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Organizations utilize self‐regulation promoting interventions to empower employees in managing challenges and resources autonomously. However, there is limited understanding of how these interventions impact employee task performance and innovative behavior, as well as which processes are critical for their effectiveness. Therefore, a field experiment was conducted to examine the effects of two self‐regulation promoting interventions—the Productivity Measurement and Enhancement Systems intervention (ProMES), a job crafting intervention, and their combination—on individual employee performance and innovation through selected process variables. We collected data before, during, and after the interventions over 16 weeks among 123 employees across three experimental and one control group. Consistent with predictions, participants of the ProMES intervention reported a higher level of perceived team climate, which consequently contributed to greater individual innovative behavior. Participants in the job crafting intervention exhibited an increase in job crafting behaviors, which consequently increased innovative behavior and task performance. Unexpectedly, the combined intervention yielded negative effects on both innovative behavior and task performance. The findings suggest that while self‐regulation promoting interventions increase favorable outcomes through different mechanisms their combination may impair relevant processes and, more generally, overwhelm employees. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study investigated adherence to physical activity (PA) guidelines and associated sociodemographic factors among older Koreans from 2011 to 2020. Methods: Utilizing four public data sets from the National Survey of Older Koreans, the study included the data on 40,993 older adults 65 years and older in South Korea, collected between 2011 and 2020. Adherence to PA guidelines and sociodemographic factors were assessed through self-reported questionnaires. The data were analyzed using a two-way analysis of variance and post hoc tests. Results: Overall adherence increased from 39.1% in 2011 to 48.2% in 2017, then decreased to 37.6% in 2020 (p <.001). Men had higher adherence than women (p <.001). Age-related adherence peaked in the young-older group (65–74 years old) and was lowest in the oldest-old group (85+ years old) (p <.001). Marital status, education, and income were also significantly related to PA adherence (p <.001) across the years. Conclusion: Although continuous increase in adherence to PA among Koreans 65 years and older was observed, the decline in PA levels during the COVID era underscored the need for targeted interventions and well-informed health care policies to address demographic challenges. Still, considering that data were collected during the recommended social distancing period, a cautions interpretation of these findings is warranted. Significance/Implications: Health policies aiming to improve adherence to PA guidelines should prioritize Korean older adults who are female, belong to the oldest-old group, are single, and have low education and income levels, with the goal of enhancing health equity. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether genetic variations in cytokine genes involved in the pathogenesis of peri-implantitis are associated with the occurrence of peri-implantitis, an issue that remains controversial and may vary according to the population evaluated. Materials and Methods: A cross-sectional analytical study was carried out on 102 Caucasian Portuguese individuals who were divided into two groups: (1) 43 individuals with peri-implantitis and (2) 59 individuals with good peri-implant health. Samples from the buccal mucosa were obtained, and genetic analysis was performed using the real-time polymerase chain reaction (PCR) technique for IL-1A and IL-1B and PCR for IL-1RN. Results: The IL-1A-889 C/T polymorphism presented with a higher prevalence of the less common allele (T allele) in patients with peri-implantitis (27.9%) than in healthy patients (16.9%), but without statistical significance (P = .060). For the IL-1B+3954 C/T and IL-1RN (variable number of tandem repeats [VNTR]) polymorphisms, analysis revealed that the allele and genotype frequencies did not differ significantly between groups. There was a significant association between a history of periodontitis and peri-implantitis (P = .020). Conclusions: The evaluated genetic polymorphisms had no influence on the occurrence of peri-implantitis in the study population. Further research into genetic variations in different populations is needed to elucidate the role of genetic factors in the onset and progression of peri-implant disease. [ABSTRACT FROM AUTHOR]

PurposeTo determine the association between sociodemographic characteristics and blood pressure among a demographically diverse population-based sample of 10-14-year-old US adolescents.MethodsWe conducted cross-sectional analyses of data from the Adolescent Brain Cognitive Development Study (N = 4,466), year two (2018-2020). Logistic and linear regression models were used to determine the association between sociodemographic characteristics (sex, race/ethnicity, sexual orientation, household income, and parental education) with blood pressure among early adolescents.ResultsThe sample was 49.3% female and 46.7% non-White. Overall, 4.1% had blood pressures in the hypertensive range. Male sex was associated with 48% higher odds of hypertensive-range blood pressures than female sex (95% confidence interval [CI], 1.02; 2.14), and Black race was associated with 85% higher odds of hypertensive-range blood pressures compared to White race (95% CI, 1.11; 3.08). Several annual household income categories less than $100,000 were associated with higher odds of hypertensive-range blood pressures compared to an annual household income greater than $200,000. We found effect modification by household income for Black adolescents; Black race (compared to White race) was more strongly associated with higher odds of hypertensive-range blood pressures in households with income greater than $75,000 (odds ratio 3.92; 95% CI, 1.95; 7.88) compared to those with income less than $75,000 (odds ratio 1.53; 95% CI, 0.80; 2.92).DiscussionSociodemographic characteristics are differentially associated with higher blood pressure in early adolescents. Future research could examine potential mediating factors (e.g., physical activity, nutrition, tobacco) linking sociodemographic characteristics and blood pressure to inform targeted interventions.

The prevalence rates and correlates of mental or physical disability among recently resettled refugees, who undergo strenuous journeys before arriving in the US, remain unknown, masking potential health disparities. Self-reported disability was measured by the 2018 Annual Survey of Refugees (ASR), and defined as having a physical, mental, or other health condition for more than 6 months that precluded one from working. Prevalence rates of self-reported disability and sample correlates were investigated using descriptive and logistic regression analyses. Of N = 4259 participating refugees in ASR (Mean Age = 28.2, SD = 17.2; 52.5% male), 2875 responded to the disability question and 21.4% reported disability. About 33.7% were born in the Middle East region, 29.5% had no formal education, and 35% had an income of less than $15,000. Age (OR = 1.06, 95% Confidence Interval (CI) [1.06,1.07], p

Purpose: Environmental factors modulate oral-health-related quality of life (OHRQoL). The aim of this study was to analyse sociodemographic and behavioural factors affecting the OHRQoL in Spanish adolescents, by using the Child-OIDP (Child-Oral Impacts on Daily Performances) index. Materials and Methods: A cross-sectional study was conducted in 337 adolescent schoolchildren aged 13–15 years. A questionnaire on sociodemographic, behavioural and oral self-perception factors was administered with the Child-OIDP questionnaire. Descriptive statistics, Kruskal-Wallis and Mann-Whitney U-tests, as well as a regression model were used in the data analysis. Results: The overall mean Child-OIDP index was 3.28±6.55. It was statistically significantly higher in females than in males (p < 0.001). Mothers having a managerial job showed statistical association with worse OHRQoL (p < 0.001). Caries experience and history of dental trauma were not associated with the oral-health-related quality of life (p > 0.05). Halitosis statistically significantly affected the activities of daily living (p < 0.001). Perceived dental problems, dental treatment needs, self-assessment of oral health status and satisfaction with oral health were associated with the impact index (p < 0.05). Conclusion: Mothers who were managers, female sex, presence of halitosis, and perceived dental treatment needs were the most important predictors of the impact index, while dietary habits, oral hygiene, and dental visits did not affect it. Knowledge of these factors will help dental professionals to apply adequate preventive and therapeutic measures. [ABSTRACT FROM AUTHOR]

Context: This study investigated individual sociocognitive factors from the theory of planned behavior and their relationship to exercise for postconcussion recovery. Design and Methods: Four hundred and fifty-nine Australian adults, two-thirds of whom had no concussion history (66%), completed an online survey of their beliefs and attitudes toward exercise for postconcussion recovery. Secondary questions evaluated program design features that could affect engagement (eg, session frequency). Results: Structured equation modeling found that subjective norms were the strongest significant predictor of intention to participate in exercise for postconcussion recovery. Perceived behavioral control was also a significant predictor of intention to participate but to a lesser extent. Attitude did not predict participation intention. The design features identified as key were personalization and being supervised during the program. Conclusions: This study found that people's intention to participate in a program of exercise postconcussion recovery is shaped by individual psychological factors and identified program design features that could be adjusted for increased engagement. Program success could be maximized through strategies such as supporting individuals to have a stronger sense of control over their participation through the choice of session timing or frequency and harnessing the influence of significant others via supportive messaging from key professionals. [ABSTRACT FROM AUTHOR]

Purpose: To identify and map the scientific evidence regarding factors associated with the nonadaptation of completely edentulous patients to mandibular complete dentures. Materials and Methods: This scoping review followed the PRISMA-ScR statement for Scoping Reviews and was based on guidelines proposed by Arksey and O'Malley and the Joanna Briggs Institute Manual for Evidence Synthesis. The methodology was registered on the Open Science Framework. An electronic search strategy was conducted in PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, Virtual Health Library, ClinicalTrials.gov, Google Scholar, and ProQuest databases was conducted. Studies that evaluated factors associated with adaptation to and acceptance of mandibular complete dentures were included, such as sociodemographic, psychologic, patient-related, and denture-related items. Results: The search conducted in March 2022 yielded 9,978 studies. In total, 24 studies were included for data extraction. Sociodemographic factors did not interfere with adaptation to a mandibular complete denture. Psychologic factors and patient-related aspects showed greater association with nonadaptation to mandibular complete dentures than denturereported factors. Conclusion: Although it is suggestive that psychologic and patient-related factors have higher association with the acceptance of new dentures, data must be interpreted with caution due to the variability of methodologies of the studies included in this review. [ABSTRACT FROM AUTHOR]

This study examined the prevalence and sociodemographic correlates of meeting individual behavior and 24-hr movement behavior guidelines among Brazilian older adults with chronic diseases. The sample comprised 273 older adults aged ≥60 years (80.2% women) with chronic diseases from Recife, Pernambuco, Brazil. Sociodemographic variables were self-reported, while 24-hr movement behaviors were assessed by accelerometry. Participants were classified as meeting (or not meeting) individual and integrated recommendations for moderate-to-vigorous physical activity (MVPA), sedentary behavior, and sleep duration. No participant met the 24-hr movement behavior guidelines, while only 8.4% met integrated MVPA/sleep recommendations. The prevalence of meeting recommendations of MVPA, sedentary behavior, and sleep was 28.9%, 0.4%, and 32.6%, respectively. Discrepancies according to sociodemographic variables on meeting MVPA recommendations existed. The findings show the need for dissemination and implementation strategies to foster adoption of the 24-hr movement behavior guidelines among Brazilian older adults with chronic diseases. [ABSTRACT FROM AUTHOR]

Lung neuroendocrine tumors (NETs) have few known predictors of survival. We investigated associations of sociodemographic, clinicopathologic, and treatment factors with overall survival (OS) and lung cancer-specific survival (LCSS) for incident lung NET cases (typical or atypical histology) in the California Cancer Registry (CCR) from 1992 to 2019. OS was estimated with the Kaplan-Meier method and compared by sociodemographic and disease factors univariately with the log-rank test. We used sequential Cox proportional hazards regression for multivariable OS analysis. LCSS was estimated using Fine-Gray competing risks regression. There were 6038 lung NET diagnoses (5569 typical, 469 atypical carcinoid); most were women (70%) and non-Hispanic White (73%). In our multivariable model, sociodemographic factors were independently associated with OS, with better survival for women (hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.57-0.68, P < 0.001), married (HR 0.76, 95% CI 0.70-0.84, P < 0.001), and residents of high socioeconomic status (SES) neighborhoods (HRQ5vsQ1 0.73, 95% CI 0.62-0.85, P < 0.001). Compared to cases with private insurance, OS was worse for cases with Medicare (HR 1.24, 95% CI 1.10-1.40, P < 0.001) or Medicaid/other public insurance (HR 1.45, 95% CI 1.24-1.68, P < 0.001). In our univariate model, non-Hispanic Black Californians had worse OS than other racial/ethnic groups, but differences attenuated after adjusting for stage at diagnosis. In our LCSS models, we found similar associations between sex and marital status on survival, but no differences in outcomes by SES or insurance. By race/ethnicity, American Indian cases had worse LCSS. In summary, beyond disease-related and treatment variables, sociodemographic factors were independently associated with survival in lung NETs.

Objectives: This study investigates the associations of retrospective reports of Recession hardships with 10-year changes in subjective and objective indicators of sleep, and whether these associations differ by race and gender. Methods: Five hundred and one adults (14.57% Black; 54.49% female) from the Midlife in the United States (MIDUS) study reported on the subjective Pittsburgh Sleep Quality Index (PSQI) across two waves (pre-Recession, collected 2004–2009; post-Recession, collected 2017–2022), as well as Recession hardships since 2008. A sub-sample of 201 adults (25.37% Black; 58.21% female) provided objective actigraphy-measured sleep data (total sleep time, sleep onset latency, and sleep efficiency) across the two waves. Results: Descriptive analyses revealed Black participants had higher average Recession hardships, poorer post-Recession PSQI scores, and poorer post-Recession actigraphy sleep quantity and quality compared to white participants. Females had higher average Recession hardships compared to males; and reported poorer post-Recession PSQI, but had better objective post-Recession sleep quantity and quality compared to males. Regression models showed Recession hardships (across overall events, and sub-domains of financial and housing hardships) were associated with poorer PSQI and actigraphy-measured sleep efficiency following the Recession, adjusting for sociodemographic covariates, corresponding pre-Recession sleep variables, and pre-Recession chronic conditions. There was no evidence for significant moderation by race on sleep outcomes. However, gender moderation indicated associations between housing hardships and poorer actigraphy-measured sleep efficiency were more apparent for females than for males. Conclusions: Findings indicate that Recession hardships (particularly in financial and housing domains) may be manifested in poor sleep. Racial and gender groups may have differential exposure and sleep-related reactivity to Recession hardships. [ABSTRACT FROM AUTHOR]

Background: Cigarette smoking is one of the leading causes of morbidity in the world. Virtual reality (VR) has been used to encourage and support quit attempts. However, interest in VR may differ according to sociodemographic characteristics. This study aimed to estimate the proportion and associated characteristics of smokers in Great Britain who were interested in using VR for smoking cessation. Methods: Data were collected from 6,858 adults between February to April 2023, from the Smoking Toolkit Study—a monthly, nationally representative, cross-sectional survey of adults in Great Britain. Of these, 873 were smokers (unweighted). Prevalence of interest was assessed descriptively and associations between interest and sociodemographic and smoking characteristics were analysed with weighted logistic regression models. Results: Of 905 (weighted) smokers, 34.6% (95% Confidence Interval (CI):31.0%-38.5%) were interested in using VR for smoking cessation. Smokers had greater odds of reporting interest in VR for smoking cessation who were: highly motivated to quit (Odds Ratio (OR):2.41, 95% CI:1.59–3.65), had made a quit attempt in the past year (OR:1.95, 95% CI:1.37–2.77), currently trying to cut down (OR:1.90, 95% CI:1.34–2.67) and interested in VR generally (OR:10.42, 95% CI:6.97–15.57). Those ≥ 65 years old (OR:0.29, 95% CI:0.15–0.57) and women (OR:0.69, 95% CI:0.49–0.97) were less likely to report interest. Conclusions: The results of this study indicate that up to a third of adult smokers may be interested in using VR to support a quit attempt. However, the potential reach of a VR smoking cessation intervention may be lower in certain subgroups such as women, adults 65 years or older, and adults less motivated to quit. From a health equity perspective, it is recommended that non-digital but effective interventions should be made readily available for adults at risk of digital exclusion due to lack of interest. However, as VR grows in popularity and its technological potential becomes fully realised, future research could also focus on strategies to reduce digital exclusion and increase interest. For example, by involving these subgroups in co-design activities and using novel dissemination strategies. [ABSTRACT FROM AUTHOR]

Background: Childhood hearing loss poses a significant public health challenge in Pakistan, with prevalence rates over double the global average. Parental knowledge and attitudes play a crucial role in timely detection and intervention. However, limited research explores this issue within the Pakistani context. This study aimed to examine parental knowledge and attitudes regarding childhood hearing loss in Rawalpindi, Pakistan, and identify key demographic factors influencing parental perspectives. Methods: This cross-sectional survey was conducted in Rawalpindi, Pakistan from March 1 to August 31, 2023. A total of 150 parents (79 fathers and 71 mothers) of children aged 0–12 years were recruited through convenience sampling at public locations such as schools, malls, and hospitals. Data were collected through face-to-face interviews using the validated "Parental Knowledge and Attitudes towards Childhood Hearing Loss Questionnaire," administered by a graduate student to assess parental knowledge and attitudes about childhood hearing loss. Descriptive statistics determined the percentage of correct responses and knowledge/attitudes scores. Chi-square tests explored associations between demographic factors and parental perspectives. Results: Overall, 67.3% of parents demonstrated good knowledge of childhood hearing loss. Notably, parents scored high on recognizing congenital causes (79.3%) but displayed low awareness of measles as a risk factor (29.3%). Significant gender disparities emerged in parental knowledge, with mothers exhibiting superior knowledge compared to fathers regarding newborn screening (63.4% vs. 46.8%), treatment availability (81.7% vs. 64.6%), and educational inclusion for children with hearing impairment (57.7% vs. 38.0%). Despite these knowledge gaps, parents generally held positive attitudes towards childhood hearing loss, with an average score of 94.7%. Gender and educational level significantly influence knowledge and attitudes. Conclusions: Although parents in Rawalpindi generally have a good understanding and positive attitudes towards childhood hearing loss, gaps in knowledge about preventable causes and gender disparities need attention. Providing tailored counselling for higher-risk, less educated groups and expanding policies for paediatric audiology services nationwide can help address these issues. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the 5-year impact of a Health Empowerment Program (HEP) on mitigating problematic conducts and enhancing the health-related quality of life (HRQOL) among children living in poverty. Methods: A prospective cohort study (N = 239, Intervention group: n = 124, Comparison group: n = 115) was established with participants recruited between July 2013 and March 2016 and followed until November 2021. During the 5-year study period, children and their parents from the intervention group were invited to join a multi-dimensional HEP. At baseline and follow-up, both intervention and comparison groups were assessed using the Chinese Strengths and Difficulties Questionnaire (SDQ) and Chinese Child Health Questionnaire Parent Form 28 (CHQ-PF28). Multiple linear regressions were conducted to identify changes in outcome variables as the effect of the HEP. Results: Upon completion of the 5-year follow-up, children in the intervention group showed a larger decline in conduct problems (B = − 0.66, p <.001), hyperactivity inattention (B = − 0.67, p =.005), and total difficulties score (B = − 1.89, p =.002) of SDQ, a greater increase in prosocial behavior of SDQ (B = 0.53, p =.040), and more substantial enhancement in CHQ-PF28's psychosocial summary score (B = 2.75, p =.017) compared to the comparison group. Conclusions: HEP is effective in mitigating behavioral problems and improving psychosocial HRQOL of children of low-income families, as evident by this 5-year cohort study. Trial Registration: This study received approval (UW 12–517) from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster. [ABSTRACT FROM AUTHOR]

The ongoing war in Ukraine has significantly impacted the mental health of academic staff, with anxiety emerging as a predominant issue. This study aimed to assess the prevalence and severity of generalized anxiety disorder (GAD) among Ukrainian academic staff and determine the influence of sociodemographic factors, such as gender, age, migration status, scientific degree, and job title, on anxiety levels. The research was conducted using a cross-sectional online survey between December 2023 and February 2024. The sample included 429 participants from various Ukrainian universities, representing both male and female academic staff, holding job positions such as assistants, senior lecturers, associate professors, and full professors. The findings revealed that 44.3% of participants experienced moderately severe to severe anxiety, with migration due to the full-scale war being a significant predictor of higher anxiety levels. Notably, male academic staff exhibited higher anxiety levels than their female counterparts, contrary to typical peacetime trends, suggesting that wartime responsibilities and societal expectations may play a crucial role. The data underscore the need for targeted mental health support, particularly for displaced academic staff, and highlight the importance of developing gender-specific interventions. These insights are vital for informing policies and support programs to enhance academic staff's mental health and productivity in conflict zones, ensuring the continuity and quality of scientific research during and after the war. [ABSTRACT FROM AUTHOR]

Background: Diabetes management poses significant challenges worldwide, with individuals often facing increased risks of mental health issues, including suicidal behaviors. While traditional statistical methods have been used to assess risk factors, this study introduces machine learning techniques to predict suicidal behaviors among diabetic patients. Therefore, this study aims to investigate the prevalence and risk factors of suicidal behaviors among individuals with diabetes in Bangladesh using both traditional statistical methods and machine learning models. Methods: A cross‐sectional study was carried out with 390 diabetic patients, assessing demographic characteristics, diabetes‐related variables, mental health indicators, and suicidal behaviors. Statistical analyses including chi‐square tests and logistic regression, and various machine learning models, were employed to examine associations and predict risk factors. Results: This study found that 13.8% of the individuals with diabetes reported lifetime suicidal behavior and 9.0% reported past‐year suicidal behavior. Significant risk factors associated with higher rates of suicidal behaviors included younger age, marital status, lower monthly income, higher educational attainment, being insulin users, not having a family history of diabetes, and suffering from anxiety. Among the machine learning models tested, the CatBoost model outperformed others, obtaining low log loss values of 0.45 and 0.32 for lifetime and past‐year suicidal behaviors, respectively. CatBoost demonstrated excellent accuracy rates of 83.97% and 88.46%, significantly higher than those of traditional logistic regression models. The most significant predictors identified by machine learning were treatment type, followed by occupation, anxiety, age group, and having chronic diseases. Conclusion: The findings suggest the urgent need for comprehensive interventions and support systems for individuals managing diabetes, particularly those at higher risk of suicidal behaviors. Machine learning offers improved predictive power and the ability to identify complex patterns in risk factors. Collaborative efforts between healthcare providers, mental health professionals, and public health initiatives are essential for prioritizing mental well‐being in diabetes management. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic generated or accelerated healthcare changes, some of which persist thereafter (e.g., healthcare reorganisation, remote consultation). Such changes entail novel risks for patient safety. Methods: Aim To compare the characteristics of patient safety incidents with harm (PSIH) in primary care before the pandemic and at present. Design and setting Cross-sectional, comparative, observational study conducted within the entire Primary Care Service of the Madrid region with observations at two time points (2018 and 2021/2022). Participants Patients > 18 years of age with at least one consultation in the previous year. The necessary sample size was established at N1 = 2,000 for the first time point and N2 = 2,700 for the second. Sampling was performed by simple randomisation for the first group and by clusters followed by simple randomisation for the second. Main measurements Age, gender, presence of PSIH in the medical record, and characteristics of the PSIH, specifically avoidability, severity, place of occurrence, nature, and contributory factors. Triggers validated in primary care were employed to screen the patients' medical records and those containing any trigger were reviewed by three nurse-physician teams who underwent previous training. Analysis Comparative analysis using Fisher's exact test. Results: A total of 63 PSIHs and 25 PSIHs were found for the first and second samples, respectively. The comparison of the characteristics of PSIH before the pandemic and currently was: avoidable 62% vs. 52% (p = 0.47), mild 51% vs. 48% (p = 0.57), in the primary care setting 73% vs. 64% (p = 0.47), respectively. Although no statistically significant differences were observed globally in the nature of the incidents (p = 0.13), statistically significant differences were found for diagnostic errors, with pre-pandemic rates of 6% vs. 20% at present (p < 0.05). Finally, no significant differences were found in the contributory factors. Conclusions: No differences were found in the avoidability, severity, place of occurrence, or contributory factors of PSIHs before the pandemic and currently. In terms of the nature of these incidents, the outcomes revealed an increase in diagnostic errors (excluding diagnostic tests), which could be attributed to a greater frequency of remote consultations and a decrease in the longitudinality of care resulting from the shortage of professionals. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyze the historical trends of inflammatory bowel disease (IBD) burden in the elderly from 1990 to 2021 and forecast future trends up to 2051. Methods: Data from the Global Burden of Disease Study 2021 were utilized. Age-standardized rates (ASR) for incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were calculated. Estimated annual percentage changes (EAPCs) were computed to quantify temporal trends. A Bayesian Age-Period-Cohort model was employed to project future trends. Results: From 1990 to 2021, the global number of elderly IBD increased from 573,500 to 1,278,190. The age-standardized incidence rate (ASIR) rose from 8.01 to 8.77 per 100,000, while the age-standardized prevalence rate (ASPR) slightly decreased from 118.14 to 117.29 per 100,000. Death number increased from 14,400 to 33,490, but the age-standardized mortality rate decreased from 3.21 to 2.84 per 100,000. DALYs increased from 324,100 to 683,750, with the age-standardized DALYs rate declining from 68.78 to 60.88 per 100,000. Significant geographical variations were observed, with high Socio-demographic Index regions showing the highest burden. Projections suggest that by 2051, elderly IBD prevalence number may reach 2,316,000, with ASIR and ASPR potentially rising after 2035 and 2042, respectively. Deaths and DALYs are projected to increase to 75,000 and 1,401,000 respectively, despite continued declines in ASRs. Conclusion: The absolute burden of IBD in the elderly population is projected to increase substantially by 2051, despite decreasing ASRs. These findings underscore the need for tailored healthcare strategies and resource allocation to address the growing challenge of elderly IBD globally. [ABSTRACT FROM AUTHOR]

Background: As South Africa's population rapidly ages, the burden of non-communicable diseases and the challenges of performing daily care activities among older individuals are increasing. This study investigates trends in self-reported difficulties with daily care activities among older adults in South Africa and examines the association between these difficulties, sociodemographic factors, and chronic conditions. Methods: The study used cross-sectional data from ten rounds of South Africa General Household Survey (2012–2021). Sample population included 26,362 men and 42,400 women aged 60 years and above. The outcome measure was assessed by self-reported difficulty in performing basic care activities such as washing or dressing. Results: Between 2012 and 2021, the percentage of participants reporting "A lot of difficulty" increased by 79.75%, "Some difficulty" increased by 112.11%, while "Unable to do" decreased by 8.97%. The risk of self-care difficulties was higher for men (RR = 1.11, 95% CI = 1.02, 1.20) and increased with age: RR = 1.24 (95% CI = 1.08, 1.42) for ages 65–69; RR = 2.27 (95% CI = 2.00, 2.58) for ages 70–74; and RR = 5.65 (95% CI = 5.08, 6.28) for ages 75+. Not being currently married (RR = 1.65, 95% CI = 1.51, 1.79), being of African/Black (RR = 1.21, 95% CI = 1.06, 1.38) or Coloured race (RR = 1.41, 95% CI = 1.21, 1.65), and having diabetes (RR = 1.44, 95% CI = 1.34, 1.55), hypertension (RR = 1.35, 95% CI = 1.26, 1.45), or asthma (RR = 1.30, 95% CI = 1.14, 1.48) were also associated with a higher risk of self-care difficulties. Conclusion: There was a notable increase in the proportion of participants reporting significant difficulty and some difficulty in performing self-care tasks, while a decrease was observed in the category of participants unable to do such tasks. Health policies should prioritize the specific needs of vulnerable sociodemographic and health groups, considering their increased risk of self-care difficulties. [ABSTRACT FROM AUTHOR]

Background: As part of efforts to reach the elimination target by 2030, the WHO and CDC recommend that all HCWs adhere to the three‐dose Hepatitis B vaccination schedule to protect themselves against the infection. This study assessed Hepatitis B vaccination coverage and associated factors among personnel working in health facilities in Kumasi, Ashanti Region, Ghana. Materials and Methods: A cross‐sectional study involving 530 HCWs was conducted in four hospitals in Kumasi from September to November 2023. An investigator‐administered questionnaire was employed in gathering participant demographics and other information related to vaccination coverage. IBM SPSS Version 26.0 and GraphPad Prism 8.0 were used for analysing the data. Results: Even though the majority (70.6%) reported having taken at least one dose of the vaccine, only 43.6% were fully vaccinated (≥ 3 doses). More than a quarter (29.4%) had not taken any dose of the HBV vaccine. Close to a quarter (23.6%) had not screened or tested for HBV infection in their lifetime. The statistically significant variables influencing vaccination status were age, marital status, profession, and status in the hospital. Nearly one‐half (44.9%) of the participants who have not taken the vaccine reported they do not have a reason for not taking it, and a high proportion (80.1%) were willing to take the vaccine when given for free. Conclusion: To combat the low Hepatitis B vaccination coverage among healthcare workers in Kumasi, Ghana, amidst the significant public health threat of HBV infection, comprehensive measures are necessary. These include implementing infection prevention control programmes, enhancing occupational health and safety, and conducting health promotion campaigns in healthcare facilities. Extending and intensifying Hepatitis B screening and vaccination initiatives to tertiary institutions and encouraging employers, supervisors, or team leaders to provide these services nationwide are also recommended. [ABSTRACT FROM AUTHOR]

Background: Self‐management (SM) is the gold standard of care and is the direct active participation of patients in their disease management. Condition‐specific factors, physical and social environment, individual and family, and the process of SM are factors that influence SM in people living with human immunodeficiency virus (PLHIV). Poor SM leads to high retroviral infection transmission, mortality, and morbidity. Objective: This study was aimed at assessing SM and its associated factors among PLHIV at the University of Gondar Comprehensive Specialized Hospital (UOGCSH), Northwest Ethiopia. Methods: A cross‐sectional study was conducted using a systematic random sampling technique at the UOGCSH from May 20 to July 30, 2022. The data were collected using a previously validated tool and were entered and analyzed using Statistical Package for Social Sciences Version 25. A binary logistic regression analysis was used to identify factors associated with poor SM. The statistical significance was considered at a p value < 0.05. Result: Of 419 PLHIV, the median (IQR) SM score was 39 (9), and above half (52.6%, 95% CI: 48%–57%) of them had poor SM. Being unemployed (AOR = 2.49, 95%CI = 1.19, 5.19), living alone (AOR = 2.16, 95%CI = 1.12, 4.17), unfamiliar with the management of HIV‐related symptoms (AOR = 3.59, 95%CI = 2.08, 6.20), poor social support (AOR = 3.02, 95%CI = 1.54, 5.93), poor self‐efficacy (AOR = 3.04, 95%CI = 1.83, 5.06), and unsupported by the adherence support group (AOR = 17.17, 95%CI = 8.37, 35.22) were significantly associated with poor SM. Conclusion: The majority of PLHIV had poor SM. This study supports the findings of individual family SM theory and previously published studies regarding factors affecting SM. The government, hospital, adherence support groups, and PLHIV should work on modifiable sociodemographic, condition‐specific, and process of SM to improve SM of PLHIV. [ABSTRACT FROM AUTHOR]

Background: Turnover intention (TI) indicates an employee's intention to depart from their current role within a defined timeframe. In China, the Targeted Admission Medical Education (TAME) program, initiated in 2010, offers tuition-free education to cultivate rural doctors. Despite continuous professional development (CPD) being considered a viable retention strategy, TI of alumni doctors from the TAME program remains high in recent years. This study aims to describe the prevalence of "turnover intention" among alumni doctors of the TAME program doctors in rural placements, and associated factors that predict high turnover intention. Methods: A snowball sampling method was adopted to collect survey responses from 1,369 alumni doctors of the TAME program in Jiangxi Province, China. Based on the survey data, a binary variable was constructed to measure the turnover intention, and multivariate binary logistic regression models were used to investigate the relationship between doctors' turnover intention and demographic characteristics, work environment characteristics, and CPD activities. Results were presented using adjusted odds ratios with 95% confidence intervals. Results: Among the 1,369 alumni doctors of the TAME program surveyed in this study, 392 (28.6%) expressed intentions to leave their current positions. Of the respondents, 620 (45.3%) were female, and 930 (67.9%) were married. Additionally, 1,232 respondents (90%) indicated that their fathers were engaged in farm work. Strong associations with turnover intention were notably found among individuals who had undergone training at a higher-level healthcare institution for more than three months (aOR = 6.810, 95% CI: 3.333 to 13.909, p-value < 0.001), particularly those who had participated in CPD through a graduate degree program (aOR = 1.818, 95% CI: 1.272 to 2.597, p-value < 0.001). Conclusion: Rural doctors in China from the tuition-free medical education program exhibit high turnover intention, especially those in graduate degree programs as CPD. To retain these highly qualified rural doctors, it is vital to offer competitive efficiency wages aligned with their skills and provide ample long-term career growth opportunities within the rural healthcare system. Highlights: Retaining rural doctors in China who graduated from the tuition-free medical education program continues to pose a significant challenge. High turnover intention is particularly prevalent among those enrolled in CPD graduate degree programs. Offering competitive efficiency wages and creating abundant long-term career growth opportunities within the rural healthcare system are essential measures. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Self‐management is vital for individuals with mild cognitive impairment (MCI) to enhance cognitive health and mitigate the risk of dementia. However, maintaining consistent engagement in self‐management strategies can be challenging for older adults with MCI. This study aimed to explore the associations between sociodemographic and clinical characteristics and adherence to self‐management behaviours among community‐dwelling older adults with MCI.A cross‐sectional study involving 467 community‐dwelling older adults with MCI was conducted from July to November 2022 across Nanjing, Xuzhou, and Lianyungang in Jiangsu Province, China. Data on sociodemographic and clinical characteristics, as well as self‐management behaviours for MCI, were collected. Multiple linear and binary logistic regressions were employed to identify factors influencing self‐management behaviours.Among the four recommended self‐management behaviours for MCI, participants adopted an average of 1.37 ± 1.202 behaviours. Physical exercise (n = 239; 51.2%) was the most prevalent behaviour, followed by modifiable risk factors management (n = 156; 33.4%), cognitive training (n = 144; 30.8%), and cognitive function monitoring (n = 103; 22.1%). Higher education level (B = 0.286, P < 0.001), urban employee medical insurance (B = 0.621, P < 0.001), and non‐smoking status (B = 0.389, P = 0.002) positively correlated with aggregate MCI self‐management behaviours, while older age (B = −0.295, P < 0.001) had a negative association. Marital status, monthly income, employment status, gender, residence, and family history of cognitive disorders were also found to be associated with specific self‐management behaviours for MCI.Enhancing adherence to self‐management among community‐dwelling older adults with MCI is critical. Sociodemographic and clinical factors should be considered to pinpoint at‐risk populations and accordingly tailor support strategies. [ABSTRACT FROM AUTHOR]

Background: Regional anesthesia (RA) can improve patient outcomes and reduce perioperative complications including deaths. Despite its benefits, RA is less utilised in low-resource settings. The purpose of this study was to assess practice and challenges related to RA in Amhara Regional Hospitals, Northwest-Ethiopia. Methods: A web- based survey was distributed among 360 anesthetists working in Amhara Regional Hospitals, Northwest-Ethiopia from November 15 - January 30, 2023. An English, semi-structure, self-administered questionnaire was disseminated by email and telegram following ethical clearance. The survey included questions about the use of RA, socio-demographic characteristics of anesthetist, types of practiced regional blocks, and barriers to perform RA. All volunteer respondents who filled online questionnaire during study period were included. The data were coded and analyzed using statistical package for social Sciences (SPSS) software-version 20. Both inferential and descriptive statistics were used to describe the results. Results: The overall response rate was 63.3% (223 out of 360 completed surveys). A total of 132 respondents (36.7%) did not provide a response, and 5 respondents (1.4%) submitted incomplete) surveys. The most frequently self-reported barriers to performing peripheral nerve blocks were a lack of equipment (regional procedure kit including block needle, ultrasound, nerve stimulator, or epidural set) 185 (82.9%), lack of knowledge 171(76.7%), lack of practical skills 112 (50.2%), and lack of drugs/medication 50 (22.4%). Conclusions: The principal findings indicate that all respondents perform spinal anaesthesia, while the practice of peripheral RA varies. Reported barriers to performing RA are related to knowledge and training, as well as a lack of equipment (there aren't enough regional procedure kits available that include an epidural set, block needle, nerve stimulator, and ultrasound). A more stringent approach with specific requirements, distinguishing between neuraxial and peripheral blocks, enhance training opportunities for peripheral nerve blocks are required in Ethiopia. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion Relevance to Clinical Practice Reporting Method Patient Contribution The infection prevention behaviours of kidney transplant recipients have been investigated, but the factors affecting these have not. Therefore, the present study aimed to examine the infection prevention behaviours of kidney transplant recipients and the factors related to these.The sample of this descriptive, cross‐sectional study included 148 kidney transplant recipients being followed in a kidney transplant outpatient clinic. Data were collected with a sociodemographic and clinical characteristics form, the Adherence to Measures against Infections Questionnaire and the Self‐Control and Self‐Management Scale between November 2022 and May 2023.The mean age of the patients was 50.29 ± 13.11 years. The rate of self‐reported hand hygiene was 51%. Age caused a significant difference in receiving a vaccine against pneumonia and wearing a mask. The rate of self‐reported behaviour of rinsing vegetables was higher among the married patients compared to single patients. Self‐management created a significant difference in receiving a vaccine against influenza and pneumonia, eating salad in a café or restaurant and wearing a mask outside home and consuming raw food, delicatessen products and street food (p < 0.05).This study revealed that the kidney transplant recipients displayed incomplete infection prevention behaviours including hand hygiene. Infection prevention behaviours differed in terms of age and self‐control and self‐management. Education and interventions are needed to improve the infection prevention behaviours of kidney transplant recipients.This study illustrates the characteristics of, and relationship between, sociodemographic factors and self‐management of infection prevention behaviours in kidney transplant recipients.Strengthening the reporting of cross‐sectional studies (STROBE) was followed.The study demonstrates that there is a need for interventions that will improve both the self‐management levels and infection protection behaviours of patients. Studies conducted in this direction will lead to a decrease in the infection rates of patients. [ABSTRACT FROM AUTHOR]

The Orang Asli (OA), Malaysia's indigenous minority, continue to experience ongoing soil-transmitted helminth (STH) infections despite efforts including the Resettlement Programme (RPS). This study explores STH epidemiology and associated risks of moderate-to-heavy infections among 259 indigenous Negritos across four states in Peninsular Malaysia. Stool samples, anthropometrics, haemoglobin levels (finger-prick) and sociodemographic and environmental-sanitation factors via pretested questionnaires were collected. Parasitological examinations (direct faecal smear, formol-ether concentration, and Kato-Katz techniques) were thoroughly performed. The study revealed a 63.3% overall STH prevalence, with Trichuris trichiura (57.9%) being the most common, followed by Ascaris lumbricoides (35.5%) and hookworm (8.9%). Moderate-to-heavy infections were observed in 39.3% for T. trichiura and 48.9% for A. lumbricoides, with mixed infections of these two species being the most prevalent (50.6%). The risk for moderate-to-heavy infection increased significantly if other household members were infected (P < 0.001). Adults and adolescents also showed high infection rates, with no significant differences with children's groups. These findings emphasize the need for anthelmintic treatment across all age groups and strategize local policies targeting older groups of the OA community to control ongoing transmission and reduce the STH burden and protect the future well-being of OA children, who deserve a healthier future. [ABSTRACT FROM AUTHOR]

Background: Heatwave warnings provide crucial information about the nature of the event and the steps that can be taken to mitigate its impact. It is well known that heat events disproportionately impact the health of older adults. Therefore, it's critical that heatwave warnings reach this population. However, our current understanding of the effectiveness of heatwave warning messages among older Queenslanders is limited. Methods: A Queensland wide survey was conducted in 2022 among 547 older adults (≥65 years), aiming to collect information on their perception of heat-related health risk, their knowledge of the existing heatwave warnings, and if they had ever heard of a heatwave warning. Chi-square analysis followed by multinomial or binomial logistic regression was utilized to understand various socio-economic and personal factors that impact the heatwave warning reach to older Queenslanders. Results: Only 43% of the respondents had heard a heatwave warning and only 49% of those who heard a warning(s) changed their behavior as a result. The results showed 20% of respondents perceived themselves to be at heat-related health risk, and these individuals were 1.98 times more likely to have heard heatwave warnings. Further, individuals who perceived themselves to be at heat-related health risk were 3.62 times more likely to adopt adaptive measures in response to heatwave warnings. Implications: This study suggests that in older adults, higher knowledge and perception of heat-related health risk are associated with higher likelihoods of attention to heatwave warnings and adoption of cooling measures. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) can adversely affect pregnancy, yet their prevalence in rural communities remains poorly understood. Objective: For an initial evaluation of the UTI burden among pregnant women in the San Marcos province of rural Andean Peru, we aimed to determine the UTI prevalence in the region. Design: A cross-sectional study was conducted in a subsample of 250 pregnant women enrolled in the Peruvian Andes Multigenerational High Altitude Cohort (ALTO) from 2021 to 2022. Methods: Structured questionnaires were administered to collect demographic, socioeconomic, maternal health and behavioural data. Urine samples were obtained for dipstick analyses. Descriptive and logistic regression analyses were performed to investigate the association between risk factors and UTI. Results: The study participants had a median age of 28 years (IQR: 22–33). A UTI prevalence of 27.6% (CI: 22.4%–33.5%) was observed, surpassing estimates from other regions of Peru. Notably, nearly all pregnant women (96%) utilised antenatal care (ANC) services at least once, primarily visiting health centres and community health posts where doctors and obstetricians were the main care providers. In this population, none of the risk factors exhibited statistically significant associations with UTIs. Conclusion: Our study highlights the prevalence of UTIs among Andean pregnant women in San Marcos and underscores the critical need for routine UTI screening and treatment during ANC visits as recommended by national guidelines. While accessibility to ANC services is not a barrier in this region, enhancing the availability and quality of UTI screening services is crucial. Plain language summary: How Common Are Urinary Tract Infections in Pregnant Women in Rural Areas of the Andes in Peru? Urinary tract infections (UTIs) can cause complications during pregnancy, but we don't know enough about how common they are in rural areas. This study looked at how many pregnant women in San Marcos, a rural area in the Andes of Peru, have UTIs. The goal was to better understand the problem in this community. We studied 250 pregnant women who were part of a larger research project called the Peruvian Andes Multigenerational High Altitude Cohort (ALTO), conducted between 2021 and 2022. The women answered questions about their health, occupation, education and lifestyle. They also provided urine samples, which were tested for UTIs using a dipstick test. The women in this study were, on average, 28 years old. We found that about 28% of the women had a UTI during pregnancy, which is higher than rates reported in other parts of Peru. Almost all of the women (96%) received antenatal care at least once, with most of them going to local health centers or community health posts, where obstetricians provided care. However, even though these women were receiving antenatal care, many were not regularly tested or treated for UTIs. Our study shows that UTIs are common in pregnant women in this region. Since UTIs can lead to serious health problems for both mothers and babies, it's important to make UTI testing a regular part of antenatal care and improve access to treatment in rural communities like San Marcos. [ABSTRACT FROM AUTHOR]

Objective: Anorexia nervosa (AN) is characterized by a tendency to limit intake of food, with specific restriction of foods that are generally considered highly palatable. This observation raises questions about whether reward processing is disturbed in AN. This study examined whether adolescents with AN differ from healthy control peers (HC) in anticipatory and consummatory reward processing. Method: Adolescents with AN (n = 71) and HC (n = 41) completed the Temporal Experience of Pleasure Scale (TEPS). The TEPS Anticipatory Pleasure scale was divided into two further subscales (Food and Non‐food). Anticipatory (Food and Non‐food) and Consummatory Pleasure (Non‐food) scores were compared between adolescents with AN and HC using independent t‐tests. Results: TEPS scores were significantly lower among adolescents with AN than HC in Anticipatory Pleasure Food (t(110) = 7.80, p < 0.001) and Non‐food (t(110) = 4.36, p < 0.001), and Consummatory Pleasure (t(110) = 2.60, p = 0.01) subscales. When controlling for BDI score, there was no significant group difference in TEPS Consummatory Pleasure scores (t(108) = 0.88, p = 0.38). Among adolescents with AN, Food Anticipatory Pleasure was significantly negatively correlated with all EDE‐Q subscales and global score (r(68) = −0.38, p = 0.002) and positively correlated with food intake at a laboratory buffet meal (r(61) = 0.53, p < 0.001). Discussion: Measures of both anticipatory and consummatory reward were reduced among adolescents with AN with a short duration of illness. In this study, eating disorder symptoms were related to diminished reward responses in anticipation of food. Dampened anticipatory reward response may comprise a mechanism of illness in AN that should be subject to further study. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess addiction to social media among university students and to explore the association of addiction to social media with academic performance. Methods: A random sample of 997 university students filled in a self-administered questionnaire using Google form (response rate 81%). The questionnaire adopted a validated scale (Social Media Addiction Scale, SMAS) and included questions about socio-demographics. Grade point average, absences, and passing rate were extracted for each student from the university management system. Results: Results showed that each of the three dimensions of addiction to social media (compulsive feelings, social consequences and time displacement) reduce at least one indicator of academic performance (GPA, absenteeism and passing rate). Conclusion: Results call to design and evaluate interventions that tackle different social media addiction dimensions to reduce their negative impact on academic performance. [ABSTRACT FROM AUTHOR]

Objective: This study assessed changes (in relation to smoking status) in tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge by applying a three Wave repeated cross-sectional assessment. Participants: Participants were students at Wave 1 (n = 2,169), Wave 2 (n = 2,576), and Wave 3 (n = 2,169) and faculty at Wave 1 (n = 256), Wave 2 (n = 204), and Wave 3 (n = 180). Methods: Measures regarding sociodemographics, tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge were completed. Results: Compared with Wave 1, more students reported having quit smoking within the last six months at Waves 2 and 3. The negative attitudes toward TFC policies of those who reported quitting in the last six months aligned with those of nonsmokers. Conclusions: Study findings suggest smoking status as a relevant covariate to focus on to further strengthen and refine existing TFC policies. [ABSTRACT FROM AUTHOR]

Objective: To assess differences in internalized stigma of mental illness based on demographic characteristics and mental healthcare utilization among college students. Participants: Students with self-reported mental illness (n = 128) were recruited via random sampling. Methods: Participants completed an online survey, including questions related to demographic characteristics and mental healthcare utilization. The survey also included the Internalized Stigma of Mental Illness (ISMI) scale. Data were analyzed using descriptive and inferential statistics. Results: Students accessing mental healthcare (pharmacological and/or psychotherapeutic) reported higher ISMI scores than students who did not access services during past year. Students with sexual minority statuses also reported higher ISMI scores than their heterosexual counterparts. Conclusions: Results highlight differences in internalized stigma based on demographics characteristics and mental healthcare utilization among college students. More research is needed to better understand intersectional stigma. Further, universities need tailored and specific interventions to address internalized stigma among students with diverse backgrounds and needs. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: The present study examines sociopolitical stress, coping, and well-being among college students. Participants: Young adult college students (N = 588; ages 18–29; 72% cisgender women) from 10 universities in the USA participated in this study. Methods: Participants completed a 45-minute online survey with closed-ended and open-ended questions, administered via Qualtrics. Results: Election-related sociopolitical stress was high with notable differences across students' demographic backgrounds (e.g., Hispanic/Latinx students, women, and sexual minority students reported high sociopolitical stress). Among those who reported being stressed by the election (N = 448), closed-ended and open-ended data reveal coping strategies including self-care, drugs and alcohol, and further civic action/political participation. Higher sociopolitical stress predicted more depression and many coping strategies were related with flourishing. Conclusions: Young adult college students are experiencing election-related sociopolitical stress and are coping in different ways. More work is needed to understand what coping strategies support well-being. Implications for colleges are discussed. [ABSTRACT FROM AUTHOR]

According to several recent studies, physicians in various medical branches have some differences in attitudes towards transgender and gender‐diverse (TGD) persons based on religious or political beliefs. Our study aims to uncover the attitudes of the general physician community in Turkey, which has a youthful profile, regarding TGD individuals. The attitudes towards transgender individuals scale (ATTI) and the general conservatism scale, along with a form that asks about socio‐demographic factors, political beliefs, and level of religion, were administered online to physicians. The ATTI score of physicians (mean = 77.8) is favourable and did not vary among branches. Being female, being close to TGD, having left‐wing views, low conservatism and low religious belief scores were associated with positive attitudes towards TGD individuals. The physician profile's moderate religious belief and left‐wing views can be interpreted as a country‐specific dynamic and did not prevent the approach from being positive. Despite physicians' positive attitude towards TGD individuals on a professional level, there is resistance to contacting them in their daily lives. The possibility of the partial contribution of socially desirable response behaviour to positive scores should not be ignored. [ABSTRACT FROM AUTHOR]

Over the last few years, digitalisation has accelerated its pace, fuelling the creation of a massive amount of data. This has resulted in a need to introduce legal mechanisms to protect the privacy and security of data being exchanged between people and organisations. However, little is known about the individuals' perspective on such mechanisms. Given the gap in the literature, this research investigated the drivers and the implications of individuals' attitude towards GDPR compliance. To test the research model, structural equational modelling was employed using 540 responses. The result showed that perceived threat severity, self-efficacy and response efficacy determine a positive attitude towards GDPR compliance, which results in emotional empowerment. The findings contribute to the literature on legal privacy-preserving mechanisms, by providing a user's view on the coping and threat appraisal factors underpinning attitude and demonstrating the implications for driving confidence in control over personal data. The findings also contribute to the literature on protection motivation by demonstrating that attitude towards adaptive behaviour drives emotional empowerment. The study offers suggestions to policymakers on how to enhance public perception of the GDPR. The findings also provide guidelines for organisations on how to inform individuals' understanding of compliance with the legal framework. [ABSTRACT FROM AUTHOR]

Background: Unhealthy alcohol use is prevalent among people living with HIV/AIDS (PLWH) and contributes to impaired functioning, diminished quality of life, and poorer HIV outcomes. Common cooccurring conditions such as chronic pain may be associated with negative outcomes both directly and through its influence on unhealthy drinking itself. However, there is relatively little known about how pain influences unhealthy drinking among PLWH over time. The current study examined whether pain was associated with indices of unhealthy alcohol use, namely heavy drinking and alcohol use disorder (AUD) assessed 12 months later. Methods: The study sample (n = 207) was from the Boston Alcohol Research Collaboration on HIV/AIDS (ARCH) Cohort, a prospective cohort of PLWH with a history of illicit substance or unhealthy alcohol use. We conducted logistic regression analyses to examine the associations between pain and both heavy drinking and AUD status (DSM‐5 criteria) (yes/no) over time. In secondary analyses, we examined whether pain was associated with greater AUD severity and whether pain interference was associated with heavy drinking and AUD outcomes. Results: We found that pain at baseline was associated with greater odds of AUD [aOR = 2.29 (95% CI: 1.13, 4.64), p = 0.02] but not heavy drinking [aOR = 0.91 (95% CI: 0.44, 1.88), p = 0.79] at 12 months. Pain was also associated with more severe AUD. Analyses of pain interference showed similar results. Conclusions: Pain is prospectively associated with higher odds of AUD among PLWH with a substance/unhealthy alcohol use history. Providers should routinely address pain among PLWH to improve AUD outcomes. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairments are common in alcohol use disorder (AUD), but only a few studies have investigated the accuracy of the Montreal Cognitive Assessment (MoCA) in this population. We examined the accuracy and precision of the MoCA in detecting cognitive impairment in a sample of patients with AUD. In addition, we investigated whether the MoCA predicts premature discontinuation from treatment. Method: A sample of 126 persons with AUD undergoing treatment in specialist health services were administered the MoCA and a battery of 12 neuropsychological tests. Five cognitive domains were derived from the reference tests. A composite total score from these tests was used as a reference criterion for determining correct and incorrect classifications for the MoCA. We analyzed the optimal cut‐off score for the MoCA and the accuracy and agreement of classification between the MoCA and the reference tests. Results: Receiver operating characteristic (ROC) curve analyzes yielded an area under the curve (AUC) of 0.77 (95% CI [0.67, 0.87]). Applying 25 as the cut‐off, MoCA sensitivity was 0.77 and specificity 0.62. The PPV was 0.53. The NPV was 0.84. Using a cut‐off score of 24 yielded a lower sensitivity 0.60, but specificity was significantly better i.e., 0.79. PPV was 0.68. The NPV was 0.82. Kappa agreement between MoCA and the reference tests was fair to moderate, 0.38 for the cut‐off of 25, and 0.44 for the cut‐off of 24. MoCA did not predict discontinuation from treatment. Conclusions: Our findings indicate limitations in the classification accuracy of the MoCA in predicting cognitive impairment in AUD. Achieving the right balance between accurately identifying impaired cases without including too many false positives can be challenging. Further, MoCA does not predict discontinuation from treatment. Overall, the results do not support MoCA as a time‐efficient screening instrument. [ABSTRACT FROM AUTHOR]

Background: Alcohol use is increasing among adults in midlife (i.e., ages 35–60), but few studies examine specific alcohol use behaviors in this age group. We examined measures of typical drinks, maximum drinks, binge drinking, and high‐intensity drinking by age, sex, and race/ethnicity among midlife adults, as well as the prospective association between age 18 binge drinking and midlife behaviors. Methods: Data from 5180 respondents participating in the national Monitoring the Future Panel study who were aged 35–60 in 2022 (followed since they were in 12th grade in 1980–2005) were used to estimate past 30‐day midlife drinking behaviors (i.e., typical drinks, maximum drinks, binge, and high‐intensity drinking) by age group, sex, and race/ethnicity. Associations between age 18 binge drinking status and midlife drinking outcomes were examined, as well as moderation by sociodemographic characteristics. Results: Across ages 35–60, the mean typical number of drinks on drinking days within the past month ranged from 1.4 to 1.8; the mean maximum drinks ranged from 2.3 to 3.2. Past‐month binge and high‐intensity drinking prevalence ranged from 19.1% to 31.2% and 3.6% to 8.1%, respectively. Estimates of drinking behaviors were generally higher among respondents aged 35–40 (vs. older age groups), males (vs. females), those identifying as White (vs. other racial/ethnic groups), and those who reported age 18 binge drinking (vs. not). Adolescent binge drinking was a stronger predictor of high‐intensity drinking among females than males and of typical and maximum drinks among older (age 60) than younger (age 35) respondents. Conclusion: Binge and high‐intensity drinking were reported by a meaningful percentage of the US midlife adults. Binge drinking in adolescence was a predictor of subsequent alcohol‐related risks. These long‐term connections were especially strong among females. Age 18 binge drinking was a stronger predictor of high‐intensity drinking at age 60 than earlier in midlife, underscoring that adolescent binge drinking is a key indicator of risk across the lifespan. [ABSTRACT FROM AUTHOR]

This mixed-methods study explores the incidence, manifestations, and drivers of secondary traumatic stress among service providers who work with Syrian refugees in Istanbul, Turkey. A survey of 104 social workers and other providers working in 17 public and civil society agencies in Istanbul in 2018 demonstrates that 54.81% had Secondary Traumatic Stress Scale scores indicating mild to severe secondary traumatic stress. In total, 28 qualitative interviews showed manifestations and possible drivers of secondary traumatic stress including weak supervision, heavy caseloads, and insecure working conditions. The findings suggest supervision and peer-support should be strengthened to address secondary traumatic stress among providers serving refugees. [ABSTRACT FROM AUTHOR]

In this study, we examined rates of insomnia and co-occurring unhealthy alcohol use in a national sample of women Veterans age 50 years and older. We further explored associations between sociodemographic measures, insomnia-related clinical characteristics, and unhealthy alcohol use, and analyzed whether women with insomnia were more likely to report unhealthy alcohol use. Study aims were evaluated using national Veterans Health Administration (VA) electronic health records data from VA's Corporate Data Warehouse. Data were extracted for women Veterans ≥50 years old with ≥1 VA primary care visit in each study year (2018: 3/11/18–3/10/19; 2020: 3/11/20–3/10/21; 2022: 3/11/22–3/10/23). Cases of insomnia were identified via diagnostic codes and prescription medications for insomnia. Unhealthy alcohol use was identified via Alcohol Use Disorders Identification Test-Consumption screening scores indicating unhealthy alcohol use. Annual sample sizes ranged from 240,420–302,047. Over the study timeframe, insomnia rates (diagnosis or medication) among women ≥50 years old ranged from 18.11–19.29%; co-occurring insomnia and unhealthy alcohol use rates ranged from 2.02–2.52%. Insomnia and unhealthy alcohol use rates were highest among women aged 50–59 years old. Depression and physical health comorbidities were consistently associated with insomnia; associations by race and ethnicity were less consistent. Compared to women without insomnia, women Veterans with either concurrent or unremitting insomnia were more likely to endorse unhealthy alcohol use. Findings signal a potential need for assessment and preventative efforts aimed at addressing insomnia and unhealthy alcohol use among women Veterans. [ABSTRACT FROM AUTHOR]

Background: Residents of assisted living facilities (ALF) transfer to a nursing home when they require a higher level of care, but limited research has examined risk factors for transfer to a nursing home. The aims of this study were to identify (1) baseline factors associated with transfer to a nursing home and (2) time‐varying factors associated with transfer to a nursing home over 8 years, using a national dataset from the National Health Aging Trends Study (NHATS). Methods: NHATS participants were included in this study if they: (1) resided in ALF from Round 1 (2011) through Round 8 (2018); (2) completed the sample person (SP) interview at baseline; (3) were admitted to ALF at age 65 years or older. We conducted Cox proportional hazards regression to examine candidate predictors (difficulty with basic activities of daily living (ADL), chronic conditions, hospitalization, sleep disturbances, mental health, physical performance, self‐reported health, participation in social and physical activity, and sociodemographic) associated with transfer to a nursing home. Employing backward elimination, we built parsimonious final models for analysis. Results: The analytic sample included 970 participants of whom 143 transferred to nursing homes over 8 years. Those who had a better physical performance at baseline (HR = 0.83, 95% CI = 0.79–0.88) and were college educated (HR = 0.58, 95% CI = 0.36–0.92) demonstrated a significantly lower risk for transfer to a nursing home over 8 years. Residents who maintained physical activity (HR = 0.56, 95% CI = 0.37–0.86), better physical performance (HR = 0.87, 95% CI = 0.80–0.94), and difficulty with fewer basic ADLs (HR = 1.13, 95% CI = 1.02–1.26) were at lower risk for transfer to a nursing home over 8 years. Conclusions: Our findings can be used to identify older adults in ALFs at risk of transfer to a nursing home. Strategies to promote physical function and physical activity could avoid/delay the need to transfer. Helping older residents to age in place will have important health and economic benefits. [ABSTRACT FROM AUTHOR]

Introduction: The intersection of ageism and racism is underexplored in geriatric emergency medicine (GEM) research. Methods: We performed a scoping review of research published between January 2016 and December 2021. We included original emergency department‐based research focused on falls, delirium/dementia, medication safety, and elder abuse. We excluded manuscripts that did not include (1) original research data pertaining to the four core topics, (2) older adults, (3) subjects from the United States, and (4) for which full text publication could not be obtained. The primary objective was to qualitatively describe reporting about older adults' social identities in GEM research. Secondary objectives were to describe (1) the extent of inclusion of minoritized older adults in GEM research, (2) GEM research about health equity, and (3) feasible approaches to improve the status quo of GEM research reporting. Results: After duplicates were removed, 3277 citations remained and 883 full‐text articles were reviewed, of which 222 met inclusion criteria. Four findings emerged. First, race and ethnicity reporting was inconsistent. Second, research rarely provided a rationale for an age threshold used to define geriatric patients. Third, GEM research more commonly reported sex than gender. Fourth, research commonly excluded older adults with cognitive impairment and speakers of non‐English primary languages. Conclusion: Meaningful assessment of GEM research inclusivity is limited by inconsistent reporting of sociodemographic characteristics, specifically race and ethnicity. Reporting of sociodemographic characteristics should be standardized across different study designs. Strategies are needed to include in GEM research older adults with cognitive impairment and non‐English primary languages. [ABSTRACT FROM AUTHOR]

Objectives: Despite cervical cancer (CC) being a preventable disease, its incidence remains high in marginalized communities due to inequalities that restrict access to health services. This article investigates the experiences, perceptions, and attitudes regarding the screening of indigenous women in a region of the Colombian Amazon during a cervical cancer prevention initiative facilitated by community participation. Design: Qualitative study based on interviews conducted with women and indigenous leaders from Paujil reserve. They participated in research focused on cervical cancer prevention, which employed a methodology of collaboration between academia and communities aimed at enhancing women's health and reducing inequalities in access to healthcare services. The analysis utilized a deductive and inductive approach. Results: Five main themes were addressed: 'Barriers within health services'; 'Individual and cultural constraints'; 'Motivations and facilitators'; 'Positive experiences within the research framework'; and 'Suggestions for encouraging women's participation.' Challenges related to appointment scheduling and result delivery were frequently cited as obstacles to access. Misinformation, feelings of shame, fear, and distrust towards health services played significant roles in the reluctance to undergo screening. Factors such as support from family and community networks, respectful treatment, ease of scheduling appointments, the presence of female healthcare professionals, and involvement of leaders fluent in indigenous languages were identified as positive facilitators of screening acceptance. Conclusion: Understanding the factors that influence access to screening is crucial for reducing inequalities in service delivery for indigenous women. The involvement of trained leaders who can identify these factors and motivate women can have a positive impact on the acceptance and guidance of cervical cancer prevention programs. [ABSTRACT FROM AUTHOR]

Simple Summary: This study assessed the supportive care services offered to breast cancer (BC) patients in Palestinian government hospitals and identified characteristics related to unmet needs. We performed a cross-sectional study involving 362 women, utilizing the Supportive Care Needs Survey (SCNS-SF34) through face-to-face questionnaires, and gathered data on sociodemographic, clinical, and social support variables. The findings indicated that 61% of participants encountered unmet supportive care needs, especially in the areas of health system and information (93.6%), physical and daily living (89.8%), and psychological support (75.1%). Elevated unmet needs are associated with variables like age, marital status, illness duration, analgesic usage, cancer treatments, family cancer history, and social support. This research highlights the urgent need to enhance supportive care services of the health system and information, physical and daily living, and psychological support, to elevate the quality of life for BC patients in Palestine. Background: Breast cancer (BC) is the most common cancer among women in Palestine, where the need for supportive care frequently goes unmet. Therefore, this study aims to assess the supportive care services provided at the governmental hospitals in the southern area of the West Bank and to determine the factors associated with the unmet needs of these services. Methods: A cross-sectional study was conducted on 362 women with BC. Data were collected using a face-to-face questionnaire that included the Supportive Care Needs Survey (SCNS-SF34), patients' sociodemographic, economic, and clinical characteristics, as well as familial history of cancer and social support. Results: The study revealed that 61% of participants had unmet supportive care needs, with health system information, physical support, and psychological support being the most unmet needs. Factors contributing to unmet needs included age, marital status, familial support, and a family history of cancer. Chemotherapy and surgery increased the probability of physical care needs by fivefold, while hormone therapy reduced the probability of psychological needs (AOR = 0.36, p < 0.001) and patient care and support needs (AOR = 0.49, p = 0.01). Additionally, radiotherapy reduced sexual care needs by 58% and biological therapy by 60%. Conclusions: There is an urgent need for enhanced supportive care services for BC patients in the West Bank, especially regarding health system information, physical care, and psychological support. Addressing these needs through targeted interventions could significantly improve patients' quality of life. [ABSTRACT FROM AUTHOR]

BACKGROUND: U.S. Special Operations Forces (SOF) are at increased risk of multiple mild traumatic brain injury (mmTBI). Testosterone was prescribed for several participants in a VA program designed to address sequelae of mmTBI for SOF. OBJECTIVE: To determine testosterone prevalence in the Palo Alto VA Intensive Evaluation and Treatment Program (IETP) and observe for association between testosterone and neurobehavioral outcomes. METHODS: A retrospective cohort study included patients in the Palo Alto VA IETP. Sociodemographic data, testosterone blood levels, and neurobehavioral outcomes were collected from medical records. RESULTS: 55 IETP participants were included: six were testosterone users; the rest were classified as non-users. Testosterone use in this population is 11%, higher than reported national averages in the U.S. Of the 6 testosterone users, 2 (33%) had a formal diagnosis of hypogonadism prior to initiation of testosterone. Neurobehavioral outcome scores between testosterone users and non-users failed to show statistically significant differences, except for the PROMIS pain score, which was higher in the testosterone user population. CONCLUSION: The current study did not find an association between mmTBI, testosterone use, or testosterone level and neurobehavioral outcomes. This study highlights a need to further examine the relationship between hypogonadism, mmTBI, SOF culture around testosterone, and the effects of testosterone use in this population. [ABSTRACT FROM AUTHOR]

Introduction Approximately 9 million veterans receive health care at the Veterans Health Administration, many of whom have psychiatric illnesses. The military continues to have higher rates of psychiatric illness compared to the civilian population. Having a diagnosis such as posttraumatic stress disorder or depression may create challenges in using health care services, such as surgery. The aim of this study was to evaluate eye surgery cancellation, risk factors for cancellation, and areas for intervention within the VA. Materials and Methods This was a single-center retrospective cohort study. The Veteran Health Information Systems and Technology Architecture were queried to identify all surgical requests at the West Los Angeles VA in 2019. Data collection included sociodemographic information and comorbid medical conditions, including psychiatric illness. Exploratory analyses using univariate logistic regression were used to evaluate factors associated with surgery cancellation. Results A total of 1,115 surgical requests were identified with a cancellation rate of 23.7% (n  = 270). Sociodemographic factors were similar between those with completed and cancelled surgery. However, having a psychiatric diagnosis correlated with surgery cancellation. For all subspecialties, patients with schizophrenia were more likely to have cancellation (odds ratio [OR], 2.53, P =  .04). For retina surgery, patients with posttraumatic stress disorder were more likely to have cancellation (OR, 4.23, P =  .01). Glaucoma patients with anxiety (OR, 5.78, P =  .05) and depression (OR, 4.05, P =  .04) were more likely to have cancellation. Conclusions There was a significant amount of eye surgery cancellations in veterans with variation by subspecialty and comorbid conditions. Having a psychiatric illness was correlated with increased rates of surgery cancellation amongst veterans. Areas to improve surgical utilization include risk stratification and increased support of vulnerable patients before surgery. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate factors associated with functioning in participants with and without borderline personality disorder (BPD). In particular, we were interested whether mentalizing and related social cognitive capacities, as factors of internal functioning, are important in predicting psychosocial functioning, in addition to other psychopathological and sociodemographic factors. Method: This is a cross‐sectional study with N = 53 right‐handed females with and without BPD, without significant differences in age, IQ, and socioeconomic status, who completed semi‐structured diagnostic and self‐report measures of social cognition. Mentalizing was assessed using the Reflective Functioning Scale based on transcribed Adult Attachment Interviews. A regularized regression with the elastic net penalty was deployed to investigate whether mentalizing and social cognition predict psychosocial functioning. Results: Borderline personality disorder symptom severity, sexual abuse trauma, and social and socio‐economic factors ranked as the most important variables in predicting psychosocial functioning, while reflective functioning (RF) was somewhat less important in the prediction, social cognitive functioning and sociodemographic variables were least important. Conclusions: Borderline personality disorder symptom severity was most important in determining functional impairment, alongside trauma related to sexual abuse as well as social and socio‐economic factors. These findings verify that BPD symptoms themselves most robustly predict functional impairment, followed by history of sexual abuse, then contextual factors (e.g. housing, financial, physical health), and then RF. These results lend marginal support to the conceptualization that mentalizing may enhance psychosocial functioning by facilitating social learning, but emphasize symptom reduction and stabilization of life context as key intervention targets. [ABSTRACT FROM AUTHOR]

Background: Ventricular tachycardia (VT) catheter ablation in the presence of intracardiac thrombi was evaluated in very few studies. Objectives: To investigate in‐hospital outcomes of VT ablation in the presence of an intracardiac thrombus, in a large inpatient US registry. Methods: Using the National Inpatient Sample (NIS) database, patients who underwent non‐elective VT catheter ablations in the United States between 2016 and 2019 were identified using ICD‐10 codes. Sociodemographic, clinical data, in‐hospital procedures, and outcomes as well as in‐hospital mortality were collected. In‐hospital outcomes were compared using propensity score (PS) matching analysis with a 1:3 ratio between patients with and without intracardiac thrombus. Results: A weighted total of 15,725 admissions for non‐elective VT ablation were included in the study, of which 190 (1.2%) had a discharge diagnosis of intracardiac thrombus. Patients with intracardiac thrombus had a higher comorbidity burden and were more likely to have ischemic cardiomyopathy and a diagnosis of cardiac aneurysm. In PS analysis, the presence of intracardiac thrombus was significantly associated with higher rates of any in‐hospital complications (42.1% vs. 19.3%, p < 0.009), driven by higher periprocedural cerebrovascular accident and vascular injury events. In‐hospital mortality rates were not significantly different between the groups. Conclusions: In patients undergoing non‐elective VT ablation, intracardiac thrombus was associated with higher rates of in‐hospital complications, but not higher in‐hospital mortality. These findings suggest that intracardiac thrombus should not contraindicate VT ablation when deemed necessary, while efforts should be made to decrease potential complications. [ABSTRACT FROM AUTHOR]

Objectives:. This cross-sectional study aimed to evaluate the degree of children's adherence to the Mediterranean Diet (MD), to estimate the weekly cost of MD, and to assess the role of food cost and demographic/socio-economic factors as potential barriers to comply with a healthy dietary model. Methods:. Data collection was conducted through an online questionnaire sent to parents of children (6–11 years old) living in Italy. This survey allowed the collection of demographic/socio-economic information about the family and their dietary habits. Adherence to the MD in children was assessed through the KIDMED index. The weekly diet cost was calculated based on the food prices of two Italian supermarket chains. Descriptive statistics and inferential tests were run to evaluate the sample's characteristics and correlations between diet cost, socio-demographics, and adherence to MD. Results:. Data highlighted that 31.5% of the children achieved high compliance with the MD, whereas 22.2% showed low adherence. The average diet cost increased significantly with the increasing level of adherence to the MD (Spearman's Rho = 0.322, p = 0.018). Moreover, results showed that a high parent educational level was positively associated with the KIDMED score (Spearman's Rho = 0.323, p = 0.017). No significant correlations were found between dietary cost and other characteristics such as economic status and house type. Conclusions for Practice:. Despite the small sample size, our results suggest that nutrition education interventions targeted at children and their parents/caregivers might favour more conscious dietary choices, which in turn will help reduce the differences in diet quality caused by the educational level gaps existing in families. Significance: Mediterranean Diet (MD) adherence may be affected by many factors, among which demographic, social, and economic ones are of great relevance. Family characteristics may, in turn, have an impact on the dietary model and nutritional status of children, who represent a vulnerable and underinvestigated population in this specific context. This study explored the cost of MD in Italian families with at least one child and highlighted that parents' educational level correlates with children's compliance to MD more decisively than demographic and economic factors. This suggests that targeted nutrition education interventions might lead families towards healthier food choices, mitigating existing educational differences. [ABSTRACT FROM AUTHOR]