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Background: Effective physical activity (PA) interventions are needed to counter the insufficient and declining levels of PA in youth. These require an updated, comprehensive planning framework that consolidates recent decades of progress in promoting PA in young children, children, and adolescents. Effective PA interventions require program planning and conceptual model development that target a coordinated and multilevel set of age-specific PA determinants. Accordingly, this paper presents a comprehensive planning framework that researchers can use to design intervention research to promote PA in youth. Methods: The first author conducted targeted searches through Google Scholar to compile PA models/frameworks/guides applicable to youth, a comprehensive set of PA determinants, and determinant-linked strategies to promote PA focusing on review articles. The information was summarized in tables, synthesized, and used to create a planning framework, all of which were reviewed by coauthors. Results: The APPLE Framework for Planning PA Opportunities for Youth (APPLE = Age, PA focus, Place and time, Leverage relevant influences and strategies, and ensure Enjoyable PA opportunities) incorporated all core elements from targeted reviews to create a comprehensive planning framework. The APPLE Planning Framework has a set of questions/prompts that guide the intervention planning process and conceptual model templates to organize planning efforts for designing intervention research. Conclusions: The APPLE Framework for Planning PA Opportunities for Youth will enable researchers to develop comprehensive conceptual models to guide the design of PA interventions for youth. Future research should refine the model and its components to enable PA intervention research in youth to move forward. [ABSTRACT FROM AUTHOR]

Young children may experience higher per- and polyfluoroalkyl substances (PFAS) exposure than adults due to breastfeeding, higher dust ingestion rates, and frequent hand-to-mouth activities. We explored temporal trends and determinants of child serum PFAS concentrations and their correlations with paired maternal PFAS concentrations. From 2009 to 2017, we collected one blood sample from each of 541 children aged 2-5 years participating in the Childhood Autism Risks from Genetics and Environment (CHARGE) study and quantified 14 PFAS in serum. For nine frequently detected PFAS (>65% of samples), we performed multiple regression adjusting for potential determinants to estimate mean percent concentration changes. For a subset of 327 children, we also quantified nine PFAS in their mother's serum collected at the same visit and computed Spearman correlation coefficients (rsp) between maternal and child PFAS concentrations. During 2009-2017, child serum concentrations of all nine PFAS decreased by 6-25% annually. Several PFAS concentrations were higher among non-Hispanic white children and those with highly educated parents. Most maternal and child PFAS concentrations were moderately correlated (rsp = 0.13-0.39), with a strong correlation for N-methyl perfluorooctane sulfonamido acetic acid (rsp = 0.68). Breastfeeding duration appeared to contribute to higher child and lower maternal PFAS concentrations, resulting in relatively weak correlations between maternal and child PFAS concentrations for samples collected in early childhood. Considering that more than half of our study children had neurodevelopmental concerns, the generalizability of our findings might be limited.

BackgroundImplementation science scholars have made significant progress identifying factors that enable or obstruct the implementation of evidence-based interventions, and testing strategies that may modify those factors. However, little research sheds light on how or why strategies work, in what contexts, and for whom. Studying implementation mechanisms-the processes responsible for change-is crucial for advancing the field of implementation science and enhancing its value in facilitating equitable policy and practice change. The Agency for Healthcare Research and Quality funded a conference series to achieve two aims: (1) develop a research agenda on implementation mechanisms, and (2) actively disseminate the research agenda to research, policy, and practice audiences. This article presents the resulting research agenda, including priorities and actions to encourage its execution.MethodBuilding on prior concept mapping work, in a semi-structured, 3-day, in-person working meeting, 23 US-based researchers used a modified nominal group process to generate priorities and actions for addressing challenges to studying implementation mechanisms. During each of the three 120-min sessions, small groups responded to the prompt: "What actions need to be taken to move this research forward?" The groups brainstormed actions, which were then shared with the full group and discussed with the support of facilitators trained in structured group processes. Facilitators grouped critical and novel ideas into themes. Attendees voted on six themes they prioritized to discuss in a fourth, 120-min session, during which small groups operationalized prioritized actions. Subsequently, all ideas were collated, combined, and revised for clarity by a subset of the authorship team.ResultsFrom this multistep process, 150 actions emerged across 10 priority areas, which together constitute the research agenda. Actions included discrete activities, projects, or products, and ways to shift how research is conducted to strengthen the study of implementation mechanisms.ConclusionsThis research agenda elevates actions to guide the selection, design, and evaluation of implementation mechanisms. By delineating recommended actions to address the challenges of studying implementation mechanisms, this research agenda facilitates expanding the field of implementation science, beyond studying what works to how and why strategies work, in what contexts, for whom, and with which interventions.

Mental health issues, especially depression among adolescents is a global concern. This study focuses on understanding the prevalence and factors influencing depression among adolescents in Uttar Pradesh (UP), India. The study was utilized data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey (Wave-1) conducted in 2015–16 among adolescents (aged 10–19 years). Bi-variate analysis, t-test, ANOVA, and ordered probit regression were employed for statistical analysis (N = 8,363). The ordered probit model demonstrated significant associations with higher depression among older adolescents (coef. = 0.16; 95% CI: 0.09, 0.24), females (coef. = 0.19; 95% CI: 0.13, 0.26), those with higher schooling (coef. = 0.19; 95% CI: 0.05, 0.33), and non-Hindu individuals (coef. = 0.08; 95% CI: 0.01, 0.15). Additionally, depression was notably higher in the richest households (coef. = 0.14; 95% CI: 0.05, 0.23), with high parental interaction (coef. = 0.11; 95% CI: 0.02, 0.21), and high peer interaction (coef. = 0.23; 95% CI: 0.16, 0.31). Conversely, lower depression was linked to good academic performance (coef. = -0.10; 95% CI: −0.18, −0.02), belonging to OBC (coef. = -0.11; 95% CI: −0.18, −0.05), and general (coef. = -0.09; 95% CI: −0.17, −0.01) categories. The study concludes that addressing adolescent depression in UP requires a nuanced approach considering demographic, socio-economic, and interpersonal factors. Interventions should target vulnerable groups while addressing academic stress, promoting positive social interactions, and providing mental health support. Further research is needed to explore underlying mechanisms and develop effective strategies for improving adolescent mental well-being in the region. [ABSTRACT FROM AUTHOR]

Background: Blended learning, a pedagogical approach combining traditional classroom instruction with online components, has gained prominence in nursing education. While offering numerous benefits, student satisfaction with blended learning remains a critical concern. This study contributes to the existing literature by providing a comprehensive evaluation of the determinants influencing nursing students' satisfaction with this innovative educational modality. By examining a wide range of factors, including sociodemographic characteristics, academic factors, and environmental influences, this research offers valuable insights for educators to optimize blended learning experiences in nursing education. Methods: A descriptive cross-sectional research design was conducted. This study investigates the factors influencing nursing students' satisfaction with blended learning at Alexandria University, Egypt, where blended learning programs have been integrated into the curriculum primarily through the Microsoft Teams platform. A convenient sample of 1266 nursing students from both bachelor and technical educational institutions participated in the study from September 2023 to the end of December 2023. Data were collected using an online survey containing two measurement tools: the Blended Learning Satisfaction Scale and the Environmental Facilitators and Barriers to Student Persistence in Online Courses scale. Statistical analyses, including descriptive statistics and backward multiple linear regression, were conducted to identify factors that are associated with the satisfaction of nursing students' with blended learning. Results: Findings indicate that factors such as age, gender, income, employment status, access to suitable internet sources, academic year, computer literacy, preferred learning method, and perceptions of environmental facilitators significantly influence satisfaction scores (all p < 0.001). The overall regression model, with an adjusted R² of 0.31, signifies that 31% of the variance in satisfaction scores is explained collectively by the previously mentioned variables (F = 21.21, p < 0.001). Conclusion: Students' sociodemographic variables, preference for blended learning, and perception of environmental facilitators such as encouragement to enroll in the course significantly influence nursing students' satisfaction levels with blended learning. However, limitations in the current study such as self-report bias, convenient sampling, and cross-sectional design limit the generalizability and causal inferences of these findings. [ABSTRACT FROM AUTHOR]

Background: Social anxiety disorder imposes impacts of functional disability, poor educational achievement, loss of work productivity, social impairment, greater financial dependency, and impairment in quality of life. Therefore, the aim of this study was to assess the prevalence and identify determinants of social anxiety disorder among people living with HIV/AIDS. Methods: A cross-sectional study was conducted from 1 to 30 May 2022 among 354 people living with HIV using a simple random sampling technique. The Social Phobia Inventory (SPIN) Scale was used to assess the presence of social anxiety disorder. Data were gathered using chart review tools and a structured questionnaire, which was administered by a pretested face-to-face interviewer. SPSS version 25 was used to analyse the data once they were imported into EpiData Manager version 4.6. Binary and multivariable logistic regressions were performed. After calculating odds ratios with a 95% confidence interval (CI), statistical significance was established at p < 0.05. Results: A total of 336 respondents participated in the study, resulting in a response rate of 94.91%. The magnitude of social anxiety disorder was 32.44% (95% CI: 27.4, 37.2). Being female [adjusted odds ratio (AOR) = 3.55, 95% CI: 1.61, 7.84], having a stage III/IV HIV/AIDS status (AOR = 3.17, 95% CI: 1.10, 9.13), being alcohol dependent (AOR = 2.81, 95% CI: 1.45, 5.44), and having perceived stigma (AOR = 5.62, 95% CI: 2.95, 10.72) were predictors of social anxiety disorder. Conclusion: In this study, approximately one-third of people living with HIV/AIDS had social anxiety disorder. Being female, having a stage III/IV HIV/AIDS status, being alcohol dependent, and having perceived stigma were predictors of social anxiety disorder. Therefore, training for health care providers on the screening, counselling, and management of social anxiety disorder is important. [ABSTRACT FROM AUTHOR]

Background: Meconium-stained amniotic fluid (MSAF) is a condition in which meconium is present in the uterus during ante-natal and complicates 10–15% of all live births. Scanty information is known about the determinants of meconium-stained amniotic fluid. Hence, this study aimed to identify determinants of meconium-stained amniotic fluid among women delivered at southwestern referral hospitals in southwest Ethiopia, in 2024. Methods: An institutional-based case-control study was employed from January 1, 2024, to June 30, 2024. The study was conducted in four southwestern referral hospitals in southwest Ethiopia. The final sample size includes 321(107 cases and 214 controls). The sample size was proportionally allocated for cases and controls for each referral hospital. Simple random sampling was used to select patient charts and data was collected from the chart using questions/tools developed after reviewing relevant literature. Data were entered using Epi-data version 3.1 and analyzed using SPSS version 25. Data was analyzed using binary logistic regression. All independent variables with P- the value of < 0.25 in univariable analysis were considered for multivariable logistic regression. Determinant factors of meconium-stained amniotic fluid were identified at a 95% confidence interval with a p-value < 0.05 was utilized to declare statistical significance. Results: A total of 107 cases and 214 controls were included in this study. The finding from this study stated that induction of labor [AOR = 2.37, 95% CI = 1.28–8.89], obstructed labor [AOR = 2.62, 95%CI = 1.1–6.79], duration of labor greater than 24 h [AOR = 2.8, 95% CI = 1.55–15.44], and premature rupture of the membrane [AOR = 2.98, 95%CI = 1.1–8.23] were found to be significantly associated with meconium-stained amniotic fluid. Conclusion: Conclusively, a mother with induced or obstructed labor, labor duration greater than 24 h, and premature rupture of membrane need special attention during delivery care to reduce potential risk factors to feto-maternal outcomes related to meconium-stained amniotic fluid. [ABSTRACT FROM AUTHOR]

Background: Marriage is a significant milestone in one's life, and the age at which individuals choose to get married can have various implications. By examining the age at marriage and its determinants in different regions, such as Kerala and Bihar, we can gain insights into Socio-demographic factors that influence this decision. Methods: The National Family Health Survey (2019–2021) data was used. A total of 41,392 ever married women from Kerala (8, 579) and Bihar (32,813) were analysed using bivariate and multiple binary logistic regression approaches to meet the study aim. Result: The significant association was found between explanatory factors and age at first marriage in Karala and Bihar. In Bihar, educated women from the poorest families had a higher rate of early marriages. Conversely, in Kerala, uneducated women from non-majority religions and larger households (more than 6 members) were more likely to be married before18. After accounting major effects of background characteristics, the adjusted odds ratio showed that In Kerala Muslim religion women have significantly higher odds of getting married before 18 (OR: 3.09, CI 2.67–3.57) then the Hindu women whereas in Bihar Muslim religion women has the significantly lower chance of getting married before turning 18 (OR: 0.87, CI 0.81–0.93) compared to Hindu. In both the states Kerala and Bihar General social group women had the significantly lower odds of getting married below 18 (OR: 0.73, CI 0.57–0.93 and OR: 0.88, CI 0.81–0.96) with respect to SC/ST social group women's. Conclusion: Women in Bihar usually marry in younger age due to socioeconomic and traditional reasons, whereas in Kerala reverse is true, because of a greater emphasis on education and a more progressive social outlook. These regional variations reflect different cultural norms and socioeconomic environments, shape different marriage age patterns between the two regions. [ABSTRACT FROM AUTHOR]

The nutrition security of women is critically important for society’s well-being. Therefore, this study was conducted to determine the determinants of the nutrition security status of rural women in Northwest Ethiopia. Data collected from rural women in 197 randomly selected households were analyzed using a binary logit regression model. The results show that 72.6% of the women are nutritionally insecure. The determinants that significantly affect nutrition security status are family size (a negative effect), women’s daily feed frequency, milk consumption, feeding habits of fruits and vegetables, feeding habits of animal products, and women empowerment (all positive effects). The weight, height, and BMI of nutritionally insecure women were significantly lower than those of nutritionally secure women. These findings reveal the need for government and other stakeholders’ interventions to increase access to nutritious food products and to provide training on feeding culture and dietary diversity to women. The findings of this study can help the Government of Ethiopia to focus on the significant determinants to achieve its National Development Priorities focusing on the Sustainable Development Goals (SDGs) of the UN, particularly Goals 2, 3, and 5. [ABSTRACT FROM AUTHOR]

Motivated by the work initiated by Chapman ['Determinants of Legendre symbol matrices', Acta Arith. 115 (2004), 231–244], we investigate some arithmetical properties of generalised Legendre matrices over finite fields. For example, letting $a_1,\ldots ,a_{(q-1)/2}$ be all the nonzero squares in the finite field $\mathbb {F}_q$ containing q elements with $2\nmid q$ , we give the explicit value of the determinant $D_{(q-1)/2}=\det [(a_i+a_j)^{(q-3)/2}]_{1\le i,j\le (q-1)/2}$. In particular, if $q=p$ is a prime greater than $3$ , then $$ \begin{align*}\bigg(\frac{\det D_{(p-1)/2}}{p}\bigg)= \begin{cases} 1 & \mbox{if}\ p\equiv1\pmod4,\\ (-1)^{(h(-p)+1)/2} & \mbox{if}\ p\equiv 3\pmod4\ \text{and}\ p>3, \end{cases}\end{align*} $$ where $(\frac {\cdot }{p})$ is the Legendre symbol and $h(-p)$ is the class number of $\mathbb {Q}(\sqrt {-p})$. [ABSTRACT FROM AUTHOR]

Context: The extent to which health care reforms affect health remains understudied. Health care reforms result in policy outputs that determine provision of medical services, which have consequences for the health of the population. The authors scrutinize this relationship between health policy outputs and population health by focusing on legislative changes implying privatization of health care delivery and finance. They ask the following question: What is the relationship between reforms that privatize health care provision and population health in terms of health outcomes and inequalities? Methods: They answer this question by relying on fixed-effects time-series cross-section models. The authors use an original dataset of health care reforms passed in 36 European countries from 1989 to 2019. Health outcomes are operationalized with measures of subjective health status, unmet health needs, and resulting health inequalities. Findings: Their results show that privatization of health care is associated with higher rates of bad subjective health and unmet health needs several years after the passing of reforms. These effects are stronger for individuals in the lower tiers of income and education, resulting in greater socioeconomic inequalities. Conclusions: The article contributes to conceptualization of the political determinants of health as health policy outputs and a better understanding of the relationship between policy outputs and population health outcomes. [ABSTRACT FROM AUTHOR]

Background: The occurrence of asymptomatic bacteriuria in pregnancy has been associated with adverse maternal and fetal outcomes. Objective: This study determined the prevalence of asymptomatic bacteriuria and its determinants among pregnant women in rural Southwestern Nigeria. Methods: A hospital-based cross-sectional study was conducted between June 2021 and May 2023 among 400 pregnant women with no signs or symptoms of urinary tract infection. Demographic and clinical data were collected using structured questionnaires. Mid-urine samples were cultured using standard laboratory procedures. Bacterial colonies were isolated, and antimicrobial sensitivity was measured using the disc diffusion technique. Data were analyzed using SPSS version 22. The determinants of asymptomatic bacteriuria were measured using odds ratio and 95% confidence Interval (CI) with significant level ( p-value <0.05). Results: The prevalence of asymptomatic bacteriuria was 24.0% (95% CI = 18.2% - 30.5%). The determinants of asymptomatic bacteriuria were the absence of post-coital urination (AOR, 4.433; 95%CI: 1.462-7.116), diabetes mellitus (AOR, 2.468; 95% CI: 1.300 -- 4.684), and anaemia (AOR, 2.699; 95%CI: 1.042 -- 6.729). The most detected asymptomatic bacteriuria was E. coli 52/96 (54.2%). The cultured isolates were 100.0% sensitive to ceftriaxone and ceftazidine but were 100.0% resistant to ampicillin and erythromycin. Conclusion: Based on the urine culture and sensitivity results, the study suggests using ceftriaxone or ceftazidine as an empirical treatment for asymptomatic bacteriuria. [ABSTRACT FROM AUTHOR]

• Small increase in BFI yearly trends but on average BFI was 10 % lower in WWE. • Chronic pain, SES, and gestational age were associated with lower BFI. • ASMs and polytherapy were strongly associated with reduced BFI. • WWE need targeted counselling to assure safety of breastfeeding while on ASMs. To examine the rates and determinants of breastfeeding initiation (BFI) amongst women with epilepsy (WWE) and women without epilepsy (WWoE) in Manitoba, Canada. We conducted a retrospective cohort study using province-wide health databases from 1995 to 2019. Annual BFI rates for WWE and WWoE were examined. Multivariable logistic regression models were used to quantify the association between maternal and infant characteristics and BFI in both groups. During the study period, 1,331 pregnant WWE and 357,334 WWoE were examined. Among WWE, 70.9 % initiated breastfeeding compared to 81.8 % among WWoE. We observed a significant small increase in yearly trends of BFI in both WWE (β=0.45, p = 0.008) and WWoE (β=0.23, p < 0.001). In WWE, BFI was associated with caesarean delivery (aOR=0.72,95 % CI: 0.53–0.97), chronic pain (aOR=0.67,95 % Cl: 0.46–0.97), lower income (aOR=0.34,95 % Cl: 0.26–0.44), and gestational age (aOR= 1.09,95 % CI:1.01–1.18). In WWoE, BFI was associated with chronic pain (aOR=0.83,95 % Cl: 0.80–0.86), lower income (aOR=0.45, 95 %CI:0.44–0.46), mood and anxiety disorder (aOR=0.84,95 % CI:0.81–0.86), and gestational age (aOR=1.13,95 % Cl:1.12–1.14). The use of any ASM (aOR=0.66,95 % Cl:0.51–0.85), new generation (aOR=0.86,95 % Cl: 0.62–1.20), polytherapy (aOR=0.46,95 % Cl: 0.31–0.69) and gabapentin (aOR=0.49,95 % Cl: 0.17–1.24) reduced the likelihood of BFI among WWE. BFI was approximately 10 % lower in WWE compared to WWoE. Determinants such as low income, ASM use, and comorbidities were significant contributors to a reduced BFI in both groups. Targeted counselling for WWE on breastfeeding benefits is essential. Further research is needed to investigate breastfeeding continuation in WWE. [ABSTRACT FROM AUTHOR]

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E-waste online recycling is a new recycling model that has received strong support from governments worldwide. It integrates multiple processes such as online inquiry and offline delivery. The complex online–offline interaction makes residents' willingness to participate susceptible to external factors, hindering their behavior. To better transform residents' recycling intentions into behavior, this paper primarily uses a questionnaire survey to explore the intention–behavior gap in e-waste online recycling participating. Our findings show that residents' e-waste online recycling intention directly predicts their behavior, but the implementation plan plays a partial mediating role between them. Additionally, perceived value and platform interactivity moderate the impact of e-waste online recycling intention towards participation behavior. Subsequent in-depth interview analysis further also confirmed these findings. The study contributes to understanding residents' online recycling behaviors and fostering the sustainable development of this model. [ABSTRACT FROM AUTHOR]

Eco‐community Development (ECD) is a specific embodiment of city sustainability and ecological civilization construction at local scale, and residents are one of the core stakeholders. They engage in ECD through various activities and their environmental behavior is the result of the interaction of "human" and "environment". The main focus of this study is to measure residents' environmental behavior and explore its influencing factors. Previous studies have limited implications to measure residents' participation intensity and give less attention to explore the impact of "environment" factors on people's environmental behavior, especially the influence of situational factors. Public environmental facilities and activities (PEFA) are important supporting measures in communities and the main type of situational factors. In this context, we initially propose "Participation Intensity (PI)" to measure residents' environmental behavior from the processes of household lifestyle, consumption, recreation and social interaction. Then, we apply OLS regression model to analyze its determinants based on a questionnaire survey to 586 residents in Dongying City, Shandong Province in China. The findings show that residents' PI varies and PEFA are powerful predictors. Furthermore, residents' psychological factors, including concern and attitude to ECD and their satisfaction on the role of neighborhood committee, as well as socio‐demographic characteristics, including gender, education level and length of residence also play important roles on PI. Our study provides a new perspective for understanding residents' participation in community environmental governance and suggests useful references for promoting ECD. [ABSTRACT FROM AUTHOR]

The paper investigates whether public debt explains income inequality in several Sub-Saharan African (SSA) countries. The core method employed is the Bayesian Model Averaging (BMA) estimator, which uses a dataset covering the period 1997–2019. The key findings reveal that public debt tends to reduce inequality among the poor but may harm the rich in the WAEMU region. Public debt generally has a neutral impact on inequality in EMCCA but can improve income distribution among the rich under stringent corruption control. In terms of contributions, the paper is one of the first works that examine how public debt impacts inequality in the Sub-Saharan African (SSA) countries across different levels of income. Moreover, it explores the intricate relationship among public debt, socio-economic characteristics, corruption, and inequality within the region. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionVitamin B12 and folate are essential micronutrients, a deficiency of which causes anaemia, poor growth and an increased risk of infections, along with irreversible neurological damage to the developing brain in children.A hospital-based prospective observational study was conducted in 100 children with severe acute malnutrition (SAM) aged 6–59 months admitted to a tertiary-care facility in northern India from July 2021 to June 2022. A structured proforma was used to record socio-demographic information, a detailed clinical history, results of general and systemic physical examination and a detailed anthropometric assessment. Serum folate and vitamin B12 were estimated by electrochemiluminescence.The mean age of the children was 24.18 months, and 64.0% were aged 6–12 months. The male-to-female ratio was 1.08:1. Anaemia was present in 87.0% of the children, and it was severe in 35% of them. There was serum vitamin B12 and folate deficiency in 61.0% and 19.0%, respectively. A deficiency of vitamin B12 was significantly associated with delayed developmental milestones in all domains, a mid-upper-arm circumference of <11.5 cm, severe anaemia, a low platelet count and folate deficiency, and a folate deficiency was significantly associated with older age, delayed developmental milestones in all domains, severe anaemia, a low platelet count and vitamin B12 deficiency.Vitamin B12 deficiency is highly prevalent in children aged 6–59 months with SAM, but the prevalence of folate deficiency is much lower. Apart from iron and folic acid supplementation, government programmes should consider vitamin B12 supplementation for children aged 6–59 months. [ABSTRACT FROM AUTHOR]

Child marriage continues to be a substantial issue of both societal and public health significance within India, characterized by a complex interplay of factors contributing to its persistence. The primary objective of this study is to investigate the regional disparities of child marriage in the context of India. This study explores child marriage prevalence across population sub-groups within a specific region of India. Utilizing the latest available data from the National Family Health Survey (2019–2021), and employing bi-variate and multivariate analysis to examine the differential patterns and factors of child marriage among women aged 20–24 years in India at a regional level. Substantial regional variations in child marriage are found in India. The highest prevalence is found in the eastern region (37.3%) and lowest in the northern region (16.3%) (2019–2021). Further, the eastern region has highest child marriage prevalence across all population sub-groups with an exception of the northeastern region where Muslim women have high prevalence of child marriage (45%). The results also demonstrate that the southern, western, northeastern, central and northern regions have lower odds of child marriage than the eastern region (0.85, 0.76, 0.81, 0.50, and 0.47 times, respectively), even after controlling for selected socio-economic characteristics. The present study suggests that India must develop targeted interventions based on identified regional disparities in child marriage prevalence, focusing on eastern regions with higher prevalence. Area-specific programs informed by the survey findings need to be implemented to reduce the rate of child marriage and empower vulnerable population sub-groups. [ABSTRACT FROM AUTHOR]

The aim of this research paper is to determine the prevalence of improved household latrine utilization and its determinants in Somalia, using the Somali Health Demographic Survey (SHDS) 2020 dataset. Limited sanitation is a major global problem mainly for the poor and disadvantaged. According to the SHDS 2020 report, around 22.3% of households in Somalia utilize unimproved toilet facilities. In this study, a secondary data analysis was carried out on the SHDS 2020 dataset. The study included 15 826 households weighted for representativeness. Four models were constructed after identifying relevant factors for the outcome variable. The first model, null (empty), had no independent variables. The second model assessed the effect of individual-level determinants on the outcome. The third model determined how community-level variables influenced on the response variable. Finally, a multilevel multivariable logistic regression model examined the combined impact of individual- and community-level factors on the outcome variable. The prevalence of improved latrine utilization in Somalia was (41.1%). The factors: educational status (AOR: 1.899 (1.598, 2.258)), wealth index (AOR: 7.815 (6.990, 8.736)), urban residence (AOR: 2.467 (2.262, 2.690)), households living in various regions/states, including Hirshabelle, Galmudug, Southwest, Puntland, Jubaland, and Somaliland, indicate statistically significant findings and were more likely to utilize improved latrines (AOR: 0.259 (0.229, 0.294)), (AOR: 0.223 (0.196, 0.254)), AOR: 0.196 (0.168, 0.230)), (AOR: 0.220 (0.194, 0.251)), (AOR: 0.204 (0.180, 0.232)), (AOR: 0.086 (0.077, 0.095)). Hirshabelle had a 0.259 times more likelihood of improved latrine utilization than the rest of the regions/states, (AOR: 0.259 (0.229, 0.294)). The prevalence of improved latrine utilization was quite low in Somalia. Higher wealth index, living in more urbanized areas, and the household head's educational status were all significant predictors of improved latrine utilization. The finding implies a need to increase household's access to latrine facilities and improve latrine utilization, particularly for rural households in the country. [ABSTRACT FROM AUTHOR]

Background: Basic sanitation services and practices are crucial for the well-being and health of a community. However, little is known about the determinants of basic sanitation services in Ethiopia, particularly in the study area. Objectives: To identify the determinants of basic sanitation service coverage among households in the Shashogo district, Hadiya Zone, and Central Ethiopia in 2023. Methods: A case–control investigation was carried out in households in Shashogo District from August 8, 2023, to December 10, 2023. Ten Kebeles were chosen randomly from a total of 34 Kebeles in the district. A total of 579 households (193 cases and 386 controls) were included in the study. The data were gathered with pretested and structured questionnaires in digital form with a smartphone. The data were analyzed with SPSS. Independent t tests and regression models were used to determine predictors of basic sanitation services. Results: The mean (±SD) age of the study participants was 38.2 (±8.9) years. After controlling for confounders in the multivariate analysis, the adoption of improved latrine services among households was found to be associated with greater average monthly income (AOR = 1.841, 95% CI (1.043, 3.251)), the study respondents who had access to the necessary materials for latrine construction/upgrade were approximately 3.5 times more likely to adopt improved latrine services among households with (AOR = 3.477 (95% CI = 1.314, 9.202) than among those who lacked access to the necessary materials for latrine construction, the study respondents who had training in sanitation and hygiene (AOR = 4.744, 95% CI (2.984, 7.542)) and who had sufficient knowledge about the adoption of improved latrine services (AOR = 2.020, 95% CI (1.125, 3.628)) were found to be determinants of the adoption of improved latrine services among households. Conclusion: This study revealed that economics, knowledge, attitudes and practices, infrastructure, and culture were identified as determinants of the adoption of improved latrines in the study area. Poor sanitation significantly impacts economic, social, environmental and many other direct and indirect impacts on the well-being of citizens. Therefore, policies on sanitation and contextual initiatives and focused actions are needed by stakeholders and policy implementers to improve knowledge gaps, access to necessary materials and the income capacity of those lagging to adopt services. [ABSTRACT FROM AUTHOR]

Background: Women living with HIV (WLWH) in low- middle-income countries (LMICs) face increased mortality risks from comorbidities despite progress in antiretroviral therapy. Palliative care (PC) is vital for these patients, yet its integration in LMICs, such as Nigeria, is suboptimal due to unique challenges. Objective: This study investigated the knowledge, perceived barriers, and facilitators influencing PC integration into routine HIV care within healthcare (HC) settings. Methodology: A cross-sectional survey was conducted among WLWH in twelve HC facilities throughout Nigeria. Data collection involved surveys focused on PC knowledge, attitudes, facilitators, and barriers. Logistic regression analyses were employed to examine the data. Results: This study revealed significant gaps in knowledge and attitudes towards PC among HIV + women at NISA-MIRCs. Over 90% were unaware of PC services, but many saw its potential to offer hope (55%) and improve quality of life (56.5%). The key predictors of PC knowledge included education, occupation, religion, having fewer children, urban residence, type of residence, and having a high income (p <.05). Despite the willingness to access PC, barriers such as negative HC worker attitudes, perceived high cost, and limited decision autonomy could hinder integration. Facilitators included low-cost services, positive HCW attitudes, physician recommendations, and perceived necessity for personal well-being. Conclusion: Knowledge gaps, diverse attitudes, and significant barriers highlight the need for targeted PC interventions for WLWH. Tailoring educational programs, addressing cost barriers, and improving healthcare infrastructure are crucial to enhancing PC accessibility and quality. These findings can guide policymakers and HC practitioners toward more effective and inclusive care strategies. [ABSTRACT FROM AUTHOR]

Background: During neoadjuvant therapy (NAT), patients with locally advanced breast cancer (LABC) experience psychological distress (PD) and adopt appropriate coping strategies. Objective: This systematic review aimed to examine the prevalence and changes in PD and coping strategies in patients with LABC during NAT and to evaluate effective interventions to reduce their PD. Design: Quantitative (cross-sectional, longitudinal, and interventional) and qualitative studies reporting PD and coping strategies related to NAT during LABC were included. Data sources and methods: PubMed, Cochrane Library, Scopus, ScienceDirect, Wiley Online Library, and Web of Science databases were consulted to gather relevant literature from the first publications until July 25, 2023. Selection was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 41 articles were included, of which four were qualitative. The main results showed that the prevalence of depression before NAT ranged from 0% to 46% and that of anxiety from 5.5% to 54%. After NAT, the prevalence of depression ranged from 40% to 78.5% and anxiety accounted for 27%. Additionally, PD decreased during NAT. The main determinants of PD were perceived social support, living in joint families, being affected by COVID-19 infection, delays in diagnosis, and starting neoadjuvant treatment. For coping strategies, after NAT, "resigned coping" decreased, whereas "social support" increased, and active coping strategies were correlated with better PD. Some interventions found a reduction in PD, such as a mobile health application, fasting-mimicking diet, relaxation training, and guided imaging. Conclusion: These findings highlight the importance of considering PD and coping strategies in patients with LABC from diagnosis to the end of NAT. The results suggest that effective psychological interventions should be implemented. [ABSTRACT FROM AUTHOR]

AbstractThe human immunodeficiency virus (HIV) heavily affects women from resource-limited settings who are vulnerable to potentially harmful mycotoxins including aflatoxin B1 (AFB1), fumonisin B1 (FB1) and ochratoxin A (OTA). We aimed to conduct biomonitoring and ascertain the determinants of maternal mycotoxin exposure in pregnancy, lactation and post-lactation periods. We conducted a retrospective longitudinal study in HIV-infected and HIV-uninfected women from Harare, Zimbabwe. 175 and 125 random urine samples in pregnancy and 24 months after delivery (post-lactation) respectively were analysed for aflatoxin M1 (AFM1) and FB1 by ELISA. 6 weeks after delivery (lactation), 226 and 262 breast milk (BM) samples were analysed for AFM1 and OTA respectively by ELISA. The association of demographics and food consumption with mycotoxins was evaluated using multivariable logistic regression. In HIV-infected, urinary AFM1 was detected in 46/94 (Median: 0.05; Range: 0.04–0.46 ng mL−1) in pregnancy and 47/66 (Median: 0.05; Range: 0.04–1.01 ng mL−1) post-lactation. Urinary FB1 was detected in 86/94 (Median: 1.39; Range: 0.17–6.02 ng mL−1) in pregnancy and 56/66 (Median: 0.72; Range: 0.20–3.81 ng mL−1) post-lactation. BM AFM1 was detected in 28/110 (Median: 7.24; Range: 5.96–29.80 pg mL−1) and OTA in 11/129 (Median: 0.20; Range: 0.14–0.65 ng mL−1). In HIV-uninfected, urinary AFM1 was detected in 48/81 (Median: 0.05; Range: 0.04–1.06 ng mL−1) in pregnancy and 41/59 (Median: 0.05; Range: 0.04–0.52 ng mL−1) post-lactation. Urinary FB1 was detected in 74/81 (Median: 1.15; Range: 0.17–6.16 ng mL−1) in pregnancy and 55/59 (Median: 0.96; Range: 0.20–2.82 ng mL−1) post-lactation. BM AFM1 was detected in 38/116 (Median: 7.70; Range: 6.07–31.75 pg mL−1) and OTA in 4/133 (Median: 0.24; Range: 0.18–0.83 ng mL−1). Location, wealth, and peanut butter consumption were determinants of AFB1 exposure. HIV infection, BMI, location, rainy season, unemployment, and age were determinants of FB1 exposure. Women especially those pregnant and/or HIV-infected are at risk of adverse effects of mycotoxins. [ABSTRACT FROM AUTHOR]

Background: Improvement of the knowledge of pregnant mothers and their partners related to low birth weight (LBW) is a vital factor in preventing LBW and reducing its prevalence. Objectives: Implement and evaluate the effectiveness of a community based health promotion intervention on pregnant mothers and their partners to increase knowledge on birth weight and its determinants. The second objective is to determine the difference of the birth weight after implementing the intervention. Methods: A quasi experimental study design was used, and the setting was 806 pregnant mothers, 403 each in two districts. In 26 ANCs, twenty six initial training sessions were conducted as a group, with an average of three hours for each session. Three follow up sessions were conducted in each ANC over 04 months (in total 104 sessions). All sessions were conducted in groups of 10 to 20 antenatal couples. The pregnant mothers and their partners completed interviewer-administered questionnaires. Pre and post data were analysed based on four major knowledge categories using statistical methods. The McNemar's Chi Square test; Chi Square test, Fisher's Exact test, Paired t test, Student's independent sample t test, Wilcoxon Signed Ranks test and Mann Whitney U test methods were applied as appropriate. Results: Both mothers and their partners in the intervention group (IG) reached significantly higher gains in knowledge than in the comparison group (CG). The participants who got the lowest scores for knowledge, at the pre assessment, in IG, also improved more than the CG {mothers (p = 0.002) and partners (p = 0.007)}. The mean birth weight shows that the IG has significantly improved for both mothers (p < 0.001) and partners (p = 0.013) with low knowledge scores (< 50% of total). Conclusions: Knowledge about birth weight and its determinants among pregnant mothers and their partners improved significantly. [ABSTRACT FROM AUTHOR]

Background: Childbirth among adolescents and young mothers has been linked to various complications, including perinatal mortality, preterm births, low birth weight, and infections, which collectively contribute to the high burden of neonatal and maternal mortality. Despite some progress, the prevalence of skilled birth attendance, proven to improve maternal and newborn health outcomes, remains consistently low in Northern Nigeria. This study assessed the prevalence and determinants of Skilled Birth Attendance (SBA) among young women ages 15–24 years in Northern Nigeria. Methods: This pooled cross-sectional study included 6,461 young women aged 15–24 years from 2011, 2016 and 2021 multiple indicator cluster surveys in Nigeria. We used a binary logistic regression model to assess the factors associated with skilled birth attendance at 95% confidence intervals (CIs) with computed adjusted odds ratios (aORs). Results: The prevalence of skilled birth attendance among young women in Northern Nigeria increased from 25.6% in 2011 to 33.1% in 2021. Women who were atleast 18 years of age at first marriage had 2.48 higher odds of SBA (aOR 2.48, 95% CI = 1.54–4.00) compared those less than 18 years of age at first marriage after controlling for confounders. Young women from rich household wealth quintile were more likely to utilize SBA (aOR 1.84, 95% CI = 1.11–3.14) compared to young women from poor household wealth quintile. In terms of education, those women who had secondary (aOR = 2.52, 95% CI = 1.77–3.56) and higher education (aOR = 10.01, 95% CI = 2.21–49.31) had higher odds of SBA compared to those with no education. Individual women with media exposure had 59% higher likelihood (aOR = 1.59, 95% CI = 1.16–2.19), women who attended 4 or more antenatal care visits during their last pregnancy demonstrated 2.28 times higher odds (aOR = 2.28, 95% CI = 1.67–3.09), while those who reported no intention for their last pregnancy were 37% less likely (aOR = 0.63, 95% CI = 0.42–0.96) to utilize SBA. Conclusion: A slight increase in the prevalence of skilled birth attendance was observed over the 10-year period. For a significant boost in skilled birth attendance among young women in Northern Nigeria, particular attention needs to be paid to girls' child education, delay in marriage, economic empowerment of young women, and strategic ways of leveraging trained community health workers (CHIPs) to bring reproductive healthcare close to young women living in rural areas. [ABSTRACT FROM AUTHOR]

The ability of a 1-time measurement of non–high-density lipoprotein cholesterol (non–HDL-C) or low-density lipoprotein cholesterol (LDL-C) to predict the cumulative exposure to these lipids during early adulthood (age 18-40 years) and the associated atherosclerotic cardiovascular disease (ASCVD) risk after age 40 years is not clear. The objectives of this study were to evaluate whether a 1-time measurement of non-HDL-C or LDL-C in a young adult can predict cumulative exposure to these lipids during early adulthood, and to quantify the association between cumulative exposure to non-HDL-C or LDL-C during early adulthood and the risk of ASCVD after age 40 years. We included CARDIA (Coronary Artery Risk Development in Young Adults Study) participants who were free of cardiovascular disease before age 40 years, were not taking lipid-lowering medications, and had ≥3 measurements of LDL-C and non–HDL-C before age 40 years. First, we assessed the ability of a 1-time measurement of LDL-C or non–HDL-C obtained between age 18 and 30 years to predict the quartile of cumulative lipid exposure from ages 18 to 40 years. Second, we assessed the associations between quartiles of cumulative lipid exposure from ages 18 to 40 years with ASCVD events (fatal and nonfatal myocardial infarction and stroke) after age 40 years. Of 4,104 CARDIA participants who had multiple lipid measurements before and after age 30 years, 3,995 participants met our inclusion criteria and were in the final analysis set. A 1-time measure of non–HDL-C and LDL-C had excellent discrimination for predicting membership in the top or bottom quartiles of cumulative exposure (AUC: 0.93 for the 4 models). The absolute values of non–HDL-C and LDL-C that predicted membership in the top quartiles with the highest simultaneous sensitivity and specificity (highest Youden's Index) were >135 mg/dL for non–HDL-C and >118 mg/dL for LDL-C; the values that predicted membership in the bottom quartiles were <107 mg/dL for non–HDL-C and <96 mg/dL for LDL-C. Individuals in the top quartile of non–HDL-C and LDL-C exposure had demographic-adjusted HRs of 4.6 (95% CI: 2.84-7.29) and 4.0 (95% CI: 2.50-6.33) for ASCVD events after age 40 years, respectively, when compared with each bottom quartile. Single measures of non–HDL-C and LDL-C obtained between ages 18 and 30 years are highly predictive of cumulative exposure before age 40 years, which in turn strongly predicts later-life ASCVD events. [ABSTRACT FROM AUTHOR]

[Display omitted] [ABSTRACT FROM AUTHOR]

AbstractTrichloramine is a disinfection by-product in chlorinated swimming pools. It can evaporate into the air and irritate eyes and airways among swimmers and pool workers. This study aimed to evaluate airborne concentrations of trichloramine in different types of indoor swimming pools. Altogether, 72 swimming pools across Sweden were included; 36 exercise pools, 16 instruction pools, seven adventure pools, and 13 rehabilitation pools. In total, 167 sampling sessions were performed with the majority (N = 91) conducted in public exercise pools. Repeated sampling sessions on different days were performed within all pool categories. Airborne trichloramine was measured stationary by the poolside using active sampling on quartz filters. In total, 434 air samples were collected. The geometric mean (GM) concentration of trichloramine for the exercise pools was 0.12 mg/m3 (range GMpool: 0.02–0.29 mg/m3) and for about 30% the GMpool exceeded the Swedish public health guideline value (0.2 mg/m3). The geometric mean for instruction pools was 0.18 mg/m3 and for adventure pools 0.20 mg/m3. Trichloramine concentrations were statistically significantly lower in rehabilitation pools (GM: 0.03 mg/m3) compared with the other pool categories. A statistically significant effect of time of the day for sampling was found for the exercise and instruction pools, with higher trichloramine levels during evenings compared with mornings and afternoons. For the rehabilitation pools, trichloramine was significantly higher during the cold season compared with the warm season. Variability in trichloramine concentrations was attributed to between-pool as well as within-pool variances. The within-pool variability encourages a repeated sampling strategy to capture the variation between different days. These findings have implications for exposure assessment in epidemiological studies as well as for indoor air quality monitoring. Trichloramine can cause acute irritative effects at elevated levels, and since trichloramine concentrations may differ depending on the time of the day it is recommended that full-day stationary measurements are supplemented with short-term samplings to capture these variations. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions Causal analysis including causal inference and causal mediation is pivotal to inform effective interventions. In modern epidemilogy, causal analysis involves four key steps: formulating causal questions, employing directed acyclic graphs (DAGs), conducting data management and selecting statistical strategies. Our objective was to conduct a scoping review to assess how longitudinal observational studies (LOSs) in dental field have integrated these four steps to contribute leverage evidence that inform oral public health interventions.LOSs focusing on determinants of dental caries published from 2012 to 2024 were systematically retrieved from five major databases. The Joanna Briggs Institute‐scoping review guidance and the Covidence application were employed to identify eligible LOSs for being reviewed.Out of the 85 eligible LOSs, none formulated causal hypothesis by applying ‘what if’ question or investigated mediation across three levels of the determinants of oral health. A minority (18 studies, ~21.2%) employed DAGs to visualise relationships among study variables, while only one third (33 studies, ~39%) clearly defined confounders. The majority (64 studies, ~75%) incorporated a time‐varying feature of their data, yet only a few (11 studies) fully leveraged this advanced aspect. Among these studies that fully utilised time‐varying data, more than half encountered challenges in employing robust statistics to address confounders arising from such data dynamics.Dental LOSs have, to date, mostly focused on investigating associations over causality, often neglecting the four‐step causal analysis and not fully utilising time‐varying data. Researchers necessitate to shift their focus to causal inference and prioritise building capacity in causal analysis with a consistent four‐step approach to advance the field. Studies exploring mechanisms linking determinants of dental caries across levels and leveraging time‐varying data are strongly encouraged. [ABSTRACT FROM AUTHOR]

Background: Many patients with post COVID-19 condition (PCC) require healthcare services. However, qualitative studies indicate that patients with PCC encounter many barriers to healthcare access. This cross-sectional study aimed to determine how many PCC patients report barriers to healthcare access and which barriers are reported, and to explore differences between subgroups. Methods: Data were collected via an online survey from 10,462 adult patients with a confirmed or suspected COVID-19 infection in the Netherlands, who experienced persisting symptoms ≥ 3 months after the initial infection. To study self-perceived barriers, a list of eleven possible barriers was used, covering multiple aspects of healthcare access. Differences between subgroups based on sociodemographic characteristics, medical characteristics, PCC symptoms (fatigue, dyspnoea, cognitive problems, anxiety and depression), and healthcare use (general practitioner, paramedical professional, medical specialist, occupational physician and mental health professional) were studied through multivariable multinomial (0 vs. 1 vs. > 1 barrier) and binomial regression analyses (for each individual barrier). Results: A total of 83.2% of respondents reported at least one barrier to healthcare access. Respondents reported a median of 2.0 (IQR = 3.0) barriers. The barriers "I didn't know who to turn to for help" (50.9%) and "No one with the right knowledge/skills was available" (36.8%) were most frequently reported. Respondents with younger age, higher educational level, not hospitalized during acute COVID-19 infection, longer disease duration, who had more severe PCC symptoms, and who did not consult an occupational physician or paramedical professional, were more likely to report barriers. Analyses per barrier showed that women were more likely to report financial and help-seeking barriers, while men were more likely to report barriers related to availability of care. Hospitalized respondents were less likely to report barriers related to availability of care, but not less likely to report financial or help-seeking barriers. Conclusions: This study shows that the majority of patients with PCC experiences barriers to healthcare access. Particular attention should be paid to younger, non-hospitalized patients with a long disease duration and severe PCC symptoms. Efforts to remove barriers should focus not only on improving availability of care, but also on helping patients navigate care pathways. [ABSTRACT FROM AUTHOR]

Background: Diarrhea diseases continue to present a significant threat to the well-being of children under the age of five in Africa, thereby contributing substantially to both morbidity and mortality rates. The period spanning between January 2013 and December 2023 has witnessed persistent challenges in the fight against these diseases, thereby necessitating a thorough investigation into the factors that determine their occurrence. It is important to note that the burden of diarrhea diseases is not evenly distributed across the continent, with residence, socioeconomic, and environmental factors playing pivotal roles in shaping the prevalence and incidence rates. Consequently, this systematic review aimed to consolidate and analyze the existing body of literature on the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. Method: The systematic review employed a rigorous methodological approach to examine the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. A comprehensive search strategy was implemented, utilizing databases such as PubMed, Scopus, and Web of Science, and incorporating relevant keywords. The inclusion criteria focused on studies published within the specified timeframe, with a specific focus on the determinants of diarrhea disease among children under the age of five in Africa. The study selection process involved a two-stage screening, with independent reviewers evaluating titles, abstracts, and full texts to determine eligibility. The quality assessment, employing a standardized tool, ensured the inclusion of studies with robust methodologies. Data extraction encompassed key study details, including demographics, residence factors, socioeconomic influences, environmental variables, and intervention outcomes. Results: The search yielded a total of 12,580 articles across 25 African countries; however, only 97 of these articles met the inclusion criteria and were ultimately included in the systematic review. The systematic review revealed geographic and seasonal disparities in the prevalence of diarrhoeal diseases across different countries in Africa. Factors such as age-related vulnerabilities, gender disparities, maternal occupation, disposal of young children's stools, and economic status were identified as significant determinants of the prevalence of diarrhea disease. Conclusion: This systematic review provides a comprehensive understanding of the determinants of diarrhea diseases among children under the age of five in Africa between January 2013 and December 2023. The nuanced analysis of residence variations, socioeconomic influences, environmental factors, and intervention outcomes underscores the complex nature of this issue. The findings highlight the necessity for region-specific and context-sensitive interventions to address the unique challenges faced by diverse communities. This review serves as a valuable resource for policymakers, healthcare professionals, and researchers, guiding the development of evidence-based strategies aimed at reducing the burden of diarrhea diseases and improving child health outcomes in Africa. [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms may increase with age, potentially influenced by sociodemographic characteristics, stressors and support, health status, and health behaviour. It is unclear if this is the case among older adults in the Philippines. Therefore, the aim of this study is to estimate the prevalence and associated factors of depressive symptoms among older adults in the Philippines. Methods: In all, 5209 items of cross-sectional nationally representative data from older adults (=60 years) participating in the 2018 Longitudinal Study on Ageing and Health in the Philippines (LSAHP) were analysed. Depressive symptoms were assessed using the 11-item 3-response category Center for Epidemiological Studies Depression (CES-D) Scale. Results: The overall prevalence of depressive symptoms was 32.1%, with 25.6% among older men and 36.5% among older women. In the final adjusted models, overall, widowed (Adjusted Odds Ratio (AOR): 1.52, 95% Confidence Interval (CI): 1.00 to 2.30), hunger (AOR: 2.22, 95% CI: 1.40 to 3.51), living alone (AOR: 1.61, 95% CI: 1.00 to 2.59), not satisfied with present life (AOR: 2.04, 95% CI: 1.09 to 3.81), body pain (AOR: 2.39, 95% CI: 1.73 to 3.31), and insomnia (AOR: 1.69, 95% CI: 1.24 to 2.31) were positively associated, while working (AOR: 0.55, 95% CI: 0.37 to 0.80) was negatively associated with depressive symptoms. In addition, among men, older age (80 years and above) (AOR: 1.95, 95% CI: 1.06 to 3.58), unmet healthcare needs (AOR: 2.19, 95% CI: 1.07 to 4.47), and hearing difficulty (AOR: 2.41, 95% CI: 1.06 to 5.52) were positively associated poor childhood health (AOR: 0.12, 95% CI: 0.04 to 0.36), while social network (AOR: 0.94, 95% CI: 0.90 to 0.99) was negatively associated. Among women, loss of bladder control (AOR: 1.69, 95% CI: 1.03 to 2.77) was positively associated with depressive symptoms. Conclusion: One in three older adults participating in this study exhibited depressive symptoms. Sociodemographic factors, stressors, and health status factors were positively associated, and support factors were negatively associated with depressive symptoms. [ABSTRACT FROM AUTHOR]

BACKGROUND: Access to safe drinking water remains a critical challenge in Sub-Saharan Africa, driven by a complex mix of environmental, political, social, economic, and infrastructural factors. This scoping review aims to map the literature on water access in Sub-Saharan Africa over the past decade. METHODS: We conducted a comprehensive search of academic databases and grey literature from January 2013 to the present. We included peer-reviewed quantitative, qualitative, and mixedmethods research, as well as reviews and reports focusing on factors influencing water access and related interventions in SubSaharan Africa. Data were extracted on study characteristics, key determinants, proposed solutions, and outcomes. RESULTS: A total of 137 studies were included. Commonly reported determinants included droughts, climate change, conflict, governance, gender, wealth, education, poverty, and inadequate infrastructure. Identified potential interventions included infrastructure development, water quality monitoring, climate adaptation, governance reforms, decentralized management, targeted subsidies, and integrated water resources management. However, most studies described barriers rather than evaluating solutions. CONCLUSIONS: Persistent inequities in water access are driven by interconnected factors such as poverty, governance, gender, and infrastructure. Implementing integrated solutions is crucial, with a shift from problem identification to evaluating contextualized interventions across sectors. Dedicated implementation research is needed to translate knowledge into action, advancing water security and achieving Sustainable Development Goal 6 in the region. [ABSTRACT FROM AUTHOR]

Weather variations have posed enormous barriers to water resources, availability of food, human health, infrastructure, and natural environment. These phenomena underscore the need for climate smart practices in South Africa. The study examined in context, the socio-economic determinants, and acceptance of climate smart agriculture practices in Mzinti, Nkomazi Local Municipality South Africa. From a known population of 455 farmers, 212 samples were selected for the survey and considered realistic for the study. This survey comprised questions that were clear, unbiased, and relevant to the research questions. Enumerators were further briefed on the study objectives and the importance of consistent and ethical data collection. The team comprised of four primary data enumerators. A pilot survey with 20 randomly selected smallholder farmers was undertaken to identify and address any questionnaire that may be ambiguous. Based on this pilot, minor revisions were made to improve the questionnaire and ensure accurate reflection of intended variables, thus enhancing the reliability of the data collection instrument. A randomized sampling method was employed to select respondents who participated in the study. This allowed every participant to have a fair chance of being chosen. The study used the structured questionnaire, and the field survey was done between the month of April 2023 and July 2023. Descriptive statistics: frequency count, tables, and percentages, were used to explain the socio-economic determinants for acceptance of climate smart agriculture practices. The hypothesized variables were assessed using the binary logistic regression to determine the correlation between the socio-demographic characteristics and dependent variables. The result revealed that age (p< 0.007), crop yield (p<0.001), farm income (p<0.047) farm size (p<0.020, and food shortages (p<0.001) were correlated and statistically significant in determining the acceptance of climate smart agriculture practices. The study concluded that climate smart agriculture practices enhance farmer productivity, and it is influenced by factors such as age, farm size, and scarcity of food, crop yield, and farm income. The adoption of climate smart agriculture enables farmers to have increased crop yields, have access to food, increased income of the farm. Thus, it can be concluded that CSA practices effectively enhance the productivity of vegetable farming and food security. [ABSTRACT FROM AUTHOR]

Notwithstanding ongoing efforts through supplementation and fortification programs, the burden of vitamin A deficiency remains high among poor and rural populations. To address this, a pro-vitamin A-enriched genetically modified (GM) rice variety, known as Golden Rice (GR), has been developed as a complementary, cost-effective micronutrient strategy. Despite its potential, the success of its future implementation will heavily rely on the acceptance and purchase intention of target populations. Therefore, this study investigated the determinants of GR purchase intention from a survey of 540 consumers from rural Bangladesh. On average, consumers exhibited a strong intention to purchase GR. Hierarchical regression analysis demonstrated that sociodemographic factors (age), cognitive and behavioral factors (prior knowledge, perceived benefits about GR, attitudes toward GM crops, and dietary choices), and expectations of GR marketing (overall, price, distribution) positively influenced consumers' purchase intention of GR. On the other hand, having more negative risk perceptions and higher income levels reduced consumers' intentions. By using a between-subjects design based on five information treatments, the role of information is examined in two ways, i.e., information length and presentation format. Findings of a series of two-way ANOVAs revealed that exposure to more detailed information about GR significantly influenced consumers' purchase intentions, especially when the level of expectations was low. Additionally, information presented through video or an information wheel proved more effective than text. These findings provide valuable insights for policymakers and health planners in devising communication strategies and decision-making regarding this valuable but controversial micronutrient strategy. [ABSTRACT FROM AUTHOR]

In the present paper, we mainly consider the direct solution of cyclic tridiagonal linear systems. By using the specific low-rank and Toeplitz-like structure, we derive a structure-preserving factorization of the coefficient matrix. Based on the combination of such matrix factorization and Sherman–Morrison–Woodbury formula, we then propose a cost-efficient algorithm for numerically solving cyclic tridiagonal linear systems, which requires less memory storage and data transmission. Furthermore, we show that the structure-preserving matrix factorization can provide us with an explicit formula for n-th order cyclic tridiagonal determinants. Numerical examples are given to demonstrate the performance and efficiency of our algorithm. All of the experiments are performed on a computer with the aid of programs written in MATLAB. [ABSTRACT FROM AUTHOR]

Background: Under nutrition has been a major problem in developing countries including Tanzania; hence, contributing to about half of the deaths among young children. Objective: The current study aimed at identifying child feeding practices and determinants of stunting in children under the age of five years in Mvomero District. Methods: A cross-sectional study involving 150 mother-child pairs was carried out in Turiani ward, Mvomero district in Morogoro region. Bivariate and multivariate logistic regression models were used to identify factors associated with stunting. A p-value ≤ 0.05 was considered sta-tistically significant. Five focus group discussions comprising 5–9 mothers with children below five years participated in the study. Thematic analysis was used to analyse data from the in-depth interviews. Results: The prevalence of underweight, stunting and wasting in Mvomero district was 16.8, 42.2, and 6.2% respectively. Pre-lacteal feeding was common in the study area (40%). Children were introduced to complementary food too early (<6 months) with plain maize porridge being the first food introduced. About 57.2% of children were on the lowest tercile (≤3 food groups per day) dietary diversity score. Significant determinants of stunting were the family source of income (AOR 1.63, 95% CI: 1.99–2.3), age of a child (AOR 2.66, 95% CI: 1.03–3.50) and family size (AOR 3.22, 95% CI: 1.61–4.27). Other factors were consumption of animal foods (AOR 5.30, 95% CI: 0.26–0.60) and dietary diversity score (AOR 1.615, 95% CI: 1.014–2.574). Conclusion: Child feeding practices in the study area are sub-optimal. These findings have important implications for interventions to address stunting among children. [ABSTRACT FROM AUTHOR]

Research suggests that there is a correlation between the characteristics of residents and target areas and the levels and types of crime occurring in cities. However, there is no consensus in the extant literature on the social and environmental characteristics of spaces that influence the occurrence of crime. This paper draws on findings in Makurdi, Nigeria to provide a contextual analysis of the determinants of the spatial patterning of crime. Data on the physical attributes of the built environment, the social characteristics of residents and types of crime were obtained through physical observation and questionnaires. The data were analysed using the regression method. The study found that the major determinants of crime are building and population density, fences, age of residents and the 'age' of residential areas. Some of these determinants are indicators and facilitators of 'eyes on the street', highlighting the importance of formal and informal monitoring of activity spaces in cities. This means that design principles that support formal or informal surveillance of urban spaces like the introduction of outdoor communal spaces to encourage interactions and the development of social networks and the regulation of the types and height of fences could enhance urban safety and security. [ABSTRACT FROM AUTHOR]

Background Nigeria has the largest global burden of HIV new infections in children despite global and national concerted efforts at the reduction of mother-to-child transmission of HIV. The goal of this study was to determine the associations between maternal characteristics, practices and mother-to-child transmission of HIV infection among mothers living with HIV. Methods This is a hospital-based descriptive cross-sectional study. Information was obtained using interviewer-administered questionnaire from the 240 participants. Data were analyzed with SPSS version 26, and P  < 0.05 was considered statistically significant. Results Out of the 240 mothers recruited, 129 (53.8%) were within 25–35 years of age, with a mean age of 31.08 ± 5.65. A total of 35 (14.6%) of the participants had at least a child with HIV infection. Maternal ART status before childbirth (AOR = 0.02, 95%CI = 0.01–0.05, P  = < 0.001) was the singular determinant of having a child with HIV infection. Mothers who delivered outside the health facility were about four-fold at risk of having an infected child (AOR = 3.89, 95%CI = 1.82–8.50, P  = 0.070). Conclusion The prevalence rate of mother-to-child transmission of HIV is high. Routine HIV testing services and the provision of accessible and affordable reproductive health services are recommended for all women of childbearing age. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first study to explore the determinants of family FMS practice via a systematic synthesis of qualitative evidence. Methods: Keyword searches were completed in SPORTDiscus, PubMed, Scopus, Web of Science, and Embase. Studies that offered perspectives relating to influences on the FMS of 2–6-year-old children in the family context via qualitative approaches, including visual methodologies that provided an important voice to children, were included. A thematic analysis was used to establish key themes. Results: The emergent themes included parent knowledge and beliefs, self-efficacy of parents to teach, and the home environment. Parents often undervalued FMS and lacked the self-efficacy to teach due to poor understanding, conflicting priorities, and multifaceted societal influences. Children preferred autonomous play and socialisation but were negatively influenced by technology and restrictive household rules. Conclusions: Greater knowledge exchange between stakeholders is necessary to empower parents and enhance FMS application at home. More community initiatives could facilitate greater access to outdoor spaces, facilities, and equipment, which may improve family engagement with FMS. [ABSTRACT FROM AUTHOR]

The United Nations Sustainable Development Goals (SDGs) have emerged as a relevant framework for Corporate Social Responsibility (CSR) at the firm level. Despite the recent proliferation of articles about firms' engagement with SDGs within a short span of time, empirical literature in this field is still in its early stages, and has not yet been organized. While a set of literature reviews have analyzed the impact of SDGs at the organizational or firm level, none have specifically focused on empirical works at the company level. To address this gap, this article aims to review the empirical studies on firms' engagement with SDGs. A total number of 29 studies published in the 2015 to 2024 period were reviewed based on the scoping review methodology, in order to identify key concepts and research gaps. In terms of the primary focus of the studies examined, although a wide array of topics were explored in the early stage of the SDG literature, a notable theme emerged: the analysis of the determinants or factors driving companies to engage with SDGs. The article delves into the implications of the findings for managers, public policymakers and various stakeholders. [ABSTRACT FROM AUTHOR]

Persuasion knowledge (PK) has become an essential construct to understand how sponsored content affects audiences. As limited or undeveloped PK makes people vulnerable to persuasion, it is crucial to understand which factors determine people's dispositional PK of sponsored content. This study aims to (1) explore whether individual factors and medium type determine people's levels of dispositional PK, and (2) identify subgroups with different levels of PK and estimate the prevalence of these groups. Results from a cross sectional survey (N = 614) show that need for cognition, education, age, medium usage, and medium type determine individual levels of conceptual and/or attitudinal PK. Thus, individual levels of dispositional PK of sponsored content depend on one's ability and motivation to process information and one's experience with sponsored content. Furthermore, based on a cluster analysis with three central components of dispositional PK (i.e., understanding tactic, self-reflective knowledge, and scepticism), we present four distinct groups: the Naïve (the largest group), the Critical Realists, the Uncritical Realists, and the Invulnerables. Our findings reveal that there are different types of consumers, and improve our theoretical understanding of who have better developed dispositional PK of sponsored content. [ABSTRACT FROM AUTHOR]

With the burgeoning threats from natural hazards and extreme weather events driven by climate change in every section and sector of society, building resilience against disasters and risks posed by climate change has become an unescapable discourse. The study's main thrust is to establish the determinants of resilience building in Zimbabwe's rural communities. The study adopted the qualitative constructivist grounded theory approach in conjunction with participatory action research to gain insights from community members and traditional leaders. A total of forty-six participants from Chimanimani District, Zimbabwe participated in the study. The findings revealed that the availability of natural and human resources, collective efficacy, government and development agency support systems, indigenous knowledge systems, and livelihood diversification were crucial determinants of resilience building for rural communities in Zimbabwe. The identified determinants for resilience building signal that these determinants need to be harnessed to inform policy and practice interventions. Furthermore, the availability of the identified determinants implies that rural communities can minimise, and prevent losses, reduce exposure to natural hazards, disasters and climate change risks and manage the impacts of natural hazards whenever they emerge. The study recommends that these determinants be complemented by access to technology, resilient community infrastructures, robust social protection systems, and hazard risk assessment participatory processes by rural communities. In addition, effective emergency and health services, among other contingent measures essential to improve community resilience. [ABSTRACT FROM AUTHOR]

The lack of convergence between rating agencies in the assessment of environmental, social, and governance (ESG) aspects of companies leads to the so‐called ESG rating disagreement. Although this phenomenon causes confusion and uncertainty among investors, it is still little investigated. Previous research has only focused on some determinants of the disagreement, mainly related to nonfinancial disclosure and corporate aspects, while broader determinants remain unexplored. This study aims to fill this gap by analysing the effects of market value, industry sensitivity, and institutional context on disagreement between two different rating providers. To achieve this goal, a cross‐sectional analysis was conducted for 1809 companies from the S&P 1200 Global Index. The results show that companies with a better market rating, belonging to critical sectors and located in countries with a better institutional environment, have a lower level of ESG disagreement. [ABSTRACT FROM AUTHOR]