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Aim: We conducted a systematic review and meta-analysis to analyse gender differences in COVID-19 vaccination intentions. Subject and methods: PubMed, Web of Science and PsycInfo were searched (November 2020 to January 2021) for studies reporting absolute frequencies of COVID-19 vaccination intentions by gender. Averaged odds ratios comparing vaccination intentions among men and women were computed. Descriptive analyses of the studies were reported. Results: Sixty studies were included in the review and data from 46 studies (n = 141,550) were available for meta-analysis. A majority (58%) of papers reported men to have higher intentions to get vaccinated against COVID-19. Meta-analytic calculations showed that significantly fewer women stated that they would get vaccinated than men, OR 1.41 (95% CI 1.28 to 1.55). This effect was evident in several countries, and the difference was bigger in samples of health care workers than in unspecified general population samples. Conclusion: This systematic review and meta-analysis found lower vaccination intentions among women than men. This difference is discussed in the light of recent data on actual vaccination rates in different countries. [ABSTRACT FROM AUTHOR]

Aim: To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods: A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results: Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion: Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices. [ABSTRACT FROM AUTHOR]

Background: According to the World Population Outlook (2019), people over 65, usually accompanied by various chronic diseases, will make up 16% of the population in 2050. Therefore, the health problems of middle-aged and elderly people are becoming the focus of current global attention. Some scholars have found that the health of middle-aged and elderly people is related to the childhood socio-economic environment. Methods: Using the China Health and Retirement Longitudinal Study (CHARLS) data, this paper innovatively constructed four measurement dimensions of health (namely, self-rated health, physical health, emotional health, and mental health). Moreover, logistic regression was used to explore the impact of childhood socio-economic environment (such as parent's education level, work experience, etc.) on the health status of middle-aged and elderly people. Results: Compared with a poor childhood social-economic environment, a good childhood socio-economic environment is more advantageous to the self-rated health of middle-aged and elderly people, especially a childhood socio-economic environment close to the medium level; the psychological health of middle-aged and elderly people who have experienced an adverse childhood socio-economic environment was better than those who did not; the childhood socio-economic environment has no apparent impact on the cognitive situation of middle-aged and elderly people. Conclusions: Some policy implications can be drawn. For example, the government should vigorously introduce policies to help migrant workers' children receive education in cities and provide special education guarantees for migrant workers' children. Societies and families should also pay more attention to the childhood socio-economic environment. [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM) involves the cutting of the external female genital organs for non-medical purposes. It is a widespread public health problem in Nigeria as it affects the health of women and girls. The views of women about FGM are widely researched and known; however, very little empirical research has been conducted to understand the views of men. Aim: This study therefore sought to examine men's views with regard to the continuation of FGM and its associated factors in a rural Igbo community in Nigeria. Subject and Method: This paper reports the results of a survey of 215 men aged 18 and above living in Isuikwuato Local Government Area, Uturu in Nigeria. Bivariate and binary logistic regression were performed on 215 completed and returned questionnaires (86% response rate) using the Statistical Package for Social Science. This is the first study to investigate Nigerian Igbo men's views of FGM. Results: Descriptive statistics revealed that almost two-thirds of the sample (63.7%) thought FGM should be discontinued. Logistic regression found that owning a television and/or a radio and holding a Christian faith significantly predicted favouring the discontinuation of FGM. Conclusion: This study provides evidence to suggest that some Nigerian Igbo men's attitudes about FGM appear to be generally less than favourable. The major implication of these findings is that policy makers must place greater emphasis on addressing the economic and social development of rural areas in Nigeria if the harmful practice of FGM is to be reduced. [ABSTRACT FROM AUTHOR]

Background: Undernutrition among children is a primary concern in sub-Saharan African countries such as Ethiopia. The objective of this paper is to measure the magnitude of undernutrition and associated factors among children under 2 years of age in the Jimma Zone of Southwest Ethiopia. Methods: A community-based cross-sectional study with stratified multistage sampling was conducted. Data were collected using a semi-structured questionnaire and anthropometric measurements. Bivariate and multivariable logistic regression models were fitted using SPSS 20.0 for Windows. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to measure the strength of the association between dependent and associated variables at a p value <0.05. Results: Among the study participants, 142 (25.4%) were stunted, 73 (13.1%) were underweight, and 54 (9.7%) were wasted. Older child age [AOR = 1.1, 95% CI (1.1, 1.2)], male sex [AOR = 2.601, 95% CI (1.681, 4.025)], and residing in an urban area [AOR = 0.526, 95% CI (0.323, 0.857)] were significantly associated with stunting. Independent predictors of wasting were younger child age [AOR = 0.894, 95% CI (0.833, 0.96)], living in a lowland area [AOR = 3.3, 95% CI (1.4, 8.1)], and living a in poor household [AOR = 6.2, 95% CI (2.2, 17.7)]. Underweight was significantly associated with male sex [AOR = 2.09, 95% CI (1.179, 3.703)], delayed initiation of breastfeeding [AOR = 2.1, 95% CI (1.0, 4.2)], and living in a poor household [AOR = 2.2, 95% CI (1.0, 4.6)]. Conclusions: Child malnutrition was found to be a moderate public health problem in the study area. Urban dwellers had higher levels of undernutrition than rural dwellers. Children living in lowlands had higher undernutrition than those living in highland areas. [ABSTRACT FROM AUTHOR]

Aim: International comparisons of public health measures relative to observed best practice are increasingly important for evaluating community health promotion strategies and policies such as meeting or not meeting public health guidelines. This study aimed to identify methods enabling robust evaluation with such binary effect measures at a population level. Subject and methods: Conventional efficiency comparisons of binary effect proportions are problematic due to a lack of consistency with alternate framing of resulting relative risks. In this paper, we illustrate such inconsistent efficiency measures comparing the proportion of school age children (9–11 years) meeting or not meeting integrated movement guidelines (IMGs) across the 12 countries from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) study. IMGs jointly consider physical activity, sleep and sedentary behaviours. An odds method is developed to enable consistent efficiency comparison with alternative framing of binary effects. Results: A novel odds solution to relative risk problems arising with conventional efficiency comparison of binary effects with alternative framing is shown to provide consistent efficiency measures relative to best practice. Furthermore, this technical advancement is shown to extend to consistent indirect comparison and evidence translation. Conclusion: Robust methods for international cross-country comparison of binary effect measures such as meeting or not meeting guidelines are identified with a novel odds ratio method. This novel solution is particularly important for health promotion evaluation of IMGs given the need for consistent comparison in evaluating practice evidence of what works now and consistent evidence translation of treatment effects as and when they emerge. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper was to investigate online health information seeking and health literacy among non-medical college students in Egypt and the differences between the two genders. Subjects and methods: A cross-sectional descriptive design was used to collect data from 600 students through a self-administered questionnaire. Results: Most of the students searched for health information on the internet (82.3%). 90.3% of them used their mobile phones and 97.8% sought data via Google. Skin and hair problems was the most searched for topic (83.3%), followed by reproductive health (79.7%). Students perceived that rapid and easy access to information were the main advantages of health information seeking online (98.5% and 95.5%, respectively), while the lack of reliability and scarcity of information in the Arabic language were the main disadvantages (78.2% and 60.5%, respectively). Only 31.2% of the sample achieved an adequate literacy level. Females in our sample had a higher frequency of online health information seeking and a higher level of health literacy. They also had a higher percentage of searching for health data on YouTube and seeking nutrition information. On the other hand, males used online health applications more frequently and were more interested in physical fitness and smoking. Females perceived the high cost as the main disadvantage of online health information seeking, while males were more concerned about the reliability of information. Health literacy was positively related to female gender and frequency of online health information seeking. Conclusion: Using the internet to deliver health information according to each gender's preferences and concerns can encourage students to search for health information online and, therefore, raise their health literacy level. [ABSTRACT FROM AUTHOR]

Aim: Risky sexual behaviours (RSB) among adolescents is one of the major public health concerns globally. These behaviours–RSB have adverse effects on their future health and well-being. Therefore, in this paper, our aim was to assess the determinants of RSB among in-school Namibian adolescents using the 2013 Global School-based Health Survey. Methods: The data was extracted and analysed with STATA version 14.2. Both bivariate and multivariable analyses were done to generate results that infomed the discussion. The results were presented as odds ratios and adjusted odds ratios (AOR) with their respective 95% confidence intervals (CI). Level of statistical significance was declared at a p-value of < 0.05. Results: Our results showed that of the 2846 adolescents surveyed, 51.8% reported they have ever had sexual intercourse. Fifty-eight percent reported having multiple sexual partners and 23.2% reported not using a condom during their last sexual intercourse. The multivariable analysis showed that age [AOR = 2.50; CI = 1.99–3.14], sex [AOR = 0.40; CI = 0.34–0.47], grade [AOR = 1.80; CI =1.38–2.36], suicidal ideation [AOR = 1.44; CI =1.16–1.79], bullying [AOR = 1.36; CI = 1.15–1.62], hunger [AOR = 1.39; CI = 1.17–1.64], alcohol use [AOR = 1.57; CI = 1.31–1.89], marijuana use [AOR = 1.98; CI = 1.14–3.45] and parental knowledge of activity [AOR = 0.82; CI = 0.68–0.99] showed statistically significant influence on sexual experience. Sex [AOR = 0.43; CI = 0.33–0.55], grade [AOR = 1.58; CI = 1.15–2.18], alcohol use [AOR = 1.37; CI =1.07–1.75], marijuana use [AOR = 2.23; CI = 1.11–4.46] and parental supervision [AOR = 0.76; CI = 0.59–0.98] were associated with multiple sexual partners. There was also statistically significant association between age [AOR = 0.32; CI = 0.21–0.48], loneliness [AOR = 1.49; CI = 1.04–2.14], number of close friends [AOR = 0.60; CI = 0.37–0.96] and parental supervision [AOR = 0.43; CI = 0.32–0.60] on non-condom use. Conclusion: These findings underscore the need for a pragmatic approach in addressing RSB among adolescents by adopting substance use prevention and mental health promotion programmes and by encouraging more parental involvement in activities of their adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Infant and child mortality are considered as one of the most important indicators of social and economic development of the nation. This paper intends to shed light on the prevalence of infant and under-five death rates with special reference to differentials in SCs, STs, and non-SCs/STs population in India. In addition, to determine the factors affecting child immunization and institutional delivery by different background characteristics. Data source and methods: The present study has used Census 2001 and 2011 for estimating the infant and under-five mortality. The National Family Health Survey (2015–16) has been used to assess the gaps in institutional delivery and coverage of child full immunization between SC, ST, and other caste population and also to assess the covariates of insitutional delivery and full immunization. Results: The study observed the high infant mortality rate and under-5 mortality among Scheduled Caste and Scheduled Tribe, while it is much lower among non-SC/ST population in 2011 census. The result of logistic regression suggests that caste has significant impact on access to institutional delivery and child immunization, adjusted for other socio-economic variables. All the castes are more likely to gain access to both institutional delivery and child immunization compared to scheduled tribe population. Conclusion: The study result shows the persistent poor health outcome among the SC/ST population in India. There is need to focus on this section of the population to achieve the sustainable development goals of child health and its core agenda "No one left behind". [ABSTRACT FROM AUTHOR]

Aim: The present paper aims to understand the fear of falling (FOF) and risk factors associated with FOF in community-dwelling individuals aged over 60 years in Pune, India. Subjects and methods: The study examined a random sample of 351 community-dwelling older adults. Data on demographic characteristics, health conditions, history of falls, and psychological factors were collected using a pre-tested, structured questionnaire. The Falls Efficacy Scale International (FES-I) was used to measure FOF. Univariate and bivariate logistic regression analyses were carried out to examine associations between various factors and FOF. Results: A high FES-I score was significantly associated with older age, females, unmarried status, education less than 6 years, living alone, unstable balance and gait, hypertension, arthritis, previous falls, self-reported loss of confidence, and depression. Adults older than 70 years of age (odds ratio, OR = 2.411), those with a history of falls (OR = 2.285), those reporting loss of confidence in the past 6 months (OR = 6.766), who had answered yes to the direct question of FOF (OR = 4.632), and had unstable balance (OR = 2.522) were also more likely to have higher FES-I values. Conclusion: A large number of older adults expressed concerns about falling and we also found several factors to be associated with developing FOF, supporting the need for screening. Thus, further research is needed in order to understand the relationship between severity of FOF and actual fall events for developing preventive measures which can be implemented before FOF becomes a problem. [ABSTRACT FROM AUTHOR]

Background: This paper examined the connection between residential histories and obesity in Ghana. In the last two decades, low- and middle-income countries (LMICs) have witnessed the fastest growth in obesity incidence. These obesity trends in many LMICs including Ghana are associated with rapid economic growth and urbanisation. Features of the urban food and built environments contribute to obesity in LMICs in many ways, including exposure to unhealthy foods, sedentary lifestyles, and passive transportation. Methods: The analytical sample consisted of 4368 adults (aged 18 and above) drawn from the World Health Organisation's Study on Global Ageing and Health in Ghana. We employed descriptive statistics and multivariate regression models to examine the relationship between residential histories and obesity in later life using STATA 14. Results: Significant differences were observed among respondents, based on their childhood and adult residential histories. For instance, 44% of respondents who spent their childhood and adult life in the same urban area were obese, compared to 18% of those who spent their childhood and adulthood in the same rural area. Multivariable analysis revealed that cumulative exposure to urban environment was significantly associated with obesity. For example, respondents who spent their childhood and adulthood in different urban areas and childhood and adulthood in the same urban area were significantly more likely to be obese than respondents who lived in rural areas during childhood and adulthood (OR = 2.37, p < 0.001 and OR = 1.44, p < 0.001, respectively). Conclusion: Our findings show that urban residence during childhood and later in life may present cumulative risks for adult obesity. Locally appropriate public health strategies that encourage healthy lifestyles among urban dwellers will be critical in the fight against obesity. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is an infectious disease, which is a significant global public health concern. The use of directly observed therapy of short course (DOTS) is the strategy recommended by the World Health Organization (WHO) to cure TB. In this paper, the effectiveness of the DOTS is assessed using data collected in 2014 from the Gazan Province, Saudi Arabia (SA). The assessment is impacted by migration from high prevalence countries into SA. The association between immigration and TB is not well documented and studied in the literature. We will address this problem and identify other factors influencing the success of DOTS.Methods: Descriptive methods are used in this study. The logistic regression model is used to identify significant factors of success or non-success of the DOTS. The data has missing observations. Multiple imputations were carried out to fill in missing outcomes and completed data sets are analyzed further.Results: The results show that none of the predictors have a significant role in treatment outcome. The cure rate for the study population is 90.3% after excluding defaulters and deportees. If we include 29 defaulters and 68 deportees assuming treatment failed for these cases, the cure rate is 67%, which is far below the WHO goal of 85%. After multiple imputations, the cure rate is 91.7%.Conclusions: Increasing number of migrants into low prevalence countries may affect TB epidemiology. In view of the huge gap, 67 versus 91.7% in the cure rates, we firmly recommend that health and immigration authorities in SA work together to see that TB treatment is completed before deportation. [ABSTRACT FROM AUTHOR]

Background: Active transport to school (ATS) is an effective health-promoting intervention to integrate physical activity into children's everyday lives. While previous studies have examined environmental and behavioural determinants on ATS in urban areas, evidence on rural areas is rare. Method: This study examined whether environmental and psychosocial characteristics are associated with ATS in two rural communities in Austria. Participants from four schools (two primary / two secondary schools) returned a self-reported questionnaire on individual and environmental determinants of ATS consisting of one section for parents and one for children, with 382 of the 467 total responses being included in the analysis. Results: Bivariate analyses showed a significant association of psychosocial characteristics of parents and children (intention, attitude, social norm, perceived behavioural control: p < 0.001), one environmental item (walking and cycling network: p ≤ 0.001) as well as distance and duration for walking to/from school between ATS. In a multiple regression model, the chances of participating in ATS were higher among children who have higher perceived behavioural control, walk between 5 to 10 minutes to school, and whose parents have a higher commitment to ATS. Conclusions: Future initiatives to enhance ATS in rural areas should focus on the control beliefs of parents and children, and should involve parents in order to increase parents' commitment to ATS. Additionally, measures should explore the effects of active transport promotion in the context of public transport and school buses. Above all, further opportunities for ATS should be considered in spatial and community planning. [ABSTRACT FROM AUTHOR]

Aim: Health-related behaviors during adolescence lay the foundation of health status during later life. Most of the studies on health behaviors among adolescents in India have a focus on adolescent girls. India has 133 million adolescent boys; it is important to understand patterns and determinants of physical inactivity and poor dietary intake among them. Method: We analyze levels and patterns of physical activity and dietary habits using data from the 'Understanding Lives of the Adolescents and Young Adults (UDAYA)' Survey, 2016, from Bihar, one of the less developed states in India. The analysis was carried out using data collected from 2004 adolescent boys aged 14–19 years covering 33,900 households. Multivariate logistic regression analysis was used to examine the effect of predictor variables on physical activity and dietary habits. Results: Most adolescent boys (71%) engaged in physical activities during the one month before the survey. Fifteen percent did not engage in physical activity during the reference period and 13% never participated in such activities. One-fourth consumed three or more food groups and 6% did not daily consume any of the six selected food groups. Participants' age, place of residence, schooling status, and co-residence with siblings are strong predictors of physical activity. Place of residence, caste and economic status, household head's gender, schooling of household head, and number of siblings are factors identified as predictors of dietary habits. Conclusion: This study underscores the urgent need for steps to enhance participation in physical activities and to promote daily consumption of meals with adequate dietary diversity among adolescent boys. [ABSTRACT FROM AUTHOR]

Aim: The maintenance of physical activity (PA) over the life course is considered a hallmark for ageing well, but individuals who practice PA also often pursue lifestyles (e.g., smoking) that may inhibit the medicinal impact of PA on them. PA is said to protect against cardiovascular diseases (CVDs), but the literature has little to say about the impact of PA on the risk of CVDs when it is associated with lifestyle factors, comorbidities, and personal characteristics. This study aimed to assess the association between PA time and CVDs, with relevant lifestyle factors, comorbidities, and personal characteristics treated as covariates. Subject and methods: The study's population was retired and working older people aged 60 years or more in Accra, Ghana. A total of 686 individuals responded to self-reported questionnaires. Pearson's chi-square test and binary logistic regression were used to present findings. Results: The study found that the risk of having one or more CVDs increases as time spent in moderate and vigorous PA increases, whereas individuals who drank alcohol a few days a week or most days a week are respectively 2 (OR = 2.415; p = 0.037) and 22 (OR = 21.933; p = 0.000) times more likely to have one or more CVDs compared to those who never drank alcohol. Conclusion: Health education should not only encourage PA maintenance but should also make individuals aware of the need to avoid unhealthy behaviours to maximize the positive effect of PA on health. [ABSTRACT FROM AUTHOR]

Background: Numerous deaths in under-five children occur from preventable and treatable causes. Seeking medical care for a sick child is an important aspect of child health. Parents decide the type and frequency of health care service utilization for their children. A number of factors influence mothers'/caregivers' health care seeking behavior for sick children. This systematic review and meta-analysis aimed to estimate the pooled prevalence of health care seeking behavior and factors associated with common childhood illnesses in Ethiopia. Methods: Studies were accessed via electronic web-based searches of PubMed, Web of Science, African Journals Online, the Cochrane Library, HINARI (Health Inter-Network Access to Research Initiative), and Google Scholar. We included all studies reporting the prevalence of health care seeking behavior for common childhood illnesses in Ethiopia and published in the English language. The data were analyzed using Stata Version 14.1 software. A forest plot and I-squared test were carried out to assess the heterogeneity of the studies. A funnel plot and Egger's regression test were done to check the publication bias. A random effect model was used to estimate the pooled prevalence and subgroup analysis performed to identify the probable source of heterogeneity. Results: Twelve articles comprising 16,873) study participants, were included in this review. The pooled prevalence of health care seeking behavior for common childhood illnesses in Ethiopia was 46.6% (95% CI: 38.7, 54.4) with severe heterogeneity (I2 = 99.0%; p value <0.001) and significant publication bias. Being of the male sex (OR = 1.21; 95% CI: 1.02, 1.43), severity of the illness (OR = 4.04; 95% CI: 2.45, 6.66), rural place of residence (OR = 0.29; 95% CI: 0.13, 0.67), and having an educated mother/caregiver (OR = 1.15; 95% CI: 0.37, 3.65) were factors associated with health care seeking behavior for common childhood illnesses. Conclusion: Mothers'/caregivers' health care seeking behavior for common childhood illnesses was low in Ethiopia. The sex of the child, severity of the illness, place of residence, and maternal educational status were the major factors that determined the health care seeking behavior for common childhood illness. We recommend that awareness-raising activities should be strengthened, with a focus on rural residents and less educated mothers/caregivers. [ABSTRACT FROM AUTHOR]

Background and aim: Early action is important for promoting newly arrived migrants' health. Politicians are major actors in decision-making that affects health outcomes in the population. Therefore, the aim of this study was to explore local and regional politicians' considerations of newly arrived migrants' health in political decision-making: whether politicians reflect on or discuss the effects of decision-making specifically on newly arrived migrants' health, whether considerations differ between municipality and regional politicians, and how knowledge and attitudes are associated with such considerations. Subject and methods: A cross-sectional quantitative study was conducted. A total of 667 municipality and regional politicians from northern Sweden responded to a questionnaire developed based on interviews with politicians. Bivariate analyses were performed using χ2 tests, the independent samples t-test, and the Wilcoxon signed-rank test. Multivariate analysis was performed using binary logistic regression. Results: Politicians considered the effects on newly arrived migrants' health significantly less frequently than those on the total population's health. Regional politicians discussed such effects more often than municipality politicians. Knowledge (odds ratio [OR] = 1.343), attitude (OR = 5.962), previous experience working on public health issues (OR = 1.784), and female gender (OR = 1.787) were positively associated with considering effects on newly arrived migrants' health in decision-making. Conclusion: Politicians play important roles in health promotion, and most consider health-related effects in their decision-making. However, about a third do not consider such effects. General health-related knowledge and attitude are important factors that could be affected or changed during political assignments. [ABSTRACT FROM AUTHOR]

Aim: Previous studies have suggested variable levels of associations between work–family conflict (W_F_C) and its antecedents in different populations. We aimed to assess the antecedents of this conflict and its two types; work-to-family (WFC) and family-to-work (FWC) among Egyptian civil workers. Subjects and methods: In a convenience sample of 3134 Egyptian civil workers, we assessed the W_F_C using the National Study of Midlife Development in the US and attributed it, by logistic and linear regression analyses, to several sociodemographic, work/family situational, behavioral, and health-related variables which were collected by a questionnaire survey between October 2019 and January 2020. Results: W_F_C was prevalent in 56% of the sample (51% for WFC and 62% for FWC). The work and family situational factors were the most significant antecedents of the W_F_C and its two types; partial R2 was 0.71. Both the health-related and behavioral clusters of antecedents were also predictors of W_F_C, while the sociodemographic antecedents contributed minimally to the FWC. The multivariable odds ratios (95% CIs) for high W_F_C in those with high vs low work demands, job control, social support at work, and family were 4.11 (2.89–7.03), 0.0 (0.66–0.90), 0.86 (0.62–0.98), and 0.74 (0.59–0.94), respectively. Conclusions: Work and family situational factors were the most significant antecedents of the levels of W_F_C in Egyptian civil workers. The Egyptian authorities could reduce the civil workers' W_F_C by improving the work environment, finding ways to relieve the workload demands, and helping the civil workers to have more job control and social support. [ABSTRACT FROM AUTHOR]

Aim: The study aim was to further clarify the relationship between psychological factors and myocardial infarction (MI) by simultaneously examining anger, depression, and anxiety as risk factors for incident MI in a healthy working sample. Subject and method: Baseline measurements of psychological variables were assessed through a self-reported questionnaire in a healthy cohort of 968 middle-aged men working at the Volvo Corporation. Single-item questions assessed depression and anxiety. Anger was assessed by the Trait Anger subscale of the Spielberger State-Trait Anger Expression Inventory. The endpoint was incident MI verified by national registers or medical records with follow up after 22 years. The main outcome was computed through logistic regression, reported as odds ratios. Additional correlation analyses were performed between psychological variables and coronary risk factors. Results: None of the psychological variables was significantly associated with the outcome; thus, the results failed to show an association between anger, depression, or anxiety and incident MI in this sample. There were some significant, but weak, correlations between psychological factors and negative health behaviors. Other components of traditional risk scoring instruments did not correlate with the psychological factors. Conclusion: A cohort restricted to middle-age healthy men limits applicability. However, our failure to replicate earlier results of population samples suggests a need for further research on associations between psychological factors and MI in healthy samples. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prevalence of cognitive impairment and its predictors among the elderly in Bangladesh. Subject and Methods: We use a cross-sectional survey of 1015 older people (≥60 years) in Bangladesh collected jointly by the Sir William Beveridge Foundation (SWBF) and Aging Support Forum (ASF), Bangladesh. The Mini-Mental State Examination (MMSE) scale, adapted to the Bengali language, was used for assessing cognitive impairment, which was available for 111 participants. Logistic regression analysis was used to identify predictors of cognitive impairment. Multiple imputation under the missing-at-random (MAR) mechanism was used to deal with missing data. Results: Overall, 31 out of 111 (27.9%) participants had mild, moderate or severe cognitive impairment, with a higher proportion among women (33.3%, 17 out of 51) than men (23.3%, 14 out of 60). More precisely, 24 out of 111 (21.6%) and 7 out of 111 (6.3%) had mild/moderate and severe cognitive impairment, respectively, with a higher percentage among women (mild/moderate: 25.5%, severe: 7.8%) than men (mild/moderate: 18.3%, severe: 5.0%). Age (odds ratio, OR = 1.06, p = 0.046, 95% CI: 1.001 to 1.119) and social engagement (OR = 0.25, p = 0.033, 95% CI: 0.072 to 0.898) were found to be statistically significant predictors of cognitive impairment in this group of people. The effect of physical disability fell short of statistical significance at the 5% level but was significant at the 10% level (OR = 2.89, p = 0.099, 90% CI: 0.999 to 8.370). Conclusion: The prevalence of cognitive impairment in Bangladesh is alarming and is comparatively higher among elderly women, which seems to increase with age and the presence of any physical disability. Also, prevalence appears to be lower in people who are more socially engaged or active. [ABSTRACT FROM AUTHOR]

Background: Very little is known about the association of back pain with subjective health and well-being and sleep problems among the older population in middle-income countries. In this study, we examine the association of back pain with four health outcomes — poor self-rated health, impairments in activities of daily living (1+ADL), sleep problems and World Health Organization Quality of Life score (WHOQOL) — and to study what extent the association differs by age group. Methods: Nationally representative data from World Health Organization's Study on global AGEing and adult health (WHO-SAGE) consisting of 33,878 older adults aged 50 or above were analyzed. The linkages of back pain with poor self-rated health, impairments in activities of daily living (1+ADL), and sleep problems were examined using multivariate logistic regression analysis. Multivariate linear regression was used to assess the association between back pain and quality of life. Results: In the pooled analysis, the association of back pain with four health outcomes were significant. Older adults who reported low back pain were more likely to report poor self-rated health (OR=1.91; p <.001), impairments in activities of dailiy living (ADL) (OR=2.06; p <.001), and sleep problems (OR=2.04; p <.001), and had lower quality of life score (β = −3.23, p <.001). Furthermore, the association of back pain and poor self-rated health, impairments in ADL, and sleep problems was stronger for the 50–59 age group than the 80 or above age group, suggesting significant age interaction in the association. Conclusion: This study suggested the significant role of back pain in determining subjective health, wellbeing, and sleep problems. Measures to prevent back pain, particularly among those in the 50–59 age group, are important to enhance overall wellbeing of the growing older population in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Aim: This study estimated the prevalence of undetected, untreated and uncontrolled hypertension in Brunei Darussalam and the associations with socio-demographic and non-communicable diseases (NCDs) risk factors. Subjects and methods: Participants were aged 18–69 years old from the national NCDs and risk factors survey in Brunei Darussalam, conducted from August 2015 to April 2016. Multiple logistic regression was applied to estimate the associations of undetected, untreated and uncontrolled hypertension with socio-demographic and NCDs risk factors. Results: The crude prevalence of hypertension was estimated to be 40.4% [95% confidence interval (CI) = 37.2–43.6] in men and 32.3% (95% CI = 29.6–35.0) in women. Multivariable adjustment using logistic regression found that those who were currently married [odds ratio (OR) = 0.34, p < 0.001], have family history of hypertension (OR = 0.43, p < 0.001), reported buying food with low salt content (OR = 0.67, p = 0.039) and diabetic (OR = 0.28, p < 0.001) were found to be significantly less likely to have undetected hypertension. Amongst those who were previously diagnosed with hypertension, younger age groups, tobacco use and having no other NCDs diagnosis were found to have significantly higher odds of having untreated hypertension. Amongst those who were on antihypertensive treatment, having body mass index (BMI) 30 kg/m2 and above was significantly associated with lower odds of uncontrolled hypertension. Conclusion: More than one-third (35.8%) of the adult population in Brunei Darussalam were found to have hypertension. Among them, over one-quarter (28.6%) of hypertension cases were not previously detected. Amongst those previously diagnosed with hypertension, more than one-third (35.1%) were not treated or on antihypertensive medication. Screening for hypertension should be emphasised in public health education and media campaigns so that hypertension can be detected and treated earlier. [ABSTRACT FROM AUTHOR]

Aim: The association between urbanization and childhood overweight/obesity (OWOB) in lower- and middle-income countries (LMICs) is poorly understood. Therefore, this study aimed to explore the association between residential district-level urbanization and OWOB among children under 5 years of age in Bangladesh. Subjects and methods: This study used data from a nationally representative sample of children under 5 years of age (N = 19,640) from the Bangladesh Multiple Indicator Cluster Survey 2012–13, including OWOB status of eligible children and other sociodemographic variables. District-level social and physical environmental features were used to create an urbanization index (low, medium, and high) using modified factor analysis. Individuals' data were linked to the district-level urbanization index, and design-based binary logistic regression was used to explore the association between urbanization and OWOB. Results: Prevalence of childhood OWOB was 1.6%, and the average urbanization score was 37.4% (standard deviation: 8.7%). Childhood OWOB was higher in highly urbanized districts (2.0%) than in low urbanization districts (1.2%). The odds of OWOB was 53% higher in highly urbanized districts compared to low urbanization districts (adjusted odds ratio: 1.53; 95% CI: 1.01–2.31). Conclusions: Residential area urbanization was associated with childhood OWOB. These results suggest the importance of formulating context-specific prevention programs and policies to mitigate the adverse impacts of urbanization on childhood overnutrition in LMICs like Bangladesh. Future studies are required to understand its causal relationship with OWOB. [ABSTRACT FROM AUTHOR]

Aim: Infectious diseases continue to be a significant impediment in the attainment of sustainable development goals related to health. A lack of essential household amenities and social determinants are the primary cause behind the outbreak of infectious diseases in LMICs. The current study aimed to examine the socio-demographic determinants of infectious diseases vis-à-vis basic household amenities in India. Subject and methods: This study was based on nationally representative data of 'Key indicators of Social Consumption in India: Health' conducted by the National Sample Survey Organisation between July 2017 and June 2018. The study measured the inicidence of various infectious diseases across basic household amenities and socio-demographic variables. Multivariate logistic regression is employed to analyse the association between the likelihood of a particular infectious disease and various intersectional variables. Results: The study findings reveal that the lack of household amenities such as access to a toilet, clean drinking water, garbage disposal and socio-economic determinants such as area of residence, gender, poverty and age have a significant impact on the incidence of infectious diseases in India. Among various infectious diseases jaundice, malaria and others, including tuberculosis and typhoid, dengue fever and chikungunya, have a relatively higher incidence. Approximately 22.32% of the population do not have proper toilet facility, 45.56% have proper tap water facility, while 50% either use water from spring/well or other unprotected sources and about half of the population do not have any arrangement for garbage disposal. Among socio-demographic determinants, incidence of infections is relatively higher in rural areas, other backward classes (OBCs), males, children, and adults. Conclusions: The study findings outlined that there is a need for better government interventions towards reducing the burden of infectious diseases in India, particularly in rural areas. [ABSTRACT FROM AUTHOR]

Aim: Norway's health scheme provides no-cost HIV pre-exposure prophylaxis (PrEP) when prescribed by a specialist, typically preceded by a general practitioner's (GP) referral. The GP perspective with regard to PrEP implementation in Norway has yet to be captured. Subject and methods: We explored PrEP knowledge, attitudes, and clinical experience of GPs in the Norwegian capital of Oslo, where HIV incidence and PrEP demand are highest. An anonymous survey was designed and distributed between November 2019 and February 2020. Univariate and multivariate logistic regression analyses were performed to identify determinants of GPs' previous clinical PrEP experience (PrEP adoption). Results: One hundred and seventeen GPs responded to the survey. GP PrEP adopters were more likely to: identify as men (aOR 2.1; 95% CI: 1.0–4.5); identify as lesbian, gay, or bisexual (LGB) (aOR 4.4; 95% CI: 1.4–14.5); have ≥ 10 LGB identifying patients on their list (aOR 4.4; 95% CI:1.8–10.4); and self-report higher levels of PrEP knowledge (aOR 2.4; 95% CI: 1.3–4.4). Conclusion: Our findings suggest that GP PrEP knowledge is crucial to patient PrEP access. Educational interventions ought to be considered to enhance GP PrEP adoption capacities, such as easy-to-access PrEP guidelines and peer-based training opportunities in both online and in-person formats. [ABSTRACT FROM AUTHOR]

Purpose: Thyroid disorders are a major public health burden. Generally, women exhibit higher differentials in the prevalence of these disorders. This study focuses on the socio-economic and behavioural correlates of thyroid disorders along with their spatial clustering among women of reproductive age in India. Methods: The study uses dataset from the fourth National Family Health Survey (NFHS-4) carried out in 2015–16 to assess self-reported thyroid disorders. Poor–rich ratio (PRR) and concentration index (CI) were used to study the variation in thyroid disorder among women arising out of economic inequality. Moran's I statistics and bivariate local spatial autocorrelation (BiLISA) maps were used to understand spatial dependence and clustering of thyroid disorder. Spatial lag and error models were applied to examine the correlates of the disorder. Results: Thyroid disorder prevalence was higher among women from socio-economically better-off households. Adjusted effects showed that users of iodized salt were 1.14 times more likely to suffer from a thyroid disorder as compared to non-users, which is contrary to the general belief that a higher percentage of consumption of iodide salt leads to a lower prevalence of thyroid disorder. A higher autoregressive coefficient (0.71) indicated significantly higher spatial clustering in thyroid disorders. Conclusions: The prevalence of thyroid disorder in India depends appreciably on spatial and various ecological factors. Sedentary lifestyles among women may be aggravating diseases, which has strong linkage with thyroid disorders. It is strongly recommended to effectively integrate universal salt iodization with activities geared towards the elimination of iodine deficiency disorders. [ABSTRACT FROM AUTHOR]

Aim: The prevalence of cesarean section (CS) delivery has been increasing dramatically in both developed and developing countries. South Asian countries, including Bangladesh, have recorded substantial increases in CS over the past decade. The objective of this study was to assess the prevalence and associated factors of cesarean delivery in Bangladesh. Subject and methods: Nationally representative cross-sectional secondary data was extracted from the Multiple Indicator Cluster Survey (MICS) 2019, Bangladesh. CS was measured in two categories with cesarean and non-cesarean responses obtained by interviewing the women aged 15–49 years with a live birth in the past 2 years. Chi-square test was used to examine the significant association of mode of delivery (cesarean or non-cesarean delivery). Binary logistic regression was used to assess the factors of CS. Analysis was carried out using STATA version 16. Results: The study showed that among 9208 respondents, 36.1% of women underwent CS. The multivariate analysis indicated that mothers who were over 30 years old [OR 1.02; (95% CI 0.85, 1.21)], had higher education [OR 3.80; (95% CI 2.92, 4.94)], had rich wealth indexes [OR 2.41; (95% CI 2.12, 2.75)], gave birth in private health facility [OR = 8.77; (95% CI 7.6, 10.2)], took antenatal care (ANC) more than three times [OR 4.84, (95% CI 4.02,5.83)], and also gave birth to a larger than average sized baby [OR 1.45; (95% CI 1.22, 1.73)] were significantly associated with CS delivery. Conclusion: Bangladesh's health system urgently needs policy guidelines to monitor clinical indications of CS delivery and prevent an exessive number of CS in private health facilities, which is an essential step to reduce the high prevalence of CS. [ABSTRACT FROM AUTHOR]

Aim: Work-related injuries and diseases are usually severe among informal sector workers (ISW) because they work under poor working conditions. However, there are scant studies on the role of demographic and socio-economic factors in predicting occupational injuries and diseases among ISW in Ghana. Subject and methods: The purpose of the study was to determine the demographic and socio-economic factors associated with exposure to occupational injuries and diseases among ISW in the Kumasi metropolis of Ghana. A cross-sectional survey design involving 350 ISW was employed for the study. Findings: The study revealed that 38.9% and 60.6% of the respondents were exposed to occupational injuries and diseases respectively in 2016. Females (AOR: 1.144; CI: 0.410–3.193; p = 0.007), those aged 50 years or above (AOR: 1.616; CI: 1.051–7.484; p = 0.014), and those who were not using personal protective devices (PPEs) (AOR: 1.062; CI: 0.604–1.867; p = 0.036) were significantly more likely to be exposed to occupational injuries. Further, females (AOR: 1.504; CI: 0.532–4.253; p = 0.041), those aged 50 years or over (AOR: 1.062, CI: 0.089–12.735; p = 0.032) and those who were not using PPE (AOR: 1.742, CI: 0.817–2.320; p = 0.10) have higher odds of being exposed to occupational diseases. Participants with more than 10 years of work experience were less likely to suffer from occupational diseases (AOR: 0.284, CI: 0.096–0.835, p = 0.022). Conclusion: This study suggests the need to consider demographic and socio-economic factors in the formulation and implementation of occupational health and safety policies that aim to lessen exposure to occupational injuries and diseases among ISW in Ghana. [ABSTRACT FROM AUTHOR]

Aim: Past studies show that farmers are especially at risk for respiratory diseases due to occupational exposure and not using protective equipment. This study aimed to provide information about the effects of occupational pesticide exposures on the respiratory system of farmers working in Central Anatolia from a wider perspective to gain insight into the effects of pesticides and other occupational exposures on the respiratory system of farmers. Subject and methods: A cross-sectional study was conduct with a representative sample size of 380 agricultural workers living in the Central Anatolia region. Data were collected with a face-to-face questionnaire and spirometry. The chi-square test was used for testing relationships between categorical variables. The Shapiro–Wilk test was conducted to investigate the distribution characteristics of FVC, FEV1, FEV1/FVC and FEF25–75 (p > 0.050), and nonparametric Mann–Whitney U tests (MW) and Kruskal–Wallis tests were used to examine differences in FVC, FEV1, FEV1/FVC and FEF25–75 between groups. Univariate analysis was performed before multiple logistic regression analyses to identify candidate variables for the final model. Results: The median duration of pesticide use was 25.00 years. According to the FEV1 of agricultural workers, 23.16% had an FEV 1 ≤ 80% predicted. The odds for FEV1 ≤ 80% predicted was 2.44 times higher for smokers (95% CI 1.2–5.0), 1.74 times higher for those with respiratory symptoms in the past 3 months (95% CI 1.1–2.9) and 5.01 times higher for those farming 30 years and more (95% CI 1.8–14.1). Conclusion: The results of the study found that pulmonary function values of agricultural workers were lower compared to reference values. Lower FEV1 was associated with the duration of farming and smoking. [ABSTRACT FROM AUTHOR]

Aims: Chronic kidney disease (CKD) poses a significant health burden in the United States (US). Although earlier studies investigated income disparities in other chronic diseases, limited research has been carried out for CKD in recent years. We investigated income disparities in the prevalence and trends of CKD among US adults. Subjects and methods: This cross-sectional study analyzed National Health and Nutrition Examination Survey 2003–18 data. Survey periods were grouped as 2003–06, 2007–10, 2011–14, and 2015–18. Using glomerular filtration rate and urinary albumin-creatinine ratio from CKD-epidemiology equation, individuals ≥20-year-old were classified into stages of CKD. Income was derived from family income to poverty ratio and equally stratified as low-, middle-, and high-income. Results: In all periods, a reduction in CKD prevalence was observed as income-level increased. In 2003–06, the prevalence (95% confidence interval [CI]) of CKD was 17.8% (15.6%–20.3%), 14.7% (13.1%–16.4%), and 11.5% (10.3%–12.9%) among low-, middle-, and high-income people, respectively. It remained similar in 2007–10 and 2011–14. In 2015–18, this prevalence (95% CI) was 17.9% (16.5%–19.5%), 15.9% (14.6%–17.2%), and 10.2% (8.8%–11.8%) among low-, middle, and high-income people, respectively. Similar differences were detected across most age, gender, and race/ethnicity categories. Income differences were also observed in prevalence of CKD risk factors, including diabetes, obesity, metabolic syndrome, and smoking. Conclusion: While there was no increase in overall CKD prevalence, there could be an association between CKD and income, and low- or middle-income people had higher prevalence of CKD than high-income people. Lifestyle intervention and chronic disease-related health service provision need to consider the income disparity in CKD burden to improve the health and wellbeing of the US population. [ABSTRACT FROM AUTHOR]

Aim: Injury causes numerous socioeconomic losses. We aimed to discover the pattern of alcohol-associated injury in South Korea. Subject and methods: This study retrospectively analysed patients who visited emergency departments (EDs) between January 2011 and December 2016, using the emergency department-based injury In-depth surveillance data of the Korea Disease Control and Prevention Agency. Demographic and injury characteristics, clinical outcome, and injury severity [admission rate, ICU care, mortality, excess mortality ratio-adjusted injury severity score (EMR-ISS)] were analysed. Results: In total, 1,383,740 patients were analysed (alcohol-use group 143,506, non-alcohol-use group 1,240,234). The mean age of the alcohol-use group (40.90 ± 15.02) was 10 years older than the non-alcohol-use group (30.19 ± 24.47). The proportion of males (74.4%) and night-time emergency department visits (59.8%) in the alcohol-use group was higher. Injury mechanism rates for assault (22.6%) and self-harm/suicides (9.9%) were significantly higher in the alcohol-use group. The odds ratios of the alcohol-use group for admission, intensive care, mortality, and EMR-ISS ≥ 25 were 1.305 (1.287–1.324), 2.403 (2.340–2.468), 1.134 (1.066–1.206), and 2.855 (2.810–2.900) respectively. Conclusion: Alcohol-related injuries in South Korea have a higher incidence in males, and night-time ED visits and intentional injury mechanisms are significantly higher than in the group who do not use alcohol. Alcohol-related injuries are associated with a higher trauma severity and death rate. [ABSTRACT FROM AUTHOR]

Aim: To explore the influencing factors of Chinese elderly health literacy (HL) by using meta-analysis method and to provide reference for the development of elderly HL intervention strategies. Methods: CNKI, CBMdisc, WanFang, VIP, PubMed, Embase, Web of Science, Springer Link, Cochrane Library, Wiley Online Library, Elsevier Science Direct, and EBSCO databases were used to search for published HL research. The search time limit was from the establishment of the database to the end of February 2021. Results: A total of 31 studies were included. The HL level of the elderly was 12.28% (95% CI, 10.70%–13.95%), with three dimensions: knowledge (20.35%, 95% CI, 17.91–22.90%), behavior (14.69%, 95% CI, 12.37–17.18%) and skills (17.82%, 95% CI, 16.29–19.41%). Regression analysis found that general physical condition (OR 1.38, 95% CI, 1.11–1.71), with or without spouse (OR 1.38, 95% CI, 1.13–1.70), population distribution (OR 1.72, 95% CI, 1.49–1.99), and place of residence (OR 2.51, 95% CI, 2.14–2.94) were the main influencing factors of low HL levels in the elderly in China. Conclusion: Chinese elderly people who generally have low HL levels tend to live in rural areas, non-eastern regions, have poor general health, and no spouse, and targeted measures will help to improve HL levels in Chinese elderly people. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association between smoking, environmental tobacco smoke (ETS), and lung cancer risk. Methods: This case–control study included 1622 newly diagnosed cases of lung cancer and 1622 healthy frequency-, age-, and gender-matched control participants. Epidemiological data were collected by in-person interviews using a standard questionnaire. Results: Smoking was a risk factor for lung cancer in men (odds ratio (OR) = 4.486, 95% confidence interval (95%CI) 3.586–5.611). In addition, decreased starting age, increased number of cigarettes smoked per day, duration of smoking, pack–years, and depth of inhalation were all risk factors that met the dose–response relationship (P < 0.001). The risk of lung cancer was lower among men who had quit smoking for more than 10 years compared to current smokers. Additionally, male smokers with lung squamous cell carcinoma were at a higher risk of lung cancer than male smokers with lung adenocarcinoma. Workplace ETS increased the risk for lung cancer for male nonsmokers (OR = 2.452, 95%CI 1.534–3.920). In contrast, household ETS increased the risk for lung cancer for female nonsmokers (OR = 2.224, 95%CI 1.644–3.009). Approximately 65.93% cases of lung cancer in men could be attributed to smoking, whereas approximately 31.03% cases of lung cancer among nonsmokers could be attributed to ETS. Conclusions: Smoking is the main risk factor for lung cancer. Workplace ETS is associated with increased lung cancer risk in male nonsmokers, while household ETS is associated with increased lung cancer risk in nonsmoking women. Thus, smoking and ETS increase the risk of lung cancer and are major public health concerns. [ABSTRACT FROM AUTHOR]

Aim: The COVID-19 pandemic drove the Government of Bangladesh to shut down educational institutions, which had an enormous effect on the psychological health of students. This study aimed to assess the mental health status of Bangladeshi university students during the lockdown period. Subject and methods: Through an online-based questionnaire, information was collected from 509 university students of Bangladesh from June 19, 2020, to June 28, 2020, using convenient sampling. K-means clustering was applied to organize students according to their psychological health score, and confirmatory factor analysis (CFA) was also conducted to determine the association among the student's activities and their mental health during the pandemic. In addition, these associations were examined through chi-square test and ordinal logistic regression. Results: Students were categorized into four categories where 4.32% had mild, 72.7% had moderate, 12.57% had moderately severe, and 10.41% suffered from severe mental health imbalance. The results showed that having family members affected by the coronavirus, facing insecurity, using social media, and smoking habits increased the mental health imbalances of students; in contrast, being worried about studying, future career, spending more time with family members, and participation in household chores reduced the mental health disturbances of students. On the other hand, the results of the ordinal logistic regression indicated that sleeping time and participation in household chores were preventive factors for students. Conclusion: This study reveals that a large proportion of University students of Bangladesh suffered from mental health disturbances during the lockdown period. Implementing mental health plans and providing job security, improved communication approaches toward family members, not flattening illusive news, and preoccupation in household activities may assist to enhance the mental health status of the university students. The authors believe that this study's findings will be helpful to expedite the rate of attaining the sustainable development goal associated with health status in Bangladesh. [ABSTRACT FROM AUTHOR]

Aims: To explore the epidemiological impact of depression on the occurrence of gastric cancer. Subject and methods: A systematic review and meta-analysis was conducted and the quality of involved studies were evaluated according to the Newcastle–Ottawa scale. The association between depression and the occurrence of gastric cancer is measured by calculating the combined odds ratio (OR) and the corresponding 95% confidence interval (CI). The epidemiological effect of depression was estimated by attributable risk percentage (ARP) and population attributable risk percentage (PARP). Results: Combined with 24 eligible studies, the risk of gastric cancer in patients with depression is 1.84 times higher than that in normal people (95%CI:1.61–2.09). The corresponding results of ARP and PARP were 45.65% and 5.86% of total meta-analysis, respectively. Conclusion: There is a positive correlation between depression and the occurrence of gastric cancer, which may be a risk factor for gastric cancer occurrence. Our results indicated that the discovery and treatment of depression was important for the prevention of gastric cancer from an epidemiological perspective. [ABSTRACT FROM AUTHOR]

Aim: School related determinants (e.g. student motivation and goals) may be important for student achievement as well as their mental health. Therefore, the aim of this study was to analyse the links between two goal orientations (mastery and performance) and psychosomatic health problems by investigating the general patterns as well as the patterns for specific classifications of students, in particular by investigating the potential statistical interaction effects by gender. Subject and methods: Swedish nationally representative data among 4573 school year 9 students (15–16 years old) responding to the Evaluation Through Follow-up (ETF) questionnaire, in 2014, were used. Linear regression analysis as well as multinomial logistic regression were applied in order to address the research questions. Results: Both the mastery orientation and the performance orientation are independently associated with adolescent psychosomatic health problems. The links between these goal orientations and psychosomatic health show different patterns. The mastery goal orientation may be considered a protective factor as there is a negative link to psychosomatic problems; the performance orientation may be considered a risk factor due to the positive association with psychosomatic health problems. The effect of performance orientation on psychosomatic health complaints was significantly stronger for girls (OR = 4.28) compared to boys (OR = 2.04). In particular, low mastery/high performance students may be at risk for experiencing poor psychosomatic health. Conclusion: Adolescent psychosomatic health may be improved by the encouragement of student goals related to adaptive and successful goal profiles such as mastery orientation. [ABSTRACT FROM AUTHOR]

Aims: Healthcare utilization is a major challenge for low- and middle-income countries, especially for the publicly funded facilities. The study has tried to explore the women's opinion behind the non-utilization of public healthcare facilities in India. Subjects and methods: This was a cross-sectional study using nationally representative samples of 351,625 women of reproductive age (15–49 years) from the 29 States and seven Union Territories. Indian National Family Health Surveys NFHS-4 (2015–2016) was the data source. The respondents were asked why the members of their households do not utilize public healthcare facilities when members of their households are sick. They have options to respond either 'yes' or 'no'. Five reasons for non-utilization of public healthcare were asked: (i) 'there is no nearby facility'; (ii) 'facility timing is not convenient'; (iii) 'health personnel are often absent'; (iv) 'waiting time is too long'; and (v) 'poor quality of care'. Results: The majority of the women in India (88%) said that their family members did not use public healthcare facilities. The reasons behind this were 'no nearby facilities' (42.4%), 'inconvenient facility timing' (29.6%), 'poor quality of care' (52.3%), 'health personnel often absent' (16.8%) and 'long waiting time' (39.9%). Conclusions: importantly, during the last 10 years, the utilization of public health care facilities has dropped significantly, which should be taken seriously as the Indian Parliament has been placing emphasis on equity. [ABSTRACT FROM AUTHOR]

Aim: Concerns around loneliness leading to increased healthcare use persist in spite of a mixed evidence base and lack of adjustment for key potential confounders. We investigated the associations among loneliness, health and healthcare use in older adults including stratification to investigate whether these associations differ by gender. Subject and methods: Secondary analysis of a nationally representative sample of 8175 community-dwelling adults aged 50 years and over from The Irish Longitudinal Study on Ageing (TILDA). Primary outcomes were self-reported general practitioner (GP) and emergency department (ED) visits in the past 12 months. Negative binomial and logistic regression analysis was used to investigate associations between loneliness and healthcare use, later adjusting for potential mediators (health and health behaviours). Results: Loneliness was consistently positively associated with number of GP visits according to both cross-sectional and longitudinal analyses, with incidence rate ratios (IRRs) ranging from 1.08 to 1.33 in the sample overall. Associations with ED visits were less consistent. After adjusting for health and health behaviours, male loneliness does not appear to influence ED or GP visits. However, women who reported loneliness had an elevated risk of an ED visit at wave 1 (W1; odds ratio (OR) 1.08 [1.01–1.16]), as well as increased GP visits at both waves (IRRs ranging from 1.05 [1.02–1.07] to 1.16 [1.07–1.26]). Conclusion: Older women experiencing loneliness visit their GP more often irrespective of health, health behaviours or social isolation. While effect sizes were small, there are implications for health service resources at a population level. Importantly, however, this may also be a useful opportunity to redirect towards appropriate services and tailored resources. [ABSTRACT FROM AUTHOR]

Objectives: To identify the maternal and social characteristics associated with age standardised birthweight in a modern developed setting. Methods: Birth records (n = 414,478) were obtained for live, singleton births in the period 2007–2015 in Queensland, Australia. Age-standardised birth weights were calculated and a multinomial logistic regression was performed to obtain odds ratios and 95% confidence intervals for a range of maternal and social characteristics. Results: Mothers who smoke (OR 2.82, 95% CI 2.72–2.93), and mothers from Southern and Central Asia (OR 3.30, 95% CI 3.08–3.53) had the highest odds of delivering small for gestational age babies. Smoking alone accounted for 21% of low birthweight. Pre-existing diabetes (OR 5.98, 95% CI 5.12–6.99) had the highest odds ratio for large for gestational age births; however, maternal overweight and obesity accounted for 24% of all cases due to its greater prevalence in the population. Conclusion for practice: Smoking continues to be an important modifiable predictor of low birthweight. The predictors associated with large for gestational age are modifiable, with maternal overweight and obesity the largest contributor to high birthweight. Significance: Maternal characteristics are changing alongside broader population change, with mothers often older and heavier than in previous decades. This study provides an update to the role of maternal and social characteristics in optimal birthweight within a large developed population. The present study finds a range of traditional and emerging risk factors remain important. Population attributable risk fractions show that maternal overweight and smoking are the most important modifiable risk factors for birthweight extremes (foetal macrosomia and small for gestational age, respectively). Public health efforts to address these risk factors could reduce up to 20% of birth weight extremes. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to examine the interactive effect of gender, rural–urban residence, and socioeconomic status on early sexual debut among young adults in Ghana. Methods: The study used the 2014 Ghana Demographic and Health Survey with a sample of 2746 sexually active youth (males = 670 and females = 2076) aged 15–24. We used multivariate logistic regression to analyse the data. Results: Our results showed that female youth in urban areas and those from the wealthiest households were less likely to initiate early sexual debut. Additionally, youth resident in urban areas from rich households are less likely to initiate early debut. However, a 3-way interactive effective revealed that female youth resident in urban areas from rich households were found to be more likely to initiate early debut. Conclusion: Our findings underscores that gender-based sexual and reproductive health interventions and programmes may be more appropriate for adolescent females in rich households living in urban areas. These intervention should reach these teenagers before they start engaging in sexual intercourse. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the prevalence of combined body mass index and waist circumference (BMI-WC) disease risk categories in a Norwegian adult population aged 18–51 years and describe selected health indicators (lifestyle factors, medical conditions, self-perceived health and high sensitive serum C-reactive protein (hs-CRP)) within these categories. Subjects and methods: A sample of 1318 adults (aged 18–51 years) answered a comprehensive questionnaire covering lifestyle factors, medical conditions, self-perceived health and background variables in the population-based cross-sectional Telemark study, Norway, 2014–2015. BMI, WC and hs-CRP were determined as part of a broader medical examination. Four combined BMI-WC risk categories were constructed, based on recommendations provided by the US National Institutes of Health (NIH), and associations with health indicators examined using multiple logistic regression analyses. Results: More than half of the participants represented combined BMI-WC categories with elevated disease risk (27% with increased risk, 11% with high risk and 19% with very high risk). Unfavourable health indicators (low physical activity, cardiovascular disease (CVD) history, physician-diagnosed high blood pressure and diabetes, lowered self-perceived health and elevated hs-CRP) increased in line with BMI-WC disease risk. Associations were observed independent of gender, age, education level and residential area. Conclusion: The findings highlight the importance of using both BMI categories and WC for personalised assessment of obesity-related risk and need for follow-up. The findings are considered relevant to public health intervention programmes targeting adults with overweight and obesity. Follow-up studies are warranted to study morbidity development in the BMI-WC risk categories. [ABSTRACT FROM AUTHOR]

Aim: Pakistan has one of the highest proportions of stunted children in the world, and the prevalence of stunting has been quite persistent over the years. This study aims to identify the factors behind the persistent prevalence of under-5 stunting in Pakistan, focusing on a child's access to food, health, care, and environment and the synergies among them. Subjects and methods: This study uses the country-representative data from the Demographic and Health Survey (2012–2013) for Pakistan. The estimations of the econometric models are carried out using ordinary least squares in STATA software. Results: Systematic synergies are found for the combination of food and environment when the sample is split into B40 (bottom 40%) and T60 (top 60%) wealth categories. For urban households, "food and environment" has a positive and significant coefficient under both definitions, showing the presence of synergies among food and environment sectors, as coefficients of their individual effects are insignificant. Under definition 2, synergies are also found for urban households in "care, environment and health". Under definition 1, the four-way interaction is significant for rural areas and at 3.5 it is significantly higher than the sum of the individual components, i.e., 2.3. Conclusions: We can conclude from the results that simultaneous improvements in multiple sectors are likely to have a much stronger impact on height-for-age than improvements in individual components. Therefore, the interventions aiming at stunting reduction should target multiple sectors instead of isolated interventions targeting one of the components. In particular, the results show that interventions aiming at stunting reduction should simultaneously consider access to adequate food and the environment, even if the primary sector of intervention is related to care or health. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the association between childhood socioeconomic status and adult health in Botswana. Subjects and methods: This article uses data from the 'Chronic Non-communicable Diseases in Botswana: Chronic disease prevalence, Health care Utilization, Health Expenditure and the Life course' survey (the NCD study) conducted in Botswana in 2016. The NCD study adopted a cross-sectional design. A total sample of 1178 adult men and women aged 15 years and above from three cities and towns, 15 urban villages and 15 rural areas across Botswana was derived using a multistage probability-sampling technique. Logistic regression models adjusted for current socioeconomic status were used to assess the independent influence of childhood socioeconomic status on adult health. All comparisons were deemed to be statistically significant at p < 0.05. Data analysis was done using SPSS version 25 (IBM, Armonk, NY, USA). Results: The odds of alcohol consumption (AOR = 2.19, p < 0.05), poor fruit and vegetable consumption (AOR = 2.67, p < 0.01), smoking (AOR = 2.18, p < 0.03) and hypertension (AOR = 1.53, p < 0.04) were significantly higher among people who reported poor childhood socioeconomic circumstances. On the other hand, people who reported poor childhood socioeconomic status were less likely to be overweight/obese. There were no significant childhood socioeconomic differences in diabetis prevalence. Conclusions: Childhood socioeconomic exposures are significantly linked to adult health. Consequently, further research is needed, especially longitudinal studies to confirm pathways through which socioeconomic conditions over the life course influence adult health. [ABSTRACT FROM AUTHOR]

Background: Globally, malaria is a major public health concern and, as a result, most nations recognize the need to prevent malaria among women during pregnancy. Intermittent preventive treatment with sulfadoxine/pyrimethamine (IPTp-SP) is one of such interventions recommended for the prevention of malaria-related adverse outcomes. This study, therefore, sought to assess the factors influencing the uptake of IPTp-SP among pregnant women at Trauma and Orthopedic Hospital, Winneba, Ghana. Methods: This is a cross-sectional study conducted among 391 pregnant women attending antenatal care (ANC) at Trauma and Orthopedic Hospital, Winneba. Questionnaires were used for the data collection. Statistical analysis was done with STATA version 14.2. Both bivariate and multivariable analyses were done and statistical significance was set at p-value less than 0.05. Results: Of the 391 women who participated in the study, 71% completed the recommended dose of three or more IPTp-SP uptake. The multivariable analysis showed that pregnant women who were single [Adjusted odds ratio (AOR) = 0.10, 95% confidence interval (CI) = 0.01–0.70], Christians (AOR = 0.21, 95% CI = 0.10–0.50), traditionalist (AOR = 0.08, 95% CI = 0.02–0.42), Mole-Dagbanis (AOR = 0.15, 95% CI = 0.02–0.91), those who were self-employed (AOR = 0.27, 95% CI = 0.09–0.82), those with parity 4 and above (AOR = 0.20, 95% CI = 0.11–0.82), and those without knowledge of malaria treatment were less likely to take optimal (3+) doses of IPTp-SP compared to those who were married, Muslims, Akans, government workers, those with parity 0, and those who had no knowledge of malaria treatment respectively. However, those who had tertiary level of education (AOR = 1.59, 95% CI = 1.05–2.45) and those who stated that there are no side effects associated with the use of IPTp-SP (AOR = 1.31, 95% CI = 1.15–14.69) were, respectively, more likely to take optimal doses of IPTp-SP compared to those with no formal education and those who indicated that there are side effects associated with the uptake of IPTp-SP. Conclusion: The rate of uptake of optimal doses of IPTp-SP among pregnant women at Trauma and Orthopaedic Hospital, Winneba was relatively high. Marital status, religion, educational level, employment, parity, and knowledge of malaria treatment and side effects of IPTp-SP were statistically significantly associated with the uptake of IPTp-SP. In light of these findings, it is recommended that the Ministry of Health, National Malaria Control Programme, Ghana Health Service, and other stakeholders consider these factors when planning and carrying out programs geared towards improving the uptake of IPTp-SP among pregnant women in Winneba. It is also imperative for stakeholders to work to ensure an improvement in the basic knowledge of malaria. [ABSTRACT FROM AUTHOR]

Background: Young adults not only face somatic and psychiatric disorders but they also engage in risky behaviors. The aim of this study was to address the association between psychiatric disorders and multiple health-risk behaviors. Methods: This study reports on a national survey of psychiatric disorders and addictive behaviors (PDABs) among 4261 Iranian university students from 13 medical science universities throughout Iran in 2017. The outcome of interest was psychiatric disorders, and the evaluated health-risk behaviors were cigarette smoking during the past month, using any kind of illicit drugs during the past month, drinking alcohol during the past month, having unprotected sexual intercourse during the past year, having suicidal ideation during the past month, attempting suicide in the past year, and Internet addiction. Results: Of the 4261 university students, 1655 (39%) had a certain level of psychiatric disorder and 1590 (37.3%) had engaged in at least one risky behavior. There was a significant association between psychiatric disorder and female gender [odds ratio (OR) = 1.40; 95% confidence interval (CI) 1.22, 1.61], single status (OR = 2.01; 95% CI 1.66, 2.44), illicit drug abuse (OR = 2.42; 95% CI 1.75, 3.33), suicidal ideation (OR = 3.03; 95% CI 1.98, 4.64), suicide attempt (OR = 2.53; 95% CI 1.62, 3.97), lack of future goal clarity (OR = 2.41; 95% CI 2.06, 2.82), and Internet addiction (OR = 5.16; 95% CI 3.79, 7.04). Conclusions: More than one-third of the students not only have a certain type of psychiatric disorder but also engage in at least one risky behavior. [ABSTRACT FROM AUTHOR]

Background: Recent global warming and the progression of the heat-island phenomenon, mainly in urban areas, have increased the risk of heat stroke development throughout Japan. Consequently, the risk of solitary death due to heat stroke has increased, particularly in summer. Therefore, we aimed to analyze the association between some sociodemographic variables (such as age, sex, marital status) and the length of the time interval between death caused by heat stroke and discovery of the body. Methods: We obtained the data of 69 persons who were diagnosed to have died of heat stroke during the 5 years between 2011 and 2015 in Yokohama City from vital statistics survey death certificate notifications. We also obtained emergency transportation records that matched the above-mentioned cases (48 of the 69 cases) from the Yokohama City Fire Bureau. Then, all cases (69 cases) were classified into the three groups according to the length of time from the occurrence of heat stroke death to the discovery of death (PMI-f: postmortem interval until finding). The information on each group was tabulated with regard to age (including the proportion of elderly persons), gender, marital status, and whether autopsy was performed. Results: The results of Cochran-Armitage trend tests among the three groups revealed that, with longer PMI-f, the proportion of elderly persons significantly decreased (p = 0.028), but the proportion of unmarried persons significantly increased (p = 0.003). Logistic regression analysis also showed that an increased likelihood of prolonged PMI-f was associated with unmarried status. Conclusions: The time from the occurrence of heat stroke death to the discovery of death tended to be longer in unmarried, non-elderly persons. [ABSTRACT FROM AUTHOR]

Background: Significant proportions of pregnant women living in malaria-endemic countries throughout the world are exposed to the risk of malaria. The World Health Organization (WHO) suggests the use of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) in at least three doses to achieve the optimal benefit of preventing malaria among pregnant women. Methods: The study uses secondary data from the 2016 Ghana Malaria Indicator Survey (GMIS). The analysis included a total of 1220 women aged from 15 to 49 who had children under the age of 24 months and who attended antenatal care (ANC) during their pregnancy. Multinomial logistic regression is used to examine the uptake of partial and optimal doses of IPTp-SP. Results: The results show that, overall, the proportion of women in Ghana with uptake of IPTp-SP during pregnancy was 63% for three or more doses, 27% for one to two doses, and 10% for no dose. Uptake varies by background characteristics. At the bivariate level, sociodemographic factors (level of education and religion) and knowledge-related factors (exposure to messages on treatment of malaria and covered by health insurance) predicted partial (1–2 doses) or optimal uptake (3+ doses) of IPTp-SP compared to no uptake among pregnant women. The multinomial regression analysis showed that region, education, wealth, and exposure to messages on treatment of malaria are associated with uptake of optimal doses of IPTp-SP compared to partial uptake. Conclusion: The Ministry of Health, the National Malaria Control Program, Ghana Health Service, and other stakeholders should take cognizance of these factors in planning programs for improving uptake of IPTp-SP among pregnant women. Efforts should be made by stakeholders to increase women's exposure to mass media messages on the use of IPTp-SP for malaria during pregnancy. [ABSTRACT FROM AUTHOR]

Aim: College students are presumed to be exposed to a vast amount of sexual health information and may participate in various sexual behaviors. Without appropriate sources of sexual health information, the sexual health of college students could be severely affected. The purpose of this study was to identify the sources of sexual information and determine the relationship between socio-demographic factors and discussing sexual matters with father, mother, brother, and/or sister. Subject and method: A school-based cross-sectional study design was conducted in the spring of 2018 (January to May). A simple random sampling was used to select a total of 808 students attending Central Michigan University. Participants answered a questionnaire from the World Health Organization administrated through Qualtrics software. The data was extracted from Qualtrics, and further analysis was done using SPSS software. The outcome of interest was discussing sexual matters with father, mother, brother, and/or sister. Descriptive statistics and bivariate and logistic regression analyses were performed, and all associations were set by p-values less than 0.05 and reported by unadjusted and adjusted odds ratios with 95% CI. Results: Nearly 80% of the study participants were females. Most of the respondents (39.7%) were first- and second-year university students, followed by third- to fifth-year students (38.4%). Approximately 59% of the study sample fell into the group 21 years of age and below. The majority (70.1%) of the study participants identified mothers (rather than fathers, brothers, or sisters) as a source of sexual health information. The majority of participants (39.4%) were non-religious, followed by Christians (35.6%). Most of the study participants (69.9%) earned less than $1000 per year. In a multivariate analysis, this study revealed that there was no statistically significant association between socio-demographic factors and obtaining sexually related information from mothers or sisters. Males also were three times more likely to discuss sexual matters with their fathers when compared to females [AOR: 3.09; 95% CI: 1.92–4.97]. Again, males were 96% more likely to discuss sexual matters with their brothers compared to females [AOR: 1.96; 95% CI:1.11–3.46]. In terms of education, first- and second-year students, and third- to fifth-year students were three times more likely to discuss sexual matters with their fathers compared to graduates [AOR: 3.41; 95% CI: 1.53–7.57, AOR: 3.02; 95% CI:1.53–6.02 respectively]. Conclusion: The majority of participants (70.1%) identified mothers as a source of sexual health matters. Therefore, mothers should be encouraged to be trained for effective communication regarding sexual health issues. Gender showed a significant association with discussing sex matters with fathers and brothers. The year of education also showed a significant association with discussing sexual matters with fathers. All findings suggest that family members need to be informed with correct sexuality information to better inform children/siblings. [ABSTRACT FROM AUTHOR]

Aim: Health insurance has been recognized globally as one of the significant means of financing healthcare to achieve universal coverage, particularly in low and middle-income countries. This article sought to examine how ecological zone interacts with other socio-demographic characteristics to influence health insurance coverage among adolescent girls in Ghana. Subjects and methods: The study used data from the 2017 Ghana Maternal Health Survey. A sample size of 3767 adolescent girls was used for this study. This study employed both descriptive and inferential analytical approaches to analyze the data using STATA version 14.0. Results: The study found that ecological zone has a statistically significant association with health insurance coverage among adolescent girls in Ghana, with adolescent girls in the Northern Zone less likely to be covered by health insurance than those in the Coastal Zone [AOR = 0.76, CI = 0.58–0.98]. Other factors that determined health insurance coverage among adolescent girls in Ghana were age, parity, education level and marital status. Conclusion: With adolescent girls in the Northern Zone less likely to be covered by health insurance, it is unlikely that Ghana will be able to achieve equity in healthcare even with the existence of health insurance. If this situation persists, the ability of the country to work towards achieving Sustainable Development Goal 3, which seeks to ensure healthy lives and promote well-being for all at all ages, is under threat. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) has a high incidence worldwide, especially in high-income countries. In France, a national CRC screening program targeting residents aged 50–74 years has been in place since 2009. Little is known about CRC screening practices in cancer survivors, even though some have an increased risk of developing a second cancer in the colorectum. This study aims to identify the barriers to CRC screening among cancer survivors. Methods: This cross-sectional study based on the French national VICAN survey included individuals diagnosed in 2010 with a cancer in 1 of 11 locations other than the colorectum and interviewed 5 years after diagnosis about various health-related issues. Binary logistic regression was used to identify the factors associated with lack of up-to-date CRC screening in cancer survivors without cancer progression. Results: Of the 2935 cancer survivors included in the study, 35.3% reported undergoing a screening test in the previous 2 years. The rate of up-to-date CRC screening rose to 49.3% in survivors aged 51–75 years. Among these, lack of CRC screening in the recommended time frame was associated with obesity, current smoking, non-use of complementary medicine, perceived financial difficulties, and poor access to general practitioners. Conclusions: Barriers to CRC screening can be personal and/or institutional. [ABSTRACT FROM AUTHOR]