Cross-sectional Analysis Research Articles

Possible sarcopenia and risk of chronic kidney disease: a four-year follow-up study and Mendelian randomization analysis

ABSTRACT Introduction Chronic kidney disease (CKD) is a common risk factor for sarcopenia. However, whether sarcopenia increases the risk of CKD remains unclear. To investigate the longitudinal and causal associations between possible sarcopenia and CKD, this study was performed. Methods Possible sarcopenia was defined according to the Asian Working Group for Sarcopenia in 2019. Participants aged ≥ 40 years were recruited from the baseline survey of the China Health and Retirement Longitudinal Study and followed up for four years. Binary logistic regression was used to evaluate the cross-sectional and longitudinal associations between possible sarcopenia, low muscle strength, low physical performance and CKD. Propensity score matching was used to balance the intergroup differences. Subgroup and interactive analyses were adopted to identify potential interactive effects. Mendelian Randomization analysis was used to assess the causal association between appendicular lean mass (ALM) and CKD. Results After data cleansing, a total of 7296 participants were included in the baseline survey. In the cross-sectional analyses, the odds ratios (ORs) of prevalent CKD were 1.50 (95% CI = 1.23–1.84, p < 0.001) for possible sarcopenia, 1.37 (95% CI = 1.10–1.70, p < 0.01) for low muscle strength and 1.42 (95% CI = 1.16–1.74, p < 0.001) for low physical performance in the full models. No significant interaction effects of covariates were detected (all P for interaction > 0.05). After four years of follow-up, an increased risk of incident CKD was also observed in participants with possible sarcopenia (OR = 1.66, 95% CI = 1.13–2.44, p = 0.010) and low physical performance (OR = 1.69, 95% CI = 1.16–2.45, p = 0.006), but not in participants with low muscle strength (OR = 1.19, 95% CI = 0.75–1.88, p = 0.469). In the Mendelian Randomization analysis, the inverse variance weighted estimator showed that a 1-standard deviation increase of genetically predicted ALM was associated with a lower risk of CKD (OR = 0.92, 95% CI = 0.85–0.99, p = 0.035). All the sensitivity analyses supported the main findings. Conclusions Possible sarcopenia is an independent risk factor for CKD and may serve as a predictor of CKD for early identification and intervention.

Association between secondhand smoke exposure and serum sex hormone concentrations among US female adults: a cross-sectional analysis using data from the National Health and Nutrition Examination Survey, 2013–2016

ObjectiveTo estimate the association between secondhand smoke (SHS) exposure and serum sex hormone concentrations in female adults (never smokers and former smokers).DesignCross-sectional analysis.SettingUS National Health and Nutrition Examination Survey, 2013–2016.Outcome...

Why location matters: Associations between county-level characteristics and availability of NCORP and NCI sites.

The majority of patients with cancer seek care at community oncology sites; however, most clinical trials are available at National Cancer Institute (NCI)-designated sites. While the NCI National Cancer Oncology Research Program (NCORP) was designed to address this problem, little is known about the county-level characteristics of NCORP site locations. This cross-sectional analysis determined the association between availability of NCORP or NCI sites and county-level characteristic theme percentile scores from the CDC's Social Vulnerability Index themes. Health Resources and Services Administration's Area Health Resource Files were used to determine contiguous counties. We estimated risk ratios and 95% confidence intervals (CI) using modified Poisson regression models to evaluate the association between county-level characteristics and site availability within singular and singular & contiguous counties. Of 3141 included counties, 14% had an NCORP, 2% had an NCI, and 1% had both sites. Among singular counties, for a standard deviation (SD) increase in the racial and ethnic theme score there was a 22% higher likelihood of NCORP site availability (95% CI 1.10-1.36); for a SD increase in the socioeconomic status theme score there was a 24% lower likelihood of NCORP site availability (95% CI 0.67-0.87). Associations were of smaller magnitude when including contiguous counties. NCI sites were located in more vulnerable counties. NCORP sites were more often in racially diverse counties, and less often in socioeconomically vulnerable counties. Research is needed to understand how clinical trial representation will increase if NCORP sites strategically increase their locations in more vulnerable counties.

Local Food Consumption Value Towards Food Destination Image in Sarawak

This study explores the role of local food consumption in enhancing Sarawak's image as a food destination, focusing on the moderating impact of food satisfaction. Drawing on a cross-sectional analysis using a self-administered questionnaire, the study investigates the influence of taste and quality value, health value, price value, emotional value, and prestige value on the food destination image. The sample consists of 181 tourists who visited Sarawak, providing insights into visitors' diverse perspectives and preferences. The data was further analysed using SPSS 28.0 and WarpPLS 8.0. The findings reveal that taste, quality, health, emotional, and prestige value significantly affect the food destination image. However, the study has shown that price value has no significant impact. Surprisingly, food satisfaction does not moderate the relationship between local food consumption value and food destination image. Theoretical implications highlight the need for a more comprehensive understanding of the factors shaping consumers' perceptions. In contrast, practical implications suggest strategic considerations for culinary destinations in marketing campaigns and pricing strategies. Overall, this study contributes valuable insights for destination marketers aiming to attract tourists interested in unique culinary experiences and enhance their overall perception of the destination.

How Variable are Patient Comorbidity Profiles Among Practicing Otolaryngologists?

To determine whether certain groups of otolaryngologists (ORLs) are treating cohorts of patients with more comorbidities. Cross-sectional population-based analysis. 2019 Medicare Provider Utilization and Payment Dataset. Each ORL's average Medicare hierarchical condition category (HCC) risk score, a comorbidity index calculated from a patient's comorbidities, was collected. These were stratified and compared by various physician characteristics, including practice region and rurality, years in practice, gender, subspecialty, and setting (academic vscommunity). Among 8959 ORLs, the mean HCC risk score for Medicare patients was 1.35 ± 0.35. On univariate analysis, ORLs practicing in urban (compared to rural), ORLs in academic settings (compared to community), and early career ORLs all had a patient population with a higher HCC risk score (P < .001 for all). On multivariate analysis controlling for gender, rurality, graduation year, and region, rural setting was associated with decreased odds of having a high-risk patient population (odds ratio: 0.58 [95% confidence interval,CI: 0.48-0.71]; P < .001), while those more recently graduated has an increased risk (2000-2009: 1.41 [1.01-1.96], P = .046; 2010-2015: 2.30 [1.63-3.25], P < .001). In a separate subgroup analysis, subspecialty differences were seen and community setting was associated with decreased odds of having a high-risk patient population (0.36 [0.23-0.55]; P < .001). There is variability in patient comorbidity profiles among ORLs, with those in urban settings, those more recently graduated, and those in academic settings treating a group with more comorbidities. As the comorbidity burden may increase the cost of practice and complications, these findings may have important implications for health inequity.

Documentation of social determinants of health across individuals from different racial and ethnic groups in home healthcare.

Home healthcare (HHC) enables patients to receive healthcare services within their homes to manage chronic conditions and recover from illnesses. Recent research has identified disparities in HHC based on race or ethnicity. Social determinants of health (SDOH) describe the external factors influencing a patient's health, such as access to care and social support. Individuals from racially or ethnically minoritized communities are known to be disproportionately affected by SDOH. Existing evidence suggests that SDOH are documented in clinical notes. However, no prior study has investigated the documentation of SDOH across individuals from different racial or ethnic backgrounds in the HHC setting. This study aimed to (1) describe frequencies of SDOH documented in clinical notes by race or ethnicity and (2) determine associations between race or ethnicity and SDOH documentation. Retrospective data analysis. We conducted a cross-sectional secondary data analysis of 86,866 HHC episodes representing 65,693 unique patients from one large HHC agency in New York collected between January 1, 2015, and December 31, 2017. We reported the frequency of six SDOH (physical environment, social environment, housing and economic circumstances, food insecurity, access to care, and education and literacy) documented in clinical notes across individuals reported as Asian/Pacific Islander, Black, Hispanic, multi-racial, Native American, or White. We analyzed differences in SDOH documentation by race or ethnicity using logistic regression models. Compared to patients reported as White, patients across other racial or ethnic groups had higher frequencies of SDOH documented in their clinical notes. Our results suggest that race or ethnicity is associated with SDOH documentation in HHC. As the study of SDOH in HHC continues to evolve, our results provide a foundation to evaluate social information in the HHC setting and understand how it influences the quality of care provided. The results of this exploratory study can help clinicians understand the differences in SDOH across individuals from different racial and ethnic groups and serve as a foundation for future research aimed at fostering more inclusive HHC documentation practices.

Local area variation in health visiting contacts across England for children under age 5: a cross-sectional analysis of administrative data in England 2018-2020

BackgroundThe health visiting service in England leads the government's Healthy Child Programme (HCP) for children under five years. Local authorities and their provider partners deliver this service differently across England. ObjectiveTo describe local authority variation in the delivery of health visiting to children under five years in England (2018-2020). MethodsWe used publicly available statistics on mandated health visiting contacts, and administrative data from the Community Services Dataset (CSDS) on duration, location, and medium of contacts. We mapped population coverage of mandated contacts (new birth visit, 6-8-week review, one-year review, and 2-2½ -year review) and described the frequency and characteristics of mandated and additional contacts across local authorities. ResultsBased on publicly available data, almost all eligible children received their new birth visit, 6-8-week review and one-year review (89%-99%), with substantial variation across local authorities in children receiving he 2-2½ -year review: median 81%, range 33%-98%. Based on CSDS, 80% of local authorities (n=46/57) delivered more additional than mandated contacts: a median of 1.6 additional contacts (range: 0.1-8.5) were delivered for each mandated contact. There was also significant variation in the duration of contacts and the percentage of contacts delivered face-to-face and at home. ConclusionsDespite decreases in funding and workforce since 2015, in 2018--2020, health visiting teams reached nearly all babies and most children face-to-face via mandated contacts, and conducted over one and a half times the number of additional contacts relative to mandated contacts, with variation between local areas. This represents a significant public health infrastructure to support the health and development of babies and children and the wellbeing of their families in the critical period before school. Our study highlights the importance of taking into account additional contacts. Further work is needed to understand variation, including in the way additional contacts are used.

Prevalence and correlates of mental disorders among Chinese overseas students during the COVID-19: A multi-regional cross-sectional analysis.

The global impact of the COVID-19 pandemic extends beyond physical health, significantly affecting mental health. Chinese overseas students are particularly susceptible to the adverse psychological effects of the pandemic. Understanding the prevalence and correlates of mental disorders in this population is essential for developing targeted interventions and support systems. Employing a snowball sampling technique, this study recruited Chinese overseas students from diverse regions. The 50-item Self-evaluation Table was utilized to assess the presence of mental disorders. Descriptive statistics, including percentages, 95% confidence intervals, means, and standard deviations, characterized the survey population. The chi-square test identified disparities among categorical variables, while logistic regression explored risk factors for mental disorders among Chinese overseas students. Out of the total sample size of 10,864 Chinese overseas students, a staggering 7,090 (65.4%) met the diagnostic criteria for mental disorders. Furthermore, the degree of mental disorder varied significantly across different regions (p < 0.001), education levels (p < 0.05), the duration of anti-epidemic measures (p < 0.05), and age (p < 0.05), while no significant differences were observed in terms of gender (p > 0.05). Several risk factors contributing to the mental disorder burden among Chinese overseas students during the pandemic were identified, including the seriousness of the epidemic in their residential area, the apprehension of getting infected, anxieties regarding academic performance, the infection control policies implemented by the host government, preventive measures taken locally to counter the epidemic, and challenges encountered in returning to their home country. Given the significant challenges in mental health faced by Chinese overseas students during the COVID-19 crisis, addressing their specific needs and implementing tailored measures is imperative. Future public health emergencies should consider the potential mental disorders and disease risks faced by Chinese overseas students. By providing comprehensive support and targeted interventions, policymakers, educational institutions, and healthcare providers can help mitigate the adverse psychological effects and promote the well-being of this vulnerable population.

Socioeconomic determinants of myalgic encephalomyelitis/chronic fatigue syndrome in Norway: a registry study

BackgroundPrevious research has shown that socioeconomic status (SES) is a strong predictor of chronic disease. However, to the best of our knowledge, there has been no studies of how SES affects the risk of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that has not been based upon self-reporting or retrospectively screening of symptoms. As far as we know, this is therefore the first study that isolate and describe socioeconomic determinants of ME/CFS and calculate how these factors relate to the risk of ME/CFS diagnosis by utilizing individual level registry data. This allows for objective operationalization of the ME/CFS population, and makes it possible to model SES affect the risk of ME/CFS diagnosis, relative to control groups.Data and methodsWe conduct a pooled cross-sectional analysis of registry data from all adult patients diagnosed with ME/CFS from 2016 to 2018 in Norway, coupled with socioeconomic data from statistics Norway from 2011 to 2018. We operationalize SES as household income and educational attainment fixed at the beginning of the study period. We compare the effects of SES on the risk of ME/CFS diagnosis to a population of chronically ill patients with hospital diagnoses that share clinical characteristics of ME/CFS and a healthy random sample of the Norwegian population. Our models are estimated by logistic regression analyses.ResultsWhen comparing the risk of ME/CFS diagnosis with a population consisting of people with four specific chronic diseases, we find that high educational attainment is associated with a 19% increase (OR: 1.19) in the risk of ME/CFS and that high household income is associated with a 17% decrease (OR:0.83) in risk of ME/CFS. In our second model we compare with a healthy population sample, and found that low educational attainment is associated with 69% decrease (OR:0.31) in the risk of ME/CFS and that low household income is associated with a 53% increase (OR: 1.53).ConclusionWe find statistically significant associations between SES and the risk of ME/CFS. However, our more detailed analyses shows that our findings vary according to which population we compare the ME/CFS patients with, and that the effect of SES is larger when comparing with a healthy population sample, as opposed to controls with selected hospital diagnoses.

Title: Cross-sectional associations between nutrient intake and tooth decay in older Australian men: The Concord Health and Ageing in Men Project.

Poor nutrition is a risk factor for dental decay in younger people. However, except for sugar it is unclear if this is true in older age groups. The aim of this study was to analyze the possible associations between overall dietary intake of nutrients and diet quality and presence of dental decay in community dwelling older men. A cross-sectional analysis of a longitudinal study with a standardized validated diet history assessment and comprehensive oral health examination in 520 community dwelling men (mean age: 84 years) participating in the Concord Health and Ageing in Men Project. Nutrient Reference Values (NRVs) were used to determine if individual micronutrients and macronutrients were meeting recommendations. Acceptable Macronutrient Distribution Ranges (AMDR) were attained for fat and carbohydrate intakes and were incorporated into a dichotomous variable to determine if the participants were consuming a high fat and low carbohydrate diet. Diagnosis of coronal caries was based on visual criteria and inspection and was completed on each of the five coronal surfaces. Root surface caries was textual changes across four root surfaces. This diagnosis was used to categorize participants by presence and severity of coronal and root caries. Adjusted logistic regression showed not meeting the recommended intakes for thiamin (odds ratio (OR): 2.32 95% confidence interval (CI) 1.15 - 4.67), and zinc (OR: 3.33, 95% CI 1.71 - 6.48) were associated with presence of severe root decay. Adjusted analysis also showed that participants who were outside the recommended AMDR for fat (OR: 0.61, 95% CI 0.38 - 0.98), and those who consumed a high fat and low carbohydrate diet (OR: 0.56, 95% CI 0.35 - 0.91) were less likely to have coronal tooth decay. Our study shows associations between micronutrients and macronutrients and coronal and root surface decay. Although this study cannot prescribe causality or be generalized to all older adults, diet has a possible association with dental decay in older men.

Goiter Prevalence and Associated Factors among Women in Hargeisa, Somalila

Background: Goiter, which is associated with various risk factors, is highly prevalent in Hargeisa region of Somalia and is a serious health problem among women living in the region.Objective: This study aims to reveal the true extent of the problem, identify the causative factors and suggest preventive methods accordingly.Methods: A cross-sectional analysis was conducted on 270 female patients randomly selected from 1659 patients at Hargeisa Group Hospital (HGH), in Somalia, between January and August of 2022. The study sample was equally distributed between those with and without a diagnosis of goiter. Independent risk factors were identified by making comparisons between groups.Results: For the study group, dietary habits were identified as an important risk factor for the development of goiter. Patients who regularly consumed ‘cabbage’ - 188 (87.4%) had a higher rate of goiter compared to those who did not - 64 (47.4%); (p&lt;0.001). Furthermore, those who consumed iodized salt regularly or more frequently - 54 (40%) were less likely to have goiter compared to those who did not - 128 (94.8%); (p&lt;0.001). The use of non-iodized salt and cabbage consumption were identified as predictive factors for the development of goiter.Conclusion: Randomized studies with larger study groups should be conducted. The Minister of Health, health professionals and the media should work in cooperation to raise public awareness and take necessary precautions.International Journal of Human and Health Sciences Vol. 08 No. 02 Apr’24 Page: 192-197

Dissecting through the decade: a 10-year cross-sectional analysis of interprofessional experiences in the anatomy lab

ABSTRACT Interprofessional education (IPE) is prioritized as a critical component in preparing pre-licensure health professional students for effective teamwork and collaboration in the workplace to facilitate patient-centered care. Knowledge in anatomy is fundamental for healthcare professionals, making interprofessional anatomy education an attractive intervention for IPE and anatomy learning. Since 2009, the Education Program in Anatomy at McMaster University has offered an intensive 10-week IPE Anatomy Dissection elective to seven health professional programs annually. From 2011, students were invited to complete the Readiness for Interprofessional Scale (RIPLS) and Interprofessional Education Perception Scale (IEPS) before and after the elective. A total of 264 students from 2011 to 2020 completed RIPLS and IEPS. There were significant differences before and after the elective in students’ total RIPLS scores and three of the four subscales: teamwork and collaboration, positive professional identity, and roles and responsibilities. Similarly, there were statistical differences in the total IEPS scores and two of three subscales: competency and autonomy and perceived actual cooperation. Statistically significant differences in RIPLS and IEPS total scores across several disciplines were also observed. This study demonstrates the elective’s impact in improving students’ IPE perceptions and attitudes, likely from the extended learning and exposure opportunity with other disciplines.

Sex-specific associations between air pollutants and asthma prevalence in Japanese adults: a population-based study

ABSTRACT This study investigated the association between air pollutants and asthma prevalence in male and female Japanese adults. In this retrospective cross-sectional analysis, annual mean exposure levels of air pollutants, specifically nitrogen dioxide (NO2) and particulate matter with a median aerodynamic diameter ≤2.5 μm (PM2.5), were assessed at a local monitoring site. Multivariable logistic regression models, adjusted for genetic and/or lifestyle factors, were used to explore the association between air pollutants and asthma, with stratification by sex. A total of 1,497 participants aged ≥40 years were included. Their mean age was 65.9 ± 12.4 years, with 847 being women. Overall, 91 participants were diagnosed with asthma. In the multivariable model, ambient exposure levels of NO2 and PM2.5 were significantly associated with asthma in women but not in men. This study highlights sex as a significant determinant of the link between air pollutants and asthma exacerbation, particularly among female Japanese adults.

The influence of depression and anxiety on cognition in people with multiple sclerosis: a cross-sectional analysis.

There are conflicting findings about the relationships between depression, anxiety, and cognitive dysfunction in people with multiple sclerosis (MS), and a paucity of research has examined the cumulative influence on cognition of depression plus anxiety. This study aimed to determine whether elevated symptoms of depression and anxiety alone or in combination are associated with worse cognition in people with MS. In this cross-sectional analysis, people with MS consecutively seen at a tertiary neuropsychiatry clinic completed the Hospital Anxiety and Depression Scale for symptoms of depression (HADS-D) and anxiety (HADS-A), and the Minimal Assessment of Cognitive Function in MS for cognitive indices. Accounting for covariates, regression models predicted cognitive indices from scores for HADS-D, HADS-A, and the interaction. Of 831 people with MS, 72% were female, mean age was 43.2years, and median Expanded Disability Status Scale score was 2.0. Depressive symptoms were independently predictive of lower verbal fluency (Controlled Oral Word Association Test, p < 0.01), verbal learning (California Verbal Learning Test-II (CVLT-II) total learning, p = 0.02), verbal delayed recall (CVLT-II delayed recall, p < 0.01), and processing speed (Symbol Digit Modalities Test, p < 0.01; three-second Paced Auditory Serial Addition Test (PASAT), p = 0.05; two-second PASAT, p = 0.01). Anxiety in people with depression predicted decreased visuospatial function (Judgment of Line Orientation, p = 0.05), verbal learning (p < 0.01), verbal delayed recall (p < 0.01), visuospatial recall (Brief Visuospatial Memory Test-Revised, p = 0.02), and executive function (Delis-Kaplan Executive Function System, p < 0.01). Anxiety alone was not independently predictive of cognition. In conclusion, depression, especially with comorbid anxiety, is associated with cognitive dysfunction in people with MS.

An Analysis of Global Surgery Opportunities in American Otolaryngology Residency Programs.

To depict the current state of global surgery opportunities in United States ACGME-approved Otolaryngology residency programs and compare the characteristics of programs with and without these opportunities. In this cross-sectional analysis, websites of ACGME-accredited Otolaryngology residency programs were analyzed for information on program size, rank, age, and geographic region as obtained through the Doximity platform in 2023. Additional parameters were obtained for programs listing global surgery opportunities such as funding, faculty oversight, location/region, focus, and relationship to the community served. Data were tabulated and analyzed in Microsoft Excel and Stata. Of the 131 ACGME-accredited Otolaryngology residency programs, 26 (20%) of programs advertised a global surgery opportunity. Nine (35%) of these promoted funding, 15 (58%) offered a clinical focus, one (4%) offered a research focus, and 10 (38%) offered a combined approach. The Midwest region had the most programs with global surgery opportunities (n = 8, 31%). Less than half (42%) of programs had an established partnership with local partners within low and middle-income countries (LMICs). When comparing programs, the average Doximity rank, average program age, and average program size of programs that offered global surgery opportunities was significantly higher than those that did not (37.2 vs. 71.5, 54 vs. 41, 19.5 vs. 13.7; all p < 0.05). Approximately one-fifth of Otolaryngology training programs have a global surgery opportunity. Programs that offer these opportunities had a higher Doximity ranking, older program age, and a larger trainee cohort. These results highlight potential areas for expanding global surgery opportunities in academic institutions. N/A Laryngoscope, 2024.

Dietary characteristics of community-dwelling older adults with poor appetite: a cross-sectional analysis.

Poor appetite is considered a key factor in the development of malnutrition, a link that can be explained by alterations in dietary intake. Given the limited data on dietary characteristics in community-dwelling older adults with poor appetite, the present study aimed to examine whether poor appetite is associated with lower nutrient intake and more unfavourable food choices. In 569 participants of the Longitudinal Aging Study Amsterdam aged ≥70years appetite was assessed using the Simplified Nutritional Appetite Questionnaire and dichotomised into normal (>14) and poor (≤14). Intake of energy, 19 nutrients, 15 food groups, the Dutch Healthy Diet Index 2015 (DHD15) and Mediterranean Diet Score (MDS) were calculated from a food frequency questionnaire. Dietary differences between appetite groups were examined using Mann-Whitney U test and binary logistic regression adjusted for potential confounders. Mean age was 78 ± 6years and 52% were female. Appetite was poor in 12.5% of participants. Energy intake was 1951 (median; quartiles 1-3: 1,653-2,384) kcal/day with no difference between appetite groups. Poor appetite was associated with lower intake of protein (OR 0.948, 95%CI 0.922-0.973), folate (0.981, 0.973-0.989), zinc (0.619, 0.454-0.846), vegetables (0.988, 0.982-0.994) and lower scores of DHD15 (0.964, 0.945-0.983) and MDS (0.904, 0.850-0.961), as well as higher intake of carbohydrates (1.015, 1.006-1.023), and vitamins B2 (4.577, 1.650-12.694) and C (1.013, 1.005-1.021). Community-dwelling older adults with poor appetite showed poorer diet quality with a lower intake of protein, folate, zinc and vegetables, compared with those reporting normal appetite and should be advised accordingly.

Sociodemographic and Lifestyle Characteristics Associated with Maternal Dietary Patterns in Mexico

There is scarce evidence on sociodemographic and lifestyle characteristics that may explain adherence to different dietary patterns (DPs) during pregnancy. Our aims were to identify dietary patterns in a sample of pregnant Mexican women and to describe their association with selected sociodemographic and lifestyle characteristics. This is a secondary cross-sectional analysis of 252 mothers of children that participated as controls in a hospital-based case–control study of childhood leukemia. We obtained parents’ information about selected sociodemographic characteristics, as well as alcohol and tobacco consumption. We also obtained dietary information during pregnancy. We identified DPs using cluster and factor analyses and we estimated their association with characteristics of interest. We identified two DPs using cluster analysis, which we called “Prudent” and “Non healthy”, as well as three DPs through factor analysis, namely “Prudent”, “Processed foods and fish”, and “Chicken and vegetables”. Characteristics associated with greater adherence to “Prudent” patterns were maternal education, older paternal age, not smoking, and being a government employee and/or uncovered population. Likewise, the “Processed foods and fish” pattern was associated with greater maternal and paternal education, as well as those with less household overcrowding. We did not identify sociodemographic variables related to the “Chicken and Vegetables” pattern. Our results may be useful to identify target populations that may benefit from interventions aimed to improve individual dietary decisions during pregnancy.

Assessment of myosteatosis and functionality in pretreatment gynecological cancer patients.

We aimed to investigate the relationship between pretreatment gynecologic cancer survival and the physical function of patients with myosteatosis. Understanding this relationship prior to treatment would help healthcare providers identify and refer patients with poor muscle quality to an exercise program prior to treatment. We conducted a cross-sectional analysis of 73 GC patients. Physical function was quantified using handgrip strength and an adapted version of the Senior Fitness Test (aerobic endurance not included). The EORTC QLC-C30 was used to evaluate general health quality. Myosteatosis (values below the median muscle radiodensity), muscle mass, and adipose tissue variables were calculated from the computed tomography (CT) scan at the third lumbar vertebra using specific software. Seventy patients (50.9 ± 15.2) were included; 41.5% had stage III or IV disease, and 61.4% had cervical cancer. The myosteatosis group was 11.9years older and showed reduced functioning compared to the normal-radiodensity group. Age and Timed Up and Go (TUG) test results were shown to be the most reliable predictors of muscle radiodensity in pretreatment gynecological patients according to multivariate regression analysis (R2 = 0.314). Gynecological healthcare professionals should be aware that prompt exercise programs might be especially beneficial for older patients with reduced TUG performance to preserve muscle function and quality.

Availability of family care resources, bathing assistance and toileting assistance among older adults with functional limitations: an evidence-based study from China

BackgroundAn aging population has contributed to an increasing prevalence of functional limitations among older adults. Family support plays a crucial role in toileting and bathing assistance. Yet, the relationship between availability of family care resources and such actual assistance remains insufficiently explored. Our study aims to describe availability of family care resources and identify the association between availability of family care resources and toileting assistance or bathing assistance.MethodsThis study employed a cross-sectional analysis of data from the 2018 National Survey of the China Health and Retirement Longitudinal Study (CHARLS). The availability of family care resources was assessed using measurements of spouse availability, adult child availability, and living arrangement. Bathing assistance and toileting assistance were measured based on self-reported receipt of such assistance. Descriptive statistics were used to depict the overall and subgroup situation of availability of family care resources. Multivariable logistic models were employed to investigate the relationship between availability of family care resources and the receipt of toileting assistance or bathing assistance.ResultsAmong the sample of older adults with functional limitations, 69% had a spouse, 63% had at least one adult child, and 80% resided with family members. Among those with bathing disability, 13% reported lacking bathing assistance, and among those with toileting disability, 54% reported lacking toileting assistance.Participants with 1-2 adult children had lower odds of receiving toileting assistance (OR: 0.28, 95% CI: 0.09, 0.91, p= 0.034) compared to those with three or more adult children. Spouse availability and living arrangement did not exhibit statistically significant associations with toileting assistance. Participants without a spouse had lower odds of receiving bathing assistance (OR: 0.27, 95% CI: 0.09-0.78, p= 0.016) in comparison to those with a spouse; however, adult child availability and living arrangement did not display statistically significant associations with bathing assistance.ConclusionThe present findings suggest a gap in family commitment when it comes to assisting older adults with functional limitations in bathing/toileting. To address this, policymakers are encouraged to prioritize the implementation of proactive mechanisms for identifying family caregivers, alongside incentives to enhance their engagement in practical caregiving activities. Furthermore, it is crucial to emphasize the prioritization of affordable and easily accessible formal toileting/bathing assistance options for older adults who lack sufficient family care resources.

Costs associated with insufficient physical activity in Germany: cross-sectional results from the baseline examination of the German national cohort (NAKO).

Insufficient physical activity (PA) is a leading risk factor for non-communicable diseases posing a significant economic burden to healthcare systems and societies. The study aimed to examine the differences in healthcare and indirect costs between sufficient and insufficient PA and the cost differences between PA intensity groups. The cross-sectional analysis was based on data from 157,648 participants in the baseline examination of the German National Cohort (NAKO) study. Healthcare and indirect costs were calculated based on self-reported information on health-related resource use and productivity losses. PA in the domains leisure, transport, and work was assessed by the Global Physical Activity Questionnaire and categorized into sufficient/insufficient and intensity levels (very low/low/medium/high) based on PA recommendations of the World Health Organization. Two-part models adjusted for relevant covariates were used to estimate mean costs for PA groups. Insufficiently active people had higher average annual healthcare costs (Δ €188, 95% CI [64, 311]) and healthcare plus indirect costs (Δ €482, 95% CI [262, 702]) compared to sufficiently active people. The difference was especially evident in the population aged 60 + years and when considering only leisure PA. An inverse association was observed between leisure PA and costs, whereas a direct association was found between PA at work and costs. Adjusting for the number of comorbidities reduced the differences between activity groups, but the trend persisted. The association between PA and costs differed in direction between PA domains. Future research may provide further insight into the temporal relationship between PA and costs.