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Introduction: Glaucoma is a leading cause of irreversible blindness. It is a prevalent disease worldwide, affecting ∼70 million people and expected to reach up to 112 million by 2040. Purpose: The aim of this study is to describe the implementation and initial experience of a telemedicine program to monitor glaucoma and glaucoma suspect patients in a large, integrated health care system during the COVID-19 pandemic. Methods: A retrospective chart review of established glaucoma or glaucoma suspect patients who participated in a telemedicine evaluation at the ophthalmic center of a large, Colombian health care system between June 2020 and April 2023 was conducted. Clinical and sociodemographic variables were analyzed. Generated clinical orders for additional testing, surgical procedures, follow-ups, and referrals, as well as changes in medical treatment, were evaluated. Results: A total of 11,034 telemedicine consults were included. The mean ± standard deviation age of this group was 63 ± 17.2 years and 67% were female. Of the patients who attended teleconsults, 49% were glaucoma suspects and 38.5% were followed with a diagnosis of open-angle glaucoma. After the consult, 25% of patients were referred to a glaucoma specialist, 40% had additional testing ordered, and 8% had a surgical procedure ordered, mainly laser iridotomy (409 cases). Almost a third of patients returned for subsequent telemedicine visits after the initial encounter. Despite some technical difficulties, 99.8% of patients attended and completed their scheduled telemedicine appointments. Conclusions: A telemedicine program aimed to monitor established glaucoma patients can be successfully implemented. Established patients within an integrated health care system have high adherence to the virtual model. Further research by health care institutions and government agencies will be key to expand coverage to additional populations. Clinical Trial Registration Number: CEIFUS 1026-24 [ABSTRACT FROM AUTHOR]

Background: The importance of providing care to mothers after childbirth is critical for lowering maternal illness and death rates. This research aimed to analyze the factors influencing the use of postnatal services among mothers with having at least one living child three years preceding the survey in the Sunsari district of Eastern Nepal. Materials and Methods: A cross-sectional study was conducted within a community setting, involving 401 ever-married women of reproductive age group. The studyperformed bivariate and multivariate logistic regression analyses to identify factors associated with the utilization of postnatal care services. Results: Among 401 women studied, 52% had Postnatal Care (PNC) visits. Among those who utilized PNC services, the majority (96%) had partial utilization, while only 4.3% had complete PNC.PNC visits are more frequent among the wealthy, migrants, and upper castes, as well as those exposed to media, aware of health services, and perceiving higher service quality and awareness at health facilities. Conclusion: Both the coverage and complete utilization of PNC attendance were low. Increasing focus on mothers from poorer households, pockets of the native population, individuals needing behavioural modification, and those with poor awareness about available services may enhance the overall usage of complete PNC.

Abstract Several risk factors including environmental exposures, socioeconomic status, and dietary factors including dietary patterns have been considered for childhood Asthma. The present study tried to examine the association between a western-style pattern and the likelihood of asthma and its symptoms in Yazd, Iran. In the present cross-sectional study, dietary intakes of elementary and high-school children were obtained through a validated GAN questionnaire. The GAN questionnaire, derived from the ISAAC questionnaire was used to assess the symptoms of allergic diseases and their related risk factors. A western dietary pattern score considered 9 food groups including chicken eggs, margarine, butter, sugar, fast foods, soft drinks, snacks, sauce, and chocolate. In total 7667 children aged 10.9 ± 3.35 years were included in the current investigation. Boys with higher adherence to western dietary pattern had a higher risk of wheezing in the past 12 months (OR 1.37, 5% CI 1.01–1.87, P = 0.04) and this association was also observed in the whole population (OR 1.30, 5% CI 1.05–1.60, P = 0.01). However, after adjustment for confounders this relation did not remain significant in boys. Our results support the hypothesis that a western dietary pattern is associated with an increased risk of wheezing in the past 12 months in children with asthma. Future prospective studies are needed to confirm this finding.

Pandemi Covid-19 memberikan banyak sekali dampak dalam berbagai bidang kehidupan, salah satunya adalah dalam bidang pendidikan. Begitupun dalam bidang pendidikan jasmani yang mengharuskan anak berinteraksi dan bekerja sama secara langsung dengan orang lain. Perubahan sisrem pendidikan dari jarak jauh menjadi tatap muka berpotensi terhadap perubahan perilaku sosial dan emosional utamanya bagi anak sekolah dasar. Oleh karena itu, melakukan deteksi dini terhadap gangguang kesehatan mental dan perilaku sosial sangat penting untuk dilakukan supaya bisa dicegah dan ditindak lanjuti sesuai dengan rekomendasi dari para ahli. Untuk bisa mendeteksi hal tersebut, digunakkanlah suatu alat ukur bernama Strenght and Difficulties Questionnaire Instrument (SDQ) untuk anak usia 4-17 tahun. Instrumen ini memiliki 2 kategori yakni untuk anak-anak usia 4-11 dan untuk usia 11-17. Dalam instrument ini, terdapat 5 aspek yang bisa diukur, yakni; gejala emosional, masalah perilaku, masalah hiperaktivitas, masalah teman sebaya dan masalah propososial yang masing-masing memiliki lima pernyataan. Penelitian ini menggunakan metode cross sectional yang dilakukan di SDN Ciparay 01 06 dengan jumlah siswa yang mengisi kuesioner berjumlah 70 orang. Hasil penelitian menunjukkan bahwa keseluruhan siswa di SD tersebut berada dalam kriteria abnormal. Hasil penelitian juga menunjukkan bahwa siswa laki-laki memiliki perilaku sosial dan emosional yang abnormal dibandingkan siswa perempuan.

Several risk factors including environmental exposures, socioeconomic status, and dietary factors including dietary patterns have been considered for childhood Asthma. The present study tried to examine the association between a western-style pattern and the likelihood of asthma and its symptoms in Yazd, Iran. In the present cross-sectional study, dietary intakes of elementary and high-school children were obtained through a validated GAN questionnaire. The GAN questionnaire, derived from the ISAAC questionnaire was used to assess the symptoms of allergic diseases and their related risk factors. A western dietary pattern score considered 9 food groups including chicken eggs, margarine, butter, sugar, fast foods, soft drinks, snacks, sauce, and chocolate. In total 7667 children aged 10.9 ± 3.35 years were included in the current investigation. Boys with higher adherence to western dietary pattern had a higher risk of wheezing in the past 12 months (OR 1.37, 5% CI 1.01–1.87, P = 0.04) and this association was also observed in the whole population (OR 1.30, 5% CI 1.05–1.60, P = 0.01). However, after adjustment for confounders this relation did not remain significant in boys. Our results support the hypothesis that a western dietary pattern is associated with an increased risk of wheezing in the past 12 months in children with asthma. Future prospective studies are needed to confirm this finding. [ABSTRACT FROM AUTHOR]

Background and Aim: Migraine is a prevalent neurological disorder characterized by recurring episodes of debilitating headache accompanied by associated symptoms and sleep disorders. This study aims to investigate migraine‐associated symptoms in female migraineurs within the Syrian population and the relation between migraines and sleep issues. Methods: A questionnaire‐based cross‐sectional observational study was conducted among the Syrian population. A total of 1009 women were enrolled in this study, including women without a history of migraine (Control group) and migraineurs (Case group) who had received a diagnosis of migraine from a hospital or private clinic. Data about migraine‐related symptoms, including tingling, visual disturbances, Nausea/Vomiting, and epileptic seizures as well as sleep‐related symptoms such as interrupted sleep, frequent awakenings, insomnia, snoring, and narcolepsy were gathered. Chi‐square test was used to examine the relation between migraines and sleep issues. Results: A total of 1009 women were enrolled in this study including 531 migraineurs and 478 healthy women. The study revealed that the most commonly experienced symptoms during migraine attacks were nausea/vomiting and visual disturbances, followed by tingling. Total Unduplicated Reach and Frequency analysis showed that visual disturbances and nausea/vomiting were the two most frequent symptoms that co‐occurred during migraine attacks. The study also demonstrated a significant relationship between snoring, insomnia, and narcolepsy with migraine (p = 0.038), with these sleep disorders being more prevalent among migraineurs. Conclusion: The findings indicate a significant association between migraines and sleep disorders, with migraineurs being at a significantly higher risk of experiencing poor sleep quality compared to healthy women. Addressing sleep disorders is crucial in managing patients with migraines. This study is the first of its kind in the Syrian population, providing valuable insights into the symptoms and sleep disorders associated with migraines in this population. [ABSTRACT FROM AUTHOR]

Abstract Background Low-diversity diets and sedentary status are risk factors for depressive symptoms, while knowledge workers were ignored before. The purpose of this current study was to examine the relationship between dietary diversity, sedentary time spent outside of work, and depressive symptoms among knowledge workers. Study design and methods This was a multicenter and cross‐sectional design that included 118,723 knowledge workers. Participants self-reported online between January 2018 and December 2020. Demographic information, the Dietary Diversity Scale, the Patient Health Questionnaire-9, dietary habits (which included eating three meals on time, midnight snacking, overeating, social engagement, coffee consumption, sugary drink consumption, smoking and alcohol use), sedentary time spent outside of work and physical activity were investigated. Results The relationships between demographic information, dietary habits and dietary diversity, and depressive symptoms were estimated. Compared with the first and second levels of dietary diversity, the third level of dietary diversity (OR: 0.91; 95% CI: 0.84–0.98) reduced the risk of depressive symptoms. Knowledge workers with different degrees of sedentary status (2–4 h (OR: 1.11; 95% CI: 1.07–1.14), 4–6 h (OR: 1.21; 95% CI: 1.17–1.26), and > 6 h (OR: 1.49; 95% CI: 1.43–1.56), presented a progressively higher risk of depressive symptoms. Conclusion High amounts of sedentary time spent after work and low levels of dietary diversity are risk factors for depressive symptoms. In addition, an irregular diet and overeating are also major risk factors for knowledge workers.

• Work environment and frequency of unfinished care vary in Norwegian nursing homes. • Tools to measure the work environment and frequency of unfinished care are available. • We found associations between work environment characteristics and unfinished care. • Frequency of unfinished care was associated with work environment characteristics. • Further research is needed on staff management for the best possible quality of care. Understanding unfinished nursing care and its relationship with modifiable care environment factors is crucial for the service delivery to long-term frail patients. This secondary analysis aimed to explore the associations between characteristics of the care environment and unfinished nursing care, as reported by nursing care workers in Norwegian nursing homes. Of 931 respondents (37% response rate) from 66 nursing homes, six care environment characteristics correlated with at least two types of unfinished nursing care. Resources and Multidisciplinary collaboration showed a positive association with all four unfinished care categories. Input and acknowledgement, Professional , or Interpersonal leadership were not associated to unfinished care. In summary, our findings suggest that nursing care workers reporting positive care environment descriptions also reported lower frequencies of unfinished nursing care. This study offers insights crucial for human resource management which ultimately can be used to improve patient outcomes in nursing homes. [ABSTRACT FROM AUTHOR]

The level of knowledge and comprehension surrounding puberty and menstruation. It can substantially impact women's overall health. This cross-sectional study is conducted to get insights about menstrual knowledge, attitudes and taboos among college and university female students in Haryana. A survey was conducted to investigate the experiences of menstruation among female students from government universities and colleges. Respondents were categorized on the basis of age, education qualification, and background setting. Random sampling was used to ensure participation from six administrative zones. The chi-square test was used to determine statistical significance, and the analysis was built around the p-value. The data reveals that there is no significant association between the age of the participants and their awareness of menstruation, scientific knowledge related to menstruation, or their personal relationships with mother, father, or family members. Similarly, there is no significant association between the participants' scientific knowledge and their level of education. However, there is a significant association between participants' personal relationships and level of education (p =.025). Additionally, a significant association was observed between taboos and level of education (p =.025). Age, residential area, and educational levels do not seem to significantly impact participants' awareness and knowledge. This study highlights the influence of personal equations and education on attitudes and beliefs surrounding menstruation. The significant association between personal relationships and education underscores the importance of a supportive family. The persistence of menstrual taboos among undergraduates suggests that there is still a need for comprehensive and inclusive menstrual health education. This study also addressed the sustainable developmental goals for good health and well-being. Future studies should focus on exploring cultural factors such as religious beliefs and cultural norms in more detail to develop interventions that may help improve menstrual health outcomes among college and university students. [ABSTRACT FROM AUTHOR]

Background: Female sexual dysfunction (FSD) is defined as persistent or recurring decrease in sexual desire, sexual arousal, dyspareunia and a difficulty in or inability to achieve an orgasm. Aim the work: is to evaluate the effect of life style and demographic factors on female sexual function in sharkia governorate, Egypt. Methods: a cross sectional survey study was carried out on a sample size of 345 married female subjects attended to Dermatology department -Zagazig university hospitals. Results: At baseline, 113 of studied subjects (33.3%) complained of sexual dysfunction, sexual dysfunction was lower in age group (21 to 29) but a higher in age group (30 to 39 years), and was lower in husband age group (21 to 29 years) but higher in husband age group (40 to 49 years), was lower in females with university degree but higher in read and write level, and was higher in employed subjects of physical work condition, and female sexual dysfunction was lower in subjects with high monthly income (>10,000 EGP) but higher in others who had low monthly income. Conclusions: both lifestyle and demographic factors have great effect on normal female sexual function. [ABSTRACT FROM AUTHOR]

Background: Low-diversity diets and sedentary status are risk factors for depressive symptoms, while knowledge workers were ignored before. The purpose of this current study was to examine the relationship between dietary diversity, sedentary time spent outside of work, and depressive symptoms among knowledge workers. Study design and methods: This was a multicenter and cross‐sectional design that included 118,723 knowledge workers. Participants self-reported online between January 2018 and December 2020. Demographic information, the Dietary Diversity Scale, the Patient Health Questionnaire-9, dietary habits (which included eating three meals on time, midnight snacking, overeating, social engagement, coffee consumption, sugary drink consumption, smoking and alcohol use), sedentary time spent outside of work and physical activity were investigated. Results: The relationships between demographic information, dietary habits and dietary diversity, and depressive symptoms were estimated. Compared with the first and second levels of dietary diversity, the third level of dietary diversity (OR: 0.91; 95% CI: 0.84–0.98) reduced the risk of depressive symptoms. Knowledge workers with different degrees of sedentary status (2–4 h (OR: 1.11; 95% CI: 1.07–1.14), 4–6 h (OR: 1.21; 95% CI: 1.17–1.26), and > 6 h (OR: 1.49; 95% CI: 1.43–1.56), presented a progressively higher risk of depressive symptoms. Conclusion: High amounts of sedentary time spent after work and low levels of dietary diversity are risk factors for depressive symptoms. In addition, an irregular diet and overeating are also major risk factors for knowledge workers. [ABSTRACT FROM AUTHOR]

Abstract Background and Aim Migraine is a prevalent neurological disorder characterized by recurring episodes of debilitating headache accompanied by associated symptoms and sleep disorders. This study aims to investigate migraine‐associated symptoms in female migraineurs within the Syrian population and the relation between migraines and sleep issues. Methods A questionnaire‐based cross‐sectional observational study was conducted among the Syrian population. A total of 1009 women were enrolled in this study, including women without a history of migraine (Control group) and migraineurs (Case group) who had received a diagnosis of migraine from a hospital or private clinic. Data about migraine‐related symptoms, including tingling, visual disturbances, Nausea/Vomiting, and epileptic seizures as well as sleep‐related symptoms such as interrupted sleep, frequent awakenings, insomnia, snoring, and narcolepsy were gathered. Chi‐square test was used to examine the relation between migraines and sleep issues. Results A total of 1009 women were enrolled in this study including 531 migraineurs and 478 healthy women. The study revealed that the most commonly experienced symptoms during migraine attacks were nausea/vomiting and visual disturbances, followed by tingling. Total Unduplicated Reach and Frequency analysis showed that visual disturbances and nausea/vomiting were the two most frequent symptoms that co‐occurred during migraine attacks. The study also demonstrated a significant relationship between snoring, insomnia, and narcolepsy with migraine (p = 0.038), with these sleep disorders being more prevalent among migraineurs. Conclusion The findings indicate a significant association between migraines and sleep disorders, with migraineurs being at a significantly higher risk of experiencing poor sleep quality compared to healthy women. Addressing sleep disorders is crucial in managing patients with migraines. This study is the first of its kind in the Syrian population, providing valuable insights into the symptoms and sleep disorders associated with migraines in this population.

Background: With improvement in a population's welfare, its food consumption patterns may change, including those of nursing mothers. This, in turn, could influence their human milk composition. Research Aim: To investigate the secular trend in macronutrient composition of mature human milk from mothers of healthy, full-term infants in urban populations in Indonesia from 1974 and 2019. Method: We compared the macronutrient composition of mature human milk of healthy full-term infants from 1974 and 2019. The data from 2019 used the Human Milk Analyzer MIRIS to quantify the milk's carbohydrate, fat, and protein content, while the historical data used methods available at that time, that is, methods described by Benedict, Gerber and Kjeldahl, respectively. Results: There were no significant differences in carbohydrate, protein and fat content across categories of maternal nutritional status in the respective periods. However, the fat content of human milk from 2019 was significantly higher than that of 1974 (4.7 g/dl, SD = 1.7 g/dl vs. 3.3 g/dl, SD = 1.1 g/dl; p < 0.001), while its carbohydrate content was significantly lower (6.2 g/dl, SD = 2.1 g/dl vs. 7.1 g/dl, SD = 0.2 g/dl; p < 0.001). There was no difference in the protein content between the two periods (1.4 g/dl, SD = 0.5 g/dl vs. 1.6 g/dl, SD = 0.3 g/dl; p = 0.491). Conclusion: The mature human milk from 2019 has a higher fat and total energy content but lower carbohydrate content than those observed 4 decades ago. The protein content remained the same. [ABSTRACT FROM AUTHOR]

Aim: To determine the correlation between vitamin D levels and gestational diabetes mellitus. Materials and Methods: Cross-sectional observational study, conducted in Gauhati Medical College and Hospital, over a period of 1 year, on 350 antenatal patients, with gestational age beyond 24 weeks, keeping in mind the inclusion and exclusion criteria. Age, obstetric score, religion, BMI were noted for all patients. They underwent screening for gestational diabetes mellitus using DIPSI (Diabetes in Pregnancy Study Group of India) guidelines and were divided into two groups. Vitamin D estimation by CLIA method (chemiluminescence method) was done in both groups and results were compared. Association between vitamin D levels and gestational diabetes mellitus was studied using Chi Square Test. Results: The prevalence of vitamin D deficiency in antenatal patients was found to be 63.7%. 73% of gestational diabetes mellitus patients were deficient in vitamin D. There was a statistically significant association seen between vitamin D level and Gestational diabetes mellitus (p value—0.046). There was 1.34 times increased risk of developing gestational diabetes mellitus when the vitamin D levels were deficient as compared to when the vitamin levels were within the normal range. Conclusion: There was a high level of vitamin D deficiency in the pregnant women of North East. Due to lack of screening of vitamin D levels, many pregnant women suffer from adverse feto-maternal outcomes. There is a need to identify them early in pregnancy, provide vitamin D supplementation and to decrease the likelihood of them developing complications. [ABSTRACT FROM AUTHOR]

Abstract Objective: Legume and pulse consumption is currently recommended for health and sustainability purposes, but barriers to consumption can include low enjoyment and poor sensory properties. This work aimed to investigate the relative importance of a number of barriers and facilitators towards legume, including pulse, consumption with a specific focus on enjoyment, sensory properties and a possible role for perceived cooking abilities in these relationships. Design: A cross-sectional questionnaire study assessed legume and pulse consumption, agreement and disagreement with statements relating to enjoyment, sensory properties, cooking abilities, practical aspects, healthiness, upbringing, social influences and quality issues, and four demographic characteristics. Complete responses were gained from 633 respondents with a mix of genders, ages, usual cooking responsibilities and usual eating habits. Setting: UK, March 2021 – September 2022. Participants: General UK adult population. Results: Using multiple regression analyses, enjoyment and cooking abilities were found to be important for both legume and pulse consumption (smallest beta = 0·165, P < 0·01), and the sensory properties of these foods were also important for the consumption of pulses (beta = 0·099, P = 0·04). Perceived cooking abilities also reduced the importance of enjoyment and sensory properties for consumption, mitigated effects due to upbringing and practical aspects and increased the value of perceived health benefits (smallest beta = 0·094, P = 0·04). Conclusions: These findings demonstrate a clear role for enjoyment, sensory properties and perceived cooking abilities in legume and pulse consumption and suggest benefits for increasing cooking abilities for improved legume and pulse consumption, as result of both direct and indirect effects.

In the past decade or two, there has been a significant change in the epidemiology of liver diseases, such as rise in the incidence of nonalcoholic steatohepatitis, good control of viral load in hepatitis B and C related liver diseases, and revolutionary changes in the treatment of hepatocellular carcinoma. Hence, monitoring of these diseases warrants effective noninvasive imaging techniques. Besides, organ transplantation has evolved to play a major role in the treatment of chronic liver diseases and acute liver failures. With the advent of better technology and new imaging sequences in cross-sectional imaging, there has been a dramatic change in the arena of liver imaging. Knowledge of these imaging modalities and effective application of the existing and new imaging techniques is essential to meet these changing clinical needs. This article aims at revisiting the liver anatomy from a practical stand point and touches upon the key cross-sectional imaging techniques of computed tomography and magnetic resonance imaging with recent advances.

Objectives: We aimed to evaluate the association between the adipokines: Leptin, Adiponectin, Resistin, and high sensitive-C-reactive protein (hs-CRP) with clinical, radiographical and magnetic resonance imaging (MRI) assessment of knee osteoarthritis (OA) severity. Design: We performed a cross-sectional study in participants with earlier knee OA. Demographics, clinical (WOMAC), radiographical and MRI (BLOKS scoring) severity of knee OA were assessed. Serum leptin, adiponectin, resistin and hs-CRP were measured. Association of adipokines and hs-CRP with clinical, radiographic and MRI severity outcomes were evaluated using regression models with adjustment with age, sex, and body mass index (BMI). Results: 137 participants with earlier knee OA (82% women, mean ​± ​SD age: 55.5 ​± ​7.8 years) were included. Participants had moderate knee OA symptoms, mean WOMAC pain and function were 30.6 ​± ​18.0, and 31.7 ​± ​19.8 respectively. Mean BMI was 27.0 ​± ​5.9 ​kg/m2. After adjustment with age, sex and BMI, serum leptin was positively associated with osteophyte size, cartilage integrity, infrapatellar synovitis and effusion. While hs-CRP was associated with meniscus extrusion and adiponectin was associated with WOMAC pain and function. Conclusion: Serum adipokines, particularly leptin was associated with severity of various structural defects of the knee joint on MRI beyond age, sex and BMI in earlier knee OA.

Acute type B aortic dissection (ATBD) is a rare yet serious cardiovascular event that potentially has an impact on health related quality of life (HRQoL). However, long term follow up data on this topic are scarce. This study aimed to review the long term HRQoL among patients treated for ATBD. In this multicentre, cross sectional survey study, consecutive treated patients with ATBD between 2007 and 2017 in four referral centres in the Netherlands were retrospectively included and baseline data were collected. Between 2019 and 2021 the 36 Item Short Form Survey (SF-36) was sent to all surviving patients (n = 263) and was compared with validated SF-36 scores in the Dutch general population stratified by age and sex. In total, 144 of 263 surviving patients completed the SF-36 (response rate 55%). Median (IQR) age was 68 (61, 76) years at completion of the questionnaire, and 40% (n = 58) were female. Initial treatment was medical in 55% (n = 79), endovascular in 41% (n = 59), and surgical in 4% (n = 6) of ATBD patients. Median follow up time was 6.1 (range 1.7–13.9; IQR 4.0, 9.0) years. Compared with the general population, patients scored significantly worse on six of eight SF-36 subdomains, particularly physical domains. Apart from bodily pain, there were no substantial differences in HRQoL between male and female ATBD patients. Compared with sex matched normative data, females scored significantly worse on five of eight subdomains, whereas males scored significantly lower on six subdomains. Younger patients aged 41–60 years seemed more severely impaired in HRQoL compared with the age matched general population. Treatment strategy did not influence HRQoL outcomes. Follow up time was associated with better Physical and Mental Component Summary scores. Long term HRQoL was impaired in ATBD patients compared with the Dutch general population, especially regarding physical status. This warrants more attention for HRQoL during clinical follow up. Rehabilitation programmes including exercise and physical support might improve HRQoL and increase patients' health understanding. [ABSTRACT FROM AUTHOR]

This study investigated changes in physical activity (PA) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection while considering age, PA level, underlying medical conditions (UMCs), vaccination profiles/types, re-infections, disease severity, and treatment. Data were collected from 5829 respondents by using a validated web-based questionnaire. The findings showed that there was a significant overall decrease in PA (−16.2%), including in daily occupation (−11.9%), transportation (−13.5%), leisure-time (−16.4%), and sporting (−27.6%) activities. Age, PA level, UMCs, vaccination profiles/types, disease severity, and treatment played a role in determining PA in individuals' post-acute SARS-CoV-2 infections. Re-infections did not impact the decline in PA. Unvaccinated individuals experienced a significant decline in PA (−13.7%). Younger (−22.4%) and older adults (−22.5%), those with higher PA levels (−20.6%), those with 2–5 UMCs (−23.1%), those who were vaccinated (−16.9%) or partially vaccinated (−19.1%), those with mRNA-type vaccines only (−17.1%), those with recurrent (−19.4%)-to-persistent (−54.2%) symptoms, and those that required hospital (−51.8%) or intensive care unit (−67.0%) admission during their infections had more pronounced declines in PA. These findings emphasize the complex relationship between post-acute SARS-CoV-2 infection and PA and highlight the need for targeted interventions, further research, and multidisciplinary care to promote PA resumption and mitigate long-term effects on global public health. [ABSTRACT FROM AUTHOR]

Female sex workers are at a high risk of abortion. This cross-sectional study included 855 female sex workers to determine the prevalence of lifetime abortion and its related factors. Logistic regression models were used to identify the factors related to lifetime abortion. The prevalence of lifetime abortion was reported at 40.8%. The chance of having a lifetime abortion was 7.8 times higher in women aged >35 years and 2.4 times higher in financially dependent women. The high prevalence of lifetime abortion indicates that these women's health and fertility needs are not met. Female sex workers are a very vulnerable group of society. These women usually have this job due to financial needs. Many of these women are usually at a high risk of unwanted pregnancies due to having unprotected sexual relationships, and the majority of them seek abortion, which are at high risk of mortality. [ABSTRACT FROM AUTHOR]

Suicide is a major health issue in India. With the advent of the COVID-19 pandemic, people have experienced loss on a tremendous scale. The impact of these losses on the youth will be massive leading to a rise in depression cases, suicidal ideation and ultimately suicidal attempts. Hence there is a need to determine the prevalence of suicidal ideation, suicide attempts and the predictors for both suicidal ideation and attempts among the young adults in Meghalaya. This cross-sectional study was conducted among the students aged 18–25 years in NEIGRIHMS and Synod College in Shillong between March to April 2022. Data was collected by using questionnaire method. The prevalence of suicidal ideation and suicidal attempts was found to be 15.9 % (12.3–20.3) and 5.8 % (3.7–8.9) respectively. There was a strong relationship for suicidal ideation with urban students, with less family members, those who had unhealthy relationship with their parents, stress, complicated relationship/loss of loved ones and also those with experience of violence/abuse and behavioural problems. However, the attempts were found to be associated only with the loss of the loved ones. The prevalence, though smaller is a serious concern considering the fact that the burden of suicides is on a rise and hence regular mental health counselling along with the management of the stress is needed at the educational institutional level which could prove to be beneficial to the students. [ABSTRACT FROM AUTHOR]

Background: Carrying an infant using M-shape method is vital in creating a bond of affection (bonding attachment) between mother and infant. Carrying using the M-shape method makes the infant calmer and sleeps easier, because the face of infant facing the person carrying them Objective: The aim of the study was to determine the effect of carrying the M-shape method on bonding attachment and infant’s sleep quality. Methods: This research was analytic correlational design with cross sectional approach. It was conducted in Pare Kediri, East Java, Indonesia on June, 9th to 25th 2022. The sampling technique used simple random sampling. The population were all infants 6 to 12 month amount 94 and the sample size were 72 infants. The research data used primary data through interviews. The independent variable was carrying the M-shape method, while the dependent variable were bonding attachment and infant’s sleep quality. The research instrument were questionnaires. The data was analyze by Wilcoxon Sign Ranked Test. Result: The result showed that 58,3% were 10-12 months old, 70,8% were the youngest child in their family, (52,8%) had carrying duration for more than an hour a day, and 68,1% were carried most dominantly by their parents. P-value were 0.000 and 0.002 , meaning that there were effects of carrying the M-shape method on bonding attachment and the infant's sleep quality. Conclusion: Carrying with M-shape was an alternative in avoiding the wrong position when carrying and can be done from the beginning of newborn.

Electrical energy consumption in the opencast coal mine is very high. Electric shovels, pumps and coal handling plants consume 75% of the total electricity consumption of an opencast coal mine. In this paper, a modelling framework has been developed for electrical energy use benchmarking (internal as well as cross-sectional) of the mine. To develop a mine specific model for benchmarking electrical energy use statistical approach (linear regression method) has been applied. Specific power consumption (SPC) is used as a benchmarking index to assess the operating energy performance of a specific mine and multiple coal mines of India based on the field studies. Seasonal analysis of the electrical energy usage has also been analysed. Our results show the benchmark SPC as 0.50 kWh/t and the energy-saving potential as 10.7% for a single mine and the benchmark SPC of multiple coal mines as 0.52 kWh/t. The result concludes that SPC widely depends on its capacity and mining method and the developed model are useful for benchmarking and targeting for efficient electrical energy use in opencast mine.

In the past decade or two, there has been a significant change in the epidemiology of liver diseases, such as rise in the incidence of nonalcoholic steatohepatitis, good control of viral load in hepatitis B and C related liver diseases, and revolutionary changes in the treatment of hepatocellular carcinoma. Hence, monitoring of these diseases warrants effective noninvasive imaging techniques. Besides, organ transplantation has evolved to play a major role in the treatment of chronic liver diseases and acute liver failures. With the advent of better technology and new imaging sequences in cross-sectional imaging, there has been a dramatic change in the arena of liver imaging. Knowledge of these imaging modalities and effective application of the existing and new imaging techniques is essential to meet these changing clinical needs. This article aims at revisiting the liver anatomy from a practical stand point and touches upon the key cross-sectional imaging techniques of computed tomography and magnetic resonance imaging with recent advances. [ABSTRACT FROM AUTHOR]

To investigate the quality of root canal fillings and frequency of apical periodontitis (AP) in root canal filled teeth in a Swedish population. This study used data from a cross-sectional survey conducted in 2013. The root canal filling quality and periapical status were assessed in 491 root canal filled teeth in 196 individuals aged 20–70 years, randomly selected from the population of Jönköping, Sweden. All root canal filled teeth were examined with periapical radiographs. Three calibrated observers recorded length and density in root canal fillings as well as periapical status according to the Periapical Index. A root filling ending within 0.5–2 mm from the radiographic apex without lateral or apical voids was considered adequate. Data were analyzed in a generalized estimating equation (GEE) model with AP as dependent variable and gender, age, number of teeth, number of root filled teeth, tooth type, and root filling quality as independent variables. Teeth with technically inadequate root fillings were associated with AP in a simple GEE-analysis. In the multiple GEE-model, the association between technical quality and apical peridontitis was nonsignificant when controlling for tooth type and gender. The quality of root canal fillings is poor and the prevalence of AP in root canal filled teeth is high, particularly in molar teeth, in a Swedish population. [ABSTRACT FROM AUTHOR]

The state of malnourishment among children <5 years age span is the major public health issue around the globe. This under nourished state of child has multitude socio-demographic, economic and medical dynamics. Adequate mothers’ nutritional knowledge along with positive attitude about breastfeeding and complementary feeding practices can be used as the combat tool to avoid malnourishment among children. Present study designed to know the KAP of mothers regarding breastfeeding and complementary feeding of malnourished children. Researcher used quantitative research design and select N=485 mothers visiting the targeted stabilization center of Children Hospital Multan through simple random sampling technique. The findings of the study revealed that there is a significant and positive relationship between breast feeding duration and malnourishment among children <5 years age span. Moreover, lack of knowledge, negative attitude and improper practices of mothers about breastfeeding becomes the major cause of child malnourishment. Role of media in provision of logical arguments and awareness campaigns along with the support provision by health care professionals can combat the pathetic situation of malnourishment in the study vicinity. [ABSTRACT FROM AUTHOR]

Objective: The goal of this meta-analysis is to improve insight into the development of cognition over the course of ALS and to assess predictors of cognitive performance. Method: A literature search was conducted in Pubmed and Web of Science on 29 July 2019 and 16 March 2021. Data were screened in Endnote® Version X9 (London, UK). Meta-analyses and meta-regressions were calculated for cross-sectional data using Rstudio®. Studies were assigned to temporal and physical categories and Hedges' g was calculated for the respective categories to provide an estimate of a cognitive course based on cross-sectional data. Due to low numbers and heterogeneity in reporting, longitudinal studies were analyzed descriptively. Results: A total of N = 45 cross-sectional and N = 13 longitudinal studies were included. Impairments in all cognitive domains, except verbal IQ, were found in ALS patients (PALS). PALS showed stable cognitive performances in cross-sectional and in most longitudinal studies. PALS with symptoms for 18–24 months and PALS who had an ALSFRS-R score of 40–36 were the most frequently reported subgroup regarding neuropsychology. Age was related to visuospatial functioning, and depressiveness to attention. In longitudinal studies, impact of site of onset and cognitive status at baseline on cognitive course was found. Conclusion: Despite vast evidence for cognitive impairment at disease onset in different domains, evidence for evolution of these deficits is rather limited, suggesting that PALS present with cognitive impairment early in the course possibly in a sense of disease trait. [ABSTRACT FROM AUTHOR]

AimsThe benefits associated with being physical active on mental health is well-established, but little is known on how rapid changes in physical activity are associated with mental health. This study investigated the association between changes in physical activity and mental health among Danish university students during the first COVID-19 lockdown.MethodsOnline survey data were collected among 2,280 university students at the University of Southern Denmark and University of Copenhagen in May–June 2020 as part the “COVID-19 International Student Well-being Study.” Multiple linear regressions were used to analyze associations between changes in physical activity and mental health (depression and stress scores) adjusted for potential socio-economic confounders.ResultsDuring the first COVID-19 lockdown, 40% decreased their moderate and 44% their vigorous physical activity, while 16% increased their moderate and 13% their vigorous physical activity. Overall, students with a stable physical activity level had the lowest mean depressive and stress scores. Adjusted analyses showed that a decrease in vigorous and moderate physical activity level was significantly associated with a higher depression score (mean difference (vigorous): 1.36, p

This study used secondary data from the longitudinal aging study of India with an objective to estimate the prevalence of hypertension among post menopausal women in India and evaluate the associated risk factors. We extracted data from the first wave of the Longitudinal Ageing Study in India (LASI), which is a nationally and state representative of aging and health. In descriptive analysis weighted prevalence & 95% Confidence Interval (CI) of hypertension with all the social determinants & health status variables were calculated in different age groups. We performed unadjusted and adjusted logistic regression analyses to assess the Odds Ratio with 95% CI. Approximately half of the Indian post-menopause women suffered from hypertension 51.68% (95% CI: 50.00% - 53.00%). Self-reported prevalence of hypertension among post-menopause women in India is 32.54% which indicates that 19.14% of the women did not aware that they had hypertension prior to the survey. Urban residents, Muslims & other religions, currently not working, and currently not married women had a higher prevalence of hypertension. Compared with women with normal BMI, those who were overweight or obese were more likely to suffer from hypertension. A large difference in the prevalence of hypertension in diabetic vs non-diabetic women (77.44% Vs 47.78%) and also with increased vs normal waist circumference (61.93% vs 41.87%). We report a significant prevalence of hypertension among pot-menopausal women in India. We found that age, high BMI, abdominal obesity and presence of diabetes were significant risk factors associated with this. [ABSTRACT FROM AUTHOR]

Background: Social determinants of health (SDOH) refer to the social, economic, and psychosocial conditions that influence health. Lower levels of SDOH factors including income, education, and employment are associated with a higher prevalence of diabetes, poorer glycemic control, and increased diabetes-related mortality. Few studies have conducted a comprehensive evaluation of multiple SDOH factors in a population with type 2 diabetes mellitus (T2DM). Objective: This study aimed to identify the range of SDOH challenges--including diabetes-related distress--that impact patients with insulin-dependent diabetes at an urban safety-net clinic using the 5-domain SDOH framework developed by the Healthy People 2020 initiative. Methods: The pilot study used a cross-sectional, mixed methods approach. Participants were recruited from 3 programs within a general internal medicine clinic that provides ambulatory care for patients with uncontrolled T2DM. We administered an investigator-developed SDOH survey based on the Healthy People 2020 framework and the validated Diabetes Distress Scale (DDS), which assesses 4 domains of diabetes-related distress. One-on-one interviews were conducted to gain in-depth information about challenges. Results: In total, 57 participants had an average hemoglobin A1c level of 11.0% (SD 2.6%). Overall, 92% (52/57) of participants had a barrier in at least one SDOH domain. SDOH challenges were most commonly reported in the domain of Health and Health Care (84%, 48/57), followed by Economic Stability (54%, n=31), Neighborhood and Built Environment (53%, n=30), Education and Health Literacy (47%, n=27), and Social and Community context (37%, n=21). The mean overall DDS score was 2.09 (SD 0.84), where scores of =2 indicate distress. Further, 79% (45/57) of participants had at least moderate diabetes-related distress in one of the 4 DDS domains. General themes that emerged from participant interviews included job interference with healthy behaviors, concerns about burdening others, challenges communicating with providers, and difficulty getting appointments in a timely manner. Conclusions: We found high levels of SDOH barriers across all 5 domains of the Center for Disease Control and Prevention's Healthy People 2020 framework, including significant levels of diabetes-related distress. Future programs to address SDOH barriers in patients with uncontrolled insulin-dependent diabetes should consider screening for and focusing on a wide range of challenges. [ABSTRACT FROM AUTHOR]

Background: QR codes have played an integral role during the pandemic in many sectors, but their use has been limited in the health care sector, especially by patients. Although some authors have stated that developing specific content for women on how to cope with health problems could be an effective way to prevent problems, especially during pandemics, there is little research regarding the use of QR codes to promote health during a pandemic, and even fewer studies are focused on women. Moreover, although the importance of assessing these interventions from the users' perspective has been stated, research carried out from this point of view is still scarce. Objective: This study aimed to assess the usefulness of using QR codes with information to promote women's health in the context of a pandemic. We also sought to design and validate a questionnaire to assess this. Methods: A cross-sectional study was conducted among women in the gynecology waiting rooms of a reference hospital. Exploratory factorial analysis with the split-half method and Cronbach α values was performed for questionnaire validation. Univariant and bivariant analyses were performed to analyze the data obtained. Results: In total, 186 women took part in the study. Exploratory factor analysis identified 2 domains: usability and applicability in medical practice. The Cronbach α value was .81. Overall, 83.7% of the answers to the first domain and 56.4% of those to the second were favorable. Women with university education or those who had used QR codes before scored better in the usability domain, while no differences were observed in the applicability scores. Conclusions: Using QR codes in the gynecology clinics'waiting rooms can help promote women's health during a pandemic, regardless of their education level or whether they have used QR codes before. The questionnaire developed herein is a helpful tool to assess this. These findings are important for clinical practice. This research can be performed in other ambits, specialties, or countries. [ABSTRACT FROM AUTHOR]

Abstract Purpose To describe the objective and design of the Fujian Eye Study and to introduce the general characteristics and vision condition of this study. Methods The Fujian Eye Study (FJES) is a population-based cross-sectional survey on the public eye health status of residents over 50 years old in the entire Fujian Province of Southern China, which contains both urban and rural areas and coastal and inland regions. 10,044 participants were enrolled using a two-stage cluster sampling design and underwent a questionnaire and a series of standard examinations both physical and ocular. The main subgroups of data collection included age, sex, region, refractive error, education background, income, eating habits, smartphone usage in the dark, complaints of eye discomfort, history of chronic diseases, consumption of tobacco, alcohol, or tea. Results 8211 (81.8%) participants were finally included and were divided into urban populations (4678 subjects) and rural populations (3533 subjects) and coastal residents (6434 subjects) and inland residents (1777 subjects); 4836 participants were female. The mean age was 64.39 (SD 8.87) years (median 64 years; range 50–98 years). 227 (3.33%) had vision impairment (VI), 195 (2.87%) had low vision and 14 (0.21%) were blind. The mean presenting near visual acuity (PNVA) was 0.28 (0.17), the mean presenting distance visual acuity (PDVA) was 0.61 (0.30), and the mean best corrected visual acuity (BCVA) was 0.82 (0.28). Conclusions The FJES collected detailed questionnaire information and overall ocular and physical examinations, which provide the opportunity to identify risk factors and images of VI and eye diseases and to evaluate their associations with chronic diseases and basic personal information.

This study aimed to describe nurses' attitudes and beliefs towards the importance of family in nursing care and explore differences in nurses' attitudes and beliefs towards family-centered care between different healthcare institutions, such as community healthcare centers and hospitals. Family significantly affects the well-being and health of individuals. Therefore, nurses should support family engagement in nursing care. In recent years, family nursing research has emphasized the importance of teaching family nursing skills in continued education in healthcare institutions. Research has indicated that nurses who believe that illness concerns the family as a whole are more likely to involve the family in patient care. A cross-sectional research design was used. Data were collected at one timepoint between March and September 2019 from 425 nurses working at the Primary Health Care Centers of the Capital Area (n=112) and in clinical settings at the University Hospital in Iceland (n=313). The main findings indicated that nurses working in the women-and-child division at the University Hospital reported significantly more positive attitudes towards family evolvement in patient care than nurses working in the intensive care or surgical units. For nurses working at healthcare centers, a significant difference was also found in the nurses' attitudes towards involving families in patient care. The nurses who were working in home care had significantly more positive attitudes when compared to those working in the infant and young children health promotion units. Greater collaboration is required between healthcare providers and families to improve the quality of care and health-related outcomes. Therefore, it is crucial to enhance nurses' knowledge about the importance of families during patient care. This study aimed to describe nurses' attitudes and beliefs towards family care. Differences were found between nurse's attitudes by units but not by institutions. [ABSTRACT FROM AUTHOR]

This study investigated changes in physical activity (PA) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection while considering age, PA level, underlying medical conditions (UMCs), vaccination profiles/types, re-infections, disease severity, and treatment. Data were collected from 5829 respondents by using a validated web-based questionnaire. The findings showed that there was a significant overall decrease in PA (−16.2%), including in daily occupation (−11.9%), transportation (−13.5%), leisure-time (−16.4%), and sporting (−27.6%) activities. Age, PA level, UMCs, vaccination profiles/types, disease severity, and treatment played a role in determining PA in individuals’ post-acute SARS-CoV-2 infections. Re-infections did not impact the decline in PA. Unvaccinated individuals experienced a significant decline in PA (−13.7%). Younger (−22.4%) and older adults (−22.5%), those with higher PA levels (−20.6%), those with 2–5 UMCs (−23.1%), those who were vaccinated (−16.9%) or partially vaccinated (−19.1%), those with mRNA-type vaccines only (−17.1%), those with recurrent (−19.4%)-to-persistent (−54.2%) symptoms, and those that required hospital (−51.8%) or intensive care unit (−67.0%) admission during their infections had more pronounced declines in PA. These findings emphasize the complex relationship between post-acute SARS-CoV-2 infection and PA and highlight the need for targeted interventions, further research, and multidisciplinary care to promote PA resumption and mitigate long-term effects on global public health.

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Seroprevalence studies provide an accurate measure of SARS-CoV-2 spread at a population level and the number of undiagnosed individuals. Repeated cross-sectional sero-studies are encouraged to monitor the spread of the virus. The aim of this study is to assess the seroprevalence rate among a random sample of Palestinians residing in the West Bank region of Palestine, especially among those who were not vaccinated and not diagnosed. The study was able to assess the prevalence of asymptomatic cases among the Palestinian adult population. The study also focused on measuring the percentage of adult Palestinians who accepted to get vaccinated across gender and age groups. Methods: This second round cross-sectional study involved 1451 participants, who agreed to be interviewed and answer the questionnaire, where 910 of them agreed to participate in the sero-study and donate a blood sample to be tested for antibodies. The sample was randomly selected from the adult population, 18 years or older, living in the West Bank region of Palestine. Serological tests for 910 adequate serum samples were performed using immunoassays for the detection of antibodies against SARS-CoV-2. Sociodemographic information and medical history data were collected. Results: Study findings indicate that as of October 2021, there was a seroprevalence rate of 75.9% (30% due to infection with COVID-19 virus and 45.9% due to vaccination) with 95% CI (73.1–78.7). The results indicate that the prevalence of antibodies among those who are unvaccinated and undiagnosed was 45.2% with 95% CI (39.9–50.5%). The average age of participants was 37.6 years old. A total of 49.2% were females, and 50.8% were males. In relation to COVID-19, 13.6% of respondents reported getting infected by COVID-19 with statistically significant difference (p-value = 0.001) between males (10.7%) and females (16.5%). In terms of vaccination, 52.8% of respondents reported getting vaccinated with an important difference between males (64.3%) and females (40.9%), (p-value < 0.01). Conclusions: Our findings reveal a drastic rise in seroprevalence of SARS-CoV-2 antibodies due to infection and vaccination. This information is useful for assessing the degree of herd immunity among the adult population and provides better understanding of the pandemic. Population-based seroprevalence studies should be conducted periodically to monitor the SARS-CoV-2 seroprevalence in Palestine and inform policy makers about the efficacy of the surveillance system and the public compliance with vaccination policies especially among females. [ABSTRACT FROM AUTHOR]

The prevalence of and factors associated with musculoskeletal (MSK) symptoms in patients with hidradenitis suppurativa (HS) have yet to be elucidated. Given the association between HS and inflammatory comorbidities, understanding the burden of MSK symptoms in patients with HS is crucial for patient-centered care. Our objective was to describe the prevalence of and factors associated with MSK symptoms in patients with HS. A cross-sectional study of 78 consecutive patients recruited between November 2021 and February 2023 with a dermatology-confirmed diagnosis of HS, irrespective of MSK symptoms, was performed. The average age of participants (n=78) was 37 (SD 12.2) years, and the average age at symptom onset was 23 (SD 12.1) years; 54% (n=42) of participants identified as women, and 46% (n=36) as men. The most common comorbidities included depression (n=17, 22%) and preexisting arthritis (n=12, 16%). Approximately 24% (n=18) of participants reported prolonged morning stiffness. In a multivariate regression, depression was significantly associated with morning stiffness (odds ratio [OR] 6.1, 95% CI 1.4-26.1; P=.02), while female sex was significantly associated with arthralgia (OR 19.1, 95% CI 1.6-235.2; P=.02). Every patient with depression reported arthralgia. We highlight the high prevalence of MSK symptoms among patients with HS and note the interplay between depression and MSK symptoms, with each one potentially contributing to the other., (©Hayley McKee, Lihi Eder, Dana Jerome, Reza D Mirza, Chikaodili Obetta, Elisabeth Pek, Vincent Piguet, Raed Alhusayen. Originally published in JMIR Dermatology (http://derma.jmir.org), 22.08.2024.)

Background: This study demonstrates that digital maturity contributes to strengthened quality and safety performance outcomes in US hospitals. Advanced digital maturity is associated with more digitally enabled work environments with automated flow of data across information systems to enable clinicians and leaders to track quality and safety outcomes. This research illustrates that an advanced digitally enabled workforce is associated with strong safety leadership and culture and better patient health and safety outcomes., Objective: This study aimed to examine the relationship between digital maturity and quality and safety outcomes in US hospitals., Methods: The data sources were hospital safety letter grades as well as quality and safety scores on a continuous scale published by The Leapfrog Group. We used the digital maturity level (measured using the Electronic Medical Record Assessment Model [EMRAM]) of 1026 US hospitals. This was a cross-sectional, observational study. Logistic, linear, and Tweedie regression analyses were used to explore the relationships among The Leapfrog Group's Hospital Safety Grades, individual Leapfrog safety scores, and digital maturity levels classified as advanced or fully developed digital maturity (EMRAM levels 6 and 7) or underdeveloped maturity (EMRAM level 0). Digital maturity was a predictor while controlling for hospital characteristics including teaching status, urban or rural location, hospital size measured by number of beds, whether the hospital was a referral center, and type of hospital ownership as confounding variables. Hospitals were divided into the following 2 groups to compare safety and quality outcomes: hospitals that were digitally advanced and hospitals with underdeveloped digital maturity. Data from The Leapfrog Group's Hospital Safety Grades report published in spring 2019 were matched to the hospitals with completed EMRAM assessments in 2019. Hospital characteristics such as number of hospital beds were obtained from the CMS database., Results: The results revealed that the odds of achieving a higher Leapfrog Group Hospital Safety Grade was statistically significantly higher, by 3.25 times, for hospitals with advanced digital maturity (EMRAM maturity of 6 or 7; odds ratio 3.25, 95% CI 2.33-4.55)., Conclusions: Hospitals with advanced digital maturity had statistically significantly reduced infection rates, reduced adverse events, and improved surgical safety outcomes. The study findings suggest a significant difference in quality and safety outcomes among hospitals with advanced digital maturity compared with hospitals with underdeveloped digital maturity., (©Anne Snowdon, Abdulkadir Hussein, Melissa Danforth, Alexandra Wright, Reid Oakes. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.08.2024.)

Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality in the developed world. Timely detection of cardiac arrest and prompt activation of emergency medical services (EMS) are essential, yet challenging. Automated cardiac arrest detection using sensor signals from smartwatches has the potential to shorten the interval between cardiac arrest and activation of EMS, thereby increasing the likelihood of survival., Objective: This cross-sectional survey study aims to investigate users' perspectives on aspects of continuous monitoring such as privacy and data protection, as well as other implications, and to collect insights into their attitudes toward the technology., Methods: We conducted a cross-sectional web-based survey in the Netherlands among 2 groups of potential users of automated cardiac arrest technology: consumers who already own a smartwatch and patients at risk of cardiac arrest. Surveys primarily consisted of closed-ended questions with some additional open-ended questions to provide supplementary insight. The quantitative data were analyzed descriptively, and a content analysis of the open-ended questions was conducted., Results: In the consumer group (n=1005), 90.2% (n=906; 95% CI 88.1%-91.9%) of participants expressed an interest in the technology, and 89% (n=1196; 95% CI 87.3%-90.7%) of the patient group (n=1344) showed interest. More than 75% (consumer group: n= 756; patient group: n=1004) of the participants in both groups indicated they were willing to use the technology. The main concerns raised by participants regarding the technology included privacy, data protection, reliability, and accessibility., Conclusions: The vast majority of potential users expressed a strong interest in and positive attitude toward automated cardiac arrest detection using smartwatch technology. However, a number of concerns were identified, which should be addressed in the development and implementation process to optimize acceptance and effectiveness of the technology., (© Wisse M F van den Beuken, Hans van Schuppen, Derya Demirtas, Vokko P van Halm, Patrick van der Geest, Stephan A Loer, Lothar A Schwarte, Patrick Schober. Originally published in JMIR Human Factors (https://humanfactors.jmir.org).)

Background: Indonesia has rapidly embraced digital health, particularly during the COVID-19 pandemic, with over 15 million daily health application users. To advance its digital health vision, the government is prioritizing the development of health data and application systems into an integrated health care technology ecosystem. This initiative involves all levels of health care, from primary to tertiary, across all provinces. In particular, it aims to enhance primary health care services (as the main interface with the general population) and contribute to Indonesia's digital health transformation., Objective: This study assesses the information and communication technology (ICT) maturity in Indonesian health care services to advance digital health initiatives. ICT maturity assessment tools, specifically designed for middle-income countries, were used to evaluate digital health capabilities in 9 provinces across 5 Indonesian islands., Methods: A cross-sectional survey was conducted from February to March 2022, in 9 provinces across Indonesia, representing the country's diverse conditions on its major islands. Respondents included staff from public health centers (Puskesmas), primary care clinics (Klinik Pratama), and district health offices (Dinas Kesehatan Kabupaten/Kota). The survey used adapted ICT maturity assessment questionnaires, covering human resources, software and system, hardware, and infrastructure. It was administered electronically and involved 121 public health centers, 49 primary care clinics, and 67 IT staff from district health offices. Focus group discussions were held to delve deeper into the assessment results and gain more descriptive insights., Results: In this study, 237 participants represented 3 distinct categories: 121 public health centers, 67 district health offices, and 49 primary clinics. These instances were selected from a sample of 9 of the 34 provinces in Indonesia. Collected data from interviews and focus group discussions were transformed into scores on a scale of 1 to 5, with 1 indicating low ICT readiness and 5 indicating high ICT readiness. On average, the breakdown of ICT maturity scores was as follows: 2.71 for human resources' capability in ICT use and system management, 2.83 for software and information systems, 2.59 for hardware, and 2.84 for infrastructure, resulting in an overall average score of 2.74. According to the ICT maturity level pyramid, the ICT maturity of health care providers in Indonesia fell between the basic and good levels. The need to pursue best practices also emerged strongly. Further analysis of the ICT maturity scores, when examined by province, revealed regional variations., Conclusions: The maturity of ICT use is influenced by several critical components. Enhancing human resources, ensuring infrastructure, the availability of supportive hardware, and optimizing information systems are imperative to attain ICT maturity in health care services. In the context of ICT maturity assessment, significant score variations were observed across health care levels in the 9 provinces, underscoring the diversity in ICT readiness and the need for regionally customized follow-up actions., (© Dewi Nur Aisyah, Agus Heri Setiawan, Alfiano Fawwaz Lokopessy, Nadia Faradiba, Setiaji Setiaji, Logan Manikam, Zisis Kozlakidis. Originally published in JMIR Medical Informatics (https://medinform.jmir.org).)

Background: Screen use time has increased in the past decade owing to the increased availability and accessibility of digital devices and the internet. Several studies have shown an association between increased screen use time and mental health issues such as anxiety and depression. However, studies in the young adult population-a demographic with high screen use-and in low- and middle-income country settings are limited., Objective: This protocol describes a study that aims to measure self-reported screen use times and patterns in young adults (18-24 y) in India and assess if increased screen use time is associated with poorer mental well-being., Methods: This protocol describes a cross-sectional study of a pan-India, web-based convenience sample of young adults (18-24 y) with access to digital devices with a screen and a minimum of secondary school education. Participants will be recruited through people in the professional networks of the investigators, which includes pediatricians. The survey will also be distributed via the social media pages of our organization (X [X Corp], Instagram [Meta], Facebook [Meta], etc). Sociodemographic details will be collected through a questionnaire designed by the authors; screen use time and patterns will be assessed using an adaptation of the Screen Time Questionnaire to include data on different apps and websites used on digital devices; and mental health parameters will be gauged using the Warwick-Edinburgh Mental Well-Being Scale, Generalized Anxiety Disorder Scale, Perceived Stress Scale, and Patient Health Questionnaire. For statistical analysis, we will consider the following variables: (1) the primary independent variable is screen use time; (2) other independent variables include age, gender, residence: rural or urban, educational qualifications, employment status, stress associated with familial financial status, average sleep time, number of people living in a house or rooms in that house, BMI, substance use, and past psychiatric history; and (3) dependent variables include mental well-being, depression, anxiety, and perceived stress. To quantify the association between screen use time and mental health, we will perform a Bayesian multivariate multiple regression analysis that models the possibility of multiple alternative hypotheses while accounting for relevant sociodemographic covariables., Results: The survey instrument has been designed, and feedback has been obtained from the domain experts and members of our organization whose profile is similar to the potential study participants. The final data received after this study has been conducted will be analyzed and shared. As of January 2023, we have not yet initiated the data collection., Conclusions: Based on the findings of this study, we will be able to establish a correlation between device- and use-specific screen use time and various mental health parameters. This will provide a direction to develop screen use time and mental health guidelines among young adults., International Registered Report Identifier (irrid): PRR1-10.2196/39707., (©Swasti Deshpande, Ashmeet Sachdev, Anwesha Maharana, Siddhesh Zadey, Surabhi P Dharmadhikari, Swati Ghate, Pawankumar Godatwar, Nisha Kumari Ojha, Sanjeev Sharma. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 16.07.2024.)

Background: During the COVID-19 pandemic, much misinformation and disinformation emerged and spread rapidly via the internet, posing a severe public health challenge. While the need for eHealth literacy (eHL) has been emphasized, few studies have compared the difficulties involved in seeking and using COVID-19 information between adult internet users with low or high eHL., Objective: This study examines the association between eHL and web-based health information-seeking behaviors among adult Japanese internet users. Moreover, this study qualitatively shed light on the difficulties encountered in seeking and using this information and examined its relationship with eHL., Methods: This cross-sectional internet-based survey (October 2021) collected data from 6000 adult internet users who were equally divided into sample groups by gender, age, and income. We used the Japanese version of the eHL Scale (eHEALS). We also used a Digital Health Literacy Instrument (DHLI) adapted to the COVID-19 pandemic to assess eHL after we translated it to Japanese. Web-based health information-seeking behaviors were assessed by using a 10-item list of web sources and evaluating 10 topics participants searched for regarding COVID-19. Sociodemographic and other factors (eg, health-related behavior) were selected as covariates. Furthermore, we qualitatively explored the difficulties in information seeking and using. The descriptive contents of the responses regarding difficulties in seeking and using COVID-19 information were analyzed using an inductive qualitative content analysis approach., Results: Participants with high eHEALS and DHLI scores on information searching, adding self-generated information, evaluating reliability, determining relevance, and operational skills were more likely to use all web sources of information about COVID-19 than those with low scores. However, there were negative associations between navigation skills and privacy protection scores when using several information sources, such as YouTube (Google LLC), to search for COVID-19 information. While half of the participants reported no difficulty seeking and using COVID-19 information, participants who reported any difficulties, including information discernment, incomprehensible information, information overload, and disinformation, had lower DHLI score. Participants expressed significant concerns regarding "information quality and credibility," "abundance and shortage of relevant information," "public trust and skepticism," and "credibility of COVID-19-related information." Additionally, they disclosed more specific concerns, including "privacy and security concerns," "information retrieval challenges," "anxieties and panic," and "movement restriction.", Conclusions: Although Japanese internet users with higher eHEALS and total DHLI scores were more actively using various web sources for COVID-19 information, those with high navigation skills and privacy protection used web-based information about COVID-19 cautiously compared with those with lower proficiency. The study also highlighted an increased need for information discernment when using social networking sites in the "Health 2.0" era. The identified categories and themes from the qualitative content analysis, such as "information quality and credibility," suggest a framework for addressing the myriad challenges anticipated in future infodemics., (©Seigo Mitsutake, Koichiro Oka, Orkan Okan, Kevin Dadaczynski, Tatsuro Ishizaki, Takeo Nakayama, Yoshimitsu Takahashi. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 11.07.2024.)

Background and purpose: Head and neck cancer (HNC) patients usually present with malnutrition during radiotherapy, leading to loss of skeletal muscle mass (SMM) and poor clinical outcomes. CT has been used in clinical practice for measuring SMM in cancer patients. However, its clinical application for monitoring SMM is limited by the expensive price and high radiation exposure. This study aimed to investigate the feasibility of cone-beam computed tomography (CBCT) for assessing SMM and its changes in HNC patients undergoing radiotherapy. Materials and methods: This study was divided into two parts. In part 1 (n = 32), the cross-sectional of skeletal muscle area (SMA) at the third cervical vertebra (C3) based on CBCT and computed tomography (CT) was assessed. In part 2 (n = 30), CT and CBCT were performed, and patients' weight was measured before and at four different time points during radiotherapy. SMAs at C3 were independently identified by three senior radiation oncologists. The interobserver agreement of SMA on CBCT (SMACBCT) findings was analyzed using the intraclass correlation coefficient (ICC). One-way analysis of variance was used to evaluate the interobserver variability and statistical significance for SMA measurements. CBCT and CT measurement differences and correlations were analyzed using paired sample t -test and Pearson correlation analysis, respectively. The Krouwer variant of the Bland–Altman plot was used to analyze the agreement of SMA measurements between CBCT and CT. A simple linear regression model was used to analyze the relationship of SMA measurements between the two imaging techniques, and the equation was established. A repeated-measures ANOVA was performed to evaluate the effects and interactions between weight loss, SMA loss, and time. Results: SMACBCT demonstrated excellent interobserver reliability; no significant difference between SMACBCT and SMA on CT (SMACT) at C3 was observed in all patients. The SMACBCT and SMACT were highly correlated (r = 0.966; 95% confidence interval = 0.955–0.975; p < 0.001). Bland–Altman analysis revealed that SMACBCT was generally higher than SMACT. The predicted SMA value at C3 on CT using CBCT was similar to the actual value. Moreover, significant differences between SMA and weight loss (F =10.99, p = 0.002), groups (weight loss and SMA loss) and times (4 time points) (F = 3.93, p = 0.013), and mean percent loss over time (F = 7.618, p < 0.001) were noted. Conclusion: CBCT may be used as an alternative for CT to measure SMA in HNC patients during radiotherapy. [ABSTRACT FROM AUTHOR]

When detected early, melanoma is highly treatable and rarely fatal. Self-skin checks can identify changes in moles that could be an indicator of melanoma. Cancer risk perceptions may influence the uptake of important preventive health behaviors such as self-skin checks. The purpose of this study is to examine cancer risk perception factors associated with those who have checked their skin for signs of skin cancer using the 2017 HINTS data. Retrospective cross-sectional analysis of a nationally representative sample of U.S. adults using the Health Information National Trends Survey (HINTS). Logistic regressions were performed to identify associations between having checked skin for signs of skin cancer, risk perceptions, and demographic variables. White women over the age of 45 with a college degree and annual incomes greater than $75,000 were more likely to check their skin for signs of skin cancer. More than a third reported they would rather not know if they had cancer and more than 60% had some level of worry about having cancer. Those with a personal or family history of cancer were more likely to check. HINTS is a cross-sectional survey which provides only a glimpse of behavioral predictors. Self-skin checks are simple and cost-effective to detect melanoma early and improve outcomes. Fear and worry about cancer were significant factors in the likelihood of checking skin for signs of skin cancer. Population-based strategies could be developed to reduce concerns about early detection. [ABSTRACT FROM AUTHOR]

Background and purposeHead and neck cancer (HNC) patients usually present with malnutrition during radiotherapy, leading to loss of skeletal muscle mass (SMM) and poor clinical outcomes. CT has been used in clinical practice for measuring SMM in cancer patients. However, its clinical application for monitoring SMM is limited by the expensive price and high radiation exposure. This study aimed to investigate the feasibility of cone-beam computed tomography (CBCT) for assessing SMM and its changes in HNC patients undergoing radiotherapy.Materials and methodsThis study was divided into two parts. In part 1 (n = 32), the cross-sectional of skeletal muscle area (SMA) at the third cervical vertebra (C3) based on CBCT and computed tomography (CT) was assessed. In part 2 (n = 30), CT and CBCT were performed, and patients’ weight was measured before and at four different time points during radiotherapy. SMAs at C3 were independently identified by three senior radiation oncologists. The interobserver agreement of SMA on CBCT (SMACBCT) findings was analyzed using the intraclass correlation coefficient (ICC). One-way analysis of variance was used to evaluate the interobserver variability and statistical significance for SMA measurements. CBCT and CT measurement differences and correlations were analyzed using paired sample t-test and Pearson correlation analysis, respectively. The Krouwer variant of the Bland–Altman plot was used to analyze the agreement of SMA measurements between CBCT and CT. A simple linear regression model was used to analyze the relationship of SMA measurements between the two imaging techniques, and the equation was established. A repeated-measures ANOVA was performed to evaluate the effects and interactions between weight loss, SMA loss, and time.ResultsSMACBCT demonstrated excellent interobserver reliability; no significant difference between SMACBCT and SMA on CT (SMACT) at C3 was observed in all patients. The SMACBCT and SMACT were highly correlated (r = 0.966; 95% confidence interval = 0.955–0.975; p < 0.001). Bland–Altman analysis revealed that SMACBCT was generally higher than SMACT. The predicted SMA value at C3 on CT using CBCT was similar to the actual value. Moreover, significant differences between SMA and weight loss (F =10.99, p = 0.002), groups (weight loss and SMA loss) and times (4 time points) (F = 3.93, p = 0.013), and mean percent loss over time (F = 7.618, p < 0.001) were noted.ConclusionCBCT may be used as an alternative for CT to measure SMA in HNC patients during radiotherapy.

Background: Based on the Indonesia basic health research report in 2018, the prevalence of chronic kidney disease (CKD) in the productive age group in Indonesia had increased from the previous year, to 1.97%. This condition can cause various complications that contribute to the high morbidity, which affects quality of life and productivity, so risk factors for CKD need to be understood to prevent the occurrence of the disease. Purpose: This study aimed to analyze the risk factors associated with CKD in the Indonesian productive-age population. Method: This study used data sourced from Indonesian Family Life Survey 5 (IFLS-5) with a cross-sectional research design. The study population was composed of all Indonesian residents who were respondents of IFLS-5. The research sample was made up of respondents aged 15–64 for whom complete information was available. The sample size was 29,120 respondents. The variables analyzed in this study were diabetes, hypertension, obesity, smoking, and CKD. The analysis method used was the chi-square test. Results: Bivariate analysis showed a significant relationship between CKD and diabetes (p = 0.01; prevalence ratio [PR] = 2.71; 95% CI = 1.74–4.22), hypertension (p = 0.01; PR = 2.62; 95% CI = 2.08–3.30), obesity (p = 0.01; PR = 1.67; 95% CI = 1.25–2.23), and smoking (p = 0.01; PR = 1.43; 95% CI = 1.17–1.75) in the productive age group in Indonesia. Conclusion: Diabetes, hypertension, obesity, and smoking have a significant relationship with CKD in the productive age group in Indonesia.

Purpose: To describe the objective and design of the Fujian Eye Study and to introduce the general characteristics and vision condition of this study.Methods: The Fujian Eye Study (FJES) is a population-based cross-sectional survey on the public eye health status of residents over 50 years old in the entire Fujian Province of Southern China, which contains both urban and rural areas and coastal and inland regions. 10,044 participants were enrolled using a two-stage cluster sampling design and underwent a questionnaire and a series of standard examinations both physical and ocular. The main subgroups of data collection included age, sex, region, refractive error, education background, income, eating habits, smartphone usage in the dark, complaints of eye discomfort, history of chronic diseases, consumption of tobacco, alcohol, or tea.Results: 8211 (81.8%) participants were finally included and were divided into urban populations (4678 subjects) and rural populations (3533 subjects) and coastal residents (6434 subjects) and inland residents (1777 subjects); 4836 participants were female. The mean age was 64.39 (SD 8.87) years (median 64 years; range 50-98 years). 227 (3.33%) had vision impairment (VI), 195 (2.87%) had low vision and 14 (0.21%) were blind. The mean presenting near visual acuity (PNVA) was 0.28 (0.17), the mean presenting distance visual acuity (PDVA) was 0.61 (0.30), and the mean best corrected visual acuity (BCVA) was 0.82 (0.28).Conclusions: The FJES collected detailed questionnaire information and overall ocular and physical examinations, which provide the opportunity to identify risk factors and images of VI and eye diseases and to evaluate their associations with chronic diseases and basic personal information. [ABSTRACT FROM AUTHOR]

Objective: To examine the impact of sleep deprivation and coping abilities on the psychological adjustment of caregivers of elderly. Study Design: Cross sectional analytical study. Place and Duration: Department of Psychology, University of Gujrat, Gujrat Pakistan, from Jan to Jul 2018. Methodology: The caregivers of the elderly were recruited in the study with the caregiving experience of 6 months to 2 years. The respondents with any physical or psychological problems were excluded from the study. The sleep deprivation, coping and psychological adjustment were measured using the Pittsburgh sleep quality index, coping styles scale, scale of adjustment for adults respectively. Results: The data of 200 caregivers of the elderly was analyzed using structure equation modeling. The model fit was established with the p-value of <0.001. It was found that caregivers' sleep deprivation and coping abilities affected their psychological adjustments. The overall model confirmed that sleep deprivation and coping ability affected the psychological adjustment. The individual relationship between sleep deprivation predicted psychological adjustment with the value of regression estimate as 5.808 (p-value <0.001). Furthermore, the role of coping abilities on psychological adjustment had a regression value of 0.151 (p-value 0.7013). Conclusion: The sleep deprivation affected the psychological adjustment of caregivers of the elderly, whereas the coping abilities did not affect the psychological adjustment. [ABSTRACT FROM AUTHOR]