Group Status Research Articles

English Cocker Spaniels under primary veterinary care in the UK: disorder predispositions and protections

BackgroundThe English Cocker Spaniel (ECS) is one of the most popular dog breeds in the UK but information on disorder predisposition and protection is limited. Using anonymised veterinary clinical data from the VetCompass™ Programme, this study aimed to compare disorder predisposition and protection between the ECS and the remaining dogs under primary veterinary care in the UK during 2016. Electronic patient records for random samples of ECS and non-ECS were reviewed. The most common disorders diagnosed during 2016 were extracted and compared using multivariable logistic regression, controlling for confounders.ResultsThe analysis included random samples of 2510/10,313 (24.3%) ECS and 7813/326,552 (2.39%) non-ECS. After accounting for confounding by age, sex, bodyweight within breed-sex, insurance status and veterinary practice group, the ECS had increased odds of 21/43 (48.85%) disorders at fine-level precision, with highest odds for aural discharge (odds ratio (OR) 14.66, 95% confidence interval (CI): 7.73–30.90, P < 0.001) and keratoconjunctivitis sicca (OR 7.64, 95% CI: 4.33–14.14, P < 0.001) and lowest odds for atopic dermatitis (OR 0.14, 95% CI: 0.05–0.31, P < 0.001) and allergy (OR 0.14, 95% CI: 0.06–0.28, P < 0.001).ConclusionsThis study provides evidence for strong predisposition to aural and ocular disorders and protection from hypersensitivity disorders in the ECS. These results can aid dog owners, breeders, and veterinarians to better monitor health in ECS, and promote earlier diagnosis with improved prognosis. Further, the results can help breeding organisations establish key priorities the health-based reforms of the ECS.

Point-of-care ultrasound is a useful adjunct tool to a clinician's assessment in the evaluation of severe hyponatraemia.

Hyponatraemia is the most common electrolyte disorder in inpatients resulting mainly from an imbalance in water homeostasis. Intravascular fluid status assessment is pivotal but is often challenging given multimorbidity, polypharmacy and diuretics use. We evaluated the utility of point-of-care ultrasound (POCUS) as an adjunct tool to standard practice for fluid assessment in severe hyponatraemia patients. Patients presenting with severe hyponatremia (Serum Sodium [Na] < 120 mmol/L; Normal range: 135-145 mol/L), managed by standard care were included. Hyponatraemia biochemistry work-up and POCUS examination were undertaken. Both clinician and POCUS independently assigned one of the three fluid status groups of hypovolaemia, hypervolaemia or euvolaemia. The final diagnosis of three fluid status groups at admission was made at the time of discharge by retrospective case review. Clinician's (standard of care) and POCUS fluid assessments were compared to that of the final diagnosis at the time of discharge. n = 19 patients were included. Median Na on admission was 113 mmol/L (109-116), improved to 129 ± 3 mmol/L on discharge. POCUS showed the higher degree of agreement with the final diagnosis (84%; n = 16/19), followed by the clinician (63%; n = 12/19). A trend towards higher accuracy of POCUS compared to clinician assessment of fluid status was noted (84% vs. 63%, p = 0.1611). Biochemistry was unreliable in 58% (n = 11/19) likely due to renal failure, polypharmacy or diuretic use. Inappropriate emergency fluid management was undertaken in 37% (n = 7/19) of cases based on initial clinician assessment. Thirst symptom correlated to hypovolaemia in 80% (4/5) cases. As subjective clinical and biochemistry assessments of fluid status are often unreliable due to co-morbidities and concurrent use of medications, POCUS can be a rapid objective diagnostic tool to assess fluid status in patients with severe hyponatraemia, to guide accurate emergency fluid management.

Distribution of ABO and Rh blood groups in gynecological cancer cases

Aims: To investigate the relationship between blood type and gynecological cancers (ovarian, endometrial, and cervical). Methods: In the study, between 2017 and 2022, 457 patient files who underwent surgery for gynecological cancer at İstanbul Prof. Dr. Cemil Taşçıoğlu City Hospital were reviewed. Seventy-eight of these files were excluded from the study due to missing data. Out of the remaining files, 379 were considered suitable for the study. Twenty-five of these were further excluded due to being cases of other gynecological cancers. A total of 354 patients were included in the study (n=354). Participants' sociodemographic data such as age and gender, cancer type, and blood groups (ABO-Rh) were retrospectively collected from patient records and the hospital automation system. Cases with missing data or inaccessible sociodemographic records were excluded from the study. The study was planned retrospectively and observationally. Gynecological cancers were examined in the three most common groups: ovarian cancer, endometrial cancer, and cervical cancer. The patients' blood group, Rh status, and pathology reports were analyzed. Based on the pathological diagnosis, three groups were initially formed, and below them, Rh and blood group status were noted. The blood group and Rh status in cancer groups were first presented in numbers and then calculated as percentages. Results: The AB+ ratio in cervical cancers was statistically significantly higher compared to the reference article and endometrial cancers (p=0.021, p=0.049). Conclusion: There are studies indicating a significant relationship between blood groups and various diseases. The expression of blood group antigens on blood cells and other epithelial surfaces acting as receptors or signal transducers contributes to these findings. The possibility of ABO antigens serving as receptors in tumor structures caused by infections, such as cervical cancer, should not be overlooked. In this regard, the significantly higher prevalence of cervical cancer in individuals with AB Rh (+) blood type, carrying A, B, and Rh antigens, can be explained concerning the population.

Cost-effectiveness of the 20-valent pneumococcal conjugate vaccine versus the 23-valent pneumococcal polysaccharide vaccine for older adults in South Korea

BackgroundDespite the demonstrated immunogenicity and safety of the 20-valent pneumococcal conjugate vaccine (PCV20) in older adults, the cost-effectiveness of the PCV20 was not examined compared to the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in South Korea. Therefore, this study aimed to evaluate the cost-effectiveness of PCV20 compared with PPSV23 in adults aged 65 years and older in South Korea. MethodsWe constructed a Markov model that included susceptible states, invasive pneumococcal disease (IPD), non-bacteremic pneumonia (NBP), and death. The population was categorized by disease risk status (low risk, moderate risk, and high risk) and age group (65–74/75–84/85–99 years) at model entry. The annual incidence and mortality of IPD and NBP associated with PCV20 and PPSV23 were estimated based on serotype coverage, vaccine coverage, and vaccine effectiveness. The disease costs and utilities were obtained from previous studies. The incremental cost-effectiveness ratio (ICER) was used to evaluate cost-effectiveness within the threshold of 16,824 USD per quality-adjusted life-year (QALY). ResultsAmong the total population (n = 8,843,072), PCV20 prevented 1941 and 50,575 cases of IPDs and NBPs, respectively, and 898 and 8593 deaths due to IPDs and NBPs compared to PPSV23. The total medical cost per person was 12.11 USD higher in PCV20, with a gain of 0.0053 LYs and 0.0045 QALYs per person. The ICER for PCV20 and PPSV23 was 2270 USD/LY and 2677 USD/QALY. ConclusionsIn South Korea, PCV20 is a cost-effective option compared with PPSV23 for adults aged 65 years and older. These cost-effectiveness results provide evidence for decision-making regarding the approval and National Immunization Program implementation of PCV20.

Efficacy of vagus nerve stimulation for children with drug-resistant epilepsy: Retrospective study

IntroductionAccording to current investigations, there are controversy in our knowledge regarding the safety and efficacy of Vagus Nerve Stimulation (VNS) in children younger than 12 years old. Therefore, we performed this study and aimed to better evaluate the safety and efficacy of VNS in children younger than 12 years. MethodThe retrospective study comprised two groups. In the first group, patients (N = 19) underwent VNS implantation procedure and second group, (N = 21) received no VNS implantation. The main study parameters are as follows: (1) Primary outcome evaluated the proportion of cases with >50 % reduction of seizures at the last follow-up. (2) Changes in patients’ status in VNS group after procedure compared to before procedure. (3) Patient's complaints in VNS group compared to control group. ResultsOur results demonstrated that there was a significant reduction in the frequency of seizures (per month) in patients 6 months after VNS surgery compared to before VNS surgery (1044.3 ± 1526.7 VS 220.7 ± 421.6; P value = 0.028). 57.9 % of patients underwent VNS showed the response rate of 50 % reduction in seizure frequency. There was significant improvement in memory problem, work/ school limitation, social limitation, and tachycardia 6 months after VNS procedure compared to before VNS procedure in patients. The most common reported side effects were difficulty swallowing (31.5 %) and coughing (31.5 %) followed by stomach discomfort (15.8 %). ConclusionConsidering the significant reduction in the frequency of seizures and improvement of life aspects including in memory problem, work/ school limitation, social limitation, we recommend VNS as an effective treatment modality for drug-resistant epilepsy in children. However, the combination of VNS with other treatment modalities that could improve other aspects of quality such as energy levels, sleep pattern, and feeling management of life is recommended.

Prospective Health Outcomes of Sugar-Sweetened Beverage Consumption Patterns Associated with Sociodemographic and Ethnic Factors among Chinese Adults

Background: The consumption rate of artificially sweetened beverages, 100% fruit juices, and soft drink products has been proliferating since the 1980s among the Chinese population. Sugar-sweetened beverages (SSBs) prevalence and high intake of SSBs are associated with several noncommunicable chronic diseases (NCDs). This trend presents a serious public health threat to the Chinese population. Purpose: The present cross-sectional study examined the association between added sugar-sweetened beverage consumption patterns and prospective adverse health outcomes among Chinese sociodemographic and ethnic groups. Methods: The study population of 662 male and female adults partook in the study. The study cohort was randomly drawn from four Chinese cities in three provinces. Participants responded to an adapted cross-sectional self-administered paper-and-pencil 24-hour dietary intake recall protocol questionnaire, including 23 closed-ended questions on the type and frequency of the beverage consumed, sociodemographic characteristics, and ethnic group affiliation. A t-test was conducted to analyze the interactions between the parametric variables and Chi-square analyses were performed to determine interactions between the nonparametric variables. Results: The consumption frequency of sugar-sweetened beverages at least once/day was examined. For all respondents, water consumption was employed as a benchmark for a healthy beverage compared to all other sugar-sweetened beverage consumption. Findings suggest that water was the most frequently consumed beverage with the highest rate of intake (53.17%) compared to sugar-sweetened beverages consumption Regarding ethnicity, Han's water consumption was reported at (67.94%) compared to sugar-sweetened beverage consumption combined at (32.06%). Concerning Huis, water consumption was (60.56%) contrasted with sugar-sweetened beverage consumption of (39.44%). Hans were more likely to consume both water and sugar-sweetened beverages compared to Hui participants. Males' water consumption rate was at (66.74%) juxtaposed with sugar-sweetened beverage consumption of (36.26%). Females' water consumption rate was (66.51%) contrasted with a sugar-sweetened beverage consumption rate of (39.44%). There were no significant differences in the water and sugar-sweetened beverages between men and women. Married respondents' water consumption was (65.44%) compared to sugar-sweetened beverage consumption rate (34.55%). Regarding marital status, the single respondents' water consumption was (64.89%) compared to sugar-sweetened beverage consumption of (33.49%). There were no significant differences in water and sugar-sweetened beverage consumption between the marital status groups. Conclusions: There is a need to introduce short-term and long-term strategies to curtail sugar-sweetened beverage consumption through excise taxes, making water more readily accessible in public schools, and launching a public health education campaign aimed at the health risks associated with added sugar-sweetened beverage consumption.

Delayed Prescribing of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Patients with Low Socioeconomic Status

Background/Objective: Atrial fibrillation (AF) and venous thromboembolism (VTE) are conditions with significant morbidity and mortality when left untreated. American Heart Association guidelines changed in 2019 to make non-vitamin K antagonist oral anticoagulants (NOACs) the preferred method for preventing stroke and systemic embolism in patients with AF or history of VTE. NOACs were first introduced to the United States in 2010 and now include dabigatran, apixaban, rivaroxaban, and edoxaban. There is a dearth of research concerning the speed with which new treatments are prescribed to those in different socioeconomic status (SES) groups. We hypothesized that patients with lower SES were prescribed NOACs later than higher SES counterparts following the introduction of NOACs in 2010.&#x0D; Methods: The IU Cardiovascular Research Consortium/Sidus Dataset was mined for AF and VTE patients prescribed a NOAC between 2010 and 2022. The SES groups were determined using 2020 U.S. Census income data that correlated to patients’ zip codes. The yearly number ofpatients in each SES group were compared to assess for proportional uptake of NOAC prescribing. The primary outcome was the proportion of low SES to high SES prescribing over each year between 2010 and 2022.&#x0D; Results: Low SES patients (n=101,945) were prescribed NOACs at an average of 0.65 times the rate of high SES patients (n= 89,130) from 2010 to 2012, the first three years of NOAC market availability. Prescribing rates equilibrated in 2013 and low SES prescribing has outpaced high SES prescribing since 2021.&#x0D; Conclusion/Impact: Low SES patients experienced a three year delay in receiving NOAC prescriptions at the same rate as their high SES counterparts. Systemic changes, like more frequent prescribing guideline updates and improved evidence-based education amongst providers in low-income areas, could prevent a similar delay when introducing similarly transformative treatments in the future.

Women empowerment and childhood stunting: evidence from rural northwest Ethiopia

BackgroundWomen are often the primary caregivers of children, and as such, their empowerment could influence the nutritional status of their children. However, the role of maternal empowerment on the nutritional status of children in Ethiopia is largely unknown.AimTo determine the association of women’s empowerment with childhood stunting in rural northwest Ethiopia.MethodsA community-based cross-sectional study was conducted among 582 mothers with children aged 6–59 months. A multistage sampling technique was used to select the study participants. Binomial logistic regression analyses were used to assess whether women’s empowerment (categorized as low, moderate and high) and its five dimensions (household decision-making, educational status, cash earnings, house/land ownership, and membership in community groups) were associated with stunting in children. Odds ratios with 95% CI were estimated, and statistical significance was declared at a p-value of < 0.05.ResultsA total of 114 (19.6%), 312 (53.6%), and 156 (26.8%) participants had low, moderate, and high empowerment levels, respectively. In addition, 255 (43.8%) mothers had children who were stunted (too short for their age). In the adjusted models, mothers with moderate empowerment (AOR 0.60, 95% CI: 0.35, 0.97) and high empowerment (AOR 0.56, 95% CI: 0.37, 0.86) had lower odds of having stunted children compared to mothers with low empowerment. Mothers who had a secondary education or higher (AOR 0.57, 95% CI: 0.35, 0.93), owned a house or land (AOR 0.64, 95% CI: 0.44, 0.94) and were members of community groups (AOR 0.54, 95% CI: 0.36, 0.80) were less likely to have stunted children.ConclusionHigh women empowerment was significantly associated with a lower likelihood of childhood stunting. The findings suggest a need to look beyond the direct causes of stunting and incorporate targeted strategies for empowering women into child nutrition programs.

Operational status of mental health, substance use, and problem gambling services: A system-level snapshot two years into the COVID-19 pandemic.

The aim of this paper is to provide a system-level snapshot of the operational status of mental health, substance use, and problem gambling services 2years into the pandemic in Ontario, Canada, with a specific focus on services that target individuals experiencing vulnerable circumstances (e.g., homelessness and legal issues). We examined data from 6038 publicly funded community services that provide mental health, substance use, and problem gambling services in Ontario. We used descriptive statistics to describe counts and percentages by service type and specialisation of service delivery. We generated cross-tabulations to analyse the relationship between the service status and service type for each target population group. As of March 2022, 38.4% (n=2321) of services were fully operational, including 36.0% (n=1492) of mental health, 44.1% (n=1037) ofsubstance use, and 23.4% (n=78) of problem gambling services. These service disruptions were also apparent among services tailored to sexual/gender identity (women/girls, men/boys, 2SLGBTQQIA+individuals), individuals with legal issues, with acquired brain injury, and those experiencing homelessness. Accessible community-based mental health, substance use and problem gambling services are critical supports, particularly for communities that have historically contended with higher needs and greater barriers to care relative to the general population. We discuss the public health implications of the findings for the ongoing pandemic response and future emergency preparedness planning for community-based mental health, substance use and problem gambling services.

Breast surgery after neoadjuvant chemotherapy in patients with lobular carcinoma: surgical and oncologic outcome.

Breast cancer patients with invasive lobular carcinoma (ILC) have an increased risk of positive margins after surgery and often show little response to neoadjuvant chemotherapy (NAC). We aimed to investigate surgical outcomes in patients with ILC treated with NAC. In this retrospective cohort study, all breast cancer patients with ILC treated with NAC who underwent surgery at the Netherlands Cancer Institute from 2010 to 2019 were selected. Patients with mixed type ILC in pre-NAC biopsies were excluded if the lobular component was not confirmed in the surgical specimen. Main outcomes were tumor-positive margins and re-excision rate. Associations between baseline characteristics and tumor-positive margins were assessed, as were complications, locoregional recurrence rate (LRR), recurrence-free survival (RFS), and overall survival (OS). We included 191 patients. After NAC, 107 (56%) patients had breast conserving surgery (BCS) and 84 (44%) patients underwent mastectomy. Tumor-positive margins were observed in 67 (35%) patients. Fifty five (51%) had BCS and 12 (14%) underwent mastectomy (p value < 0.001). Re-excision was performed in 35 (33%) patients with BCS and in 4 (5%) patients with mastectomy. Definitive surgery was mastectomy in 107 (56%) patients and BCS in 84 (44%) patients. Tumor-positive margins were associated with cT ≥ 3 status (OR 4.62, 95% CI 1.26-16.98, p value 0.021) in the BCS group. Five-year LRR (4.7%), RFS (81%), and OS (93%) were not affected by type of surgery after NAC. Although 33% of ILC breast cancer patients undergoing BCS after NAC required re-excision for positive resection margins, it is considered safe given that five-year RFS remained excellent and LRR and OS did not differ by extent of surgery.

Impaired perceptual discrimination of complex objects in older adults at risk for dementia.

Tau pathology accumulates in the perirhinal cortex (PRC) of the medial temporal lobe (MTL) during the earliest stages of the Alzheimer's disease (AD), appearing decades before clinical diagnosis. Here, we leveraged perceptual discrimination tasks that target PRC function to detect subtle cognitive impairment even in nominally healthy older adults. Older adults who did not have a clinical diagnosis or subjective memory complaints were categorized into "at-risk" (score <26; n = 15) and "healthy" (score ≥26; n = 23) groups based on their performance on the Montreal Cognitive Assessment. The task included two conditions known to recruit the PRC: faces and complex objects (greebles). A scene condition, known to recruit the hippocampus, and a size control condition that does not rely on the MTL were also included. Individuals in the at-risk group were less accurate than those in the healthy group for discriminating greebles. Performance on either the face or size control condition did not predict group status above and beyond that of the greeble condition. Visual discrimination tasks that are sensitive to PRC function may detect early cognitive decline associated with AD.

Application of a rehabilitation management strategy based on symptom management theory in postoperative functional exercises in patients with lower extremity arteriosclerosis obliterans.

Lower extremity arteriosclerosis obliterans (ASO) is the most common occlusive disease of the peripheral blood vessels. To explore the application effect of symptom management-based rehabilitation strategy in postoperative functional exercises in patients with lower extremity ASO. The researchers selected 136 patients that underwent lower extremity ASO surgery for the first time in their department from January to September 2020. Patients were divided into a control group (n= 68) and an experimental group (n= 68). The control group implemented routine discharge rehabilitation education and continuous nursing. On this basis, the experimental group applied the symptom management theory to the rehabilitation management strategy to compare the degree of pain, the ankle-brachial index, self-care ability and quality of life between the two groups before and after the intervention. Three months (P= 0.045) and six months (P=0.013) after discharge, the experimental group's degree of pain was significantly lower than that of the control group. At one month (P= 0.019), three months (P= 0.003) and six months (P= 0.000) after discharge, the experimental group recovered significantly better than the control group. At six months after discharge, the self-care ability, mood status and physical pain of the experimental group were significantly higher than in the control group (P< 0.05). The rehabilitation management strategy, which is based on symptom management theory, can effectively improve the symptoms, quality of life and self-efficacy of ASO patients in continuous care. This nursing strategy is worthy of clinical promotion.

Clinical Impact of Improvement in Sarcopenia through Cardiac Rehabilitation in Patients with Heart Failure

ObjectivesSarcopenia in patients with heart failure (HF) is associated with poor prognosis. Cardiac rehabilitation (CR) decreases the incidence of adverse events in patients with HF. However, the clinical implications of improving sarcopenia status through CR remain unclear. This study investigated the relationship between the changes in sarcopenia status in patients with HF undergoing outpatient CR and the risk of mortality and adverse events. DesignThis was a retrospective cohort study of patients hospitalized at the Kitasato University Hospital Cardiovascular Center for the treatment of HF between January 2007 and December 2020. Setting and ParticipantsPatients with HF whose sarcopenia status was assessed at hospital discharge and following at least 3 months of outpatient CR were included. Based on the sarcopenia status, all patients were divided into 3 groups: patients without sarcopenia at discharge (ie, robust), patients with sarcopenia at discharge but no sarcopenia following CR (ie, improved), and patients with sarcopenia at discharge and following CR (ie, unimproved). MethodsCox regression analysis was used to examine the risk of all-cause death associated with the 3 sarcopenia status groups. ResultsOf 546 patients with HF (median age: 70 years; male: 63.6%), 377 (69.0%), 54 (9.9%), and 115 (21.1%) were classified as robust, improved, and unimproved, respectively. Multivariate Cox regression analysis showed that the unimproved group had a significantly greater risk of all-cause death when compared to the robust group [hazard ratio (HR) 2.603, 95% CI 1.375-4.930, P = .004], but it did not differ from the improved group (HR 1.403, 95% CI 0.598-3.293, P = .43). Conclusions and ImplicationsNo improvement in sarcopenia status in patients with HF undergoing outpatient CR was associated with a higher risk of all-cause death. Sarcopenia may be an important target to improve the prognosis of patients with HF.

Prevalence, incidence, risk factors and residual risk associated with viral infections among eligible Brazilian blood donors.

Knowledge regarding the profile of eligible blood donors presenting positive results in laboratory screening is essential for reducing transfusion-transmitted human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Our study aimed to evaluate the prevalence, incidence, predictor variables and residual risk (RR) of HIV/HBV/HCV in blood bags donated in Minas Gerais, Brazil. This study analysed data retrieved from the records of a large blood bank relating to donations collected at multiple centres within the period 2012-2018, during which 1 991 120 blood bags were screened using immunoassays and nucleic acid tests (NATs). Multilevel modelling was used to investigate the association between sex, civil status and age group with HIV/HBV/HCV. RR was estimated from the incidence values (restricted to negative and positive tests within the study period) and window periods for infections. The prevalence in first time donors, incidence and RR of HCV (223.73 cases per 100 000; 54.84 per 100 000 persons-year and 1.6527 per 100 000, respectively) were higher than those of HIV (172.65 cases per 100 000; 28.25 per 100 000 persons-year and 0.8514 per 100 000) and HBV (168.17 cases per 100 000; 18.54 per 100 000 persons-year and 0.5588 per 100 000). The odds of acquiring infection were greater in male, single and older donors. Sixteen donors were identified as seronegative and NATs+ during the 7-year span of the study. Our study has clarified some spatiotemporal trends regarding HIV/HBV/HCV infections in donated blood in Brazil. The results will contribute to the formulation of directives addressed to high-risk donors.

Social inequality in completion rates in higher education: Heterogeneity in educational fields.

This article examines how social disparities in dropout rates vary by educational field. Previous studies have shown that first-generation students, in general, have lower higher education completion rates than their fellow students. Less is known, however, about how such disparities vary between educational fields. We distinguish between general and field specific cultural capital and find that general cultural capital mainly operates through academic preparedness in upper secondary school, and after controlling for upper secondary school grade point average (GPA), students with parents with higher education degrees in a different field than themselves do not complete their degrees more often than first-generation students. More field-specific advantages of having a parent with a similar education are nonetheless visible in many fields also when we compare students with equal grades. Our analyses of Norwegian register data on the entire student population (N≈400,000) show that the social inequalities are largest in fields that are both soft and pure, like humanities and social science, and that in soft and applied educational fields, like teaching and social work, the social differences are small and insignificant after controlling for GPA from upper secondary school. In fields classified as hard, it is only the students with parents with a similar education who complete their initial degree more often than first-generation students. We suggest that status group formation, field-specific cultural capital and micro-class reproduction may all contribute to explaining these patterns.

Religious identification in a changing Turkey

ABSTRACT Turkish politics is changing rapidly, as is the place of religion in its public square. In this context, it is useful to ask who prioritizes religious identity and who does not. Our social-psychological approach emphasizes the importance of understanding why religion is more central to certain individuals’ sense of self than others. We analyze data from an original, nationally representative survey of over 2,000 adults in Turkey that includes a measure of how strongly respondents identify with religion (among other identity options). We run statistical regression analysis to assess how well existing theories of religiosity in general explain the under-explored theoretical and empirical domain of religious identification. Our findings indicate that ideological conservatism, religious fundamentalism, and minority religious group status have significant implications for one’s strength of identification with religion. These results underscore the importance of future research into the psychological roots of attachment to religion and religious identity.

Association of spiritual well-being with quality of life among undergraduate nursing students

Objective: The study was conducted with the aim of determining the spiritual well-being (SWB) of nursing students and its association with quality of life (QOL). Materials and Methods: A cross-sectional analytical study was conducted with a sample size of 504 nursing students collected from January 2023 to March 2023 in the nursing institutes of Khyber Pakhtunkhwa, Pakistan, using convenient sampling techniques. A Spiritual Health and Life-Orientation Measure (SHALOM) questionnaire for SWB and K-27 QOL (K-27 QOL) instrument were used for data collection that contains three parts. Results: The number of female participants was in the majority (50.4%) compared to male nurses (49.6%). The overall mean score of SWB of the students was 3.79 ± 0.48, while the mean K-27 QOL score was 3.73 ± 0.57. There were significant differences between the groups of gender (P = 0.001), while no significant difference within the groups of semester (P = 0.061) and college status (0.285). In QOL, there were significant differences within the groups of semester (P = 0.000) and college status (P = 0.036) while no significant difference in gender category (P = 0.480). SHALOM score is positively and moderately correlated with QOL score (r = 0.597, P &lt; 0.05). Conclusion: Spiritual practices are one of the important factors that are associated positively with QOL, therefore to enhance the QOL, it will require spiritual practices.

Impact of Respiratory Motion on the Quantification of Pediatric Hepatic Steatosis Using Two Different Ultrasonography Machines.

This study aimed to investigate the effect of respiratory motion on hepatic steatosis quantification using ultrasound attenuation imaging (ATI) or ultrasound-guided attenuation parameter (UGAP) in pediatric patients. Pediatric patients (aged ≤18 years) who underwent liver ultrasonography (US) with ATI or UGAP between May 2022 and February 2023 were included retrospectively. Median, interquartile range (IQR), and IQR/median values were calculated in both free-breathing (FB) and breath-holding (BH) states. Subjects were divided into normal and fatty liver groups according to grayscale US. Wilcoxon signed rank test, intraclass correlation coefficient (ICC), and linear regression test were used. A total of 83 patients (M:F=46:37, median age 10 years, range 6-17 years) was included, with 55 patients in the ATI group and 28 patients in the UGAP group. The measured values of ATI and UGAP were not significantly different between FB and BH. The ICC values between FB and BH states were 0.950 [95% confidence interval (CI) 0.916-0.971] for median ATI and 0.786 (95% CI 0.591-0.894) for median UGAP. FB and BH status did not significantly affect the median ATI and UGAP (p=0.852, 0.531, respectively). The IQR/median value showed a significant association with age only in the FB status of the normal group using ATI (β= -0.014, p=0.042). Respiratory motion does not significantly affect the measurement of ATI or UGAP. Median ATI value showed excellent agreement in FB and BH status, while UGAP showed good agreement. Younger age may affect measurement variability in FB status of the normal group using ATI.

ГРУППА РАБОТНИКОВ КАК САМОСТОЯТЕЛЬНЫЙ СУБЪЕКТ ТРУДОВЫХ ОТНОШЕНИЙ

In the current labor legislation practically there are no rules governing relations with industrial groups of employees. However, the association of workers into groups, due to the common social and labor interests, widespread during the Soviet period, has not lost its relevance even today, on the contrary, in modern conditions there is a tendency to strengthen collective beginnings in the process of production activities. The purpose of the study: determining the place of a group of workers in the system of modern subjects of labour law. Tasks: to study groups of workers as subjects of labor law in Russia and abroad, to study forms that accept groups of workers in traditional and atypical labor relations, to determine the status of modern industrial groups, proposals to improve labour legislation with regard to the legal regulation of labour relations with groups of workers. In the process of work such research methods as the method of scientific analysis, as well as formallogical, system-structural, technical-legal methods and comparative methods were used. Results: analysis of selected atypical forms of employment (various forms of joint work and temporary management)as well as the analysis of new approaches to the management of independent work leads to the conclusion that the issue of regulation of the legal status of groups of production associations of employees is being updated. The author notes the similarity of the structure and organization of such entities with the group forms of production activities known to Soviet legislation. Conclusions. It is concluded that it is necessary to legally define groups of workers as subjects of labor legislation, to determine the place of such subjects in the system of subjects of labor relations, as well as to regulate both intra-group and external relations of the group, including the employer.

Determining the sweet detection threshold of COVID-19 patients during infection and recovery periods.

The loss of taste and smell is a common symptom of COVID-19, affecting individuals' quality of life and nutritional status. Detecting sweet thresholds during infection and recovery periods can assist in implementing dietary modifications and nutritional strategies for these patients. To investigate the changes and differences in sweet detection thresholds of confirmed COVID-19 patients on Day 1, Day 10, and Day 14 of the infection and recovery periods. The demographic factors such as gender, smoking status, BMI, and age group were abstracted on Excel sheet from the medical health records for confirmed COVID-19 patients, who were admitted to King Fahad General Hospital in Jeddah, Saudi Arabia, a COVID-19 care facility, from September 2021 to July 2022. Sweet detection thresholds were determined using a pair-wise comparison procedure and sugar solutions with varying concentrations, arranged in ascending order and presented to participants until the lowest detected concentration was noted after three consecutive positive detections, with the median just noticeable difference (JND) value calculated as the population average threshold. Sensory tests were conducted on COVID-19 patients during their infection and recovery periods to evaluate their taste sensation thresholds. The demographic factors of gender, smoking status, BMI, and age group were considered in the analysis. A total of 37 patients who met the inclusion criteria of the study were enrolled as participants. Significant variances in sweet detection thresholds were observed among the COVID-19 patients, with consistent decreases over the three testing days, indicating increasing sucrose sensitivity. Infected men showed significant returns to sweet detection thresholds on Day 14 compared to women, while infected smokers exhibited greater recoveries than non-smokers. Overweight patients had consistently elevated thresholds and recovery rates that were comparable to those of normal-weight patients by Day 14, while younger patients had lower thresholds than their older counterparts. On Day 14, the thresholds had significantly recovered to a level comparable to that of healthy individuals (approximately 0.23%). These findings suggest that sweet detection thresholds can be used as a marker for assessing the progression and recovery of COVID-19 patients. These findings highlight the importance of recognizing and managing alterations in sweet detection thresholds promptly in COVID-19 patients, as this could positively impact dietary management, nutritional recommendations, and interventions during infection and recovery periods.