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Despite huge advances in the diagnosis and treatment of pediatric cancers over the past several decades, it remains one of the leading causes of death during childhood in developed countries. The development of new targeted treatments for these diseases has been hampered by two major factors. First, the extremely heterogeneous nature of the types of tumors encountered in this age group, and their fundamental differences from common adult carcinomas, has made it hard to truly get a handle on the complexities of the underlying biology driving tumor growth. Second, a reluctance of the pharmaceutical industry to develop products or trials for this population due to the relatively small size of the 'market', and a too-easy mechanism of obtaining waivers for pediatric development of adult oncology drugs based on disease type rather than mechanism of action, led to significant difficulties in getting access to new drugs. Thankfully, the field has now started to change, both scientifically and from a regulatory perspective, in order to address some of these challenges. In this review, we will examine some of the recent insights into molecular features which make pediatric tumors so unique and how these might represent therapeutic targets; highlight ongoing international initiatives for providing comprehensive, personalized genomic profiling of childhood tumors in a clinically-relevant timeframe, and look briefly at where the field of pediatric precision oncology may be heading in future.

Abstract. Background: Few studies have examined the effect of pandemics on suicide-related outcomes. Aims: We examined whether suicidal ideation levels among the general population changed owing to the COVID-19 pandemic by tracking individuals between January and April 2020. Method: We used a prospective observational longitudinal design ( n = 6,683) and stratified sampling to conduct online surveys of the general adult population in Japan before (baseline) and during the pandemic (follow-up). Results: Suicidal ideation levels were significantly lower during than before the pandemic; however, the effect size was very small. Participants who were younger, with unstable employment, without children, with low income, and receiving psychiatric care were more likely to have higher suicidal ideation levels during the pandemic. Limitations: Because this was an Internet survey and subject to selection bias, the sample was not necessarily representative of the Japanese population. At the time of the survey, COVID-19 cases and deaths in Japan were relatively lower than in other developed countries. The dropout rate may have affected the results. Conclusion: Although the short-term impact of the COVID-19 pandemic on suicidal ideation is limited, relatively young and economically vulnerable individuals are more likely to show exacerbated suicidal ideation during the pandemic.

Foreign aid is one of the most important policy tools that developed countries used to help poor countries improve population well-being and facilitate economic and institutional development. However, the effectiveness of aid as an instrument of development has been questioned several times, especially for its deleterious effects on governance. This study examines the effect of foreign aid on economic complexity in developing countries. Using annual data for 78 developing countries over the period 1990-2017, the empirical findings show that foreign aid exerts a negative effect on economic complexity. Although the effect of aid on economic complexity differs across donors, we also find a U-shaped relationship between foreign aid and economic complexity. In addition, the empirical results of this paper show that democracy mitigates the negative effect of foreign aid on economic complexity. Thus, in order to benefit from the effects of foreign aid for better economic complexity, the governments of developing countries would benefit from putting more effort into improving democracy.

BACKGROUND Stroke and diabetes (DM) are significant interrelated healthcare issues but there is a dearth of data on the prevalence of DM among Australia's regional stroke population. AIMS We aimed to determine the prevalence of DM in stroke patients at a large regional centre, including sub-analyses on stroke subtypes, glycaemic control and renal function in ischaemic stroke (IS). METHODS We conducted a retrospective analysis of all patients (n = 323) with IS or transient ischaemic attack (TIA) admitted to Ballarat Base Hospital from January 2015 to December 2016. Demographic data, cardiovascular risk factors, aetiology/territory of IS, pre-morbid DM status, indicators of glycaemic control and renal impairment were recorded. RESULTS DM was present in 28.5% of IS and TIA patients including 4% being newly diagnosed. Among diabetic IS patients, 45.3% had poor glycaemic control (HbA1c ≥7.0%) while 16% had moderate to severe renal impairment (eGFR of

Survival rates for out-of-hospital cardiac arrest (OHCA) patients in the UK are low compared with other developed countries. UK ambulance services are in an important position to influence these survival rates by improving their ‘chain of survival’ (Nolan et al, 2006). A paramedic-led resource, with enhanced technical and non-technical skills specialising in OHCAs, has been shown to improve patient outcomes in this population group in the UK. The author proposes that this concept should be considered by all UK ambulance services to improve OHCA patient survival.

BACKGROUND: People experiencing homelessness have an increased risk of hepatitis C virus (HCV) infection, with rates higher than the general population. However, their access to HCV diagnosis is limited and treatment uptake is low. OBJECTIVES: To identify and describe the barriers and facilitators for HCV screening and treatment for adults with lived experience of homelessness in highly developed countries. METHODS: Bibliographic databases (Embase, MEDLINE, CINAHL and SocINDEX) and grey literature (Google, EThOS, the Health Foundation, Social Care Online, the World Health Organisation, Shelter, Crisis and Pathway) were searched. Two reviewers independently screened and appraised all studies. The Critical Appraisal Skills Programme tool and the Joanna Briggs Institute checklist were used. The analysis involved a three-stage process: coding, theme generation and theme mapping under Penchansky and Thomas's modified access model. RESULTS: Twelve papers/reports were included in the review. Several interacting factors influence access of people with lived experience of homelessness to HCV testing and treatment. Some mirror those identified for the general population. The precarious conditions associated with the lived experience of homelessness along with the rigidity of hospital settings and lack of awareness emerged as dominant barriers. Flexibility, outreach, effective communication, tailoring and integration of services were found to be important facilitators. Evidence from Black, Asian and minority ethnic groups is limited. CONCLUSIONS: People experiencing homelessness face multiple barriers in accessing and completing HCV treatment, relating to both their lived experience and characteristics of health systems. Although some barriers are readily amenable to change, others are more difficult to modify. The facilitators identified could inform future targeted measures to improve HCV diagnosis and treatment for people experiencing homelessness. Research is warranted into successful models to promote screening, diagnosis and treatment. PATIENT OR PUBLIC CONTRIBUTION: Our team includes a peer advocate, a hepatology nurse and a community volunteer, all with significant experience in promoting and engaging in HCV care and outreach for people experiencing homelessness. They contributed to the protocol, interpretation and reporting of the review findings. ispartof: HEALTH EXPECTATIONS vol:25 issue:1 pages:48-60 ispartof: location:England status: published

Cardiovascular diseases (CVD) are the leading cause of death and disability in the population of most countries of the world. It is also noted the dangerous trend to «rejuvenation» of myocardial infarction and stroke. It is expected that by 2030, over 23 million people will die from these diseases, and they retain the leadership among the causes of death of the world’s population. However, if in the developed countries the number of deaths from cardiovascular disease is reduced, in others it is growing rapidly. Ukraine — among the latter.According to World Health Organization, the World Heart Federation and the World Stroke Organization, 30 % of CVD deaths in the world are untimely, and 2/3 of these cases can be avoided through prevention, the main directions of which, in terms of evidence-based medicine, are discussed in this review.

BACKGROUND: Drug supply disruptions have increased during the COVID-19 pandemic, especially for medicines used in the ICU. Despite reported shortages in wealthy countries, global analyses of ICU drug purchasing during COVID-19 are limited. RESEARCH QUESTION: Has COVID-19 impacted global drug purchases of first-, second-, and third-choice agents used in intensive care? STUDY DESIGN AND METHODS: We conducted a cross-sectional time series study in a global pharmacy sales dataset comprising approximately 60% of the world's population. We analyzed pandemic-related changes in units purchased per 1,000 population for 69 ICU agents. Interventional autoregressive integrated moving average models tested for significant changes when the pandemic was declared (March 2020) and during its first stage from April through August 2020, globally and by development status. RESULTS: Relative to 2019, ICU drug purchases increased by 23.6% (95% CI, 7.9%-37.9%) in March 2020 (P < .001) and then decreased by 10.3% (95% CI, -16.9% to -3.5%) from April through August (P = .006). Purchases for second-choice medicines changed the most, especially in developing countries (eg, 45.8% increase in March 2020). Despite similar relative changes (P = .88), absolute purchasing rates in developing nations remained low. The observed decrease from April through August 2020 was significant only in developed countries (-13.1%; 95% CI, -17.4% to -4.4%; P < .001). Country-level variation seemed unrelated to expected demand and health-care infrastructure. INTERPRETATION: Purchases for intensive care medicines increased globally in the month of the COVID-19 pandemic declaration, but before peak infection rates. These changes were most pronounced for second-choice agents, suggesting that inexpensive, generic medicines may be purchased more easily in anticipation of pandemic-related ICU surges. Nevertheless, disparities in access persisted. Trends seemed unrelated to expected demand, and decreased purchasing from April through August 2020 may suggest overbuying. National and international policies are needed to ensure equitable drug purchasing during future pandemics.

Purpose To evaluate the current trends and factors associated with the first anti-seizure medications (ASMs) prescribed for epilepsy in Taiwan. Methods Data for patients with epilepsy were collected from the National Health Insurance Research Database, a population-based claims database. We selected patients with newly diagnosed epilepsy from 2013 to 2016. Multivariate logistic regression was used to examine the factors associated with the selection of newer ASMs for the first prescription. Results A total of 73,891 patients with newly diagnosed epilepsy were eligible for the study, and the annual incidence was approximately 0.79 per 1,000 people. The five ASMs most prescribed for monotherapy were valproic acid, phenytoin, levetiracetam, gabapentin, and oxcarbazepine, accounting for nearly 90% of all ASMs. Valproic acid was the most-prescribed ASM (more than 30%), and levetiracetam has replaced phenytoin as the second choice since 2015. Factors associated with the selection of newer ASMs for the first prescription were patients’ year of diagnosis, gender, socioeconomic level, and previous or existing comorbidities and the profiles of the care providers (accreditation level, service volume, geographic location, and degree of urbanization of the surrounding area). Conclusion The data indicated that the trends in ASMs first prescribed for patients in Taiwan accorded with most of the international epilepsy treatment guidelines. However, there were some differences between our results and those in developed countries. In addition, we observed a large urban-rural disparity in the administration of ASMs.

BACKGROUND: An important global public health problem in many economically developed countries, in particular Kazakhstan, is the leading cause of incidence of and mortality from cardiovascular disease (CVD). AIM: The purpose of our study was to compare incidence and mortality from CVD in urban and rural areas of the Republic of Kazakhstan in 2019 based on statistics. METHODS: We conducted a descriptive study, which based on secondary data from the statistical reports on the Republic of Kazakhstan «Health of the Republic of Kazakhstan and the activities of health care organizations». Information from this database were generated by 14 provinces, three cities of republican significance and whole Kazakhstan. In addition, these indicators were divided for rural and urban settlements. RESULTS: Data from our epidemiological study of the incidence of and mortality from cardiovascular disease (CVD) in all provinces indicate a relatively high incidence of and mortality from CVD among urban population of the Republic of Kazakhstan. Among urban residents (per 100,000 population), the highest incidence rates of CVD was in Akmola province (3771.7), the ischemic heart disease (IHD) was in Almaty city (850.8), arterial hypertension (AH) was in Akmola province (2623.8), acute myocardial infarction was in the North Kazakhstan province (212.9), the highest mortality from CVD was in Karaganda province (365), the IHD was in East Kazakhstan province (135.4). Among rural residents (per 100,000 population), there are high incidence rates of CVD in the East Kazakhstan province (3452.8), the IHD in Zhambyl province (713.1), AH in the East Kazakhstan province (1871.4), acute myocardial infarction in Atyrau province (148.3), the highest mortality from CVD was in East Kazakhstan province (201.9), and the IHD also in East Kazakhstan province (77.3). CONCLUSIONS: There is rural-urban health inequality in many countries and CVD is not the exclusion. In the Republic of Kazakhstan, the rural population has got lower rates of incidence and mortality. This may be due to the bad access to medical facilities that are typical for rural areas of Kazakhstan and the shortage of modern diagnostic equipment which may interfere with timely diagnosis.

Introduction: Nowadays, adolescent and youth’s health has become increasingly important. The world health organization (WHO) emphasizes the importance of evaluating the structure, process, and outcome of health services. This study was conducted to design a health services’ management of adolescents and youth model for the Iranian population, to improve young people's health. Method: This study is a comparative, quantitative-qualitative study. Countries were selected by comparing adolescent and youth health indicators based on population and availability of information. By studying the health services’ management of adolescents and youth, essential variables and dimensions in the initial model were identified, and a preliminary questionnaire was developed and approved by experts. One hundred seventy-eight final questionnaires were completed by experts. Exploratory factor analysis was performed to determine the practical factors (SPSS 20), and the model’s fit was examined by confirmatory factor analysis (Amos 24). Results: A total of 6 factors were identified as effective in health services’ management of adolescents and youth, including, health service package, human resources, financial resources, equipment and services’ provision, data & statistics information resources, and health service delivery management of adolescents and youth, With a maximum 0.97 operating load had the highest and equipment and services’ provision (0.53), had the least impact. Conclusion: The proposed model has the most significant impact on the management of health services’ management of adolescents and youth components.

The article highlights the experience of libraries working with older generation users in certain foreign countries faced with the modern demographic problem - the aging of the population: Germany, Canada and Australia. The modern forms of work of libraries of these countries with the elderly, which are of interest to Russian libraries, are identified and characterized. Difficulties in the work of foreign libraries with the older generation during the COVID-19 pandemic are separately noted. The authors come to the conclusion, that despite the differences in location, size, departmental affiliation, quantity and quality of the fund, and so on, many libraries in developed countries face the same problem - the increasing number of elderly readers and reconstruct their work in accordance with the new demographic and socio-cultural situation, which requires libraries to develop special services to save the cultural capital of older generations.

PurposeTo investigate the burden of near vision loss (NVL) in China by year, age and gender from 1990 to 2019.MethodsWe used estimates from the Global Burden of Disease (GBD) 2019 study to report the prevalence and disability-adjusted life-years (DALYs) due to NVL in China. Estimates of crude counts and age-standardised rates per 100 000 population are accompanied by 95% uncertainty intervals (UIs). We summarised the age-specific and sex-specific patterns and trends regarding the burden of NVL in China, compared with seven neighbouring countries.ResultsFrom 1990 to 2019, the all-age number and rate for NVL prevalence and DALYs increased significantly in China (all pConclusionsDespite a small decrease in age-standardised prevalence and DALYs due to NVL in China in the past two decades, the existing burden is still considerable and significantly higher compared with neighbouring developed countries. An approach that includes all stakeholders is needed to further reduce this burden.

Introduction. Cerebrovascular diseases are a medical and social problem for developed countries in the second half of the 20th century and the beginning of the 21st century. The study of special mortality rates makes it possible to study in depth the nature of this pathology, its intensity among the population and to formulate reasoned program solutions aimed at reducing its frequency in the population.The aim of the research is to identify trends and features of the dynamics of mortality in connection with cerebrovascular diseases in different age and sex groups of Irkutsk Region population.Materials and methods. The subject of the research is deaths from cerebrovascular diseases among Irkutsk Region population for the period of 2000–2020. A continuous method of statistical observation was used; the grouping of the material was carried out by distributing the deceased by sex and five-year age interval, with subsequent calculation of mortality tables. The dynamics of the quantitative measure of mortality was determined by calculating the matrix of time series indicators.Results and discussion. For the period of 2000–2020, in the Irkutsk Region, there was a decrease in mortality rates from cerebrovascular diseases both among the male and female population. Mortality rates by sex are higher among the male population, as indicated by the ratio of the ratio of mortality between men and women in all age intervals. The multiplicity of the ratio of indicators increases during the research period from the maximum values of 2.1 times in 2000 to 5.0 times in 2020. The maximum difference shifts from the age of 55–59 to the age group of 40–44. The intensity of mortality reduction in the dynamics of 2000–2020 among the female population is higher than the male. Based on the results of the analysis of the time series, it was found that the age-specific exponent of mortality in the content of 1 % of the mortality increase has a more pronounced quantitative measure for the male population.Conclusion. As the result of the research, for twenty-year observation period a decrease in mortality rates from cerebrovascular diseases was revealed. The age-specific mortality rate from cerebrovascular diseases in the male population is higher than in the female population. The maximum intensity of the difference in mortality between men and women is reached in the working age groups. The content of the indicator 1% of increase in deaths in the male population is higher than that of the female. State policy in the development and implementation of target-oriented programs for reduction of mortality should be based on thorough analysis of data of administrative districts.

Healthy nutrition is the most important component of the quality of life of the population. Disorders of the nutritional structure lead to the development of alimentary-dependent diseases, including cardiovascular, oncological, diabetes mellitus, obesity, osteoporosis, etc., that are the main causes of premature mortality of the population of economically developed countries, including Russia. This is due, among other things, to the low level of knowledge of the population about the principles of healthy nutrition. In order to eliminate the existing gap in the competence of the population on healthy nutrition, the Centre for Hygienic education of the population of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow, as a part of the implementation of the federal project ‘Formation of a system of motivation of citizens to a healthy lifestyle, including healthy nutrition and rejection of bad habits' (‘Strengthening the Public Health'), which is a part of the national project ‘Demography', conducts systematic activities aimed at creating and maintaining an information and educational environment.

Background Rapid population aging in developed countries has resulted in the working-age population increasingly being tasked with the provision of informal care. Methods An educational intervention was delivered to 21 carer-employees employed at a Canadian University. Work role function, job security, schedule control, work–family conflict, familywork conflict, and supervisor and coworker support were measured as part of an aggregated workplace experience score. This score was used to measure changes pre/post intervention and at a follow-up period approximately 12 months post intervention. Three random intercept models were created via linear mixed modeling to illustrate changes in participants' workplace experience across time. Results All three models reported statistically significant random and fixed effects intercepts, with a positive coefficient of change. Conclusion This suggests that the intervention demonstrated an improvement of the workplace experience score for participants over time, with the association particularly strong immediately after intervention.

Forty-six mothers and children from the United Arab Emirates participated in a pilot study to determine possible micronutrient deficiencies in the country. Thirty-five per cent [35%] of the children and 21% of the mothers had low serum ferritin levels, while 30% of the mothers had low serum 25-hydroxyvitamin D with 28% of mothers having a low serum folate status. These deficiencies are widespread in the nationals of the United Arab Emirates. In view of the increasing importance of intrauterine and early infant nutrition, further investigation and a national study seem warranted

Resumen: En los últimos 25 años, Chile se ha consolidado como país agroexportador en la economía mundial. Posee una eficiente tasa de productividad basada en el desarrollo tecnológico de la agricultura, con vastas extensiones de monocultivos cuya productividad depende de la aplicación intensiva de plaguicidas, la cual se realiza con escasas regulaciones y fiscalizaciones, y se desconoce la magnitud del riesgo de exposición en la población y sus efectos en la salud a corto o largo plazo. Esta revisión sistemática recopila evidencia epidemiológica de varias regiones de Chile respecto a la exposición a plaguicidas y sus efectos en la salud poblacional. Del total de las publicaciones, el 50% se refieren a trabajadores agrícolas, el 25% a niños/as y el 25% a mujeres en edad fértil, y los efectos más observados son neurotóxicos (54%), genotóxicos (31%) y reproductivos (15%). La evidencia muestra que, en Chile, los niveles de exposición en población general y ocupacional son superiores a los encontrados en estudios internacionales. Es urgente proteger la salud tanto de la población ocupacional como de la general, en especial de los/las niños/as, a través de un mayor control en la venta y el uso de plaguicidas, con sistemas integrales de vigilancia en salud ambiental y acciones educativas en el contexto social y cultural de las comunidades rurales. Resulta prioritario potenciar la investigación sobre daños en salud y restringir legalmente de manera estricta el uso de plaguicidas peligrosos ya prohibidos en países desarrollados por su alto riesgo para la salud de las personas y el medio ambiente. Abstract: In the last 25 years, Chile has had an expanding role as an agro-export country in the global economy, with efficient rates of productivity in the region, based on the technological development of agriculture, with of large monocultures whose productivity depends on the intensive application of agrochemicals. This form of agriculture has also lacked efficient regulations and surveillance, so it is difficult to estimate the real magnitude of the exposed population and its effects on health in the short or long term. This systematic review compiles the epidemiological evidence generated from studies conducted in several regions of Chile regarding pesticide exposure and health effects. Of the total number of articles, 50% included agricultural workers, 25% children, and 25% women of childbearing age, with the greatest effects being the neurotoxic (54%), genotoxic (31%) and reproductive (15%). The evidence collected shows that in Chile the levels of exposure to pesticides in the general and occupational population are higher than international studies levels. It is urgent to protect the health of both the occupational and general population and especially children through a stricter control of the sale and use of pesticides, with comprehensive surveillance systems in environmental health and educational actions in the social and cultural context of rural communities. It is a priority to strengthen research with national relevance on health effects, and strictly restrict the use of pesticides already prohibited in developed countries due to their high level of risk to human and environmental health.

Background Many deaths in infants from low-middle income countries (LMICs) occur at home or upon arrival to health facilities. Although acute lower respiratory tract illness plays an important role in community mortality, the accuracy of mortality rates due to respiratory syncytial virus (RSV) remains unknown. Methods An active surveillance study among children aged under 5 years old (U5) was performed in Buenos Aires, Argentina, between January and December 2019, to define the burden and role of RSV in childhood community mortality. Results A total of 63 families of children U5 participated in the study. Based on a combined approach of tissue sampling, verbal autopsies, and expert’s analysis, RSV infection was found in the causal chain of 11 from 12 cases with positive molecular biology results in respiratory samples. The estimated mortality rate due to RSV among infants was 0.27 deaths/1000 live births. The mean age of RSV-related household deaths was 2.8 months of age (standard deviation [SD] 1.7), and 8/12 were male infants (66.7%). Dying at home from RSV was associated with Streptococcus pneumoniae and/or Moraxella catarrhalis lung coinfection (75%), living in slums and settlement (odds ratio [OR], 17.09; 95% confidence interval [CI], 1.3–219.2), and other underlying comorbidities (OR, 14.87; 95% CI, 1.3–164.6). Conclusions Infant community mortality rates due to RSV are higher than those reported in industrialized countries and similar to those reported in hospital-based studies in the same catchment population.

Studied the pharmaceutical support of affected individuals in the conditions of special period. The meaningful meaning is determined: special period; affected individuals and their close relatives. Particularities of the pharmaceutical provision of affected contingents of the population in the conditions of special period were studied. Proved that the analysis of the experience of economically developed countries is useful for the formation of a powerful and effective healthcare system in Ukraine for the pharmaceutical provision of affected and privileged categories of citizens in emergency situations. The necessity of further researches in the field of pharmaceutical provision of persons who suffered in the conditions of the special period is substantiated.

Purpose of review Risk factors for obstetric venous thromboembolism (VTE), a leading cause of maternal mortality in the United States, are increasing on a population basis. This review provides the obstetrician with an update of current issues related to obstetric VTE risk, prophylaxis, outcomes, anaesthesia considerations and future research opportunities. Recent findings Obstetric VTE affects approximately 1 per 1000 pregnancies and accounts consistently for 9-10% of maternal deaths in the United States. In industrialized countries, risk factors for VTE, including overweight/obesity, caesarean delivery and obstetrical complications such postpartum haemorrhage and infection continue to increase. VTE prophylaxis is central to reducing maternal mortality. However, recommendations for prophylaxis from leadership societies vary widely. In the UK, maternal mortality risk from VTE has decreased significantly in the setting of broader heparin prophylaxis. In the United States where mechanical VTE prophylaxis is used more commonly, mortality risk has remained constant. Summary Obstetric VTE is a leading cause of maternal mortality in the United States. The incidence of risk factors for obstetric VTE continues to increase. Currently, recommendations for obstetric VTE prophylaxis vary substantially. Opportunities for research in this area exist to optimize prophylaxis and improve maternal outcomes.

Background: Malaysians are less likely to be highly exposed of the information regarding genetic tests as compared to citizens of developed countries in the world. In addition to that, little is known about the level of knowledge and awareness of the genetic testing for risk of breast cancer detection among the students in University Technology Mara (UiTM). Materials and methods: A cross-sectional with correlational design study using a self-administered questionnaire was conducted among medical and non-medical undergraduate students of University Technology Mara (UiTM). The population from which the convenience sample gathered were those who fulfilled the inclusion criteria of this study. Results: Three hundred and eighty six (386) respondents were involved in present study, (50.8%) of them were familiar with the existence of the test while the remaining (49.2%) did not know about the genetic tests available for detecting gene mutations. Regards their interest in genetic testing to detect inheritable mutations, (35.8%) of them were definitely interest in the test, (38.3%) of them were probably interest in the test, (20.7%) of them were considering the test and the remaining (5.2%) have no interest in the test at all. About their awareness of the genetic test available for mutations detections, majority of them, (67.9%), agreed to get tested in order to learn of their own risk in getting breast cancer. In terms of their reason to avoid being tested, many of them, (40.7%) mentioned that the main reason is if the result comes out positive for genetic mutations, it will disrupt their daily lives. Conclusion: There were mild level of knowledge and moderate level of awareness about breast cancer genetic tests, but the respondents showed high level of interest towards genetic test available for breast cancer risk detection. Educational materials and programs may increase knowledge and awareness about the genetic test available for detection of inheritable mutations. The effectiveness of the educational strategies shall be tested in the future.

O câncer de boca é um problema de saúde pública em todo o mundo. Apesar da grande incidência de casos em países desenvolvidos, a maior parte dos casos detectados tardiamente são em países subdesenvolvidos e frequentemente na população com pouco acesso a serviços de saúde e informação. O diagnóstico precoce exerce um importante papel estratégico nesse enfrentamento, visto que o diagnóstico tardio contribui para um prognóstico desfavorável. As principais causas associadas ao desenvolvimento dessa neoplasia são principalmente o tabagismo e o etilismo. O cirurgião-dentista ocupa um papel de grande importância no diagnóstico do câncer de boca, além disso pode contribuir na elaboração ações e políticas para a prevenção e o diagnóstico precoce do câncer de boca. O objetivo é avaliar, por meio de revisão de literatura a atividade do cirurgião-dentista no diagnóstico e manejo do câncer de boca. Foi realizado uma revisão de literatura usando o Google Acadêmico e palavras-chave: câncer de boca, fatores de risco, cirurgião-dentista, diagnóstico e tratamento. O papel do cirurgião-dentista é de grande importância nos níveis de atenção à saúde, pois além de diagnosticar e acompanhar o paciente com câncer de boca, o qual pode apresentar efeitos colaterais em decorrência do tratamento antineoplásico. O cirurgião-dentista pode contribuir na elaboração e execução de projetos que visam a prevenção, reforçando os fatores de risco e os aspectos clínicos das lesões potencialmente malignas.

In the current century, the development of medicine and molecular biotechnology led to successful containment and even eradication of some human pathogens, especially in developed countries. However, some pathogens have evolved, resulting in the emergence of other infectious diseases in developed countries. Human socioeconomic activities and the advancement of technology and transportation have led to the quick movement of humans to different parts of the world. There is a significant concern that this movement enhances the distribution of pathogens, making it difficult to contain, as witnessed with the global spread of the 2009 influenza pandemic within only 3 months and the 2014 Ebola outbreak, which spread in various West African countries within 8 months. Natural products obtained from plant sources can be identified as the next-generation antibacterial and antiviral alternatives. In developed countries, 80% of the population depends on traditional medicine for their primary healthcare issues, according to the World Health Organization (WHO). Relatedly, India is one of the highest producing countries for medicinal herbs. It is considered an international botanical garden. Therefore, the focus of this current review was on the importance of using plants to treat bacterial and viral diseases due to the many advantages of these plants.

Lung cancer (LC) is the main cause of morbidity and mortality in the population of Russia and many economically developed countries of the world. At the same time, referring to localizations with a high mortality rate, the official data on the number of recorded primary cases (which form the incidence rate) are significantly underestimated, which is confirmed by the registration reliability index, which in many territories is higher than critical values. The aim of our study is to present the real state of the prevalence of PC in Russia, based on the newly created database (DB) of the population cancer register (PRR) of the Northwestern Federal District of the Russian Federation (NWFD RF) — the only one in Russia. We analyzed the loss of the number of primary patients who were not included in the state reporting, showed the real value of the achieved death rate of patients in the first year of dispensary observation, calculated the patterns of annual mortality of patients, the median of survival and 1 and 5-year survival of patients with lung cancer based on the database of the population cancer registry. Northwestern Federal District of the Russian Federation, on the materials of which for the first time in Russia the dynamics of changes in the detailed localization and histological structure of lung cancer was traced.

Recent years have seen an increase in research on leisure and aging due, in part, to the aging of the population in many economically developed countries. Much of this literature has explored the r...

India is more challenged than developed nations in reducing the Covid-19 cases and lowering death rates due to the huge population and unprepared health care system. As intention to vaccinate is contextual and its availability does not translate into their de facto adoption., this paper examines the factors that determine intention to vaccinate against COVID-19 in India. A research model was tested using 222 responses was tested using structural equation modeling. Findings suggested that credibility and awareness positively impacted whereas vaccine hesitancy and perceived risk negatively influenced intention to vaccinate. The fear of side effects did not impact the intention to vaccinate.

Purpose of the Study: The key purpose of the study was to know the perceptions of stakeholders (Principals, Teachers, Students, and Parents) regarding economic (financial) adjustment of Public, Private Schools, and Deeni Madaris students in society. Methodology: The study was a survey (cross-sectional) in nature. The population of the study consisted of (N = 405957) respondents including Principals, teachers, students, and parents in which (n =1500) respondents were taken as samples of the study by applying L.R. Gay, (2003) Sample Size rule of thumb through multistage sampling techniques. In the study, Public, Private schools and Deeni Madaris students were compared regarding their economic (financial) adjustment in society. Data were taken through a self-developed questionnaire of the 6-Points Likert scale. The Study delimited to six Southern districts of KP. Results, Discussion, and Conclusions were drawn in the study. Main Findings: The key findings of the study revealed in results were that the perceptions of stakeholders (Principals, teachers, students, and parents) were found more inclined towards Deeni Madaris students regarding their economic (financial) adjustment of students in society as compared to Public and Private school students. Applications of this study: The study may be quite useful and significant for school heads, teachers, parents, students, government, education department, policymakers, and public as well if the students of Public, Private schools and Deeni Madaris were encouraged towards economic (financial) activities in developing country like Pakistan for their better earning purposes e.g. students practicing their economic (financial) practices in advanced countries like China, USA, United Kingdom and so on. Novelty/Originality of this study: This study may be a new approach in Pakistan to encourage students towards economic (financial) responsibilities to earn and make money in order to facilitate their families (parents), and even the government of the time to reduce poverty in Pakistan in this regard like students earning and strengthening their financial positions (income/economy) in China, France, US, UK, etc.

The increase in the percentage of the elderly (the population 65 years or older) in developed countries is a cause for concern about the levels of health care services expenditures and the widening of long-term care services in these countries. The current debate includes the issue of establishing a system of protection for dependence as a new modality of social protection. The objective of this paper is to analyse the evolution of the degree of dependence in the Spanish population over 65 years during the period between 1997 and 2003, and to estimate the impact of dependence on health status and health care utilisation for the same period. An increasing trend of dependence prevalence as well as of the consumption of health care services has been found. A statistical association between the degree of dependence and the variables of health status, drug consumption and in-patient services has been observed. But this association is not significant in the case of medical consultations. The low degree of association between dependence and out-patient health care services strengthens the hypothesis that the elderly population presents specific necessities, oriented to assistance of dependence needs rather than ambulatory health care services.

Objective: To explore (a) the risk factors associated with a deficiency of vitamin B12, and (b) the baseline (cutoff) serum level of vitamin B12 for a clinically-symptomatic deficiency in the Jordanian adult population. Background: Compared to the data available for developed countries, there is a marked scarcity of information on the levels and symptomology of vitamin B12 deficiency in developing countries, particularly in the Middle Eastern region. Methods: A total of 485 subjects were included in this study. Blood samples were drawn for biochemical analysis and data regarding socio-demographics, general health, anthropometric measures, and past medical, surgical, and medication history were collected. To explore the cut-off point, we compared all parameters included in a standard complete blood count as well as main symptoms reported to be associated with B12 deficiency between groups of different B12 cut-off values, consisting of those above and below 200, 175, 150 and 125 pg/ml. Results: Dietary habits, age, recurrent headaches, heart burn and peptic ulcer disease were found to be significantly associated with lower vitamin B12 levels. Surprisingly, daily smoking was associated with significantly higher B12 levels. The results revealed that none of the included potential indicators of B12 deficiency could be considered an indicative feature of deficiency. There were no significant differences neither in the symptoms nor in the CBC parameters between any of the tested study groups. Conclusion: Low dietary intake, older ages, recurrent headaches, heartburn and peptic ulcer disease, all could be considered as a risk factors of having low vitamin B12 levels within the Jordanians. Also, they tend to have lower levels of vitamin B12 levels, in comparison to countries in the West, without necessarily having deficiency symptoms. Cut-off value to diagnose functional B12 deficiency could be less than 125 pg/ml for the Jordanians. More local studies are needed to establish an accurate vitamin B12 cut-off value for the population in Jordan.

Rheumatic heart disease (RHD) is a chronic cardiovascular disease that has almost been eradicated from developed countries but still exists in developing regions like South Asia. However, the prevalence of RHD in the South Asian region has not been reported as a whole. The aim of our study was to systematically review the existing data from population-based studies in this region to determine the current prevalence trend of RHD in South Asia. In this systematic review, electronic databases including Google Scholar, PubMed, ScienceDirect, and the national journal databases of the South Asian region were searched to find relevant articles published between 1991 to 2019 based on predefined inclusion/exclusion criteria. Twenty-five population-based studies were included from four South Asian countries (Bangladesh, India, Pakistan, and Nepal). The findings of the included studies showed a decreasing trend of RHD in Bangladesh, India, and Pakistan, whereas an increasing trend of RHD was observed in Nepal. The prevalence of RHD was higher in rural areas compared to urban areas. This systematic review thus reveals a decreasing trend of RHD in most South Asian countries in the last decade. The findings of this study will help public health leaders understand the current scenario of RHD in the South Asian region.

Loneliness has emerged as a chronic and persistent problem for a considerable fraction of the general population in the developed world. Concurrently, use of online social media by the same societies has steadily increased over the past two decades. The present study analyzed a recent large country-wide loneliness survey of 20,096 adults in the US using an unsupervised approach for systematic identification of clusters of respondents in terms of their social media use and representation among different socioeconomic subgroups. We studied the underlying population heterogeneity with a computational pipeline that was developed to gain insights into cluster- or group-specific patterns of loneliness. In particular, distributions of high loneliness were observed in groups of female users of Facebook and YouTube of certain age, race, marital, and socioeconomic status. For instance, among the group of predominantly YouTube users, we noted that non-Hispanic white female respondents of age 25–44 years who have high school or less education level and are single or never married have more significant high loneliness distribution. In fact, their high loneliness scores also seem to be associated with self-reported poorer physical and mental health outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s41347-021-00208-4.

This paper reviews Ecuador’s population structure and labor market dynamics with a focus on the causes of inequality, particularly among older adults receiving contributory pensions. This serves as a basis for characterizing the main restrictions that the Ecuadorian pension system must address. This analysis is valuable for three key reasons. First, the population structure of many less developed countries is converging toward that of developed countries, with older age groups increasing in proportion. Second, Ecuador is among the countries in Latin America and the Caribbean with the highest degree of informality in the labor market, which lowers the coverage of contributory pension schemes. Third, regarding gender inequality, the rate of women’s labor participation in 2010 was among the lowest in South America. The findings suggest that a younger population structure will not be the main solution to financial problems and the pension inadequacy that are facing most pension systems worldwide. Improvements in labor market institutions are required to increase the pension system’s insurance. The study concludes by discussing several proposals aimed at increasing pension coverage and reducing inequality.

The advancement of technology has changed how parents engage in health information seeking activities through the Internet. Such trends not only shown in developed countries but also most of developing economies as the growth of population access to Internet have been steadily increased in the past ten years. Despite the growing penetration rate, little is known on the extent the Internet is being used by parents to obtain health-related information to improve the wellbeing of their children in developing countries. Five hundred and nineteen responses were collected from parents in selected areas of Klang Valley region in Malaysia. The collected data were analysed by partial least square method of structural equation modelling. The results indicated a positive relationship between information satisfaction and online health information seeking continued use. The moderating role of household income and education are confirmed. The research implications of our results would help medical practitioners and policymaker to design the appropriate supports and awareness programs for parents on the risk and benefits of using online health information.

Road safety refers to the idea of methods and solutions to protect road users from being injured or killed in road accidents. Road users include pedestrians, cyclists, rickshaw and van drivers, and riders of public transport systems such as buses, trams, etc. According to the World Health Organization, more than one million people die in road accidents every year and about 50 million people are injured. Road accidents are identified as one of the major obstacles to sustainable development in Bangladesh. In developing countries such as Bangladesh Road, Safety is much lower in developing or underdeveloped countries and the rate of casualties in road accidents is much higher than in developed countries. The scenario is getting serious day by day. Therefore, Dhaka City has been witnessing tremendous growth in population and physical expansion. This study uses the qualitative research theory and the idea of sustainable development as analytical tools. The research was conducted to analyze and discuss road safety in Dhaka. The research method used in the research is descriptive qualitative research with various primary and secondary sources of the studies. This research resulted in the various aspects of road safety in Bangladesh. The differences between theory and practice, domestic legal arrangements as well judicial decisions.

Background Median survival age in cystic fibrosis (CF) has increased in developed countries. Scarce literature exists about survival in Latin American, especially in Mexico. The aim of our study was to assess the median age of survival in CF patients and the impact of risk factors in Mexico over a 20-year period. Methods We conducted a retrospective study with all patients registered and followed in the CF Center in Monterrey, Mexico from 2000 to 2020. Median survival age was the primary outcome, assessed with the Kaplan-Meier analysis. Influence of clinical, biological, and demographic factors on survival were analyzed with the Cox regression model. Results Two-hundred five patients were included. Median survival for the cohort was 21.37 years (95% CI 17.20 - 25.55). In the multivariate Cox regression model, low socioeconomic status (hazard ratio [HR] 4.21, 95% CI 2.43 - 7.27), chronic Pseudomonas aeruginosa (P. aeruginosa) infection at 6 years (HR 10.45, 95% CI 5.66 - 19.28), and pancreatic insufficiency (HR 3.13, 1.38 - 7.13) were independent risk factors for mortality. Conclusion Median survival in Mexican patients with CF is lower than in high-income countries, and socioeconomic status plays a conspicuous role in the disparity. To increase patient survival for those residing in low-middle income countries, public health authorities must design policies that fully cover diagnosis and treatment strategies for the CF population. This article is protected by copyright. All rights reserved.

Poverty rates amongst youth are high even in the most developed countries in the world. The aim of alleviating poverty in many nations, therefore, remains a significant issue. To comprehend the risks posed by poverty, its dimension and the process by which it can become deeper must be identified and recognized. A broad consensus among policy makers, academic and other institutions is that poverty can be a mixture of various monetary and non-monetary components. These components can limit people’s capacity to achieve their ability and affect their well-being. Therefore, the socio-economic growth of a family and the increase in welfare of a country should be defined in the combination of both monetary and non-monetary aspects. In this study, we aim to estimate the Multidimensional Poverty Index (MPI) for the young and the general population in Turkey over the period 2006–2015. The results of the study show a significant reduction in youth poverty, especially in the Eastern part of the country in the period we explore. The second aim is to evaluate the effect of the 2012 Regional Investment Incentive Scheme on the MPI of the youth population. The findings suggest that the Regional Investment Incentive Scheme had a positive impact on the poverty level in the Eastern part of Turkey, which is the major region of the policy’s interest.

Tanto Colombia como España son Estados que afrontan sobrepoblación de adultos mayores según las cifras expuestas en la II Asamblea Mundial sobre Envejecimiento de Madrid (ONU, 2002), donde se discutieron temas sobre el aumento considerable de la población de los adultos mayores, no sólo en los países desarrollados sino en todos los países del mundo. Este aumento en la población de adultos mayores ha ocasionado problemas financieros a los diferentes sistemas pensionales del mundo con respecto a la sostenibilidad y a los fondos con los que se cuenta para garantizar el derecho a una pensión a los adultos mayores en edad de jubilación, especialmente en España, donde se habla de una crisis en el Sistema Público de Pensiones. Con el siguiente artículo, se analiza el sistema público de pensiones español, haciendo una descripción de sus componentes y la incidencia de sus cambios desde la Constitución de 1978.

Using data from Population Censuses, 1% National Population Sample Surveys of China and the Human Mortality Database, this article adopts robust percentile-based methods to analyze the changing trend of life expectancy of the Chinese elderly especially the young–old and rural–urban disparity from 1989 to 2015, and attempt to explain the disadvantage of old-age mortality improvement in China compared to developed countries. We find that life expectancy at age 65 in China has increased continuously in recent decades, but at a lower speed than in developed countries, leading to a widening gap between China and developed countries, and the increase in e65 has not shown a clear catch-up trend that has been observed in the life expectancy at birth. Similar patterns are found when we explore the rural–urban disparity of China. Based on the age-at-death distribution, we find that the old-age deaths in rural areas are more concentrated at relatively younger ages compared to urban areas due to the higher death risks and slower improvement in mortality of the young–old in rural China. Our findings describe the age-patterns underlying the rural–urban disparity in life expectancy of the elderly within China, and also the main reason for the slower improvement of life expectancy among the Chinese elderly compared with those in developed countries. Survival improvement of the young–old and equalization of available health services are key to reducing the rural–urban bias and achieving accelerated increase in life expectancy among the elderly in China.

Strengthening regional differentiation creates problems for the implementation of an effective state policy associated with the equalization of the socio-economic development of the regions of the country and the approach of their characteristics to the levels of more developed countries. As a result of the flow of capital and the working-age population from poor regions to rich regions, the risk of regional crises and interregional conflicts increases, so differentiation in this case discourages development and has to be reduced. To solve the noted problem, it is necessary, on the basis of cluster analysis, to assess the level of differentiation of the socio-economic development of the problem regions of the South of Russia. Purpose of the study: on the basis of cluster analysis, to determine the level of differentiation of the socio-economic development of the regions of the South of Russia before and after the introduction of anti-Russian sanctions. Method or methodology of the work: the article used economic and statistical methods of analysis. Results: the article presents the results of a cluster analysis of the regions of the Southern and North Caucasian Federal Districts in terms of the level of indicators of their socio-economic development and demographic situation before and after the introduction of anti-Russian sanctions. Field of application of the results: the obtained results of the study can be used in the development of the Strategy of socio-economic development of the North Caucasus Federal District for the period up to 2035.

Objective. Based on the analysis of special literature and advanced domestic and foreign practical experience, to study modern approaches to the management of insufficient body weight in adolescent girls by means of health-enhancing physical exercise. Material and methods. The follow­ing methods were used: theoretical analysis of special scientific and methodological literature and documentary materials, comparative method for the purpose of comparison and analysis of foreign and domestic experience on the investigated problem; abstraction and logical-theoretical analysis. Results. Insufficient body weight was found to be currently typical for a significant number of school students (from 11 to 25 %). Despite the high prevalence of low body weight among adolescent girls that is comparable to the prevalence of overweight in developed countries, most health-related pro­grams focus on preventing and combating obesity, while the problem of underweight are not usually considered in these programs. Domestic and foreign researchers draw attention to the importance of timely management of insufficient body weight. Insufficient body weight in girls is associated with an increased risk of osteoporosis, underweight adolescents have a negative body image and are char­acterized by rapid fatigability, frequent morbidity, and low academic performance; furthermore, they have insufficient reproductive potential. Underweight adolescents showed a lower level of physical fitness that limits their participation in physical activity programs. As the main means of managing physical condition of underweight adolescents, experts recommend the means of health-enhancing physical exercise, in particular, exercise focused on increasing muscle mass, changing the diet, and exercises for psycho correction. Conclusions. The health-enhancing exercise programs for underweight adolescent girls were found to be insufficiently substantiated. The issues related to the insufficient body weight in teenage girls who have substantial previous physical activity experience are insufficiently studied. Considering the high prevalence and negative consequences of insufficient body weight for adolescent girls, the studies focused on improving the level of physical condition and normalization of body weight in this population using the means of physical exercise are seemed relevant.

Ageing is a natural biological property of all living beings. There is an estimated 120 crore population around the world currently over the age of 65 years, it is also estimated that half of the world’s population would be in geriatric group by year 2050. Developed nations have about 30% of their population in geriatric age group. In India 10% of population belong to geriatric age, even though it comparatively low with other nations the numbers are huge due to population size. Special senses such as hearing and smell are impaired along with ageing body. Other otorhinolaryngological problems are also common due to degenerative changes in head and neck region. Cosmetic problems are a concern too due to the ever increasing zeal for youthfulness in modern society. We review some of the common problems faced in the elderly. Keywords: Gerontology head and neck otorhinolaryngology ageing.

Objective To examine patterns and trends of firearm injuries in a nationally representative sample of US women. Summary background data Gun violence in the United States exceeds rates seen in most other industrialized countries. Due to the paucity of data little is known regarding demographics and temporal variations in firearm injuries among women. Methods Data was extracted from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (2001 - 2017) for women 18 years and older. Number of non-fatal firearm assaults and homicide per year were extracted and crude population-based injury rates were calculated. Sub-stratification by age-group and time period were performed. Results Between 2001 and 2017, there were 88,823 non-fatal firearm assaults involving women and 29,106 firearm homicides. There were 4,116 victims of non-fatal firearm assault in 2001 (3.8 per 10) and 12,959 by 2017 (10.0 per 10). Homicide rates were 1.5 per 10 in 2001 and 1.7 per 10 in 2017. Sub-stratification by age-group and time period showed that there were no significant changes in non-fatal firearm assault rates between 2001 and 2010 (P-trend = 0.132 in 18 - 44 yo; 0.298 in 45 - 64 yo). However between 2011 and 2017, non-fatal assault rates increased from 7.10 per 10 to 19.24 per 10 in 18 - 44 yo (P-trend = 0.013) and from 1.48 per 10 to 3.93 per 10 in 45 - 64 yo (P-trend = 0.003). Similar trends were seen with firearm homicide among 18 - 44 yo (1.91 per 10 to 2.47 per 10 in 2011-2017, P-trend = 0.022). However, the trends among 45 - 64 yo were not significant in both time periods. Conclusions Female victims of gun violence are increasing and more recent years have been marked with higher rates of firearm injuries, particularly among younger women. These data suggest that improved public health strategies and policies may be beneficial in reducing gun violence against US women.

PurposeThe purpose of the paper is to analyze the different results between the effects of electronic word of mouth (e-WOM) on the perception of potential tourist in Japan and Indonesia regarding destination image, destination trust, satisfaction and their intention to visit.Design/methodology/approachThis research method is a structural model. Based on the existing literature review, several variables were obtained which were then analyzed by WarpPLS 6.0 software. The sampling method applied in this study is the purposive sampling technique. Samples of 200 potential tourists were collected in Indonesia and 100 potential tourists were collected in Japan. The population in this study was a potential tourist in Indonesia and Japan, with the following criteria: An Indonesian citizen, age between 19 and 60 years, who has never visited Japan and a Japanese citizen who has never visited Indonesia and have ever read or conduct online discussions regarding Japan and Indonesia as a tourist destination.FindingsThe results of the analysis of the two respondents in Japan and Indonesia prove that e-WOM has a positive effect on the image of the destination and intention to visit but not on the confidence of the destination. Destination image was also proven to significantly mediate the influence of e-WOM on intention to visit. These findings bring important implications for the theory and practice of tourism marketing.Originality/valueTheoretically, the result could be used as a reference for further research about the comparison between the effect e-WOM on destination image, destination trust and intention to visit of potential tourist in developed countries and developing countries. Practically, the result could be used as a consideration for the tourism industry and authority in both countries when formulating the destination marketing strategy.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-03-2019-0111

Significance: The prevalence of chronic wounds is increasing worldwide. The most recent estimates suggest that up to 2% of the population in the industrialized countries is affected. Recent Advance...

Background Gout continues to increase in prevalence in developed countries with Oceanic countries particularly affected. Both gout and hyperuricaemia are associated with the metabolic syndrome and its sequelae. Recently, the Australian Institute for Health and Welfare (AIHW) reported a prevalence rate of 0.8% which appeared incongruous with other published research. Thus, an updated systematic review was undertaken to review the literature on the prevalence of gout and hyperuricaemia in Australia from data published after 2011. Methods A comprehensive, systematic search was conducted in MEDLINE, Embase and Web of Science in addition to relevant websites to identify research reporting the prevalence of gout and/or hyperuricaemia in Australia from May 2011 until June 2020. Crude gout and hyperuricaemia prevalence data was obtained and presented alongside case ascertainment, time-period, age range and stratified by gender if available. Results 118 full text articles were screened. 12 articles were included for analysis of gout prevalence. 4 articles were identified for the hyperuricaemia analysis. Wide variation in prevalence figures exist largely due study design and sample age range. Studies using a case definition of self-reported diagnosis of gout reported prevalence rates between 4.5% and 6.8%. The remaining studies used either electronic coding data from general practitioners or wastewater estimation of allopurinol consumption and documented adult prevalence rates between 1.5% and 2.9%. Prevalence increases with age, male sex and over time in keeping with global data. Hyperuricaemia prevalence ranged between 10.5% and 16.6% in Caucasian or an Australian representative population. AIHW estimates applied a chronic condition status, defined as current and lasted or expected to last more than six months, to cases of gout in the Australian National Health Survey. This likely results in an under-estimation in reported Australian gout prevalence rates. Conclusions Gout is highly prevalent in Australia compared to global comparisons and continues to increase over time. Hyperuricaemia prevalence is also high although contemporary data is limited.

One of the well-recognized conditions linked to diabetes mellitus (DM) is cardiovascular disease (CVD). Those affected by DM face greater risk for early onset of CVD. Although huge strides have been made in cardiovascular therapy and prevention, with striking results in decreasing diabetesrelated coronary mortality in developed countries, the morbidity and mortality due to CVD continue to remain high among patients with diabetes. While there is an increasing incidence of cardiovascular event survivors with DM across the world, the number of DM patients with higher cardiovascular risk is predicted to soar, presenting a massive challenge for health care systems globally, including Saudi Arabia. A report of the Saudi Scientific Diabetes Society indicates that more than 50% of patients with DM die due to cardiovascular causes. In fact, Saudi Arabia globally ranks among the top 10 countries in the prevalence of diabetes. However, the incidence of CVD and its risk factors among patients with diabetes in Saudi Arabia have not yet been well documented. This review aims to present an overview of CVD among patients with DM in Saudi Arabia, through a comprehensive review of currently available published literature. The findings indicate that diabetes linked CVD burden in Saudi Arabia is expected to exponentially increase to a very high degree unless a wide-ranging epidemic control program is initiated. The findings emphasize the need for maintenance of a healthy diet accompanied by exercise, an active lifestyle and weight control measures among the population. It is essential that the health care system focus on raising awareness among the population, and implement appropriate measures for prevention, early detection and suitable management of CVD among patients with DM.

Introduction The unequivocal association between exposure to smoke and numerous complications of pregnancy, demonstrated in the last decades, has led to a significant decrease of smoking rates in pregnancy. The aim of the present study was to determine the prevalence of maternal smoking and to elucidate factors predisposing to it among pregnant women in Athens, Greece. Methods A population of 1700 pregnant women (mean age: 31.2 ± 5.5 years) who visited consecutively the Cardiology Department of Helena Venizelou Maternity Hospital in Athens, Greece, between September 2016 and August 2017, was prospectively analyzed. Data regarding changes in the future mother’s smoking habit as well as different sociodemographic factors potentially related to these changes were recorded. Results Of the 1700 participants, 704 (41.4%) were smokers, and of those 52.4% quit smoking after knowledge of their pregnancy status. The overall prevalence of smoking in pregnancy was 19.7%. Prevalence was higher in women who were aged

Agegnehu Bante,1 Abera Mersha,1 Azene Tesfaye,2 Behailu Tsegaye,3 Shitaye Shibiru,1 Gistane Ayele,4 Meseret Girma4 1School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 4School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Agegnehu BanteArba Minch University, PO Box 21, Arba Minch, EthiopiaTel +251-918-487-338Email agegnehubante@gmail.comIntroduction: COVID-19 is one of the huge general wellbeing crisis for the planet. Since its first recognition, over 90.2 and 1.9 million people are infected and dead, respectively. Although it is not easily available for low-income countries, after many trials vaccination is initiated by some industrialized nations. However, still now there is no effective treatment for the infection. Henceforth, adherence with COVID-19 preventive and control measures is the only option to stop its spread and minimize its disastrous impact, especially, in developing nations like Ethiopia. Knowledge and behavior change are pillars to engage with preventive measures. Thus, the motivation behind this study was to assess communities’ adherence with COVID-19 preventive measures and its associated factors among inhabitants of Dirashe district, Southern Ethiopia.Materials and Methods: A cross-sectional study was directed among 648 inhabitants in Dirashe district from June 20 to July 5, 2020. A multistage sampling technique was applied to select the participants. A pretested, validated and reliable interviewer-administered survey tool comprising the socio-demographic characteristics, knowledge (α = 0.78), and adherence with COVID-19 preventive measures (α = 0.73) was used. The data were assorted electronically using Open Data Kit (ODK) collect version 1.17.2 android application and exported to Stata version 15.0 for analysis. Adjusted odds ratio (aOR) with 95% CI was used to identify variables associated with the community’s adherence with COVID-19 preventive measures.Results: An aggregate of 644 inhabitants were participated in this study; of them, only 12.3% [95% confidence interval (CI): 9.8, 15.1] adhered to the recommended COVID-19 preventive measures. Likewise, 63.51% [95% CI: 59.7, 67.2] and 54.5% [95% CI: 50.6, 58.4] of the participants had good knowledge and favorable attitude towards COVID-19 preventive measures, respectively. Urban residence [aOR: 9.74, 95% CI: 4.72, 20.10], favorable attitude [aOR: 1.97, 95% CI: 1.05, 3.68] and concerned about COVID-19-related stigma [aOR: 2.43, 95% CI: 1.02, 5.79] were independently associated with communities adherence with COVID-19 preventive measures.Conclusion: In general, communities’ adherence to the recommended COVID-19 preventive measures was very low in the area. Addressing underprivileged population groups, disseminating teaching aids in local languages, behavioral change communications, and law enforcement is imperative to strengthen COVID-19 prevention practice.Keywords: coronavirus disease 2019, public adherence, knowledge, prevention practice, southern Ethiopia

Pulse (beans, lentils, chickpeas, peas) consumption is low in developed countries. Pulses have the potential to benefit the management of polycystic ovary syndrome (PCOS) because they improve aspects of metabolic derangements (dyslipidaemia, insulin resistance), which contribute to reproductive disturbances (oligo-amenorrhea, hyperandrogenism). We compared changes in knowledge, attitudes, and barriers towards pulse consumption in PCOS cohorts who participated in a pulse-based or a Therapeutic Lifestyle Changes (TLC) dietary intervention. Thirty women (18–35 years old) randomised to a pulse-based diet (supplied with pulse-based meals) and 31 women in a TLC group completed pulse consumption questionnaires before and after a 16-week intervention. The pulse-diet group demonstrated increased knowledge of pulses per Canada’s Food Guide recommendations versus the TLC group post-intervention (p &lt, 0.05). In both groups, increased scores were evident in the domain of attitude about pulses (p &lt, 0.01). The top-ranked barrier to pulse consumption in no-/low-consumers was lack of knowledge about cooking pulses pre- and post-intervention. We attributed increased knowledge about pulse consumption in the pulse group to greater awareness through education and consuming pulse foods during the intervention. Our observations highlight the importance of multi-dimensional behavioural counselling and education to integrate healthy dietary practices for improving reproductive and sexual health in this under-studied high-risk population (ClinicalTrials.gov identifier: NCT01288638).