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We examined racial/ethnic inequities in the prevalence of adverse childhood experiences (ACEs) and examined the association between ACEs and selected health-related behaviors and problems. Data for this cross-sectional study come from the 2018 Maryland Youth Risk Behavior Survey/Youth Tobacco Survey, a statewide survey of high school students (n = 40,188). ACEs included caregiver verbal abuse and household food insecurity, substance use or gambling, mental illness, and involvement with the criminal justice system. We estimated the prevalence of ACEs overall and by race/ethnicity, and then used multiple logistic regression to determine associations between ACEs and emotional/behavioral problems, adjusting for race/ethnicity. Outcome variables included emotional distress, poor school performance, suicidal ideation, fighting, alcohol use, and marijuana use. More than one fifth of students reported each individual ACE. Differences in the prevalence of ACEs by race/ethnicity were statistically significant (p < .001). More than one fourth (25.8%) reported one of the five ACEs, 15.1% reported two, and 15.4% reported three or more. For each ACE, reporting having experienced it (vs. not) was associated with a >30% higher prevalence for each of the outcome variables. Among students who reported three or more ACEs (relative to none), the odds of emotional distress and suicidal ideation were more than 8 times greater. Among Maryland adolescents, ACEs are common, are inequitably distributed by race/ethnicity, and are strongly linked to behavioral health. Findings suggest the need to monitor ACEs as a routine component of adolescent health surveillance and to refocus assessment and intervention toward “upstream” factors that shape adolescent health.

Decision-making errors such as present bias (PB) can have important consequences for health behaviors, but have been largely studied in the financial domain. We conducted a mixed-method study on PB in the context of ART adherence among clinic-enrolled adults in Uganda (n = 39). Specifically, we quantified PB by asking about preferences between medication available sooner to minimize headaches versus available later to cure headaches. We describe demographic similarities among PB participants and qualitatively explored how participants reflected on their PB (or absence thereof) in the context of health. Participants reporting PB were predominantly male, single/unmarried, older, had higher levels of education and income and more advanced HIV progression. Three common reasons for more present-biased choices provided were: (1) wanting to avoid pain, (2) wanting to return to work, and (3) fear of one's health worsening if s/he did not address their illness immediately. While PB in the financial domain often suggests that poorer individuals are more likely to prefer immediate rewards over their wealthier counterparts, our results suggest poor health is potentially a driving factor of PB. Further research is needed to build on these finding and inform how programs can frame key messages regarding ART adherence to patients displaying PB.Trial registration: ClinicalTrials.gov identifier: NCT03494777.

BACKGROUND: Becoming an adult comes with education, work, living, and health-related transitions. Health care transition (HCT) services help adolescents prepare for a smooth transition to adult care, ensure health insurance retention, and promote adolescents' independent management of health care and life needs. Lack of HCT services can result in negative outcomes such as unmet needs, overmedication, and loss of decision-making authority. Autistic young adults (AYA) are half as likely to receive HCT services compared with special needs young adults. Furthermore, there are no HCT readiness measures that address the unique needs of AYA. METHODS: This study used a mixed-methods approach to develop and test a holistic caregiver-reported measure of HCT readiness for AYA Health-Related Independence (HRI). The phases used to create and test the HRI measure included: (1) construct and question topic development through qualitative data collection with AYA and caregivers; (2) question development with clinicians and caregivers; and (3) initial question testing utilizing cognitive interviews and pretesting of the instrument with caregivers. RESULTS: Measure constructs were developed based on qualitative findings from AYA (n = 27) and caregivers (n = 39). The researchers identified 12 themes related to HRI from the data. Next, questions were developed for each theme by caregivers (n = 5) and clinicians (n = 25). Finally, questions and the survey format were tested using caregiver feedback in the form of cognitive interviews (n = 15) and pretests (n = 21). The final version of the caregiver-reported HRI measure included 8 constructs and 58 questions. CONCLUSION: The development of the HRI measure was a comprehensive and iterative process. This article highlights the measurement development process and its potential impact on AYA, caregivers, and clinicians. LAY SUMMARY: WHY WAS THIS STUDY DONE? Health care transition services help youth keep their health insurance, transition to an adult doctor smoothly, and promote independence. To date, there is no health care transition intervention for autistic young adults. Few studies have examined how to prepare autistic young adults to manage their health and self-care needs and the transition to an adult model of care. We wanted to fill in these gaps by creating a measure of health care transition readiness for autistic young adults. WHAT WAS THE PURPOSE OF THIS STUDY? The purpose of the study was to develop the Health-Related Independence measure based on autistic young adult and caregiver input. We define Health-Related Independence as a young adult's ability to manage their health, healthcare, and safety needs. We also wanted to examine the measure to make sure it was easy to read, made sense, and was easy to answer. WHAT DID THE RESEARCHERS DO? We used a mixed-methods approach to develop and test the Health-Related Independence measure. There were three parts to the study: (1) we conducted individual interviews with autistic young adults and focus groups with caregivers to understand what topics should be included in the measure, (2) clinicians and caregivers then used those topics to create specific survey questions, (3) we conducted interviews and online pretest of the measure with caregivers. WHAT WERE THE RESULTS OF THE STUDY? The autistic young adults and caregivers identified twelve topics/themes to include in the Health-Related Independence Measure. Caregiver feedback helped make the measure shorter and easier to understand and complete. The final version of the caregiver-reported HRI measure included 58 questions. WHAT DO THESE FINDINGS ADD TO WHAT WAS ALREADY KNOWN? We learned that young adults and caregivers have a broad understanding of health-related independence such as safety and sexuality/relationship knowledge. There weren't any measures to capture these ideas. This study created an important new measure that can be used in healthcare clinics, schools, and at home. WHAT ARE POTENTIAL WEAKNESSES IN THE STUDY? This study aimed to work with autistic young adults to develop the Health-Related Independence measure, but due to funding and study limitations, we only included young adults in the 1(st) phase of the study. Caregivers were used as proxy reporters in phases 2 and 3. Not including autistic young adults in phases 2 and 3 was a weakness of the study. Future research should aim to fully incorporate young adults into the research process. Their views should inform the development of the qualitative interview guides and all portions of the study. HOW WILL THESE FINDINGS HELP AUTISTIC ADULTS NOW OR IN THE FUTURE? The Health-Related Independence measure can help caregivers and health care providers identify areas in which the autistic young adults are successful and areas of needed improvement to assist in the successful transition to adult care and adult life. The authors are currently working on a study proposal to validate the Health-Related Independence measure as a self-assessment tool for young adults to take themselves.

Examine predictors of social media use among a nationally representative sample of adults with children in the household.Data were collected from the Health Information National Trends (HINTS) Survey from 2017 to 2020 (N = 3559). Multivariate logistic regression models assessed the association between sociodemographic variables and social networking site (SNS) use, SNS use to share health information, participation in online forum or support groups for health issues and watching health-related videos on YouTube.Older adults and men were significantly less likely to use social media (p.05). Non-Hispanic African American (aOR: 1.83; 95%CI: 1.30-2.57), Hispanic (aOR: 2.16; 95%CI: 1.56-2.99), and Asian (aOR: 2.82; 95%CI: 1.67-4.75) adults were more likely to watch health-related videos on YouTube.Racial/ethnic minorities with children in the household were more likely to seek health information on YouTube, highlighting opportunities to disseminate culturally relevant, accurate messages on the platform. Effective health communication targeted to specific demographics can help counter misinformation and promote health behavior particularly during public health emergencies.Providers need to foster trust so that patients are comfortable to ask questions in addition to seeking information online. Providers can direct patients to credible resources to counter misinformation exposure and promote healthy behavior.

Mixed dish is a food category that contains differentdishes mixed in one plate, and is popular in Eastern andSoutheast Asia. Recognizing the individual dishes in a mixeddish image is important for health related applications, e.g. tocalculate the nutrition values of the dish. However, most existingmethods that focus on single dish classification are not applicableto the recognition of mixed dish images. The main challenge ofmixed dish recognition comes from three aspects: a wide rangeof dish types, the complex dish combination with severe overlapbetween different dishes and the large visual variances of samedish type caused by different cooking/cutting methods applied indifferent canteens. In order to tackle these problems, we proposethe contextual relation network that encodes the implicit andexplicit contextual relations among multiple dishes from region-level features and label-level co-occurrence respectively. Besides,to address the visual variances of dish instances from differentcanteens, we introduce the domain adaption networks to alignboth local and global features, and eliminating domain gaps ofdish features across different canteens. In addition, we collecta mixed dish image dataset containing 9,254 mixed dish imagesfrom 6 canteens in Singapore. Extensive experiments on both ourdataset and public one validate that our methods can achieve topperformance for localizing and recognizing multiple dishes andsolve the domain shift problem to a certain extent in mixed dishimages

Digital tools play an important role in fighting the current global COVID-19 pandemic. We conducted a representative online study in Germany on a sample of 599 participants to evaluate the user perception of vaccination certificates. We investigated five different variants of vaccination certificates, based on deployed and planned designs in a between-group design, including paper-based and app-based variants. Our main results show that the willingness to use and adopt vaccination certificates is generally high. Overall, paper-based vaccination certificates were favored over app-based solutions. The willingness to use digital apps decreased significantly by a higher disposition to privacy, and increased by higher worries about the pandemic and acceptance of the coronavirus vaccination. Vaccination certificates resemble an interesting use case for studying privacy perceptions for health related data. We hope that our work will be able to educate the currently ongoing design of vaccination certificates, will give us deeper insights into privacy of health-related data and apps, and prepare us for future potential applications of vaccination certificates and health apps in general., Comment: 22 pages, 4 figures, 5 tables

PurposeBuilding on prior studies on the role of health-related and job-related issues in affecting presenteeism, the present study tested a mediation model of the relationship between job demands and presenteeism by exploring the mediation effect of menopausal symptoms.Design/methodology/approachData were collected through a self-report questionnaire involving social service menopausal employees (N = 204) from a public municipal organization. The survey was cross-sectional and non-randomized.FindingsResults revealed that job demands, namely emotional, cognitive and physical demands, were significantly and positively associated with presenteeism. Furthermore, mediation analysis evidenced that physical job demands were also associated with higher levels of menopausal physical symptom bothersomeness, which in turn serves as a condition to increase the act of presenteeism.Originality/valueThe findings of this study widen the perspective on presenteeism research by evidencing the role of an overlooked health-related factor in relation to the act of presenteeism, that is the menopausal transition. Insights for the development of targeted preventive measures of the act of presenteeism and menopausal symptom management in the workplace may also be derived from these results.

Gamification's widespread application across industries has demonstrated its usefulness as a user engagement strategy. In the healthcare sector, the impact of lifestyle diseases has seen the need for modifying health-related behaviours. Health Behaviour Change Support Systems (HBCSS) enhanced with gamification features seek to help users achieve their health related goals. Adapting the Technology Acceptance Model, the role of informational feedback as a game mechanic in influencing perceptions, attitudes and continued usage intentions towards the gamified HBCSS is assessed. The results show a strong influence of attitude towards informational feedback afforded on the continued use intentions of the user.

The objective of this study is to investigate factors associated with health-related behavior clusters amongst emerging adults in Taiwan. We employed data from the 2009 National Health Interview Su...

Racial bias and language discrimination are recognized in the health sector in countries such as Sri Lanka. This may extend to images used in health communication and educational literature. We analyzed the racial and ethnic representation in a sample of newspapers and websites related to health obtained over a period. Most of the human figures in health-related messages in newspapers had an overrepresentation of Caucasians. This trend was absent in websites where 73% of the images of Sri Lankans. The reasons for this pattern could be due to the availability of image-quality photographs and exposure to a norm that is racially biased. For example, a majority of images in medical textbooks and prestigious journals are of white Caucasians. A predominance of such images could have two impacts. At an individual level, it would affect acquiring skills of visual diagnoses. At a societal level, it may reinforce a view that most forms of health-related knowledge are created in the West and could add to existing discrimination based on skin color (i.e., colorism). The latter is a known psychosocial stressor that contributes to psychological distress among socially disadvantaged populations and promotes behaviors adverse to health and residential segregation. These may contribute to poorer physical, mental, and infant health outcomes in dark-skinned individuals compared to lighter-skinned in the USA and Canada. Such discrimination within the health system would compromise basic human dignity, disempower patients, and violate the principle of autonomy. Sri Lankan media, the healthcare profession, and educationists need to recognize the relevance and importance of using images that appropriately reflect the realities of their own environment, its people, and patients.

Background Few studies have examined the clinical utility of a brief psychosocial screening questionnaire and assessing the health-related quality of life as part of routine care in a pediatric cardiology clinic. Subject and methods A cross-sectional study was conducted over 6 months duration involving 224 patients with congenital heart diseases (CHD) aged 4–18 years and their parents to fulfill Pediatric Symptom Checklist (PSC) and Health related – Quality Of Life (HR-QOL) score. Statistical analysis of reliability of these scores among the studied population was carried using Cronbach’s alpha value. Results The studied population with CHD, aged 4–18 years with a mean ± standard deviation of 99.48 ± 43.37 months. They were 54.5% males (n = 122) and 45.5% females (n = 102). Internalizing problems were identified by PSC in 12.95% of patients (n = 29), Cyanosis was found to be the only significant independent risk factor for developing internalizing defects (p Conclusions Children with CHD have increased need for psychosocial assessment for improvement of their quality of life.

During this covid pandemic it is clearer than ever how much health misinformation effects. It is much easier now to publish health related articles online without validation, these articles are shared across social media contributing to the spread of health fake news. This Health fake news are spread with intent to damage image of person or product, to increase sells of a product or to promote a product. In recent research papers, many useful health misinformation detection models use BERT (Bidirectional Encoder Representations from Transformers) which is pretrained on unlabeled data extracted from English Wikipedia and book corpus and are mostly dealt with health misinformation on social media. Therefore, a self - ensemble SCIBERT (Scientific BERT) based model that makes use of domain specific word embeddings is proposed for detection of health misinformation specifically in news which is less explored and a dataset combining existing FakeHealth dataset and custom dataset that contains health articles scraped from news fact checking website Snopes.com. Classification results exhibits that the proposed model provides weighted F1 score of 0.715.

Background: The outbreak of COVID-19 has been the cause of agony for millions of people worldwide. Anxiety of losing near ones and stress of rearing children besides bearing the bulk of domestic tasks have led to certain behavioral changes in the pregnant women. Aims and Objectives: This study aims to assess anxiety, awareness, and behavioral changes among pregnant women during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, College of Medicine and J.N.M. Hospital, Kalyani, West Bengal, India, from May 1, 2020, to December 31, 2020. All antenatal patients after the second trimester visiting the OPD or maternity ward, satisfying inclusion criteria after formal consent, were considered for the study. Results: Out of a total of 139 patients, mostly primigravida, 122 (87.7%) participants were of 18–33 years age. Observations revealed that 24% more women were worried about their own health after the arrival of pandemic. The overall worry percentage for unborn baby (88%), existing children (76%), and older relatives (38%) remained uniform throughout the study period. Staying at home, stocking of food, and medical equipment showed a downward trend toward the end of the study. Conclusion: The impact of the pandemic has been mammoth, taking a toll on the behavior and anxiety of the pregnant women, which when unnoticed may have a long-term effect on their mental health as well as family life. Physical and mental support from external and internal sources will pave the way to a healthier mental well-being of these antenatal mothers.

People care about relative position and are willing to engage resources to be above others or at least not below them. Nevertheless, the scarce existing evidence suggests that health is a less positional good: people prefer to be healthy even if others are healthier than them. Unlike previous literature, we use a survey-based study to explore the positionality of several health-related dimensions (e.g., health care reimbursement, cosmetic surgery) in a Choice versus Happiness condition. We find that agents exhibit mainly egalitarian preferences, namely they take into account others' situations but prefer everybody to receive the same amount of health attributes. Moreover, when health attributes are related to physical appearance, agents express significantly higher levels of positional preferences. We draw several policy implications from these egalitarian preferences.

The aim of this study was to assess gender differences in the prevalence non-communicable diseases (NCDs) and in associated health-related habits, weight status and common risk factors in Botswana. Data were from the cross-sectional, population-based Botswana STEPS Survey II conducted in 2014. A total sample of 2947 survey participants aged 25–64 years were included the study. The results showed that a statistically significant higher percentage of men used tobacco compared with women (34.4%, 95% CI: 33.5–35.1 vs 4.4%, 95% CI: 4.3–4.5). Men also had consistently and statistically significantly greater heavy alcohol consumption and lower fruit and/or vegetable consumption than women. Physical inactivity among women was higher than in men. Controlling for other factors, men had a higher probability of being overweight (28.7%, 95% CI: 28.6–28.8 vs 18.3%, 95% CI: 18.0–18.6) and obese (25.8%, 95% CI: 25.4–26.2 vs 10.2%, 95% CI: 9.9–10.5) than women. Women were at a greater risk of developing NCDs compared with men since their adjusted prevalence of having at least three common risk factors was higher than men’s. Women had a higher adjusted predicted prevalence of suffering from hypertension than men (39.4%, 95% CI: 38.9–40.0 vs 26.1%, 95% CI: 25.5–26.8). Appropriate policies and programmes need to be adopted to urgently address the problem of NCDs in Botswana.

Zusammenfassung Hintergrund Die negativen Auswirkungen von sexueller Gewalt auf die Gesundheit sind im vergangenen Jahrzehnt weltweit erneut stark in den gesundheitspolitischen Fokus gerückt. Bislang fehlen für Deutschland bevölkerungsrepräsentative Daten, auf deren Basis die Lebenszeitprävalenz für unterschiedliche Altersgruppen sowie spezifische Zusammenhänge zu gesundheitsbezogenen Faktoren dargestellt werden können. Ziel der Arbeit Die Studie untersucht 1) die Lebenszeitprävalenz für Sex sowie sexuelle Berührung gegen den eigenen Willen im Kindesalter und über die Lebensspanne sowie 2) die Zusammenhänge mit gesundheitsbezogenen Faktoren. Material und Methoden 4955 Personen im Alter von 18 bis 75 Jahren wurden in einer zweistufig geschichteten, randomisierten Einwohnermeldeamtsstichprobe im Rahmen des bundesweiten wissenschaftlichen Survey „Gesundheit und Sexualität in Deutschland“ (GeSiD) befragt. Die Zusammenhänge mit soziodemografischen und gesundheitsbezogenen Faktoren wurden (altersadjustiert und stratifiziert für Geschlecht) mittels logistischer Regression berechnet. Ergebnisse Für Frauen lag die Lebenszeitprävalenz für (versuchten/vollzogenen) Sex bei 14,9 % und für (versuchte/vollzogene) sexuelle Berührung gegen den Willen bei 40,8 %, für Männer bei 3,1 % respektive 13,2 %. Für erzwungenen Sex vor dem 14. Lebensjahr lag die Prävalenz bei 2,1 %, für sexuelle Berührung bei 7,5 %. Es zeigten sich höhere Prävalenzen bei Personen mit beeinträchtigter Lebensqualität, schlechtem Gesundheitszustand, chronischer Erkrankung oder Behinderung, einer Behandlung aufgrund von Depression oder einer anderen psychischen Störung im letzten Jahr. Diskussion Die Studie verdeutlicht Zusammenhänge von sexueller Gewalt mit psychischer und somatischer Gesundheit. Sie unterstreicht die Dringlichkeit, nach solchen Erfahrungen regelhaft in der ärztlichen Anamnese zu fragen.

Background: Menopause is associated with numerous somatic dysfunctions, an increased risk of chronic diseases, and complications in the mental and social components of health that lower the quality of life (QoL). Obesity and related comorbidities affect over 60% of postmenopausal women in Poland. A significant role for systematic physical activity (PA) in the prevention of dysfunctions and chronic diseases, including obesity and mental disorders, has been observed previously. A low level of PA is observed across the Polish population, especially in postmenopausal women. Aim of the study: To examine QoL in postmenopausal women participating in a community health promotion program as it relates to obesity and levels of PA. Material and methods: The study sample consisted of 76 postmenopausal women (aged 65.75±5.14 years) participating in the Active Wrocław 55+ program. Before starting the program, anthropometric measurements were taken, and QoL and PA were assessed using the 36-Item Short Form Health Survey (SF-36) and the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. Results: Most women had a PA level above 600 MET -min/week (78.95%), and were overweight or obese (86.84%). A waist circumference over 80 cm, indicating an increased risk for metabolic syndrome, was observed in 85.89% of the participants. BMI and waist circumference negatively correlated with the level of PA (p=0.001 and p=0.017, respectively). Women exhibiting low levels of PA and higher BMIs showed a significantly lower QoL compared to those with higher PA and lower BMIs, particularly with regard to the physical domains of QoL. Conclusions: Obesity and a low level of PA are associated with a significant decline in the health-related QoL (especially in the PF and PCS domains) of postmenopausal women an urban setting.

Background Engaging youth throughout the research process improves research quality and outcomes. Youth advisory groups provide one way for youth to express their opinions on relevant issues. Objective This study aimed to identify research‐ and health‐related youth advisory groups (‘groups’) in Canada and understand the best practices of these groups. Methods Google searches and supplementary methods were used to identify relevant groups in Canada. Group information was extracted from websites or through interviews with key informants. Results We identified 40 groups. Groups were commonly part of a hospital/healthcare facility, nonprofit/health organization or research group. The majority focused on a specific content area, most commonly, mental health. Over half the groups advised on health services. Members' ages ranged from 9 to 35 years. The number of members ranged from 5 to 130. Interviews (n = 12) identified seven categories relating to group practices: (a) group purpose/objectives, (b) group development, (c) group operations, (d) group structure, (e) adult involvement, (f) membership and recruitment and (g) group access. Challenges and facilitators to the success of groups were described within the following themes: (a) retaining engagement, (b) creating a safe environment and (c) putting youth in positions of influence. Advice and recommendations were provided regarding the development of a new group. Conclusion This study provides a comprehensive overview of research‐ and health‐related youth advisory groups in Canada. This information can be used to identify groups that stakeholders could access as well as inform the development of a new group. Patient or Public Contribution Youth advisory group representatives were interviewed as part of the study.

Background: SARS-CoV-2 infection (COVID-19) is clinical threat to healthy individuals around the world. Risk of disease and related complications are high among immunocompromised individuals and those with pre-existing chronic diseases. Aim: To assess the fear of Covid-19 among patients having chronic diseases and to determine its relationship with preventive practices among them. Study Design: Cross-sectional study Place and Duration of Study: Department of Community Medicine, HITEC Hospital Taxila from 1st September2020 to 31st March 2021. Methodology: Three hundred and seventeen patients having chronic diseases were included. Fear of Covid-19 scale used to assess the fear level and questions related to preventive practices. Results: Fear of Covid-19 was high among females, hypertensive, diabetics and those having cardiovascular disease. Fear was found among 133 (42%) participants. Regarding Covid-19 preventive practices, 8(2.5%) had unsatisfactory, 115 (36.3%) had satisfactory and 194(61.2%) had good preventive practices. Covid precautions were significantly practiced among those having fear. Statistically significant positive correlation was found between mean Covid fear and practices scores (r=.30, p=.001) Conclusion: Fear of Covid is a recognized risk factor for anxiety and depression among people. However, fear is found to promote risk perception and health related preventive behaviors among chronic patients that can positively ensure safety, decrease the risk of infection and serious complications among chronic patients. Keywords: SARS-CoV-19, Fear for Covid-19, Preventive Practices, Chronic diseases.

Villages and its farmers are the base of Odisha. But, when farmers suffer from ailments, they have to pay heavy economic, social and emotional price. Financial hazard and health related expenses led the farmer to suffer in poverty. Whereas, Biju Krushak Kalyan Yojana (BKKY) brought as a solution to farmers for their health security. The study was conducted in Angul district of Odisha under ex-post facto research design. 120 respondents from 10 villages of Angul block in Angul district of Odisha was selected for the study. Primary data were collected from the respondents with the help of pre-tested semi-structured interview schedule through personal interview. Data collected were subjected to statistical analysis and the identified that majority of the respondents were middle aged, illiterate, earns medium level of annual income, with medium level of mass media exposure and extension contact. Further added that, respondents reported positive impact on BKKY and socio-economic characteristics like education, income, mass media exposure and extension contact has positive and significant association with the impact of BKKY among the farmers. It was suggested to create awareness among farmers on benefits of BKKY, providing quality health consultations, proper knowledge at timely manner. View Article DOI: 10.47856/ijaast.2021.v08i9.010

Health, injury, and pain within the social contexts of sports remain relevant. Sociologists have repeatedly pointed out a set of factors that shape the sociocultural background of sports and aim to normalize the high risk of injury, pain, and negative impacts on health. The literature contains inspiring studies with valuable guidelines for conceptualizing this issue. Some researchers have focused on the social factors shaping athletes’ experiences with health-related risks and have proven that it is possible to oppose the deeply rooted “culture of risk.” The fact that most studies on the subject involve men’s sports increases the importance of those that address health-related risks in women’s sports. The literature includes few works concerning the sociocultural contexts of injury, pain, or health issues in handball. The aim of this study was to learn about the opinions and experiences of professional female handball players related to health in their discipline. Three main directions of research were followed: 1) health as a value; 2) significance of injury and pain; and 3) effect of health-related risks on a career in sports. The data were collected before the COVID-19 pandemic. The results do not reflect the opinions or experiences of the participants during the period of heightened epidemiological risk. The sample comprised female athletes (n=52) who participated in the Polish First League of women’s handball and represented the highest competitive level in their category in Poland.

Stigma contributes to the burden of individuals and families affected by Sickle cell disease (SCD) and causes delay in appropriate care seeking. The aim of this study is to examine the levels and associations between stigma, social support, self-efficacy, and self-care actions among adult patients with SCD in Oman using a cross-sectional, correlational design. Of the 264 participants, 56.1% ( n = 148) were males, with mean age of 30.1 years ( SD 7.7). Half of the participants were married, and 88.3% had no other associated diseases. The results demonstrate that patients in Oman suffer from health-related stigma. However, social support, self-efficacy, and self-care actions were reported to be high and correlated with several clinical and demographic variables. Based on the results, effective, low-cost interventions such as psycho-educational groups, individual counseling, or group therapies might be developed. They can promote belief in enhanced efficacy and improved SCD adaptation, thereby increasing patient, and provider satisfaction.

This study reports changes in the concentrations of important health-related bioactive compounds (vitamin C and ellagic acid) and morphology of wild harvested Kakadu plum fruits that were collected during three harvest seasons and four maturities. The results showed that fruit weight increased, whereas fruit length and width changed slightly with the advance in maturity. Vitamin C increased up to 20 folds (from 1.2 to 21.2% dry weight [DW]) from immature to mature stage, whereas ellagic acid decreased approximately three times (from 6.5 to 2.1% DW). Similar trends were observed over the three harvest seasons studied. A positive correlation between fruit weight and vitamin C, whereas a negative correlation with ellagic acid was observed, indicating that maturity plays an important role in contributing to the variation of ellagic acid and vitamin C. Season also had an effect and showed the influences of rainfall, temperature and solar exposure on the biosynthesis of vitamin C and ellagic acid.

Bangladesh is entering from low-income to lower-middle-income status in 2020, and this will be completed in the next 5 years. With gross national income growing, vaccines will need to be procured through private market for the Expanded Program on Immunization. A cost-benefit analysis is needed to evaluate vaccine demand in different socioeconomic groups in the country, to inform this procurement. Moreover, disease burden studies and awareness of importance of specific vaccines are needed as we move forward. A life-course approach to vaccination may enable whole society to realize the full potential of vaccination and address most significant threats to its success over time.

Objective: Peer support interventions can be successful in enhancing physical activity (PA) in a variety of health-related contexts. However, the evidence base remains equivocal, and ways to integrate structured peer support within the context of exercise referral schemes (ERSs) remain unexplored. In this regard, few studies consider the prospective acceptability of peer support interventions. Prior qualitative exploration can elicit insight into factors likely to influence peer intervention success, thus maximising the likelihood of developing and implementing effective peer support interventions. This study assessed the prospective acceptability of a peer support intervention for exercise referral. Design/Setting: Individual semi-structured interviews were conducted with 14 ERS clients ( n = 10) and providers ( n = 4) across two ERS sites in the North West of England, UK. Method: Interviews covered preferred demographic and personal characteristics of ERS peers and prospective peer roles. Interviews were analysed using thematic analysis. Results: A desirable ERS peer was perceived as someone who was positive and empathetic, with good interpersonal skills. ERS peers were considered to present a promising opportunity to enhance the accessibility of emotional, motivational and informational support among ERS clients while alleviating burden on ERS providers. Conclusion: Study findings have relevance to the integration of peer support in comparable ERS contexts, highlighting the value of developmental research to refine peer recruitment criteria and to facilitate ownership and support among providers across a variety of health-related contexts.

Qualitative research can clarify how the racialized social system of Whiteness influences White Americans’ health beliefs in ways that are not easily captured through survey data. This secondary analysis draws upon oral history interviews (n=24) conducted in 2019 with Whites in a rural region of Appalachian western North Carolina. Interviewees discussed personal life history, community culture, health beliefs, and experiences with healthcare systems and services. Thematic analysis conveyed two distinct orientations toward health and healthcare: (1) bootstraps perspective, and (2) structural perspective. Whiteness did not uniformly shape interviewees’ perceptions of health and healthcare, rather, individual experiences throughout their life course and the racialized social system contributed to these Appalachian residents’ assessments of who is responsible for health and healthcare. Dissatisfaction with the Affordable Care Act was salient among interviewees whose life stories reflected meritocratic ideals, regardless of education level, age, or gender identity. They apprised strong work ethic as a core community value, assuming that personal contributions to the social system match the rewards that one receives in return for individual effort. Conversely, interviewees who were primarily socialized outside of rural Appalachia acknowledged some macro-level social determinants of health and expressed support for universal healthcare models. Findings suggest that there is not one uniform type of “rural White” within this region of Appalachia. Interventions designed to increase support for health equity promoting policies and programs should consider how regional and place-based factors shape White Americans’ sense of identity and subsequent health beliefs, attitudes, and voting behaviors. In this Appalachian region, some White residents’ general mistrust of outsiders indicates that efforts to garner more political will for health-promoting social programs should be presented by local, trusted residents who exhibit a structural perspective of health and healthcare.

Background Culinary medicine (CM) or culinary nutrition (CN) education provided to professionals with the capacity to influence behaviour change is an emerging strategy to promote diet quality and reduce the burden of diet related chronic disease in adults. The purpose of this scoping review was to synthesise current research describing CM/CN education provided to or by health, education and culinary professionals, or students of these disciplines. Methods Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was used. Eleven electronic databases were searched in March 2019. Included studies were: (i) nutrition, health or lifestyle programs with a CM/CN component (ii) study participants or programs facilitated by people working or training in health, community and/or adult education, or culinary roles where facilitator training was described (iii) reported in the English language (iv) published from 2003. Results A total of 33 studies were included. Nineteen studies delivered programs to general population groups and were facilitated by health professionals and/or health university students. Fourteen studies delivered CM/CN training to health professionals or students. Studies reported changes in participants' culinary skill and nutrition knowledge (n=18), changes in dietary intake (n=13), attitudes and behaviour change in healthy eating and cooking (n=4), competency in nutrition counselling and knowledge (n=7). Conclusions Further research examining effectiveness of CM/CN programs, and that describe optimal content, format and timing of programs is needed. Research evaluating the impact of training in CM/CN to education and culinary professionals on healthy cooking behaviours of their patients/clients is warranted. This article is protected by copyright. All rights reserved.

Összefoglaló. Bevezetés: Jóllehet Magyarországon a várandósok a társadalombiztosítási rendszer által támogatott komplex várandósgondozási ellátásra jogosultak, mégis sokan vesznek közülük igénybe privát szolgáltatásokat. Ezt a döntést többek között a biztonságérzet fokozása és a várandósgondozást végző szakember szülésig tartó folytonosságának biztosítása motiválja. Nemzetközi szakirodalmi adatok alapján mindemellett feltételezhető, hogy hazánkban is befolyásolja a választást a társadalmi-gazdasági helyzet. Célkitűzés: A jelen elemzés célja annak vizsgálata magyarországi várandósok reprezentatív mintáján, hogy az állami/magán/vegyes finanszírozású várandósellátás igénybevétele mennyiben kapcsolódik bizonyos demográfiai, szocioökonómiai, egészségi és pszichológiai változókhoz. Módszer: Az elemzés a Kohorsz ’18 Magyar Születési Kohorszvizsgálat első, várandós anyák körében zajló szakaszának súlyozott adatain történt (n = 8287). Az adatok forrását a védőnők által szóbeli interjúk során felvett, valamint önkitöltős formában begyűjtött kérdőíves adatok szolgáltatták. Eredmények: Az egyes várandósgondozási formák igénybevétele erősen összefüggött a várandós korával, iskolai végzettségével, anyagi helyzetével és foglalkozási presztízsével. Közepes erősségű kapcsolatban állt a várandós partnerkapcsolati helyzetével és meglévő gyermekeinek számával, míg gyenge összefüggésben az egészségi állapotával és pszichés tüneteivel. A finanszírozási formához mindemellett erősen kapcsolódott az, hogy a várandós választott orvossal, szülésznővel tervezte-e szülését. Megbeszélés: A kapott eredmények rámutatnak, hogy a várandósellátás különböző finanszírozású formáinak igénybevétele jelentős mértékben együtt jár a várandós szocioökonómiai és demográfiai sajátosságaival, míg egészségi és pszichés állapotával csupán gyenge összefüggésben áll. Következtetés: A hazai várandósgondozást jellemző kettős finanszírozás háttér-egyenlőtlenségek egész sorát hordozza magában. Jövőbeli elemzésekben vizsgálat tárgyává szükséges tenni, hogy ez mennyiben mutat összefüggést ellátásminőségi és -hozzáférési különbségekkel, valamint ezeken keresztül a várandós és gyermeke egészségével. Orv Hetil. 2021; 162(35): 1402–1412. Summary. Introduction: While pregnant women in Hungary are entitled to complex pregnancy care financed by the social security system, many of them do use private services. This decision is motivated, among other things, by increasing the sense of security and ensuring the presence of the doctor providing pregnancy care at the birth. However, based on the international literature, it can be assumed that this decision is influenced by the socio-economic background as well. Objective: The aim of the present analysis is to examine the extent to which the use of public/private/mixed funded pregnancy care is related to certain demographic, socioeconomic, health related and psychological variables on a representative sample of pregnant women in Hungary. Method: The analysis was performed on the weighted data of the first, pregnant wave of the Cohort ’18 Growing Up in Hungary (n = 8287). The analysis is based on data from personal interviews and self-administered questionnaires conducted by the health visitors among pregnant women in 2018. Results: The use of different forms of pregnancy care was strongly related to the age of the pregnant women, their education, financial situation and occupational prestige. It was moderately correlated with the pregnant woman’s partnership status and their parity, while it was weakly correlated with her health status and psychological symptoms. The form of financing of the pregnancy care was, however, strongly related to whether the pregnant woman planned to give birth with a chosen doctor or midwife. Discussion: The results show that the use of different forms of pregnancy care is greatly associated with the socioeconomic and demographic characteristics of the pregnant women, while it is only weakly related to the health status and mental wellbeing. Conclusion: Double funding in the Hungarian pregnancy care system carries a whole range of background inequalities. Future analyses should examine whether this has an impact on the quality and availability of care and, indirectly, on the health of pregnant women and their children. Orv Hetil. 2021; 162(35): 1402–1412.

PurposeInvolvement of youth in electronic sports is increasing and outdoor sports are decreasing day by day. It not only affects their health but also leads them towards noncommunicable diseases. Risk of noncommunicable diseases is associated with physical inactivity and affects physical and mental health. It results in different personal and social implications. Therefore, the purpose of this paper is to highlight the importance of outdoor sports and risks of electronic sports for health.Design/methodology/approachThe data for study is collected from 450 university students using purposive sampling technique. In order to measure outdoor sports, a four items instrument developed by Simon and Smoll (1974) is used. For electronic sports, instrument is adopted from Lemmens et al. (2009) and for health of youth, instrument by Bailis et al. (2003) is used. After reliability and validity check, structural equation modeling is used to analyze data.FindingsThe results reveal that perceived outdoor sports have significant positive impact on health, whereas electronic sports have negative impact on youth health that lead them to certain noncommunicable diseases. There is need to emphasize and encourage youth for outdoor sports and avoid indulging in esports that may lead to addiction.Practical implicationsElectronic games have various risks for the development of syndromes among younger generation. Awareness should be provided that physical activities are essential for healthy life and how risky be the esports for their health. This study may be helpful for government as well to reduce dependency of youth on technological devices and provide necessary recreation facilities to engage in. This research study validates that outdoor sports have significantly positive impact on health of youth and it reduces health related problems and destructive behaviors among youth.Originality/valueInvolvement of youth in electronic sports is increasing and outdoor sports are decreasing day by day. It not only affects their health, but also leads them toward non-communicable diseases. The present study examines the impact of esports and physical sports on youth health.

Zusammenfassung Hintergrund Studierende bilden die größte Gruppe an Hochschulen, somit ist ein studentisches Gesundheitsmanagement unerlässlich. Diese Gruppe zählt zwar aufgrund ihres Alters zu einer eher gesunden Bevölkerungsgruppe, dennoch sind auch Studierende gesundheitlichen Belastungen ausgesetzt. Daher sind die Auswirkungen der Coronapandemie auf die Studierenden von allgemeinem Interesse. Fragestellung Der Artikel befasst sich mit der Frage, wie die Rahmenbedingungen der Coronapandemie gesundheitsbezogene Verhaltensweisen und Belastungen der Studierenden an der Ostfalia Hochschule für angewandte Wissenschaften beeinflussen. Material und Methoden Auf Grundlage einer Literaturrecherche wurde ein Fragebogen zu den Themenbereichen Bewegung, Ernährung, wahrgenommenes Stresserleben und Suchtmittelkonsum erstellt. Die Stichprobe der Onlinebefragung umfasst 1281 Studierende. Die Ergebnisse wurden über Microsoft Excel ausgewertet. Ergebnisse Infolge der Coronapandemie bewegen sich Studierende in ihrem Alltag weniger, müssen aufgrund der gesetzlichen Regelungen ihre Mahlzeitenplanung neu organisieren und sind, z. B. durch veränderte Prüfungsleistungen oder den Verlust des Nebenjobs, einem höheren Stresslevel ausgesetzt. Der Suchtmittelkonsum bleibt dabei nahezu unverändert. Schlussfolgerung Die Coronapandemie bewirkt sowohl positive als auch negative Veränderungen der gesundheitlichen Verhaltensweisen und Belastungen bei Studierenden. Dennoch sind weitere Untersuchungen erforderlich, um die Auswirkungen der Pandemie auf die Studierenden umfassender in den Blick zu nehmen.

This review aims to (a) investigate the characteristics of both the research community and the published research on health-related fake news on social media platforms, and (b) identify the challenges and provide recommendations for future research on the subject. We reviewed 69 journal articles found in the main academic databases up to April 2021. The studies extracted data mainly from Twitter, YouTube, and Facebook. Most articles aimed to investigate the public’s reaction to fake health information, concluding that health agencies and professionals should increase their online presence. The articles also suggest that future work should aim to improve the quality of health information on social media platforms, develop new tools and strategies to combat fake news sharing, and study the credibility of health information. Nonetheless, those in control of the platforms are the only ones which can take effective measures to ensure that their users receive reliable information.

Objectives: Social media (SM) are evolving and dynamic applications which can be used in health-care settings to enhance professional networking and education; patient communication, care, and education; public health programs; organizational promotion; and research. This review aims to analyze, summarize, and describe the current Saudi experience of SM use for health. Methods: A MEDLINE/PubMed electronic database search was performed in July 2020 utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The initial search has yielded a total of 263 articles, of which 25 met our inclusion criteria. Results: In Saudi Arabia, the literature reports a high interest in using SM for health-related purposes among the public, with a prevalence of >51%. The Saudi population has been found to highly favor the use of WhatsApp and Twitter for gaining and exchanging knowledge. Multiple facilitators and barriers have been identified and further categorized based on the users’ population, such as general public, health-care practitioners, and patients with specific conditions. Overall, the common facilitator and barrier between all users’ population categories were found to be younger age and lack of time, respectively. Conclusion: SM use for health-care activities is increasing in Saudi Arabia. Thus, it is important for SM-based health education programs to target specific population and patients’ demographics with programs tailored to their particular interests and needs. This is particularly evident in the current achievements and future plans of the Saudi Ministry of Health.

BACKGROUND Health-related risky behaviors generally refer to behaviors that have a negative impact on health and quality of life. Health-related risky behaviors in adolescents with high-functioning autism (HFA) have not been well understood so far. Adolescents with HFA may have more health-related risky behaviors than neurotypical adolescents. AIM To investigate health-related risky behaviors and their risk factors with HFA. METHODS This is an observational study. Our study enrolled 110 adolescents aged 12-19-years-old meeting Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria for HFA. They were recruited from Peking University Sixth Hospital. There were also 110 age, sex and nationality matched controls enrolled who came from a public school in Beijing, China. Both groups completed the Adolescents Health-related Risky Behavior Inventory. Nonparametric tests were carried out for comparison of the Adolescents Health-related Risky Behavior Inventory scores between the two groups. Expression recognition, the Inventory of Subjective Life Quality for Child and Adolescent, Chinese Wechsler Intelligence Scale for Children, Wechsler Intelligence Scale for Adult-Chinese Revised, Theory of Mind test and Autism Spectrum Screening Questionnaire were assessed in the autism group to explore factors associated with health-related risky behaviors. Multivariate regression analysis was conducted to explore the risk factors of health-related risky behaviors in the HFA group. RESULTS The results showed that the total score of the Adolescents Health-related Risky Behavior Inventory and scores of “aggression and violence,” “suicide and self-injury,” “health compromising behavior” and “unprotected sex” subscales in the HFA group were significantly higher than those in the control group (Z range -4.197 to -2.213, P < 0.05). Among the associated factors, poor emotional experience (B = -0.268, P < 0.001), depression (B = -0.321, P < 0.001), low score of intelligence (B = -0.032, P = 0.042), low score of Theory of Mind test (B = -1.321, P = 0.003) and poor adaptation to school life (B = -0.152, P = 0.006) were risk factors. These risky behaviors may promote the occurrence of health-related risky behaviors in adolescents with HFA. CONCLUSION This study showed that adolescents with HFA were more likely to be involved in health-related risky behaviors. Different health-related risky behaviors have different reasons.

Background: Research findings indicate that four health-related behaviors (HRBs), smoking, alcohol, diet, and physical activity, do not co-occur within individuals by chance and therefore cluster. To date, there is a lack of research investigating the clustering of these HRBs in the Japanese population. Methods: The Japanese National Health and Nutrition Survey 2010 was used, containing information on 8,015 community-dwelling adults. Latent profile analysis identified distinct cluster patterns of four HRBs: smoking status, alcohol consumption, calorie intake, and the number of steps per day. Results: For men, four distinct HRB clusters were identified. The largest cluster (54%) was characterized by drinking more than Japan’s recommended alcohol guidelines and walking an inadequate number of steps per day. A small cluster (4%) also emerged, characterized by smoking, high calorie intake, and exceeding alcohol guidelines. Members of these clusters had higher systolic blood pressure than those in the remaining clusters. For women, five distinct HRB clusters were identified. The largest cluster (57%) was characterized by not smoking or drinking and walking an inadequate number of steps per day. For both genders, there was a relationship between cluster membership and age. Cluster membership was associated with income and health status among men but not women. Conclusion: Detecting distinct clusters of HRBs in a Japanese population-based survey provides a person-centered understanding of Japanese lifestyles. This approach can assist policy makers in Japan and overseas to identify new strategies for targeting behavioral risk factors and make health promotion policies more effective in their respective countries.

A tanulmány célja a 11-17 éves magyar fiatalok egészségmagatartásának bemutatása. A kutatás során hazai és nemzetközi primer kutatásokon alapuló cikkek, valamint az "Iskoláskorú gyermekek egészségmagatartása” (HBSC) elnevezésű nemzetközi kutatás részeként Magyarországon végzett felmérés eredményeit elemeztük. A kutatás célja a 11 és 17 éves korosztály egészséget befolyásoló szokásainak és egészségi állapotának felmérése, az eredmények időbeli és nemzetközi trendjeinek követése és az egészségi mutatókat befolyásoló tényezők felderítése. Tanulmányunkban bemutatjuk az egészséget támogató (táplálkozás, fizikai aktivitás), illetve kockázatot jelentő magatartásformák (dohányzás, alkoholfogyasztás) eredményeit és jellegzetes változásait az elmúlt 5 hazai felmérés (2002, 2006, 2010, 2014, 2018) adatai alapján. A tanulmány során korábbi hazai kutatási eredmények adatait felhasználva végeztünk dokumentumelemzést, mely során tapasztalt kedvező adatok rávilágítanak arra, hogy elindult már egy folyamat, de még a hosszú út elején járunk. A legnagyobb problémát a gyerekek jelenlegi életmódjában a tudatos magatartás hiánya okozza. A legtöbben nincsenek tisztában az életmód egészségre gyakorolt hatásával. JEL-kódok: I12

Background Skin-sparing debridement (SSd) was introduced as an alternative to en bloc debridement (EBd) to decrease morbidity caused by scars in patients surviving Necrotizing soft-tissue infections (NSTI). An overview of potential advantages and disadvantages is needed. The aim of this review was to assess (1) whether SSd is noninferior to EBd regarding general outcomes, that is, mortality, length of stay (LOS), complications, and (2) if SSd does indeed result in decreased skin defects. Methods A systematic literature search was performed according to the PRISMA guidelines. All human studies describing patients treated with SSd were included, when at least of evidence level consecutive case series. Studies describing up to 20 patients were pooled to improve readability and prevent overemphasis of findings from single small studies. Results Ten studies, one cohort study and nine case series, all classified as poor based on Chambers criteria for case series, were included. Compared to patients treated with EBd, patients treated with SSd had no increased mortality rate, LOS or complication rate. SSd-treated patients had a high rate (75%) of total delayed primary closure (DPC) in the pooled case series. Conclusion The current available evidence is of insufficient quality to conclude whether SSd is noninferior to EBd for all assessed outcomes. There are suggestions that SSd may result in a decreased need for skin transplants, which could potentially improve the (health related) quality of life in survivors. Experienced surgical teams could cautiously implement SSd under close monitoring, ideally with uniform outcome registry.

Lankhorst, K, Takken, T, Zwinkels, M, van Gaalen, L, Velde, St, Backx, F, Verschuren, O, Wittink, H, and de Groot, J. Sports participation, physical activity, and health-related fitness in youth with chronic diseases or physical disabilities: the health in adapted youth sports study. J Strength Cond Res 35(8): 2327-2337, 2021-Youth with chronic diseases or physical disabilities (CDPD) often show reduced fitness and physical activity (PA) levels and participate less in organized sports compared with healthy peers. The purpose of this study was to examine the associations between participation in sports and health-related fitness and PA in youth with CDPD. A total of 163 subjects (mean age 14 years; range 8-19 years) with CDPD were included in this cross-sectional study, with 81 participating in organized sports and 82 not. Subjects were recruited between October 2014 and November 2016. Aerobic and anaerobic fitness, agility, and muscle strength were assessed in the laboratory, whereas PA was monitored in daily life using accelerometry during 1 week. Linear regression analyses were used to assess the associations of sports participation (independent variable) with health-related fitness and PA (dependent variables). Results show that youth with CDPD participating in organized sports 2 times a week performed better on all outcome measures. They reached a higher peak oxygen uptake (difference of 4.9 ml O2·kg-1·min-1, P = 0.001) compared with their peers not participating in sports. Also, anaerobic fitness, agility, muscle strength, and PA were all positively associated with sports participation. Moreover, the association between sports participation and aerobic fitness was mediated by PA for 31% (P = 0.045). In conclusion, participation in sports is associated with both higher levels of PA and health-related fitness in youth with CDPD. Promotion and stimulation of participation in sports seems a good way to promote health-related fitness as well as a healthy active lifestyle in youth with CDPD.

Objective To give an overview of the available methods to investigate research misconduct in health-related research. Study Design and Setting In this scoping review, we conducted a literature search in MEDLINE, Embase, The Cochrane CENTRAL Register of Studies Online (CRSO), and The Virtual Health Library portal up to July 2020. We included papers that mentioned and/or described methods for screening or assessing research misconduct in health-related research. We categorized identified methods into the following four groups according to their scopes: overall concern, textual concern, image concern, and data concern. Results We included 57 papers reporting on 27 methods: two on overall concern, four on textual concern, three on image concern, and 18 on data concern. Apart from the methods to locate textual plagiarism and image manipulation, all other methods, be it theoretical or empirical, are based on examples, are not standardized, and lack formal validation. Conclusion Existing methods cover a wide range of issues regarding research misconduct. Although measures to counteract textual plagiarism are well implemented, tools to investigate other forms of research misconduct are rudimentary and labour-intensive. To cope with the rising challenge of research misconduct, further development of automatic tools and routine validation of these methods is needed. Trial registration number Center for Open Science (OSF) ( https://osf.io/mq89w ).