Cross-sectional Sample Research Articles

Factors Affecting Stunting in Toddlers in the Working Area of the UPTD Puskesmas Deleng Pokhisen Aceh Tenggara

Background: Stuntingis a condition of failure to thrive in children under five years old (babies under five years) resulting from chronic malnutrition so that the child is too short for his age. Stunting has the potential to slow down brain development, with long-term impacts in the form of mental retardation, low learning ability, and the risk of developing chronic diseases such as diabetes, hypertension, and obesity. The aim of this research is to determine and analyze the factors that influence stunting in toddlers in the UPTD Puskemas Deleng Pokhisen Aceh Tenggara. Research Method: This research uses quantitative methods with a cross sectional design and sampling using total sampling. The population and research sample were 210 respondents, namely mothers who had stunted toddlers. This research uses a questionnaire. The research time is June - July 2024. This research analysis uses Univariate, Bivariate and Multivariate. The statistical tests used are the chi-square test and logistic regression. Research Results: Research results regarding the influence of maternal height p value= 0.006, history of diarrheal disease p value= 0.049, family income p value= 0.003, diet p value= 0.001 with stunting in toddlers. Based on the results of the logistic regression test, the most influential variable was a history of diarrhea with an Exp(B) value of 2.769. Conclusion: The conclusion in this study is that there is an influence on maternal height, history of diarrhea, family income, and eating patterns on stunting among toddlers in the UPTD Puskemas Deleng Pokhisen Aceh Tenggara. In order to reduce the prevalence of stunting in toddlers, it is hoped that the Health Service, Community Health Centers, especially health workers, will collaborate to increase health promotion about stunting, the risk of diarrheal disease due to stunting, the benefits of family income and the importance of a good diet for toddlers.

The role of impulsivity in the association between rumination and cannabis-related problems among trauma-exposed cannabis users.

The Emotional Cascade Model posits that rumination is associated with impulsivity and risky behaviours such as substance use. Although trauma-exposed individuals often engage in rumination and problematic cannabis use, this model has not been tested on trauma-exposed cannabis users. Therefore, our study examines the direct and indirect effects between rumination and its subtypes with problematic cannabis use among trauma-exposed cannabis users. We also examine how these associations occur through impulsivity. A cross-sectional sample of 56 trauma-exposed young adult cannabis users (Mage = 21 years, 59% female, 73% white) self-reported rumination, impulsivity, and cannabis-related problems. All participants provided written informed consent, and procedures were approved by the university's Institutional Review Board and pre-registered. Regression analyses indicated total and brooding rumination were related to greater cannabis-related problems, after covarying for number of traumas and cannabis use frequency. Rumination, specifically brooding, was incrementally associated with greater cannabis-related problems and had an indirect effect on cannabis-related problems through impulsivity. Consistent with hypothesis, rumination and impulsivity were incrementally associated with greater problematic cannabis use among trauma-exposed cannabis users. The current study expands work on the Emotional Cascade Model by supporting the indirect effect of impulsivity in the association between rumination and problematic cannabis use.

Enhancing Patient Management Effectiveness: The Roles of Transformational Leadership, Safety Culture, Employee Satisfaction, and Service Digitalization in the Digital Healthcare Era

The effectiveness of patient management in hospitals is influenced by transformational leadership, patient safety culture, and employee satisfaction. In the digital era, technology plays a crucial role in improving managerial efficiency. This study examines the relationship between these factors and patient management effectiveness, with service digitalization as a moderating variable. This study aims to analyze the influence of transformational leadership, patient safety culture, and employee satisfaction on patient management effectiveness while exploring the role of service digitalization as a moderator. An explanatory approach with a quantitative research design was used. Data were collected through a Likert-scale questionnaire from 207 employees of Dian Husada Hospital Mojokerto and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The findings show that employee satisfaction positively affects patient management effectiveness, while patient safety culture has a negative influence. Transformational leadership positively impacts employee satisfaction but does not directly affect patient management effectiveness. Meanwhile, service digitalization does not show a significant moderating effect. These results suggest that hospitals should focus on improving employee satisfaction and managing safety culture effectively. Strengthening transformational leadership is essential to creating a supportive work environment, while optimizing service digitalization can enhance employee performance. This study fills a gap in the literature on factors influencing patient management effectiveness and the role of digitalization in hospital settings. However, its cross-sectional design and limited hospital sample restrict generalizability. Future studies should use longitudinal approaches with broader samples for better external validity.

Do the Provisional Paediatric Rheumatology International Trials Organisation Enthesitis/Spondylitis-Related Juvenile Idiopathic Arthritis Criteria Capture Youth With Axial Spondyloarthritis?

The Paediatric Rheumatology International Trials Organisation (PRINTO) recently undertook an effort to better harmonize the pediatric and adult arthritis criteria. These provisional criteria are being refined for optimal performance. We aimed to investigate differences between patients who did and did not fulfill these PRINTO criteria among youth diagnosed with juvenile spondyloarthritis (SpA) that met axial juvenile SpA (axJSpA) classification criteria. This was a retrospective cross-sectional sample of youth diagnosed with juvenile SpA who met the axJSpA classification criteria. Demographics, clinical manifestations, and physician and patient-reported outcomes were abstracted from medical records. Magnetic resonance imaging (MRI) scans underwent central imaging review by at least two central raters. Differences between groups were compared using Wilcoxon signed-rank test or chi-square test, as appropriate. Of 158 patients who met axJSpA criteria, 107 patients (68%) met the PRINTO provisional criteria for enthesitis/spondylitis-related arthritis. A total of 41 patients (26%) did not fulfill any of the three major PRINTO criteria due to lack of peripheral disease manifestations. Demographics, prevalence of inflammatory or structural lesions on MRI, family history of SpA, and duration of pain were not statistically different between those who did and did not meet PRINTO criteria. Those who fulfilled the PRINTO criteria had significantly more peripheral arthritis, enthesitis, and HLA-B27 positivity but reported less sacral/buttock pain. Phenotypic differences of children with axJSpA between those who were and were not classified by the PRINTO criteria were primarily due to peripheral disease manifestations and HLA-B27 positivity. Modification of the PRINTO provisional criteria may facilitate capture of youth with primarily axial disease.

A Preliminary Analysis of Psychological Strengths: Service Members' Well-being Post-deployment.

Deployments are stressful for both service members and their families. To promote the overall health and welfare of those impacted by military deployment, it is important to identify individual resilience-building resources that service members can employ to strengthen their own well-being, the well-being of their families, and the readiness of the force. This pilot study examines different resilience-building skills that may impact individual well-being, relationship quality, and family satisfaction post-deployment. A cross-sectional sample of 78 married U.S. military enlisted service members (n = 24) and commissioned officers (n = 54) completed the Coping Self-Efficacy Scale, Resilience Scale for Adults, Humor Styles Questionnaire, Mindful Attention Awareness Scale, Dispositional Resilience Scale, the emotional well-being and spirituality subscales of the Work-Life Well-Being Inventory, and the Social Problem-Solving Inventory-Revised. The use of a positive humor style was significantly associated with individual well-being. Spirituality and religious practices were significantly predictive of a service member's family satisfaction. Responding to qualitative open-ended questions, service members identified their top 6 subcategories of stress, which were communication, moving, finances, family separation, children, and future employment during post-deployment. The strengths and resources reported as contributing the most to family effectiveness and well-being were personal character traits, external relationship skills, emotional maturity, and the ability to work. The results identified unique individual resilience-building resources for service members, which contribute to their well-being and the well-being of their families. Findings suggest that training on individual resilience-building resources for service members can offer support to the entire family system following military deployment.

Dimensional early life adversity and anxiety symptoms: A network analysis and longitudinal study.

Accumulating literature has found a close relation between early life adversity (ELA) and anxiety. However, previous studies did not rule out the high co-occurrence of different types of ELA when exploring the association of ELA and anxiety. In the present study, we carried out network analysis based on a cross-sectional sample and longitudinal sample to investigate the relationship between ELA and anxiety symptoms in non-clinical populations over time. Online advertisement was carried out to recruit participants. The cross-sectional sample included 871 Chinese participants (Mage=19.11, SDage=1.57), and the longitudinal sample involved 440 Chinese participants (Mage=18.93, SDage=0.75). Three dimensions of ELA were assessed. The Threat/Harm dimension was assessed by subscales of physical abuse, emotional abuse, and sexual abuse of Childhood Trauma Questionnaire (CTQ). The Deprivation dimension of ELA was measured by subscales of physical neglect, and emotional neglect of CTQ. The Unpredictability dimension of ELA was evaluated by the Childhood Unpredictability scale. Anxiety symptoms were captured by the Generalized Anxiety Disorder-7 (GAD-7). Regularized partial correlation networks were constructed, and the expected influence (EI) as well as predictability of each node were calculated. Stability within the network was tested and the network comparison test was conducted to examine the difference between the cross-sectional network and the longitudinal network. The cross-sectional network was relatively tight, and nodes within the dimension of ELA clustered together. Childhood unpredictability and emotional abuse revealed stronger associations with anxiety symptoms than other ELAs. Emotional abuse showed the highest EI in the network. These findings were replicated in the longitudinal network. The network comparison test indicated no significant difference between the cross-sectional network and the longitudinal network. Childhood unpredictability and emotional abuse were strong predictors of anxiety symptoms, and the prediction was reliable and persistent. Reduce the experience of childhood emotional abuse can serve as a target to prevent anxiety.

Factors Influencing Obstructive Sleep Apnea Among Employees With Metabolic Syndrome: An Example of a District Hospital in Northern Taiwan

Obstructive sleep apnea (OSA) is a common sleep disorder shown to be significantly correlated with metabolic syndrome (MS). Healthcare professionals affected by both MS and OSA may suffer from poor sleep quality, raising potential concerns about patient safety. Currently, there remains a gap in research specifically addressing the relationship between MS and OSA in healthcare professionals. This study was conducted to examine the prevalence of employees with MS concomitant with OSA and to identify the factors of influence affecting MS employees with OSA in the workplace. A cross-sectional study design and convenient sampling were used, and participants were recruited from a district hospital in northern Taiwan. Data were collected using a structured questionnaire and a home sleep apnea test. Multiple logistic regression analysis was used to determine the significant factors influencing OSA in employees with MS. A total of 89 participants completed the assessment, with 65.2% of those with MS also found to have OSA. The main factors found to be associated with these employees with MS having OSA as well include gender, job position, body mass index, neck circumference, waist circumference, oxygen desaturation index, and snoring frequency. In light of the high percentage (65.2% in this study) of MS employees affected by OSA, regular health screenings should include a home sleep apnea test for high-risk employees to assess their risk of developing OSA. In addition, promoting a healthy lifestyle to improve MS and prevent OSA is needed.

Assessing the determinants of out-of-pocket health expenditures among Cambodian households in informal employment using survey data

BackgroundAs the deadline for the Sustainable Development Goals approaches, financial protection in Cambodia remains inadequate, especially for nonpoor informal workers lacking formal social health protection coverage or access to other prepayment schemes. This exposes them to high out-of-pocket health expenditures (OOPE) and related financial hardship. To better understand the drivers behind these expenditures, our study aims to model their healthcare, health, and social determinants and to assess their relative importance.MethodsIn 2023, we conducted a cross-sectional multistage clustered sampling survey across seven Cambodian provinces, surveying 3,254 households engaged in informal employment and not covered by any formal social health protection scheme. The survey gathered information on households’ use of outpatient and inpatient care and associated OOPE. We employed generalized linear models (GLMs) to analyse the healthcare, health, and social determinants of OOPE and the OOPE budget share (the proportion of total annual household consumption expenditure spent on OOPE) and applied Shapley decomposition analysis to quantify the relative contributions of these determinants to the explained variance in our outcomes.ResultsHealthcare variables were the dominant contributors to the explained variance in all outcomes (41.36–50.73%), followed by health factors. While several social variables were significant, only the wealth quintile made notable contributions to explaining variance in our outcomes. The key healthcare contributors included the sector type and level of care, and the number of outpatient medications. Important health contributors included illness severity and the presence of chronic illnesses or noncommunicable diseases.ConclusionsOur findings emphasize the necessity of integrating nonpoor informal workers and their dependents into formal prepayment schemes to reduce OOPE and enhance financial protection on Cambodia’s path toward universal health coverage. Strategically engaging with private providers and pharmacies to improve access to essential services and medicines, coupled with the implementation of an effective referral system are important policy considerations to this end. Further research is needed on how health determinants are modifiable with policy interventions. Our findings can assist the Cambodian government in advancing its universal health coverage goals and offer insights for other countries aiming to extend coverage to similar population groups.

Changing Oral Health Trajectories: A 10-Year Cross-Sectional Comparison of 2 Domiciliary Dental Care Patient Groups in Nursing Homes.

Since 2010, Gerodent has been a comprehensive oral health care program including biannual domiciliary dental care in nursing homes in Flanders, Belgium. Previous research revealed poor oral health among nursing home residents attending the mobile clinic. The objective of this study was to evaluate potential changes in the oral health needs of patients receiving domiciliary dental care, thus providing insights for future cohorts. This study compares the oral health status and treatment needs of 2 cross-sectional samples. First-time patients attending the mobile dental clinic in nursing homes, collected a decade apart. Generalized estimating equations were used to compare both samples (sample 1 [S1]: 2010-2012: n= 1226; sample 2 [S2]: 2021-2023: n= 775). Results were adjusted for age, sex, increased reimbursement for health care costs, number of medications and care dependency. Differences in oral health outcomes were decomposed in a component attributed to the explanatory variables and an unexplained component using the Blinder-Oaxaca decomposition analysis. There were statistically significant lower edentulism rates in S2 (28%) than S1 (42%; odds ratio [OR], 1.82; 95% CI, 1.34-2.47). Among dentate patients, S2 had a significantly lower caries prevalence (S1: 70% vs S2: 53%; OR, 0.55; 95% CI, 0.44-0.69) and a significantly higher mean of filled teeth (S1: 1.5 vs S2: 2.8; risk ratio, 1.82; 95% CI, 1.58-2.09). In the dentate sample, 77% of S1 and 54% of S2 residents required extractions and/or restorations (OR, 0.72; 95% CI, 0.53-0.98). The decomposition analysis showed that the change in explanatory variables attributed little to the shift in dental status. The explained component accounted for only 13.5% of the total risk difference in edentulism (bias-corrected and accelerated 95% CI,-0.6% to 30.6%). From 2021 to 2023, more dentate care home residents consulted Gerodent with more natural teeth per person, showing lower levels of untreated disease, maintaining dental team treatment demands comparable with 2010-2012. These findings underscore the continued urgency for structured and accessible dental service provision for nursing home residents.

Expanding the human gut microbiome atlas of Africa.

Population studies provide insights into the interplay between the gut microbiome and geographical, lifestyle, genetic and environmental factors. However, low- and middle-income countries, in which approximately 84% of the world's population lives1, are not equitably represented in large-scale gut microbiome research2-4. Here we present the AWI-Gen 2 Microbiome Project, a cross-sectional gut microbiome study sampling 1,801 women from Burkina Faso, Ghana, Kenya and South Africa. By engaging with communities that range from rural and horticultural to post-industrial andurban informal settlements, we capture a far greater breadth of the world's population diversity. Using shotgun metagenomic sequencing, we identify taxa with geographic and lifestyle associations, including Treponema and Cryptobacteroides species loss and Bifidobacterium species gain in urban populations. We uncover 1,005 bacterial metagenome-assembled genomes, and we identify antibiotic susceptibility as a factor that might driveTreponema succinifaciens absence in urban populations. Finally, we find an HIV infection signature defined by several taxa not previously associated with HIV, including Dysosmobacter welbionis and Enterocloster sp. This study represents the largest population-representative survey of gut metagenomes of African individuals so far, and paired with extensive clinical biomarkers and demographic data, provides extensive opportunity for microbiome-related discovery.

P-1978. Long-Term Mast Cell Activation Patterns in Systemic and Tissue-Resident Compartments Following COVID-19: Insights from a 2-Year Post-Infection Study

Abstract Background The pathogenesis of Post-COVID syndrome (PCS) following mild coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) remains unclear. In particular, the involvement of activated mast cells (MC) in the highly angiotensin converting enzyme 2 (ACE2) expressing small bowel, the largest lymphoid organ, might be significant in PCS pathogenesis. This study aimed to elucidate the role of activated MC, residual SARS-CoV-2 spike (S) protein and zonulin (a marker for impaired intestinal integrity), in the context of PCS, examining peripheral blood (PB) and terminal ileum (TI) 2 years post-infection. Methods In this cross-sectional, controlled study, paired PB and TI samples were obtained from 21 SARS-CoV-2 convalescents with (PCS+) and 11 without PCS (PCS−). CD117+CD25+ activated MC and residual S protein were assessed using fluorescent immunohistochemistry on sections of the the ileal tissue from the gut. Tryptase, zonulin and S protein were quantified in serum by enzyme-linked immunosorbent assay (ELISA). Flow cytometry assessed frequencies of T-cells (CD3+CD4+ (TCD4), CD3+CD8+ T-cells (TCD8)) and CCR7±CD27± memory subsets (TCM: T central memory, TEM: T effector memory) on mononuclear cells of PB and TI. Results Among PCS+ and PCS−, median follow up was 22 and 18 months post-infection, 81% and 73% were female, and 57% and 55% had pre-existing conditions of which arterial hypertension, chronic lung disease and diabetes mellitus were the most frequent. Compared to PCS−, PCS+ expressed significantly more MC (p< 0.0001) in ileal sections, along with elevated levels of tryptase (p=0.0196) and zonulin (p=0.024) in PB. S protein, by contrast, was undetectable in PB of PCS+ and PCS− even 2 years post-infection. In TI however, the frequency of tissue-resident S protein-infected cells was significantly higher in PCS+ compared to PCS− (p=0.0135). Interestingly, systemic tryptase levels correlated positively to elevated TCM in TI (r=0.7407, p=0.0034). Conclusion Elevated MC activity and S protein in the TI, along with increased tryptase and zonulin levels in PB, indicate ongoing immune activation and intestinal damage in the TI of PCS+. Understanding the role of tissue-resident MC in PCS pathogenesis could lead to targeted therapies. Disclosures All Authors: No reported disclosures

Childhood Trauma and Dissociative Experiences: Moderating Role of Perceived Social Support among Adults

Purpose: Childhood trauma or adverse childhood experiences including physical, emotional, and sexual abuse, neglect, and witnessing violence, often evokes fear and disrupts a child's sense of safety. These experiences can have long-lasting effects on behavior and lifestyle, leading to mental health challenges such as dissociation. As a coping mechanism, dissociation helps individuals detach from overwhelming emotions but can impair daily functioning and quality of life. Despite extensive research on childhood trauma and dissociation, there is limited understanding of how perceived social support may aggravate these effects. Therefore, the present research aims to fill this gap by investigating whether perceived social support moderate the relationship between childhood trauma and dissociative experiences among adults. Material and Methods: The study hypothesized that higher levels of perceived social support will weaken the relationship between childhood trauma and dissociative experiences and vice versa. Using cross-sectional study design and convenience sampling, the data for the study was collected from adults of twin cities using self-report measures. The participants (N=262) were asked to fill Childhood Trauma Questionnaire-Short Form (Bernstein et al., 2003), Dissociative Experiences Scale-II (Carlson & Putnam, 1993) and Multidimensional Scale of Perceived Social Support (Zimet et al., 1988). Findings: The data analysis revealed satisfactory reliability for all scales and subscales used in the study. It showed a positive correlation between childhood trauma and dissociative experiences, indicating that trauma exposure leads to dissociation. Multiple regression analysis identified emotional abuse and physical neglect as key predictors of dissociative experiences. Males from nuclear families reported higher neglect and abuse. Social support, especially from friends and significant others, was found to reduce the impact of trauma on dissociation, while family support had no effect. These findings emphasize the protective role of social support and will inform therapeutic interventions to address the long-term effects of childhood trauma and reduce dissociative symptoms, enhancing mental health and quality of life. Implications to Theory, Practice and Policy: The study contributes to theory by highlighting the moderating role of social support and emotional regulation in the relationship between childhood trauma and dissociation. It informs practice by suggesting targeted therapeutic interventions that enhance social support and emotional regulation to reduce dissociative symptoms. Additionally, the study has policy implications, emphasizing the integration of emotional regulation and support systems into mental health strategies to address the long-term effects of childhood trauma.

P-1879. Change in Healthcare Professional’s Identification, Counseling, and Adherence with Black Women for Long-Acting Cabotegravir (CAB LA) for PrEP Across Women’s Health, Primary Care, and Infectious Diseases Sites: Findings from the EBONI Study

Abstract Background The CDC estimates that 400,000 Black women would benefit from PrEP but only 1% obtain a prescription for it in the US. Ensuring equitable access requires expanding delivery outside of infectious disease clinics and equipping healthcare professionals (HCPs) with strategies to support Black women’s PrEP use. EBONI is a phase 4 gender-concordant, implementation science trial evaluating the delivery of CAB LA, a new PrEP modality, to Black cisgender and transgender women in 15 US women’s health, primary care, and infectious disease sites. We present changes in HCPs’ perceptions of identifying, counseling, and supporting CAB LA use in Black women after four months of study implementation. Methods Shifts from baseline (BL) to Month 4 (M4) in HCPs’ appropriateness, acceptability, feasibility and patient identification, counseling and adherence were assessed via surveys completed by a longitudinal sample of HCPs (N=65). At M4, a cross-sectional sample HCPs (N=69) evaluated usefulness of patient support tools. Descriptive statistics are reported. Results Table 1 presents demographics. HCPs reported high levels of appropriateness, acceptability, and feasibility of CAB LA (BL mean scale scores ≥4.6; M4 mean scale scores ≥4.3). Concerns decreased between BL and M4 for the perceived factors related to patient identification, counseling, and adherence (Table 2). HCPs reported feeling “extremely positive”/ “positive” about implementing CAB LA into care at BL (90.8%) and M4 (87.7%). At M4, of HCPs (50%) who completed the PrEP Education Training for Black Women training, most “completely agreed”/“agreed” the training would be useful to their practice (88%), helped them address patient HIV concerns effectively (84%), and improved their likelihood of providing PrEP (84%). Among HCPs (68.8%) that used a shared decision tool, most completely agreed/agreed the tool was easy to implement (82%) and supported conversations with Black women (82%). Conclusion HCPs across women’s health, primary care, and infectious disease clinics maintained high appropriateness, acceptability, and feasibility after four months of integrating CAB LA into care. Effective tools exist to support HCPs in identifying, counseling, and supporting CAB LA use in Black women. Disclosures Dylan M. Baker, MBBS, ViiV Healthcare: Grant/Research Support Katherine L. Nelson, PhD, MPH, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Yolanda Lawson, MD, Gilead: Honoraria|Gilead: Meeting and travel support|National Medical Association: Board Member|ViiV Healthcare: Advisor/Consultant|ViiV Healthcare: Grant/Research Support Alftan Dyson, PharmD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Deanna Merrill, PharmD, MBA, AAHIVP, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Lisa Petty, MT(ASCP), GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Peter Jeffery, BSc, PgDip, GSK: Complimentary Worker Kenneth Sutton, MA, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Kimberley Brown, PharmD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Maggie Czarnogorski, MD MPH, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Nanlesta Pilgrim, PhD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee

P-362. Outbreak of neonatal sepsis in a maternity hospital in Kyrgyzstan, 2022-2023

Abstract Background Sepsis is a leading cause of neonatal mortality and morbidity worldwide, notably in Kyrgyzstan. In January 2023, six neonatal sepsis deaths were reported within two weeks at a 157-bed maternity hospital, which usually has < 2 cases/month. We investigated to identify sources of infection and risk factors.Table 1.Factors associated with neonatal sepsis in a maternity hospital in Kyrgyzstan, 2022-2023*AOR- adjusted odds ration; ** CI- confidence interval; ***1. Healthy population (Reference group): Apgar scores at 1 and 5 min above 7; Unhealthy population: Apgar scores at 1 min below 7 and at 5 min below 7; Improved population: least one below 7 Methods A concurrent case-control study included infants (< 28 days old) born at the hospital in January 2022-February 2023 and diagnosed with sepsis. Controls met same criteria and were born +/- 1 day from cases without sepsis. In February 2023, we collected rectal, nasopharyngeal, and high-touch environmental areas swabs in a single-day cross-sectional sample of hospitalized case-patients and mothers for culturing and MALDI-TOF. We used logistic regression to identify factors associated with sepsis.Figure 1.Two clusters of Acinetobacter baumannii detected among newborns with neonatal sepsis in a maternity hospital in Kyrgyzstan, 2022-2023 Results The study comprised 129 cases and 509 controls. More cases than controls weighed < 2500g at birth (52% vs 5%, p< 0.01), had anhydrous interval of ≥12 hours (43% vs 29%, p< 0.01), had Apgar scores of < 7 at 1 minute (83% vs 20%, p< 0.01), were more likely to receive both ventilation and an invasive device (98% vs 1%, p< 0.01) and to be admitted to the intensive-care unit (ICU) (82% vs 17%, p< 0.01) (Table 1). Sepsis was associated with birth weight of ≤2500g vs greater (adjusted odds ratio: 5.6; 95% confidence interval: [2.1-15.1]), infant blood transfusion vs no (9.9 [3.8-26.0]), use of ventilation and invasive device vs no (144 [28.8-729.7]), Apgar scores at 1 and 5 minutes < 7 vs greater (2.8 [1.0-7.8], urinary tract disease in mother vs not (3.5 [1.1-10.6]), and anhydrous interval ≥12 hours vs less (2.6 [1.2-5.5]). Acinetobacter baumannii resistant to cephalosporins, aminoglycosides, and fluoroquinolones was detected in 8/8 pharyngeal swabs from case-patients in two ICU rooms, forming two distinct clusters (Figure 1). Acinetobacter baumannii was not detected in environmental sampling, but the hospital had conducted deep cleaning shortly before the environmental team arrived. Conclusion Resistant Acinetobacter baumanni likely contributed to the outbreak. The hospital conducted environmental cleaning, replaced non-disposable instruments (cannulas, masks, tubes) and updated infection control practices. Neonatal sepsis cases dropped sharply to < 2/month by May 2023. Disclosures All Authors: No reported disclosures

Emotions, connectedness to nature and sustainable behaviour: investigating the effects of students’ engagement in extracurricular activities with living animals

ABSTRACT Several studies have shown how first-hand experiences with living animals can foster students’ connectedness to nature, even if there have been no studies on topic-specific emotions and sustainable behaviour. Using a retrospective questionnaire with qualitative and quantitative data from a cross-sectional sample of 211 school students, we investigated (1) predictors and (2) qualitative causes for experiencing enjoyment or fear when working with bees, (3) predictors of inclusion of nature in self (INS) and (4) predictors of attitudes towards sustainable behaviour. A subgroup of the students took part in an extracurricular activity focused on learning about honey bees (Apis mellifera) in a bee club. While the attendance in the bee club and individual demographic factors predicted the INS, the students reported different causes for these emotions. Furthermore, INS and enjoyment were predictors of students’ attitudes towards sustainable behaviour. Using a mediation model, we found that the bee club also fostered sustainable behaviour through INS as a mediator. Even when further studies are needed to clarify the causality and further antecedents of students’ emotions such as values, the results show how primary nature experiences from working with bees are connected to sustainable behaviour by fostering connectedness to nature and positive emotions.

Associations of sedentary time, sleep duration and physical exercise with multimorbidity among older adults in Shanghai, China: a cross-sectional study based on national physical fitness surveillance data

BackgroundMultimorbidity has emerged as a significant challenge for healthcare systems globally. This study aims to examine the associations between key determinants of lifestyle behavior and various multimorbidity patterns.MethodsIn a cross-sectional sample of older adults (aged 60–79) from the Fifth National Physical Fitness Surveillance in Shanghai, latent class analysis (LCA) was used to identify multimorbidity patterns among 9 chronic diseases. Multinomial logistic regression was performed to analyze the associations between sedentary time, sleep duration, physical exercise, and the different multimorbidity patterns. Weighted analysis was performed to appropriately account for complex sampling designs and provide more robust results.ResultsAmong 13,465 study participants (unweighted mean age 69.3 years; weighted mean age 67.4 years, 50.7% female), the overall prevalence of multimorbidity was 40.9%–42.3%. Four latent classes among the older adults were identified, with the relatively healthy class (63.6%–64.6%) had an average of less than 1 chronic disease. The other 3 classes, namely the metabolic-cardiovascular-joint-digestive-respiratory disease class (2.9%–3.0%), the metabolic-cardiovascular disease class (14.5%–15.5%), and the joint-digestive-respiratory disease class (17.9%–18.0%), each had an average of more than 2 chronic diseases, representing different multimorbidity patterns. Prolonged sedentary time (> 3 h/day) increased the odds of belonging to the metabolic-cardiovascular-joint-digestive-respiratory disease class by 56%–57% (unweighted odds ratio [OR] 1.57, 95% confidence interval [CI] 1.27–1.94; weighted OR 1.56, 95% CI 1.36–1.80), the metabolic-cardiovascular disease class by 38% (unweighted OR 1.38, 95% CI 1.25–1.53; weighted OR 1.38, 95% CI 1.29–1.48), and the joint-digestive-respiratory disease class by 30%–32% (unweighted OR 1.32, 95% CI 1.19–1.45; weighted OR 1.30, 95% CI 1.22–1.38). Shorter sleep duration (< 7 h/day) also increased the odds of membership in the metabolic-cardiovascular disease class by 48%–49% (unweighted OR 1.49, 95% CI 1.35–1.65; weighted OR 1.48, 95% CI 1.38–1.58), the metabolic-cardiovascular-joint-digestive-respiratory disease class by 37%–47% (unweighted OR 1.47, 95% CI 1.19–1.80; weighted OR 1.37, 95% CI 1.19–1.58), and the joint-digestive-respiratory disease class by 41%–42% (unweighted OR 1.42, 95% CI 1.29–1.56; weighted OR 1.41, 95% CI 1.32–1.50). Each additional daily hour of low-intensity physical exercise (LIPE) reduced the odds of membership in the metabolic-cardiovascular-joint-digestive-respiratory disease class by 24%–25% (unweighted OR 0.76, 95% CI 0.64–0.90; weighted OR 0.75, 95% CI 0.66–0.84), the joint-digestive-respiratory disease class by 20%–21% (unweighted OR 0.79, 95% CI 0.73–0.86; weighted OR 0.80, 95% CI 0.76–0.85), and the metabolic-cardiovascular disease class by 11%–12% (unweighted OR 0.88, 95% CI 0.81–0.95; weighted OR 0.89, 95% CI 0.85–0.94). Compared to LIPE, high-intensity physical exercise (HIPE) showed a significant advantage only in reducing the odds of the metabolic-cardiovascular disease class by 18%–23% (unweighted OR 0.77, 95% CI 0.62–0.97; weighted OR 0.82, 95% CI 0.71–0.95).ConclusionsOver 40% of older adults in Shanghai, China, suffer from multimorbidity. Prolonged sedentary behavior and shorter sleep duration were associated with membership in the metabolic-cardiovascular-joint-digestive-respiratory disease class, the metabolic-cardiovascular disease class, and the joint-digestive-respiratory disease class. Physical exercise showed varying degrees of protection against these 3 multimorbidity patterns, with special attention warranted for LIPE. Identifying the relationship between determinants of lifestyle behavior and patterns of multimorbidity can help develop more targeted prevention and management strategies.

Trends in work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs): Data from the German National Database (2010-2022).

To analyse work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs), namely rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and ANCA-associated vasculitis (AAV). A cross-sectional sample of 16 421 patients from the National Database of the German Collaborative Arthritis Centers, aged <65 years were analysed. For each diagnosis, yearly rates of absenteeism, employment and disability pensions were analysed from 2010 to 2022. Population data were used to calculate standardised employment ratios (SERs), adjusted for age, sex, federal state and vocational qualification. The analysis was additionally stratified by sex, adjusting for other factors. Over the observed time span, large employment increases were found across all diagnoses, namely in RA (54%-68%), PsA (58%-72%), SSc (47%-66%), AAV (43%-61%), SLE (48%-60%) and axSpA (65%-73%). SERs were for RA 0.88 (95% CI 0.86 to 0.90), axSpA (0.88 (0.84 to 0.91)), PsA (0.88 (0.85 to 0.91)), SSc (0.83 (0.75 to 0.91)), SLE (0.76 (0.72 to 0.80)) and AAV (0.73 (0.63 to 0.83)). In RA, axSpA, PsA and AAV, SERs were higher in men while in SLE and SSc men had lower SER. Median of yearly absenteeism due to the disease decreased by 5 (RA), 1 (axSpA), 6 (PsA), 11 (SLE), 4 (SSc) and 10 days (AAV) in the time span. Except for SSc, the proportion of disability pension receivers decreased for all diagnoses. Since 2010, work participation has improved for patients with iRMDs, as reflected in higher employment, reduced absenteeism and less disability retirement. However, patients have not reached population employment rates.

Assessing levels of flourishing: Diener’s flourishing scale reveals greater insights into low flourishing in a Hungarian sample

Abstract The present study seeks to validate Diener’s flourishing scale in the context of a sizable Hungarian sample and explore its informative characteristics across diverse score ranges to discern the levels of flourishing accurately captured by the instrument. A large cross-sectional sample (N = 1540) was used for the study. The analyses, including Confirmatory Factor Analysis (CFA), established model fit and invariance across distinct groups (sex and education), validating the scale’s construct validity. Correlative validities were assessed by examining associations with Savoring and PERMA constructs, along with their subscales. Additionally, Item Response Theory (IRT) was used to explore the latent relationship between flourishing and its constituent items. The study strongly supported the one-dimensional model of flourishing by confirming its factor structure within the Hungarian context. Measurement invariance across gender and education was established, ensuring consistent measurement across diverse groups. The Flourishing Scale displayed robust validity, correlating significantly with Savoring and PERMA constructs (r =|0.39| to|0.71|). Nevertheless, the IRT analysis revealed limitations for scores above the mean, indicating higher standard errors and reduced precision in assessing flourishing levels, particularly for respondents with elevated scores. The Diener’s flourishing scale demonstrated robust fit and exhibited commendable reliability and validity within the extensive Hungarian sample under investigation. However, the IRT findings underscored the need for cautious interpretation when gauging higher levels of flourishing, as the scale’s precision may be somewhat compromised in this range.

Resting Body Temperature and Long-Term Survival in Older Adults at a Mental Health Center: Cross-Sectional and Longitudinal Data

Background/Objectives: Elevated body temperature is a well-established biomarker of infection, increased disease risk, and adverse health outcomes. However, the relationship between resting body temperature and long-term survival in older individuals is complex. Emerging evidence suggests that higher basal body temperature is associated with reduced survival and accelerated aging in non-obese older adults. This study aimed to compare body temperatures across different age groups in hospitalized older adults. Methods: Data were retrospectively collected from 367 physically healthy residents of a mental health center. Longitudinal data from 142 individuals (68 men and 74 women), aged 45 to 70 years and monitored continuously over 25 years, were compared with cross-sectional data from 225 individuals (113 men and 112 women) who underwent periodic clinical examinations with temperature measurements. The cross-sectional sample was stratified into four survival categories. Resting oral temperatures were measured under clinical conditions to ensure protocol consistency. Age-related changes in both sexes were evaluated using standard regression analysis, Student’s t-tests, ANOVA, and Generalized Linear Models. Results: Longitudinal analysis revealed an increase in body temperature with age among women, while cross-sectional analysis showed that long-lived residents generally had lower body temperatures compared to their shorter-lived counterparts. Conclusions: These findings support the hypothesis that lower lifetime steady-state body temperature is associated with greater longevity in physically healthy older adults. However, further research is needed to determine whether the lower body temperature observed in long-lived individuals is linked to specific health advantages, such as enhanced immune function, absence of detrimental factors or diseases, or a reduced metabolic rate potentially influenced by caloric restriction.

Epigenetic age across development in children and adolescents with ADHD.

Three well-established epigenetic clocks (PedBE, Horvath, and Skin & blood) were used to estimate EpiAge in 293 saliva samples from 169 participants (91 with ADHD symptoms) from the Neuroimaging of the Children's Attention Project (NICAP). Participants attended single (cross-sectional sample, n = 75) or multiple (2-3) waves of assessment (longitudinal sample, n = 94). We compared EpiAge Gap between ADHD and control groups cross-sectionally and longitudinally, and replicated these findings in a second pediatric cohort from the Oregon ADHD-1000 cohort. Across all three clocks, EpiAge Gap was comparable between ADHD and controls from the cross-sectional sample, and was a null finding for our longitudinal analysis of change in EpiAge Gap, after FDR correction (pFDR=0.24). Both cross-sectional and longitudinal findings were consistent in the replication cohort. This study found no strong evidence of differential epigenetic aging in developing children and adolescents with or without ADHD. Larger cohort studies, which utilize estimates over a prolonged duration, crossing both early and later developmental periods, would further our understanding of biological age in ADHD.