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Abstract The issue of adolescent secondhand smoke (SHS) is globally significant, given that it serves as a preventable risk factor for disease prevalence and mortality rates among youth. This study evaluates trends in adolescent SHS across 27 countries from 2003 to 2021, aiming to identify global variations and sex-specific differences, providing insights for future policy recommendations. The data for this study were collected from the Global School-based Student Health Survey conducted by the World Health Organization, 2003–2021. The term SHS in this context denoted how many days people smoked in their presence for at least one day within the past 7 days. Linear regression models were employed to examine the trends of SHS exposure by country. In the present analysis based on 175,370 adolescents (male, 46.69%) aged between 13 and 15 years from 27 countries across the five continents, SHS decreased in 14 countries but exhibited an increasing trend in 3 countries (Benin [β, 3.20; 95% CI, 2.50–3.91]; Maldives [β, 0.93; 0.21–1.65]; Myanmar [β, 0.62; 0.29–0.95]). Significant increasing trends in females were observed in the Maldives (β, 1.18; 0.25–2.11) and Thailand (β, 0.36; 0.04–0.69) while males showed increasing trends in Kuwait (β, 1.90; 0.79-3.00) and Vanuatu (β, 1.95; 0.35–3.54). Our analysis of adolescents from 27 countries indicates that the majority of nations exhibited decreasing trends in SHS. This suggests that global efforts to prevent SHS are achievable through individual initiatives and international monitoring. However, the presence of increasing trends in certain countries underscores the need for stronger regulations and policies to address this issue.

Objective: Although thyroid disease is a common condition, there is limited research examining the prevalence of thyroid disease over a long period of time, including both before and during the COVID-19 pandemic. Therefore, we aimed to investigate sociodemographic aspects that might be associated with thyroid disease and how its prevalence has varied during the pandemic. Methods: We assessed the prevalence of thyroid disease among Korean adults by using data from the Korea National Health and Nutrition Examination Survey from 1998 to 2021. We evaluated weighted prevalence and β-coefficients with 95 % CI for factors such as age, sex, residential area, education level, household income, perceived stress level, weight change, occupation category, and body mass index groups. Results: From 1998 to 2021, the prevalence of thyroid disease among 159,896 Korean adults (88,120 females [55.1 %]) aged 20 years and older exhibited an overall increasing trend. The weighted prevalence in the general population rose from 1.52 % (95 % CI, 1.41–1.64) in 1998–2005 to 3.84 % (3.30–4.39) in 2021, with a higher likelihood of thyroid disease exposure as age increased. In addition, females, individuals with lower education levels, those with high levels of perceived stress, those who gained weight, and those classified as overweight or obese emerged as vulnerable groups for thyroid disease. For the majority of subgroups, the change amid the effect of the pandemic on prevalence was minimal. However, the aged ≥60 years group showed a greater increase in prevalence during the pandemic than before the pandemic (βdiff: 0.52 [95 % CI, 0.37–0.68]). Conclusions: A nationwide representative study in South Korea revealed an increasing trend in the prevalence of thyroid disease over 24 years, particularly among the older population. Despite the minimal variation during the pandemic, our findings emphasize the need for targeted thyroid disease policies and further research, especially for specific subgroups such as the older population.

Abstract Previous studies have examined the prevalence of allergic diseases in adolescents 1–2 years after the emergence of the COVID-19 pandemic. However, more data is needed to understand the long-term impact of COVID-19 on allergic diseases. Thus, we aimed to examine the trend of the atopic dermatitis prevalence in Korean adolescents before and during the COVID-19 pandemic across 14 years. Additionally, we analyze the risk factors of atopic dermatitis (AD) based on the results. The Korean Disease Control and Prevention Agency conducted the Korea Youth Risk Behavior Web-based Survey from 2009 to 2022, from which the data for this study were obtained. Prevalence trends were compared across subgroups, and the β difference (βdiff) was calculated. We computed odds ratios to examine changes in the disease prevalence before and during the pandemic. This study included a total of 917,461 participants from 2009 to 2022. The prevalence of atopic dermatitis increased from 6.79% (95% CI 6.66–6.91) in 2009–2011 to 6.89% (95% CI 6.72–7.05) in 2018–2019, then decreased slightly to 5.82% (95% CI 5.60–6.04) in 2022. Across the 14 years, middle school student status, low parent’s highest education level, low household income, non-alcohol consumption, non-smoker smoking status, no suicidal thoughts, and no suicide attempts were associated with increased risk of atopic dermatitis, while female sex, rural residence, high BMI, low school performance, low household income, and no feelings of sadness and despair was associated with a small increase. This study examined the prevalence of atopic dermatitis across an 18-year, and found that the prevalence increased in the pre-pandemic then decreased during the start of the pandemic and remained constant throughout the pandemic. This trend could be explained mainly by the large scale social and political changes that occurred during the COVID-19 pandemic.

Abstract Prior research has predominantly focused on the overall effects of the tobacco tax increase and the COVID-19 pandemic on adolescent smoking behavior. However, there is a need to examine both the immediate and sustained associations of these two factors on subgroups of adolescents, employing an interrupted time-series model. We aimed to investigate the immediate and sustained association of tobacco tax increase and the COVID-19 pandemic on adolescent smoking prevalence. This study utilized data from the Korea Youth Risk Behavior Web-Based Survey to analyze the prevalence of current smoking among all participants (CSP) and the prevalence of daily smoking among current smokers (DSP) of Korean adolescents (n = 1,159,995; mean, age 14.99; male 51.5%) over 18 years from 2005 to 2022. The study examined 18-year trends in CSP and DSP among Korean adolescents, emphasizing the influences of the 2015 tobacco tax increase and the COVID-19 pandemic, using β coefficients and their differences (βdiff) from an interrupted time-series ARIMA model. While CSP exhibited a decreasing trend, DSP exhibited an increasing trend. Tobacco tax increase was associated with both the short and long terms in smoking prevalence, however, the short-term association on prevalence (CSP, − 3.076 [95% CI, − 3.707 to − 2.445]; DSP, − 4.112 [95% CI, − 6.488 to − 1.735]) was stronger. The pandemic was associated with an immediate increase in DSP (9.345 [95% CI, 5.285–13.406]). These effects were strongest among adolescents from low economic status and those exposed to familial secondhand smoking. Supportive programs for adolescents in low-income families will help overcome the effects associated with the pandemic. As a tobacco tax increase was associated with a reduction in smoking prevalence, this could be one method to overcome the effects of the pandemic.

Purpose: Zoledronic acid can inhibit the activity of osteoclasts, and thus, may slow or inhibit bone loss. The purpose of this study was to systematically evaluate the efficacy and safety of zoledronic acid in the treatment of osteoporosis. Methods: Four databases, PubMed, Embase, Cochrane Library, and Web of Science, were systematically searched up to December 26, 2022. The primary outcomes included bone mineral density (BMD), carboxy-terminal cross-linked telopeptide of type 1 collagen (CTX), bone-specific alkaline phosphatase (BSAP), procollagen type 1 N-terminal prope-ptide (P1NP), adverse events, and fracture. Secondary outcomes included serum sclerostin level, Visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI). Results: A total of 22 randomized controlled trials were included in this meta-analysis. Meta-analysis results showed that zoledronic acid was effective in increasing BMD of the lumbar spine, femoral neck, trochanter and serum sclerostin level; and reduced CTX, BSAP, P1NP, VAS score, and ODI in patients with osteoporosis. Regarding safety, zoledronic acid could reduce the incidence of fractures but had relatively more adverse events. Conclusion: Zoledronic acid can significantly improve BMD of the lumbar spine, femoral neck and trochanter, and effectively reduce incidence of fracture in patients with osteoporosis, thereby significantly improving patients' quality of life. However, the incidence of adverse events was higher than that of patients treated with placebo.

Abstract Although food labeling on food packages is crucial for promoting a healthy diet, limited research has been conducted on how the COVID-19 pandemic (hereinafter “the pandemic”) has affected food labeling awareness. Therefore, this study aims to analyze the changes in trends in food labeling awareness, comprehension, and usage in South Korea during the pandemic. We utilized a nationwide, large-scale, and long-term dataset provided by the Korea Community Health Survey (KCHS) from 2014 to 2022 (total = 1,756,847 participants). This allowed the researchers to assess the long-term trends in the prevalence of food labeling awareness, comprehension, and usage. Furthermore, we investigated the factors associated with awareness specifically related to the pandemic. In total, 1,756,847 adults (54.19% women) participated in this study. The upward slope in overall food labeling awareness became less pronounced and even exhibited a downward slope during the pandemic (βdiff − 1.759; 95% CI − 1.874 to − 1.644). The upward slope in food labeling comprehension and usage became more pronounced during the pandemic (comprehension: βdiff 0.535; 95% CI 0.436–0.634; usage: βdiff 0.693; 95% CI 0.601–0.785). The vulnerability factors associated with lower food labeling awareness during the pandemic included older age, male, obesity, residing in rural areas, lower household income, lower educational level, smoking, and increased alcohol consumption. This study analyzed the 9-year trend in the prevalence of food labeling awareness, comprehension, and usage based on nationally representative data of adults in South Korea from 2014 to 2022. Our findings suggest that personalized nutrition strategies are needed to recognize vulnerable groups with risk factors and improve food labeling awareness among Korean adults during the pandemic.

Background: Therapeutic ultrasound (US) is a treatment for knee osteoarthritis (KOA), but its efficacy and safety are unclear. The objective of this study is to quantify the effect of US on pain relief and function recovery in KOA, and to analyze the US treatment duration and parameters on treatment outcome. Methods: We searched PubMed, MEDLINE, EMBASE, Google Scholar, Cochrane databases and ClinicalTrials.gov databases up to April 7, 2023. RCTs that compared the efficacy of therapeutic US with the control in KOA were included in the study, and the methodological quality of the trials was assessed using the Cochrane Risk of Bias tool. Results: Twenty-one RCTs (1315 patients) were included. US had a positive effect on visual analog scale (VAS) (SMD = −0.64, 95 % CI [-0.88, −0.40], I2 = 71 %) and Western Ontario and McMaster Universities (WOMAC) total scale (SMD = −0.45, 95 % CI [-0.69, −0.20]; I2 = 67 %). Pulsed US with an intensity ≤2.5 W/cm2 reduced visual analog scale (VAS), and differed in sessions (24 sessions (SMD = −0.80, 95 % CI [-1.07, −0.53], I2 = 0 %) vs 10 sessions (SMD = −0.71, 95 % CI [-1.09, −0.33], I2 = 68 %)). For pulsed US, a duration of treatment of 4–8 weeks (SMD = −0.69, 95 % CI [-1.13, −0.25], I2 = 73 %) appeared to be superior to ≤4 weeks (SMD = −0.77, 95 % CI [-1.04, −0.49], I2 = 0 %) for reducing visual analog scale (VAS). No US treatment-related adverse events were reported. Conclusion: Therapeutic US may be a safe and effective treatment for patients with KOA. The mode, intensity, frequency, and duration of US may affect the effectiveness of pain relief. Pulsed US with an intensity ≤2.5 W/cm2, 24 sessions, and a treatment duration of ≤4 weeks appears to have better pain relief.

Abstract Purpose People with eating disorders may be at increased risk for physical health problems, but there are no data on the relationship between eating disorders and physical multimorbidity (i.e., ≥ 2 physical conditions) and its potential mediators. Thus, we investigated this association in a representative sample of adults from the UK, and quantified the extent to which this can be explained by various psychological and physical conditions, and lifestyle factors. Methods Cross-sectional data of the 2007 Adult Psychiatric Morbidity Survey were analyzed. Questions from the five-item SCOFF screening instrument were used to identify possible eating disorder. Respondents were asked about 20 physical health conditions. Multivariable logistic regression and mediation analysis were conducted. Results Data on 7403 individuals aged ≥ 16 years were analyzed [mean (SD) age 46.3 (18.6) years; 48.6% males]. After adjustment, possible eating disorder was associated with 2.11 (95%CI = 1.67–2.67) times higher odds for physical multimorbidity. Anxiety disorder explained the largest proportion this association (mediated percentage 26.3%), followed by insomnia (21.8%), perceived stress (13.4%), depression (13.1%), obesity (13.0%), and alcohol dependence (4.3%). Conclusion Future longitudinal studies are warranted to understand potential causality and the underlying mechanisms in the association between eating disorder and multimorbidity, and whether addressing the identified potential mediators in people with eating disorders can reduce multimorbidity.

Abstract Background There are no data on the association between leisure‐time physical activity (LTPA) and sarcopenia in older adults from low‐ and middle‐income countries (LMICs). This study aimed to investigate the association between LTPA and sarcopenia in individuals aged ≥65 years living in six LMICs. Methods Cross‐sectional data from the Study on Global AGEing and Adult Health (China, Ghana, India, Mexico, Russia and South Africa) were analysed. Sarcopenia referred to the presence of both low skeletal muscle mass and weak handgrip strength. LTPA was assessed using the Global Physical Activity Questionnaire and was analysed as a dichotomized variable [high LTPA (>150 min/week of moderate‐to‐vigorous LTPA) or low LTPA (≤150 min/week)]. Multivariable logistic regression analysis was conducted to assess associations. Results There were 14 585 individuals included in this study [mean (SD) age 72.6 (11.5) years; 55.0% women]. The prevalence of high LTPA and sarcopenia was 8.9% and 12.0%, respectively. After adjusting for potential confounders, low LTPA was significantly associated with higher odds for sarcopenia [prevalence odds ratio (POR) = 1.85, 95% confidence interval (CI) = 1.29–2.65] compared with high LTPA. Significant associations were found in women (POR = 3.22, 95% CI = 1.82–5.68) but not in men (POR = 1.52, 95% CI = 0.99–2.35). Conclusions A positive and significant association between low LTPA and sarcopenia was found among older adults from LMICs. The promotion of LTPA among older adults in LMICs may aid in the prevention of sarcopenia, especially among females, pending future longitudinal research.

Objective This study examined the effect of vitamin D supplementation, sunlight radiationradiation, and home isolation during the COVID-19 pandemic on the seasonal changes in 25(OH)D concentration and selected biomarkers in young soccer players along a one-year training cycle. Method Forty elite young soccer players (age: 17.2 ± 1.16 years, body mass: 70.2 ± 5.84, and body height: 179.1 ± 4.26 cm) participated in the research. Only 24 players completed the measurements during all four time- points (T1-: September 2019, T2-: December 2019, T3-: May 2020, and T4-: August 2020) and were divided into two subgroups: supplemented group (GS) and placebo group (GP). Players from GS received 5,000 IU of vitamin D for 8 weeks (January-MarchJanuary–March 2020). Several biomarkers such as 25(OH)D, white blood cells (WBC), red blood cells (RBC), hemoglobin (HGB), muscle damage markersmarkers, and lipid profile were measured. Results AnalysisThe analysis of the total group demonstrated significant seasonal changes in 25(OH)D, HGB, asparagine aminotransferaseaminotransferase, and creatine kinase along the one1-year training cycle. The level of 25(OH)D concentrationinconcentration in T4 was significantly (p

Summary: Background: Autoimmune hepatitis (AIH) varies significantly in incidence and prevalence across countries and regions. We aimed to examine global, regional, and national trends in incidence and prevalence of AIH from 1970 to 2022. Methods: We conducted a thorough search of the PubMed/MEDLINE, Embase, CINAHL, Google Scholar, and Cochrane databases from database inception to August 9, 2023, using the search term “autoimmune hepatitis” in combination with “incidence,” “prevalence,” or “trend.” Only general population-based observational studies with larger samples sizes were considered for inclusion. Studies that recruited convenience samples, and those with fewer than 50 participants were excluded. Summary data were extracted from published reports. A random effects model was used and pooled estimates with 95% CI were used to calculate the incidence and prevalence of AIH. Heterogeneity was evaluated using the I2 statistic. The study protocol was registered with PROSPERO, CRD42023430138. Findings: A total of 37 eligible studies, encompassing more than 239 million participants and 55,839 patients with AIH from 18 countries across five continents, were included in the analysis. Global pooled incidence and prevalence of AIH were found to be 1.28 cases per 100,000 inhabitant-years (95% CI, 1.01–1.63, I2 = 99·51%; number of studies, 33; sample population, 220,673,674) and 15.65 cases per 100,000 inhabitants (95% CI, 13.42–18.24, I2 = 99·75%; number of studies, 26; sample population, 217,178,684), respectively. The incidence of AIH was greater in countries with high Human Development Index (>0.92), in North America and Oceania (compared with Asia), among females, adults (compared with children), and high latitude (>45°). Similar patterns in AIH prevalence were observed. Pooled AIH prevalence increased gradually from 1970 to 2019 (1970–1999; 9.95 [4.77–15.13], I2 = 95·58% versus 2015–2022; 27.91 [24.86–30.96], I2 = 99·32%; cases per 100,000 inhabitants). The overall incidence and prevalence of AIH, as well as some subgroup analyses of the studies, displayed asymmetry in the funnel plots, suggesting potential evidence of publication bias. Interpretation: AIH incidence and prevalence have increased significantly and exhibit substantial variation across regions worldwide. Further research is required to assess the incidence and prevalence of AIH, specifically in South America and Africa. Funding: National Research Foundation of Korea.

(1) Objective: We performed a systematic review to explore the prevalence of intravenous (IV) rehydration therapy in hospital settings, and we assessed it by patient groups and populations. (2) Methods: A systematic review of major databases and grey literature was undertaken from inception to 28 March 2022. Studies reporting prevalence of IV rehydration therapy in a hospital setting were identified. The data were synthesised in a narrative approach. (3) Results: Overall, 29 papers met the inclusion criteria. The prevalence of IV rehydration therapy in paediatric patients ranged from 4.5% (hospitalised with diarrhoea and dehydration) to 100% (admitted to the emergency department with mild to moderate dehydration caused by viral gastroenteritis), and in adults this ranged from 1.5% (had single substance ingestion of modafinil) to 100% (hospitalised with hypercalcemia). The most common indication for IV rehydration therapy in paediatric patients was dehydration due to fluid loss from the gastrointestinal tract. Other causes included malnutrition, neuromuscular disease, bronchiolitis, and influenza. In adults, indications for IV rehydration therapy were much more diverse: fever, diarrhoea, drug intoxication, hypercalcemia, cancer, and postural tachycardia syndrome; (4) Conclusions: This systematic review showed that IV rehydration therapy in paediatric patients is often used to treat dehydration and diarrhoea, while in adults it has a broader spectrum of use. While IV rehydration therapy is important in correcting fluid problems and electrolyte status, the maintenance fluid prescribing practices vary considerably, and guidelines are scarce.

Abstract There is a small body of evidence suggesting that unclean cooking fuel use may be associated with cognitive decline. However, to date, no study has investigated the association between unclean cooking fuel and mild cognitive impairment (MCI). Thus, we investigated the association between cooking fuel type or ventilation type and MCI among adults aged ≥ 65 years using nationally representative datasets from six low- and middle-income countries. Cross-sectional, community-based data from the World Health Organization (WHO) Study on global Ageing and adult health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. Unclean cooking fuel referred to kerosene/paraffin, coal/charcoal, wood, agriculture/crop, animal dung, and shrubs/grass. Multivariable logistic regression analysis was conducted to assess associations. Data on 13,623 individuals were analyzed [mean (SD) age 72.8 (11.0) years; 45.5% males]. Unclean cooking fuel (vs. clean cooking fuel) was associated with a significant 1.48 (95% CI = 1.08–2.03) times higher odds for MCI. Having no chimney or hood for cooking ventilation was also associated with significantly higher odds for MCI (OR = 1.88; 95% CI = 1.25–2.84). Unclean cooking fuel use and lack of chimney or hood for cooking ventilation were associated with higher odds for MCI. Findings support the implementation of the United Nations Sustainable Goal 7, which advocates affordable, reliable, sustainable, and modern energy for all, as this may also help reduce MCI and ultimately dementia.

ObjectiveTo assess the effectiveness of 448 kHz monopolar capacitive resistive radiofrequency (MCRR) in the treatment of females with stress urinary incontinence (SUI).Materials and methodsForty females with SUI complaints were separated randomly into two equal groups. Group A with 20 females received the MCRR therapy for 20 min and performed pelvic floor exercises for 20 min. Group B with 20 females received placebo treatment by applying the same application as in Group A without emitting any waves for 20 min, three times a week, for 4 weeks. The patients in both groups were instructed to pause the treatment during their menstruation; the patients were instructed to maintain home pelvic floor exercises. Both groups were assessed by a perineometer that was used to assess the strength of the pelvic floor muscles (PFM), the visual analogue scale (VAS), and the Incontinence Symptom Severity Index to assess the frequency of urinary incontinence symptoms as described by each patient before treatment and after 4 weeks of treatment.ResultsThere was a significant reduction (p

The aim of the study was to investigate the cross-sectional association between diabetes and dental caries in a representative sample of 23,089 adults residing in Spain. Data from the Spanish National Health Survey 2017 were analysed. Diabetes (independent variable) and dental caries (dependent variable) were evaluated through a self-reported questionnaire. The association between diabetes and dental caries in the overall sample was assessed using logistic regression models adjusted for sex, age, marital status, education, smoking, alcohol consumption, obesity, hypertension, and hypercholesterolemia. The prevalence of dental caries was 20.6% in the overall population and was significantly higher in men and in young (≤40 years) and middle-aged adults (41–65 years) than in women and older adults (>65 years), respectively. After adjusting for control variables, there was a positive and significant association between diabetes and dental caries in the overall population (OR = 1.30, 95% CI = 1.15–1.46). The relationship between diabetes and dental caries was particularly strong in women (OR = 1.45, 95% CI = 1.22–1.71) and in adults aged ≤40 years (OR = 1.80, 95% CI = 1.05–3.05). In conclusion, in this large representative sample of Spanish adults, diabetes was associated with having a higher prevalence of dental caries, with females and younger adults at greatest risk. Patients with diabetes and dental practitioners should be aware of these associations and act accordingly. Future research should aim to investigate the mediating factors involved in the observed association between diabetes and dental caries.

ObjectiveThe prevalence of diabetes mellitus in Mexico is very high. This study aimed to compare the risk factors of diabetes mellitus in Mexican adults in 2003 and in 2014.MethodsThis study had a repeated cross-sectional design. Data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) from Mexico (Wave 0, 2003, and Wave 2, 2014) were compared. Self-reported diabetes mellitus (outcome) was evaluated with the yes/no question: “Have you ever been diagnosed with diabetes mellitus (high blood sugar)?” Bivariate analyses and multivariable logistic regression analyses adjusted for potential risk factors were conducted.ResultsIn 11 years (2003–2014), the prevalence of self-reported diabetes mellitus in Mexican adults increased by 2.6 times in those younger than 50 years (2003: 2.1%; 2014: 5.5%) and by 1.9 times in those ≥50 years (2003: 12.7%; 2014: 24.2%). In 2003, the risk factors associated with diabetes mellitus were female sex (OR 1.344, 95% CI 1.176–1.536), age ≥50 years (OR 6.734, 95% CI 5.843–7.760), being overweight (OR 1.359, 95% CI 1.175–1.571), obesity (OR 1.871, 95% CI 1.583–2.211), and lower physical activity of

We aimed to analyze personality-related determinants of physical activity among Polish and Spanish physical education (PE) students. The study was conducted among 219 Polish and 280 Spanish PE students, using the International Physical Activity Questionnaire (IPAQ) and the NEO-FFI Personality Inventory. Compared with Spanish PE students, their Polish counterparts are characterized by a higher level of extraversion and conscientiousness and a lower level of neuroticism. The level of total physical activity for all students was 8,697.21 METs, and this value was higher among Polish students. Among Polish and Spanish PE students, the level of total, vigorous, and moderate physical activity increased along with the increase in extraversion, while a decrease occurred along with the increase in neuroticism. The level of each domain of physical activity also increased in line with the intensification of student conscientiousness. In moderation analyses, it was shown that the home country of students may be considered a moderator of the relationship between conscientiousness and total exercise in such a way that the physical activity increased along with the increase in conscientiousness only among the Polish students. In addition, the country is a moderator of the correlation between moderate physical activity and neuroticism (p = 0.031), openness (p = 0.049), and conscientiousness (p = 0.019), with moderate activity only decreasing among Polish students and increasing along with the increase in openness and conscientiousness. Positive correlations among physical activity, extraversion, and conscientiousness, as well as negative ones with neuroticism, were demonstrated among Polish and Spanish students, and also the moderating impact of the country on the correlation between personality-related dimensions and physical activity.

This study aimed to demonstrate the changes of selected blood parameters in relation to 25(OH)D concentration during the autumn period in young soccer players. A total of 35 participants’ results (age: 17.5 ± 0.6 years, body mass 71.3 ± 6.9 kg) were tested twice: in mid-September and in mid-December and divided into subgroups with regard to two criteria. First, according to the initial level of the 25(OH)D concentration (optimal group—ODG, suboptimal group—SDG), second, according to drops in 25(OH)D concentration (high drop group—HDG, low drop group—LDG). A significant decrease (p < 0.001) in the 25(OH)D concentration was reported in the total group (TGr) and in all subgroups. Blood parameters such as white blood cells, red blood cells, haemoglobin and haematocrit increased significantly (p < 0.05) in TGr during the analysed period of time. The analysis of changes in the lipid profile did not expose significant differences except triglycerides. The asparagine amino transferase and creatine kinase activity decreased significantly after autumn in all analysed groups. The declining level of 25(OH)D concentration should be compensated (e.g., with vitamin D supplementation) during autumn. Applied training loads could also influence the blood parameters variability in young soccer players. Regular measurements of 25(OH)D concentration are helpful in identifying potential drops and allows for the preparation of individual supplementation plans for the players.

Objective: This study aimed to explore gender differences in the associations between cataracts and self-reported depression and chronic anxiety in Spanish adults with diabetes.Methods: Cross-sectional data from the Spanish Health Survey 2017 were analyzed. Inclusion criterion was a positive response to the question “Have you ever been diagnosed with diabetes?” Diabetes, cataracts, depression and chronic anxiety were based on self-reported lifetime diagnosis. Multivariable logistic regression was conducted to assess the association between cataracts and depression or anxiety among respondents with diabetes, stratifying by gender.Results: Out of a total 23,089 respondents, 2,266 people self-reported suffering from diabetes (50.2% women; average age 69.7 ± 12.7 years; age range 15-98 years). In people with diabetes, the presence of cataracts was associated with significantly higher odds for depression (OR = 1.655; 95% CI = 1.295-2.115). Gender-stratified analyses showed that only women with cataracts were significantly associated with higher odds for depression (OR = 1.762; 95% CI = 1.307-2.374) and chronic anxiety (OR = 1.519; 95% CI = 1.067-2.163).Conclusion: Cataracts are a significant risk factor for depression and chronic anxiety in Spanish women with diabetes, but not in men. Women with both diabetes and cataracts require assessment for depression and chronic anxiety, and possibly earlier interventions in order to reduce the potential risk of further mental health complications.

This study aimed to analyse the temporal change of diabetes and any associated risk and protective factors for diabetes in Chinese adults between Wave 0 (2003) and Wave 1 (2009) of the World Health Organization (WHO) Study on global AGEing and adult health (SAGE).Data from China of the SAGE were analysed. Diabetes (outcome variable) was assessed by the yes/no question: “Have you ever been diagnosed with diabetes (high blood sugar)?”. Exposure variables examined in bivariate and multivariate multiple regression included sex, age, marital status, education, smoking, alcohol, fruit and vegetables consumption, physical activity and body mass index (BMI). Significant exposure variables in bivariate analyses were included in multivariate analyses (2003: age and tobacco; 2009: age, BMI, education and alcohol).In Wave 0 (2003), there were 3993 Chinese adults, of which 67 (1.7%) self-reported to have diabetes. In Wave 1 (2009), there were a total of 9524 Chinese adults, of which 770 (8.1%) had diabetes. The overall prevalence of diabetes in Chinese adults increased by 4.76 times between the two timeframes (1.7%, age range 27–84 years, average age 58.51 ± 12.70 years, 59.70% females in 2003 to 8.1%, age range 20–95 years, average age 65.31 ± 10.19 years, 53.64% females in 2009). Multivariate regression retained older age ≥ 60 years (OR 4.34, 95% CI 2.67–7.07) as the main risk factor in 2003 data, while in 2009 the odds ratio for older age ≥ 60 years decreased (OR 2.45, 95% CI 2.06–2.92), but included a significant association of obesity (OR 2.11, 95% CI 1.60–2.78) and excess weight (OR 1.42, 95% CI 1.19–1.69).The significant association with excess weight and obesity associated with the increased prevalence of diabetes in 2009 is a cause of concern and should be addressed by public health strategies in China.

High-heeled shoes adversely affect spinal curvature, increase the risk of low back pain, and disturb the normal gait pattern. The purpose of this study was to examine, from a biopsychosocial point of view, the combined effect of wearing two different heel heights and of hormonal oscillation throughout different phases of the menstrual cycle on spinopelvic alignment. Notably, 70 females with an average age of 20.42 ± 1.51 years participated in this study, wearing each female two different heel heights as follows: low (2.5 cm) and high (7 cm). Spinopelvic alignment was evaluated by rasterstereography formetric 3D analysis during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Statistical analysis showed that there was no significant difference (p > 0.05) on spinopelvic alignment [kyphotic angle (KA), trunk inclination (TI), and pelvic inclination] between wearing low- or high-heeled shoes during early follicular, ovulatory, and mid-luteal phases of the menstrual cycle. Considering that high-heeled shoes are traditionally associated with femininity, body image, beauty, and charm, this research has important biopsychosocial implications that should be explored in detail in future studies.

In response to the coronavirus disease 2019 (Covid-19) world pandemic, affected countries such as Spain enacted measures comprising compulsory confinement as well as restrictions regarding free movement. Such measures likely influence children's and adolescents' lifestyles. Our study aimed to investigate the impact that the Covid-19 confinement has on health-related behaviors (HRBs) among Spanish children and adolescents. An online survey was administered to 516 parents to collect data about 860 children and adolescents (49.2% girls) aged between 3 and 16 years in relation to physical activity, screen exposure, sleep time, and fruit and vegetable consumption during the Covid-19 confinement. Respectively, t-paired test and t-test between groups served to check differences between HRBs levels before and during the confinement as well as between strict and relaxed confinement. Significant differences were found for a reduction of weekly minutes of physical activity during the confinement (−102.5, SD 159.6) (p < 0.001), an increase of daily hours of screen exposure (2.9, SD 2.1) (p < 0.001), and a reduction of daily fruit and vegetable consumption (−0.2, SD 1.6) (p < 0.001). Sleep time showed a significant difference between strict and relaxed confinement (−0.3, SD 0.1) (p < 0.05), whereas binomial logistic regression adjusted for covariates (age, sex, education of the parents, siblings, current condition, exposure to Covid-19, and previous health risk behavior) showed significantly lower odds for screen exposure risk behavior with relaxed confinement (OR 0.60, 95%CI 0.40–0.91). The present study suggests that Covid-19 confinement reduced physical activity levels, increased both screen exposure and sleep time, and reduced fruit and vegetable consumption. Therefore, most HRBs worsened among this sample of Spanish children and adolescents. Closure of schools, online education, and the lack of policies addressing the conciliation between labor and family life could have played an important role in HRBs worsening among pupils, which might be mitigated with adequate conciliation policies, parental guidance, and community support.

The World Health Organization (WHO) has declared a world pandemic due to COVID-19, and several enacted measures such as compulsory confinement may have collateral consequences on both physical and mental health. We aimed to investigate associations between current physical activity (PA) and current perceived anxiety and mood among a sample of Spanish adults confined due to COVID-19 restrictions of movement. Using an online survey, we collected data on the Spanish adult population regarding health habits during the first days of enacted confinement. A total of 2250 participants (54.8% women) aged 35.3 (SD 13.6) completed the survey, which included questions about sociodemographic characteristics (i.e. age, gender, civil status, education, and occupation), health habits (i.e. prior PA, alcohol consumption, smoking, screen exposure, and sleep hours) and COVID-19 confinement context (i.e. number of isolation days, solitude, and exposure to COVID-19). Physical Activity Vital Sign (PAVS) short form was used to estimate weekly minutes of PA, whereas a single-item question was used to assess both current perceived anxiety and mood. We conducted weighted binomial logistic regressions to check associations between current adherence to WHO guidelines of PA and current perceived anxiety and mood of confined adults. Significant inverse associations between overall adherence to PA and current perceived anxiety in the final adjusted model (OR, 0.66; 95% CI, 0.54–0.79) as well as in several subgroup analyses such as younger women were observed. In addition, a borderline significant inverse association was found between current PA and current perceived worse mood when fully adjusted (OR, 0.82; 95% CI, 0.68–1.00); this association was significantly stronger in women than men. The results of the present study indicate that current PA adherence to WHO guidelines in the initial phase of COVID-19 confinement associates with both lower current perceived anxiety and lower current perceived worse mood among a sample of Spanish adults.

The World Health Organization (WHO) has declared a world pandemic due to COVID-19. In response, most affected countries have enacted measures involving compulsory confinement and restrictions on free movement, which likely influence citizens' lifestyles. This study investigates changes in health risk behaviors (HRBs) with duration of confinement. An online cross-sectional survey served to collect data about the Spanish adult population regarding health behaviors during the first 3 weeks of confinement. A large sample of participants (N = 2,741) (51.8% women; mean age 34.2 years [SD 13.0]) from all Spanish regions completed the survey. Binomial logistic regressions adjusted for socioeconomic characteristics (i.e., gender, age, civil status, education, and occupation), body mass index (BMI), previous HRBs, and confinement context (i.e., solitude and exposure to COVID-19) were conducted to investigate associations between the number of weeks confined and a set of six HRBs (physical activity, alcohol consumption, fresh fruit and vegetable consumption, smoking, screen exposure, and sleep hours). When adjusted, we observed significantly lower odds of experiencing a higher number of HRBs than before confinement overall in a time-dependent fashion: OR 0.63; 95% CI: 0.49–0.81 for the second and OR 0.47; 95% CI: 0.36–0.61 for the third week of confinement. These results were equally consistent in all age and gender subgroup analyses. The present study indicates that changes toward a higher number of HRBs than before confinement, as well as the prevalence of each HRB except screen exposure, decreased during the first 3 weeks of COVID-19 confinement, and thus the Spanish adult population may have adapted to the new situational context by gradually improving their health behaviors.

The aim was to investigate the effectiveness of glucocorticoid therapy in patients with COVID-19. A systematic search of the literature across nine databases was conducted from inception until 15th March 2020, following the PRISMA guidelines. Patients with a validated diagnosis of COVID-19 and using corticosteroids were included, considering all health outcomes. Four studies with 542 Chinese participants were included. Two studies reported negative findings regarding the use of corticosteroids in patients with COVID-19, i.e., corticosteroids had a detrimental impact on clinical outcomes. One study reported no significant association between the use of corticosteroids and clinical outcomes. However, one study, on 201 participants with different stages of pneumonia due to COVID-19, found that in more severe forms, the administration of methylprednisolone significantly reduced the risk of death by 62%. The literature to date does not fully support the routine use of corticosteroids in COVID-19, but some findings suggest that methylprednisolone could lower mortality rate in more severe forms of the condition.

Animals can have a positive influence on human health. However, it is not yet known whether pet ownership can prevent cognitive decline. Therefore, we aimed to investigate cross-sectional and prospective associations between pet ownership and cognitive function in a large, representative sample of older adults. Data were from the English Longitudinal Study of Ageing (ELSA) using data collected in wave 5 and six years later in wave 8. Pet ownership was categorized as no pet, dog, cat or other pet. Cognitive function was assessed using tests of verbal fluency (assessed by asking how many different animals the participants could name in 60 seconds) and memory (sum of immediate and delayed verbal recall). Multiple linear regression, adjusted for potential confounders, was used to test the associations between pet ownership and cognitive function. A total of 8291 people (mean age: 66.72 years) were included. In cross-sectional analyses, dog owners had better verbal fluency than individuals with no pet, but there was no significant difference between cat or other pet owners and those with no pet. In prospective analyses, dog owners had a significantly larger decline in recall than those with no pet, whilst cat owners had a significantly smaller decline in verbal fluency. These results provide some evidence to suggest that pet ownership may have positive effects on cognition in later life. However, benefits of pet ownership were not unilaterally observed across different types of pet and measures of cognitive function suggesting that further research is required.

The purpose of this study was to see the effects of an appropriate behavior development program in relation to the improvement of fair play and social skills behaviors of elementary school children during the physical education class. The participants of this study were 204 students from 5th and 6th grade from seven different public schools in Castilla–La Mancha, Spain. Data was collected through a questionnaire to measure students’ pre and post appropriate behaviors when winning, appropriate behaviors when loosing, appropriate behaviors during the game, fair play skills and social skills, during the physical education class. Results from this study revealed that participants improved their behaviors with the implementation of the intervention (appropriate behavior program), generating positive changes in students’ attitudes and social skills during physical education class. In relation to children gender, girls had better scores than boys in relation to appropriate behaviors when losing. Further, when comparing students’ age, those from 10 to 11 years old scored higher in fair play behaviors and social skills. In conclusion, the intervention program was effective to improve the behaviors of the school children, generating positive changes in their attitudes and social skills during physical education.