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In this paper, we study a slotted Aloha cooperative network where a source node and a relay node send status updates of two underlying stochastic processes to a common destination. Additionally, the relay node cooperates with the source by accepting its packets for further re-transmissions using probabilistic acceptance and relaying. We obtain the exact steady state distributions of Age of Information (AoI) and Peak AoI sequences of both nodes using Quasi-Birth-Death Markov chains. The analytical model is first validated by simulations and then used to obtain optimal cooperation policies when transmission probabilities are fixed. Subsequently, we study the more general problem of joint optimization of the transmission probabilities and cooperation level between the source and relay, with detailed numerical examples. [ABSTRACT FROM AUTHOR]

The aim of this paper is to perform an observational descriptive study of the Obstructive Sleep Apnea Syndrome (OSAS) in a population of children by evaluating the prevalence and role of sex and age variables. The 22-item Pediatric Sleep Questionnaire (PSQ) was administered to parents of children aged 3 to 12 years. The questionnaire is a very simple tool since it allows for the indication of patients with possible OSAS diagnosis through a cut-off of 0.33. The anonymous diagnostic questionnaire, available in digital format, was administered to the population under study by a link or QR code. Only the questionnaires completed in all their parts were recorded and analyzed. Eight hundred and thirty-two questionnaires were collected. One hundred and fifty-four subjects obtained a PSQ score > 0.33 and the prevalence of OSAS was 18.51%. The Chi-square test showed a statistically significant association between the PSQ score > 0.33 and male sex. The higher prevalence of subjects with a value of PSQ > 0.33 (n = 277) are aged 3–4–5 years, followed by the 6–7–8 range in the group with PSQ score > 0.33, p < 0.05. The prevalence of OSAS was 18.51% in children aged 3 to 12 years. The variables male biological sex and the age group 3–8 year were statistically significant for subjects with OSAS diagnosis. This study underlines the use of the 22-item Pediatric Sleep Questionnaire as a first screening tool to identify children at risk of OSAS. [ABSTRACT FROM AUTHOR]

Spanish legislation obliges the public administration to ensure equal opportunities and support for access to higher education for people with disabilities. This work has one central goal: to analyse and understand the causes for the potential inequality for people with disabilities in accessing higher education in Spain and the barriers they encounter during their academic life. This paper focuses on the differences in inclusive education between people with disabilities and people without disabilities by sex, age, and type of university. A mixed research design is used: qualitative research of two focus groups and fourteen interviews to sixteen students with disabilities; and statistical analysis of the Social Integration and Health Survey 2012, using two-way and multi-way cross-tables. There are significant differences between presence of disability and learning variables. Controlling by sex and age, almost every age-group is significant. Using sex as independent variable, and controlling by disability, there is no relationship with the variables relating to barriers to accessing education; therefore, the larger differences by sex are in the group of people without disabilities. [ABSTRACT FROM AUTHOR]

Although violence among youth remains an important, global issue, little research has been conducted regarding how young people themselves define violence and what practices in relation to violence that are evident in their everyday lives. Using an intersectional gender perspective, specifically exploring the intersection of gender, age, and class, this paper therefore aims to explore how young people define violence, as well as to explore what practices in relation to violence that are evident in young people's everyday lives. By using a photovoice methodology, 11 focus groups of young boys and girls (17–19 years old) living in two municipalities in northern Sweden were interviewed and asked to take photographs representing themes that were discussed. Overall, three main themes in the young peoples' stories were identified: Violence as ubiquitous, Easy prey and dangerous predators, and The way forward. The findings demonstrated that violence is pervasive, all-encompassing and normalized in young people's everyday lives, and that this violence is moderated by intersecting power orders of gender, age, and class. Any future theoretical frameworks or prevention strategies should therefore aim to include an intersectional perspective as well as including the voices of the youths themselves. [ABSTRACT FROM AUTHOR]

Background: Child marriage has powerful implications for a young woman's reproductive health, education, and personal development as well as the development of communities and nations. Child marriage frequently marks the beginning of a young woman's sexual activity and early childbearing. As a country where child marriage is common, Ethiopia has placed additional emphasis on addressing child marriage over the past years. Methods: Using data from Ethiopia Demographic and Health Surveys for 2005, 2011 and 2016, this paper explores trends in child marriage over the last decade in various locations and regions of Ethiopia. Results: Between 2005 and 2016, the percentage of young Ethiopian women married before age 18 declined from 49 to 40%, a reduction of 18% from 2005 levels. The percentage of women married before age 15 experienced even greater reductions, declining by 26% in the same period. The greatest reductions in child marriage took place in the Addis Ababa, Amhara, and Tigray regions. Over the period, estimates for Oromia and Somali suggest that child marriage has increased in these regions. Notwithstanding recent declines, Afar, Beneshangul-Gumuz, Somali, and Oromia are regions where nearly half or more of all girls are married before age 18. Conclusions: Nationally, Ethiopia has experienced impressive declines in child marriage over the last decade. However, progress has also been uneven. Trends in the last decade have resulted in a geographical shift in where child marriage is most prevalent. In particular, locations that are challenging in terms of access, including the most remote and hard to reach, pose persistent challenges to those attempting to eradicate the practice. Intensifying efforts in rural areas and underserved regions can facilitate further declines in child marriage in Ethiopia. Plain Language Summary: Child marriage has powerful implications for young women's reproductive health, education, and welfare. Using data from Ethiopia Demographic and Health Surveys for 2005, 2011, and 2016, this paper analyzes subnational trends in child marriage over the last decade. Between 2005 and 2016, the percentage of Ethiopian women married before age 18 declined from 49 to 40%, a reduction of 18%. The percentage of women married before age 15 experienced even greater reductions, declining by 26% in the same period. The greatest reductions in child marriage took place in Addis Ababa, Amhara, and Tigray regions. Over the same period, estimates for Oromia and Somali regions suggest that child marriage has increased in these regions. Afar, Beneshangul-Gumuz, Somali, and Oromia are regions where more than or nearly half of all girls are married before age 18. Nationally, Ethiopia has experienced impressive declines in child marriage over the last decade. However, progress has also been uneven, resulting in a geographical shift in where child marriage is most prevalent. Remote and hard-to-reach locations pose persistent challenges to eradicating child marriage. Intensifying efforts in rural areas and underserved regions can achieve the elimination of child marriage in Ethiopia. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate psychosocial, demographic and obstetric factors that affect health practices in pregnancy. Methods: This cross‐sectional study was conducted with pregnant women selected by using random sampling in a public hospital in Turkey. The pregnant women (n = 383) completed the Health Practices Questionnaire in Pregnancy, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Multidimensional Scale of Perceived Social Support. Multiple linear regression was used to examine predictors of participation in health practices. The variables were subjected to multiple linear regression analysis to estimate the effect of each independent variable (depression, anxiety, perceived social support, age, educational level, gestational week and parity) on the dependent variable (health practices). Results: Depression and anxiety were not significantly related to gestational health practices. The multiple linear regression model showed that inadequate social support, low education level, early gestational week and high parity were significant predictors of nonengagement in favourable health practices during pregnancy. Conclusions: Pregnant women with inadequate social support and specific demographic and obstetric characteristics are less likely to participate in gestational health practices. This study suggests that more attention should be paid to these groups to improve the health practices of pregnant women. Summary statement: What is already known about this topic? There are significant effects of health practices in pregnancy on maternal, fetal and newborn health.Some maternal factors may be associated with adverse health practices. What this paper adds? Social support was a significant predictor of gestational health practices.Low education level, early gestational week and high parity were predictors of nonengagement in favourable health practices during pregnancy.Depression and anxiety were not significantly related to gestational health practices. The implications of this paper: Health‐care professionals should be aware of psychological factors related to gestational health practices. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the distribution of foot conditions, the risk of foot ulceration and its associated factors in patients with diabetes. Few studies have focused on the risk of foot ulceration in patients with diabetes. Methods: A total of 267 patients with diabetes who attended outpatient clinics in two tertiary referral hospitals were recruited from June to September 2016. The risk of foot ulceration was classified using the American Diabetes Association (ADA), International Working Group on the Diabetic Foot (IWGDF) and Scottish Intercollegiate Guidelines Network (SIGN) classification systems. The risk categories of each system were reclassified into high‐ (categories of 2 and 3 for the ADA and IWGDF systems and high for the SIGN system) and low‐risk. Results: Foot deformity was the most prevalent condition (38.2%). Among 261 patients without active ulcers, between 17.6% to 35.2% were classified in the high‐risk group and overall agreement among systems ranged from.42 to.56 of the kappa statistic. Insulin treatment was consistently associated with a high‐risk of foot ulceration. Conclusions: As the risk varies between systems, nurses should select a suitable classification system through validation studies and assess the risk in patients with diabetes, particularly, those receiving insulin treatment. Summary statement: What is already known about this topic? Foot ulceration is a major complication of diabetes and may cause serious health issues, adversely affecting the patient's quality of life.Although risk assessment of foot ulceration in patients with diabetes is regarded as a critical preventive measure, implementation of diabetic foot examinations by health‐care providers varies among countries.Only 6.1% of patients with diabetes have received a foot examination in the last 2 years in South Korea, and there are few studies on the distribution of risk factors for diabetic foot ulceration. What this paper adds? Among participants, 73.4% had at least one foot condition and between 17.6% to 35.2% of patients were classified in the high‐risk group, depending on the system.Overall agreement among systems ranged from.42 to.56 of the kappa statistic.Participants with diabetes on insulin treatment were found to be at a higher risk of foot ulceration. The implications of this paper: As the risk of foot ulceration varies between international systems, nurses need to select the most suitable one through validation studies.Although the prevalence of active foot ulcers is very low, two to four of every 10 patients with type 2 diabetes attending outpatient clinics in tertiary referral hospitals in South Korea are at high‐risk for foot ulceration. Therefore, nurses should regularly assess the risk of foot ulceration, particularly in high‐risk patients, such as those receiving insulin treatment. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the relationship between family caregivers' health‐related quality of life and health outcomes in care recipients. Methods: A total of 160 female caregivers in Japan were initially assessed using self‐reported baseline questionnaires to determine physical and mental aspects of their health‐related quality of life. Based on these scores, they were divided into three groups: lower, middle, and higher quality of life. We followed up with the 133 participants (after excluding those that did not respond) 6 years later to assess the health of their care recipients; 36 caregivers continued to provide home care, while 97 reported that their care recipient had died or been admitted into institutionalized care. Results: Statistically, a higher risk for care recipients' health deterioration was strongly associated with the mental component score in the lower caregivers' quality of life group of than for the middle group, after adjusting for the care recipients' age, health status, and caregivers' age at baseline. There was no significant association between deterioration of health of care recipients and physical component scores of the caregivers. Conclusion: Caregivers' poor health‐related quality of life, particularly poor mental health, may be linked to the deterioration of care recipients' health. Summary statement: What is already known about this topic? Family caregivers reportedly have lower quality of life than noncaregivers.While factors associated with decreased quality of life of caregivers such as high caregiving burden and longer care duration are being identified, they remain difficult to prevent.Lower caregiver quality of life may negatively influence the care recipients. What this paper adds? Poor mental health in caregivers, calculated with health‐related quality of life scores, is associated with health deterioration of care recipients.Physical health in caregivers is not associated with health deterioration of care recipients. The implications of this paper: Support for improving the health‐related quality of life of caregivers is necessary, especially in relation to their mental health, from the viewpoint of maintaining the health status of care recipients. [ABSTRACT FROM AUTHOR]

Background: Many researchers have explored the impact of various technologies in museums on learning effects. Whether the application of technology in informal museum learning is effective, is the current issue that scholars pay more attention to. Objectives: This study will find the evidence to determine the effects of technology use on museum learning outcomes, and identify the future research trends in the field of technology application in museum learning. Methods: This study used a meta‐analysis method to statistically analyse the experimental and quasi‐experimental research in this field, and explored the effect sizes of technology application on the learning effect of museums. And the co‐citation network analysis method was used to analyse the distribution of academic groups and research institutions in this field and the changes in research hotspots. Results and Conclusions: The results show that technologies significantly enhance noncognitive learning. Significant differences exist in the effects of the moderating variables on the influence of technology on the learning outcomes of museum learning. The scholars engaged in this research field come from various countries or regions and institutions. The research hotspots of and extended research on technically supported museum learning have changed continually in the past decade. Major Takeaways: This study answers the question of "whether, how, and to what extent does the application of technology affect the learning effect of museums". According to the research conclusions, certain suggestions are proposed in this paper from the perspectives of researchers and museum institutions for the effective application of museum technology. Lay Description: What is already known about this topic: The formal learning in the classroom has been unable to meet the learners' thirst for knowledge, and the museums have become the main educational battlegrounds for inheriting history and culture and popularizing scientific knowledge.Some studies have proved that the use of some technologies in the museum can affect the learning effect of learners.The application of technology is an important part of the physical situation among the three major situations of museum influencing factors. What this paper adds: This paper integrated meta‐analysis with co‐citation network analysis method is used to analyse and evaluate the 34 experimental or quasi‐experimental studies and 572 citations.The contextual model of learning was used as a theoretical framework to construct the meta‐analysis framework.The moderating effects of technology category, museum category, learner category and visiting mode on museum learning effect were significantly different. Implications for practice and/or policy: Researchers in museum learning must strengthen academic exchange and cooperation and explore a new path for museum technology integration.The administrative organizations of museum institutions must accelerate the construction of museum resources and implement the "new normal" of the integration of exhibition and education. [ABSTRACT FROM AUTHOR]

The social and behavioral sciences have long suffered from a lack of diversity in the samples used to study a broad array of phenomena. In an attempt to move toward a more contextually-informed approach, multiple subfields have undertaken meta-science studies of the diversity and inclusion of underrepresented groups in their body of literature. The current study is a systematic review of the field of relationship science aimed at examining the state of diversity and inclusion in this field. Relationship-focused papers published in five top relationship science journals from 2014 to 2018 (N = 559 articles, containing 771 unique studies) were reviewed. Studies were coded for research methods (e.g., sample source, dyadic data, observational data, and experimental design) and sample characteristics (e.g., age, education, income, race/ethnicity, and sexual orientation). Results indicate that the modal participant in a study of romantic relationships is 30 years old, White, American, middle-class, college educated, and involved in a different-sex, same-race relationship. Additionally, only 74 studies (10%) focused on traditionally underrepresented groups (i.e., non-White, low-income, and/or sexual and gender minorities). Findings underscore the need for greater inclusion of underrepresented groups to ensure the validity and credibility of relationship science. We conclude with general recommendations for the field. [ABSTRACT FROM AUTHOR]

In a response to a research paper which analyses how US newspapers represent young people and parents in their response to climate crisis, this commentary observes that the newspapers achieve some advantage in selecting frames, which privilege adult behaviour at the expense of actions taken by young people. It suggests that one effect of newspapers' choice to frame teens' awareness and activities surrounding climate change in disparaging terms may be to increase any eco‐anxiety by devaluing it. It argues that this is done to benefit the newspapers by supporting rather than challenging the schema of their adult readers, following a commercial rather than societal agenda. A subsidiary effect may be to drive younger people away from mainstream media, which fails to represent their viewpoint and towards misinformation and disinformation from unreliable sources. [ABSTRACT FROM AUTHOR]

Trends in people having children later in life and increasing evidence of male age‐related fertility decline (ARFD) has led some to propose sperm freezing as a suitable response. However, little consideration has been given to how men might respond to such a proposal, and there has been a paucity of empirical data to inform such a consideration. This paper arises from in‐depth, semi‐structured interviews with men (n = 25) who do not have children but want or expect to have them in the future. Data on men's perceptions of male ARFD and sperm freezing are presented and discussed in accordance with theoretical and conceptual tools relating to reproductive masculinity, biomedicalisation, gendered risk perception and meanings of sperm and masculinity. It suggests that that men's overall lack of concern regarding male ARFD and resistance towards ideas of sperm freezing result not only from a lack of exposure to evidence regarding male ARFD but are also shaped by ideals of reproductive masculinity, and may indicate resistance towards the idea of reproductive control. It argues that these positions perpetuate a gender unequal politicisation of ARFD and perpetuate particular gendered subjectivities relating to culpability and responsibility for guarding against risks of ARFD. [ABSTRACT FROM AUTHOR]

Background: Epstein-Barr virus (EBV) is an important human pathogen; it infects >90% people globally and is linked to infectious mononucleosis and several types of cancer. Vaccines against EBV are in development. In this study we present the first systematic review of the literature on risk factors for EBV infection, and discuss how they differ between settings, in order to improve our understanding of EBV epidemiology and aid the design of effective vaccination strategies.Methods: MEDLINE, Embase, and Web of Science were searched on 6th March 2017 for observational studies of risk factors for EBV infection. Studies were excluded if they were published before 2008 to ensure relevance to the modern day, given the importance of influencing future vaccination policies. There were no language restrictions. After title, abstract and full text screening, followed by checking the reference lists of included studies to identify further studies, data were extracted into standardised spreadsheets and quality assessed. A narrative synthesis was undertaken.Results: Seventy-seven papers met our inclusion criteria, including data from 31 countries. There was consistent evidence that EBV seroprevalence was associated with age, increasing throughout childhood and adolescence and remaining constant thereafter. EBV was generally acquired at younger ages in Asia than Europe/North America. There was also compelling evidence for an association between cytomegalovirus infection and EBV. Additional factors associated with EBV seroprevalence, albeit with less consistent evidence, included ethnicity, socioeconomic status, other chronic viral infections, and genetic variants of HLA and immune response genes.Conclusions: Our study is the first systematic review to draw together the global literature on the risk factors for EBV infection and includes an evaluation of the quality of the published evidence. Across the literature, the factors examined are diverse. In Asia, early vaccination of infants would be required to prevent EBV infection. In contrast, in Western countries a vaccine could be deployed later, particularly if it has only a short duration of protection and the intention was to protect against infectious mononucleosis. There is a lack of high-quality data on the prevalence and age of EBV infection outside of Europe, North America and South-East Asia, which are essential for informing effective vaccination policies in these settings. [ABSTRACT FROM AUTHOR]

Background: Electronic formats of patient-reported outcome (PRO) measures are now routinely used in clinical research studies. When changing from a validated paper and pen to electronic administration it is necessary to establish their equivalence. This study reports on the value of Rasch analysis in this process.Methods: Three groups of US pulmonary hypertension (PH) patients participated. The first completed an electronic version of the CAMPHOR Activity Limitation scale (e-sample) and this was compared with two pen and paper administrated samples (pp1 and pp2). The three databases were combined and analysed for fit to the Rasch model. Equivalence was evaluated by differential item functioning (DIF) analyses.Results: The three datasets were matched randomly in terms of sample size (n = 147). Mean age (years) and percentage of male respondents were as follows: e-sample (51.7, 16.0 %); pp1 (50.0, 14.0 %); pp2 (55.5, 40.4 %). The combined dataset achieved fit to the Rasch model. Two items showed evidence of borderline DIF. Further analyses showed the inclusion of these items had little impact on Rasch estimates indicating the DIF identified was unimportant.Conclusions: Differences between the performance of the electronic and pen and paper administrations of the CAMPHOR Activity Limitation scale were minor. The results were successful in showing how the Rasch model can be used to determine the equivalence of alternative formats of PRO measures. [ABSTRACT FROM AUTHOR]

While research has found important links between religion and health, there is a gap in knowledge in sub-Saharan Africa. The purpose of this paper is to examine the relationship between religion and health in rural Malawi. After controlling for baseline health, results show that: (1) the relationship differs between younger (15–44 years) and older (45 + years) adults; (2) among younger adults, Muslims are relatively less healthy, whereas Muslims are healthier in older age; (3) religious activities have a stronger relationship with health than do other measures, especially for women; and (4) religious activities have a relationship with health only for two or more activities. These findings suggest that religion is tied to health in Malawi, especially for older women. This paper was originally presented at the European Conference on African Studies in June 2017. [ABSTRACT FROM AUTHOR]

Background: Difficulties in language development are related to social and emotional problems, lower academic outcomes, and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. The introduction of systematic screening for language delay (LD) in 3‐year‐old children in Hungary was based on the recent adaptation of the MacArthur–Bates CDI‐III (HCDI‐III). Aims: To explore the relevant psychometric properties of the HCDI‐III; to identify factors characteristic of the families and children influencing language development at the age group under investigation; and to evaluate the adequacy of the tool for the purpose of screening LD in kindergarten at the age of 3 years. Methods & Procedures: The norming study of the HCDI‐III was conducted in a collaborative research project with the Metropolitan Pedagogical Services in Budapest. HCDI‐III parent report forms along with a demographic survey form were distributed to parents of all Hungarian‐speaking children between the ages of 2;0 and 4;2 without special education needs. The normative sample comprised data from 1424 children aged 2;0–4;2 with 51.1% boys and 48.9% girls. The data set contained information including language skills, basic demographics, birth conditions, health issues and socio‐economic status (SES). Outcomes & Results: In the HCDI‐III form, six outcome variables were created to cover the domains of expressive vocabulary, morphosyntax and language use. Statistical analyses revealed appropriate psychometric properties of five outcome variables that showed a normal distribution and were strongly correlated to age. Outcomes of girls were slightly (but significantly) higher on scales corresponding to vocabulary, syntax, language use and productivity. Most variables were highly correlated with one another even with age partialled out. Multiple regression analyses revealed significant effect of age, gender and parental education on all main outcome variables. Neither one of the other eight predictors, including familial and birth‐related factors, affected linguistic outcomes in our sample. Conclusions & Implications: The results are consistent with the majority of Communicative Development Inventory (CDI) studies, and support the psychometric eligibility of the instrument for screening purposes between 30 and 50 months. As certain regions of Hungary are characterised by a high prevalence of low‐SES families, more research is needed to adapt the screening procedure and subsequent measures to their needs. What this paper adds: What is already known on the subject: Difficulties in language development are related to lower social and academic outcomes and lower quality of life from childhood to adolescence. These grave consequences might be significantly reduced by timely identification and professional support. Structured parent report forms such as the MacArthur–Bates CDI are widely accepted methods for screening children with LD. What this paper adds to existing knowledge: This study reports the Hungarian adaptation and norming of the CDI‐III form. Statistical analyses revealed appropriate psychometric properties of most of its sections. Language outcomes were affected by age, gender and parental education on all main outcome variables in children between 2 and 4 years of age. What are the potential or actual clinical implications of this work?: The results support the psychometric eligibility of the HCDI‐III instrument for screening purposes. The introduction of the screening procedure in clinical practice is expected to improve early support of children with language difficulties and reduce risks of developmental problems related to language disorders. [ABSTRACT FROM AUTHOR]

Background: Aims: To describe typical phonological development of Brazilian Portuguese (BP)‐speaking children, considering the following parameters: age of customary production, acquisition and mastery. Methods & Procedures: Data were collected from 857 children aged between 3 years and 8 years 11 months with typical language and speech development. The sample was grouped into 6‐month age bands. The data were analysed using one‐way analysis of variance (ANOVA) followed by Games–Howell post‐hoc tests. Outcomes & Results: Stops (/p, b, t, d, k, g/), nasals (/m, n, ɲ/) and some fricatives (/f, v, s, z/) were mastered before the age of 3 years (age of mastery). The age of acquisition for phonemes /ʃ, ʒ/ was 3;6, though both were only mastered at 4;0 years. The liquid /l/ was acquired at 3;0 and mastered at age 3;6, while /x/ was acquired and mastered at age 3;6. The phoneme /ʎ/ was acquired at 7;0 and mastered at age 8;6. The tap /ɾ/ was acquired between the ages of 4;0 and 4;6, and mastered at 4;6. In coda position, /n, l/ were acquired at 3;0, while /s/ was mastered at 4;6 and /ɾ/ between 4;6 and 5;0 years. Clusters involving /ɾ/ were acquired at 6;0, while those with /l/ were acquired between the ages of 6;6 and 7;0. Conclusions & Implications: This study presented acquisition for consonants in BP and can be used as a reference for the assessment of developmental speech disorders. In this study, stops and nasals were acquired first, followed by fricatives and, lastly, liquids. This finding is corroborated by previous studies in BP and other languages. What this paper adds: What is already known on the subject: What this paper adds to existing knowledge: What are the potential or actual clinical implications of this work?: [ABSTRACT FROM AUTHOR]

The absence of reliable registration of Covid-19 deaths in India has prevented proper assessment and monitoring of the coronavirus pandemic. In addition, India's relatively young age structure tends to conceal the severity of Covid-19 mortality, which is concentrated in older age groups. In this paper, we present four different demographic samples of Indian populations for which we have information on both their demographic structures and death outcomes. We show that we can model the age distribution of Covid-19 mortality in India and use this modeling to estimate Covid-19 mortality in the country. Our findings point to a death toll of approximately 3.2–3.7 million persons by early November 2021. Once India's age structure is factored in, these figures correspond to one of the most severe cases of Covid-19 mortality in the world. India has recorded after February 2021 the second outbreak of coronavirus that has affected the entire country. The accuracy of official statistics of Covid-19 mortality has been questioned, and the real number of Covid-19 deaths is thought to be several times higher than reported. In this paper, we assembled four independent population samples to model and estimate the level of Covid-19 mortality in India. We first used a population sample with the age and sex of Covid-19 victims to develop a Gompertz model of Covid-19 mortality in India. We applied and adjusted this mortality model on two other national population samples after factoring in the demographic characteristics of these samples. We finally derive from these samples the most reasonable estimate of Covid-19 mortality level in India and confirm this result using a fourth population sample. Our findings point to a death toll of about 3.2–3.7 million persons by late May 2021. This is by far the largest number of Covid-19 deaths in the world. Once standardized for age and sex structure, India's Covid-19 mortality rate is above Brazil and the USA. Our analysis shows that existing population samples allow an alternative estimation of deaths due to Covid-19 in India. The results imply that only one out of 7–8 deaths appear to have been recorded as a Covid-19 death in India. The estimates also point to a very high Covid-19 mortality rate, which is even higher after age and sex standardization. The magnitude of the pandemic in India requires immediate attention. In the absence of effective remedies, this calls for a strong response based on a combination of non-pharmaceutical interventions and the scale-up of vaccination to make them accessible to all, with an improved surveillance system to monitor the progression of the pandemic and its spread across India's regions and social groups. [ABSTRACT FROM AUTHOR]

Background: There is increasing acceptance of the importance of social values such as equity and fairness in health care priority setting (PS). However, equity is difficult to define: the term means different things to different people, and the ways it is understood in theory often may not align with how it is operationalized. There is limited literature on how development assistance partner organizations (DAP) conceptualize and operationalize equity in their health care prioritization decisions that affect low-income countries (LIC). This paper explores whether and how equity is a consideration in DAP priority setting processes. Methods: This was a qualitative study involving 38 in-depth interviews with DAPs involved in health-system PS for LICs and a review of their respective webpages. Results: While several PS criteria were identified, direct articulation of equity as an explicit criterion was lacking. However, the criterion was implied in some of the responses in terms of prioritizing vulnerable populations. Where mentioned, respondents discussed the difficulties of operationalizing equity as a PS criterion since vulnerability is associated with several varying and competing factors including gender, age, geography, and income. Some respondents also suggested that equity could be operationalized in terms of an organization not supporting the pre-existing inequities. Although several organizations' webpages identify addressing inequities as a guiding principle, there were variations in how they spoke about its operationalization. While intersectionalities in vulnerabilities complicate its operationalization, if organizations explicitly articulate their equity focus the other organizations who also have equity as a guiding principle may, instead of focusing on the same aspect, concentrate on other dimensions of vulnerability. That way, all organizations will contribute to achieving equity in all the relevant dimensions. Conclusions: Since most development organizations support some form of equity, this paper highlights a need for an internationally recognized framework that recognizes the intersectionalities of vulnerability, for mainstreaming and operationalizing equity in DAP priority setting and resource allocation. Such a framework will support consistency in the conceptualization of and operationalization of equity in global health programs. There is a need for studies which to assess the degree to which equity is actually integrated in these programs. Research highlights: Equity has become an increasingly important focus in the health and social science literature, however, equity is a contested concept. While development assistance partners supporting health development subscribe to equity as a guiding principle, they struggle with its operationalization. There is need for a general framework that explicitly conceptualizes the operationalization of equity in health development. [ABSTRACT FROM AUTHOR]

The purpose of this paper is twofold: to explore the factors influencing the emergence and growth of informal e-waste activities and to examine workers' motivation for involvement in informal e-waste activities. Semi-structured interviews and observations among actors in the recently established Dagomba-Line e-waste site in Kumasi, Ghana were employed to gather relevant data. Emergence and growth of e-waste activities are largely influenced by spatial, political, socio-cultural and economic factors. The reuse and open disposal of e-waste are the common practices due to the cost of transportation to a final disposal site. Similar to findings at the well-established Agbogbloshie e-waste site, also in Ghana, scavengers are found at the bottom of the e-waste financial ladder. The major motivating factor for engaging in e-waste handling is poverty. Additionally, some respondents mentioned the lucrative nature of the activity, landlessness, and peer influence as a motivation. The results showed that younger workers (below 35 years) were more likely to be engaged in the activity for reasons of peer influence and poverty and major source of livelihood. The paper recommends that policy and planning should reflect ways of delivering and creating stable socio-economic conditions that promote an inclusive and sustainable development. [ABSTRACT FROM AUTHOR]

As health care improves and more people work into later age, it is important to understand what impacts open-mindedness has on decision-making. This paper examined the role of aging on open-mindedness. Open-mindedness was measured across 12 studies before data amalgamation. The Actively Open-minded Thinking (AOT) scale and Actively Open-minded Thinking about Evidence (AOT-e) scale measured open-mindedness in this sample (n = 9010) of participants between 18 and 87-years of age. Summary AOT positively correlated with AOT-e (r = 0.27). For two subfactors derived from factor analysis based on the AOT, scores for both subfactors positively correlated with AOT-e (subfactor-1: r = 0.17/subfactor-2: r = 0.31) but negatively correlated with age (subfactor-1: r = −0.01/subfactor-2: r = −0.16). Age negatively correlated with both AOT (r = −0.11) and AOT-e (r = −0.13). Regressions revealed that open-mindedness decreased with aging. Age marginally predicted the change in open-mindedness, and sex differences were not a predictor. It is proposed that the observed differences are the result of a reluctance to change long-established values and ideas at the cognitive level and cortical changes that occur with aging. In an aging population where more adults work into later age, the decrease in open-mindedness could influence many areas of judgments of decision-making. Importantly, this demonstrates that open-mindedness varies across lifespan. [ABSTRACT FROM AUTHOR]

The relevance of the study of coronavirus infection in animals is conditioned upon the lack of sufficient information about the mechanisms of development of this disease, imperfect methods of diagnosis and treatment, and, most importantly, almost 100% of their mortality. The purpose of this study was to identify the age, breed, seasonal, and sexual characteristics of cats' predisposition to coronavirus infection and the development of infectious peritonitis. The paper presents the results of epizoothogolic features of the spread of coronavirus infection among animals of this species and feline infectious peritonitis during 2020-2022 based on the veterinary clinic "White Wolf" (city of Kyiv). During this period, 483 samples were examined from cats with symptoms of coronavirus infection. From these samples, using immunochromatographic analysis, a virus of the Coronaviridae family was detected in 399 animals, and infectious peritonitis was established in 63 animals. This paper highlights the results of a study of the age, breed, and sexual predisposition of cats to coronavirus infection and the development of infectious peritonitis. It was found that cats of any age are susceptible to coronavirus infection, while infectious peritonitis develops in animals aged from 2 months to 3 years. Coronavirus infection was most frequently found in mixed breed cats and British shorthair cats, infectious peritonitis -- in Burmese and Bengal breeds. The study also summarised data on the seasonal manifestation of coronavirus infection and infectious peritonitis of cats. Based on the results of epizootological analysis, a nosological profile of infectious diseases was formed in animals of this species that had similar clinical symptoms of coronavirus infection and infectious peritonitis. Eight infections are presented, of which the most frequently recorded diseases were caused by viruses of the Herpesviridae, Caliciviridae, and Parvoviridae families. The results of this study provide new information about the epizootological features of the manifestation and development of coronavirus infection in cats, which allows not only improving the available diagnostic methods, but also developing new ones [ABSTRACT FROM AUTHOR]

Monitoring the changes in mortality patterns and levels requires studying mortality models and measures of lifespan length and variation. Measures of lifespan length and variation can be obtained from life tables or from mortality modes. In this paper, measures of lifespan length and variation are presented for mixture model introduced by Zanotto, L., V. Canudas-Romo, and S. Mazzuco. 2021. "A Mixture-Function Mortality Model: Illustration of the Evolution of Premature Mortality." European Journal of Population 37 (1): 1–27. This was applied to the case of Egypt for males and females in the period 1950–2021. The mixture model was able to fit Egypt's mortality pattern well for both males and females. The calculated measures of lifespan length and variation show that there is an increasing longevity and a declining variation of age at death distribution across time for both males and females. [ABSTRACT FROM AUTHOR]

• Adherence to Ketogenic Diet Therapies (KDT) is challenging for subjects. • The measurement of adherence lacks standardization, despite being essential. • The average adherence rates across age groups range from 63.9 to 71.5%. • Adherence is higher in short-therm KDT treatment. Treatment adherence, defined as the degree to which the patient actively follows the plan of care, is very difficult for subjects undergoing ketogenic dietary therapies (KDTs). This is a relevant issue because adherence to dietary therapies is considered 1 of the primary determinants of the treatment's success. This paper aimed to review the literature evidence about KDT adherence according to age and diagnosis of patients. Performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, this systematic review included clinical trials and observational studies. The risk of bias was assessed by the RoB 2.0 Cochrane tool and the quality of evidence according to the Mixed Methods Appraisal Tool system. Twenty-two articles were included, with more than half (n = 12) having average quality (2–3 stars). The studies' heterogeneity in measuring adherence and diagnosis made it difficult to compare results. Mean adherence rates were 71.5%, 66%, and 63.9% for children, adolescents, and adults, respectively. Adherence and compliance rates varied according to the follow-up period (79.7%, 66.7%, and 37.7% at 6, 24, and 36 months, respectively). The most frequent reasons for low adherence were linked to inefficacy in seizure control, adverse effects, food refusal, difficulty in preparing KDT meals or diet restrictiveness, lack of motivation, poor parental compliance, or cost of the diet. To conclude, there is a lack of standardized tools to measure adherence. Several studies highlighted the families' challenges in adhering to KDTs. These factors should be considered when creating strategies and resources on family education. A systematic review of 22 articles on ketogenic diet therapy adherence showed high heterogeneity, challenging comparisons with other studies. Mean adherence rates were similar across age groups: 71.5% for children, 66% for adolescents, and 63.9% for adults. Adherence varied over time: 79.7%, 66.7%, and 37.7% at 6, 24, and 36 months, respectively. Adherence was influenced by inefficacy in seizure control, adverse effects, food refusal, meal preparation challenges, diet restrictions, lack of motivation, poor parental compliance, and cost of the diet. Abbreviations: KDT, ketogenic diet therapies; mo, months. [Display omitted] [ABSTRACT FROM AUTHOR]

This paper examined gender (N = 1406;77.7% women) patterns of religious coping and psychological impact following the devastating 2023 Syrian earthquakes. Measures in this nation-wide convenience sample study included positive religious coping (PRC) and negative religious coping (NRC) using the Brief Religious Coping Scale (RCOPE), and probable PTSD, depression, and anxiety, using the PCL-5, PHQ-9, and GAD-7, respectively. Women reported higher endorsement of PRC items while men higher endorsement of NRC items. Within the women only sample, lower education and lower income, education and younger age predicted PRC and NRC, respectively. NRC was strongly positively associated with PTSD, depression and anxiety; while, PRC was positively associated only with PTSD. These vulnerable women require targeted support to adopt more adaptive religious coping strategies. [ABSTRACT FROM AUTHOR]

This paper investigates the trends in erectile dysfunction research by integrating individual keywords such as COVID-19, mental health, psychiatry, and drug use. The study spans a six-year period from September 21, 2017, to September 21, 2023, and utilizes resources from the National Library of Medicine. For instance, the quantity of relevant documents is determined using the Google search engine. A custom date range can be set on the browser via tools, and the search is limited to the nih.gov site domain. The phrase-site search command used is executed with "erectile dysfunction" COVID-19 site:nih.gov. The result revealed that from Sept 2021 to 2022, research on COVID-19 and erectile dysfunction spiked. However, the previous year saw a rise in studies linking drugs or mental health with erectile dysfunction. Meanwhile, psychiatry-focused publications have consistently grown. The time-series trends of erectile dysfunction linked to COVID-19 are substantiated by a comprehensive literature review. [ABSTRACT FROM AUTHOR]

When organisations make employees redundant, they increasingly offer outplacement counselling to them, either in-house or as a service of specialised companies. Despite outplacement counsellors' importance, their work-related stress has not been studied yet. In this paper we argue that internal (in-house) outplacement counsellors have a particularly demanding job (especially because being employed by firing organisations should increase role conflicts among internal outplacement counsellors) and they should thus be more emotionally exhausted than external outplacement counsellors. Data from 98 German outplacement counsellors supported this argumentation. Mediation analyses showed that these differences were mediated by increased role conflicts, consistent with role theory arguments. The same effect was found for counsellors' job satisfaction. These results help understanding the stress that outplacement counsellors experience. [ABSTRACT FROM AUTHOR]

Oklahoma's medical cannabis is some of the least restrictive in the US. Previous research suggests that American Indian/Alaska Native (AIAN) have higher rates of cannabis use than other racial or ethnic groups. The goals of this paper are, first, to look at cannabis use among high school students living on the Cherokee Nation Reservation before (2017) and after (2019) medical cannabis because legal in Oklahoma (2018) utilizing the Cherokee Nation Youth Risk Behavior Survey (CNYRBS). Second, to describe the socio-demographic characteristics of youth using cannabis in the Cherokee Nation Reservation. Data were retrieved from the 2017 and 2019 CNYRBS. The data for this study included 1,216 high school students who completed the 2017 and 1,476 who completed the 2019 CNYRBS. After removal of incomplete records, there were 2,602 students whose data was analyzed in this study. Data were weighted to be representative of public-school students attending grades 9–12 within Cherokee Nation Reservation. Despite the legalization of medical cannabis in Oklahoma in 2018, there was no change in cannabis use among youth between 2017 and 2019. There were variations in cannabis use based on demographic factors and other substance uses. AIAN individuals had higher odds of current cannabis use compared to non-Hispanic White students, but there were no differences based on ethnicity. Additionally, the use of cigarettes, e-cigarettes, alcohol, and illegal drugs were associated with increased odds of cannabis use among both current and former users compared to those who had never used it. There was no spike in use among youth at least immediately after the legalization of cannabis in the Cherokee Nation Reservation. There were socio-demographic as well as substance use disparities in the use of cannabis. [ABSTRACT FROM AUTHOR]

Background and Objectives Chronological age is invariably used as a categorizing tool for spaces, collections, and programs in public libraries. With age-based conceptions of human experience in library practice, education, and scholarship primarily focused on those under the age 18, little is known how age-based classifications are implemented in public libraries, and with what impacts, for older library patrons. Research Design and Methods Stemming from a larger project that seeks to bring attention to the ways in which public libraries engage with community-dwelling older adults, this paper explores 51 older patrons' perspectives on the numbers and language (e.g. 55+, older adult, seniors, adult) assigned to older adults in library programs and which label best (or least) suits their sense of identity and, in turn, what language encourages or deters their engagement with library programs. Results Findings illustrate that age-based language describing older adult library programs is often at odds with patrons' perceptions of how library programming relevant to them ought to be labeled. Common to all participants was a clear dislike for the term "elderly." While most participants preferred "older adult" to "senior," others voiced no preference, as long as they felt heard and valued. Many participants linked the use of language used to describe library programs to being excluded from and treated differently from other (younger) library patrons. Discussion and Implications The language used to group and describe different library populations directly shapes feelings of belonging (or exclusion) in library programs. Insights from this research contribute to our evolving understandings of the ways in which language connected to age can shape one's sense of identity. Results also serve to cultivate a more sensitive and critical approach to the question of age within library science, and, by extension, the experiences of older adults who frequent the library. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a critical period for social emotional development. The need to focus on social emotional competencies is exacerbated by the COVID 19 pandemic. Objective: This systematic review paper provides a collective account of mindfulness interventions conducted exclusively with adolescent students in an educational setting (mean age 11 to 18) with the sole focus on social emotional and behavioral competencies primarily as outlined by the Collaborative for Academic, Social, and Emotional Learning (Safe and sound: an educational leader's guide to evidence-based social and emotional learning programs, Author, Chicago, IL, 2003, 2011). Method: Mindfulness literature in the past 15 years, i.e., Jan 2008–Feb 2023 was reviewed. Additionally, the type of intervention implemented, dosage, delivery, measures used, and targets of intervention were examined. All the articles were also assessed for their methodological quality using the EPHPP quality assessment tool for quantitative studies (Effective Public Health Practice Project in Quality assessment tool for quantitative studies, Effective Public Health Practice Project, Hamilton, ON, 1998. https://merst.ca/ephpp/). Results: With less than one third of the 30 included studies rated as strong, there appears to be moderate evidence for the effectiveness of MBIs on adolescent social emotional competencies. Overall, there appears to be mixed evidence for the effectiveness of MBIs on adolescents' self-awareness, social awareness, social skills, with relatively more consistent evidence that MBIs positively impact their self-management (e.g., emotional regulation). We classify broader characteristics of the MBIs that could help explain some of the differences in effectiveness into three categories: intervention implementation related (e.g., dosage), method related (e.g., psychometric properties), and participant related (e.g., age and gender). Conclusion: Future work on MBIs in schools needs to consider the quality of and factors known to impact effective implementation and resultant social emotional outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines the prevalence of long COVID across different demographic groups in the US and the extent to which workers with impairments associated with long COVID have engaged in pandemic-related remote work. Methods: We use the US Household Pulse Survey to evaluate the proportion of all adults who self-reported to (1) have had long COVID, and (2) have activity limitations due to long COVID. We also use data from the US Current Population Survey to estimate linear probability regressions for the likelihood of pandemic-related remote work among workers with and without disabilities. Results: Findings indicate that women, Hispanic people, sexual and gender minorities, individuals without 4-year college degrees, and people with preexisting disabilities are more likely to have long COVID and to have activity limitations from long COVID. Remote work is a reasonable arrangement for people with such activity limitations and may be an unintentional accommodation for some people who have undisclosed disabilities. However, this study shows that people with disabilities were less likely than people without disabilities to perform pandemic-related remote work. Conclusion: The data suggest this disparity persists because people with disabilities are clustered in jobs that are not amenable to remote work. Employers need to consider other accommodations, especially shorter workdays and flexible scheduling, to hire and retain employees who are struggling with the impacts of long COVID. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates who requests workplace accommodations and who is more likely to have requests granted. We investigate the role of demographic characteristics and their intersection, including disability, gender, race/ethnicity, and age. We also consider the role of other personal and job-related factors. Methods: We use the data from the Current Population Survey (CPS) 2021 Disability Supplement to estimate the odds ratio of having requested workplace accommodations and having such request granted during the COVID-19 pandemic when the survey was conducted. In supplementary analyses, we explore the relationship between remote work and flexible scheduling and workplace accommodations, as well as possible trends using CPS 2019 Disability Supplement. Results: Our results indicate that Hispanics with disabilities are more likely than others to request workplace accommodations, but they are substantially less likely to be granted accommodations. Consistent with other studies, our paper also finds that people with disabilities, women, and older people are more likely to request accommodations than their respective counterparts. Other personal and job-related factors such as higher education, parenthood, being single, being a citizen, and working in management-related occupations are associated with higher likelihood of requesting workplace accommodations compared to their counterparts, while receiving accommodations is largely explained by occupational differences. Conclusion: Our findings show that there are still disparities in the rates of workplace accommodation requests and provision for multiply marginalized groups, and as such, taking into account intersectional differences in addition and in relation to disability is important. [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]

INTRODUCTION The underlying factors of oral squamous cell cancers (OSCC) have been elucidated, but studies have focused little on etiological differences in affected oral cavity sites. The aim of this retrospective study was to clarify the role of carcinogen exposure in OSCC of different oral cavity areas. METHODS A cross-sectional study of patients with primary OSCC was conducted retrospectively, based on patient records from Helsinki University Hospital, Finland, between January 2016 and December 2020. The patients' self-reported history of tobacco smoking and alcohol use was explained by tumor site, age, sex, tumor size, and lymph node status in a logistic regression model. The information on smoking and alcohol use was compiled from a patient background form. RESULTS In 519 patients, tumors occurred most often in the tongue (51%), gingiva (21%), or floor of the mouth (FOM; 15%). FOM had 26-fold greater odds for a history of smoking and alcohol use than other tumor sites (OR=25.78; 95% CI: 8.02-82.95; p<0.001). Gingival and buccal sites were associated significantly less with smoking and alcohol use (OR=0.43, 95% CI: 0.28-0.67; p<0.001 and OR=0.47; 95% CI: 0.25-0.92; p<0.026, respectively). Patients of older age were less likely to have a history of smoking and alcohol use (AOR=0.95; 95% CI: 0.94-0.97; p<0.001) than younger patients. Tumor size (T3-4) and FOM increased the odds for history of smoking and alcohol use (AOR=1.73; 95% CI: 1.15-2.60; p=0.009 and AOR=26.15; 95% CI: 8.01-84.84; p<0.001, respectively). CONCLUSIONS OSCC of oral cavity sites has notable differences in etiology. FOM seems to be related almost exclusively to conventional smoking and heavy alcohol use. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this research is to identify the factors that negatively impact the achievement of the minimum clinically significant change (MCID) for the American Shoulder and Elbow Surgeons (ASES) score within the realm of various orthopedic shoulder procedures. Methods: We conducted a comprehensive review of studies published from 2002 to 2023, utilizing OvidMedline and PubMed databases. Our search criteria included terms such as "minimal clinically important difference" or "MCID" along with associated MeSH terms, in addition to "American shoulder and elbow surgeon" or "ASES." We selectively included primary investigations that assessed factors linked to the failure to achieve MCID for the ASES score subsequent to orthopedic shoulder procedures, while excluding papers addressing anatomical, surgical, or injury-related aspects. Results: Our analysis identified 149 full-text articles, leading to the inclusion of 12 studies for detailed analysis. The selected studies investigated outcomes following various orthopedic shoulder procedures, encompassing biceps tenodesis, total shoulder arthroplasty, and rotator cuff repair. Notably, factors, such as gender, body mass index, diabetes, smoking habits, opioid usage, depression, anxiety, workers' compensation, occupational satisfaction, and the preoperative ASES score, were all associated with the inability to attain MCID. Conclusion: In summary, numerous factors exert a negative influence on the attainment of MCID following shoulder procedures, and these factors appear to be irrespective of the specific surgical technique employed. Patients presenting with these factors may perceive their surgical outcomes as less successful when compared to those without these factors. Identifying these factors can enable healthcare providers to provide more effective counseling to patients regarding their expected outcomes and rehabilitation course. Furthermore, these findings can aid in the development of a screening tool to better identify these risk factors and optimize them before surgery. [ABSTRACT FROM AUTHOR]

This paper explores some of the ways in which access to the census enumerators books for later nineteenth century censuses, now digitised by the 'Integrated Census Microdata' project, can throw new light on a range of socio-demographic developments in the 'Crofting Counties' between the early 1850s and the early 1880s. Collating and mapping occupational titles by parish reveals major changes in the titles recorded for those farming small land parcels and in the spatial distributions and age profiles or those heading such households. The numbers of household heads reported as 'Crofter' markedly increased between 1851 and 1881 (including outside the 'Crofting Counties'), as use of terms like 'Tenant' and 'Lotter' declined. 'Cottar', even in 1851 used in very small numbers in most places, was reported in 1881 in very limited areas, even where the estates still used it extensively. The number of households headed by 'Fishermen' increased greatly in some areas, notably in Lewis. At the same time, the numbers of men becoming heads of small agriculturalist households at younger ages fell markedly, while rising numbers headed households as 'Fishermen'. Comparative analysis of four case study areas suggests that, when fishing and other incomes fell markedly in the early 1880s, inter-generational differences in access to headship of a croft may have been a significant stimulus to localised outbreaks of disturbance pressing for land reform. [ABSTRACT FROM AUTHOR]

Background and Objectives Ageism is oftentimes sugarcoated within humor. Paper birthday cards are 1 delivery approach in which ageist messages are perpetuated and reinforced through humor. Research Design and Methods A convenience sample of birthday cards (k = 227), all indicating a decade of age, were acquired from 7 national retail stores in Colorado Springs, CO. The decades sampled ranged from 21 to 100. With a predeveloped codebook, 3 raters coded the decade birthday cards on various variables, including age group, ageist tone, and humor. Results Birthday cards intended for age 30–60 contained significantly more ageist messages compared to cards intended for age 21 and age 70–100, which did not show a significant difference from each other. Additionally, birthday cards with humor showed more ageist messages than cards without humor. Characteristics of decade birthday cards were also explored. Discussion and Implications Consumers need to learn to evaluate these ageist messages in birthday cards to reduce the perpetuation of damaging stereotypes. [ABSTRACT FROM AUTHOR]

The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data. [ABSTRACT FROM AUTHOR]

Background: Delayed discharge is problematic. It is financially costly and can create barriers to delivering best patient care, by preventing return to usual functioning and delaying admissions of others in need. This systematic review aimed to collate existing evidence on delayed discharge in psychiatric inpatient settings and to develop understanding of factors and outcomes of delays in these services. Methods: A search of relevant literature published between 2002 and 2022 was conducted on Pubmed, PsycInfo and Embase. Studies of any design, which published data on delayed discharge from psychiatric inpatient care in high income countries were included. Studies examining child and adolescent, general medical or forensic settings were excluded. A narrative synthesis method was utilised. Quality of research was appraised using the Mixed Methods Appraisal Tool (MMAT). Results: Eighteen studies from England, Canada, Australia, Ireland, and Norway met the inclusion criteria. Six main reasons for delayed discharge were identified: (1) accommodation needs, (2) challenges securing community or rehabilitation support, (3) funding difficulties, (4) family/carer factors, (5) forensic considerations and (6) person being out of area. Some demographic and clinical factors were also found to relate to delays, such as having a diagnosis of schizophrenia or other psychotic disorder, cognitive impairment, and increased service input prior to admission. Being unemployed and socially isolated were also linked to delays. Only one study commented on consequences of delays for patients, finding they experienced feelings of lack of choice and control. Four studies examined consequences on services, identifying high financial costs. Conclusion: Overall, the findings suggest there are multiple interlinked factors relevant in delayed discharge that should be considered in practice and policy. Suggestions for future research are discussed, including investigating delayed discharge in other high-income countries, examining delayed discharge from child and forensic psychiatric settings, and exploring consequences of delays on patients and staff. We suggest that future research be consistent in terms used to define delayed discharge, to enhance the clarity of the evidence base. Review registration number on PROSPERO: 292515. Date of registration: 9th December 2021. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to (1) translate and validate the PEACH + Rating Scale in Malay and (2) establish normative curves as a function of age and examine test-retest reliability for the Malay and English versions of PEACH+. This is a cross-sectional study that used a convenient sampling technique. One hundred and fifty-seven parents of typically developing children aged between 4 months and 7 years participated in the study. Forty-nine completed the Malay PEACH + in a pen-to-paper format (Aim 1). One hundred and eight parents completed PEACH + online (69 completed the Malay version and 39 the English version), and 20 of them completed the questionnaire twice (Aim 2). The PEACH + in Malay showed high internal consistency and item-total correlation. The normative data revealed that scores for frequency of auditory behaviour increased rapidly with age until about 20 months and reached an asymptote of around 90% by about 40 months of age. A similar trend was observed for ease of listening scores, which asymptoted around 85%. The validated Malay PEACH + Rating Scale can be used as a guide to monitor auditory functional performance and listening efforts of Malaysian children in real-world environments. [ABSTRACT FROM AUTHOR]

Summary: The purpose of this paper is to describe rates of forearm fractures in adults in Norway 2008–2019. Incidence rate of distal forearm fractures declined over time in both sexes. Forearm fracture constitute a significant health burden and prevention strategies are needed. Purpose: To assess age- and sex-specific incidence rates, and time trends for forearm fractures in Norway, and compare these with incidence rates in other Nordic countries. Methods: Data on all patients aged 20–107 years with forearm fractures treated in Norwegian hospitals from 2008 to 2019 was retrieved from the Norwegian Patient Registry. Fractures were identified based on International Classification of Disease 10th revision code S52. Age- and sex-specific incidence rates and changes in incidence rates were calculated. Results: We identified 181,784 forearm fractures in 45,628,418 person-years. Mean annual forearm fracture incidence rates per 100,000 person-years were 398 (95% CI 390–407) for all, 565 (95% CI 550–580) for women, and 231 (95% CI 228–234) for men above 20 years. Mean annual number of forearm fractures was 15,148 (95% CI 14,575–15,722). From 2008 to 2019, age-adjusted total incidence rates of forearm fractures S52 diagnoses declined by 3.5% (incidence rate ratio (IRR) of 0.997 (95% CI 0.994–0.999)) in men. The corresponding decline in women was not significant (IRR: 0.999 (95% CI 0.997–1.002)). In the same period, the age-adjusted incidence rates of distal forearm fractures declined by 7.0% in men (IRR = 0.930; 95% CI 0.886–0.965) and 4.7% in women (IRR = 0.953; 95% CI 0.919–0.976). The incidence rates of distal forearm fractures were similar to rates in Sweden and Finland. Conclusion: Age-adjusted incidence rates of distal forearm fractures in both sexes declined over time. [ABSTRACT FROM AUTHOR]

Previous research has found varied effects of informal care provision on the carer's health status. Few studies have, however, examined this relationship dynamically. This paper is the first to analyse trajectories of care among men and women in mid-life and their impact on health outcomes using a nationally representative prospective cohort study. Data from three waves of the United Kingdom (UK) National Child Development Study (N = 7,465), when the respondents were aged 46, 50 and 55, are used to derive care trajectories capturing the dynamics of care provision and its intensity. Logistic regression investigates the impact of caring between the ages of 46 and 55 on the carers' report of depression and poor health at age 55. At age 46, 9 per cent of men and 16 per cent of women provided some level of informal care; rising to 60 per cent for both genders at ages 50 and 55. Just 7 per cent of women and 4 per cent of men provided care at all observation points, with the most common trajectory being 'starting to care' at ages 50 or 55. New carers experienced a lower risk of depression at age 55, reflecting that they may not have experienced the caring role long enough to have an adverse impact on their wellbeing. The findings highlight that the majority of individuals with surviving parents experience caring at some point during mid-life, underlining the need for further longitudinal research to better understand the complex relationships between care-giving and health for different groups of cares. [ABSTRACT FROM AUTHOR]

An electrocardiogram (ECG) is a diagnostic tool that can identify heart conditions and offer valuable information about electrical activity and age-related changes. Our primary concern is studying ECG changes related to age, gender, and body mass index (BMI) for the benefit of researchers and clinicians. A comprehensive search for relevant literature was conducted in the PubMed, Embase, and Scopus databases. The selection criteria were limited to original papers published between January 1, 2015, and December 31, 2022, that were deemed eligible. We executed a meticulous selection process that involved eliminating duplicates, screening abstracts and full texts, and manually adding some articles. During the full-text screening process, we excluded articles that were not relevant to our study. Ultimately, we included only nine observational studies that fulfilled our eligibility criteria. Our primary objective was to determine the factors that influence the ECG pattern in children and adolescents. This review systematically highlights the significance of identifying ECG patterns that could be correlated to factors such as age, gender, and BMI. Identifying such patterns may play a crucial role in improving the diagnostic accuracy of ECG. Physicians who fail to recognize these patterns may mistakenly endanger their patients' lives. [ABSTRACT FROM AUTHOR]

It has been demonstrated that alcohol continues to be the most prevalent reason causing traffic accidents. This study aimed to evaluate the alcohol levels in the traffic accident cases admitted to Ege University Hospital. Blood samples of the 4,266 cases were analyzed with the enzymatic immunoassay method between 2016 and 2017. The data was obtained from the hospital automation system and analyzed statistically. Of all cases (n = 20,058) admitted to the hospital department, the rate of traffic accidents was 21.3% (n = 4,266). The mean age was 32.38 ± 12.4, and 70.4% of the cases were male. Ethyl alcohol was positive in 9.6% (n = 409) of the cases, and 33.1% (n = 136) of them were in the 25–34 age range. A significant increase was observed in 2017 compared to 2016 (p < 0.05). About 87.6% (n = 360) of the positive cases were above the legal limit of 0.50 g/L for drivers except for professional drivers. About 57.7% (n = 237) of the positive traffic accident cases were passengers, and 27.2% (n = 112) were motor vehicle and motorcycle drivers. This paper presented an updated ethyl alcohol determination in the traffic accidents of the Izmir region in order to have an overall picture of Turkey. Continuous and systematic follow-up studies may help to monitor the alcohol use problem. [ABSTRACT FROM AUTHOR]

INTRODUCTION We aim to assess the association between smoking behavior and intracranial aneurysms (IAs) and the effect of smoking cessation medications on IAs at the genetic level. METHODS Causal effects of four phenotypes: 1) age at initiation of regular smoking, 2) cigarettes smoked per day, 3) smoking cessation, and 4) smoking initiation on IAs, were analyzed using two-sample inverse-variance weighted Mendelian randomization analyses. The effects of genes interacting with the smoking cessation medications were analyzed using cis-expression quantitative trait loci genetic instruments on IAs using summary statistics-based Mendelian randomization analyses. Colocalization analyses were then used to test whether the genes shared causal variants with IAs. The role of confounding phenotypes as potential causative mechanisms of IAs at these gene loci was tested. RESULTS Cigarettes smoked per day (OR=2.89; 95% CI:1.85-4.51) and smoking initiation on IAs (OR=4.64; 95% CI: 2.64-8.15) were significantly associated with IA risk. However, age at initiation of regular smoking (OR=0.54; 95% CI: 0.10-2.8) and smoking cessation (OR=6.80; 95% CI: 0.01-4812) had no overall effect on IAs. Of 88 genes that interacted with smoking cessation medications, two had a causal effect on IA risk. Genetic variants affecting HYKK levels showed strong evidence of colocalization with IA risk. Higher HYKK levels in the blood were associated with a lower IA risk. Gene target analyses revealed that cigarettes/ day could be a main mediator of HYKK's effect on IA risk. CONCLUSIONS This study provides evidence supporting that smoking initiation on IAs and cigarettes/day may increase IA risk. Increased HYKK gene expression may reduce IA risk. This can be explained by the increased number of cigarettes consumed daily. HYKK could also reduce IA risk due to the positive effect of continuous abstinence and varenicline therapy on smoking cessation. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndromes (MetS) are clinical syndromes involving multiple pathological states with distinct gender-specific clinical patterns. As a serious disorder associated with psychiatric conditions, the prevalence of MetS is significantly higher in the population with schizophrenia (Sch). The aim of this paper is to report gender differences in the prevalence, associated factors and severity-related factors of MetS in first-treatment and drug-naïve (FTDN) patients with Sch. Methods: A total of 668 patients with FTDN Sch were included in this study. We collected socio-demographic and general clinical information on the target population, measured and evaluated common metabolic parameters and routine biochemical indicators, and assessed the severity of psychiatric symptoms using Positive and Negative Symptom Scale (PANSS). Results: In the target group, the prevalence of MetS was significantly higher in women (13.44%, 57/424) than in men (6.56%, 16/244). In the males, waist circumference (WC), fasting blood glucose (FBG), diastolic blood pressure (DBP), and triglycerides (TG) were risk factors for MetS, while systolic blood pressure (SBP), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and platelet (PLT) were risk factors for the females. More importantly, for the females, we found that age, LDL-C, PANSS scores and blood creatinine (CRE) were risk factors for higher MetS scores, while onset age and hemoglobin (HGB) were protective factors. Conclusion: There are significant gender differences in the prevalence of MetS and its factors among patients with FTDN Sch. The prevalence of MetS is higher and the factors that influence MetS are more numerous and extensive in females. The mechanisms of this difference need further research and clinical intervention strategies should be formulated with gender differences. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity is likely to be a significant contributor to ill health and inequality in South Africa and yet has been largely overlooked. Purpose: This paper focuses on the findings of a recent large study that highlighted emerging issues - namely (i) the high levels of multimorbidity among three key groups - older adults, women, and the wealthy; (ii) discordant and concordant disease clusters among the multimorbid. Research Design: Narrative. Study Sample and Data Collection: Not applicable. Results: We discuss the implications of each emerging issue for health systems policy and practice. Conclusion: Although key policies are identified, many of these policies are not implemented and are therefore not part of routine practice, leaving much space for improvement. [ABSTRACT FROM AUTHOR]

Introduction: Alzheimer’s disease (AD) and Type 2 diabetes (T2D) are both ageassociated diseases. Identification of shared genes could help develop early diagnosis and preventive strategies. Although genetic background plays a crucial role in these diseases, we noticed an underrepresentation tendency of North African populations in omics studies. Materials and methods: First, we conducted a comprehensive review of genes and pathways shared between T2D and AD through PubMed. Then, the function of the identified genes and variants was investigated using annotation tools including PolyPhen2, RegulomeDB, and miRdSNP. Pathways enrichment analyses were performed with g:Profiler and EnrichmentMap. Next, we analyzed variant distributions in 16 worldwide populations using PLINK2, R, and STRUCTURE software. Finally, we performed an inter-ethnic comparison based on the minor allele frequency of T2D-AD common variants. Results: A total of 59 eligible papers were included in our study. We found 231 variants and 363 genes shared between T2D and AD. Variant annotation revealed six single nucleotide polymorphisms (SNP) with a high pathogenic score, three SNPs with regulatory effects on the brain, and six SNPs with potential effects on miRNA-binding sites. The miRNAs affected were implicated in T2D, insulin signaling pathways, and AD. Moreover, replicated genes were significantly enriched in pathways related to plasma protein binding, positive regulation of amyloid fibril deposition, microglia activation, and cholesterol metabolism. Multidimensional screening performed based on the 363 shared genes showed that main North African populations are clustered together and are divergent from other worldwide populations. Interestingly, our results showed that 49 SNP associated with T2D and AD were present in North African populations. Among them, 11 variants located in DNM3, CFH, PPARG, ROHA, AGER, CLU, BDNF1, CST9, and PLCG1 genes display significant differences in risk allele frequencies between North African and other populations. Conclusion: Our study highlighted the complexity and the unique molecular architecture of North African populations regarding T2D-AD shared genes. In conclusion, we emphasize the importance of T2D-AD shared genes and ethnicity-specific investigation studies for a better understanding of the link behind these diseases and to develop accurate diagnoses using personalized genetic biomarkers. [ABSTRACT FROM AUTHOR]

The misuse and abuse of opioids has become a serious public health threat in the United States. The state of California has been hit particularly hard by the opioid epidemic, with a noticeable increase in opioid-related fatalities and hospitalizations. This brief report paper aims to contribute to the growing literature by conducting a geospatial analysis of opioid dispensing patterns in California in 2021. The primary objective was to identify areas characterized by high-risk opioid dispending patterns and explore possible contributing factors. This retrospective study analyzed data from over 7 million records of opioid and benzodiazepine prescriptions dispensed by outpatient pharmacies in California in 2021. A series of generalized linear regression models was employed to assess the impact of neighborhood characteristics on opioid recipients and high-risk opioid dispensing. The study defined high-risk opioid dispensing behavior as: (1) multiple provider episodes, (2) overlapping opioid prescriptions for seven or more days, (3) overlapping opioid and benzodiazepine prescriptions for seven or more days, and (4) a high standardized dosage of opioid prescriptions per month. The study identified variables associated with high-risk opioid dispensing behaviors, including age, population density, income, and housing-related variables, as well as marital status and family-related variables. The study uncovered that there are noticeable disparities in opioid dispensing among different racial and ethnic groups within California. The findings indicated a correlation of high-risk dispensing indicators with certain demographic and socioeconomic factors. There was a substantial regional variation in opioid dispensing practices, with certain rural areas having higher rates of opioid prescriptions than urban areas. [ABSTRACT FROM AUTHOR]