Cluster Sampling Approach Research Articles

Disaster Education and Social Media Use Influence Disaster Preparedness in Coastal Communities

This study aims to examine the impact of disaster education and social media usage on disaster preparedness in coastal communities, focusing on Masawah Village in the Cimerak District, Pangandaran Regency. The research was conducted using a quantitative survey method with data collected from a sample of 100 respondents selected through probability sampling with a cluster sampling approach. Data were analysed using Partial Least Squares (PLS) with SmartPLS 3.0 software. The findings reveal that both disaster education and social media usage significantly influence individual intentions and actual disaster preparedness. Additionally, the mediating role of intention is identified, highlighting its importance in linking disaster education and social media usage to preparedness. These results suggest that disaster education should incorporate practical training and community participation, while social media campaigns should leverage popular platforms like WhatsApp and TikTok to engage wider audiences effectively. This study contributes to the literature by integrating the Theory of Planned Behavior (TPB) to explore the mediating effects of intention in disaster preparedness. It offers practical implications for policymakers and disaster management organisations to enhance community readiness. The originality of this research lies in its focus on a coastal community and its use of TPB as a theoretical framework, addressing gaps in previous studies that have not thoroughly investigated the role of social media in disaster preparedness.

Methodological report of a cross-sectional survey of abortion-related knowledge, attitudes and practices amongst health professionals in Britain, strategies adopted and lessons learned: evidence from the SACHA Study

BackgroundMost surveys examining health professionals’ knowledge, attitudes and practices around abortion have used convenience samples and have targeted doctors. Our goal in the SACHA Study, drawing on evidence-based strategies to maximise response rates, was to achieve a representative sample of a wider range of health professionals, working in general practice, maternity services, pharmacies, sexual and reproductive health (SRH) clinics and specialist abortion services in Britain, to explore the knowledge, attitudes and experience of abortion care and views on future models of delivery.MethodsA cross-sectional questionnaire-based survey of midwives, doctors, nurses and pharmacists in England, Scotland and Wales was undertaken between November, 2021 and July, 2022. We used a stratified cluster sampling approach to select a random sample of sites and all eligible staff within those services were asked to respond to the survey. Evidence-based strategies to maximise completion rates were adopted, including postal delivery of the one-page questionnaire with personal letter of invitation and a stamped address envelope for return, inclusion of an unconditional voucher and follow-up.ResultsOverall, 147 of the 314 (46.8%) health service sites randomly selected took part in the survey. Reasons for non-participation included local Research and Development (R&D) Department non-response, lack of resources or insufficient time to support or approve the study, lack of interest in or perceived relevance of the topic and insufficient capacity to take part, exacerbated by work demands during the COVID epidemic. Of the 1370 questionnaires sent to eligible identified participants within these services, 771 were completed and returned (56.3%). At the service level the highest proportion of returns was from SRH clinics (81.0%) and the lowest from general practice (32.4%). In relation to profession, returns were highest amongst midwives (69.6%) and lowest amongst pharmacists (36.5%).ConclusionsObtaining information about health professional knowledge, attitudes and practices is key to guide service development and policy and to identify gaps in training and service provision in abortion. Despite our attempts to gain a representative sample of health professionals, the challenges we experienced limited the representativeness of the sample, despite the use of an evidence-based strategy.

Self-Reported Cervical Cancer Screening Uptake Among Women of Reproductive Age in Zambia: Evidence from the 2021 Zambia Population-Based HIV Impact Assessment (ZAMPHIA) Survey.

Despite Zambia implementing the World Health Organisation's (WHO) tri-pillar cervical cancer prevention goals 90-70-90 Prevent, Screen, and Treat, cervical cancer claims 2000 lives annually and reigns as the most common cancer among women, especially those living with HIV (WLHIV). Our study describes the national uptake of screening and treatment from the ZAMPHIA 2021 survey. Utilising a two-stage cluster sampling approach, the study included participants aged 15years and older across Zambia's ten provinces. Data were collected on demographic traits, reproductive history, sexual behaviour, and cervical cancer prevention using a structured questionnaire, and HIV was diagnosed from biological samples. Women aged 15-49 were eligible for inclusion in the analysis. The primary outcome of interest was whether a woman self-reported being screened for cervical cancer. Sociodemographic characteristics were calculated for categorical variables using the SAS proc surveyfreq procedure, producing both raw and weighted estimates. The weighted estimates and their variance were generated using jackknife replicate weights for each record. Of the 8801 surveyed women, 22.2% reported undergoing cervical cancer screening, the majority being aged between 35-49 years. Cervical cancer screening uptake was more likely among compared to HIV negative counterparts (aOR = 3.92, 95% CI: 3.10, 4.95), those aged 25-34 years (aOR = 1.76, 95% CI: 1.42, 2.21) or 35-49 years (aOR = 2.65, 95% CI: 2.11, 3.33) than younger and those with 1-4 (aOR = 2.16, 95% CI: 1.54, 3.02) or more than 5 live births (aOR = 1.98, 95% CI: 1.37, 2.87) than none. Marital status, WLHIV, education, and parity were other factors significantly associated with screening. We report low cervical cancer screening uptake compared to the 70% target of WHO. The WHO's call for bolstered strategies and efforts to increase cervical cancer screening and treatment is timely and urgent. Therefore, ongoing messaging and health education among all women is key.

The non-linear correlation between the severity of alcohol consumption and depressive symptoms in the Chinese Wa ethnic minority.

The aim of this research was to examine the association between alcohol consumption and depressive symptoms in the Wa ethnic minority of China, a population where this relationship has been insufficiently explored. A cross-sectional analysis was conducted on a sample of 317 current drinkers from the Wa ethnic minority, a "direct fast-forward" group in Cangyuan County, between December 1, 2022, and February 28, 2023. Utilizing a multi-stage cluster sampling approach, participants were selected, each of whom exhibited an Alcohol Use Disorder Identification Test (AUDIT) score exceeding 0. Data were collected via face-to-face interviews employing a uniform questionnaire. Quantification of alcohol use was achieved through the application of the AUDIT, while the Patient Health Questionnaire (PHQ)-9 was employed to gauge depressive symptoms. The relationship between the severity of alcohol consumption and depressive symptoms was evaluated using a multivariable logistic regression model. Subsequently, potential non-linear associations were scrutinized through the application of a smoothing plot. The study included 317 current drinkers (196 males [61.83%]; mean age 41.78 ± 12.91 years), of which 94 (29.65%) exhibited comorbid depressive symptoms. Multivariable logistic regression analysis, adjusting for confounders, revealed that higher AUDIT scores were significantly associated with an increased probability of depressive symptoms (OR = 1.09, 95% CI: 1.02-1.18, p = 0.008). The risk of depressive symptoms was notably greater in the group with alcohol dependent range in contrast the group at low-risk range (OR = 7.01, 95% CI: 1.66-29.62, p = 0.008). The smoothing plot indicated a J-shaped non-linear relationship with an inflection point at an AUDIT score of 15. To the left of this inflection point, no significant relationship was observed, whereas to the right, a positive correlation emerged (OR = 1.39, 95% CI: 1.11-1.74, p < 0.001). The findings reveal a non-linear relationship between alcohol consumption and the probability of depressive symptoms within the Wa ethnic minority in China, with implications for the development of nuanced and effective treatment strategies tailored to this population.

Exploring the determinants of fertility rates in Ethiopia: a decomposition analysis using count regression models with a focus on urban and rural residence, based on the 2019 Ethiopian demographic health survey

IntroductionFertility refers to the biological capacity to reproduce and have children. It is a key aspect of reproductive health influenced by various factors. Therefore, this study aims to explore the determinants of fertility rates based on urban and rural settings in Ethiopia.MethodA stratified two-stage cluster sampling approach was used, employing data from the 2019 Ethiopian Mini Demographic and Health Survey (https://dhsprogram.com). The study comprised 8,885 women aged 15 to 49 years. The study employed Stata 17, and the data was described using descriptive statistics. Associations were examined using decomposition analysis and negative binomial regression. The Incidence Rate Ratio and p-value were used to determine the statistical significance of the variables examined.ResultsThe negative binomial regression found that factors such as maternal age (IRR, 1.08, P-value,0.00), living in rural (IRR,1.09, P-value,0.00), being Muslim (IRR,1.13, P-value,0.00), being from other religious groups (IRR,1.16, P-value,0.00), having six up to nine household members (IRR,1.24, P-value,0.00), having greater than nine household member(IRR,1.14, P-value,0.04), having one child under five year (IRR,1.35, P-value,0.00), having two children under five year (IRR,1.77, P-value,0.00), and having more than two under five years (IRR,1.99, P-value,0.00), being currently pregnant (IRR,1.08, P-value,0.00), use of contraceptive(IRR,1.13, P-value,0.00) are positively associated with bearing more children. On the other hand, completing primary education (IRR,0.84, P-value,0.00), secondary education (IRR,0.61, P-value,0.00), being from the richest household (IRR = 0.94, P-value,0.00), and being single/divorced and widowed (IRR,0.49, P-value,0.00) are negatively associated with having more children because their IRR is less than one. The decomposition analysis also demonstrated that marital status has a stronger negative correlation with fertility in rural compared to urban settings. Additionally, the number of children under five exerts a greater influence on fertility in urban areas.Conclusionthe study found significant rural-urban differences in the factors shaping fertility in Ethiopia. While demographics like maternal age, education, and wealth influenced fertility in both settings, the relationships varied in nature and magnitude. To address this, Policymakers should develop targeted fertility programs that address the unique needs and challenges faced by rural and urban populations.

The Impact of Job Stress on University Teachers' Career Development: The Mediating Role of Social Support

This article investigates the impact of job stress on the career development of Afghan university teachers, considering the mediating role of social support. Using a cluster sampling approach, data were collected from 370 teachers in both government and private universities through questionnaires. The analysis utilized SPSS and SPSS AMOS for regression analysis, guided by the Job Demand-Control-Support (JDCS) model. Findings indicate a negative relationship between job stress and career development across all stages: early, mid, advanced, and continuing professional development. Higher job stress correlates with lower career development, while social support mitigates these negative effects. This underscores the need for interventions that address job stress and enhance social support to promote positive career outcomes for university teachers.

Principals Quality Management Strategies in Administration of Secondary Schools in Bayelsa State, Nigeria

The study investigated the quality management practices of secondary school administrators in Bayelsa State. A total of 485 principals from Bayelsa State's public secondary schools made up the study's population, and it used an ex-post facto research approach. Because 485 public secondary school principals made up a reasonable portion of the total population, researchers were able to conduct their experiment using the cluster sampling approach. Researchers collected the data using a 32-item structured questionnaire. "Principal Management Strategies for Quality Secondary Education Questionnaire" was the name of the structured questionnaire. A four-point scale was used to develop the instrument: SA = 4, agree = 3, disagree = 2, and SD = 1. The reliability analysis generated a coefficient of 0.731 after the instrument's confirmation. We used the mean score to look at the survey results. Bayelsa State's principals used strategies for quality management in secondary schools, including planning, organizing, staffing, and coordinating. The research concluded that the government should select capable principals who can work closely with educators to accomplish school goals and implement quality management practices.

Drivers of COVID-19 Vaccination among Eligible Adults in Abuja, Nigeria: A Mixed-Methods Study Using the WHO Behavioral and Social Drivers of Vaccination Framework.

Despite the availability of COVID-19 vaccines, Nigeria still faces significant COVID-19 vaccine hesitancy, with only 60.7% of the eligible population fully vaccinated as of 20 March 2023. Our study, part of a community-based effort to improve knowledge and uptake of the COVID-19 vaccine in the Gwagwalada Area Council of Abuja, the Federal Capital Territory (FCT) of Nigeria, utilized the WHO's Behavioral and Social Drivers (BeSDs)-of-vaccination framework to examine the drivers of COVID-19 vaccination among eligible adults. This was a mixed-method study with focus group discussions (FGDs) and in-depth interviews (IDIs) involving 40 purposively sampled participants. We triangulate qualitative findings with data from a household survey of 1512 eligible adults identified using a two-stage systematic cluster sampling approach. All data were collected from the 1-18 November 2022. The household survey showed 46% COVID-19 vaccine uptake, with Pearson chi-square and Fisher's exact test showing significant associations between vaccine uptake and gender, religion, and education. Multivariate logistic regression showed that confidence in vaccine safety, knowing vaccination sites and family/friends' endorsement of COVID-19 vaccination were the strongest items associated with vaccine uptake in the thinking-and-feeling, practical-issue, and social-process domains, respectively. Multiple items measuring these domains aligned with BeSD priority question, demonstrating the robustness of the pared-down framework. Qualitative data corroborated these findings. To address vaccine hesitancy and increase uptake, community-driven approaches to improve trust in vaccine safety and benefits and promote positive vaccination norms are needed. In addition, service delivery strategies to make vaccination services easily accessible and identifiable should be developed and tailored to community needs.

The association between family emotional climate and moral development with vandalism in students: The mediating role of academic self-efficacy

Background: Research on the mediating role of academic self-efficacy can help identify how the family environment and moral judgment influence destructive behaviors, informing targeted strategies to promote positive youth development. This study investigates the mediating role of academic self-efficacy in the relationship between family emotional climate and moral development with vandalism in students. Methods: In this research, a correlational path analysis framework was adopted to investigate the relationships between various factors and destructive behaviors in adolescents. The target population encompassed all high school students within Eyvan, Iran, during the year 2023. A multistage cluster sampling approach yielded a sample of 364 participants. Standardized instruments assessed vandalism, family emotional climate, moral development, and academic self-efficacy. Structural equation modeling (SEM) software (AMOS 23) was utilized to evaluate the hypothesized model. Results: The findings revealed a non-significant direct association between family emotional climate and vandalism. In contrast, the analysis yielded significant positive and negative associations, respectively, between moral development and academic self-efficacy (P=0.001) and moral development and vandalism (P=0.001). The indirect effect of family emotional climate on vandalism through academic self-efficacy was negative and significant (P=0.012). Similarly, the indirect effect of moral development on vandalism mediated by academic self-efficacy was also negative and significant (P=0.009). Conclusion: These findings highlight the importance of promoting academic self-efficacy alongside efforts to cultivate positive family environments and moral development. By strengthening students’ belief in their academic abilities, interventions can empower them to make positive choices and reduce their likelihood of engaging in destructive behaviors like vandalism.

Investigating tooth morbidity risks, prevalence, and interventions in tribal setting: a study protocol focused on the Irula community in Tamil Nadu

AimDentistry is uniquely positioned as a healthcare profession, distinguished from allied health or paramedical fields. It operates within a university-based structure, maintaining primary care responsibilities. Oral diseases impose a substantial worldwide health and economic burden, profoundly affecting the well-being of those affected. This cross-sectional study is centered on the Irula tribes in Tamil Nadu, India. Investigating the extent of tooth morbidity and loss, identifying possible risk factors, looking at oral hygiene habits, and evaluating the oral health-associated quality of life (OHRQoL) in this population are the main goals. As this population is at high risk for dental issues, promoting good oral hygiene becomes crucial. Indigenous populations, including the Irula tribes, have been underrepresented in research studies. The vulnerability of the Irula tribes is exacerbated by their remote locations, resulting in limited access to fundamental healthcare facilities.Materials and methodsThis study employs a cluster sampling approach, aiming to include 880 individuals aged 60 and above from Kancheepuram and Chengalpattu districts. The methodology encompasses a community-based questionnaire, clinical assessments utilizing standardized indices, and the assessment of the Oral Health-Related Quality of Life (OHRQoL). The Statistical Package for Social Services, version 20, will be used to analyze all of the data that has been gathered (SPSS).Categorical variables will undergo analysis, with descriptive statistics and frequency percentages computed.ConclusionThis study evaluates tooth morbidity and dentistry's role in screening chronic diseases like diabetes among the Irula tribes. It explores risk factors, oral hygiene practices, treatment seeking behavior, and oral health-related quality of life to gain a comprehensive understanding.

Waste management techniques to promote sustainability and green practices

PurposeThis study aims to fill a knowledge gap about the best ways to execute waste management regulations that support sustainability and environmental responsibility. However, the study seeks to investigate and assess how well waste management systems support sustainability and environmentally friendly behaviors.Design/methodology/approachSince the quantitative technique was used to discover and generate hypotheses about relationships between variables, it was chosen for the entirety of the study. The data collection from ready-made garments (RMG) in Bangladesh was carried out using a survey strategy that involved the distribution of questionnaires using a cluster sampling approach. The partial least squares structural equation model (PLS-SEM) was used for quantitative analysis with SmartPLS.FindingsHowever, the results show the importance of waste management, green practice methods and sustainability for the company's goal of maintainable performance. On the other hand, PLS-SEM demonstrated that based on the provided t-statistics and p-values, all of the routes in the structural model are statistically significant at the level of p < 0.05. These routes also appeared to have far broader and more powerful effects. Principles of the circular economy are highlighted, as are the importance of holistic methods, awareness and education, stakeholder participation and fusing these concepts. Furthermore, it seems to affect significantly both short-term and long-term success due to its distinctiveness in sustained performance.Research limitations/implicationsMuch time will be required to assess waste management methods and their long-term effects. A healthcare manager may adapt research findings to practice, ensuring the study enhances management and patient care.Originality/valueThis research addresses a significant literature gap by providing managers and policymakers with concrete ideas on integrating sustainability into operational and strategic frameworks. In today's competitive environment, integrating stakeholder engagement and green practices into core company operations is an innovative way to achieve sustainable excellence.

The relationship between spiritual health, quality of life, stress, anxiety and depression in working women.

While there are benefits to women entering the workforce, there are also drawbacks, such as stress, anxiety, and depression, which can lower quality of life. However, some research indicates that women's spiritual health may be a protective factor in these situations. This study is to explore the relationship between spiritual health and quality of life, stress, anxiety, and depression among a population of women working in health care centers, given the existence of such a relationship among women. In 2022, 500 women who worked in health centers in Izeh City, Iran, participated in this cross-sectional survey. The clustered census sampling approach was used for the sample. The research participants completed a 12-item quality of life questionnaire on spiritual health, stress, anxiety, and depression as part of the data gathering process. The data were examined using independent t tests, one-way variance, and Pearson correlation after being entered into SPSS-24. Of the participants, 18% were single and 68% were married. In terms of depression, stress, and anxiety, the mean and standard deviation were 8.26 ± 5.78, 11.26 ± 4.89, and 7.91 ± 0.98, respectively. The quality of life had a mean and standard deviation of 30.82 ± 3.56. Women who were unmarried and had more work experience reported a considerably greater quality of life (p < 0.05). The findings indicated that stress and spiritual health (p = 0.001), anxiety and spiritual health (p = 0.032), and depression and spiritual health (p = 0.024) all had a significant and inverse association. Furthermore, a strong and positive correlation was found (p = 0.001) between spiritual health and quality of life. The study's conclusions demonstrated a clear link between spiritual health and life satisfaction, suggesting that working women's quality of life may be raised by treatments that support spiritual health. Furthermore, the findings demonstrated a significant inverse relationship between spiritual health and the psychological variables of stress, anxiety, and depression. This suggests that by understanding the factors influencing mental health and the role of spiritual health moderator, it may be possible to improve the psychological state of employed women.

The relationship between good governance, social support, and perceived discrimination with mental health through the mediation role of quality of life: a cross-sectional path analysis in Iran

BackgroundRecognizing the established link between social determinants of health, such as social support, good governance, and perceived discrimination, and individual mental health, this study aims to delve deeper into the specific relationships within the Iranian adult population. It seeks to elucidate the potential mediating role of quality of life in the association between mental health disorders (MHDs) and these social factors.MethodsThis cross-sectional study employed path analysis to investigate the relationships between social determinants of health and MHDs among 725 Iranian adults in Tabriz, Northwest Iran. Data collection occurred between March and September 2022, utilizing a multi-stage and cluster sampling approach. Good governance, social support, perceived discrimination, MHDs, and quality of life were assessed using valid questionnaires. Statistical analysis was conducted using SPSS-24 and Lisrel-8 software, with a significance level set at p < 0.05.ResultsThis study found that nearly 70.0% of the participants reported experiencing mental health problems. The path analysis showed that good governance had a significant indirect and negative effect on MHDs via quality of life (β = -0.05; P < 0.05). Major racial discrimination had a positive relationship in the direct and indirect paths (β = 0.24; P < 0.01). While, social support was a directly and indirectly significant predictor of decreased MHDs (β = -0.17, p < 0.01). Furthermore, quality of life had a negative relationship on the indirect path with MHDs (β = -0.24, P < 0.01).ConclusionsThis study reveals a significant burden of mental health issues among Iranian adults. It highlights the crucial role of social factors like good governance, social support, and perceived discrimination in shaping mental health through their impact on quality of life. Consequently, addressing these factors through improved governance, strengthened social support systems, and active efforts to reduce discrimination is essential for promoting mental well-being.

Snakebite incidence and healthcare-seeking behaviors in Eastern Province, Rwanda: A cross-sectional study.

Snakebite envenoming (SBE) is a potentially life-threatening event that can lead to severe physical, mental, and economic hardships, particularly in under-resourced regions like sub-Saharan Africa. In Rwanda, there have been no epidemiological assessments of SBE to guide the Ministry of Health in its efforts to reduce the burden. This study had two main objectives: first, to estimate the incidence of snakebites across districts, and second, to describe formal versus informal healthcare seeking behaviors among snakebite victims in Eastern Province, Rwanda in 2020. This cross-sectional study utilized a cluster sampling approach, involving Community Health Workers (CHWs) who recorded snakebite cases across seven districts. The descriptive analysis considered sampling weights, and healthcare seeking behavior was assessed based on the type of care sought as the first point of treatment. The study surveyed 390,546 individuals across 763 villages and estimated a provincial annual incidence rate of 4.3 cases per 1,000 individuals. Incidence estimates ranged from 1.1 cases per 1,000 in Nyagatare to 9.1 cases per 1,000 individuals in Bugesera and Ngoma districts. Among the 2,545 cases recorded by CHWs, three resulted in deaths. Regarding healthcare-seeking behavior, 13% of snakebite victims (143 out of 1,098) initially consulted formal care providers (CHWs, health post/center, or hospital), while 87% sought informal care (family/friends, pharmacist, or traditional healer). Approximately half of the victims (583, 53.1%) reported severe symptoms. Unsafe practices included skin cutting/burning, tourniquet application, use of black stones, and venom extraction; only 24 cases (2.2%) received anti-venom. This large-scale community-based assessment highlights variations in snakebite incidence between districts and confirms frequent involvement of traditional healers in management. Improving access to anti-venom and community education on the risks of ineffective practices, along with timely use of formal healthcare, are crucial. Collaboration between healthcare providers, traditional healers, community leaders, and policymakers is essential to implement targeted interventions for enhancing snakebite prevention and management strategies.

Prevalence of mild cognitive impairment and modifiable risk factors: A cross-sectional study in rural older adults with diabetes

To determine the prevalence and modifiable risk factors for MCI in older adults with T2DM in rural China. This cross-sectional study encompassed 96 villages, employing a cluster sampling approach to recruit eligible older adults with T2DM as study participants. Logistic regression analysis was utilized to identify modifiable risk factors associated with MCI. Average marginal effects were calculated. The discriminatory performance of these risk factors in identifying MCI was evaluated by plotting the receiver operating curve and calculating the value of the area under the curve. A total of 898 older adults with T2DM in our study. The overall prevalence of MCI was 50.22 %. Independent associations with MCI were found in poor self-management ability of diabetes (OR = 0.808, 95 % CI: 0.808, 0.766), depressive symptoms (OR = 3.500, 95 % CI: 1.933, 6.337), moderate (OR = 0.936, 95 % CI: 0.017, 0.075) and high (OR = 0.939, 95 % CI: 0.016, 0.100) levels of physical activity, poorer oral health (OR = 2.660, 95 % CI: 2.226, 3.179), and lower grip strength (OR = 0.913, 95 % CI: 0.870, 0.958). The AUC was 0.967 (95 % CI 0.508–0.470). The prevalence of MCI was high among older adults with T2DM in rural areas of China. The self-management ability of diabetes, depressive symptoms, physical activity, oral health and grip strength were modifiable risk factors of MCI. Targeted interventions should be developed and implemented to address these modifiable risk factors, aiming to enhance cognitive function and mitigate the incidence of MCI in older adults with T2DM.

Prevalence and Determinants of Exclusive Breastfeeding Among Mothers of Children Aged 6-24 Months in the Aseer Region.

Background Exclusive breastfeeding (EBF) is crucial for infant and maternal health, providing optimal nutrition and immune protection for infants while reducing maternal postpartum depression and cancer risk. However, global trends show an early cessation of breastfeeding and the introduction of other foods. This study aims to determine the prevalence and factors influencing EBF among mothers in the Aseer region of Saudi Arabia. Methodology A cross-sectional study using a multistage cluster sampling approach was conducted from January to March 2024 in primary healthcare centers across the Aseer region. Participants included mothers of children aged 6-24 months attending primary healthcare centers for immunizations or routine check-ups. A pretested structured questionnaire, developed after an extensive literature review and expert consultation, was used to interview consenting participants. The questionnaire covered sociodemographic data, obstetric and medical history, child data, EBF practices, maternal knowledge and perception of breastfeeding, counseling about breastfeeding, antenatal care, breastfeeding support, and barriers and motivators of EBF. Results A total of 1,008 eligible mothers were included. Only 131 (13%) fulfilled the World Health Organization criteria for EBF. Moreover, 257 (25.5%) mothers initiated breastfeeding within the first hour after delivery, and 387 (38.4%) exclusively breastfed for six months or more. EBF was less frequent among mothers with higher education (8%, n = 2) compared to those with lower education (23%, n = 23, p = 0.017). EBF was also less frequent among mothers who delivered via cesarean section (7.9%, n = 28) compared to those who had a vaginal delivery (15.8%, n = 103, p = 0.001). Conversely, EBF was more common among mothers with more than five pregnancies (15.8%, n = 45) compared to those with one to two pregnancies (9.4%, n = 37, p = 0.023). EBF was also more common among mothers who had breastfed more than four children (16.7%, n = 39) compared to those who had not (12.1%, n = 49, p = 0.048). Finally, EBF was more common among mothers without postpartum complications (13.4%, n = 131) or whose infants had no birth complications (13.4%, n = 128) compared to their respective counterparts (p = 0.029 and p = 0.048, respectively). Conclusions This study found a low prevalence of EBF in the Aseer region, despite high maternal knowledge and positive perceptions. Factors such as low education, medical barriers, unemployment, and high parity were associated with increased EBF rates. Interventions should focus on improving workplace support and increasing maternal awareness of EBF recommendations.

Prevalence of overweight/obesity, and associated factors among adolescents aged 12 ∼ 15 in Shandong Province, China: A cross-sectional study

Overweight/obesity among adolescents in Shandong Province, China, has been rising, posing significant public health challenge. Comprehensive investigation is needed to develop effective interventions. Following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, a stratified random cluster sampling approach was used from September to October 2023 across 17 cities in Shandong Province. The study included 165 middle schools, surveying 99,638 students aged 12 ∼ 15. After applying exclusion criteria, 97,356 students (97.71% effective rate) completed anthropometric measurements and questionnaires. Overweight/obesity were assessed based on national and international standards. Univariable chi-square test and multivariable logistic regression were used to analyze factors influencing overweight/obesity. In 2023, the overweight/obesity rate among 12 ∼ 15-year-olds in Shandong was 19.75%. Significant factors included sex, age, residence, family income, parental weight status and activity, mother’s gestational diabetes history, birth weight, physical activity, sleep, screen time, homework, and diet. Girls, older adolescents, and those with physically active parents or who themselves engaged in over 1.5 hours of daily physical activity had lower odds of being overweight/obese. Adequate sleep and frequent consumption of vegetable and fruit were also protective. Higher odds were associated with urban residence, high family income, overweight/obese parents, maternal gestational diabetes, high birth weight, excessive screen time, extensive homework, and frequent fast food consumption. Overweight/obesity in Shandong adolescents is influenced by multiple determinants. Holistic interventions addressing genetic, behavioral, and environmental factors are essential for promoting healthier lifestyles and reducing the prevalence in this demographic.

Screening for frailty and its association with activities of daily living, cognitive impairment, and falls among community-dwelling older adults in China

ObjectivesFrailty is a prevalent geriatric condition that significantly impacts the health of older adults. This study aimed to examine the prevalence of frailty among older Chinese adults aged ≥ 65 years and to assess its association with adverse geriatric outcomes.MethodThis study included 20,724 older adults aged ≥ 65 years in Jiangsu Province, China, utilizing a random, stratified, multistage cluster sampling approach. Frailty was assessed using the 5-item FRAIL scale. Geriatric outcomes, such as independence in activities of daily living (ADL), cognitive impairment, and frequent fall events (occurring four or more times in the preceding year), were evaluated. Logistic regression models were employed to evaluate the association between frailty and geriatric outcomes, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe mean age of the participants was 73.4 ± 6.4 years. The standardized prevalence of prefrailty and frailty was 35.2% and 10.3%, respectively. Individuals identified as prefrail or frail tended to live in rural areas, have lower educational levels, be widowed, have lower incomes, and engage in less physical activity. Prefrailty and frailty were associated with an increased risk of limitations in BADL (OR: 9.62, 95% CI: 7.43–12.46; and OR: 29.25, 95% CI: 22.42–38.17, respectively) and IADL (OR: 2.54, 95% CI 2.35–2.74; and OR: 5.19, 95% CI 4.66–5.78, respectively), positive cognitive impairment screening (OR: 1.23, 95% CI: 1.16–1.31; and OR: 1.72, 95% CI: 1.56–1.91, respectively), and frequent falls (occurring four or more times in the preceding year) (OR: 3.38, 95% CI: 2.50–4.56; and OR: 8.37, 95% CI: 6.01–11.65). The association between frailty and both limitations in BADL and falls was notably more pronounced among the younger age groups (p for interaction < 0.001).ConclusionsAccording to the 5-item FRAIL scale, frailty was associated with limitations in BADLs and IADLs, positive cognitive impairment screening, and recent falls among older adults living in the community. Screening for frailty in younger age groups has the potential to prevent declines in physical function and falls.

A national survey of iodine nutrition in children aged 3-6 years in China and its relationship with children's physical growth.

Iodine, an essential trace element for the human body, plays a pivotal role in sustaining health. Malnutrition has emerged as a pressing public health concern, posing a significant threat to human well-being. Iodine deficiency poses a substantial threat to the development of children, potentially leading to neurological developmental disorders and mental retardation. Conversely, excessive iodine intake can result in structural and functional abnormalities in the thyroid gland. In this study, we selected children aged 3-6 years through a stratified cluster sampling approach in six regions across China to explore the correlation between iodine nutrition and their physical growth. A total of 5920 preschool children participated in this study, with a median urinary iodine concentration (UIC) of 177.33 [107.06, 269.92] μg/L. Among these children, 250 (4.2%) exhibited stunting, 180 (3.0%) were underweight, 198 (3.3%) experienced wasting, 787 (3.3%) were overweight and 414 (7.0%) were classified as obese. The multivariate linear regression revealed that UIC exhibited a positive correlation with body mass index z-Score (BMIZ) in overweight children (β = 0.038; 95% CI: 0.001, 0.075). In normally growing children, the associations between UIC and height-for-age z-score, weight-for-age z-score and BMIZ displayed nonlinear patterns. Our findings suggest that iodine nutrition is adequate for Chinese children aged 3-6 years. Furthermore, iodine nutrition is intricately linked to the growth and development of these children. Consequently, it is imperative to implement decisive measures to prevent both iodine deficiency and excess.

The Impact of Urban Migration on the Mental Well-Being of Young Women: Analyzing the Roles of Neighborhood Safety and Subjective Socioeconomic Status in Shaping Resilience against Life Stressors

This study evaluates the impact of urban migration on the mental health of young women, focusing specifically on how objective life stressors, perceived neighborhood safety, and subjective socioeconomic status influence depression. Depression is the main outcome measure in this research, serving as a critical indicator of mental health in the context of urban migration. Utilizing a stratified cluster sampling approach, we collect data from 2138 young female migrants in Bao’an District, Shenzhen, employing the Life Stress Scale, Patient Health Questionnaire-9 items, Perceived Neighborhood Safety Scale, and Subjective Social Economic Status Scale to assess the corresponding constructs. Our findings highlight that life stressors directly contribute to increased depression levels among young female migrants, with perceived neighborhood safety significantly mediating this relationship. Furthermore, subjective socioeconomic status moderates the impact of life stressors on perceived neighborhood safety, underlining the intricate dynamics between objective life stressors and the social-environmental context in shaping mental health outcomes. This research underscores the importance of creating supportive and inclusive social environments to mitigate the adverse psychological effects of life stressors on young female migrants, thereby contributing to discussions on sustainability and social welfare.