders in children. Obesity and its associated comorbidities have become increasingly common, and a relation between obesity, nocturia, incontinence, and ...nocturnal enuresis has been suggested.
This large scale population study aims to determine the prevalence of fecal incontinence (FI), daytime urinary incontinence (DUI), nocturnal enuresis (NE), and nocturia in children at school entry and in adolescence and to clarify whether obesity is associated to any of the aforementioned symptoms.
First-grade children and their parents and adolescents in the seventh to ninth grades were interviewed in relation to school nurse visits. The interview included questions on whether incontinence or nocturia were experienced at least once per month. The participants' age was recorded, and weight and height were measured. Body mass index (BMI) was calculated and age standardized by the use of BMI-standard deviation score (SDS), with reference to World Health Organization normative BMI data. Obesity was defined as BMI-SDS >2. Associations between obesity and incontinence and nocturia were quantified by odds ratio (OR).
Completed interview questionnaires and measurements were obtained from 4002 children (95.1%) in the child population and 2801 adolescents (84.4%) in the adolescent population. The mean age of children was 6.45 ± 0.39 years, and 4.4% were obese. Overall 11.2% reported FI, 21.8% DUI, 16.8% NE, and 31.4% experienced nocturia. Obesity was associated with FI in first-grade boys (OR 1.86 compared with normal weight). Mean age of adolescents was 13.9 ± 0.85 years, and 7.6% of adolescent boys and 5.5% of the girls were obese. Fecal incontinence was reported by 2.1% of the adolescents, 4.5% had DUI, 1.0% stated to have NE, and 32.3% reported nocturia. Obesity was significantly associated with nocturia in adolescents (OR 1.74–2.01).
The prevalence of nocturia seems constant throughout childhood and adolescent life; this has not previously been documented. Incontinence is very common at school entry, with DUI reported more frequently than enuresis by both children and adolescents. Obesity is associated with nocturia in adolescents and FI in first-grade boys, but no significant association between obesity and NE or DUI is found. Strength of this study is the very high participation rates, but the study does not reveal information on previous treatment, subtype, or severity of symptoms.
Incontinence is very common in children. One-third of both children and adolescents experience nocturia. Obesity is associated with FI in first-grade boys and nocturia in adolescents.
This paper reviews the main findings concerning mechanisms explaining the increased risk of coronary heart disease (CHD) in shiftworkers. We discuss a conceptual model, in which three main shiftwork ...pathways to CHD are postulated--social problems, behavioral change, and disturbed circadian rhythm. Social problems that are associated with shiftwork might lead to stress. Significant shiftwork-related behavioral problems are smoking and unhealthy food habits. Disturbed circadian rhythm might result in sleep deprivation. Unphysiologic timing of physical activity and food intake in relation to circadian rhythms is another possible explanation for the negative impact on the cardiovascular system.
Abstract
Background
Trends towards longer labor market participation are seen in international policies. In the EU countries, labor force participation rate for those past 60 years of age, has been ...raised extensively for the past decade. In 2035 Danish workers are expected to work till 69 years of age. The aim of the study was twofold, firstly to identify and synthesize findings from former studies of factors of importance in construction workers (age 55+) work participation and secondly to understand and explore how construction workers experience their work participation.
Methods
A systematic review and integrative thematic synthesis of qualitative and quantitative studies aiming to identify factors of importance in construction workers work participation were carried out followed by individual interview 20 Danish construction workers and thematic analysis.
Results
Four themes illustrating factors influencing construction workers work participation were identified in the review. Theme 1 Socioeconomical and cultural factors, Theme 2 Legislation and policy, Theme 3 Workplace factors and Theme 4 Individual factors. The identified themes helped structure the interview guide. Preliminary results of the individual interviews provide a deeper understanding of how both individual, social and workplace factors interacts and how it is possible for construction workers to compensate from the experienced age-related physical limitations. Elderly construction workers adjust and compensate for demanding work tasks by receiving support from co-workers and having less demanding work tasks during their workday. Both physical and psychosocial work environment and employers’ attitudes towards elderly workers seems to be significant for their ability for working late in life.
Conclusions
The interplay between individual, psychosocial, and work environmental factors are affecting elderly construction workers work participation which have an impact on their work retention late in life.
Key messages
• Elderly construction workers work participation depends on the physical and the psychosocial work environment and possibilities for adjustment and compensation for performing demanding work tasks.
• individual, social and workplace factors interacts and how it is possible for construction workers to compensate from the experienced age-related physical limitations.
The literature on shift work, morbidity and mortality from cardiovascular disease, and changes in traditional risk factors is reviewed. Seventeen studies have dealt with shift work and cardiovascular ...disease risk. On balance, shift workers were found to have a 40% increase in risk. Causal mechanisms of this risk via known cardiovascular risk factors, in relation to circadian rhythms, disturbed sociotemporal patterns, social support, stress, behavior (smoking, diet, alcohol, exercise), and biochemical changes (cholesterol, triglycérides, etc) are discussed. The risk is probably multifactorial, but the literature has focused on the behavior of shift workers and has neglected other possible causal connections. In most studies methodological problems are present; these problems are related to selection bias, exposure classification, outcome classification, and the appropriateness of comparison groups. Suggestions for the direction of future research on this topic are proposed.
Abstract
Background
A breast cancer diagnosis affects an individual’s affiliation to the labor market, but whether the effect of breast cancer variates in different sectors in a Danish setting has ...not been examined. The present study investigated the effect of stage IA breast cancer (tumor<20 mm and no lymph nodes involved in six sectors among Danish women being part of the work force. Stage IA breast cancer has a good prognosis, and it would be assumed that the majority have returned to work after 1 year.
Methods
This registry-based cohort study was based on data from linked Danish nationwide registries. We identified 5,543 women (aged 25-63 years) diagnosed with breast cancer (BC) stage IA (exposed) and 65.889 women without breast cancer (unexposed) and included women from the different sectors. We calculated a yearly Work Participation Score (WPS), defined as the proportion of weeks being self-supported during a year. We compared the means of WPS for exposed and unexposed women in six different sectors: 1) teaching, 2) childcare, 3) eldercare, 4) cleaning, 5) administration and 6) hospitality industry.
Results
BC had a negative effect on being self-supporting for women in all six sectors in all three years, although the effect declined. In the first year, the difference in WPS varied between 0.38 and 0.54. During the second year all BC patients had still significantly lower WPS with the largest difference in hospitality industry (0.65 (95% CI 0.50-0.80) for exposed women and 0.86 (95% CI 0.83-0.88) for unexposed women). In the third year, the effect further declined although WPS was still significantly lower for most sectors with the biggest difference in the cleaning sector.
Conclusions
A stage IA BC diagnosis had a negative effect on being self-supportive after 2 and 3 years among women in all six sectors, although the difference was largest among cleaning workers. This may indicate, that individual follow-up in relation to work participation is necessary.
Key messages
Although breast cancer stage IA has a good prognosis, it still affects being self-supporting after three years.
A diagnosis of breast cancer affects the affiliation to the labour market, but the effect differs according to different sectors.
Abstract
Background
Understanding and utilizing health information has become increasingly demanding whereby people's health literacy becomes important. European Health Literacy Survey Questionnaire ...(HLS-EU-Q16) measures health literacy (HL). We aimed to study the psychometric properties of the Danish version in the general population and a population with coronary artery disease.
Methods
A national, cross-sectional survey of individuals from the general Danish population and patients with Myocardial Infarction (MI) was conducted. The general population sample consisted of 7,653 individuals. The MI sample of 4,440 individuals had previously been hospitalized with MI. To assess the influence of large sample sizes, we examined five randomly drawn subsamples of 500 from each population. The Rasch analysis was conducted using RUMM-2030 consisting of inspection of unidimensionality, local dependency, Differential item Functioning (DIF), and item fit.
Results
The results are preliminary and analyses still ongoing. The HLS-EU-Q16 did not fit the Rasch model, neither for the total sample, subsamples, the general population sample, nor for the MI sample.
For the MI sample, there were signs of local dependence and item 6 had the largest item misfit. DIF was observed for item 6 and 7 (age and gender). The general population sample also showed signs of local dependence, and item 1 indicated the largest item misfit. DIF was observed for item 1 (age) and item 1, 7, 8, 13 and 16 (gender).
Conclusions
The Danish version of HLS-EU-Q16 did not fit the Rasch model neither in the general population sample nor for the MI sample. Our large population-based study indicated scalability problems of the HLS-EU-Q16. The validation procedure is a step on the path to ensure the use of valid measures of HL in both populations and patient groups to support the raising awareness of HL as a necessary element to ensure equity in our health system and thereby initiating an urgent public health activity.
Key messages
We studied the construct validity of the Danish version of the European Health Literacy Survey Questionnaire HLS-EU-Q16 with a Rasch model. Our large population-based study indicate problems with the psychometric properties of the current Danish version of the HLS-EU-Q16.
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