Individual Sociodemographic Factors Research Articles

Determinants of physical function, as measured using PROMIS PF-10a, in patients with rheumatoid arthritis: results from the international COVID-19 Vaccination in Autoimmune Diseases (COVAD) study

Abstract Objectives Physical function in RA is largely influenced by multiple clinical factors; however, there is a growing body of evidence that psychological state and other comorbidities also play an essential role. Using data obtained in the COVAD study, an international self-reported e-survey, we aimed to a) explore the predictive ability of sociodemographic and clinical variables on PROMIS physical function short form-10a (PROMIS PF-10a) in RA and b) to investigate variation in disease activity and functional outcomes based on country-level socio-economic parameters. Methods Patient demographics, disease characteristics including current symptom status, functional status and treatment variables as well as income level of the country of residence, were extracted from survey responses. PROMIS PF-10a scores were compared across country income levels. The influence of extracted variables on reversed PROMIS PF-10a scores were investigated using negative binomial univariable- and multi-variable regression. Results A total of 1,342 RA patients were included in this analysis. In the optimised parsimonious predictive model for reversed PROMIS PF-10a, older age, female gender, disease duration, fatigue and pain levels were independently associated with worse physical function, whereas Asian ethnicity, higher overall physical health ratings, ability to carry out everyday activities, and residing in a country with an upper-middle or high-income level were independently associated with better physical function. Conclusion Our study highlights that clinical factors remain strong predictors of physical function in RA, irrespective of individual and country-level socioeconomic differences. Interestingly, high country-level income was associated with better physical function, irrespective of individual sociodemographic and clinical factors.

Unveiling socioeconomic disparities in maternal smoking during pregnancy: a comprehensive analysis of rural and Appalachian areas in Virginia utilizing the multi-dimensional YOST index

BackgroundMaternal smoking during pregnancy carries significant health risks for both mothers and infants, especially in vulnerable regions like rural and Appalachian areas with high smoking rates. Understanding the causes of high smoking rates in vulnerable areas is crucial for designing effective interventions to promote smoking cessation and reduce preventable health disparities.MethodsData from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS; years 2009–2020) comprised of 7,861 women aged over 18 were used in this cross-sectional observational study. Pregnant individuals were categorized as smoking if they reported smoking during the last trimester. A multi-level logistic regression was employed to examine the association of individual sociodemographic factors, rurality, Appalachian status, and county socioeconomic status (SES) proxied by Yost Index quintiles with smoking behaviors during pregnancy. The county of residence was considered as a random factor in the analysis. Trend analysis were also conducted.ResultsOut of the overall sample, 92.8% (n = 7,292) were non-smokers, while 7.2% (n = 569) were smokers. The multi-level logistic regression analysis showed pregnant individuals aged 18–24 had 1.06 times higher odds of smoking compared to those over 35 (95% CI [1.02–1.10]). Those with a college education or higher had significantly reduced odds (OR: 0.10, 95% CI [0.10, 0.10]), as did racially minoritized individuals (OR: 0.59, 95% CI [0.51–0.68]) and Hispanic individuals (OR: 0.14, 95% CI [0.09–0.21]). Living in rural areas was associated with a 26% higher likelihood of smoking during pregnancy compared to urban areas (OR: 1.26, 95% CI [1.21–1.31]), while residing in Appalachian regions led to a 25% higher probability of smoking. Additionally, lower SES quintiles were linked to higher odds of smoking, with the lowest quintile at OR: 2.10 (95% CI [1.67–2.65]) and the second quintile at OR: 1.64 (95% CI [1.53–1.76]) as compared with the most affluent quintile. Trend analsysis shows smoking has declined across all quintiles, but a substantial gap persists between lowest and highest SES regions.ConclusionsSmoking rates during pregnancy have dropped overall but remain alarmingly high in specific rural and Appalachian areas. As smoking during pregnancy poses significant health risks, targeted interventions and resources for tobacco cessation programs are needed in these highly vulnerable regions.Trial registrationNot Applicable.

Association of neighborhood-level disadvantage beyond individual sociodemographic factors in patients with or at risk of knee osteoarthritis

ObjectiveLower socioeconomic status (SES) is a risk factor for poorer pain-related outcomes. Further, the neighborhood environments of disadvantaged communities can create a milieu of increased stress and deprivation that adversely affects pain-related and other health outcomes. Socioenvironmental variables such as the Area Deprivation Index, which ranks neighborhoods based on socioeconomic factors could be used to capture environmental aspects associated with poor pain outcomes. However, it is unclear whether the ADI could be used as a risk assessment tool in addition to individual-level SES.MethodsThe current study investigated whether neighborhood-level disadvantage impacts knee pain-related outcomes above sociodemographic measures. Participants were 188 community-dwelling adults who self-identified as non-Hispanic Black or non-Hispanic White and reported knee pain. Area Deprivation Index (ADI; measure of neighborhood-level disadvantage) state deciles were derived for each participant. Participants reported educational attainment and annual household income as measures of SES, and completed several measures of pain and function: Short-form McGill Pain Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, and Graded Chronic Pain Scale were completed, and movement-evoked pain was assessed following the Short Physical Performance Battery. Hierarchical linear regression analyses were used to assess whether environmental and sociodemographic measures (i.e., ADI 80/20 [80% least disadvantaged and 20% most disadvantaged]; education/income, race) were associated with pain-related clinical outcomes.ResultsLiving in the most deprived neighborhood was associated with poorer clinical knee pain-related outcomes compared to living in less deprived neighborhoods (ps < 0.05). Study site, age, BMI, education, and income explained 11.3–28.5% of the variance across all of the individual pain-related outcomes. However, the ADI accounted for 2.5–4.2% additional variance across multiple pain-related outcomes.ConclusionThe ADI accounted for a significant amount of variance in pain-related outcomes beyond the control variables including education and income. Further, the effect of ADI was similar to or higher than the effect of age and BMI. While the effect of neighborhood environment was modest, a neighborhood-level socioenvironmental variable like ADI might be used by clinicians and researchers to improve the characterization of patients’ risk profile for chronic pain outcomes.

Discrimination against migrants: does social capital moderate harmful effects on mental health?

Abstract The harmful mental health effects of perceived discrimination are well established. Yet, the role of regional-level social capital in mitigating these effects remains underexplored. Using data from the German Socioeconomic Panel (SOEP; 2010-2021) we apply random effects models to assess the effect of perceived discrimination on mental health (mcs subscale of the SF-12) adjusting for individual socio-demographic factors and regional-level socioeconomic deprivation. We assess interaction with general social capital (civic organisations, electoral turnout, generalised trust) and migrant-specific resources (proportion of non-nationals and share of far-right votes). We juxtapose non-refugee migrants (n = 13478) with refugees subject to mobility restrictions (n = 5558) to assess for bias introduced by selective mobility into regions. In the non-refugee sample, we confirm negative effects of frequent discrimination experiences on mcs (ß: -3.74; 95%CI: -4.39, -3.08). Moderation analyses show insignificant results for general social capital, but a negative interaction effect of proportion of non-nationals (ß: -0.71; 95%CI: -1.34, -0.08). Analyses among refugees confirm the negative effect of discrimination on mcs (ß: -6.29; 95%CI: -7.49, -5.08) and the moderating effect of the proportion of non-nationals (ß: -1.63; 95%CI: -2.78, -0.48), as well as showing a positive moderation effect for generalised trust (ß: 0.84; 95%CI: 0.11-1.57). Results demonstrate the negative implications of living in areas with a high proportion of non-nationals for migrants experiencing discrimination, which may be explained by the higher marginalisation of migrants in these areas and increased service access barriers. The absence of a moderation effect of general social capital appears to be the result of selection bias, with positive effects of generalised trust seen for refugee migrants. Key messages • Ethnic discrimination affects mental health of refugee and non-refugee migrants. • The effect of discrimination on mental health are stronger in areas with higher proportion of non-nationals.

Examining Care Network Characteristics in Older Adults' Relocation to Residential Care Settings.

When older adults face increasing care needs or limited support, remaining safely and comfortably at home becomes challenging. Extant research has primarily concentrated on characteristics of the older adult or their primary caregiver on nursing home admission. This study examines the risk of older adults transitioning to residential care (e.g., assisted living, nursing home), focusing on the influence of their care network or involvement of multiple helpers. Using the National Health and Aging Trends Study, we conducted competing risk regression models that account for mortality, following 7,085 initially community-dwelling older adults across Rounds 1-9 (2011-2019). We assessed network composition, size, shared tasks, and the number of in-network specialists or generalists while controlling for individual sociodemographic and health factors. Individuals with care networks that shared medical tasks had the highest risk of moving to a residential care setting, followed by those sharing household tasks. Conversely, shared mobility or self-care and transportation responsibilities were associated with lower risks. Having more generalists, but not specialists, increased the risk. Larger networks were associated with heightened risk, although having close family members like a spouse was protective. The findings underscore that care network characteristics are critical to older adults' ability to age in place. Specifically, older adults with larger networks, lacking a spouse or child, and providing complex care are at greater risk for relocating. Understanding care networks can guide interventions related to care network coordination and resource allocation to help avoid or postpone a residential care move.

Abstract A025: Trends in liver cancer mortality by sex, race, and ethnicity in California from 2000-2019

Abstract Background: Liver cancer disproportionately affects foreign-born individuals and racial and ethnic minoritized groups, with higher incidence among Asian American/Pacific Islander (AAPI) and Hispanic populations than non-Hispanic (NH) White populations. California has one of the highest overall mortality rates from liver cancer and a large proportion of AAPI and Hispanic residents compared to other U.S states. While prior studies have examined racial and ethnic disparities in liver cancer incidence and treatment, few studies have examined trends in liver cancer mortality in California by sex, race, and ethnicity. Methods: Adults aged 20+ years diagnosed with first primary malignant liver and intrahepatic bile duct cancer from January 2000 through December 2019 were identified through the California Cancer Registry, a statewide population-based cancer registry. We used SEER*Stat software to compute age-adjusted mortality rates (per 100,000 population; standardized to the 2000 U.S. standard million population) by sex, race, and ethnicity. To analyze temporal trends of mortality rates, we calculated annual percent change (APC) using Joinpoint regression. Results: Overall, the mortality rate of liver cancer increased from 8.05 to 10.75 per 100,000 (average APC=1.53, 95% CI 1.23, 1.82) from 2000-2019. For males, rates increased from 11.39 in 2000 to 15.77 until 2013 (APC=2.53, 95% CI 2.07, 3.21), and stabilizing thereafter (APC=-0.74, 95% CI -2.37, 0.30). In contrast, for females, mortality rates increased continuously from 2000-2019 from 5.27 to 7.17 (APC=1.63, 95% CI 1.27, 2.04). Across racial and ethnic groups, the mortality rate for liver cancer was highest for the AAPI adults at 16.77 in 2000, and this decreased over time to 12.29 in 2019 (APC=-3.17, 95% CI -5.36, -2.24). Similarly, the liver cancer mortality rate among Hispanic adults increased initially and then decreased. Mortality among non-Hispanic Black adults increased from 10.98 in 2000 to 12.99 in 2019 (APC=0.89, 95% CI -0.07, 2.02), though this did not reach statistical significance. The liver cancer mortality rate was lowest among non-Hispanic White adults from 5.65 in 2000 but increased over time to 7.87 in 2019 (APC=1.76, 95% CI 1.39, 2.08), which is still the lowest compared to other racial and ethnic groups. Discussion: In contrast to studies that show a decline in liver cancer mortality in recent years, liver cancer mortality rates have continued to increase in California, particularly for females. Liver cancer mortality rates initially increased for AAPI and Hispanic populations but have started to stabilize. Next steps are to understand multilevel drivers contributing to these trends in liver cancer mortality in California, including individual sociodemographic and clinical factors, healthcare system factors, and neighborhood factors, including neighborhood socioeconomic status and ethnic enclaves. Citation Format: Janet N. Chu, Meera Sangaramoorthy, Meg Mckinley, Stephen Li, Mindy C. DeRouen, Alice Guan, Michele M. Tana, Ma Somsouk, Caroline A. Thompson, Chanda Ho, Hashem B. El-Serag, Iona Cheng, Scarlett L. Gomez, Salma Shariff-Marco. Trends in liver cancer mortality by sex, race, and ethnicity in California from 2000-2019 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A025.

Clinical and social characteristics of patients with pulmonary tuberculosis and anxiety-depressive disorders

The purpose of the study was to investigate the complex interrelationships of clinical, psychopathological, and socio-psychological characteristics in patients with pulmonary tuberculosis (TB) and anxiety-depressive disorders (ADD). The study involved 145 patients: 85 patients were diagnosed with pulmonary tuberculosis (the study group) and 60 patients – with anxiety-depressive disorders without tuberculosis (the comparison group). The study assessed the level of anxiety and depressive disorders, asthenia, the nature and intensity of somatic complaints, and signs of vegetative changes; the Personal and Social Performance Scale (PSP) and the WHOQOL-BREF questionnaire were used. A cluster analysis of clinical and social factors in patients with tuberculosis and ADD showed that they had an "infiltration" of individual psychological, socio-demographic, and clinical factors that demonstrated close affinity with each other. Notably, subjective indicators of social and physical well-being were mostly related to the clinical manifestations of ADD, while objective socio-demographic indicators showed greater affinity with the clinical manifestations of the tuberculosis process. In the comparison group, a more significant autonomy of the studied individually and socially oriented parameters, as well as clinical factors, was revealed compared with the study group. A cluster analysis of the entire patient sample (145 patients) allowed obtaining results that complement and largely confirm the results of the analysis of the two samples (the study and the comparison groups). Almost all TB patients are concentrated in clusters characterized by the most severe clinical manifestations and impaired social functioning. TB patients were characterized by the most severe manifestations of ADD with severe asthenia, a high level of somatic complaints on the exhaustion scale, and pronounced signs of vegetative changes. Despite the good formal indicators of social adaptation (family, household), they are characterized by an extremely low level of socially oriented and social functioning and indicators of quality of life. The assessment of the parameters of quality of life and social functioning, their correlations with clinical characteristics, and the establishment of a hierarchy of their relationships should be taken into account when conducting a complex of therapeutic and rehabilitation measures for patients with pulmonary tuberculosis and ADD, which contributes to a more differentiated approach to rehabilitation and the development of optimal therapeutic strategies.

Predictors of medical adherence following a bowel management program for youth and young adults with Spina Bifida.

To evaluate individual and community sociodemographic factors that predict bowel regimen adherence in youth and young adults with Spina Bifida (SB) following participation in a bowel management program (BMP). Participants were drawn from clinical cases seen through an International Center for Colorectal and Urogenital Care. Area deprivation index (ADI) scores were extracted from participant addresses and bowel regimen adherence data were collected from the electronic medical record (EMR). Participants' mean age was 8.06years old, 51.7% were male, 72.4% white, 37.9% Hispanic, 56.9% government insurance, 89.7% myelomeningocele, 15.5% non-adherent. Average neighborhood disadvantage was 5.19 (SD:2.83, range:1-10). After controlling for variables correlated with adherence (p < .20), every one decile higher neighborhood disadvantage score was associated with a 48% decrease in the odds of being adherent (OR = 0.52, p = .005, 95% CI: -101.90, -0.21). Our results suggest that neighborhood disadvantage is a strong predictor of medical adherence following a BMP, more so than other sociodemographic and health-related variables. These results may assist with identifying which individuals may be at higher risk for poor health outcomes due to neighborhood socioeconomic disadvantage and help health care systems intervene proactively.

How Selective Mobility, Social and Ecological Influence may Impact Geographic Variations in Life Satisfaction Scores: An Australian Longitudinal Study

The spatial clustering of life satisfaction scores noted in recent empirical research suggests that ‘happier’ people may live in specific neighbourhoods or regions. This prompts the questions: Do ‘happier’ people choose to move to specific places? Does living in specific places make people ‘happier’? To answer these questions, this paper explores possible occurrences of selective mobility, and social and ecological influence. Using panel data collected in Australia from 2013 to 2021, we examine the association between life satisfaction scores and selective geographic mobility, and the possible influence that living at specific locations may have on individual life satisfaction trajectory, while controlling for individual personality traits and socio-demographic factors. Our results indicate that urban residents reporting lower life satisfaction scores before the move have a higher probability of moving to a rural area. Similarly, lower life satisfaction scores are associated with a higher probability of moving to a region with a different climate. We also find evidence that moving from the city to the country is associated with an uplift of the life satisfaction trajectory for the individual. A similar conclusion is reached for people who moved to a warmer climate, but not for a move to a cooler climate. To our knowledge, this is the first time the concepts of selective mobility and social and ecological influence have been applied in life satisfaction research. Our work provides an indicator that can be important to demographers predicting population movements. It can also inform policy development around assisting regional and rural areas attract/ retain residents to support regional sustainability.

Association between Neighborhood Stressors and Allostatic Load in Breast Cancer Survivors: The Pathways Study.

Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations of neighborhood stressors and AL in 2,553 women with breast cancer recruited into the Pathways Study in 2006-2013. AL score was derived from biomarkers in the cardiovascular, metabolic, and immune domains of physiological stress measured within 3 years after baseline. Neighborhood data were appended to participants' geocoded baseline addresses. Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate associations between neighborhood stressors and risk of higher AL score. Adjusting for age and stage, high AL was positively associated with low versus high neighborhood socioeconomic status (nSES; OR=2.24, 95% CI=1.61-3.12) and green space (OR=1.55, 95% CI=1.18-2.03); high versus low traffic (OR=1.32, 95% CI=1.01-1.72), crime (OR=1.32, 95% CI=1.05-1.67), and household crowding (OR=1.57, 95% CI=1.22-2.01); and more versus no fast-food restaurants (OR=1.50, 95% CI=1.21-1.84). Associations remained for nSES and fast-food restaurants after co-adjustment with other neighborhood stressors, and for fast-food restaurants after additional adjustment with individual sociodemographic and lifestyle factors. Our preliminary findings can inform further studies of the physiological effects of neighborhood stressors, which collectively may help improve survivorship outcomes for the growing population of breast cancer survivors.

Socioeconomic inequalities in the uptake of postpartum care at home across Dutch neighbourhoods.

Postpartum care focuses on prevention of health problems by performing medical check-ups and through enhancing maternal empowerment, the parent-infant interaction and knowledge about mother's own health and that of her newborn. We aimed to investigate whether there was significant clustering within neighbourhoods regarding the uptake of postpartum care and to what extent neighbourhood-level differences are explained by individual socio-demographic factors, pregnancy-related factors and neighbourhood-level determinants (i.e. deprivation and urbanization). A nationwide population-based observational study was carried out using linked routinely collected healthcare data from appropriate-for-gestational-age weight live-born term singleton deliveries (2015-18) in the Netherlands. We performed two-level multivariable logistic regression analyses, using three different models. Model 1 contained no explanatory variables and was used to assess clustering of postpartum care uptake within neighbourhoods. In model 2, individual-level determinants were added one by one and in model 3, neighbourhood-level determinants were added. About 520818 births were included. Multilevel modelling showed that 11% of the total variance in postpartum care uptake could be attributed to the neighbourhood of residence. Individual characteristics explained 38% of the neighbourhood variance, of which income and migration background were the most important contributors. An additional 6% of the variation could be explained by neighbourhood-level determinants. We found substantial neighbourhood differences in postpartum care uptake. These differences are influenced by a complex interplay between individual-level and neighbourhood-level determinants, highlighting the importance of addressing both individual and neighbourhood-level determinants to improve the uptake of postpartum care and therewith overall community health.

Difficult Toddler Temperament - Prevalence and Associated Factors at 18-Month Follow-Up of a Birth Cohort.

Difficult temperament coupled with other risk factors may lead to mental health problems in childhood and have long-lasting effects in adolescence and adulthood. This study aimed to investigate the prevalence of parental perception of difficult temperament in toddlers and identify significant factors associated with individual and family-level sociodemographic risk factors. The prevalence of parental perception of difficult temperament was derived from items in the 18-month follow-up questionnaire within the Watch Me Grow (WMG) longitudinal birth cohort study in a multicultural and socioeconomically disadvantaged community in Sydney, Australia. Data was available for 500 children and their parents. Descriptive analysis was used to calculate the participant characteristics and the prevalence of parental perception of difficult temperament, whereas multivariable logistic regression analysis was used to assess significant risk factors associated with a difficult temperament. Parental perception of difficult temperament in the cohort was 7.3% (n = 492). Findings of the multivariable logistic regression showed that screen time >2 hours a day (AOR 2.43, 95% CI: 1.2, 4.9), child not being read to (AOR 3.92, 95% CI: 1.8, 8.5), and family history of mental health problems (AOR 2.69, 95% CI: 1.1, 6.5) significantly increased the odds of having a difficult temperament. Toddlers with difficult temperament were less likely to have received stimulatory experiences, and their families were more likely to be under greater stress. The findings emphasize the importance of parental support and anticipatory guidance in promoting nurturing care to facilitate child health and development, particularly in disadvantaged communities.

Bullying and Posttraumatic Stress Disorder (PTSD) Symptoms Among Adolescents of Public Schools in Colombia: A Cross-Sectional Study

ABSTRACT Bullying is a frequent, yet sometimes dismissed dynamic in school-aged youth, despite all the literature around its prevalence and detrimental effects. Around the world, prevalence estimates have demonstrated wide variability. In Colombia, between 22% and 49.9% of adolescents have experienced bullying. Much research on school bullying has focused on perpetrators and those victimized; less is known about those who witness it. The main objective of this cross-sectional study of 1224 Colombian public high school students was to determine if there is an association between the different types of involvement (victims, aggressors, witnesses) in bullying and the presence of symptoms of post-traumatic stress disorder (PTSD). We measured individual sociodemographic factors, types of involvement in bullying, the presence of PTSD symptoms, and levels of family dysfunction. We found that verbal abuse was the most frequent behavior reported. Also, a high proportion of PTSD symptoms among victims, witnesses, and aggressors were identified. In the logistic regression analysis, presence of PTSD symptoms was associated with subjects identified as social victims (OR = 2.067; CI = 1.381– 3.095), verbal victims (OR = 2.779; CI = 1.599–4.828), victims by coercion (OR = 4.038; CI = 1.710–9.532), social aggressors (OR = 1.974; CI = 1.355–2.919), and in those with severe family dysfunction (OR = 3.372; CI = 1.744–6.520). Additional research is needed in the Colombian population to identify and explore appropriate options for prevention and intervention in those most vulnerable to bullying.

Impact of the COVID-19 Pandemic on Changes in Consumer Purchasing Behavior in the Food Market with a Focus on Meat and Meat Products-A Comprehensive Literature Review.

The coronavirus has wreaked havoc on the global economy before the eyes of the entire world. Due to evolving consumer needs and expectations during the pandemic, the supply and demand for various goods and services varied from the pre-COVID-19 period. This article aims to understand the changes in purchasing and food choices, focusing particularly on meat and meat products, made by consumers and households in response to the crisis caused by the COVID-19 pandemic. The study also indicates the impact directions of these changes and assesses the magnitude of the contribution of various determinants that influenced them. The literature review from 2020 to 2023 was conducted using Scopus and the Web of Science scientific databases. The study identified sociodemographic and individual factors as the main determinants influencing consumers' purchasing or eating behavior. Positive shifts (e.g., implementing strategies to better manage food at home through activities like creating shopping lists, the average increase in consumer spending during store visits, and decrease in visit frequencies) or negative changes (e.g., shortages of food products in stores due to consumer panic buying, unusually high demand resulting from stockpiling, purchasing fewer fresh products, increased consumption of unhealthy foods and snacking, among other factors) during isolation were influenced by various individual factors (e.g., motivation, mental state) or sociodemographic factors (e.g., gender, age, income level, education). While individual factors had a greater impact on changes in consumer behavior in the early stages of the COVID-19 pandemic, socio-demographic factors became more important as the pandemic progressed.

A Sociodemographic Assessment of Infant Malnutrition in Rural Area, Bangladesh: Logistic Regression Approach

Abstract : This study investigates the association between socio-demographic factors and infant child (0-1 year) malnutrition defined by underweight, stunting and wasting, in rural areas, Bangladesh. Survey data, Multiple Indicator Cluster Survey (MICS) 2019 executed by UNICEF and Bangladesh Bureau of Statistics (BBS), is used in the study. The percentage of undernutrition is 17.08% for underweight out of 3571 sample, 18% for stunted out of 3504 sample, 9.8% for wasted out of 3470 sample with omitting missing value. Statistical methods, ANOVA, chi-square test and sampling weighted logistic regression model, are used to figure out impact of individual socio-demographic factors on child malnutrition. The variables gender, receiving prenatal care, delivery place, parents education, wealth index, child weight at birth, geographical division, and women age group at birth, are significantly associated with malnourished children (P-value: 1%, 5% or 10%). Odds of being malnutrition is lower among female children, educated parents and rich family. Prevalence of child underweight is higher among mother physical disability, childbirth weight. The undernutrition, stunting and wasting, are highly likely among the children of disabled mother. The presence of underweight and wasting is higher in Sylhet Division, lower in Mymenshingh Division respectively, while the prevalence of stunting is higher in Mymenshingh, Rajshahi, Rangpur and Sylhhet Division.

The Influence of the Time Factor and Marital Status on the Quality of Life of Patients After Kidney Transplantation in Uzbekistan

Background: Currently, compared to program hemodialysis and peritoneal dialysis, kidney transplantation is considered to be the preferred method of renal replacement therapy in patients with end-stage chronic kidney disease (CKD) in terms of patient survival and improvement in their quality of life (QOL). This study aimed to investigate the influence of the post-transplantation period and marital status on the health-related QOL of patients with CKD who underwent kidney transplantation.Methods and Results: A cross-sectional study was conducted among 78 patients who had received a kidney transplant from living related donors in the Republican Specialized Scientific and Practical Medical Center for Nephrology and Kidney Transplantation between January and April 2022. Kidney transplant recipients (KTRs) were divided into four groups depending on the time after kidney transplantation: 3, 6, 12 months, and 2 years or more after surgery. The study used 2 questionnaires. The first included questions about the sociodemographic data of patients; the second was the standardized health-related QOL questionnaire SF-36. This study of the QOL of KTRs, residents of the Republic of Uzbekistan, showed an improvement in most scales of physical and mental health components 12 months and 2 years or more after kidney transplantation. On the scales of physical and mental health components, unmarried KTRs had a higher self-assessment of QOL than married KTRs, and among married KTRs, those with children had higher QOL indicators.Conclusion: Clarifying how the time after kidney transplantation and individual sociodemographic and medical factors influence QOL indicators requires further research (including longitudinal studies) in a wider КTR population.

Environmental Justice Index and adverse pregnancy outcomes

The Environmental Justice Index is a tool released by the Centers for Disease Control and Prevention that quantifies and ranks the environmental burden and social vulnerability of each census tract. Racial and ethnic disparities in adverse pregnancy outcomes are well established. The relative contributions of individual (person-level) and environmental (neighborhood-level) risk factors to disease prevalence remain poorly understood. This study aimed to determine whether the Environmental Justice Index is associated with adverse pregnancy outcomes after adjustment for individual clinical and sociodemographic risk factors. This was a retrospective cross-sectional study of all patients who delivered a singleton newborn at ≥23 weeks of gestation between January 2019 and February 2022 at 7 hospitals within a large academic health system in New York. Patients were excluded if their home address was not available, if the address could not be geocoded to a census tract, or if the census tract did not have corresponding Environmental Justice Index data. Patients were also excluded if they had preexisting diabetes or hypertension. For patients who had multiple pregnancies during the study period, only the first pregnancy was included for analysis. Clinical and demographic data were obtained from the electronic medical record. Environmental Justice Index score, the primary independent variable, ranges from 0 to 1. Higher Environmental Justice Index scores indicate communities with increased cumulative environmental burden and increased social vulnerability. The primary outcome was adverse pregnancy outcome, defined as the presence of ≥1 of any of the following conditions: hypertensive disorders of pregnancy, gestational diabetes, preterm birth, fetal growth restriction, low birthweight, small for gestational age newborn, placental abruption, and stillbirth. Multivariable logistic regression was performed to investigate the relationship between Environmental Justice Index score and adverse pregnancy outcome, adjusting for potential confounding variables, including body mass index group, race and ethnicity group, advanced maternal age, nulliparity, public health insurance, and English as the preferred language. A total of 65,273 pregnancies were included for analysis. Overall, adverse pregnancy outcomes occurred in 37.6% of pregnancies (n=24,545); hypertensive disorders of pregnancy (13.4%) and gestational diabetes (12.2%) were the most common adverse pregnancy outcome conditions. On unadjusted analysis, the strongest associations between Environmental Justice Index score and individual adverse pregnancy outcome conditions were observed for stillbirth (odds ratio, 1.079; 95% confidence interval, 1.025-1.135) and hypertensive disorders of pregnancy (odds ratio, 1.052; 95% confidence interval, 1.042-1.061). On multivariable logistic regression, every 0.1 increase in Environmental Justice Index score was associated with 1.4% higher odds of adverse pregnancy outcome (adjusted odds ratio, 1.014; 95% confidence interval, 1.007-1.021). The strongest associations with adverse pregnancy outcomes were observed with well-established clinical and social risk factors, including class 3 obesity (adjusted odds ratio, 1.710; 95% confidence interval, 1.580-1.849; reference: body mass index <25 kg/m2) and certain race and ethnicity groups (reference: non-Hispanic White), particularly Asian and Pacific Islander (adjusted odds ratio, 1.817; 95% confidence interval, 1.729-1.910), and non-Hispanic Black (adjusted odds ratio, 1.668; 95% confidence interval, 1.581-1.760) people. Environmental Justice Index score is positively associated with adverse pregnancy outcomes, and most strongly associated with stillbirth and hypertensive disorders of pregnancy. Geospatial analysis with Environmental Justice Index may help to improve our understanding of health inequities by identifying neighborhood characteristics that increase the risk of pregnancy complications.

How do users compare the costs between nicotine vaping products and cigarettes? Findings from the 2016-2020 International Tobacco Control United States surveys.

Nicotine vaping products (NVPs) can potentially help adult tobacco users quit smoking. This study evaluated how adult consumers compare the costs between NVPs and cigarettes. We used data from the US arm of the 2016-2020 International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys to perform a multinomial logit model with two-way fixed effects to measure how perceived cost comparisons are associated with NVP and cigarette taxes, use patterns, NVP device types and individual sociodemographic factors. Higher cigarette taxes are associated with a greater likelihood of perceiving NVPs and cigarettes as costing the same for the overall population and among people who exclusively smoke, and a lower likelihood of perceiving NVPs as more expensive among people who exclusively vape, compared with lower cigarette taxes. Pre-filled cartridge and tank users are more likely to perceive NVPs as less expensive than cigarettes, compared with people who use other types of NVPs. The associations between taxes and perceived cost comparison were more pronounced among males, younger and low-income populations. Higher cigarette taxes are associated with perceived financial incentives for nicotine vaping products (NVPs) over cigarettes, whereas NVP taxes are not associated with perceived cost comparison between NVPs and cigarettes.

Inflammation and immune response in the development of periodontal disease: a narrative review.

We present this critical review with the aim of highlighting the current status of periodontal diseases, focusing on the relevance of host modulating agents and immune pathways, in addition to new complementary therapeutic approaches for the treatment of these pathologies. Periodontal diseases are prevalent pathologies worldwide and the main cause of edentulism in the adult population. Their pathogenesis seems to be based on a dysbiosis of the oral microbiota that interacts with the host's immune defenses and is responsible for the inflammatory/immune response, which would be modified by a number of conditions such as individual susceptibility, environmental and sociodemographic factors, certain systemic pathologies and the individual's genetic condition, among others. Numerous studies have reported on the complex web of inflammatory mediators in periodontal disease and their role in tissue destruction as well as in homeostatic imbalance. Precisely, the role of epigenetics as a modifier of the host genetic condition has captured research attention in recent years. Therefore, this mini-review first discusses an updated etiological hypothesis of periodontal disease and the roles of certain cytokines in the immune response. In addition, the latest therapeutic trends with new developments and future perspectives are summarized.

State of the maternal healthcare continuum in Guinea, awaiting the next Demographic and Health Survey: the case of the five communes of Conakry in 2022.

The continuum of maternal health care ensures consistency in the delivery of care from pregnancy to the postnatal period. It recommends a minimum of 4 antenatal visits, skilled birth attendance, and 42 days of postnatal care. This approach helps reduce maternal deaths. The aim of this study was to estimate the proportion of women who had completed the different stages of the continuum of maternal health care (four antenatal visits, given birth under the care of qualified personnel, and received postnatal care within 42 days of delivery). This was a cross-sectional analytical study conducted in the five communes of Conakry, using a two-stage cluster sampling for data collection. Results were described using medians and percentages. The proportions of women in the continuum of care, and at the different stages of this continuum, have been weighted. Multivariate logistic regression was used to identify the factors associated with non-completion of the different stages of the maternal health care continuum among the women included in this study. We found that 26.9% of women had completed all stages of the maternal health care continuum, while 73.1% had not. While 56.7% received four antenatal visits, only 29.5% delivered under the care of a qualified healthcare professional. Key factors associated with discontinuity were not attending school (AOR 1.825: 1.594-2.089), unemployment (AOR 4.588: 3.983-5.285), having two or more living children (AOR 1.890: 1.016-1.296), and not receiving a free Long-Lasting Insecticidal Net at the first Antenatal Care. Maternal care discontinuity is a major issue in Guinea. The country's Health Development Plan had set an expected level for maternal care which has not been met as of 2022. The completeness of care is influenced by various factors, including individual socio-demographic characteristics and factors related to the organization, availability, and quality of health services. To reduce maternal and child mortality rates, it is essential to improve interpersonal communication during antenatal care, ensure the availability of quality health services, and conduct a national study on maternal health service quality and maternal satisfaction. This will help establish a proper continuum of care for mothers and children.