National Cross-sectional Survey Research Articles

A National Cross-Sectional Survey of EMG Physician Volume.

This study presents results from a survey of physicians performing electrodiagnostic studies to assess average volume. We also assessed how different factors (trainees, technologists, age of the physician, and case complexity) affected volume. Productivity is an important factor for physicians across practice settings. However, unlike evaluation and management services for neurologists, there are no published data for benchmarks of average volume of electrodiagnostic studies. A 34-question survey was designed collecting information on demographics, electrodiagnostic study volume, technologists, trainees, referrals, and case complexity. The anonymous survey was disseminated through a QR code or hyperlink to multiple online neurology, physical medicine and rehabilitation, electromyography, and neuromuscular forums. The primary outcome was EMG volume including number of EMGs per half-day and EMG volume per year. We conducted bivariate association analysis between primary outcomes and respondent characteristics using the Pearson χ2 test. Multivariable regression models determined factors associated with each of our outcome variables. A total of 201 respondents initiated the survey. 71% were certified in adult neurology, 19.6% in physical medicine and rehabilitation, and 2.7% in pediatric neurology. 37.5% practiced in academic medicine. The remaining respondents were from private practice, group, solo, hospital employed, or other. 83% of respondents allotted a dedicated half-day to performing EMGs. The median number of EMGs scheduled during a half-day was within 3-4 (45%). 30% and 7% scheduled 5-6 or more than 7 patients per half-day, respectively. The median number of EMGs performed per year was within 251-500 (37%). This national, cross-sectional survey evaluates average metrics of EMG volume. Our survey showed that the median number of EMGs annually lies between 251 and 500 studies (37%). In addition, for those respondents who allotted a dedicated half-day to performing EMGs, the median number of EMG studies scheduled per half-day lies between 3 and 4 studies (45%). In multivariate analysis, respondent characteristics of age of the physician (older than 45), working with nerve conduction technologists, and holding the position of EMG director were associated with increased EMG volume.

Fourth COVID anniversary: does our practice have changed? The case of ENT outpatient consultations in Cameroon — a national cross-sectional survey

BackgroundIn Cameroon, the COVID-19 disease has demonstrated shortcomings in preventing nosocomial infections at both collective and individual levels. This study aimed to identify practice changes in ENT outpatient consultations in Cameroon inducted by the COVID-19 pandemic.MethodsThis was a descriptive cross-sectional study that took place in March 2024. A Google Form was submitted to ENT practitioners online across Cameroon. It consisted of 20 questions grouped into socio-professional and clinical data.ResultsSixty-four practitioners responded to the questionnaire. The average age of respondents was 36, with extremes of 31 and 70. The sex ratio was 0.35 in favor of women. In terms of experience, 47.7% had been practicing for less than 10 years. A total of 91.3% practiced in public health facilities. Before the COVID-19 outbreak, attitudes towards respiratory diseases were as follows: wearing of masks by suspected patients (4.3%), information posters in waiting rooms (13%), constant use of disinfectant gel (26.1%), wearing of masks by practitioners (0%), wearing of gloves (54.5%), wearing of gowns (87%), constant hand hygiene after each consultation (26.1%), and regular surface hygiene (30.4%). All precautions were improved after 4 years of the pandemic except wearing eye protection.ConclusionENT practice has been strongly impacted by the COVID-19 pandemic, and many measures still need to be taken to improve infection control in hospitals in Cameroon.

Anaemia and associated factors among children aged 6–59 months during the post-ebola period in Sierra Leone: a national cross-sectional survey- 2019

BackgroundAnaemia is a global public health problem associated with early childhood adverse effects on mental, physical, and social development. Sierra Leone had made progress in reducing the prevalence of anaemia pre-Ebola period however this was affected by the Ebola epidemic which further strained an already struggling health system. Therefore, this study aimed to assess the prevalence and factors associated with anaemia during post-Ebola period among children aged 6–59 months in Sierra Leone.MethodsWe analyzed data from the 2019 Sierra Leone demographic and health survey (SLDHS), a nationally representative cross-sectional study. We used data collected using a stratified two-stage cluster sampling design that resulted in the random selection of a representative sample of 13,872 households. A total sample of 3,459 children aged 6–59 months were included in the study. Multivariable logistic regression was used to calculate the adjusted odds ratios and corresponding 95% confidence intervals.ResultsThe prevalence of anaemia was 68.9%, that of mild anaemia was 35.8%, moderate anaemia was 30.3% and for severe anaemia was 2.8%. Children aged 6–36 months were 1.83 times more likely to have anaemia compared to those above 36 months, while boys 1.33 times more likely to be anaemic compared to girls. Children born in poor households, to mothers who had anaemia and had a history of fever had 65%, 85% and 38% increase in likelihood of childhood anaemia respectively. In addition, children living in rural areas and stunted were 1.55 and 1.38 times more likely to be anaemic respectively compared to those living in urban areas and not stunted. Children born to younger mothers (15–24 years) were 1.45 times more likely to be anaemic compared to older mother (35–49 years.ConclusionThe current study demonstrated the predominant existence of anaemia among children aged 6–59 months in Sierra Leone. Owing to the adverse effects of anaemia on the development of children in the future, there is an urgent need for effective and efficient remedial public health interventions to prevent further complications.

Current practice, trends and attitudes of rheumatologists towards glucocorticoids use for rheumatoid arthritis (GURANTEE): a national cross-sectional survey across China.

To investigate current practices, changes, and perceptions of rheumatologists regarding GC use in RA patients. A cross-sectional survey was conducted using a structured questionnaire between April and August 2023. Rheumatologists from 31 province-level regions of Mainland China were invited to participate. Chi-squared tests were adopted to investigate the differences by sociodemographic characteristics. 1,717 rheumatologists from 598 hospitals completed the survey with a response rate of 92%. Up to 60% of participants expressed currently infrequent initiation of GC co-therapy with csDMARDs (hardly ever 7.0%; occasionally 24.6%; sometimes 29.1%), accompanied by a decline of frequency over time reported in 64.2%. Regarding attitudes towards bridging therapy with GC, 604 (35.2%) participants supported this approach, 468 (27.3%) opposed it, and 645 (37.6%) remained inconclusive. Time to GC discontinuation in context of csDMARDs was commonly reported within 6 months in current practice which has been narrowed over time. Reasons for chronic GC use were mostly reported due to suboptimal disease control, followed by the need of RA complications, and pre-existing comorbidities. After failure of GC cessation, majority of respondents (84.4%) would escalate RA therapy (commonly by addition of JAK inhibitors, TNF inhibitors), which usually or often facilitated the GC cessation. The most frequently reported advantages and weaknesses of GC were rapid and strong efficacy, adverse events, respectively. Regarding long-term low-dose GC use for RA, the percentage of respondents who supported, opposed, or depended on the situation were 15.9%, 17.2%, and 66.9%, respectively. The current data demonstrate that GC initiation for RA treatment is not as frequent as before and the awareness of GC discontinuation is growing in current practice. Attitudes towards GC co-therapy with csDMARDs vary considerably and long-term low-dose GC use remain situation dependent.

Expanding a cohort of children who had a response to the Household Food Security Survey Module: A novel approach using linked ICES administrative data

ObjectiveThe Canadian Community Health Survey (CCHS) is a national cross-sectional survey, rich with household, health-related measures. Through linkage with administrative health services data, we aimed to investigate the relationship between household food-insecurity in childhood, and incident health conditions (asthma and diabetes). Linking mothers with children and children with siblings, provided a unique opportunity to expand our child cohort. ApproachWe linked five cycles of the CCHS with ICES administrative databases, to conduct longitudinal cohort studies of children <18 years who had a household response to the Household Food Security Survey Module (HFSSM). Three approaches were used to increase our sample of children: we included children who personally completed the HFSSM; the children of mothers who completed the HFSSM (via a unique database linking mothers with biological children); and the siblings of children who completed the HFSSM. We examined the characteristics of children from food secure and insecure households, accounting for the clustering of children living within the same home. In addition, we investigated the incidence of health outcomes using marginal time-to-event regression analysis to adjust for clinical and socio-economic confounders. Results and ConclusionsUsing novel linkages and multiple data sources we were able to study a large cohort of children (20,023 children whose mothers completed the HFSSM, 5,199 siblings of child respondents, 8,820 children who personally responded to the survey). This creative approach built capacity to investigate household-level determinants of health in a large cohort of Canadian children.

Evaluating Health Canada’s Proposed Front-of-Pack Labelling Policy: Burden of Healthcare Use Attributed to Health Canada’s Proposed Front-of-Pack Labelling Policy

The economic burden of disease due to consumption of poor diet costs billions of dollars annually to the Canadian healthcare system. This project is in response to the growing interest in the use of nutrient profiling systems on front-of-package (FOP) nutrition labels in Canada. There is a high demand for simplified healthy eating messaging. Health Canada announced improving food environments is a priority in the Healthy Eating Strategy and will implement the mandatory FOP label policy in 2026. Two Ontario-based studies examined the impacts of health behaviors (smoking, alcohol consumption, poor diet and physical inactivity) attributed to hospital bed-days and costs. They found 36% of hospital use was attributable to all health behaviours resulting in 900,000 bed-days annually. Between 2004-2013, 22% of healthcare costs totalling $89.4 billion were attributable to the four health behaviours. These are likely underestimates as diet was measured based on fruit/vegetables frequency. The objective is to evaluate Health Canada’s Proposed FOP policy on hospital bed-days. Detailed dietary data from the nationally representative cross-sectional national survey data Canadian Community Heath Survey-Nutrition 2004 linked to Discharge Abstract Database (2004-14) for hospital use will be used for analysis. Data-driven methodology will be employed and development of multivariable risk models using zero-inflated negative binomial regression with multiple exposure groups to test a dose-response. Results are undergoing, will be ready September 2024. This is the first study to analyze Health Canada’s proposed FOP policy related to economic outcomes. These findings will provide evidence-based recommendations to policymakers on nutrition policy.

Impact of COVID-19 pandemic on ocular disease: KNHANES 2015–2021

The aim of this study was to evaluate the impact of COVID-19 on ocular diseases and changes in risk factors before and after the COVID-19 pandemic. This study was conducted using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2015–2021, a national cross-sectional health examination and survey. Associations between ocular diseases and risk factors were determined using the chi-squared test and logistic regression analysis. Bivariable adjusted logistic regression analysis was performed to examine the odds ratio (OR) and 95% confidence interval (CI) to evaluate of the impact of COVID-19 on ocular diseases. Individuals were divided into two age groups (< 60 and ≥ 60 years). A total of 50,158 people were diagnosed, of whom 7270 were diagnosed with cataract, 921 with glaucoma, and 439 with age-related macular degeneration (AMD). Risk factors for cataract were COVID-19 pandemic (OR 1.161), hypertension (OR 1.608), diabetes (OR 1.573), dyslipidemia (OR 1.167), stroke (OR 1.272), and depression (OR 1.567). Risk factors for AMD were COVID-19 pandemic (OR 1.600), dyslipidemia (OR 1.610), and depression (OR 1.466). Risk factors for glaucoma were hypertension (OR 1.234), dyslipidemia (OR 1.529), diabetes (OR 1.323), and depression (OR 1.830). The COVID-19 pandemic was a risk factor for cataracts and AMD, but not for glaucoma. Cataracts and AMD may be more influenced by the acquired health conditions or the environment.

Primary healthcare providers' knowledge, practices and beliefs relating to preventive sexual and reproductive health care for women from refugee and asylum-seeking backgrounds in Australia: a national cross-sectional survey.

Background Many refugee women and women seeking asylum arrive in high-income countries with unmet preventive sexual and reproductive health (SRH) care needs. Primary healthcare providers (HCPs) are usually refugee and asylum seekers' first point of care. This study aimed to identify HCP characteristics associated with initiating conversations and discussing SRH opportunistically during other health interactions. Methods An anonymous online survey was distributed nationally to representatives of health professional organisations and Primary Health Networks. Hierarchical logistic regression analysed factors including HCP demographics, knowledge and awareness, perceived need for training and professional experience with refugee women were included in the models. Results Among 163 HCPs, those initiating conversations ranged from 27.3% (contraceptive care) to 35.2% (cervical screening). Opportunistic discussions ranged from 26.9% (breast screening) to 40.3% (contraceptive care). Positively associated factors included offering care to refugee women or women seeking asylum at least once every 2months 7.64 (95% CI 2.41;24.22, P P P P P P Conclusions Direct professional experience, frequency of service provision, years of practice, and part time work positively influence HCPs' SRH care practices. Enhancing bilingual health worker programs, outreach, education, and support for SRH and cultural competency training are essential to improving the preventive SRH care of refugee women and women seeking asylum.

Experienced financial toxicity among long-term cancer survivors: results from a national cross-sectional survey.

Financial toxicity, the subjective distress caused by objective financial burden, significantly impacts cancer survivors. Yet, enduring effects on survivors remain unclear. Therefore, we investigated the experienced objective financial burden and subjective financial distress in long-term cancer survivors. A cross-sectional nationwide online survey of adult cancer survivors ≥ 5y after diagnosis were analyzed. Objective financial burden was measured via extra expenses and income loss, while subjective financial distress covered psychological well-being, coping and support-seeking behavior, and financial concerns. Groups were compared (i.e., having cancer vs. former patients) by t-tests and chi-squared tests. Financial toxicity was visualized with Sankey plots and sunburst diagrams. 4,675 respondents completed the survey, of whom 2,391 (51%) were ≥ 5y after their cancer diagnosis. Among them, 75% experienced income loss and/or extra expenses after diagnosis. One-third of the previously employed respondents relied on work disability benefits. Further, 'being unable to make ends meet' increased from 2% before diagnosis to 13% ≥ 5y after diagnosis (p < .001). Additionally, 58% reported negative psychological impacts of financial toxicity, and 47% worried about their financial future. Cancer survivors often face income loss and additional expenses, leading to ongoing financial difficulties that affect their psychological well-being. Despite this significant impact, there is a lack of guidance and support to help them manage these financial challenges. These findings highlight the need for healthcare professionals to recognize and address the financial challenges. This study underscores the widespread financial challenges cancer survivors encounter, emphasizing the need for ongoing financial support and comprehensive assessments of their physical and psychological well-being.

Assessment of the public knowledge, attitudes, and perceptions of Nigerians regarding preparedness for future pandemics

IntroductionPandemics are global health crises that have caused millions of deaths, enormous socio-economic disruptions, and considerable public and global health security consequences. This study assessed Nigerians’ knowledge, attitudes, and perceptions regarding preparedness for the next pandemics.MethodsA cross-sectional questionnaire-based national survey was conducted among 1276 respondents in Nigeria to determine public knowledge, attitudes, and perceptions of preparedness for future pandemics. Descriptive and inferential statistics were used for analyses.ResultsOf the 1276 respondents to this survey, > 50% had not heard of the Spanish flu and Zika disease. Approximately half (594) of the respondents did not consider antimicrobial resistance a possible cause of future pandemics. Over an average proportion of respondents reported unsatisfactory knowledge (655, 51.3%) and poor perceptions (695, 54.5%) about pandemic preparedness. The respondents’ good knowledge and satisfactory attitudes toward pandemic preparedness decreased with age. The respondents' education, age, and state of residence were significantly associated with good knowledge, satisfactory attitudes, and positive perceptions of pandemic preparedness with respondents with tertiary education levels being at least two times more likely to have these positive outcomes.ConclusionThis study revealed serious gaps in Nigerians’ knowledge, attitudes, and perceptions of their readiness for upcoming pandemics. To protect Nigerians’ health, emphasis should be placed on these issues by all stakeholders, including the government.

Behind the Sadness of Teen Girls: A Retrospective Survey Analysis Amidst the COVID-19 Crisis of 2021

(1) Background: Adolescent girls have increasingly faced mental health challenges. We examined prevalence trends and associated risk factors for depression among adolescent girls. (2) Methods: Data for girls aged 12 to 17 years (N = 4346) from the 2021 cross-sectional National Survey on Drug Use and Health were analyzed. Factors associated with depression were examined using multiple regression analysis. (3) Results: Rates of severe depression were significantly higher (p &lt; 0.001) in older girls (adjusted odds ratio [AOR]: 1.63, 1.61), those who did not have authoritative parents (AOR: 3.40), and those with negative school experiences (AOR: 4.03). Black and Asian/Native Hawaiian or other Pacific Islanders were less likely to report severe depression than white girls. As previously reported, non-white girls were significantly less likely to receive treatment for depression (p &lt; 0.05). Parents’ characteristics and school experiences had no effect on the likelihood of receiving mental health treatment. (4) Conclusions: Depression has become increasingly common among American adolescent girls, who are now three times as likely as adolescent boys to have had recent experiences with depression. Our results show that family structure, parenting style, and negative school experiences significantly contribute to the rate of depression and that treatment disparities exist with regard to race and ethnicity. The results of our research could be valuable for policymakers, healthcare professionals, and educators in developing specific preventative initiatives and support networks that effectively address these unique challenges.

National cross-sectional survey of US adults to assess the reliability of current and lifetime cannabis smoking

ObjectiveThe objective is to examine the test–retest reliability and internal reliability of six self-report questions assessing both current (past 30 days) and lifetime cannabis smoking in an internet survey in...

Assessment of diabetes related-knowledge and practice among Algerian university students: a cross-sectional survey

Diabetes is increasing significantly in the world especially among low- and middle-income countries including Algeria where it is ranked second in term of morbidity. This study was conducted aiming to evaluate the level of knowledge and lifestyle practice among Algerian university students. A national online cross-sectional survey was conducted between 14 November 2022 and 11 February 2023. 417 students answered the questionnaire. Demographically, females (82%), singles (86.1%), students aged between 20 and 30 years old (62.2%) and those living in urban areas (86.8%) were the most represented. More than half were students of bachelor level (52.3%) and were mainly studying in Natural and Life Sciences (37.2%) and Humanities (29.5%) faculties, and 10.6% of them declared living with diabetes. Overall, an average percentage of 75.1% correct responses was obtained and 54.6% of the respondents have shown a high level of knowledge. If age, the field of study and paternal education were associated with a high level of knowledge, being a Health Sciences student (OR: 10.175, CI 95%: 2.985–34.677) and being diabetic (OR: 10.486, CI95%: 3.424–32.12) were highly significant factors (p < 0.01). Regarding lifestyle practice, a moderate level of good practice of 54.2% was obtained and the level of knowledge was the only associated factor. These results described that some gaps of knowledge were observed especially among certain categories including students without formal education in Health, and Natural and Life Sciences. Results of this study could be helpful to the health program deciders in their campaigns of prevention against this silent disease.

Being insulted by parents is the most severe early adverse experience of anxiety in adulthood

IntroductionWhich adverse childhood experiences are causally associated with anxiety in adulthood is unclear. Sensitive Period Model states that early adverse experiences can influence anxiety levels in adulthood. However, it remains unknown which adverse experience is the most important early adverse factor for anxiety in adulthood, and whether early alleviation or aggravation of this adverse experience predicts a decrease or increase in anxiety levels in adulthood. MethodsA national cross-sectional survey was conducted from 20 June 2023 to 31 August 2023, with a total of 30,054 adults aged 18 years or older recruited on questionnaires that completed the Adverse Childhood Experiences Scale and Generalised Anxiety Disorder Scale. We used network analysis and computer simulation techniques to simulate aggravating and simulate alleviating interventions to observe changes in anxiety levels to identify early adverse experiences causally associated with anxiety levels in adulthood. ResultsThe results of both the network analysis and the nodeIdentifyR algorithm (NIRA) indicated that in the Adverse Childhood Experiences-Anxiety Network (ACE-GAD Network), being cursed and insulted (CUR) by parents in childhood was the most severe early adverse experience contributing to anxiety in adulthood. In particular, simulated aggravation interventions targeting CUR in young and middle-aged adults resulted in significantly higher levels of anxiety in adulthood. ConclusionsThis suggests that preventing verbal curses or insults in childhood can be an early preventive measure for future anxiety interventions. This study has important theoretical and practical implications, providing new insights for early prevention of anxiety and family education.

Physicians' Experiences of EHR Technical Quality: Results from Four Large Cross-Sectional Surveys in 2010-2021.

Unexpected downtime and long response times of electronic health record (EHR) systems not only impact user satisfaction and clinicians' work efficiency but also bring about potential harm for patients. Despite improvements in the performance of EHR systems' architecture, hardware, and networks, technical challenges continue to cause problems. We explored the end-user experiences of EHR technical functionality and quality from four large national cross-sectional surveys conducted among Finnish physicians in 2010-21. The results were analyzed by healthcare sector/specialty groups. In most groups, the experiences of stability and reaction speed became worse in 2010-17, which is readily explained by the implementation of the national patient data repository services, but improvements were seen in 2021, suggesting that EHR vendors have solved at least some of the slowness problems. The proportion of physicians reporting having experienced faulty system function with potential or actualized harm for the patient had decreased in operative and medical specialties and in the private sector but remained stable in other groups. Our findings underline the importance of continuing to develop technical qualities - including the implementations of national integrations.

Rural-urban differences in common mental disorders among Indonesian youth: a cross-sectional national survey.

The onset of common mental disorders (CMDs) is most prevalent among youth; thus, mental health management is crucial. We examined differences in risk and risk factor determinants regarding CMDs prevalence among youth in rural and urban Indonesia. This cross-sectional study utilized data from the 2018 Indonesia National Health Survey. The population comprised 122,114 respondents, aged 15 to 24 years, who had completed the 20-item Self-Report Questionnaire along with providing demographic and health behavior data. Chi-square testing and logistic regression were employed for analysis. The CMDs risk was higher among urban than rural youth. Risk factors impacting both populations included being female, having a lower education level, consuming fewer than 7 portions of vegetables weekly, smoking, and drinking alcohol (p<0.05). Consuming under 7 portions of fruit weekly and being in the highest or lowest wealth quintile were significant risk factors only in urban youth, while unemployment and divorce were significant only among rural respondents (p<0.05). Marriage was protective against CMDs among rural participants. Being male, possessing a college degree, consuming at least 7 portions of vegetables weekly, not smoking, and not consuming alcohol were associated with reduced CMDs risk in urban and rural youth. Among rural youth, marriage and employment were linked to decreased risk, whereas divorce displayed the opposite relationship. In urban populations, consuming at least 7 portions of fruit weekly and belonging to neither the highest nor the lowest economic quintile were protective factors. Management strategies for CMDs in young people must address these considerations.

Degenerative Cervical Myelopathy Awareness in Primary Care: UK National Cross-Sectional Survey of General Practitioners.

Degenerative cervical myelopathy (DCM) is a progressive neurological condition, characterized by spinal cord injury secondary to degenerative changes in the spine. Misdiagnosis in primary care forms part of a complex picture leading to an average diagnostic delay of 2 years. This leads to potentially preventable and permanent disability. A lack of awareness secondary to deficits in postgraduate education may contribute to these delays. This study aims to assess the awareness of DCM in the setting of general practice. General practitioners completed a quantitative web-based cross-sectional questionnaire. The 17-item questionnaire captured data regarding demographics, subjective awareness, and objective knowledge. The questionnaire was disseminated via professional networks, including via practice managers and senior practice partners. Incentivization was provided via a bespoke DCM fact sheet for those that completed the survey. A total of 54 general practitioners representing all 4 UK nations responded to the survey. General practitioners most commonly self-assessed that they had "limited awareness" of DCM (n=24, 51%). General practitioners felt most commonly "moderately able" to recognize a case of DCM (n=21, 46%). In total, 13% (n=6) of respondents reported that they would not be at all able to recognize a patient with DCM. Respondents most commonly reported that they were "moderately confident" in their ability to triage a patient with DCM (n=19, 41%). A quarter of respondents reported no prior introduction to DCM throughout their medical training (n=13, 25%). The mean score for knowledge-based questions was 42.6% (SD 3.96%) with the lowest performance observed in patient demographic and clinical recognition items. General practitioners lack confidence in the recognition and management of DCM. These findings are consistent with the diagnostic delays previously described in the literature at the primary care level. Further work to develop and implement educational interventions to general practitioner practices is a crucial step to improving patient outcomes in DCM.

Large-Scale Serological Survey of Crimean-Congo Hemorrhagic Fever Virus and Rift Valley Fever Virus in Small Ruminants in Senegal.

Crimean-Congo hemorrhagic fever (CCHF) and Rift Valley fever (RVF) are among the list of emerging zoonotic diseases that require special attention and priority. RVF is one of the six priority diseases selected by the Senegalese government. Repeated epidemic episodes and sporadic cases of CCHF and RVF in Senegal motivated this study, involving a national cross-sectional serological survey to assess the distribution of the two diseases in this country throughout the small ruminant population. A total of 2127 sera from small ruminants (goat and sheep) were collected in all regions of Senegal. The overall seroprevalence of CCHF and RVF was 14.1% (IC 95%: 12.5-15.5) and 4.4% (95% CI: 3.5-5.3), respectively. The regions of Saint-Louis (38.4%; 95% CI: 30.4-46.2), Kolda (28.3%; 95% CI: 20.9-35.7), Tambacounda (22.2%; 95% CI: 15.8-28.6) and Kédougou (20.9%; 95% CI: 14.4-27.4) were the most affected areas. The risk factors identified during this study show that the age, species and sex of the animals are key factors in determining exposure to these two viruses. This study confirms the active circulation of CCHF in Senegal and provides important and consistent data that can be used to improve the surveillance strategy of a two-in-one health approach to zoonoses.

Racial/ethnic differences in risk of suicidal ideation and suicide attempts in a nationally representative sample of U.S. adolescents

BackgroundSuicidal ideation (SI) and suicide attempts (SA) are risk factors for suicide which peak during adolescence; however, evidence focused on differences in SI and SA risk among racial/ethnic minority youth is limited despite increasing suicide rates among several racial/ethnic minority groups. MethodsWe analyzed a representative sample of adolescents aged 12–17 with prior depressive symptoms (n = 32,617) from the cross-sectional National Surveys on Drug Use and Health (2008–2019). Survey-weighted adjusted logistic regressions estimated the association of race/ethnicity with self-reported lifetime SI and SA, controlling for sociodemographics, lifetime substance use, lifetime major depressive episode, and self-rated health. ResultsCompared to white adolescents, Black and Hispanic adolescents had a 2.5 % (p = 0.04) and 4.2 % (p < 0.001) lower likelihood of reporting SI. However, among participants reporting SI, Black and Hispanic adolescents had a 3.2 % (p = 0.03) and 3.1 % (p = 0.03) higher likelihood of reporting SA than white adolescents. Multiracial adolescents were 5.9 % (p = 0.03) more likely to report SA than white adolescents. LimitationsAlthough racial/ethnic minority groups are less likely to self-report mental health symptoms, we could only assess SI/SA among adolescents self-reporting prior depressive symptoms, and we could only assess SA among adolescents self-reporting SI due to survey methods. ConclusionsVariation in the racial/ethnic distribution of suicidality supports theories conceptualizing separate pathways for SI and SA. This underscores the need for greater attention to racial/ethnic differences in suicide-related research, surveillance, and prevention efforts, including ensuring that mental health risk assessments directly evaluate SA in addition to SI in order to better identify high-risk racial/ethnic minority youth.

Objective alertness, rather than sleep duration, is associated with burnout and depression: A national survey of Japanese physicians.

Approximately 40% of Japanese physicians report working more than 960 hr of overtime annually, with 10% exceeding 1860 hr. To protect their health, annual overtime limits went into effect in 2024. The objective of this study was to investigate associations of self-reported sleep duration with psychological health and objective alertness. This was a cross-sectional National Survey for The Work Style Reform of Long Working Physicians. Physicians self-reported daily sleep duration, burnout (Abbreviated Maslach Burnout Inventory), depression (Center for Epidemiologic Studies Depression Scale) and traffic accidents. Alertness was then evaluated using the brief Psychomotor Vigilance Test. Of 20,382 physicians invited, 1226 completed the survey and brief Psychomotor Vigilance Test. Daily sleep duration was inversely associated with weekly work hours (β = -5.4; 95% confidence interval -6.8 to -4.0, p < 0.0001). Sleep duration < 6 hr and ≥ 8 hr per day was associated with slower responses on the brief Psychomotor Vigilance Test (adjusted p < 0.05). An additional 10 hr worked per week was associated with a 0.40 point (95% confidence interval 0.08-0.72) increase in burnout severity and a 1.7% (95% confidence interval 0.1-3.3%) increase in odds of reporting a traffic accident. Increased brief Psychomotor Vigilance Test lapses, indicating lower alertness, were associated with worse symptoms of depression (β = 0.23 points; 95% confidence interval 0.14-0.31, p < 0.0001) and burnout (β = 0.25 points; 95% confidence interval 0.13-0.36, p < 0.0001). This study emphasizes the importance of sufficient sleep to maintain alertness, and supports limiting work hours for Japanese physicians to protect psychological health. Performance on the brief Psychomotor Vigilance Test may be a useful indicator of psychological health.