Health-related Characteristics Research Articles

Use of Sotrovimab in Pregnancy: Experiences from the COVID-19 International Drug Pregnancy Registry.

Available data regarding the safety and efficacy of sotrovimab in pregnant patients remain limited due to their exclusion from clinical trials. The COVID-19 International Drug Pregnancy Registry (COVID-PR) was established to gather comprehensive safety data from pregnant women who have received monoclonal antibody (mAb) or antiviral treatments for mild, moderate, or severe coronavirus disease 2019 (COVID-19) during pregnancy. Participants actively contributed self-reported data concerning their COVID-19 symptoms, in addition to sociodemographic and health-related characteristics. Obstetric, neonatal, and infant outcomes were also documented, with follow-up extending up to 12 months after childbirth. As of 30 November 2023, sotrovimab was administered to 39 participants enrolled in the COVID-PR. At the time of this report, 26 participants had given birth, with nine deliveries performed via cesarean section. The infants' birthweight ranged from 2381g to 4762g, with a mean of 3439.91g. Twenty-five infants were born at ≥37weeks. A total of 31 adverse events (AEs) were reported by 12 participants. The most frequently reported AE was gestational hypertension, observed in three participants. COVID-19 re-infection, fatigue, gestational diabetes, headache, and morning sickness were each reported by two participants. Of the reported AEs, eight (in five participants) were classified as serious, including four AEs (prolonged labor, pre-eclampsia, polyhydramnios, premature labor) that affected pregnancy. Seven of these eight serious AEs (SAEs) were found to be unrelated to sotrovimab, with one event (urinary retention) not assessable. A total of 44 AEs were reported in 19 delivered infants or in utero fetuses. The most common were COVID-19 (n=6 events), ear infection (n=5 events), neonatal dyspnea (n=3 events), and respiratory syncytial virus infection (n=3 events). Sixteen AEs (in 11 infants/fetuses) were classified as serious, including one report each of fetal cardiac disorder, congenital ankyloglossia, persistent right umbilical vein, and congenital hydronephrosis; the latter was considered a major congenital malformation. For all assessable SAEs, causality of sotrovimab treatment was ruled out based on lack of a temporal relationship alone or in combination with absence of a plausible mechanism. A sizable proportion of sotrovimab-treated participants in the COVID-PR had underlying medical conditions associated with an increased risk of severe COVID-19. None of the assessable SAEs were considered to be related to sotrovimab treatment.

Comparison of the characteristics of the population eligible for lung cancer screening under 2013 and population newly eligible under 2021 US Preventive Services Task Force recommendations.

In 2021, the United States Preventive Services Task Force (USPSTF) revised their 2013 recommendations for lung cancer screening eligibility by lowering the pack-year history from 30+ to 20+ pack-years and the recommended age from 55 to 50years. Simulation studies suggest that Black persons and females will benefit most from these changes, but it is unclear how the revised USPSTF recommendations will impact geographic, health-related, and other sociodemographic characteristics of those eligible. This cross-sectional study employed data from the 2017-2020 Behavioral Risk Factor Surveillance System surveys from 23 states to compare age, gender, race, marital, sexual orientation, education, employment, comorbidity, vaccination, region, and rurality characteristics of the eligible population according to the original 2013 USPSTF recommendations with the revised 2021 USPSTF recommendations using chi-squared tests. This study compared those originally eligible to those newly eligible using the BRFSS raking-dervived weighting variable. There were 30,190 study participants. The results of this study found that eligibility increased by 62.4% due to the revised recommendations. We found that the recommendation changes increased the proportion of eligible females (50.1% vs 44.1%), Black persons (9.2% vs 6.6%), Hispanic persons (4.4% vs 2.7%), persons aged 55-64 (55.8% vs 52.6%), urban-dwellers(88.3% vs 85.9%), unmarried (3.4% vs 2.5%) and never married (10.4% vs 6.6%) persons, as well as non-retirees (76.5% vs 56.1%) Respondents without comorbidities and COPD also increased. It is estimated that the revision of the lung cancer screening recommendations decreased eligibility disparities in sex, race, ethnicity, marital status, respiratory comorbidities, and vaccination status. Research will be necessary to estimate whether uptake patterns subsequently follow the expanded eligibility patterns.

Community screening for dementia among older adults in China: a machine learning-based strategy

BackgroundDementia is a leading cause of disability in people older than 65 years worldwide. However, diagnosing dementia in its earliest symptomatic stages remains challenging. This study combined specific questions from the AD8 scale with comprehensive health-related characteristics, and used machine learning (ML) to construct diagnostic models of cognitive impairment (CI).MethodsThe study was based on the Shenzhen Healthy Ageing Research (SHARE) project, and we recruited 823 participants aged 65 years and older, who completed a comprehensive health assessment and cognitive function assessments. Permutation importance was used to select features. Five ML models using BalanceCascade were applied to predict CI: a support vector machine (SVM), multilayer perceptron (MLP), AdaBoost, gradient boosting decision tree (GBDT), and logistic regression (LR). An AD8 score ≥ 2 was used to define CI as a baseline. SHapley Additive exPlanations (SHAP) values were used to interpret the results of ML models.ResultsThe first and sixth items of AD8, platelets, waist circumference, body mass index, carcinoembryonic antigens, age, serum uric acid, white blood cells, abnormal electrocardiogram, heart rate, and sex were selected as predictive features. Compared to the baseline (AUC = 0.65), the MLP showed the highest performance (AUC: 0.83 ± 0.04), followed by AdaBoost (AUC: 0.80 ± 0.04), SVM (AUC: 0.78 ± 0.04), GBDT (0.76 ± 0.04). Furthermore, the accuracy, sensitivity and specificity of four ML models were higher than the baseline. SHAP summary plots based on MLP showed the most influential feature on model decision for positive CI prediction was female sex, followed by older age and lower waist circumference.ConclusionsThe diagnostic models of CI applying ML, especially the MLP, were substantially more effective than the traditional AD8 scale with a score of ≥ 2 points. Our findings may provide new ideas for community dementia screening and to promote such screening while minimizing medical and health resources.

Epidemiological features of depression and anxiety among homeless adults with healthcare access problems in London, UK: descriptive cross-sectional analysis.

In England in 2021, an estimated 274 000 people were homeless on a given night. It has long been recognised that physical and mental health of people who are homeless is poorer than for people who are housed. There are few peer-reviewed studies to inform health and social care for depression or anxiety among homeless adults in this setting. To measure the symptoms of depression and anxiety among adults who are homeless and who have difficulty accessing healthcare, and to describe distribution of symptoms across sociodemographic, social vulnerability and health-related characteristics. We completed structured questionnaires with 311 adults who were homeless and who had difficulty accessing healthcare in London, UK, between August and December 2021. We measured anxiety and depression symptoms using the 4-item Patient Health Questionnaire (PHQ-4) score. We compared median PHQ-4 scores across strata of the sociodemographic, social vulnerability and health-related characteristics, and tested for associations using the Kruskal-Wallis test. The median PHQ-4 score was 8 out of 12, and 40.2% had scores suggesting high clinical need. Although PHQ-4 scores were consistently high across a range of socioeconomic, social vulnerability and health-related characteristics, they were positively associated with: young age; food insecurity; recent and historic abuse; joint, bone or muscle problems; and frequency of marijuana use. The most common (60%) barrier to accessing healthcare related to transportation. Adults who are homeless and have difficulty accessing healthcare have high levels of depression and anxiety symptoms. Our findings support consideration of population-level, multisectoral intervention.

낙상 경험이 있는 지역사회 거주 노인의 반복 낙상 위험 요인

Objectives This study aimed to identify risk factors for recurrent falls among community-dwelling older adults who had experienced a fall in the past year. Methods This study performed secondary analysis using data from the 2020 National Survey of Older Koreans. Data from 650 community-dwelling older adults with one or more fall experiences in the past year were utilized. To identify risk factors for recurrent falls, a multinomial logistic regression analysis was conducted including general characteristics, health-related characteristics, and reasons for falls. Results The distribution of participants according to the number of falls in the past year was 435 (66.9%) people who had fallen once, 156 (24.0%) people who had fallen twice, and 59 (9.1%) people who had fallen three or more times. In the multinomial logistic regression analysis, the categorical number of falls (1, 2, and 3 or more) were considered as dependent variables, and the category of “1” was determined as the reference group. The findings of the analysis revealed that failure to perform a five-time-sit-to-stand test and depression were risk factors for the group that experienced falls twice. In addition, depression and physical reasons for falling were found to be risk factors in the group that experienced falls three or more times. Conclusions This study suggested that risk factors for recurrent falls among community-dwelling older adults comprehensively. Health care providers who provide screening and intervention to prevent recurrent falls need to consider mental problems such as depression along with the participants' balance disorder and physical problems.

골다공증 진단 여성노인의 삶의 질 영향요인

The purpose of this study was to investigate osteoporosis prevalence and factors influencing quality of life (HRQoL) among older Korean women with osteoporosis. The study design was a retrospective study using secondary data analysis. Data for 1,679 women aged 65 and older from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 to 2020 were included. Linear regression analysis was conducted for influential factors on HRQoL, measured by the Euro Quality of Life-5D (EQ-5D). The prevalence of osteoporosis among older women was found to be 39.6%. Significant variations in quality of life were observed across demographic factors such as age, residence, marital status, household type, household income, education level, and economic activity. Similarly, health-related characteristics including depression, subjective health status, comorbidity, activity limitation, stress perception, alcohol consumption, body mass index, exercise, and aerobic activity showed statistically significant differences in the quality of life. Participants had an average quality of life score of 0.84 ± 0.005. Factors influencing quality of life included household type, household income, subjective health status, depression, activity limitation, stress levels, age, and body mass index. Quality of life was higher among those living alone, with higher household income, better subjective health status, lower levels of depression and activity restriction, reduced stress levels, younger age, and lower body mass index. The model's explanatory power was 34.1%. These findings underscore the necessity for comprehensive and individualized nursing intervention programs.

Longitudinal leisure-time physical activity profiles throughout adulthood and related characteristics: a 36-year follow-up study of the older Finnish Twin Cohort

BackgroundPersonalized interventions aiming to increase physical activity in individuals are effective. However, from a public health perspective, it would be important to stimulate physical activity in larger groups of people who share the vulnerability to be physically inactive throughout adulthood. To find these high-risk groups, we identified 36-year leisure-time physical activity profiles from young adulthood to late midlife in females and males. Moreover, we uncovered which anthropometric-, demographic-, lifestyle-, and health-related characteristics were associated with these physical activity profiles.MethodsWe included 2,778 females and 1,938 males from the population-based older Finnish Twin Cohort Study, who responded to health and behavior surveys at the mean ages of 24, 30, 40 and 60. Latent profile analysis was used to identify longitudinal leisure-time physical activity profiles.ResultsWe found five longitudinal leisure-time physical activity profiles for both females and males. Females’ profiles were: 1) Low increasing moderate (29%), 2) Moderate stable (23%), 3) Very low increasing low (20%), 4) Low stable (20%) and 5) High increasing high (9%). Males’ profiles were: 1) Low increasing moderate (29%), 2) Low stable very low (26%), 3) Moderate decreasing low (21%), 4) High fluctuating high (17%) and 5) Very low stable (8%). In both females and males, lower leisure-time physical activity profiles were associated with lower education, higher body mass index, smoking, poorer perceived health, higher sedentary time, high blood pressure, and a higher risk for type 2 diabetes. Furthermore, lower leisure-time physical activity was linked to a higher risk of depression in females.ConclusionsWe found several longitudinal leisure-time physical activity profiles with unique changes in both sexes. Fewer profiles in females than in males remained or became low physically active during the 36-year follow-up. We observed that lower education, higher body mass index, and more smoking already in young adulthood were associated with low leisure-time physical activity profiles. However, the fact that several longitudinal profiles demonstrated a change in their physical activity behavior over time implies the potential for public health interventions to improve leisure-time physical activity levels.

Examining sociodemographic and health-related characteristics as moderators of an mHealth intervention on physical activity outcomes in young adult cancer survivors.

This study explored whether sociodemographic and health-related characteristics moderated mHealth PA intervention effects on total and moderate-to-vigorous physical activity (MVPA) at 6 months, relative to a self-help condition among young adult cancer survivors (YACS). We conducted exploratory secondary analyses of data from a randomized controlled trial among 280 YACS. All participants received digital tools; intervention participants also received lessons, adaptive goals, tailored feedback, text messages, and Facebook prompts. Potential moderators were assessed in baseline questionnaires. PA was measured at baseline and 6 months with accelerometers. Linear model repeated measures analyses examined within- and between-group PA changes stratified by levels of potential moderator variables. Over 6 months, the intervention produced MVPA increases that were ≥ 30min/week compared with the self-help among participants who were males (28.1 vs. -7.7, p = .0243), identified with racial/ethnic minority groups (35.2 vs. -8.0, p = .0006), had baseline BMI of 25-30 (25.4 vs. -7.2, p = .0034), or stage III/IV cancer diagnosis (26.0 vs. -6.8, p = .0041). Intervention participants who were ages 26-35, college graduates, married/living with a partner, had a solid tumor, or no baseline comorbidities had modest MVPA increases over 6 months compared to the self-help (ps = .0163-.0492). Baseline characteristics did not moderate intervention effects on total PA. The mHealth intervention was more effective than a self-help group at improving MVPA among subgroups of YACS defined by characteristics (sex, race, BMI, cancer stage) that may be useful for tailoring PA interventions. These potential moderators can guide future optimization of PA interventions for YACS. NCT03569605.

Dispositional mindfulness: Is it related to knee osteoarthritis population's common health problems?

A growing body of research supports dispositional mindfulness as important in influencing physical and mental health as well as physical activities in patients with chronic illnesses. Knee osteoarthritis (OA), which often causes health problems, is one of the most common chronic illnesses, but less is known about dispositional mindfulness in relation to this condition. To explore possible associations between dispositional mindfulness and physical and mental health as well as physical activity in knee OA patients. For this cross-sectional study, we recruited a purposive sample of orthopedic clinic patients in hospitals in Southern Taiwan. Instruments included the Mindful Attention Awareness Scale (MAAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Health-related characteristics were also measured. Demographic statistics, bivariate correlations, and multiple linear regression informed our exploration of potentially related factors for dispositional mindfulness. Participants with knee OA (N = 250) were mostly elderly (88%), female (70.5%), and married (84%). Marital status, perceived health status, depression, and physical activity were associated with dispositional mindfulness. Better perceived health, lower depression, and greater physical activity were significantly associated with greater dispositional mindfulness. However, the severity of symptoms, fear of falling, and exercise self-efficacy did not reach statistical significance in relation to dispositional mindfulness. Greater emphasis should be placed on the cultivation of mindfulness to enhance individuals' perceived health, decrease their depressive mood, and promote their engagement in physical activity, which could indirectly alleviate their experience of pain and improve their physical function, yielding better quality of life and well-being. Future research should focus on interventions to apply dispositional mindfulness in order to determine whether dispositional mindfulness can effectively improve physical and mental health as well as physical activity in those with knee OA.

The influence of sociodemographic and health-related factors, clinical education status, and sleep quality on work-related quality of life among dental students.

With the premise that the demanding educational process and associated factors could influence the work-related quality of life (WRQoL) of dental students, this study aimed to investigate the influence of diverse sociodemographic and health-related factors, clinical education status, and sleep quality on the WRQoL of dental students. A three-part questionnaire was administered to a group of preclinical and clinical dental students studying in different classes. The first part of the questionnaire included various sociodemographic and health-related questions. In the second part, the multidimensional 23-item WRQoL scale, with established validity and reliability, was applied to evaluate the WRQoL of the students. The last part of the questionnaire included the Pittsburgh Sleep Quality Index, comprising 19 items. General linear models were created to predict subscale scores using sociodemographic and health-related characteristics, as well as univariate significant independent variables. It was observed that the majority of the participants (78.2%) had poor sleep quality. Being clinical dental students had a significant and positive effect on the stress at work domain of WRQoL (p = .006), while it had a significant and negative effect on the home-work interface domain (p < .001). The decrease in sleep quality had a significant and negative effect on all domains of WRQoL (p < .05) except for the stress at work domain. Clinical education status, regular smoking, and sleep quality significantly affect different domains of dental students' WRQoL. Changes in these factors should be considered in approaches to increasing students' WRQoL.

Sex differences in cognitive decline among middle-aged and older adults: a cohort study in Europe.

Previous studies on sex differences in cognitive decline provide inconsistent findings, with many European countries being underrepresented. We determined the association between sex and cognitive decline in a sample of Europeans and explored differences across birth cohorts and regions. Participants 50+ years old enrolled in the Survey of Health, Ageing and Retirement in Europe had their cognition measured by tests of immediate recall, delayed recall and verbal fluency biennially up to 17years of follow-up (median 6, interquartile range 3-9years). We used linear mixed-effects models to assess the relationship between sex and the rate of cognitive decline, adjusting for sociodemographic and health-related characteristics. Of 66,670 participants (mean baseline age 63.5 ± standard deviation 9.4), 55% were female. Males and females had similar rates of decline in the whole sample in immediate recall (beta for interaction sex × time B = 0.002, 95% CI -0.001 to 0.006), delayed recall (B = 0.000, 95% CI -0.004 to 0.004), and verbal fluency (B = 0.008, 95% CI -0.005 to 0.020). Females born before World War II had a faster rate of decline in immediate recall and delayed recall compared to males, while females born during or after World War II had a slower rate of decline in immediate recall. Females in Central and Eastern Europe had a slower rate of cognitive decline in delayed recall compared to males. Our study does not provide strong evidence of sex differences in cognitive decline among older Europeans. However, we identified heterogeneity across birth cohorts and regions.

Examining the Proteus Effect in the Context of Healthy Food Choices and Intentions to Eat Healthy: The Role of Avatar Body Size, Avatar Allocation Type, and Visual Perspective

Abstract As avatars gain prominence in health-promoting applications, understanding how health-related avatar appearance characteristics could affect users’ behavior is crucial. Drawing upon the Proteus effect, avatars can positively and negatively affect health behaviors, depending on whether the avatar appearance is aligned with stereotypes about healthy or unhealthy behavior. Investigating avatar appearances is essential to understand potential negative health effects. Three experiments in a non-immersive virtual supermarket examined whether controlling an overweight avatar negatively affected (1) intentions to eat healthy and (2) food choice healthiness in the virtual supermarket, thereby investigating avatar allocation type (Study 1) and visual perspective (Study 2) as moderators. 2 (Avatar body size: overweight vs. healthy weight) by 2 (Avatar allocation type: self-assigned vs. experimenter-assigned [Study 1]; Visual perspective: first-person vs. third-person [Studies 2 and 3]) between-subjects designs were employed. None of the studies demonstrated the Proteus effect and no moderating role of avatar allocation type was found (Study 1). Unexpectedly, controlling an overweight avatar resulted in stronger intentions to eat healthy from a third-person perspective only (Study 2), which led to the hypothesis that the overweight avatar functioned as a fear stimulus. To test this, a health message was added that highlighted obesity as a health risk (Study 3). The addition of this message did not affect intentions to eat healthy and food choice healthiness. The combination of fear appeal and self-perception theory as explanatory frameworks for behavioral responses to avatars opens avenues for new research, such as exploring specific conditions that trigger each effect.

The association between food neophobia, bi-dimensional aspects of orthorexia, and anxiety among vegetarians and omnivores

Vegetarianism is a growing trend, and food neophobia and orthorexia nervosa could act as barriers to achieving a healthy vegetarian diet. The aim of this study is to compare the levels of food neophobia, anxiety, and both healthy and pathological aspects of orthorexia among vegetarians and omnivores. Additionally, the study aims to identify the relationships between food neophobia, anxiety, and orthorexia. In this cross-sectional online survey, a total of 324 vegetarian and 455 omnivores adults participated. The questionnaire consisted of four sections: sociodemographic, lifestyle, and health-related characteristics, the Food Neophobia Scale (FNS), the Teruel Orthorexia Scale (TOS), and the Generalized Anxiety Disorders-7 Scale. Vegetarians exhibited lower FNS scores (p < 0.001) and had higher healthy orthorexic scores (p < 0.001) than omnivores. There were no differences between groups for anxiety scores (p > 0.05). Regression analysis indicated that higher food neophobia (OR: 0.953, 95% CI:0.937–0.968) and TOS-OrNe scores (OR: 0.946, 95% CI: 0.901–0.993) were associated with lower odds of following a vegetarian diet. Conversely, higher TOS-HeOr scores (OR: 1.135, 95% CI:1.096–1.176) were linked to an increased likelihood of adopting a vegetarian diet. Furthermore, both FNS and GAD-7 scores showed negative correlations with TOS-HeOR (r = −0.124, p < 0.001 and r = −0.129 p < 0.001, respectively), and positive correlations with TOS-OrNe (r = 0.106, p < 0.001 and r = 0.146, p < 0.001). In conclusion, vegetarians exhibit lower levels of food neophobia and a greater interest in healthy eating than omnivores. Additionally, the distinct correlation between two dimensions of orthorexia and food neophobia and anxiety provides support for the two-dimensional nature of orthorexia.

골관절염 여성노인의 건강관련 삶의 질 영향요인

This research investigates factors impacting the health-related quality of life in elderly women with osteoarthritis. The study surveyed 1,855 participants using National Health and Nutrition Examination Survey data from 2016 to 2020. Statistical analyses, conducted with SPSS/WIN 25, employed T-tests, analysis of variance (ANOVA), cross-analysis, and general linear analysis for descriptive statistics, along with Bonferroni post-hoc tests. Correlations between variables and the quality of life in elderly women with osteoarthritis were determined through correlation coefficients. Additionally, factors influencing the quality of life were analyzed using multiple regression analysis with general linear models. The study revealed significant differences in the quality of life based on demographic such as age, residence, marital status, education level, economic activity, depression, subjective health status, activity limitation, stress perception, smoking, body mass index, exercise, and aerobic activity. Similarly, there were statistically significant differences in the quality of life based on health-related characteristics, including age, residence, marital status, education level, economic activity, depression, subjective health status, activity limitation, stress perception, smoking, body mass index, exercise, and aerobic activity. The average quality of life score for participants was 0.82±0.18, with notable correlations found with age, subjective health status, and stress perception. Factors influencing health-related quality of life included having a spouse, higher household income, engagement in economic activity, lower age, and lower stress levels, as well as higher subjective health status. The model's explanatory power was 36.5%. Based on these findings, the study underscores the necessity for comprehensive and individualized nursing intervention programs.

Heterogeneity in the Prevalence of Cardiovascular Risk Factors by Ethnicity and Birthplace Among Asian Subgroups: Evidence From the 2010 to 2018 National Health Interview Survey.

Asian people in the United States have different sociodemographic and health-related characteristics that might affect cardiovascular disease (CVD) risk by ethnicity and birthplace. However, they are often studied as a monolithic group in health care research. This study aimed to examine heterogeneity in CVD risk factors on the basis of birthplace among the 3 largest Asian subgroups (Chinese, Asian Indian, and Filipino) compared with US-born non-Hispanic White (NHW) adults. A cross-sectional analysis was conducted using the 2010 to 2018 National Health Interview Survey data from 125 008 US-born and foreign-born Chinese, Asian Indian, Filipino, and US-born NHW adults. Generalized linear models with Poisson distribution were used to examine the prevalence and prevalence ratios of self-reported hypertension, diabetes, high cholesterol, physical inactivity, smoking, and overweight/obesity among Asian subgroups compared with US-born NHW adults. The study included 118 979 US-born NHW and 6029 Asian adults who self-identified as Chinese (29%), Asian Indian (33%), and Filipino (38%). Participants' mean (±SD) age was 49±0.1 years, and 53% were females. In an adjusted analysis, foreign-born Asian Indians had significantly higher prevalence of diabetes, physical inactivity, and overweight/obesity; foreign-born Chinese had higher prevalence of physical inactivity, and foreign-born Filipinos had higher prevalence of all 5 CVD risk factors except smoking compared with NHW adults. This study revealed significant heterogeneity in the prevalence of CVD risk factors among Asian subgroups by ethnicity and birthplace, stressing the necessity of disaggregating Asian subgroup data. Providers should consider this heterogeneity in CVD risk factors and establish tailored CVD prevention plans for Asian subgroups.

Population Norms for the EQ-5D-5L, PROPr and SF-6D in Hungary.

This study aimed to develop population norms for three preference-accompanied measures [EQ-5D-5L, Patient-Reported Outcomes Measurement Information System (PROMIS)-preference scoring system (PROPr) and Short-Form Six-Dimension (SF-6D)] in Hungary. In November 2020, an online cross-sectional survey was conducted among a representative sample of the Hungarian adult general population (n = 1631). Respondents completed the Hungarian versions of the EQ-5D-5L, PROMIS-29+2 version2.1 and 36-item Short Form Survey version 1 (SF-36v1). The association of utilities with sociodemographic and health-related characteristics of respondents was analysed using multivariate regressions. The proportion of respondents reporting problems ranged from 8 to 44% (self-care to pain/discomfort) on the EQ-5D-5L, 39-94% (physical function to sleep) on PROPr and 38-87% (role limitations to vitality) on the SF-6D. Problems related to physical function, self-care, usual activities/role limitations and pain increased with age, while mental health problems decreased in all three measures. In almost all corresponding domains, respondents indicated the fewest problems on the EQ-5D-5L and the most problems on the SF-6D. The mean EQ-5D-5L, PROPr and SF-6D utilities were 0.900, 0.535 and 0.755, respectively. Female gender (PROPr, SF-6D), a lower level of education (EQ-5D-5L, PROPr), being unemployed or a disability pensioner (EQ-5D-5L), being underweight or obese (SF-6D), lack of physical exercise (all) and polypharmacy (all) were associated with significantly lower utilities. PROPr yielded the lowest and EQ-5D-5L the highest mean utilities in 28 of 30 chronic health conditions. This study presents the first set of Hungarian population norms for the EQ-5D-5L, PROPr and SF-6D. Our findings can serve as reference values in clinical trials and observational studies and contribute to the monitoring of population health and the assessment of disease burden in Hungary.

Dose-response association of sleep duration with anxiety symptoms in Chinese type 2 diabetes mellitus

Objectives Anxiety is a disorder with a high prevalence in T2DM, and some studies have found that sleep problems can cause anxiety. Therefore, this study explored the independent effects of night sleep duration on anxiety symptoms in T2DM patients. Research Design and Methods A cross-sectional population-based study was conducted using self-reported questionnaires and taking into account several socio-demographic, lifestyle and health related characteristics. The 1,611 participants enrolled in our study. Anxiety was assessed by the Zung self-rating anxiety scale (SAS). A multivariate logistic regression model and restricted cubic spline with anxiety symptoms as the dependent variable were fitted. Results Of the T2DM patients in this study, 891 (55.31%) were male, 720 (44.69%) were female and 207 (12.85%) had anxiety symptoms. Controlling for potential confounders and intermediates, sleep duration &gt;8 h relative to intermediate sleep (7–8 h) was significantly associated with anxiety syndrome (OR: 1.46, 95% CI [1.06–2.02], p = 0.02) and a J-shaped association was found between sleep duration and anxiety. The prevalence of anxiety symptoms was higher in the male group (&gt;8 h/night) compared to the female. Study participants under the age of 50 who had a shorter sleep duration had a higher prevalence of anxiety compared to those between the ages of 50 and 60. Conclusion Among Chinese T2DM patients, there is a dose-response relationship between night sleep duration and anxiety, these findings may propose important public health implications for diabetes management.

Review of the Lifestyle Issues of the Khumi Community

The Khumi community is primarily patriarchal and is a notable ethnic group in Bangladesh, India, and Myanmar. They reside in the western part of Myanmar, specifically in the Arakan hill region. Their settlements are found in the hilly areas adjacent to the India-Bangladesh border. The data analysis reveals the comprehensive insights into the socio-demographic, health-related, education-related, income, and livelihood characteristics of the Khumi community in remote hilly regions of Bangladesh. Most of the participants are male, farmers, and Christian. Health issues, such as their eye problems and ankle pain, vary between the genders, with a notable reliance on local pharmacies for their healthcare services. Education-wise, illiteracy is prevalent, and economic and teacher-related obstacles hinder their education accessibility. Monthly and yearly income distributions highlight their economic disparities, with a significant proportion earning between the ranges of 3,001 to 5,500 Taka monthly. Livelihood-related characteristics showcase a heavily reliance on solar power, diverse agricultural practices, and predominantly nuclear family structures. The various challenges in livelihood, including economic, cultural, healthcare, education, communication, and linguistic issues, are addressed through the community-driven solutions. There are various notable efforts focus on water drainage, transportation system improvement, electricity infrastructure enhancement, primary school education, and agricultural training. Therefore, the study concludes that the Khumi community faces various economic vulnerability, educational disparities, and cultural erosion while the recommendations include community-centric development programs, education enhancement, healthcare access improvement, agricultural support, infrastructure development, preservation of culture, social welfare programs, government-community collaboration, research and data collection, and awareness and advocacy efforts. Implementing these numerous recommendations can contribute to the overall development of the Khumi community with addressing their various unique challenges and fostering the sustainable progress.

Who smokes in Australia? Cross-sectional analysis of Australian Bureau of Statistics survey data, 2017-19.

To assess the socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked in Australia. Cross-sectional analysis of Australian Bureau of Statistics (ABS) survey data. Adult participants (16 370 people aged 18 years or older) in the ABS 2017-18 National Health Survey (NHS); adult participants in the ABS 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (6423 people aged 18 years or older). Socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked, expressed as population-weighted proportions, overall and by Indigeneity. Among adult NHS respondents, an estimated 58.8% of people who smoked daily (95% confidence interval [CI], 56.2-61.4%) were men, 61.3% (95% CI, 58.7-63.9%) were 25-54 years old, 72.5% (95% CI, 70.0-74.8%) were born in Australia, and 65.4% (95% CI, 62.8-67.8%) lived in major cities and 54.3% (95% CI, 51.6-57.0%) in areas in the two socio-economically most disadvantaged quintiles; 75.9% (95% CI, 73.5-78.1%) reported good to excellent health, 73.0% (95% CI, 70.5-75.4%) reported low to moderate psychological distress, 69.0% of those aged 25-64 years (ie, of working age) had completed year 12 (high school), and 68.5% were currently employed. An estimated 2.57 million people smoke daily in Australia: 2.37 million non-Indigenous people (92%) and 195 700 Aboriginal or Torres Strait Islander people (8%). While smoking is more frequent among people living in socio-economically disadvantaged areas and in certain population sub-groups, this first quantitative national profile indicates that most people who smoke daily are in paid employment, are non-Indigenous, are in good physical and mental health, and have completed year 12. Improved comprehensive structural supply- and demand-based tobacco control, informed by the needs of priority groups and the overall profile of people who smoke, is needed to reduce daily smoking prevalence among adults to the 2030 targets of 5% or less for all Australians and 27% or less for Aboriginal and Torres Strait Islander people.

Examining a Healthy Lifestyle as a Moderator of the Relationship between Psychological Distress and Cognitive Decline among Older Adults in the NuAge Study

Introduction: The objective of this study was to examine whether a healthy lifestyle composite score of social engagement, physical activity, and Mediterranean diet adherence moderates the association between psychological distress and global cognitive decline among cognitively healthy older adults (67+ years of age at baseline). Methods: A total of 1,272 cognitively intact older adults (M_age = 74.1 ± 4.1 years, 51.9% female) in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) completed a series of self-reported questionnaires to measure psychological distress and lifestyle behaviors, and the Modified Mini-Mental Examination (3MS) to assess cognitive performance at baseline and annually over 3 years. Results: Controlling for sociodemographic and health-related characteristics, greater psychological distress was associated with steeper cognitive decline over time among males (B = −0.07, 95% CI: [−0.12, −0.02]), but not females (B = 0.008, 95% CI: [0.03, 0.04]). Although a healthy lifestyle composite score did not statistically significantly moderate the distress-cognition relationship (B = −0.005, 95% CI: [−0.02, 0.01]), there was an association between higher psychological distress and greater cognitive decline at low levels of social engagement (B = −0.05, 95% CI: [−0.09, −0.006]), but not at high levels of social engagement (B = 0.02, 95% CI: [−0.03, 0.07]). Conclusion: This study suggests that the potentially harmful impact of stress on cognitive function may be malleable through specific healthy lifestyle behaviors and emphasizes the importance of taking a sex-based approach to cognitive aging research.