Important Associated Factors Research Articles

A study of prevalence and comparison of anxiety and depression among separated, divorced and widowed females in the rural population

Abstract Background: Psychological distress is an important immediate outcome of the death of a spouse or divorce, which may arise because of financial and emotional challenges and can lead to adverse health outcomes with more stress, anxiety, depression, and social isolation than the general population. Methods: Cross-sectional study among separated, divorced, and widowed females from two rural villages. All eligible participants were screened for depression and anxiety using DSM 5 criteria. The severity of depression was assessed using the Hamilton depression rating scale (HDRS) and for anxiety, the Hamilton anxiety scale (HAM-A) was used. Results: Out of 162 women, 30% had mild depression whereas 42% of widow and divorced women had moderate levels of depression but it is in 50% of separated women. Severe and very severe level of depression was in around 20% of widowed and divorced women compared to 16% of separated women. There was no anxiety in around 80% of divorced and widowed women whereas 24.3% of separated women had severe anxiety. On regression analysis, separated women, dependent women, and those with less than two years of duration of separation had higher levels of depression and anxiety. Conclusion: The prevalence of Depression and Anxiety is more common in all three groups. Moderate to severe Depression is around 75% among divorced/separated and widowed females but moderate to severe anxiety was more in separated women compared to widowed women. Dependency and the early phase of widowhood/separation were also important associated factors.

Prevalence of diaper need and diaper dermatitis and associated risk factors among children aged 1–24 months in a referral hospital in Ghana: A cross-sectional study

Abstract Objectives This research aimed to determine the prevalence of diaper need and diaper dermatitis (DD) and associated risk factors in children aged 1–24 months. Methods Data were collected through face-to-face exit interviews with 456 mothers at a Child Welfare Clinic. A chi-square, correlation, and multivariate logistic regression analyses at a significance level of p < 0.05 were conducted. Results The prevalence of diaper need was found to be 53.5%, with lower odds observed in households with monthly incomes greater than $167 and in children on breastmilk only. Diaper need was higher in parents with no formal education and use of disposable diapers. The prevalence of DD was 27.4%, with lower odds observed in households with monthly incomes greater than $167 and in children less than 6 months old and on breastmilk only. There was a moderately positive correlation between diaper need and DD. Conclusion The researchers recommend affordable alternative diapering methods and educating parents on the importance of frequent diaper changes to improve the prevalence of diaper need and DD. Overall, this study highlights the significant prevalence of diaper need and DD among children and identifies the important associated risk factors.

Post COVID-19 mucormycosis- histopathology and associated factors

Introduction: SARS-COV-2 infection (COVID-19) may be associated with wide range of bacterial and fungal infections. Mucormycosis is a common and potentially life threatening opportunistic fungal infection responsible for morbidity and mortality. Many factors like diabetes mellitus, hypertension and corticosteroid therapy might have been a role in the immunocompromised state of the patients. The aim of present study was to know the predisposing factors and role of histopathology in diagnosis and assessing the prognosis of post COVID-19 mucormycosis cases. Material and methods: It is a prospective observational study conducted in tertiary care hospital over a period of 6 months from April 2021 to September 2021. Functional endoscopic sinus surgery (FESS) and maxillectomy samples from 157 post COVID-19 mucormycosis suspected cases were studied and details regarding history of diabetes mellitus, hypertension and corticosteroid therapy were retrieved. All tissue samples were examined under H&E stain and special fungal stain (PAS). Results: On histopathological examination, out of total 157 cases, 94 cases were found to be positive for mucormycosis. Of these 94 cases, 63 were males and 31 were females. Age range was from 23 to 75 years. 5 cases showed mixed mucormycosis and aspergillosis infection. Also out of 94 post COVID mucormycosis cases, 72 were diabetic, 21 were hypertensive and 68 had a history of corticosteroid intake for treatment of COVID-19 infection. Conclusion: Histopathology plays a pivotal role in accurate diagnosis and assessing the severity and invasiveness of mucormycosis. Diabetes mellitus and corticosteroid use are the important associated factors. Keywords: post COVID -19; mucormycosis; daibetes; steroid therapy

A Predictive Performance Analysis of Vitamin D Deficiency Using a Decision Tree model

Background. HBV infection is a major health problem which may be life-threatening. Vitamin D (VD) is involved in various pathophysiological mechanisms in a plethora of diseases. And also, there is a strong demand for the prediction of its severity using different methods. The study aims to evaluate performance of DT as one of the machine learning models in the prediction of severity in vitamin D deficiency. Methods. In total, data containing serum VD levels were collected from 292 CHB patients. The independent characteristics such as: age, sex, weight, height, zinc, BMI, body fat, sunlight exposure, and milk consumption were used for prediction of VD deficiency. 60% of them were allocated to a training dataset randomly. To evaluate the performance of decision-tree the remaining 40% were used as the testing dataset. The validation of the model was evaluated by ROC curve. Results. The prevalence of VD deficiency was high among patients (63.0%). The final experimentation results showed that DT classifier achieves better accuracy of 96 % and outperforms well on training and testing of VD dataset. Also, the areas under the ROC curve AUC is 0.78, when we applied DT algorithm with the significant variables by cross validation, the values of AUC = 0.78 and 85.3% accuracy were obtained. Conclusion. We concluded that the serum level of Zn is an important associated risk factor for identifying cases with vitamin D deficiency. Also, the risk of VD deficiency could be predicted with high accuracy using decision tree learning algorithm that could be used for antiviral therapy in CHB patients.

The relationship of psychological well-being and cognitive emotions with breastfeeding self-efficacy in mothers in the postpartum period.

To determine the relationship of psychological well-being and cognitive emotion regulation and breastfeeding self-efficacy in mothers in the postpartum period. The research was designed as cross-sectional and correlational and carried out between 1 November 2021 and 1 January 2022 in the pediatric outpatient clinic of a Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Responses from a total of 325 mothers who were in postpartum 1-6 months were analyzed. Data were collected using a Personal Information Form, the Scales of Psychological Well-Being (SPWB), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The following factors were found to be important associated risk factors that negatively affected breastfeeding self-efficacy in 29% of the mothers (F=14.536, p<.001): mothers' poor mental health, using self-blaming maladaptive cognitive coping strategy, inability to use positive reappraisal coping strategy, and feeding the baby only formula or both breast milk and formula. Weak and positive correlations were found between psychological well-being of mothers and adaptive cognitive coping subdimensions, and negative and weak correlations were found between psychological well-being of the mothers and maladaptive cognitive coping subdimensions (p<.001). Breastfeeding self-efficacy of mothers in a well psychological state, who can use adaptive cognitive coping strategies, and who exclusively breastfeed their babies is positively affected.

Implantation Mycoses and Invasive Fungal Infections with Cutaneous Involvement in Tropical Taiwan: An 11-Year Retrospective Study of a Medical Center

The rising incidence of implantation mycoses and invasive fungal infections prompts the need for studies describing the latest trends of these diseases; however, the literature remains scarce from tropical Asia in recent years. We shared our 11-year clinical experience at a tertiary center in Southern Taiwan to improve physicians' understanding of the diseases, which could help them assume appropriate management strategies. Forty cases of pathology-proven cases of implantation mycoses and invasive fungal infections with cutaneous involvement were retrospectively reviewed. The epidemiology, patients' characteristics, initial clinical impressions, fungal species, management, and outcomes were compared and reported. Fonsecaea sp. was the most commonly (14%) involved species in implantation mycoses. The percentages of immunocompromised patients with implantation mycoses and invasive fungal infections were 26% and 60%, respectively. Additionally, 46% of patients with implantation mycoses had type 2 diabetes mellitus. The lesions were commonly mistaken for skin appendage tumors, skin cancers, and hyperkeratotic dermatoses. The prognosis was favorable for the implantation mycoses (83% showed clinical improvement) but bleak for the invasive fungal infections (100% mortality). Presentations of implantation mycoses and invasive fungal infections vary widely, and immunocompromised status and diabetes mellitus are important associated factors.

The Prevalence and Impact of Low Back Pain Among Anaesthesia Care Providers in South-South, Nigeria.

Low back pain (LBP) is a common musculoskeletal disorder, that significantly impedes productivity. This study aims to ascertain the risk factors responsible for developing low back pain and the impact on personal workplace service delivery among Anesthetist's practicing in Rivers and Bayelsa States of Nigeria. A cross-sectional survey was conducted, A self-administered questionnaire reflecting the modified Oswestry Disability Index (ODI) was used to detect the risk factors and assess the severity and impact of low back pain on this group of professionals. The prevalence of low back pain was calculated and described by using frequency tables. A multivariate logistic regression model was fitted to identify factors associated with the prevalence of low back pain. Significance was considered at p<0.05 with a 95% confidence interval. A total of 65 anesthetist's responded, giving a response rate of 90%. There were more males (52.3%) than females (47.7%). The majority (69.2%) of those who responded had low back pain, more in females (53.3%) compared to males (46.7%) although not significant. (P=0.994); Majority had moderate pain 58.6%, 22.7% severe and 20.5% mild pain. There was no association between low back pain and age (P=0.130), gender(P=0.994), marital status (P=0.333) and BMI (P=0.164). Bending (P=0.032), lifting (P=0.024), and standing(P=0.016) were predictive variables for low back pain and were statistically significant P<0.05. Using the Oswestry pain assessment tool for LBP, the estimated prevalence of low back pain was more than fifty percent among the respondents. In this study, frequent bending and twisting, prolonged standing, and lifting were important significant associated factors in the development of LBP among anesthetist's.

Evaluating the Prevalence and Factors Associated With an Optimal Neurodevelopmental Outcome in 4- to 6-Year-Old Children With Fontan Circulation.

We sought to evaluate the prevalence and factors associated with "optimal" neurodevelopmental outcomes in 4- to 6-year-old children with Fontan circulation. Patients followed through the Western Canadian Complex Pediatric Therapies Follow-Up Program, and born between September 1996 and December 2015, were included. Optimal neurodevelopmental outcome was defined as full-scale intelligence quotient; visual-motor integration; adaptive behaviour assessment system-general adaptive composite scores of ≥ 80 each; and the absence of chronic motor disability, permanent hearing loss, visual impairment, and seizure disorder. Multivariable regression models and decision algorithms evaluated variables associated with optimal outcomes. The Fontan procedure was completed on 225 children, with neurodevelopmental outcome data available for 205 (mean [standard deviation]) age at Fontan 3.4 (0.9) years, 37% female). Optimal neurodevelopmental outcome was identified in 55% (112 of 205). Factors independently associated with optimal neurodevelopmental outcome were female sex (odds ratio [OR], 2.1; 95% confidence interval [CI] 1.1-4.1), years of maternal schooling (OR, 1.2 [1.1-1.4]), age at Fontan (years) (OR, 0.97 [0.94-1.0]), need for concomitant atrioventricular valve (AVV) intervention (OR, 0.4 [0.2-1.0]), and time (hours) for lactate to be ≤ 2 mmol/L (OR, 0.9 [0.8-1.0]). Of those with Fontan completion < 3.25 years, without concomitant AVV intervention and lactate normalization within 8 hours post-Fontan, 87% (27 of 31) had optimal neurodevelopmental outcomes. Optimal neurodevelopmental outcome was present in more than one-half of 4- to 6-year-old children with Fontan circulation in this cohort study, with important associated factors identified, including potentially modifiable factors such as younger age at Fontan surgery and lack of concomitant AVV intervention.

Seroprevalence and associated factors of infectious bursal disease (IBD) in indigenous chicken in eastern province in Rwanda

ABSTRACT The status of Infectious bursal disease (IBD) in indigenous chickens and backyard poultry in Rwanda has not been previously elucidated. This cross-sectional study was to determine the seroprevalence of infectious bursal disease in indigenous chickens and to identify the associated factors. The study was been done in three districts in the Eastern province of Rwanda where blood from 364 indigenous chickens were collected. ID Screen® IBD indirect enzyme-linked immunosorbent assay (ELISA) test was used to detect IBD antibodies in these birds. 145 questionnaires were also administered to poultry farmers to obtain information on biosecurity measures and associated factors to IBD outbreaks. The study revealed 48.4% (176/364) prevalence of the chicken with IBDV antibodies with statistical significance (P < .05) among/between location and age groups. The questionnaire revealed that there were other important associated factors which included chicken scavenging for seed as a source of food (59.3% of farmers reported), absence of routine vaccination (53.8%), live chickens are purchased from the open market with no information about IBD outbreaks and vaccination (30.0%), open disposal of dead chickens suspected of IBD (58.9%). IBD virus antibodies are present in indigenous chicken in Eastern Rwanda hence further investigation to better understand the epidemiology of IBD virus in indigenous chickens is desired and more research is needed to identify the role of indigenous chickens in the spread of IBD virus in Rwanda.

What is Associated with the Greatest Effect on Lengths of Stay after Total Knee Arthroplasty: The Hospital, the Surgeon, or the Patient

Introduction: Patient-, hospital-, and surgeon-related factors are each associated with the variable nature of length of stay (LOS) after total knee arthroplasty (TKA). However, there is a paucity of literature regarding these intertwined relationships. This study aimed to determine if the hospital, the surgeon, or the patient has the greatest association with LOS after TKA. Materials and Methods: A total of 11,402 patients were identified from a multicenter prospectively collected institutional database between January 01, 2017, and April 01, 2019. Surgeons and hospitals were subdivided into three groups: (1) low volume (&lt;10 and &lt;100 cases, respectively), (2) intermediate volume (10–150 and 100–400 cases, respectively), and (3) high volume (&gt;150 and &gt;400 cases, respectively). Patient demographics, comorbidities, hospital academic status, and LOS were identified. Univariate and multivariate analyses were performed to compare hospital-, surgeon-, and patient-related factors. Results: Neither hospital (P = 0.173) volume nor surgeon (P = 0.413) volume were significantly associated with LOS in multivariate analyses while controlling for patient-, surgeon-, and hospital-related factors. Patient medical factors including diabetes (P &lt; 0.001), congestive heart failure (P &lt; 0.001), peripheral vascular disease (P &lt; 0.001), chronic kidney disease (P &lt; 0.001), chronic obstructive pulmonary disease (P &lt; 0.001), and anemia (P &lt; 0.033), as well as academic teaching hospitals (P &lt; 0.001) were associated with a significant increase in hospital LOS. Conclusion: Patient’s chronic medical conditions and hospital status as an academic teaching hospital were found to be the most important associated risk factors on post-operative hospital LOS after TKA. This study directs the focus onto pre-operative optimization and patient selection and helps demonstrate where to best allocate resources to successfully decrease LOS. Keywords: Lengths of stay, Total knee arthroplasty, Pre-operative optimization, Complications, High volume surgeon.

Predisposing factors and incidence of pneumothorax in the neonatal care unit at Al-Ramadi Teaching Hospital for Maternity and Children

Background: Pneumothorax in neonates is a hazardous condition with a high incidence of complications and death. It is more frequent than at any other time of life and requires rapid management in the first three days of the neonatal period. Objectives: This study aims to identify the predisposing factors and incidence of pneumothorax in the neonatal care unit at Al-Ramadi Teaching Hospital for Maternity and Children. Materials and Methods: A retrospective cohort study was conducted in the neonatal care unit from 1st January to 31st December 2020. It included 6198 neonates admitted to the inborn and out-born neonatal care unit and collected from the archives files. Any newborn who developed pneumothorax was recorded as an outcome. Data regarding the age, gender, body mass index, antenatal care, antenatal steroids, gestational age, mode and place of delivery, and Apgar score for each case were registered. Results: In this study, pneumothorax was identified in 47 of the recruited newborns, giving an incidence of 0.8%. It occurred spontaneously in 25 (53.2%) of them. The proportion of pneumothorax was significantly higher among males, birth weight &lt; 2500 g, delivered with gestational age &lt; 32 weeks, 5 minutes Apgar Score &lt; 7, those who needed active resuscitation, neonates whose mothers delivered through Cesarean section, delivered at home, did not receive antenatal care during the last pregnancy and did not receive antenatal steroids. Conclusion: The incidence of pneumothorax in newborns was 0.8%. The most important associated factors that may increase the incidence of neonatal pneumothorax were male gender, low birth weight, prematurity, low Apgar score at birth, Cesarean section mode of delivery, home deliveries, and lack of antenatal steroid injections.

Childhood Wheeze, Allergic Rhinitis, and Eczema in Hong Kong ISAAC Study from 1995 to 2015.

The prevalence of allergic diseases has been increasing in developing areas but has reached a plateau in many developed areas. Regular surveys are imperative to assess the disease burden for the prioritization of resource allocation. We examined the change in the prevalence of wheezing, allergic rhinitis (AR), and eczema in school-aged children with possible associative factors and possible health effects of school air quality. This was the third repeated cross-sectional study conducted in 2015-2016 using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. Our first and second surveys were conducted in 1994-1995 and 2000-2001, respectively. Regarding the third survey, we recruited 3698 children aged 6-7 from 33 local schools in 18 districts. Air quality, temperature, and humidity were also measured. The changes in prevalence, multiple regression, and GLIMMIX procedure were analyzed. From our first survey to our third survey, the increased prevalences for lifetime wheeze, current wheeze, lifetime rhinitis, current rhinitis, current rhinoconjunctivitis, lifetime chronic rash, and current chronic rash were 4.2%, 2.1%, 12.5%, 12.6%, 14.2%, 3.9%, and 4.1%, respectively. Increased prevalence of parental atopy had the strongest association with an increased prevalence of each of these seven health outcomes. There was no significant association between school air pollutant levels and the prevalence of health outcomes. There was an increase in the prevalence of wheezing, allergic rhinitis, and eczema across the surveys. The most important associated risk factor identified was the increased prevalence of a parental history of atopy.

Factors related to self-rated health of older adults in rural China: A study based on decision tree and logistic regression model.

This study aimed to explore the related factors of self-rated health (SRH) by using decision tree and logistic regression models among older adults in rural China. Convenience sampling was employed with 1,223 enrolled respondents who met the inclusion criteria from 10 randomly selected villages in M County in China. The content of the questionnaire covered demographic characteristics, physical and mental health, sleep status, and risk of falling. The Pittsburgh Sleep Quality Index (PSQI) and the Morse Falls Risk Scale (MFS) were used to evaluate sleep status and risk of falling, respectively. The decision tree and logistic regression models were employed to analyze the related factors of SRH. Notably, 817 (68.7%) subjects had good SRH. The logistic regression model showed that living standard, alcohol consumption, sleep quality, labor, hospitalization, discomfort, the number of chronic diseases, and mental health were associated with SRH (P-value < 0.05), while the decision tree model showed that the number of chronic diseases, sleep quality, mental health, hospitalization, gender, and drinking were associated with SRH. The sensitivity and specificity of the logistic regression model were 67.7 and 75.5%, respectively, and the area under the ROC curve was 0.789 (0.763, 0.816); the sensitivity and specificity of the decision tree model were 71.5, and 61.4% respectively, and the area under the ROC curve was 0.733 (0.703, 0.763). Decision tree and logistic regression models complement each other and can describe the factors related to the SRH of the elderly in rural China from different aspects. Our findings indicated that mental health, hospitalization, drinking, and sleep quality were the important associated factors.

Associations between PM2.5 exposure and Alzheimer’s Disease prevalence Among elderly in eastern China

BackgroundStudies showed that PM2.5 might be associated with various neurogenic diseases such as Alzheimer’s Disease (AD). However, this topic had been little studied in Zhejiang province of China. MethodsIn 2018, we established a cohort of AD high-risk population with 1,742 elderly aged 60 and above. In 2020, the cohort was followed up, a total of 1,545 people participated the 2 surveys. Data collection included questionnaires and basic physical examinations. The average residential exposure to PM2.5 for each participant, that in a 5-years period prior to the first survey, was estimated using a satellite-based spatial statistical model. We determined the association between PM2.5 and AD prevalence by cox proportional hazards regression model. ResultsThis study showed that an increase in the PM2.5 level was an important associated risk factor that contributed to AD. The average PM2.5 exposure levels among the study population ranged from 32.69 μg/m3 to 39.67 μg/m3 from 2013 to 2017, which were much higher than 5 μg/m3 that specified in the WHO air quality guidelines. There was an association between PM2.5 exposure and AD, and the correlations between PM2.5 and Mini-Mental State Examination, Montreal cognitive assessment scale scores were statistically significant. An increase in the PM2.5 level by 10 μg/m3 elevated the risk of AD among residents by 2%-5% (HR model 2-model 4 = 1.02 to 1.05, CI model 2-model 4 = 1.01–1.10). The subgroups of male, with old age, with low education levels, used to work as farmers or blue-collar workers before retirement, overweight and obese were associated with a higher effect of PM2.5.ConclusionsReducing PM2.5 exposure might be a good way to prevent AD.

Stress, anxiety, intolerance of uncertainty, and psychological well-being characteristics of pregnant women with and without threatened miscarriage: a case-control study

The aim of this study was to examine the stress, anxiety, intolerance of uncertainty, and psychological well-being of pregnant women with and without threatened miscarriage. This is a case-control study. The research was carried out between January 2022 and March 2022 in the early pregnancy service and obstetrics clinic of the only training and research hospital in a province in the Central Anatolian Region of Turkey. Two hundred and one pregnant women with threatened miscarriage constituted the study group and 201 pregnant women without threatened miscarriage constituted the control group. A total of 402 pregnant women were included in the study. Stress, anxiety, and intolerance of uncertainty were found to be important risk factors affecting the psychological well-being of pregnant women with threatened miscarriage at a rate of 52% (F = 63,196, p < 0.001). In addition, the pregnant women with threatened miscarriage had higher levels of stress, anxiety, and intolerance of uncertainty, and their psychological well-being was considerably lower compared to pregnant women without threatened miscarriage (p < 0.05). There was a moderate and negative relationship between psychological well-being and intolerance of uncertainty (p < 0.05). It was determined that stress, anxiety, and uncertainty of pregnant women with threatened miscarriage were considerably higher compared to controls, and their psychological well-being was adversely affected. Health professionals should evaluate the levels of anxiety, stress, intolerance of uncertainty, and psychological well-being of pregnant women, especially in the routine follow-up of pregnant women with threatened miscarriage, and they should provide holistic care, not only physiologically but also bio-psychosocially. IMPACT STATEMENT What is already known on this subject? Although there are many studies on the emotional and psychological effects of miscarriage, there are limited studies on the effect of threatened miscarriage on the mental health of pregnant women. What do the results of this study add? Stress, anxiety, and intolerance to uncertainty were found to be important associated risk factors that negatively affect the psychological well-being of pregnant women with threatened miscarriage. It was determined that the pregnant women with threatened miscarriage had higher levels of stress, anxiety, intolerance to uncertainty, and their psychological well-being was much lower than the pregnant women without threatened miscarriage. It was determined that there was a moderate and negative relationship between the mean psychological well-being of pregnant women and the mean scores of intolerance to uncertainty. What are the implications of these findings for clinical practice and/or further research? This is the first case-control study to examine the determination of stress, anxiety, intolerance to uncertainty and psychological well-being of pregnant women with and without threatened miscarriage. Health professionals should evaluate the anxiety, stress, intolerance of uncertainty levels and psychological well-being of pregnant women, especially in the routine follow-up of risky pregnant women, and should provide holistic care not only physiologically but also bio-psychosocially to these pregnant women with a holistic approach.

Bone Loss in Patients with Pancreatic Neuroendocrine Tumors.

Pancreatic diseases may affect nutritional status, which is one of the important associated factors of bone health. High prevalence of osteoporosis or osteopenia has been reported in patients with pancreatitis. The bone loss in pancreatic neuroendocrine tumors (PNETs) has not been reported. In this study, we showed the prevalence of bone loss and possible associated factors in PNET patients. A total of 91 PNET patients were included. Bone status was evaluated based on computed tomography (CT) attenuation (Housfield units, HU): &gt;160 HU, normal bone mineral density; osteopenia, 135 HU ≤ CT value ≤ 160 HU; osteoporosis, &lt;135 HU. Associated factors for bone loss were identified by logistic regression analyses. The average age was 55.76 years old in PNET patients. The prevalence of osteoporosis and low bone mass was 37.4% and 60.4%, respectively. Higher prevalence of osteoporosis was observed in patients older than 50 years (64.0%). Multivariate logistic analysis showed that age was an associated factor for low bone mass (odds ratio (OR) = 1.13, 95% confidence interval (CI): 1.04-1.22) and osteoporosis (OR = 1.14, 95% CI: 1.03-1.20). Diabetes was also associated with bone loss in PNET patients after adjusting with confounders (OR = 13.56, 95% CI: 1.02-132.4). Our data show that bone loss is common in patients with PNETs. Age and diabetes are associated with bone loss in PNET patients.

Current Status and Associated Factors of Health Information Literacy Among the Community Elderly in Central China in the COVID-19 Pandemic: A Cross-Sectional Study.

COVID-19 posed a threat to the public's physical and mental health, and under outbreak control, the opportunities to go outside of the elderly have been reduced and making it more difficult to access health information and detrimental to their health management. This study aims to assess the current status of health information literacy (HIL) among older adults in the community in the context of COVID-19 and to identify its associated factors. A cross-sectional survey was conducted from April to July, 2021, for which 617 community elderly members were recruited in Chenzhou, China. Data were collected through a general information questionnaire, The Chinese residents' HIL self-rated scale and a reliability evaluation form. The average score of HIL was 75.87 ± 9.85, and after processed by the 100-point system, we found 84.12% (519/617) of the participants scored less than 60 points, which indicates that the overall level of HIL among the community elderly is low. Multiple linear regression showed that age, gender, education, annual family Income, living arrangement, and chronic disease status (β = -0.341, -0.296, 0.384, 0.327, 0.296, 0.356, respectively; all P < 0.001) were significantly associated with the level of HIL found among the community elderly, out of which education was the most important associated factor. The overall HIL level among the community elderly was low in Central China during the COVID-19 pandemic. Our results further prove the need for tailor-made health education programs for this group, with particular attention paid to the low-educated and low-income among them. Those measures must highlight on three aspects of health information search, evaluation, and application skills to offer useful experiences that improve the HIL level of the elderly and strengthen their ability to cope with emerging public health events.

HYPERTENSION AND ITS NUTRITIONAL ASSOCIATED FACTORS IN ADULTS IN TWO COASTAL COMMUNES, NGHE AN PROVINCE, 2020

Aims: To identify the hypertension status and its nutritional associated factors in adults in two coastal communes of Nghe An province. Methods: A cross-sectional study was conducted on 1170 adults aged 40-69 years in Nghi Thinh and Nghi Thai communes, Nghi Loc district, Nghe An province. General information, blood pressure, anthropometry, salt intake behavior, alcohol consumption frequency, and disease history were collected. The hypertensive prevalence was adjusted for age-sex structure of population. Multilogistic regression analysis was applied to test several models for the association of hypertension to socio–economic conditions, body mass index and waist circumference, high salt intake behavior, and frequency of alcohol consumption. Results: The age- and sex-adjusted prevalence (95%CI) of hypertension status was 46.3 (42.6-50.0), 11.3 (9.12-14.0), 18.1 (15.1-21.5), 7.97 (6.11-10.3), 16.3 % (13.7-19.3), respectively, in normal, hight-normal, grade 1 hypertension, grade 2 hypertension, and previous diagnosed with current use of antihypertensive drugs. There were still 61.5% of hypertensive subjects without knowing the condition. The independent associated factors of hypertension were age, sex, obese status, vegetable and fruit intake/day (&lt;5 units/day), high salt intake behavior, alcohol consumption (&gt; 1 time/week), previously diagnosed dyslipidemia and family members with hypertension. Conclusions: The study indicates the high hypertension prevalence in the coastal communes. The most important associated factors for hypertension should be given a great attention in controlling hypertension in the population.

Spatial distribution and determinant factors of unmet need for family planning among all reproductive-age women in Ethiopia: a multi-level logistic regression modelling approach

BackgroundUnmet need for family planning has been remaining high in developing countries than developed countries, notably in sub-Saharan Africa. Data on unmet needs can help countries set service priorities. This study aimed to explore the geographical disparities of unmet need among reproductive-age women in Ethiopia using a 2016 national population-based survey.MethodsThis study was based on the nationally representative 2016 Ethiopian Demographic and Health Survey data. We used a total weighted sample of 15,683 reproductive-aged women. A multi-level logistic regression analysis was used to account for the Demographic Health Survey data’s hierarchal nature. In the multivariable multi-level analysis, those variables with a p-value < 0.05 were significantly associated with unmet needs. Spatial autocorrelation techniques were used to explore the clustering tendencies of unmet needss using Getis-Ord Gi* statistics.ResultsOverall, 15.2% (95% Confidence Interval (CI): 14.63, 15.76) of women of the reproductive age group in Ethiopia had an unmet need for family planning in 2016. In multivariable multilevel logistic regression analysis; individual-level variables such as being married (Adjusted odds ratio (AOR) = 25.7,95% CI: 11.50,60.42), lowest wealth status (AOR = 1.43,95% CI:1.14,1.79), having five or more children (AOR = 1.98, 95% CI:1.62,2.41), being a follower of Muslim religion (AOR = 1.35,95% CI:1.03,1.76) and protestant religion (AOR = 0.73,95% CI: 0.53,0.99) than orthodox Christian followers were statistically associated factors with unmet need. Among community-level variables; being in rural residency (AOR = 1.37, 95% CI: 1.01, 1.93), belong to the Oromia region (AOR = 1.53, 95%CI: 1.10, 2.11) and Somali region (AOR = 0.37, 95% CI: 0.22, 0.61) were significantly associated unmet need. The spatial analysis of unmet need among all women revealed that Oromia, Southern Nations, and Nationality of People and Gambela regions had high hotspots than other parts of the country.ConclusionsIn this study, the prevalence of unmet needs was high. Significant regional unmet need variation was indicated among reproductive-age women in Ethiopia, specifically in western parts of the country. Wealth status, number of children, marital status, residence, and religion were the most important associated factors with unmet needs. Addressing unmet needs targeted rural residents with low socioeconomic status, and western regions should be given top priority.

Spatiotemporal urban water profiling for the assessment of environmental and public exposure to antimicrobials (antibiotics, antifungals, and antivirals) in the Eerste River Catchment, South Africa.

Antimicrobial agent (AA) usage, excretion, and persistence are all important factors in association with the occurrence and dissemination of antimicrobial resistance. Urban water profiling was utilised in the Eerste River catchment (South Africa) to establish AA usage in a region where comprehensive prescription records were not readily available and where portions of the community did not have sufficient access to sanitation. This technique enabled the environmental exposure to be quantified throughout the catchment area and the identification of contamination hotspots. Monitoring occurred over a 11-month period. 812 samples were processed using UPLC-MS/MS for the quantitation of 56 antimicrobials and 26 of their metabolites. Spatiotemporal trends were established, with consideration to community behaviour, seasonal changes, and physiochemical properties of the analytes. The Eerste River samples collected upstream from the town of Stellenbosch had the lowest AA loads (<4 g/day), unafflicted by industrial presence and with only small impact from farming activities. This was followed by sites downstream from a wastewater treatment plant (serving 178K people). The measurement of low AA loads (influent: 500-800g/day and effluent 50-100g/day), indicates a high efficiency of wastewater treatment, allowing for an effective reduction of AA and a lower environmental burden. This is compared to river sites that receive untreated waste from communities in informal settlements (6-12K people) that are not connected to the sewer infrastructure (with AA levels accounting for 100-600g/day). Temporal trends exhibited reduced daily loads during the summer to early autumn (Nov-May). This is likely due to seasonal patterns in community health and/or notable changes in rainfall and temperatures at the sampling locations throughout the year. However, weather patterns are also important to consider - particularly for the river sites. South Africa has notable rainfall and temperature seasonality. Antiretrovirals (ARV), emtricitabine and lamivudine, were the most prevalent drugs throughout the monitoring campaign, followed by tuberculosis drugs and sulfonamides. ARVs were, however, effectively reduced via wastewater treatment processes (>97%). This was also the case for beta-lactams, nitrofurantoin, and trimethoprim. The treatment efficacy for other drugs was more variable, that did not appear to have temporal significance.