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Objectives: Due to social challenges and difficulties adapting to their treatment, middle-aged adults with Diabetes Mellitus (DM) are at a greater risk for developing psychological distress. This study aimed to determine the prevalence of psychological distress and its determinants among middle-aged adults with DM in Indonesia. Methods: A national population-based health survey (Indonesian Riset Kesehatan Dasar, Riskesdas) involving 1,017,290 respondents was conducted in 2018. The present analysis included all middle-aged adults (45–60 years old) with DM. Information regarding socio-demographic, clinical-related, social-behavior, and psychological distress status using the World Health Organization Self-Reporting Questionnaire-20 (SRQ-20) was abstracted from the database. Logistic regression analyses were applied. Results: The prevalence of psychological distress among middle-aged adults with DM was 18.3% (95% CI 13.7, 22.9). The participants' mean (standard deviation) age was 53.0 (4.44) years. They were predominantly female, had low education levels, were employed, married, and lived in urban areas. Multiple logistics regression analysis demonstrated nine factors associated with psychological distress—sex, education, occupation, marital status, home location, body mass index, comorbidities, DM regimen, and smoking. Conclusions: Multiple factors were significantly associated with psychological distress. This lays the groundwork for future policymakers to strongly recommend integrating mental health screening at DM diagnosis and on a yearly basis, prompt referral, early interventions, and the delivery of targeted mental health education to the high-risk populations in the effort of prevention and control of psychological distress among middle-aged adults with DM. [ABSTRACT FROM AUTHOR]

Objective: To determine the factors associated with undiagnosed hypertension. Methods: A quantitative, observational, retrospective, cross-sectional and analytical study was carried out in people aged 15 years and over included in the Demographic and Family Health Survey from 2019 to 2021 in Peru. A statistical analysis was carried out using the corrected F test, and crude and adjusted prevalence ratio (aPR), with a 95% confidence interval (95%CI) for inferential analysis, through Poisson regression with robust variance. Likewise, the CSPLAN analysis was carried out for complex samples according to the sample design and taking into account the weighting factor. Results: In the multivariate analysis, a significant association was found between the factors male sex (aPR: 1.22; 95%CI: 1.19-1.26), age from 30 to 49 years (aPR: 0.94; 95%CI: 0.92-0.96), native ethnicity (aPR: 1.07; 95%CI: 1.04-1.10), having health insurance (aPR: 0.91; 95%CI: 0.89-0.93), suffering from some permanent limitation (aPR: 0.83; 95%CI: 0.76-0.91) and diabetes mellitus (aPR: 0.59; 95%CI: 0.55-0.64). No significant association was found with educational level, language, Afro-Peruvian ethnicity, or alcohol or tobacco consumption (p > 0.05). Conclusions: The prevalence of undiagnosed arterial hypertension is high, 69.5%. The associated factors are male sex, native ethnicity, age between 30 and 49 years, having health insurance, suffering from some permanent limitation and having diabetes mellitus. [ABSTRACT FROM AUTHOR]

Sanitation, which offers safe and effective methods for waste disposal, is important for development. However, in Africa and other developing regions, the prevalent practice of open defecation (OD) impedes attaining the sustainable development goals (SDGs). This research delves into the analysis of OD in Africa and proposes a three-tier priority system, comprising critical, high, and medium areas, through which developmental endeavours can be targeted. To achieve this, the study utilizes data from demographic and health surveys (DHS) and the World Bank. The rates of OD at country and sub-country/region levels were calculated to define the priority system, and regression analyses were used to determine predictors of OD practice. The findings are that Nigeria, Ethiopia, Niger, the Democratic Republic of Congo, Burkina Faso, and Chad have a high number of people struggling with open defecation. In addition, disparities in access to proper sanitation facilities were identified among impoverished individuals and those residing in rural areas. After adjusting for education and residence, the poorest are 43 times (95% confidence interval 42.443–45.290) more likely to practice open defecation in comparison with the wealthiest. Consequently, wealth index is a pivotal factor in eradicating open toileting. To address this pressing issue in Africa, it is imperative to prioritize evidence-based targeted interventions that concentrate on regions and communities urgently needing improved sanitation infrastructure and programmes. Special attention should be paid to West Africa since many of its communities are in the critical category. Poverty and inequality must be addressed and investments in sanitation infrastructure, behavioural change promotion, and support multistakeholder collaborations should be encouraged. To evaluate OD interventions and monitor health impact, variables such as antimicrobial resistance (AMR) should be included in important health surveys (e.g. DHS). This study is the largest meta-data analyses of OD in Africa detailing drivers and communities that should be prioritised on sanitation interventions. [ABSTRACT FROM AUTHOR]

Abstract Objectives Due to social challenges and difficulties adapting to their treatment, middle-aged adults with Diabetes Mellitus (DM) are at a greater risk for developing psychological distress. This study aimed to determine the prevalence of psychological distress and its determinants among middle-aged adults with DM in Indonesia. Methods A national population-based health survey (Indonesian Riset Kesehatan Dasar, Riskesdas) involving 1,017,290 respondents was conducted in 2018. The present analysis included all middle-aged adults (45–60 years old) with DM. Information regarding socio-demographic, clinical-related, social-behavior, and psychological distress status using the World Health Organization Self-Reporting Questionnaire-20 (SRQ-20) was abstracted from the database. Logistic regression analyses were applied. Results The prevalence of psychological distress among middle-aged adults with DM was 18.3% (95% CI 13.7, 22.9). The participants' mean (standard deviation) age was 53.0 (4.44) years. They were predominantly female, had low education levels, were employed, married, and lived in urban areas. Multiple logistics regression analysis demonstrated nine factors associated with psychological distress—sex, education, occupation, marital status, home location, body mass index, comorbidities, DM regimen, and smoking. Conclusions Multiple factors were significantly associated with psychological distress. This lays the groundwork for future policymakers to strongly recommend integrating mental health screening at DM diagnosis and on a yearly basis, prompt referral, early interventions, and the delivery of targeted mental health education to the high-risk populations in the effort of prevention and control of psychological distress among middle-aged adults with DM.

Health agencies rely upon survey-based physical measures to estimate the prevalence of key global health indicators such as hypertension. Such measures are usually collected by nonhealthcare worker personnel and are potentially subject to measurement error due to variations in interviewer technique and setting, termed interviewer effects. In the context of physical measurements, particularly in low- and middle-income countries, interviewer-induced biases have not yet been examined. Using blood pressure as a case study, we aimed to determine the relative contribution of interviewer effects on the total variance of blood pressure measurements in three large nationally representative health surveys from the Global South. We utilized 169,681 observations between 2008 and 2019 from three health surveys (Indonesia Family Life Survey, National Income Dynamics Study of South Africa, and Longitudinal Aging Study in India). In a linear mixed model, we modeled systolic blood pressure as a continuous dependent variable and interviewer effects as random effects alongside individual factors as covariates. To quantify the interviewer effect-induced uncertainty in hypertension prevalence, we utilized a bootstrap approach comparing subsamples of observed blood pressure measurements to their adjusted counterparts. Our analysis revealed that the proportion of variation contributed by interviewers to blood pressure measurements was statistically significant but small: ∼0.24--2.2% depending on the cohort. Thus, hypertension prevalence estimates were not substantially impacted at national scales. However, individual extreme interviewers could account for measurement divergences as high as 12%. Thus, highly biased interviewers could have important impacts on hypertension estimates at the subdistrict level.

There have been no systematic epidemiological evaluations of the relationship between thyroid autoimmunity and the clinical background of young patients with thyroid nodules. We aimed to clarify the clinical features associated with thyroglobulin or thyroperoxidase antibodies (thyroid autoantibodies [Tabs]) in children and young adults with nodules. We performed a cross-sectional study using data from 3,018 participants of 3–29 years of age with nodules, including thyroid cancer, from the Fukushima Health Management Survey. After stratification of the data for body mass index (BMI) and the bilateral width and thickness of the area (BWTAR) as indicators of thyroid volume for age, sex, body surface area (BSA), and sex-adjusted standard deviation score (SDS), trend analyses were performed. A logistic regression analysis was performed using tab-positivity as an objective variable. The overall prevalence of tab-positivity is 13.9%. It was high in females (17%), participants with diffuse goiter (DG) (19.2%), and those with papillary thyroid carcinoma (PTC) (12.8%). The age- and sex-adjusted odds ratios (95% confidence intervals) for BMI-SDS, BWTAR-SDS, presence of DG, diagnosis of PTC, and TSH concentrations were 0.962 (0.863–1.073), 1.263 (1.171–1.361), 7.357 (4.816–11.239), 2.787 (1.965–4.014), and 1.403 (1.257–1.564), respectively. Tab positivity was independently associated with a large thyroid, the presence of DG, the presence of PTC, and a high TSH concentration in patients with nodules. Based on the systematic epidemiologic evidence shown in young patients, Tab positivity might complement ultrasonography for the assessment of the thyroid function and identification of malignancy in younger patients with asymptomatic thyroid nodules.

Hongli Liu,1,2,* Tengfei Niu,3,* Jiajia Chen,2,4 Zhenyu Wu,5 Taowu Gong,5 Pengcheng Zhao,5 Yuhang Zhu,6 Li Zhang2,7 1Department of Intensive Care Unit, Chongqing General Hospital, Chongqing University, Chongqing, 401147, People’s Republic of China; 2Nursing School of Zunyi Medical University, Zunyi, Guizhou, 563000, People’s Republic of China; 3Department of Basic Courses, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, People’s Republic of China; 4Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563000, People’s Republic of China; 5Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563000, People’s Republic of China; 6Early Clinical Research Ward, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563000, People’s Republic of China; 7Discipline Inspection and Supervision Office of Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuhang Zhu; Li Zhang, Email zhuyuhang_zmc@sina.com; zhli8523@163.comBackground: This study examined the current state of health-related quality of life among family caregivers of elderly individuals with dementia, analyzing associated influencing factors to provide a foundation for enhancing their health-related quality of life and developing pertinent intervention strategies and measures.Methods: From September 2023 to February 2024, a convenient sampling method was used to investigate the status quo of Health-Related Quality of Life (HRQOL) among family caregivers for dementia patients, family caregivers for non-dementia patients, and people with no caregiving burdens in Sichuan, Chongqing and Guizhou in southwest China. The risk factors were analyzed by multiple regression.Results: A total of 678 questionnaires were distributed, and 630 valid questionnaires were obtained, resulting in a response rate of 92.92%. The study found that family caregivers for elderly individuals with dementia exhibited the lowest scores in both physical and mental health, followed by family caregivers for elderly individuals without dementia, while people with no caregiving burdens scored the highest. The multiple linear regression analysis demonstrated that age, chronic disease, the relationship between the family caregiver and the person being cared for were dependent of physiological health scores. While females, caregivers with secondary-education, and caregivers with a chronic disease showed poorer mental health scores.Conclusion: We need to focus on the role that family caregivers for dementia patients play in the health and quality of life of older people with dementia. Therefore, we should pay more attention to the physical and mental health of family caregivers for dementia patients and ensure that this should be taken into consideration in policy-making, which will contribute to a better quality of life for theses caregivers.Keywords: dementia, family caregivers, general health, SF-36, health survey, associated factors

Introduction: We assessed the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and associated sociooccupational factors among delivery riders from a Brazilian city at two time points during the pandemic. Methodology: Surveys for antibody and viral RNA testing were conducted from November 2020 to January 2021, and from March to May 2021 in a group of 117 delivery riders. A questionnaire on socio-occupational characteristics and coronavirus disease 2019 (COVID-19) preventive measures was completed. Factors associated with prevalence were analyzed using bivariate analyses and multiple logistic regression models. Results: The overall prevalence of COVID-19 was 15.4% (CI 9.0-23.0). Although not statistically significant, the prevalence was higher in the second phase of the survey (12% (CI 6.0-19.0)) than in the first (5.1% (CI 1.0-10.0)). The seroprevalence was significantly higher (p < 0.05) in the second phase of collection (10.3%) than in the first phase (3.4%). There were no statistically significant associations between the social characteristics assessed in the study and prevalence. Five behavioral variables were selected for the final multiple logistic regression model; and only the variable "cleans hands" had a significant association with the outcome, indicating that those who cleaned their hands had lower occurrence. Conclusions: The prevalence among delivery riders was high and they were potentially exposed to risk of infection. Occupational activity and individual prevention behavior were better determinants of infection than social differences. It is necessary to take specific public measures for this group, especially during outbreaks of communicable diseases such as COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Despite growing research, the relationship between social determinants of health (SDoH) and low back pain (LBP) remains inconsistent. This study aimed to investigate the associations between SDoH and self‐reported LBP in the Portuguese population in 2019 and explore potential differences between rural and urban areas. Methods: This is a cross‐sectional study that includes 13,230 participants from the 2019 Portuguese National Health Interview Survey. Multivariable logistic regression models were used to assess the associations between SDoH and LBP. Interaction effects were examined to determine whether these relationships are modified by the degree of urbanisation/rurality. Results: The regression model for demographic and economic determinants showed associations between LBP and sex, age, marital status, education and financial capacity, with older rural residents having a higher likelihood of reporting LBP. The psychosocial model revealed that poor health status, sleep disturbances, fatigue, and dissatisfaction with life course were positively associated with LBP. In the behavioural model, obesity and history of smoking increased the probability of reporting LBP, whereas exercise behaviours reduced it and significantly varied across urban and rural regions. Health‐system factors, including hospital visits, medication use, consultations with rehabilitation professionals, delayed healthcare access, and unmet health needs due to financial constraints, were associated with LBP. Rural residents were more likely to seek outpatient care at hospitals. Discussion: These findings emphasise the importance of integrating the evaluation of SDoH into healthcare settings to develop tailored interventions for LBP management. Conclusion: LBP was influenced by several SDoH, but differences between rural and urban areas were limited. [ABSTRACT FROM AUTHOR]

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Dysphagia or swallowing dysfunction is associated with reduced quality of life and poor long term outcomes. While standard dysphagia treatment focuses on improving swallowing function, it is not clear if people with dysphagia also have difficulties performing daily tasks. This study aimed to determine if individuals with dysphagia had difficulties with participating in daily tasks requiring physical function, as compared to those with no dysphagia. We conducted a secondary data analysis using the responses of 24,107 adults aged 18 years or older who completed the 2022 National Health Interview Survey. The independent variable was report of swallowing problem during the past 12 months, and the dependent variables were report of difficulty in physical function tasks (e.g., self-care, mobility, working, social participation). We utilized propensity score methods to balance demographic and clinical variables between groups, and examined if individuals with dysphagia had more difficulties with the physical function tasks. The propensity score methods balanced the demographic and clinical variables (absolute standardized differences < 0.1). People with dysphagia had significantly higher odds ratios (ranged from 1.23 to 1.70, all p < 0.05) of having difficulties in physical function tasks than those without dysphagia. The findings revealed an association between experiencing dysphagia and encountering difficulties in self-care, mobility, working, and social participation in the general adult population in the US. Results of our study indicate that during the course of rehabilitation, healthcare professionals should consider the potential impact of dysphagia symptoms on clients' ability to partake in independent activities in their community settings. [ABSTRACT FROM AUTHOR]

Simple Summary: For many diseases and infections, practitioners of veterinary medicine draw upon the established literature and anecdotal reports. In rabbits, infection with Encephalitozoon cuniculi, a microsporidian parasite, can result in severe disease. While several comprehensive reviews have been published on this infectious agent and resultant disease, there continue to be many challenges in antemortem diagnosis and treatment which has led to some variability in protocols. Using an international survey of veterinary clinicians, we found both differences and consistencies by geographic location which may reflect the influences of client/practice composition and the education/training level of respondents. The results should aid in generating guidelines and education initiatives involving this infectious disease. In 2022–2023, the first survey of clinicians regarding Encephalitozoon cuniculi infection of rabbits was undertaken. The purpose was to assess the current worldwide knowledge of clinicians regarding influence of breed and age, clinical presentations, use of various diagnostic tools, and treatment regimens and to explore how responses may differ by geographic location. Identifying mostly as exotic animal clinicians, 339 respondents participated, with nearly half from the United States and the remainder from 35 other countries. Neurological signs were most consistently reported as associated with Encephalitozoon cuniculi and the most recurrent clinical case presentation. Other responses showed differences by geographic location. For example, age predilection for disease varied, with 71.1% of international respondents indicating that infection was more common in young rabbits versus 28.9% who suggested it was more frequent in older rabbits. This was significantly different (p = 0.001) from the information from respondents from the United States, where 48.0% indicated that younger rabbits had an increased incidence versus 52.0% who indicated that older age increased occurrence. While some differences may be related to the practice composition and the training level of respondents, many responses were in alignment with the existing literature. Future inquiries should focus more on these discrepancies to aid in generating guidelines for the diagnosis and treatment of this infectious disease. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the prevalence of obesity and identify associated health problems and behaviors among monks residing in Bangkok Noi and its adjacent districts. Materials and Methods: Employing a cross-sectional design, this research incorporated self-report questionnaires and specialized health checkup programs at a university hospital. Eligible participants were monks aged 20 years or older, living permanently in temples within the Bangkok Noi District and its adjacent districts. Monks in short- term ordination were excluded. Data collection occurred between February 2022 and July 2023. Results: Out of 560 monks who participated by completing both the questionnaires and health examinations, the average age was 46.49±16.97 years. Most participants resided in the Taling Chan (35.4%) and Bangkok Noi (31.8%) districts. Significant health issues included non-communicable diseases, with dyslipidemia affecting 57.8% and obesity 44.2% of the cohort. Monks over the age of 50 exhibited a remarkably higher rate of multimorbidity (50.2%) than their younger counterparts (24.2%, p < 0.001, 95% CI 20.71–27.97). Dietary habits revealed that younger monks were more prone to consuming fried, sweet and instant foods (74.5%, p < 0.001, 95% CI 70.67–78.07). Moreover, a significant proportion of younger monks demonstrated proficient e-health literacy (74.2%, p < 0.001, 95% CI 70.37–77.78). Conclusion: The study highlights a high prevalence of obesity among monks in urban settings. There is a pressing need for tailored preventive interventions that integrate health promotion and lifestyle modifications through Dhamma and Vinaya teachings. The interventions should address the distinct needs of different age groups. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions This study investigates the utilisation of blended tube feeding by health professionals in Australia and New Zealand, assessing factors influencing its implementation following the Australasian Society of Parenteral and Enteral Nutrition blended tube feeding consensus statement.A cross‐sectional survey was conducted targeting health professionals across Australia and New Zealand. The survey comprised 35‐questions including multiple choice, Likert scales and open‐ended responses, to gain insights into blended tube feeding practices and perspectives. The effect of the health professional factors on outcomes was explored in pairs with a series of Chi‐squared tests. Odds ratios (ORs) were calculated using standard univariate logistic regression. An exploratory content analysis was used to code the open‐ended text responses to the survey questions which were then categorised and further synthesised into overarching themes.Out of 89 health professionals who completed the survey, the majority were dietitians, 63% reported managing fewer than five patients using blended tube feeding within their services. Parental request was the leading reason for adoption. Notable barriers included clinician time constraints, resource limitations and a lack of formal guidelines. Some health professionals considered the primary risk associated with blended tube feeding to be poor growth and/or weight loss. Professional development was pivotal in increasing confidence and advocating for blended tube feeding, with significant correlations observed between blended tube feeding training and clinical practice.This study emphasises the essential role of education, resource availability and institutional policy in promoting blended tube feeding practices for health professionals. Findings suggest that focusing on professional development and standardised resources could significantly enhance knowledge, confidence and competence of health professionals in blended tube feeding application. The outcomes point towards the need for a coordinated approach to support evidence‐based blended tube feeding practices, aligning with the Australasian Society of Parenteral and Enteral Nutrition blended tube feeding resources and recommendations. [ABSTRACT FROM AUTHOR]

To evaluate the association of ultra-processed food (UPF) consumption with depression among Brazilian adults (≥18 years). Cross-sectional study. Data were obtained from a population-based survey conducted in 2023 (n = 21,690). UPF consumption was investigated using a questionnaire regarding the consumption on the previous day of 13 subgroups of UPF selected from those most consumed in Brazil according to a previous national survey (cutoff score ≥5 subgroups). The medical diagnosis of depression was self-reported. Logistic regression models were used to estimate the adjusted (by sex, age, education, presence of partner/spouse, and overweight) Odds Ratio (aOR) of UPF consumption according to the presence of depression. Analyses were conducted for the total population and stratified by sex. Medical diagnosis of depression was reported by 12.3%. The prevalence of high UPF consumption (≥5 subgroups) was 17.7%, being higher in men (22.0%) and those with depression (19.3%). Depression increased the chance of presenting a high UPF consumption among the total population (aOR 1.35; CI 95% 1.08–1.68) and women (aOR 1.35; CI 95% 1.03–1.77), with no association among men. The presence of depression was associated with greater consumption of UPF among Brazilian adults, especially among the female population. Public health actions to reduce UPF consumption could benefit from targeting this population group. [ABSTRACT FROM AUTHOR]

Perceived Social Support (PSS) and Physical Activity (PA) could have an important role in reducing psychological distress in women with problems in the menopausal period. The aim was to analyze the associations between a) Self-Perceived Health (SPH), prevalence of self-reported depression and anxiety, and mental health and its subscales, through the Goldberg General Health Questionnaire (GHQ-12) with b) the Physical Activity Level (PAL) and c) the PSS, through the Duke-UNC-11 functional social support questionnaire in Spanish women with problems in the menopausal period. This document uses data from the Spanish National Health Survey of 2017, focusing on women between 40 and 69 years of age with problems in the menopausal period. Dependency relationships were found between the prevalence of depression and PAL, anxiety and PAL, and SPH with PAL (p < 0.001). Weak inverse correlations were found between PAL and mental health, Coping Success, Self-confidence, and Stress (rho: − 0.214 to − 0.258; p < 0.001). Also, weak and very weak significant inverse correlations were found between PAL and all items of the GHQ-12. Weak inverse correlations were found between PSS scores and mental health, Coping, and Stress (r: −0.201 to − 0.304; p < 0.001). Likewise, weak and very weak inverse correlations, although statistically significant, were found between the PSS scores and the responses to the GHQ-12 items. Very active women with higher PSS have less psychological distress, higher self-esteem, and better prevalence of positive health. [ABSTRACT FROM AUTHOR]

Biosocial surveys increasingly use interviewers to collect objective physical health measures (or "biomeasures") in respondents' homes. While interviewers play an important role, their high involvement can lead to unintended interviewer effects on the collected measurements. Such interviewer effects add uncertainty to population estimates and have the potential to lead to erroneous inferences. This study examines interviewer effects on the measurement of physical performance in a cross-national and longitudinal setting using data from the Survey of Health, Ageing and Retirement in Europe. The analyzed biomeasures exhibited moderate-to-large interviewer effects on the measurements, which varied across biomeasure types and across countries. Our findings demonstrate the necessity to better understand the origin of interviewer-related measurement errors in biomeasure collection and account for these errors in statistical analyses of biomeasure data. [ABSTRACT FROM AUTHOR]

Ensuring adequate iodine nutrition during pregnancy is crucial for fetal brain development. Thus, the WHO recommend monitoring iodine nutrition in pregnant women. With changing dietary habits and declining iodine intake in coastal populations, iodine nutrition in pregnant Faroese women was a focus in newly established pregnancy cohorts. This study aimed to monitor the iodine status of pregnant women in the Faroe Islands by assessing urinary iodine concentration (UIC) and maternal iodine intake. For 2 years, all pregnant women were invited to participate in a nationwide study. Participants completed questionnaires addressing personal and lifestyle factors, supplement intake and dietary habits, Additionally, they provided spot urine samples for UIC measurements. Iodine was measured spectrophotometrically using the ceri/arsen method after alkaline-ashing. Among the 1030 invited, 654 participated and 647 provided a spot-urine sample. The average age was 30·4 years (18–47 years). The overall median UIC was 110 µg/l, declined from 117 to 101 µg/l over 2 years (P = 0·004). UIC was significantly impacted by diet. Women consuming fish and eggs had a higher median UIC compared with those whose primary iodine source was dairy: fish-dinner, 151 µg/l; dairy products, 112 µg/l (P < 0·001). Furthermore, there was a positive association between maternal age, reported intake of iodine-containing supplements and the UIC. This nationwide study of pregnant Faroese women found UIC below the WHO-recommended cut-off for pregnant women and decreasing with time. This decline highlights the importance of continuous monitoring to prompty identify shifts in iodine status, enabling timely intervention to address emerging deficiencies. [ABSTRACT FROM AUTHOR]

This study examined the socioeconomic demographics and health status of residents in a hinterland community in Guihulngan City, Negros Island, Philippines. The research utilized the RAND 36-Item Health Survey to collect data from 163 household heads, measuring eight health concepts: physical functioning, bodily pain, role limitations (physical and emotional), emotional well-being, social functioning, energy/fatigue, and overall health perceptions. The findings revealed that the community faces socioeconomic challenges, including low educational attainment, limited employment opportunities, and reliance on government assistance. Despite these challenges, residents reported good overall health status, highlighting the potential influence of factors beyond socioeconomic demographics, such as lifestyle choices, social support, and access to healthcare. The study also identified variations in health status based on age, employment status, family monthly income, and weight, emphasizing the complex interplay of various social determinants. The research concludes by emphasizing the need for targeted interventions that address the specific needs of vulnerable groups and promote health equity in hinterland communities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mercury (Hg) is a toxic heavy metal with multiple uses in various medical devices. Hg is used in dentistry as a restorative material. Such use creates significant exposure to dental practitioners. Hence, it is important to assess the risk created by Hg use in healthcare. OBJECTIVE: To quantify airborne Hg vapour exposure and Hg levels in dental healthcare workers, and determine the association of various symptoms and diseases to Hg exposure. METHODS: Air monitoring of Hg vapours were conducted in dental clinics and amalgam rooms. Urine samples were collected from occupationally exposed dental healthcare workers and urine Hg levels were measured. A cross-sectional health survey was conducted in 23 healthcare units of Delhi to determine an association between Hg exposure and various health effects. RESULTS: Hg vapour concentration ranged from 0.96μg/m3 to 15μg/m3, the highest concentration was recorded in the amalgam room (15μg/m3). Urine Hg levels in healthcare workers (0.51±0.17μg/L) were higher than the control (0.29±0.05μg/L). A cross-sectional health survey revealed a significant prevalence of confusion, forgetfulness, muscle spasm, and tremors by the respondents. CONCLUSION: Hg concentration in dental clinics may hover above the prescribed safe levels posing a definitive health risk to healthcare workers. Urinary Hg measurements did not reveal an excess of body burden except in one case. Since Hg bio accumulates, it is probable as these workers grow older, they may end up with a higher body burden of Hg that may lead to a variety of adverse health outcomes. [ABSTRACT FROM AUTHOR]

Epidemiological studies frequently classify groups based on phenotypes like self-reported skin color/race, which inaccurately represent genetic ancestry and may lead to misclassification, particularly among individuals of multiracial backgrounds. This study aimed to characterize both global and local genome-wide genetic ancestries and to assess their relationship with self-reported skin color/race in an admixed population of Sao Paulo city. We analyzed 226,346 single-nucleotide polymorphisms from 841 individuals participating in the population-based ISA-Nutrition study. Our findings confirmed the admixed nature of the population, demonstrating substantial European, significant Sub-Saharan African, and minor Native American ancestries, irrespective of skin color. A correlation was observed between global genetic ancestry and self-reported color-race, which was more evident in the extreme proportions of African and European ancestries. Individuals with higher African ancestry tended to identify as Black, those with higher European ancestry tended to identify as White, and individuals with higher Native American ancestry were more likely to self-identify as Mixed, a group with diverse ancestral compositions. However, at the individual level, this correlation was notably weak, and no deviations were observed for specific regions throughout the individual's genome. Our findings emphasize the significance of accurately defining and thoroughly analyzing race and ancestry, especially within admixed populations. [ABSTRACT FROM AUTHOR]

Globally, there is an increasing trend of morbidity and mortality from non-communicable diseases (NCDs). Traditional health service is one of the new approaches to support NCDs program. This study aimed to determine the prevalence and factors associated with the use of traditional health services among people with NCDs in Indonesia. We conducted a secondary analysis of integrated nationwide health and socio-economic survey data in 2018. Of the 127,198 people with NCDs included in the analysis, 38.7% of people with NCDs have ever used traditional health services, with the most common type being those that involve manual therapies. Compared to the reference group, likelihood of higher utilization of the traditional health service was among those aged 45-54 years (adjusted odds ratio (AOR) 1.19; p 1, p 1, p

ABSTRACT Objective: To analyze the association of household composition with risk behaviors in Brazilian adolescents. Methods: Cross-sectional study, with a nationally representative sample of Brazilian adolescents (n=159,245) aged 13 to 17, enrolled and regularly attending the 7th to 9th year of elementary school and the 1st to 3rd year of high school, participants in the National Survey of School Health in 2019. The risk behaviors were: insufficient physical activity, sedentary behavior, alcohol consumption, smoking, poorer diet quality, skipping breakfast and not having meals with parents/guardians. In the analyses, the sampling weights and study design were considered, stratified by the type of school (public or private) and estimated using Poisson regression models. Results: Adolescents, from public and private schools, who lived in single-parent households or where parents were absent, had a higher prevalence of alcohol consumption, smoking, poorer diet quality, skipping breakfast and not eating meals with parents/guardians, compared to those who lived with both parents. Additionally, adolescents from public schools showed a higher prevalence of sedentary behavior than those from single-parent households. Adolescents from private schools had a higher prevalence of sedentary behavior among those who lived only with their mother and a higher prevalence of insufficient physical activity among those who lived without either parent. Conclusion: Brazilian adolescents, from public and private schools, who lived in single-parent households or without parents, showed higher prevalence of risk behaviors.

Parkinson’s Disease (PD) is a progressive neurological disorder affecting patients’ quality of life (QoL). The Parkinson’s Disease Questionnaire (PDQ‑39) is a widely used instrument for assessing health‑related QoL in PD, but it has not been validated for Arabic‑speaking populations. This pilot study aims to validate the Arabic version of the PDQ‑39 in the Arab context, specifically among Tunisian patients. A total of 433 patients diagnosed with PD, recruited from four regional hospitals in Tunisia, were selected for the study. Eligible participants were those aged 50 years and older, diagnosed with PD for at least one year, and able to understand and complete the PDQ‑39 questionnaire. The questionnaire was administered through structured interviews conducted by trained healthcare professionals to ensure clarity and comprehension. We conducted both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the factorial structure. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega. The EFA revealed eight factors with eigenvalues above 1, and the CFA demonstrated a good model fit (CFI = 1.12, RMSEA = 0.08). The PDQ‑39 showed strong internal consistency (α = 0.763 to 0.923) and good convergent and discriminant validity. Our findings support the use of the Arabic PDQ‑39 as a reliable tool for assessing QoL in Tunisian PD patients, with potential for broader application across Arabic‑speaking populations.

Abstract Introduction Intimate partner violence is a human rights violation that often involves violence against women, which appears to be the most prevalent type of abuse. Intimate partner violence is a major global public health issue that includes physical, emotional, and sexual violence. The prevalence of intimate partner violence in Africa is high. The burden of intimate partner violence among reproductive-age women is high in Kenya. Therefore, the main aim of this study is to determine the associated factors of intimate partner violence among reproductive-age women at the individual and community level from the recent Demographic and Health Survey (DHS) 2022 data of Kenya. Methods The Kenya National Demographic and Health Survey data of 2022 was used for this study. The overall sample size for this study was 14,612, which focused on women aged 15 to 49 years who had ever been partnered and responded to the domestic violence module. Multilevel logistic regression models to determine the prevalence and associated factors at the individual and community level with intimate partner violence with a 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR). Result The overall prevalence of intimate partner violence was 41.1% with a 95% CI (40.07%, 42.60. Male-headed households, poorest and middle wealth status, partner alcohol use, separated/widowed current marital status, and low education of women were statistically significantly associated with intimate partner violence at the individual level variables in this study. Conclusions The prevalence of intimate partner violence was high. Educating women, reducing partner alcohol use, and improving the economic status of women, were crucial in mitigating the burden of intimate partner violence. The intimate partners are supposed to respect the rights of women.

Abstract This study evaluated an oscillometric device (OD), Microlife WatchBP Office AFIB, and a hybrid manual auscultatory device (AD), Greenlight 300TM, to determine a suitable blood pressure (BP) measurement device for the Korea National Health and Nutrition Examination Survey in a mercury‐free context. Adhering to the 2018 Universal Standard's suggested consensus, the study involved 800 subjects (mean age 51.2 ± 17.5 years; 44.3% male), who underwent triplicate BP measurements following 5 min of rest in a randomized order (OD‐first: 398 participants; AD‐first: 402 participants). BP difference was calculated as OD value minus AD value, with results stratified by measurement sequence. The overall BP difference and tolerable error probability were ‐1.1 ± 6.5/‐2.6 ± 4.9 mmHg and 89.2%/92.5% for systolic/diastolic BP (SBP/DBP), respectively. Lin's concordance correlation coefficient was 0.907/0.844 for SBP/DBP (OD‐first/AD‐first: 0.925/0.892 for SBP, 0.842/0.845 for DBP). The overall agreement for hypertension (BP ≥ 140 and/or 90 mmHg) was 0.71 (p

The main cause of diffuse thyroid goiter is autoimmune chronic thyroiditis, otherwise known as Hashimoto’s thyroiditis. Thyroid hormones play pivotal roles in growth and development during childhood. However, the prevalence of diffuse goiter and the relationships between diffuse goiter, thyroid volume, cysts and nodules, and anthropometric measurements in children are not well known. Among 789,459 participants who participated in thyroid ultrasound examinations, 320,206 participants (male: 161,728; female: 158,478) aged 1–23 years were analyzed. Logistic regression analyses were conducted to calculate the odds ratios of the standard deviation score of body mass index (BMI-SDS), the SDS of bilateral width multiplied thickness area (BWTAR-SDS) as a provisional determination of thyroid volume, and the presence of nodules or cysts for positive diffuse goiter compared with negative diffuse goiter after correction for sex and age. The prevalence of diffuse goiter increased in a female-dominant manner with aging. Compared with the absence of diffuse goiter, the age- and sex-adjusted odds ratios (95% confidence intervals) for BMI-SDS (1 SD), BWTAR-SDS (1 SD), cysts, and nodules were 1.24 (1.21–1.27), 3.21 (3.13–3.29), 0.53 (0.50–0.58), and 1.38 (1.17–1.64), respectively. The odds ratios of nodules for positive diffuse goiter were 4.18 (1.08–16.08), 1.76 (1.01–3.07), 1.80 (1.32–2.45), and 1.34 (1.08–1.67) in the age groups 1–7, 8–11, 12–15, and 16–23 years, respectively. The age-dependent increase in the prevalence of diffuse goiter was independently associated with increased BMI and positive prevalence of nodules in young individuals.

Introduction: Intimate partner violence is a human rights violation that often involves violence against women, which appears to be the most prevalent type of abuse. Intimate partner violence is a major global public health issue that includes physical, emotional, and sexual violence. The prevalence of intimate partner violence in Africa is high. The burden of intimate partner violence among reproductive-age women is high in Kenya. Therefore, the main aim of this study is to determine the associated factors of intimate partner violence among reproductive-age women at the individual and community level from the recent Demographic and Health Survey (DHS) 2022 data of Kenya. Methods: The Kenya National Demographic and Health Survey data of 2022 was used for this study. The overall sample size for this study was 14,612, which focused on women aged 15 to 49 years who had ever been partnered and responded to the domestic violence module. Multilevel logistic regression models to determine the prevalence and associated factors at the individual and community level with intimate partner violence with a 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR). Result: The overall prevalence of intimate partner violence was 41.1% with a 95% CI (40.07%, 42.60. Male-headed households, poorest and middle wealth status, partner alcohol use, separated/widowed current marital status, and low education of women were statistically significantly associated with intimate partner violence at the individual level variables in this study. Conclusions: The prevalence of intimate partner violence was high. Educating women, reducing partner alcohol use, and improving the economic status of women, were crucial in mitigating the burden of intimate partner violence. The intimate partners are supposed to respect the rights of women. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether eligibility for an age‐related universal (pioneer generation [PG]) subsidy incentivises dental attendance by older Singaporeans. Methods: Data were collected between 2018 and 2021 from in‐person interviews of Singaporean adults aged 60–90 years using a questionnaire and a clinical examination. The questionnaire included details of age, gender, ethnicity, education, residential status, socio‐economic status, marital status, eligibility for subsidy (community health assistance/CHAS, PG or both) and frequency of dental attendance. The clinical examination recorded number of teeth (categorized as edentulous, 1–9 teeth;10–19 teeth; ≥20 teeth). To estimate the effect of the PG subsidy on dental attendance pattern, a regression discontinuity (RD) analysis was applied using age as the assignment variable. Results: A total of 1172 participants aged 60–90 years (64.2% female) were recruited, with 498 (43%) being eligible for the PG subsidy. For those eligible for PG subsidy, there was a higher proportion of regular attenders than irregular attenders (53.6% vs. 46.4%). In age adjusted RD analysis, those eligible for the PG subsidy were 1.6 (95% CI: 1.0, 2.7) times more likely to report regular attendance than their PG non‐eligible counterparts. The association remained strong (OR 2.1; 95% CI: 1.1–3.7) even after further controlling for demographics, socioeconomic factors, number of teeth and eligibility for the CHAS subsidy. Conclusions: Being eligible for the PG subsidy substantially increased the odds of regular dental attendance. [ABSTRACT FROM AUTHOR]

Introduction: Youths are the most vulnerable population to initiate tobacco use. It is the need of the hour to prevent tobacco addiction among young people to reduce the morbidity and mortality associated with it. Therefore, there is a need for necessary data to build an appropriate strategy to combat this epidemic. Aim: To determine the prevalence and trends of tobacco use and to assess the factors associated with tobacco use among youths (age 15-24 years) in India. Materials and Methods: This retrospective secondary data analysis study was conducted at Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India, between January 2023 and June 2023, using data from the National Family Health Survey-5 (NFHS-5), 2019-2021, which was conducted across all states of India to estimate the prevalence of tobacco use among the 15-24 age group. Data were compared with NFHS 3 and 4 to observe the trends in tobacco use. The data were analysed using Statistical Packages for Social Sciences (SPSS) software (version 21.0). Multivariate logistic regression was used to identify the significant risk factors associated with tobacco use. A p-value less than 0.05 was considered statistically significant. Results: The prevalence of smoking and smokeless tobacco use was 2109/14525 (14.52%) and 2237/14525 (15.40%) respectively among male youths aged 20-24 years, and it was 374/119043 (31%) and 119/119043 (1.53%) in females of similar age. For males, the prevalence has decreased from 40.07% in NFHS-3 to 27.31% in NFHS-4 and to 22.51% in NFHS-5. For females, the prevalence has decreased from 4.55% in NFHS-3 to 2.38% in NFHS-4 and to 1.33% in NFHS-5. Males and females belonging to the scheduled caste/scheduled tribe, having a poor wealth index, and in the married category had a higher prevalence of tobacco use. Youths residing in rural areas were using more smokeless tobacco. Conclusion: There was a declining trend of tobacco use among youths over NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 (2019-2021). Male gender, higher age, rural area, the northeast region of India, poor wealth index, education upto primary level, being married, and other categories of marriage had higher adjusted odds of using both forms of tobacco. There is a need to implement and enforce evidence-based tobacco control strategies that can substantially improve the health of the young, hence securing India's future. [ABSTRACT FROM AUTHOR]

This study evaluated an oscillometric device (OD), Microlife WatchBP Office AFIB, and a hybrid manual auscultatory device (AD), Greenlight 300TM, to determine a suitable blood pressure (BP) measurement device for the Korea National Health and Nutrition Examination Survey in a mercury‐free context. Adhering to the 2018 Universal Standard's suggested consensus, the study involved 800 subjects (mean age 51.2 ± 17.5 years; 44.3% male), who underwent triplicate BP measurements following 5 min of rest in a randomized order (OD‐first: 398 participants; AD‐first: 402 participants). BP difference was calculated as OD value minus AD value, with results stratified by measurement sequence. The overall BP difference and tolerable error probability were ‐1.1 ± 6.5/‐2.6 ± 4.9 mmHg and 89.2%/92.5% for systolic/diastolic BP (SBP/DBP), respectively. Lin's concordance correlation coefficient was 0.907/0.844 for SBP/DBP (OD‐first/AD‐first: 0.925/0.892 for SBP, 0.842/0.845 for DBP). The overall agreement for hypertension (BP ≥ 140 and/or 90 mmHg) was 0.71 (p < 0.0001), and the OD underestimated the overall hypertension prevalence by 5.1%. Analysis of the AD‐first data revealed a lower level of agreement compared to the OD‐first data; however, the observed blood pressure difference adhered to Criterion 1 of the 2018 Universal Standard. Microlife met the Criterion 1 of 2018 Universal Standard but underestimated the prevalence of hypertension. The BP discrepancy increased with higher BP levels, male sex, and smaller AC. With increasing age, the discrepancy decreased for SBP and increased for DBP. [ABSTRACT FROM AUTHOR]

The experience and self-confidence of healthcare professionals play critical roles in reducing anxiety levels during emergencies. It is important to recognize the potential impact of anxiety on performance. To enhance preparedness and confidence in managing emergencies, healthcare professionals benefit from regular training and simulations. Additionally, repeated exposure to emergency scenarios can help modulate physiological responses. Managing anxiety effectively is key, as heightened sympathetic stimulation associated with anxiety can adversely affect performance. This study aimed to investigate nurses' self-assessed ability to manage emergency guidelines and their self-confidence in performing tasks in critical care settings. A questionnaire was provided to 1097 nurses. We compared the self-confidence of experienced nurses (ENs) and newly licensed nurses (NLNs) in managing emergency department shifts or critical patients, and found that ENs are more confident in these scenarios. This phenomenon was also observed in subjects who had taken simulation courses, although they were still a low percentage. Most NLNs feel sufficiently ready to work in medium-intensity wards. Attending advanced training courses enhances nurses' self-confidence and may improve patient safety management., improving patient recovery, and minimizing errors. Attending courses improves the perception of autonomy of nurses in different scenarios. [ABSTRACT FROM AUTHOR]

Objective: To analyze the prevalence of Natural and Traditional Medicine (NTM) use in the last 12 months, according to the report from the National Health Survey (NHS), Cuba 2018-2019. Material-Method: It was an observational, descriptive cross-sectional study that was part of the referred NHS. Sociodemographic characteristics of the survey respondents were collected (living area, gender, age, skin color, marital status, educational level, and occupation). The main variable selected for this study was the prevalenc e of NTM use by the Cuban population in the previous 12 months. Results: More than one out of five Cubans used NTM therapies in the previous 12 months to the NHS, Cuba 2018-2019, with a higher prevalence of use by people living in rural areas, females, the age group of 65-74 years old, a co-habited marital status, university educational level and those in retirement. Phytotherapy was the most reported NTM therapy. Conclusion: This study analyzed for the first time the prevalence of NTM use by the Cuban pop ulation. It demonstrated that more than one out of five Cubans used NTM therapies in the previous 12 months, according to the NHS, Cuba 2018-2019. Cuba The data from the CNHS and the information from this particular study would contribute to strengthening the integration of these treatments with conventional medicine in Cuba. [ABSTRACT FROM AUTHOR]

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The aim of this study was to investigate how sociodemographic and health factors contribute cognitive abilities in the older population of the Republic of Serbia, using data from the 2019 national health survey. The study included 3,743 participants, of whom 2,061 (55.1%) were women and 1,682 (44.9%) were men. The median age of all participants was 72 (10) years. Study used logistic regression on cross-sectional data to analyze how education, social support, and healthcare access affect cognitive abilities, while adjusting for demographic variables. The results revealed negative associations between higher levels of education and lower odds of experiencing memory and concentration problems, while recent visits to specialists were positively associated with increased risk for the same. The highest percentage of participants (22.6%) reporting major difficulties in memory and concentration were in the age group of 85–89 years (p

Abstract Accurate blood pressure (BP) measurement is crucial for hypertension detection and management. The Korea National Health and Nutrition Examination Survey (KNHANES) assesses the health of Koreans using representative cross-sectional data. BP measurements were historically done with mercury sphygmomanometers for participants aged ≥10 years. However, KNHANES transitioned to Greenlight 300TM (mercury-free auscultatory device) in 2020 for participants aged ≥6 years and used dual devices (Microlife WatchBP Office AFIB and Greenlight) in 2021-2022. To ensure consistency, KNHANES will adopt Microlife as the unified BP device with Greenlight for device validation from 2023. Under the new protocol, participants aged ≥6 years will have their BP measured three times at 30-second intervals after a 5-minute rest under ambient temperature (20-25℃) and noise ≤65 dB. The average of the 2nd and 3rd readings will be used as the representative BP value. The quality control (QC) program involves four trained examiners passing the “quality control and assurance of BP measurement program” three times annually, and undergoing “video monitoring of weekly calibration process” once a year. Additionally, the QC team will conduct “on-site evaluations of BP measurement” at mobile examination centers three times a year. A Five-Step QC process for BP devices was also developed. This document outlines the standardized BP measurement protocol and rigorous QC program in KNHANES, aiming to ensure accurate and reliable BP data for epidemiological research and public health policymaking in South Korea. Graphical Abstract

Aim: Perinatal mortality can be used as a reference to assess health status in a country. In Indonesia, none of previous studies specifically discuss the incidence of prenatal mortality by region. The objective of this study was to analyze perinatal mortality difference by region of Indonesia. Study design: This study used a cross-sectional approach. Method: The sample in this study was 13,310 women of childbearing age obtained from the Indonesian Demographic Health Survey (IDHS) 2017. The perinatal mortality rate was calculated using data on stillbirths with a gestational duration of seven months or more and early neonatal deaths. Perinatal mortality was analyzed by region using a binary logistic regression statistical test to examine the relationship between perinatal mortality and its factors (socio-demographic factors, individual disease control factors, and maternal factors). Results: This study shows that the proportion of perinatal mortality in Indonesia is 1.5 % of total births. The highest proportion of perinatal mortality (2.5 %) was in the Papua region, while the lowest proportion (1.3 %) was in the Java region. The results of this study indicated that women in the Maluku Islands had a 1.82 times higher chance of perinatal mortality compared to the Java-Bali region. The causative variable associated with perinatal mortality in the Java-Bali and Papua regions was employment status. The causative variables associated with perinatal mortality in Kalimantan were the quality of antenatal care and delivery assistance. The causative variable associated with perinatal mortality in Nusa Tenggara and Papua was the location of delivery. The causative variable associated with perinatal mortality in Kalimantan, Maluku, and Papua was the mother's age. The causative variable associated with perinatal mortality in the Java-Bali region was parity. The causative variable associated with perinatal mortality in Sumatra was the type of delivery. Conclusion: This study show that there were disparities in the incidence of perinatal mortality between regions in Indonesia. The government needs to re-adjust the existing strategies to improve health status and focus on community empowerment for women to prevent perinatal mortality.

Abstract: This study aimed to analyze the prevalence of indicators of use of healthcare services according to sex, income and race/skin color, in adolescents (aged 10-19 years old) based on data from the Health Survey of the Municipality of Campinas (ISACamp), carried out in 2014/2015 in Campinas, São Paulo, Brazil. The chi-square test was used to evaluate the differences between the outcome variables (indicators of use of healthcare service) and sex, income and race/skin color. Adjusted prevalence ratios (PR) were estimated using Poisson multiple regression models. The demand for medical care was high in the last year of the interview (79.2%), mostly attended by the Brazilian Unified National Health System (65.2%), with routine consultations being more prevalent for females (PR = 1.17; 95%CI: 1.01-1.34) and injury for the male population (PR = 0.47; 95%CI: 0.26-0.84). Economic and racial differences were found in the evaluation of the last medical consultation, with a higher prevalence of worse care among those with lower income (PR = 1.46; 95%CI: 1.14-1.87) and black people (PR = 1.27; 95%CI: 1.01-1.61). Inequalities remained for delay or failure to carry out exams (PR = 1.64; 95%CI: 1.02-2.64) and worse quality of dental care (PR = 2.10; 95%CI: 1.38-3.21) in those with lower income. Also, black people had fewer appointments with dentists (PR = 0.90; 95%CI: 0.82-0.99).

Objective: To conduct a cross-cultural adaptation and validation in Primary Care of the PREMEPA doctor-patient relationship perception questionnaire. Design: Descriptive, cross-sectional study, using self-administered questionnaires. Qualitative validation: an adapted version of the original questionnaire, was adapted to our culture. The process consisted of the evaluation, cross-cultural adaptation and consensus of a group of experts. The questionnaire was piloted on a sample of 32 patients diagnosed with at least 2 chronic pathologies. Measures: Cognitive piloting, comprehensibility assessment, content validation and internal consistency analysis using Cronbach's alpha coefficient. Quantitative validation: the internal consistency, construct validity and validity of the questionnaire were studied by means of a confirmatory factor analysis developed in a multicenter study, randomly selecting 202 patients with at least 2 chronic pathologies. Results: Content validity of the new Spanish version was confirmed to be adequate. Comprehensibility and internal consistency (Cronbach's α coefficient = 0.78) were adequate. The confirmatory factor analysis showed good dimensionality, factor relationship and internal consistency, as well as acceptable construct validity. The final result was a 13-item questionnaire consisting of 2 dimensions, which explain 58.5% of the variance: participation in decision-making (accounting for 45.2% of the variance) and person-centered communication (encompassing courtesy, empathy, humanity, and trust). Conclusions: This adapted version of the PREMEPA questionnaire can be considered valid for use in the Spanish population with a history of chronic pathology. This version of PREMEPA provides a new instrument to understand and improve chronic patient care, which can improve the doctor-patient relationship, encouraging adherence to treatment and enhancing health outcomes. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency is recognized as a general health condition globally and is acknowledged as a public health concern in Europe. In Romania, a national program of examination of the status of vitamin D for high-risk groups has demonstrated a vitamin D deficiency prevalence of 39.83%. No national data on the status of vitamin D in the general adult population are available to date. Methods: We used the framework of the European Health Examination Survey to analyze vitamin D levels in a sample population of adults aged 25–64 years, from 120 family doctors' patients lists, by using a sequential sampling method. Data were weighted to the Romanian population. Vitamin D deficiency was defined as 25(OH)D < 20 ng/mL. Results: In total, 5380 adults aged 25–64 years were included in this study. The overall prevalence of vitamin D deficiency is 24.8%. Predictors of vitamin D deficiency were found to be obesity, female sex, living in rural areas, lower education level, and lower socioeconomic status. Conclusions: Specific recommendations for vitamin D screening and supplementation should be issued for women by specialist boards. Further studies are needed to identify seasonal variation and to establish a correlation with nutritional surveys. [ABSTRACT FROM AUTHOR]

Foodborne Diseases (FBDs) are a worldwide problem and occur after contaminated food has been ingested, signaling a lack of food quality. Even though the SARS-CoV-2 virus is not transmitted through food, the COVID-19 pandemic has caused several challenges worldwide that have had direct implications on food production and handling, stimulating and reinforcing the adoption of good manufacturing and food handling practices. The aim of this study was to analyze data on notifications of FBD in Brazil in the years before (2018 and 2019) and during (2020 and 2021) the COVID-19 pandemic. Secondary data from the National System of Notifiable Diseases was analyzed, evaluating: overall incidence rate, lethality and mortality, contamination sites, and criteria for confirming the etiological agent. There were 2206 records of FBDs, and the mortality rate was 0.5% in both periods. The incidence rate before the pandemic was 6.48 and during the pandemic was 3.92, while the mortality coefficient was 0.033 before and 0.019 during the pandemic, both per 100,000 inhabitants. There was no significant difference in the number of FBD notifications in the evaluated periods. There was a migration of the location of FBD, with a significant increase in FBD notifications in hospitals and health units and a reduction in notifications from social events. There was a significant increase in the type of criteria used to confirm outbreaks, with an increase in clinical laboratory tests and clinical reports for bromatology. The increase in notifications in hospitals and health units demonstrates the necessity of improving food safety knowledge and the attitudes and practices of food handlers and healthcare professionals. [ABSTRACT FROM AUTHOR]

ObjectivesTo characterize the extent to which brief cognitive assessments administered in the population-representative U.S. Health and Retirement Study (HRS) and its International Partner Studies can be considered to be measuring a single, unidimensional latent cognitive function construct.MethodsCognitive function assessments were administered in face-to-face interviews in 12 studies in 26 countries (N = 155,690), including the U.S. HRS and selected International Partner Studies. We used the time point of the first cognitive assessment for each study to minimize differential practice effects across studies and documented cognitive test item coverage across studies. Using confirmatory factor analysis models, we estimated single-factor general cognitive function models and bifactor models representing memory-specific and nonmemory-specific cognitive domains for each study. We evaluated model fits and factor loadings across studies.ResultsDespite relatively sparse and inconsistent cognitive item coverage across studies, all studies had some cognitive test items in common with other studies. In all studies, the bifactor models with a memory-specific domain fit better than single-factor general cognitive function models. The data fit the models at reasonable thresholds for single-factor models in 6 of the 12 studies and for the bifactor models in all 12 of the 12 studies.DiscussionThe cognitive assessments in the U.S. HRS and its International Partner Studies reflect comparable underlying cognitive constructs. We discuss the assumptions underlying our methods, present alternatives, and future directions for cross-national harmonization of cognitive aging data.

Background: The longitudinal population-based study Gesundheit 65+ aimed to close data gaps on health and well-being of older adults in Germany in times of the COVID-19 pandemic. Methods: The target population comprised persons 65 years and older permanently residing in Germany and with sufficient German language skills. Proxy interviews were possible and consent from legal representatives was obtained as necessary in order to enable participation of physically or cognitively impaired persons. A two-stage sampling process, was used to draw 128 primary sample points (PSUs) and within these PSUs sex- and age-stratified random samples were drawn from population registries. A mixed-mode design was applied to contact the study population and for data collection. Data were collected between June 2021 and April 2023. Participants were surveyed a total of four times at intervals of four months. At month 12 participants were offered a home visit including a non-invasive examination. Data on all-cause mortality and information on neighborhood social and built environment as well as health insurance data will be linked to primarily collected data at the individual level. Discussion: Results will inform health politicians and other stakeholders in the care system on health and health care needs of older people in Germany.