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Studies on the long-term effects of rising temperature by climate change on mental health are limited. This study investigates the influence of temperature rise on the prevalence rate of depressive symptoms according to district type and age group in Korea. This cross-sectional study included 219,187 Korea Community Health Survey 2021 participants. Yearly average temperature and yearly average temperature difference are the main exposures of this study. Temperature difference was calculated by subtracting the historical average temperature in 1961–1990 (climate normal) from the yearly average temperature. The main outcomes are moderate depressive symptoms measured by Patient Health Questionnaire-9. Multilevel analyses were conducted to estimate the association between temperature factors and depressive symptoms. 7491 (3.4 %) participants reported moderate depressive symptoms, and 99,653 (69.9 %) participants lived in an urban district. The odds of depressive symptoms increased with 1 °C increase in temperature difference for all participants, adult participants aged 19–40, and participants who lived in same metropolitan area for 20 years or more (aOR = 1.13, CI: 1.04–1.24, aOR = 1.14, CI: 1.02–1.24, and aOR = 1.15 CI: 1.04–1.27). The association between temperature difference and depressive symptoms was consistent among urban districts participants. Due to the study's cross-sectional nature, the temporal association between regional and individual factors and depressive symptoms could not be assessed. Limited number of weather stations, especially among less populated in-land areas, may limit the accuracy of this study. Conclusion: The increase in temperature compared with historical average is associated with increased likelihood of depressive symptoms, especially for the adults aged 19–40 years old. More study on the long-term impact of climate change on mental health is needed to determine effective responses to climate change. [Display omitted] • Temperature rise over long-term average by climate change may affect mental health. • Temperature rise was associated with increased likelihood of depressive symptoms. • Early adults, urban area, and long-time residents were particularly vulnerable. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to provide a population-based evaluation of vaccination coverage to prevent respiratory complications from SARS-COV-2, influenza, and pneumococcus, among communitydwelling persons with spinal cord injury/disease. Design: This is a cross-sectional survey conducted in 2022, utilizing questionnaires administered to persons with spinal cord injury/disease living in Switzerland. Main outcomes were ever-vaccination rates for SARS-COV-2, influenza, and pneumococcus. Secondary outcomes included demographics, lesion and education levels, as well as respiratory and cardiovascular conditions. Vaccine hesitancy was additionally assessed for all three vaccines in nonvaccinated persons through questions on reasons for not getting vaccinated. Results: A total of 1158 persons participated in this survey. Overall vaccination rates were highest for SARS-COV-2 86.5% (95% CI = 84.4-88.3), followed by influenza 44.6 (41.7-47.6) and pneumococcus: 7.5% (6.0-9.3). The most prominent reasons for not being vaccinated were doubt on effectiveness (72.7%) and potential side effects (60%) for SARS-COV-2, patients did not feel at risk for influenza (57%) and insufficient information from the physician (52.4%) for pneumococcus vaccination. Conclusions: In individuals with spinal cord injury/disease, vaccination coverage is notably low for influenza and especially pneumococcus. Vaccine hesitancy varies between vaccination types and is associated with vaccine-specific reasons. These findings underscore the imperative for updated clinical vaccination guidelines, improved public health information, and targeted intervention programs for specific patient groups. [ABSTRACT FROM AUTHOR]

Study Design: Survey study. Objectives: People living with spinal cord injury (SCI) are major healthcare and rehabilitation services consumers and have unmet healthcare needs. This study aimed to describe the socioeconomic characteristics of people living with SCI in Spain and to determine the level of use and satisfaction with the public healthcare system. Methods: We conducted a survey (the Spanish version of the International Spinal Cord Injury Community Survey) consisting of 134 questions. We analyzed the age, sex, neurological classification of the injury on the American Spinal Injury Association Impairment Scale, time of injury, socio-occupational and socioeconomic status, and level of use and satisfaction with the public health system. Results: 472 people responded to the survey [68.9% male; mean age 51.2 years (standard deviation: 13.9 years); 61.7% with paraplegia and 38.3% with tetraplegia]. 89.2% of those surveyed were unemployed and 77.1% received a disability pension. The number of medical visits was 2.3/year, and 19.8% of the patients required at least 1 hospital admission during the previous year. 94.7% of the people with SCI considered the health care received as good or very good. Conclusions: Respondents with SCI in Spain considered they had good access to primary and specialized care and were satisfied with the healthcare system. Notably, we observed a high average of annual visits to medical professionals but a low rate of hospitalizations. Technical aids and state services related to disability should be the most important elements to be improved. [ABSTRACT FROM AUTHOR]

Abstract Background The Karamoja subregion in north-eastern Uganda has very high Tuberculosis (TB)case notification rates and, until recently, had suboptimal treatment completion rates among patients diagnosed with TB. We evaluated community knowledge, attitudes and practices towards Tuberculosis in order to identify barriers to TB control in this region. Methods From September to October 2022, we conducted a community-based survey in four districts in the Karamoja subregion. We collected data on TB knowledge, attitudes, and practices using a structured electronic questionnaire. We generated knowledge, attitude and practice scores. We used a survey-weighted zero-truncated modified Poisson model to assess the association between knowledge/attitude scores and respondents’ characteristics and a complementary log-log model to assess the association between practice scores and respondents’ characteristics. Data analysis was carried out using STATA version 14. Results A total of 1927 respondents were interviewed. Of these, 55.5% were female, and 1320 (68.6%) had no formal education. Overall, 68.5% 95% CI (59.6–76.7%) had knowledge scores of ≥ 60%. Higher TB knowledge scores were associated with being employed (adjusted prevalence ratio, aPR = 1.22, 95% CI 1.04–1.42, p = 0.01) while being a wife in a household was associated with lower TB knowledge (aPR = 0.90, 95% CI 0.82–0.99, p = 0.03). Being 25–34 years old was associated with a positive attitude towards TB (PR = 1.06, 1.01–1.11, p = 0.01). Over 85% of respondents would go to the health facility immediately if they had TB signs and symptoms. Almost all respondents (98.6%) would start TB treatment immediately if diagnosed with the disease. Conclusion More than two thirds of patients had good knowledge and practices towards TB which can be leveraged to improve uptake of TB control interventions in the region. Additional interventions to improve TB knowledge and practice should focus on specific segments within the communities e.g., older women in the households.

Background: The Karamoja subregion in north-eastern Uganda has very high Tuberculosis (TB)case notification rates and, until recently, had suboptimal treatment completion rates among patients diagnosed with TB. We evaluated community knowledge, attitudes and practices towards Tuberculosis in order to identify barriers to TB control in this region. Methods: From September to October 2022, we conducted a community-based survey in four districts in the Karamoja subregion. We collected data on TB knowledge, attitudes, and practices using a structured electronic questionnaire. We generated knowledge, attitude and practice scores. We used a survey-weighted zero-truncated modified Poisson model to assess the association between knowledge/attitude scores and respondents' characteristics and a complementary log-log model to assess the association between practice scores and respondents' characteristics. Data analysis was carried out using STATA version 14. Results: A total of 1927 respondents were interviewed. Of these, 55.5% were female, and 1320 (68.6%) had no formal education. Overall, 68.5% 95% CI (59.6–76.7%) had knowledge scores of ≥ 60%. Higher TB knowledge scores were associated with being employed (adjusted prevalence ratio, aPR = 1.22, 95% CI 1.04–1.42, p = 0.01) while being a wife in a household was associated with lower TB knowledge (aPR = 0.90, 95% CI 0.82–0.99, p = 0.03). Being 25–34 years old was associated with a positive attitude towards TB (PR = 1.06, 1.01–1.11, p = 0.01). Over 85% of respondents would go to the health facility immediately if they had TB signs and symptoms. Almost all respondents (98.6%) would start TB treatment immediately if diagnosed with the disease. Conclusion: More than two thirds of patients had good knowledge and practices towards TB which can be leveraged to improve uptake of TB control interventions in the region. Additional interventions to improve TB knowledge and practice should focus on specific segments within the communities e.g., older women in the households. [ABSTRACT FROM AUTHOR]

Background: It is difficult to quantify the impact of the COVID-19 pandemic on mental health as many community surveys have limited quality, rely on screening tests to measure mental health conditions and distress, and often use convenience samples. Moreover, robust surveys come mainly from high-income countries. Aim: To measure the prevalence of depressive disorders with onset during the pandemic in a community of a Lower-Middle-income country (LMIC)-Tunisia. Methods: Clinical semi-structured face-to-face interviews were carried out during the pandemic (September–December 2021) by medical doctors among a representative sample of the general population in the governorate of La Manouba, Tunisia. Psychiatric diagnoses were established according to DSM-IV. Results: The prevalence of Major Depressive Disorder (MDD) started or recurred after the pandemic was 5.66%. The factors associated with MDD were loss of job and considerably diminished income due to the pandemic (OR = 2.1, 95% CI [1.5, 2.9]) and the perception of having the family's financial situation below the Tunisian average (OR = 2.3, 95% CI [1.7, 3.2]). Female sex, marital status as separated/divorced, and having a COVID-19 infection were associated with MDD only in the overall sample and urban areas, but not in rural areas. Age and having loved ones who passed away due to COVID-19 were not associated with MDD. Conclusion: In Tunisia, the pandemic seems to have increased the risk of depression in people experiencing a precarious financial situation, also due to the pre-existing economic crisis. Specific local level factors, such as not establishing a rigid lockdown for an extended period, may have protected young people and allowed for better mourning in families suffering the loss of a loved one. [ABSTRACT FROM AUTHOR]

Children account for a significant proportion of antibiotic consumption in low- and middle-income countries, with overuse occurring in formal and informal health sectors. This study assessed the prevalence and predictors of residual antibiotics in the blood of children in the Mbeya and Morogoro regions of Tanzania. The cross-sectional community-based survey used two-stage cluster sampling to include children aged under 15 years. For each child, information on recent illness, healthcare-seeking behaviour, and use of antibiotics, as well as a dried blood spot sample, were collected. The samples underwent tandem mass spectrometry analysis to quantify the concentrations of 15 common antibiotics. Associations between survey variables and the presence of residual antibiotics were assessed using mixed-effects logistic regression. In total, 1742 children were surveyed, and 1699 analysed. The overall prevalence of residual antibiotics in the blood samples was 17.4% (296/1699), the highest among children under the age of 5 years. The most frequently detected antibiotics were trimethoprim (144/1699; 8.5%), sulfamethoxazole (102/1699; 6.0%), metronidazole (61/1699; 3.6%), and amoxicillin (43/1699; 2.5%). The strongest predictors of residual antibiotics in the blood were observed presence of antibiotics at home (adjusted odds ratio [aOR] = 2.9; 95% CI, 2.0–4.1) and reported consumption of antibiotics in the last 2 weeks (aOR = 2.5; 95% CI, 1.6–3.9). However, half (145/296) of the children who had residual antibiotics in their blood, some with multiple antibiotics, had no reported history of illness or antibiotic consumption in the last 2 weeks, and antibiotics were not found at home. This study demonstrated a high prevalence of antibiotic exposure among children in Tanzanian communities, albeit likely underestimated, especially for compounds with short half-lives. A significant proportion of antibiotic exposure was unexplained and may have been due to unreported self-medication or environmental pathways. Incorporating biomonitoring into surveillance strategies can help better understand exposure patterns and design antibiotic stewardship interventions. [ABSTRACT FROM AUTHOR]

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Concerning the forthcoming implementation of the Disposable Plastic Tableware Regulation in Hong Kong, the Social Impact Assessment approach can help decision-makers and government agencies predict and forecast the potential impacts of the regulation before its actual implementation. This study aims to 1) identify the potential impacts of the Regulation of Disposable Plastic Tableware in Hong Kong, in multiple aspects and through the eyes of multiple stakeholders; 2) analyze the interlinked relationships among these potential impacts; and 3) generate mitigation measures and monitoring plans to minimize the adverse impacts. Two rounds of questionnaires were collected from 11 experts using the Delphi method, followed by a community survey used to reach a wider population. The survey gathered opinions from 507 restaurant owners and 500 members of the general public. A cross-impact analysis was then conducted to analyze the complex interactions of impacts within and across different impact categories. These analyses inform the development of mitigation strategies and plans to monitor and prevent potential adverse impacts. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to assess the lifestyle-related behaviors of patients with gastric cancer (GC) and to investigate the associations between the time since GC diagnosis and these behaviors. Materials and Methods: This study included 29,478 adults (including 338 patients with GC) aged ≥ 40 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2021. Multiple logistic regression analysis explored the associations between the time since GC diagnosis (patients diagnosed with GC less than 5 years ago [<5 years group] and those diagnosed with GC 5 or more than years ago [≥5 years group]) and lifestyle factors. Subgroup analyses were conducted based on age and sex. Results: The current smoking rate was not lower in the GC group than in the healthy group, regardless of time since diagnosis. Compared to the healthy controls, monthly alcohol intake was lower in the <5 years group (odds ratio [OR], 0.450; 95% confidence interval [CI], 0.275–0.736). The ≥5 years group showed a lower rate of strength training (OR, 0.548; CI, 0.359–0.838), compared with the healthy control group. Subgroup analysis focusing on the ≥5 years group revealed a significantly lower rate of strength training, particularly in patients aged ≥65 years and male patients (OR, 0.519 and 0.553; CI, 0.302–0.890 and 0.340–0.901, respectively). Conclusions: Clinicians should continue educating patients on lifestyle behavior modifications, particularly alcohol abstinence, even beyond 5 years after GC diagnosis. Education on strength training is especially important for patients ≥65 years or male patients. [ABSTRACT FROM AUTHOR]

Abstract In this cross-sectional random survey among Thai adults living in Bangkok, we aimed to identify the prevalence of hearing problems and examine their relationship with individual factors. We administered a self-report questionnaire and performed pure-tone air conduction threshold audiometry. A total of 2463 participants (1728 female individuals) aged 15–96 years were included. The hearing loss prevalence was 53.02% and increased with age. The prevalence of a moderate or greater degree of hearing impairment was 2.8%. Participants aged 65 years and over had 8.56 and 6.79 times greater hearing loss and hearing impairment than younger participants, respectively. Male participants were twice as likely to have hearing loss and hearing impairment as female individuals. Participants with higher education levels showed less likelihood of having hearing loss and hearing impairment than those with no or a primary school education. Participants who ever worked under conditions with loud noise for > 8 h per day had 1.56 times greater hearing loss than those without such exposure. An inconsistent correlation was found between hearing loss, hearing impairment and noncommunicable diseases (diabetes, hypertension, and obesity). Although most participants had mild hearing loss, appropriate care and monitoring are necessary to prevent further loss in such individuals. The questionnaire-based survey found only people with hearing problems that affect daily communication.

Abstract Background Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area. Methods Six villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the “strong” educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a “weak” intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention. Results Overall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6–9.9) in the first intervention group, 1.9 mm Hg (95% CI − 0.5–4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4–7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis. Conclusions Community-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries. Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023.

Objective: The importance of researching the socio-emotional development of a child is reflected in the prevention of the risk of deviations in socio-emotional development with the aim of early intervention in work with children who deviate from normal development or belong to the group of children at neurological risk. The aim of the work was to determine the validity and reliability of the socio-emotional assessment scale for standardization of the measurement instrument in the Republic of Croatia and to determine the level of socio-emotional development of young children in order to determine possible deviations from orderly development and factors influencing socio-emotional development. Methods: The socio-emotional rating scale was used in the study as a measurement tool to assess the socio-emotional development of infants (from 2 to 18 months) as an instrument for early detection of developmental deviations. Sixty-three parents from Primorsko- Goranska County participated in the survey. Results: The psychometric properties of the socio-emotional scale showed that the instrument is valid for assessing socio-emotional development with Cronbach a=0.92. At the same time, the results showed that there were no statistically significant differences in the children's socio-emotional development in relation to birth weight, type of pregnancy, time and type of delivery, and the child's condition, indicating that the children's parents created all the conditions for promoting orderly socio-emotional development, regardless of possible risk factors. Conclusion: The obtained results show that the questionnaire for assessing socio-emotional development in this research is valid and reliable. The research has clearly demonstrated the importance of early assessment of a child's socio-emotional development to prevent developmental abnormalities through early intervention. The importance of assessing the validity of the questionnaire ensures its application in the work of outpatient nurses who assess infant health and development as part of comprehensive outpatient infant care. [ABSTRACT FROM AUTHOR]

Aim and background: Short, pragmatic measures of interpersonal violence are needed to facilitate effective evaluation and equitable translation of prevention interventions in low-resource contexts. Measures need to be (1) valid in contexts of high vulnerability, (2) capable of efficiently evaluating multiple forms of violence perpetration/victimization in diverse settings, (3) brief and inexpensive to users/implementers, and (4) sensitive to change. This study reports on the development and evaluation of a measure of adolescent interpersonal violence for use in lowresource contexts. Materials and methods: Informed by the “Psychometric and Pragmatic Evidence Rating Scale” (PAPERS) process, we followed a four-step process: (1) define violence using qualitative interviews with local stakeholders, (2) develop items for a pragmatic measure, (3) pilot the survey measure with target populations in two different low-resource contexts to evaluate the psychometric properties, and (4) review and revise the measure to maximize future use. Results: We synthesized qualitative interviews, community engagement (CE) studios, and expert reviews to generate 20 perpetration and 20 matched victimization items across eight categories of interpersonal violence. We then deployed the measure on adolescents from Nicaragua (N = 101) and the Dominican Republic (DR) (N = 111) who were participating in school-based violence prevention interventions. Exploratory factor analysis (EFA) resulted in an eight-item, one-factor measure in Nicaragua and a 10-item, one-factor measure in the DR. The psychometric evaluation demonstrates acceptable reliability but limited statistically significant findings for some validity tests. Conclusion: Drawing from existing measures and sequential mixed methods analysis in low-resource contexts in Latin America and the Caribbean (LAC), we present a pragmatic measure for tapping into adolescent interpersonal violence. Additional refinement and cultural adaptation may be needed in each specific context to achieve maximum practicality. Clinical significance: Synthesizing existing measures into pragmatic ones improves researchers’ ability to evaluate outcomes of psychosocial health interventions. [ABSTRACT FROM AUTHOR]

Background. The infant mortality rate (IMR) (24 per 1 000 live births) remains high in South Africa (SA), well above the recommended sustainable development goal (SDG) 3 of 12 deaths per 1 000 live births. High infant mortality is a poor indicator of the health of a population and will hamper attainment of the SDGs. Objectives. To investigate the trends and distribution patterns of IMR between 2007 and 2016 and its association with HIV-positive pregnant mothers in SA. Methods. This study used a cross-sectional study design by analysing secondary data on infant mortality from the 2007 and 2016 Statistics South Africa Community Surveys (CSs), as well as data from the 2007 National Antenatal Sentinel HIV and Syphilis Prevalence Survey. (Antenatal HIV Sentinel Survey – ANCHSS). Line charts with descriptive statistics were used to detail trends in IMRs, and multiple logistic regression models were used to identify risk factors for infant mortality in the 2007 and 2016 CS datasets. Spearman’s rank-order correlation (rho) was used to correlate infant mortality with data from the 2007 ANCHSS. All analyses were performed with Stata version 16.0. Results. A total sample of 87 805, comprising 43 922 males and 43 883 females, was included in the analysis. The results revealed a decline in IMR from 55 deaths per 1 000 live births in 2007 to 32 in 2016. Overall, there was a significant decrease in the mortality rate from 2007 to 2016. The infant mortality proportions by province showed KwaZulu-Natal Province having the highest IMR (17.5 deaths per 1 000 live births in 2007 and 6.3 in 2016). Males had a higher IMR (28 deaths per 1 000 live births in 2007 and 17.7 in 2016) compared with females at 26.7 deaths per 1 000 live births in 2007 and 13.8 in 2016. IMR data from the 2007 CS was correlated with the 2007 ANCHSS (28% HIV prevalence in 2007), using Spearman’s rank-order correlation, which showed a moderate correlation of 0.58 (p

Summary: Background: Emerging research indicates growing concern over long COVID globally, although there have been limited studies that estimate population burden. We aimed to estimate the burden of long COVID in three districts of Haryana, India, using an opportunity to link a seroprevalence study to follow-up survey of symptoms associated with long COVID. Methods: We used a population-based seroprevalence survey for COVID-19 conducted in September 2021 across Haryana, India. Adults from three purposively selected districts (Rohtak, Gurugram, and Jhajjar) were eligible to participate; 2205 of 3213 consented to participate in a survey on health status. Trained investigators administered a structured questionnaire that included demographic characteristics, self-reported symptoms of illness in the last six months before the survey, mental health, and history of COVID-19. Findings: Unadjusted regression estimates indicated positive correlations between symptomatic complaints and COVID-19 exposure, suggesting lingering effects of COVID-19 in this population. The overall physical morbidity index was higher among those who tested positive for COVID-19, as was the incidence of new cases. However, both morbidity and incidence became statistically insignificant after adjustment for multiple comparisons. Cough emerged as the only statistically significant individual persistent symptom. Sex-stratified analyses indicated significant estimates only for physical morbidity in women. Interpretation: This study is one of the first from India that uses a large population-based sample to examine longer term repercussions of COVID infections. The burden of long COVID should primarily be addressed in clinical settings, where specialised treatment for individual cases continues to evolve. Our analyses also provide insight into the size and nature of studies required to assess the population-level burden of long COVID. Funding: This paper was produced under the auspices of the Lancet COVID 19 Commission India Task Force, which was supported financially by the Reliance Foundation. The Lancet COVID 19 Commission was set up in July 2020 and submitted its final report by October 2022. This report by the India Task Force was prepared during the same period.

Abstract Introduction Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by progressive muscle weakness and atrophy. While chronic fatigue is a common manifestation of SMA, the field lacks comprehensive data to assess the extent of its impact. Cure SMA, an SMA patient advocacy organization, conducted an online survey of its adults with SMA community members to measure the impact of fatigue. Methods All survey respondents were asked to complete questions on demographics, use of SMA treatment, and quality of life, but respondents were randomized to receive three of the following fatigue instruments: the Modified Fatigue Impact Scale (MFIS), Multidimensional Fatigue Inventory (MFI), Fatigue Severity Scale (FSS), PedsQL™ Multidimensional Fatigue (PedsQL MF) Scale, and Spinal Muscular Atrophy Health Index (SMA-HI) fatigue modules. Scales were evaluated for reliability and overall fatigue scores were evaluated by multivariate regression models to determine which variables were related to the final scores of each instrument. Results A total of 253 adults completed the online survey. When measured against the general population, statistically significant differences were found among adults with SMA for certain variables within each measurement instrument. However, there did not appear to be differences in fatigue levels among key subgroups within the SMA population. Conclusions This was the first use of more than two fatigue questionnaires simultaneously in SMA. The lack of a consistent relationship between SMA severity and fatigue levels was surprising. This may be related to the lack of specificity of the instruments for this population. An SMA-specific scale is needed to evaluate differences in fatigue impact across the SMA population.

The aim of this study was to examine the construct and known-groups validity of the total score of five items adapted from the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure outdoor walking (CHAMPS-OUTDOORS) in older adults. Data from the baseline assessment of the Getting Older Adult OUTdoors (GO-OUT) trial were used. Construct validity of the CHAMPS-OUTDOORS used objective measures of outdoor walking (accelerometry–GPS), Ambulatory Self-Confidence Questionnaire, RAND-36, 6-min walk test, 10-m walk test, and Mini-Balance Evaluation System Test. For known-groups validity, we compared the CHAMPS-OUTDOORS of those who walked < or ≥1.2 m/s. Sixty-five participants had an average age of 76.5 ± 7.8 years. The CHAMPS-OUTDOORS was moderately correlated with total outdoor walking time (r =.33) and outdoor steps (r =.33) per week measured by accelerometry-GPS, and weakly correlated with Mini-Balance Evaluation System Test score (r =.27). The CHAMPS-OUTDOORS did not distinguish known groups based on crosswalk speed (p =.33). The CHAMPS-OUTDOORS may be used to assess outdoor walking in the absence of accelerometry GPS. Further research examining reliability is needed. [ABSTRACT FROM AUTHOR]

Introduction: Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by progressive muscle weakness and atrophy. While chronic fatigue is a common manifestation of SMA, the field lacks comprehensive data to assess the extent of its impact. Cure SMA, an SMA patient advocacy organization, conducted an online survey of its adults with SMA community members to measure the impact of fatigue. Methods: All survey respondents were asked to complete questions on demographics, use of SMA treatment, and quality of life, but respondents were randomized to receive three of the following fatigue instruments: the Modified Fatigue Impact Scale (MFIS), Multidimensional Fatigue Inventory (MFI), Fatigue Severity Scale (FSS), PedsQL™ Multidimensional Fatigue (PedsQL MF) Scale, and Spinal Muscular Atrophy Health Index (SMA-HI) fatigue modules. Scales were evaluated for reliability and overall fatigue scores were evaluated by multivariate regression models to determine which variables were related to the final scores of each instrument. Results: A total of 253 adults completed the online survey. When measured against the general population, statistically significant differences were found among adults with SMA for certain variables within each measurement instrument. However, there did not appear to be differences in fatigue levels among key subgroups within the SMA population. Conclusions: This was the first use of more than two fatigue questionnaires simultaneously in SMA. The lack of a consistent relationship between SMA severity and fatigue levels was surprising. This may be related to the lack of specificity of the instruments for this population. An SMA-specific scale is needed to evaluate differences in fatigue impact across the SMA population. [ABSTRACT FROM AUTHOR]

Objective: Critical gaps remain in understanding community perceptions and treatment‐seeking behaviours in case of fever. This is especially relevant considering global antimicrobial resistance, where fever is assumed to provoke non‐judicious antibiotic use. Our study objective was therefore to document the community‐level incidence of fever, the resulting treatment‐seeking processes, and their underlying behavioural drivers. Methods: In a cross‐sectional observational design, we used descriptive and inferential statistics and multivariable regression analysis to estimate the population‐level incidence of fever and individual and socio‐economic factors associated with treatment‐seeking process characteristics. We utilised a detailed publicly available survey of community‐level treatment‐seeking behaviour (collected in 2017/2018), comprising a representative sample of 2130 rural adults in Thailand (Chiang Rai Province) and Lao PDR (Salavan Province). Results: Fever was reported by 7.1% of the rural adult population in Chiang Rai (95% CI: 5.1%–9.0%) and 7.5% in Salavan (95% CI: 4.5%–10.5%) during a 2‐month recall period. Treatment‐seeking patterns varied by socio‐economic characteristics like precarious employment. 69.3% (95% CI: 60.8%–77.7%) of fever episodes involved access to formal (public/private) healthcare providers, 11.0% (95% CI: 4.5%–17.5%) involved informal providers, and 24.3% (95% CI: 16.6%–32.1%) took place without either formal or informal healthcare access. Febrile patients had on average 0.39 antibiotic use episodes when accessing formal healthcare settings, compared to 0.05 otherwise (p < 0.01). Conclusion: Treatment‐seeking behaviour during fever varies according to population characteristics. Clinical studies would benefit from contextualising quantitative outcomes. Treatment algorithms for non‐malarial febrile illnesses should involve outreach to informal healthcare and community settings to support patients in precarious circumstances, and antibiotic resistance interventions should prioritise formal healthcare facilities. [ABSTRACT FROM AUTHOR]

Introduction: Seasonal influenza is a contagious viral respiratory condition typically occurring in the fall to early spring months of the year globally. The risk of infection from seasonal influenza can be greatly reduced with vaccination. Unfortunately, research has indicated that the seasonal influenza vaccination rate in Saudi Arabia is low. This study assessed the uptake of seasonal influenza vaccination among adults residing in Al-Jouf region, Saudi Arabia. Materials and Methods: A cross-sectional survey targeting adults (20–80 years) residing in Al-Jouf region, Saudi Arabia, was conducted to gather information about their sociodemographic characteristics, chronic conditions, knowledge about periodic health examinations (PHE), regular use of PHE, and uptake of seasonal influenza vaccination. Comparative statistics and a multivariate logistic regression analysis were conducted to determine characteristics associated with the uptake of seasonal influenza vaccination. Results: A total of 624 respondents completed the survey and participated in this study. Among the participants, 27.4% indicated they visited their primary healthcare centers or hospitals every year to get a seasonal influenza vaccination. The regression analysis showed that the odds of getting a seasonal influenza vaccination were higher among employed respondents (Odds Ratio [OR] = 1.73; P = 0.039), respondents who were employees of the healthcare sector (OR = 2.31; P = 0.001), and those with a higher PHE Knowledge Score (OR = 1.22; P = 0.008), compared to their counterparts. Conclusions: Seasonal influenza is a serious condition warranting appropriate prevention measures, including vaccination. However, this study confirmed low rates of seasonal influenza vaccination in Al-Jouf Region of Saudi Arabia. Interventions to boost vaccination uptake, in particular among unemployed individuals, those not working in the healthcare sector, and those with lower PHE knowledge Scores, are therefore recommended.

IntroductionThe number and proportion of older adults living alone is a significant issue. While the number of the oldest old people is also expected to increase, their health characteristics are poorly understood. This study aims to evaluate the health-related quality of life (HRQoL) of the oldest old people according to age, sex, and living arrangements.MethodsThis study is based on the Korea Community Health Survey 2021. Among the survey's 229,242 observations, 73,617 observations aged 65 or higher were used for the analysis. The study participants were divided into 5-year age intervals (from 65–69 to 90+), sex, and living arrangements. The outcome variables are the EuroQol 5 Dimensions (EQ-5D) index score and the problem reporting rates of the five dimensions of EQ-5D.ResultsThe mean EQ-5D index scores were 0.896 at 65–69 and 0.741 at 90+. The mean EQ-5D index score decreased more rapidly as age increased. Women showed consistently lower mean EQ-5D index scores than men in all age intervals. The proportion of older adults living alone increased from 18.1% at 65–69 to 43.6% at 90+. The odds of reporting problems with anxiety/depression among older men living alone were estimated to be significantly higher than older men living with someone (aOR 1.22 95% CI 1.05–1.43). The odds of reporting problems in self-care and usual activity among older women living alone were estimated to be significantly lower than older women living with someone (aOR 0.88 95% CI 0.70–0.83 and aOR 0.88 95% CI 0.82–0.94)ConclusionThis study showed that older adults' HRQoL deteriorates as their age increases. Moreover, living alone may lead to different effects on older adults' HRQoL according to sex. More comprehensive studies and collaborative attention are needed to identify and provide customized care for older adults.

This cross-sectional observational study examined the cluster groups of risk behaviors and beliefs associated with non-communicable diseases (NCDs) and the demographic factors that influence these cluster groups. The questionnaire survey was conducted in Lohagara Upazila in Narail District, Bangladesh and included basic demographics and items associated with NCDs. The inclusion criteria for the participants in this study included those who were aged between 20 and 80 years and both sexes. The survey items were based on risk behavior, belief, and improvement behavior. To identify the several cluster groups based on NCD-related behavior and belief patterns, a log-likelihood latent class analysis was conducted. Then, a multinomial regression analysis was performed to identify the factor associated with each cluster group. Of the 600 participants, 231 (38.5%) had hypertension, 87 (14.5%) had diabetes, and 209 (34.8%) had a body mass index of 25 or more. Finally, risk behaviors and beliefs associated with NCDs were classified into three cluster groups: (1) very high-risk group (n = 58); (2) high-risk group (n = 270); and (3) moderate-risk group (n = 272). The very high-risk group was significantly associated with female gender, older age, fewer years spent in education, and the absence of daily medication compared to the moderate-risk group. Educational interventions in rural Bangladesh should be immediately implemented to improve the risk behaviors and beliefs associated with NCDs. [ABSTRACT FROM AUTHOR]

Background: Globally, the average age of the world's population of older people continues to rise and having a good social support network becomes increasingly relevant with the aging populace. Overall, in Malaysia, social support prevalence was low among older persons. This study was conducted to determine the association between social support and smoking status among the older Malaysian population. Methods: Data were obtained from the National Health and Morbidity (NHMS) 2018 survey on the health of older Malaysian adults and analyzed. This cross-sectional population-based study used a two-stage stratified random sampling design. Sociodemographic characteristics, smoking status, and social support data were collected from respondents aged 60 years and more. A validated Malay language interviewer-administered questionnaire of 11-items, the Duke Social Support Index, was utilized to assess the social support status. A multivariable logistic regression analysis was used to assess the association of social support and smoking status among the respondents. Results: The prevalence of good social support was significantly higher among the 60–69 years old (73.1%) compared to the ≥80 years old respondents (50%). Multivariate logistic regression analysis showed that respondents aged ≥80 years old were 1.7 times more likely to have poor social support compared to those aged 60–69 years. Respondents with no formal education were 1.93 times more likely to have poor social support compared to respondents who had tertiary education. Respondents with an income of MYR 3000. Former smokers had good social support compared to current smokers (73.6% vs. 78.7%). For current smokers, they had poor social support, which is almost 1.42 times higher than that for non-smokers. Conclusion: There was poor social support among older people who were current smokers, had an increased age, had no formal education and had a low income. The findings obtained from this study could assist policymakers to develop relevant strategies at the national level to enhance the social support status among older smokers and aid in their smoking cessation efforts. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) vaccination campaign highlighted the requirement to better understand the needs of different populations. French-speaking minorities (FSMs) have greater difficulty accessing quality care in French, and this problem was exacerbated during the COVID-19 pandemic. Objective: The aim of this survey was to develop a descriptive portrait of the health needs of FSMs in relation to the COVID-19 vaccination campaign by describing their vaccination status, attitudes and beliefs compared with English-speaking majorities. Methods: A survey was conducted among eligible participants using convenience sampling. Data measurement includes a descriptive statistical comparison using analysis of the variance, univariate logistic regressions and a two-proportions z-test. Results: Of the 1,505 respondents (554 FSMs vs. 951 English speakers), the FSMs have an average age of 51.4 years and 89.2% are Canadian citizens. Vaccination of children was preponderant among English speakers (74.2% vs. 86.3%), including against COVID-19 (58.6% vs. 73.9%). A higher proportion of FSMs had gotten vaccinated in order to obtain a vaccine passport (39% vs. 29.3%). Among the unvaccinated, FSMs were more likely to question the efficacy of vaccines (60% vs. 36.4%). Canadian citizen FSMs with higher education could be divided in relation to the vaccine regimen. Conclusion: This survey revealed differences between FSMs and the English-speaking majority in their perceptions of vaccine efficacy, particularly vaccination of children, and a polarization of attitudes/beliefs among FSMs according to certain sociodemographic factors. [ABSTRACT FROM AUTHOR]

We partnered with African American churches in South Los Angeles (LA) and trained Community Health Advisors (CHAs) to assess cancer screening. The purpose of this analysis is to report adherence to national cancer screening guidelines among African Americans in South LA, to assess relationships between adherence to colorectal cancer and other cancer screening guidelines, and to explore regional differences in screening rates. Between 2016 and 2018, 44 CHAs surveyed 777 African Americans between 50 and 75 years of age. Among 420 South LA residents, 64% of men and 70% of women were adherent to colorectal cancer screening guidelines. Adherence to mammography screening guidelines was 73%. Adherence to cervical cancer screening guidelines among women 50 to 65 years of age without hysterectomy was 80%. Fifty-nine percent of men had ever discussed the Prostate Specific Antigen (PSA) test with a physician. Adherence to colorectal cancer screening guidelines was significantly higher among respondents who were adherent to other cancer screening guidelines compared to their peers who were not adherent to other cancer screening guidelines (all p

Traditional small mammal survey methods (e.g., Sherman traps) are beneficial in certain conditions but tend to require substantial effort and funds and can introduce various biases. The recently described adapted-Hunt drift fence technique (AHDriFT) camera trap system (i.e., camera traps combined with drift fences) can survey small terrestrial vertebrates and does not require much time in the field. Our objective was to compare the efficiency and effectiveness of AHDriFT systems and traditional Sherman traps for surveying small mammal communities. We conducted surveys with both methods in four sites of varying habitat types at the Eagle Marsh Nature Preserve (Fort Wayne, Indiana) from February to July in 2020 and May to August in 2021. We conducted 640 trap nights (one trap set on one calendar night) of Sherman trap surveys and 551 trap nights of AHDriFT system surveys. We captured 192 small mammals of three species with Sherman traps and obtained 532 images of unique small mammal individuals of seven species with AHDriFT systems. Our AHDriFT systems resulted in two times greater species richness (Z = −6.21, P < 0.01), 16 times greater species evenness (Z = −4.83, P < 0.01), and 23 times greater Shannon's diversity values (Z = −4.87, P < 0.01) than Sherman traps. The AHDriFT systems also documented the presence of four species that the Sherman traps did not (northern short-tailed shrew Blarina brevicauda, common shrew Sorex cinereus, long-tailed weasel Neogale frenata, eastern chipmunk Tamias striatus). Overall, AHDriFT system surveys provided 1.5–5 times more observations per dollar spent and required 90% less time in the field than Sherman trap surveys. These results suggest that AHDriFT systems may be a more efficient and effective method of surveying small mammal communities. [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to examine the public response to public health and media messaging during the human monkeypox virus (MPXV) outbreak in the UK, focusing on at‐risk communities. Methods: A co‐produced, cross‐sectional survey was administered in June and July 2022 using community social media channels and the Grindr dating app. Basic descriptive statistics, logistic regression, and odds ratio p values are presented. Results: Of 1932 survey respondents, 1750 identified as men, 88 as women, and 64 as gender non‐conforming. Sexual identity was described as gay/lesbian/queer (80%), bisexual (12%), heterosexual (4%), and pansexual (2%); 39% were aged <40 years; 71% self‐identified as White, 3% as Black, 8% as Asian, 2%as LatinX, and 11% as 'Mixed or Other' heritage groups. In total, 85% were employed and 79% had completed higher education. A total of 7% of respondents identified themselves as living with HIV. Overall, 34% reported limited understanding of public health information, 52% considered themselves at risk, 61% agreed that people with MPXV should isolate for 21 days, 49% reported they would first attend a sexual health clinic if symptomatic, 86% reported they would accept a vaccine, and 59% believed that MPXV originated from animals. The most trusted sources of information were healthcare professionals (37%), official health agencies (29%), and mainstream media (12%). Conclusions: Vaccine acceptability was very high, yet the understanding and acceptance of public health information varied. Social determinants of health inequalities already shaping the UK landscape risk were compounded in this new emergency. Engagement with structurally disadvantaged members of affected communities and better dissemination of public health messaging by trusted healthcare professionals are essential for the public health response. [ABSTRACT FROM AUTHOR]

Seasonal influenza is a contagious viral respiratory condition typically occurring in the fall to early spring months of the year globally. The risk of infection from seasonal influenza can be greatly reduced with vaccination. Unfortunately, research has indicated that the seasonal influenza vaccination rate in Saudi Arabia is low. This study assessed the uptake of seasonal influenza vaccination among adults residing in Al-Jouf region, Saudi Arabia. A cross-sectional survey targeting adults (20–80 years) residing in Al-Jouf region, Saudi Arabia, was conducted to gather information about their sociodemographic characteristics, chronic conditions, knowledge about periodic health examinations (PHE), regular use of PHE, and uptake of seasonal influenza vaccination. Comparative statistics and a multivariate logistic regression analysis were conducted to determine characteristics associated with the uptake of seasonal influenza vaccination. A total of 624 respondents completed the survey and participated in this study. Among the participants, 27.4% indicated they visited their primary healthcare centers or hospitals every year to get a seasonal influenza vaccination. The regression analysis showed that the odds of getting a seasonal influenza vaccination were higher among employed respondents (Odds Ratio [OR] = 1.73; P = 0.039), respondents who were employees of the healthcare sector (OR = 2.31; P = 0.001), and those with a higher PHE Knowledge Score (OR = 1.22; P = 0.008), compared to their counterparts. Seasonal influenza is a serious condition warranting appropriate prevention measures, including vaccination. However, this study confirmed low rates of seasonal influenza vaccination in Al-Jouf Region of Saudi Arabia. Interventions to boost vaccination uptake, in particular among unemployed individuals, those not working in the healthcare sector, and those with lower PHE knowledge Scores, are therefore recommended. [ABSTRACT FROM AUTHOR]

This community-based project explored levels of father-friendliness across local organizations, agencies, and schools. A community coalition of individuals from diverse backgrounds and roles created a community survey to gather quantitative and qualitative information from individuals who worked with children or families. An analysis of survey responses (N=122) led to descriptive and thematic results of how the community served or marginalized fathers. Results were used to guide efforts in father engagement across various professional sectors. [ABSTRACT FROM AUTHOR]

Spinal cord stimulation (SCS) clinical trials are evaluating its efficacy and safety for motor, sensory, and autonomic recovery following spinal cord injury (SCI). The perspectives of people living with SCI are not well known and can inform the planning, delivery, and translation of SCS. To obtain input from people living with SCI on the top priorities for recovery, expected meaningful benefits, risk tolerance, clinical trial design, and overall interest in SCS. Data were collected anonymously from an online survey between February and May 2020. A total of 223 respondents living with SCI completed the survey. The majority of respondents identified their gender as male (64%), were 10+ years post SCI (63%), and had a mean age of 50.8 years. Most individuals had a traumatic SCI (81%), and 45% classified themselves as having tetraplegia. Priorities for improved outcome for those with complete or incomplete tetraplegia included fine motor skills and upper body function, whereas priorities for complete or incomplete paraplegia included standing and walking, and bowel function. The meaningful benefits that are important to achieve are bowel and bladder care, less reliance on caregivers, and maintaining physical health. Perceived potential risks include further loss of function, neuropathic pain, and complications. Barriers to participation in clinical trials include inability to relocate, out-of-pocket expenses, and awareness of therapy. Respondents were more interested in transcutaneous SCS than epidural SCS (80% and 61%, respectively). SCS clinical trial design, participant recruitment, and translation of the technology can be improved by better reflecting the priorities and preferences of those living with SCI identified from this study. [ABSTRACT FROM AUTHOR]

ObjectivesThe goal of this study was to establish relationships with Latino churches in South Los Angeles and to collect data from parishioners regarding their access to care, cancer risk factors, and cancer-related knowledge, attitudes and screening.MethodsIn 2014, we approached five Latino churches. All allowed us to describe the study and to consent potential respondents at a designated time during the church service.Results398 Latino respondents (75% female) completed the survey in English (15%) or Spanish (85%). Most respondents were born in Mexico (63%). Only 56% had health insurance and 51% had a regular doctor. Based on self-reported height and weight, 33% were overweight and 51% were obese. However, only 42% of obese respondents had been told by their doctor that they were obese. Although it is well-established that obesity is a major cancer risk factor, respondents lacked knowledge about the important role of nutrition and exercise in cancer prevention. Among women, adherence to national screening guidelines was 88% for cervical cancer, 72% for breast cancer and 58% for colorectal cancer. However, they were quite willing to undergo cancer screening if recommended by a physician and reported few barriers to colorectal cancer screening.ConclusionsOur data suggest a need to focus on both primary and secondary cancer prevention by promoting healthy lifestyles to curb the obesity epidemic and by promoting colorectal cancer screening. These data will inform future interventions to promote wellness in South Los Angeles in collaboration with the Latino faith community.

Urban centers around the world are grappling with the challenges associated with population increases, drought, and projected water shortages. Potable water reuse (i.e., purification of municipal wastewater for reuse as drinking water) is an option for supplementing existing water supplies. Public perception research on potable water reuse has predominantly employed surveys with multiple‐choice questions that constrain survey respondents to describe their concerns by choosing from several response options. This research examines hundreds of write‐in responses to a large public survey in Albuquerque, New Mexico, to provide a detailed analysis of residents' questions and concerns about potable water reuse. Findings demonstrate that allowing respondents to voice their actual concerns adds richness and nuance that cannot be obtained from multiple‐choice response data alone. Especially with controversial resource considerations, such as potable water reuse, planners would benefit from a full understanding of the problem before engaging with the community. [ABSTRACT FROM AUTHOR]

Unpaid or informal caregivers are people who provide assistance without compensation to adults and children who require care beyond typical needs. Although often rewarding, informal caregiving can be associated with high rates of depression, stress, anxiety, sleep and endocrine system disruption, immunosuppression, and general morbidity and mortality. Few recent studies of informal caregivers have included data from American Indians and Alaska Natives (AI/AN). Given this noteworthy gap in the literature, we surveyed a total of 225 AI/ANs attending two cultural, community functions in the Pacific Northwest to gain a general understanding of frequency of caregiving, caregiver and recipient characteristics, caregiving duties, support needs, and financial, emotional, and physical strains as a consequence of caregiving. Of the 225 participants who completed the survey, 90 (40%) indicated that they had been an unpaid caregiver for a month or more and 28 (12%) were current unpaid caregivers. Consistent with prior research, most caregivers (84%) reported satisfaction from providing help, but 84% of caregivers reported experiencing "increased stress," 40% reported financial strain, and 34% reported decreased health "because of involvement with providing care." Our data also suggested a disproportionate impact on AI/AN women given higher rates of being a caregiver compared to other populations and less support from others in their communities. Our data suggest similarities for AI/AN caregivers with other groups of caregivers but also emphasize the importance of including AI/AN populations in future research in order to understand ways to best serve their unique needs. [ABSTRACT FROM AUTHOR]

Patient-centric drug development is crucial to creating treatments that address unmet patient needs but is often ignored. The COPD Foundation's COPD360Net® includes a multistakeholder approach for operationalizing patient-centric development of treatments where patients, caregivers, scientists, and clinicians review opportunities based on scientific merit, potential to address an unmet need, and feasibility of adoption. COPD360Net deploys large-scale online community surveys to review profiles of potential therapies based on those criteria. This approach was implemented to inform the development of an intranasal spray to prevent viral respiratory infections (VRIs), a major cause of exacerbations in people with chronic lung diseases. Insights included: Of the 376 respondents with COPD surveyed, frequent exacerbators reported strong interest in a new type of antiviral nasal spray to prevent VRI. Patient survey and advisory committee insights demonstrated that a pan antiviral nasal spray has potential high value to both clinicians and patients and informed the COPD360Net decision to partner on its development. Including patient perspectives from the outset can be conducted efficiently by mobilizing an engaged online patient community. [ABSTRACT FROM AUTHOR]

Abstract Large rivers and their estuaries are structurally complex and comprise a diversity of habitats supporting a rich biodiversity. As a result, identifying and monitoring fish communities using traditional methods in such systems may often be logistically challenging. Using the mitochondrial DNA 12S MiFish primers, we performed an eDNA metabarcoding analysis to assess the effect of spatial and environmental factors on the variation of the fish community structure along most of the St. Lawrence River/Estuary/Gulf (Québec Canada), a transect spanning 1300 km across a diversity of habitats from a fluviatile non‐tidal section to a marine environment. A total of 129 species were identified including freshwater and marine species. For the freshwater sectors, eDNA identified 80 species compared with the 85 species previously reported based on conventional sampling. eDNA also revealed similar species diversity and communities in the fluviatile section of the St. Lawrence River. Furthermore, our study improved current knowledge about the brackish and marine sections by describing community transition between freshwater and marine fish communities in association with a drastic shift in environmental conditions observed between the end of the fluvial estuary and the beginning of the middle (brackish) estuary. Altogether, this study exemplifies how eDNA metabarcoding is a powerful tool to document fish community shifts in large temperate lotic ecosystems.

Objectives: This study described leisure-time physical activity (LTPA) for people in Australia with spinal cord injury (SCI) and whether certain sociodemographic and psychosocial variables might be associated with LTPA uptake and guidelines adherence.Methods: The Physical Activity Scale for Individuals with a Physical Disability was used to measure the intensity and volume of LTPA of 1,579 individuals with SCI. Summary statistics were calculated for LTPA guidelines adherence. Analyses included regression modelling.Results: Of the 1,579 participants, 58% performed LTPA and 13% adhered to recommended guidelines for weekly LTPA. There was an association with being an “exerciser” based on the time since injury (OR = 1.02 [95% 1.01–1.03]), a traumatic injury (OR = 1.53 [95% CI 1.13–2.08]) and a higher self-rating of health (OR = 1.10 [95% CI 0.95–1.27]). Where LTPA guidelines were met, adherence was most related to a traumatic injury (OR = 1.75 [95% CI 1.02–3.02]) and being unemployed (OR = 1.53 [95% CI 1.03–2.25]).Conclusion: Of those who performed LTPA with SCI, one in four met population-specific LTPA guidelines. Sociodemographic variables were moderately associated with being an “exerciser” or LTPA “guideline-adherent.”

Background: For community-dwelling elderly individuals without enough clinical data, it is important to develop a method to predict their dementia risk and identify risk factors for the formulation of reasonable public health policies to prevent dementia.Objective: A community elderly survey data was used to establish machine learning prediction models for dementia and analyze the risk factors.Methods: In a cluster-sample community survey of 9,387 elderly people in 5 subdistricts of Wuxi City, data on sociodemographics and neuropsychological self-rating scales for depression, anxiety, and cognition evaluation were collected. Machine learning models were developed to predict their dementia risk and identify risk factors.Results: The random forest model (AUC = 0.686) had slightly better dementia prediction performance than logistic regression model (AUC = 0.677) and neural network model (AUC = 0.664). The sociodemographic data and psychological evaluation revealed that depression (OR = 3.933, 95% CI = 2.995-5.166); anxiety (OR = 2.352, 95% CI = 1.577-3.509); multiple physical diseases (OR = 2.486, 95% CI = 1.882-3.284 for three or above); "disability, poverty or no family member" (OR = 1.859, 95% CI = 1.337-2.585) and "empty nester" (OR = 1.339, 95% CI = 1.125-1.595) in special family status; "no spouse now" (OR = 1.567, 95% CI = 1.118-2.197); age older than 80 years (OR = 1.645, 95% CI = 1.335-2.026); and female (OR = 1.214, 95% CI = 1.048-1.405) were risk factors for suspected dementia, while a higher education level (OR = 0.365, 95% CI = 0.245-0.546 for college or above) was a protective factor.Conclusion: The machine learning models using sociodemographic and psychological evaluation data from community surveys can be used as references for the prevention and control of dementia in large-scale community populations and the formulation of public health policies. [ABSTRACT FROM AUTHOR]

Background: Public stigma is a form of devaluation by other people's negative reactions to a specific behavior or mental health condition. When dealing with the physical consequences of addiction, substance users experience distress due to negative prejudice against them and their families. Method: In Shanghai, China, a community survey was conducted with four experimental vignettes to examine the general public's experience with mental health issues and their perceptions toward substance users. Respondents were randomly assigned to answer one of these vignettes regarding public stigma toward a male or female vignette subject (VS) with substance addiction. Results: Data from 123 respondents showed no statistical significance in public stigma perception toward a male or female subject either with alcohol or cocaine misuse problems. However, older individuals perceived mental illness more negatively when it is connected to substance addiction. These respondents see public stigma as a matter of "family shame," "hostility," "discrimination," and "labeling" that represent the risks that hinder help-seeking. Conclusion: This study suggests designing culturally sensitive treatment models that could help substance users recognize face-saving factors in their help-seeking process. Community education as a prevention measure should emphasize the importance of treating substance users as an individual, not as a problem. [ABSTRACT FROM AUTHOR]

Objective:It was aimed to investigate the attitudes, experiences, and barriers towards scientific research among otolaryngology residents in Turkey.Methods:Anonymous data were collected via an online survey. The demographic characteristics and experience in scientific research were investigated in the first section of the survey. The attitudes of participants towards scientific research and the barriers to the scientific research were examined in the second section of the survey using 17 items.Results:The present study involved 119 otolaryngology residents continuing their education. It was determined that 68.1% of participants think that “participating in scientific research” is a part of otolaryngology training. In the present study, it was shown that the residents having journal club hours in clinics on regular basis participated in various steps of scientific research projects (p

• This novel study investigates real-world user responses to a seizure forecast app. • Seizure forecasts were adopted for scheduling daily events and helping mental state. • People with greater mood disorder symptoms seemed to benefit most from forecasting. • Seizure forecasting may improve internal locus of control for people with epilepsy. Over recent years, there has been a growing interest in exploring the utility of seizure risk forecasting, particularly how it could improve quality of life for people living with epilepsy. This study reports on user experiences and perspectives of a seizure risk forecaster app, as well as the potential impact on mood and adjustment to epilepsy. Active app users were asked to complete a survey (baseline and 3-month follow-up) to assess perspectives on the forecast feature as well as mood and adjustment. Post-hoc, nine neutral forecast users (neither agreed nor disagreed it was useful) completed semi-structured interviews, to gain further insight into their perspectives of epilepsy management and seizure forecasting. Non-parametric statistical tests and inductive thematic analyses were used to analyse the quantitative and qualitative data, respectively. Surveys were completed by 111 users. Responders consisted of "app users" (n = 58), and "app and forecast users" (n = 53). Of the "app and forecast users", 40 % believed the forecast was accurate enough to be useful in monitoring for seizure risk, and 60 % adopted it for purposes like scheduling activities and helping mental state. Feeling more in control was the most common response to both high and low risk forecasted states. In-depth interviews revealed five broad themes, of which 'frustrations with lack of direction' (regarding their current epilepsy management approach), 'benefits of increased self-knowledge' and 'current and anticipated usefulness of forecasting' were the most common. Preliminary results suggest that seizure risk forecasting can be a useful tool for people with epilepsy to make lifestyle changes, such as scheduling daily events, and experience greater feelings of control. These improvements may be attributed, at least partly, to the improvements in self-knowledge experienced through forecast use. [ABSTRACT FROM AUTHOR]

Objectives The aims were to examine the prevalence of comorbidities and role of oral analgesic use in people with knee pain (KP) compared with those without. Methods The Knee Pain and related health In the Community (KPIC) cohort comprises community-derived adults aged ≥40 years, irrespective of knee pain. Thirty-six comorbidities across 10 systems were compared between people with KP and controls without KP or knee OA. Multivariable logistic regression analysis was used to determine the adjusted odds ratio (aOR) and 95% CI for multimorbidity (at least two chronic conditions) and each specific comorbidity. Both prescribed and over-the-counter analgesics were included in the model, and their interactions with KP for comorbidity outcomes were examined. Results Two thousand eight hundred and thirty-two cases with KP and 2518 controls were selected from 9506 baseline participants. The mean age of KP cases was 62.2 years, and 57% were women. Overall, 29% of the total study population had multimorbidity (KP cases 34.4%; controls 23.8%). After adjustment for age, sex, BMI and analgesic use, KP was significantly associated with multimorbidity (aOR 1.35; 95% CI 1.17, 1.56) and with cardiovascular (aOR 1.25; 95% CI 1.08, 1.44), gastrointestinal (aOR 1.34; 95% CI 1.04, 1.92), chronic widespread pain (aOR 1.54; 95% CI 1.29, 1.86) and neurological (aOR 1.32; 95% CI 1.01, 1.76) comorbidities. For multimorbidity, the use of paracetamol and opioids interacted positively with KP, whereas the use of NSAIDs interacted negatively for seven comorbidities. Conclusion People with KP are more likely to have other chronic conditions. The long-term benefits and harms of this change remain to be investigated. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov , NCT02098070. [ABSTRACT FROM AUTHOR]

Abstract Background Generalized anxiety disorder (GAD) is one of the most reported diagnoses in psychiatry, but there is some discrepancy between the cases identified in community studies and those identified in tertiary care. This study set out to evaluate whether the use of clinicians as interviewers may provide estimates in a community survey close to those observed in primary or specialized care. Methods This is a community survey on a randomly selected sample of 2338 adult subjects. The Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS) was administered by clinicians, providing lifetime diagnosis based on the DSM-IV-TR. Health-related quality of life (HR-QoL) was measured with the Short-Form Health Survey (SF-12). Results Overall, 55 (2.3%) subjects met the criteria for GAD, with greater prevalence in women (3.6%) than in men (0.9%): OR = 4.02; 95%CI: 1.96–8.26. Up to 40% of those with GAD had at least another diagnosis of mood, anxiety, or eating disorders. The mean score of SF-12 in people with GAD was 32.33 ± 6.8, with a higher attributable burden than in other conditions except for major depressive disorder. Conclusions We found a relatively lower lifetime prevalence of GAD than in community surveys based on lay interviewers and a structured interview. The identified cases of GAD showed a strong impact on the quality of life regardless of co-morbidity and high risk in women, suggesting a profile similar to the one identified from studies in primary and specialized care.