Low Educational Level Research Articles

Trends and Factors Affecting Functional Limitations on Activities of Daily Living Performance Among Korean Adults With Disabilities, 2008–2020: A Longitudinal Study

ABSTRACT Background Loss of the ability to perform activities of daily living (ADLs) leads to negative health outcomes such as reduced quality of life, institutionalization, and mortality. In Korea, the proportion of older adults with disabilities is increasing along with rapid population aging. Therefore, providing a comprehensive approach to the prevention and management of ADL limitations in people with disabilities is necessary. This can be accomplished by understanding the trends and factors affecting these limitations over time. Purpose This study was developed to examine the longitudinal trend and factors affecting ADL limitations over time among people with disabilities in Korea. Methods Data from 346 people with disabilities in the 2008–2020 Korean Welfare Panel Study were used. Bivariate analysis and a Kendall trend test were performed to determine the longitudinal trends for ADL limitations, and multiple logistic regression was used to evaluate whether relevant variables could predict these limitations. Results The prevalence of ADL limitations among people with disabilities increased by 16.5% over the 12 years of the study. The highest rate of increase in these limitations over time was found in people with mental disorders (27.8%), those over 65 years of age (27.3%), and those with depression (25.6%). In multiple logistic regression, the odds ratios of the variables were slightly different at each survey wave. However, severe disability and low educational level were consistently found to be associated with ADL limitations over time. Conclusions The findings provide evidence of a significant relationship between level of disability and/or educational status and ADL limitations in people with disabilities in Korea. To prevent the development of ADL limitations in people with disabilities, comprehensive identification of longitudinal trends and factors affecting ADL limitations is necessary. Early intervention, including integrated services such as home rehabilitation services to prevent ADL limitations, especially for disabled people with severe disabilities and low educational levels, has the potential to delay ADL limitations.

Prevalence and Predictors of Depression Symptoms Among Afghan Hypertensive Patients: Secondary Analysis of a Multi-Center Cross-Sectional Study.

Although depression is a frequently occurring mental disorder in patients with hypertension, little is known about the symptoms of depression among Afghan hypertensive patients. This study aimed to analyze the prevalence and predictors of depression symptoms among Afghan hypertensive patients. This was a secondary analysis of a multi-center cross-sectional study conducted between August and December 2022 across three major provinces in Afghanistan. Socio-demographic and clinical characteristics of the eligible participants were used in the analysis. A score of ≥ 5 on the PHQ-9 (Patient Health Questionnaire) was considered the cut-off point for labeling hypertensive patients as screening positive for depressive symptoms. We performed binary logistic regression to determine the predictors of depression symptoms among hypertensive patients. Out of 853hypertensive patients, 51.8% (95% CI: 48.4-55.2%) had depressive symptoms. Binary logistic regression revealed that low monthly household income [AOR=1.42, 95% CI (1.01-1.97), low education level [2.41 (1.57-3.71)], physical inactivity [1.81 (1.22-2.71)], poor blood pressure control [2.41 (1.57-3.71)], and the presence of medical comorbidity [1.59 (1.15-2.19)] were the predictors of depression symptoms. This study showed a high prevalence of depressive symptoms among Afghan hypertensive patients. Moreover, we found that low monthly household income, physical inactivity, low education level, poor blood pressure control, and the presence of medical comorbidity were the predictors of depression symptoms. Our findings suggest that hypertensive patients should be screened for mental health symptoms, and those most at risk for depression should seek supportive counseling.

Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in patients from a public referral hospital in a non-metropolitan region of Brazil during and post the SARS-CoV-2 pandemic.

Antimicrobial resistance (AMR) poses a global threat, with carbapenem-resistant Enterobacterales (CRE) representing a significant concern due to limited therapeutic options. This study investigated the prevalence of carbapenemase genes in CRE strains isolated from tracheal aspirates of patients at a Brazilian university hospital between January 2020 and August 2023. Bacterial identification was conducted using MALDI-TOF, while carbapenemase genes were detected by qPCR. Demographic and clinical data were collected, and univariate analysis was performed using the chi-square test (p < 0.05). Variables with p ≤ 0.10 were further investigated using the chi-square test for linear trend, along with stratified analysis. Out of 1,133 samples, 111 (9.79%) showed CRE growth, with 46 isolates included in the final sample, predominantly comprising Klebsiella pneumoniae (65.21%) and Serratia marcescens (19.57%). The blaKPC gene was prevalent (78.26%), while blaNDM was detected in 21.74% of cases. The identified population was predominantly male (67.39%), elderly (69.57%), white (56.52%), unmarried (63.04%), and had a low level of education (56.52%). Most patients (69.57%) were in the intensive care unit and remained hospitalized for more than 30 days (76.08%). There was a significant inverse trend between Klebsiella pneumoniae and age (p = 0.045), as well as a direct linear trend between blaNDM and the annual increase in COVID-19 cases in Brazil (p = 0.050). A high probability of finding non-Klebsiella pneumoniae bacteria was observed in patients with prolonged hospital stays, independent of COVID-19 (p = 0.006) and the type of resistance genes (p = 0.020). The persistent prevalence of CRE, especially with blaKPC, underscores the urgency of effective control measures.

Is it possible to detect women at higher risk of intrapartum stillbirth? An area-based prospective cohort study.

The aim of the study is to perform an overview of intrapartum stillbirth (SB) at term, assessing risk factors, causes of death and quality of pregnancy care. This is an area-based, prospective cohort study on pregnant women at ≥37 weeks from 2014 to 2021. We compared intrapartum SB' information to alive birth and to antepartum deaths of the same period. Results of logistic regression are reported as the Odds Ratio (OR) with 95% confidence interval (95% CI) and the P value. A descriptive analysis about the causes of death and quality of pregnancy care is performed. The overall rate of SB at term in Emilia-Romagna was 1.06 ‰ births. Among the 260 cases, 27 (10.4%) occurred during labor, with an intrapartum SB rate of 0.11‰. This SB rate was stable during years. SGA newborn (P=0.005, 95% CI 1.47-9.04, OR 3.63), low level of education (P<0.0001, 95% CI 2.98-16.11, OR 6.93), pre pregnancy BMI ≥ 25 kg/m2 (P<0.0001, 95% CI 6.61-31.74, OR 14.50) are independent risk factors for intrapartum SB when compared to alive newborns. Compared with antepartum SB, excessive weight gain in pregnancy (RR 2.91, 1.43-3.98, P=0.001) represents a risk factor for intrapartum ones. Preventing intrapartum SB at term in developed country should be based on both the appropriate antenatal management of fetal growth and the avoidance of maternal excessive weight gain. An effort toward pre conceptional intervention of improving maternal shape could be of value.

Personal income tax reform and household savings rates: Evidence from a quasi-natural experiment in China

This study examines the effects of the 2018 personal income tax reform on household savings rates using data from the China Household Finance Survey (CHFS). Employing a quasi-natural experiment approach, our findings demonstrate that the reform has led to an increase in savings rates among Chinese households. Mechanism tests indicate that income uncertainty serves as the underlying mechanism linking the personal income tax reform to household savings rates. Heterogeneity analyses reveal that the impact of the personal income tax reform on household savings rates is particularly pronounced for households with lower income and those whose heads have lower levels of education. Additionally, the personal income tax reform has elevated the proportion of household development and enjoyment consumption in total consumption. This study provides a novel micro-perspective on the influence of Chinese fiscal policies on residents' saving behavior and offers valuable insights for promoting high-quality consumption and fostering high-quality economic development.

Complex Regional Pain Syndrome: a cross-sectional study of physical symptoms, disability, and psychological health in long term.

Knowledge about long-time residual symptoms, disabilities, and psychological health in complex regional pain syndrome (CRPS) is limited. The aim was to evaluate outcome, focusing on physical symptoms, disability, and psychological health, in individuals with CRPS through a cross-sectional survey study. Individuals with a confirmed diagnosis of CRPS were identified through medical charts and sent validated survey forms (Disabilities of the Arm, Shoulder and Hand-Quick version, Specific Hand Surgery Questionnaire-8 questions, EuroQol 5 Dimensions 3 levels, Life Satisfaction Questionnaire-11, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and Sense of Coherence-29) and complementary questions. Responders (response rate: 99/238, 42%; CRPS type 1: 72%; CRPS type 2: 28%; time since diagnosis median: 59 [34-94] months) reported remaining symptoms and disability (Disabilities of the Arm, Shoulder and Hand-Quick version score: 45 [20-70]) and more improvement in type 1 than in type 2. Only 9% of individuals with CRPS reported no residual pain or discomfort. Approximately 60% had problems in daily activities, 49% had sleeping problems, and 90% experienced moderate-extreme pain with 23% still on sick leave. The Hospital Anxiety and Depression Scale survey revealed significantly higher scores than a Swedish reference population. Individuals with a low Sense of Coherence and high pain catastrophizing had worse disability and were less satisfied with their lives and physical and psychological health. A lower level of education and more anxiety were associated with worsened disability over time. Individuals with CRPS suffer in the long term from pain, sleeping problems, and limitations in daily activities with occurrence of anxiety and depression, resulting in dissatisfaction with many aspects of their lives. A low Sense of Coherence and high pain catastrophizing are associated with a worse outcome. Biopsychosocial aspects should be addressed in clinical practice.

Parental Education and Attitudes Towards Institutionalization of Children in West Java, Indonesia

BackgroundIn low- and middle-income countries, orphanages are often perceived as a means to secure education for children. Consequently, many parents send their children to orphanages, unaware of the potential risks involved. ObjectiveThis study aims to explore caregivers' attitudes toward child institutionalization in the context of placing children in orphanages. Participantsand Settings: Data were collected from 736 caregivers of children aged 0-7 years in Cianjur, West Java, Indonesia, in 2017. MethodsDescriptive analysis and logistic regression were used to assess caregivers’ attitudes and the likelihood of agreeing or disagreeing with six statements about child institutionalization. ResultsThe study found that most caregivers agreed that poor children are better off being raised in orphanages, but parents remain responsible for the child even after placement. Logistic regression showed that caregivers with higher levels of education were less likely to agree with placing children in orphanages compared to caregivers with lower levels of education. ConclusionsThis study highlights the importance of higher formal education in reducing caregiver support for institutionalization.

The relationship between radiation oncology department NIH funding and institutional community inclusion/investment.

153 Background: Disparities in healthcare access and funding allocation persist among racial minorities and low-income populations. Radiation Oncology departments play a crucial role in cancer treatment, yet the extent to which these departments serve historically underrepresented communities following receipt of National Institutes of Health (NIH) funding remains unclear. This study accessed the relationship between radiation oncology departments that are awarded National Institute of Health (NIH) funding and Lown Institute Hospitals Index rankings for community benefit and inclusivity. Methods: Radiation oncology departments awarded funding from the NIH from 2019-2021 were retrospectively studied. The 2023 Lown Institute Hospital Index rankings for community benefit and inclusivity were examined. The community benefit metric measures financial assistance spending, community investment spending, and Medicaid as a portion of patient revenue. The inclusivity metric measures the similarities of income, race, and education level between the hospital patient population and the surrounding community. Kendall’s correlation coefficient (tau value) and linear regression were used to evaluate the relationship between measures of community benefit and inclusivity and NIH radiation oncology department research funding. Results: Twenty-two radiation oncology departments that received NIH funding (median = $ 419,555.00) were included. A statistically significant positive correlation was observed between the amount of radiation oncology NIH research funding received and institutional rankings for overall community benefit (tau = 0.378; P &lt; 0.034), with a trend towards significance for institutional rankings for community investment spending (tau = 0.497; P &lt; 0.053). No significant correlation was observed between the amount of radiation oncology department funding and institutional rankings for charity care spending (P = 0.430), Medicaid as a portion of patient revenue (P = 0.837), and service of patients from racial and or ethnic minorities (P = 0.505), with low income (P = 0.612), or with lower levels of education (P = 0.700). Conclusions: Our study highlights the relationship between recent NIH funding received by Radiation Oncology departments and their commitment to community health and inclusivity. Our findings indicate a significantly positive correlation between NIH funding received by radiation oncology departments and overall community benefit. This suggests that departments receiving NIH funding may be incentivized to allocate resources towards initiatives to improve community health outcomes beyond direct patient care. This study prompts further exploration into the mechanisms through which NIH-funded radiation oncology departments allocate resources and engage with their surrounding communities.

Knowledge of self-management and asthma control among asthma patients attending a polyclinic in Western part of Singapore

BACKGROUND: Self-management is important for asthma control, yet it is unclear whether asthmatic patients have sufficient knowledge to optimally manage their disease. We examined the associations between the knowledge of self-management in adult patients attending a polyclinic in Singapore, sociodemographic factors, and asthma control. MATERIALS AND METHODS: A cross-sectional survey was conducted among adult asthmatic patients in a public primary care clinic (polyclinic) using convenience sampling. A a structured and validated self-administered questionnaire solicited the responses of study participants. Questionnaire comprised three sections: (1) Sociodemographic and asthma-related variables, (2) Modified Asthma Self-Management Questionnaire (ASMQ), and (3) The GINA assessment of asthma control. Participants completed the questionnaire in the clinic waiting area and returned them into a sealed box in the same area. Data were analyzed using SPSS version 29.0. Summary statistics were used to describe the study sample; t-test or analysis of variance (ANOVA), as appropriate, tested the differences in self-management knowledge by sociodemographic characteristics. Logistic regression was used to determine the association between asthma control and self-management knowledge controlling for sociodemographic characteristics. RESULTS: The sample comprised 141 asthma patients; Out of a total of 100 points, the mean ASMQ score was 46.8 (standard deviation 21.7). The scores for the knowledge of self-management of Asthma differed by age, level of education, and having been taught about asthma on bivariate analyses (P &lt; 0.05). Linear regression showed a significant association of asthma self-management knowledge with educational level only. No association was observed between ASMQ scores and asthma control. CONCLUSION: There were gaps in patients’ knowledge about asthma self-management, although they were generally knowledgeable about the inhaler technique. Higher education levels were associated with higher levels of knowledge beyond the effect of age and having been instructed about asthma, suggest that it is crucial that educational programs on asthma are made accessible to patients with lower levels of education. Further research needs to determine whether asthma educational programs targeting the knowledge gaps found in this study can improve knowledge of self-management and asthma control.

Cross-sectional study of assessment of lung cancer (LC) screening awareness in an underserved community in the Bronx, New York.

155 Background: LC remains the second most diagnosed cancer but is the leading cause of cancer death in the USA, accounting for 21% of all cancer deaths. Despite advances in screening and treatment, it remains the principal cause of cancer mortality worldwide. Notably, survival rates have improved from 21% to 25% over the past 5 years. However, LC screening with low-dose computed tomography (LDCT) is underutilized, with only 5.8% of eligible individuals screened in 2021. Methods: A prospective 29-question survey was conducted at St. Barnabas Health Care System in the Bronx, NY, from February to April 2024. The survey included patients aged 50-80, both former and active smokers. Data on demographics, social determinants, and knowledge of LC and LDCT screening were collected and processed using JASP Version 0.18.3. The study aimed to assess the community's knowledge of lung cancer screening, with demographic characteristics as secondary outcomes. Results: From all the surveys collected, 115 met the inclusion criteria, 53% male (61) and 47% female (54), with no significant difference between proportions (p=0.576). The median age was 63 years. Race: 73% were Hispanic, 22% Black, and 5% White, with significant differences from an equal distribution (p&lt; 0.001). Legal Status, citizens (74%), followed by green card holders (17%). Most of the patients lived in the USA for over 20 years (90%), with very few having lived for less than five years (1%), indicating a long-term residency trend (p &lt; 0.001). Education Level: high school education was the most common (58%), followed by middle school (17%) and elementary school (15%). Doctorate and graduate degrees were less common (7%). 91% of patients were aware of the relationship between cigarette smoking and LC, while 9% did not (p&lt;0.001). On the other hand, 66% believed there was a relationship between e-cigarette use and LC, while 44% believed there was not. Patients with an income greater than $50,000 have significantly more knowledge of the screening tool for LC (STLC), as indicated by a Chi-square value of 50.87 (p &lt; 0.05, with a critical value of 5.99). Patients with low education levels have less knowledge of the existing STLC, with a Chi-square of 143.587 (p&lt;0.05 and a critical value of 9.488). Conclusions: Our study highlights critical disparities in LC awareness and knowledge of screening tools among different demographic groups. There is a clear need for targeted educational initiatives, especially for lower-income and less-educated populations, to improve understanding of LC risks associated with both traditional and electronic cigarette use. The significant presence of long-term Hispanic residents suggests that culturally tailored interventions could be particularly effective. Addressing these gaps is essential for enhancing lung cancer prevention and early detection efforts across diverse communities.

Vulnerability to heat-related mortality and the effect of prevention measures: a time-stratified case-crossover study in Switzerland.

Swiss climate scenarios predict increases in the frequency and intensity of extreme heat episodes in the future. For the effective prevention of heat-related mortality, several aspects of the population's vulnerability to heat must be understood on a local level. A nationwide analysis of individual death records was conducted, enabling a more comprehensive understanding than typical heat studies based on aggregated data. A total of 320,306 individual death records from the Swiss National Cohort with precise address information during the warm season (May to September) from 2003-2016 were linked to indoor and outdoor high-resolution daily temperature estimates. A time-stratified case-crossover study combined with distributed lag non-linear models was then performed to assess the temperature-mortality associations for various causes of death and to estimate the potential effect modification of individual characteristics. Additionally, it was explored whether the effect of extreme heat changed over time in regions with and without cantonal heat-health action plans (HHAPs). Using the temperature with the lowest cause-specific mortality risk (minimum mortality temperature) as the reference temperature, extreme heat (defined as ambient daily maximum temperature reaching 33 °C) was associated with a strong increase in all-cause mortality (odds ratio (OR): 1.21, 95% CI: 1.17-1.25) and disease-specific mortality from Alzheimer's disease and dementia (OR: 1.67, 95% CI: 1.48-1.88), COPD (OR: 1.37, 95% CI: 1.12-1.67), diabetes (OR: 1.34, 95% CI: 1.06-1.70), and myocardial infarction (OR: 1.26, 95% CI: 1.10-1.44). Indoor temperatures above 24 °C were found to be critical for mortality. The population most vulnerable to heat included older adults (≥75 years), unmarried individuals, people with a low education level, older women with low neighbourhood socioeconomic position, and men under 75 years old with low socioeconomic position. Overall, the risk of heat-related all-cause mortality in 2009-2016 was lower than that in 2003-2008. The decrease was significantly stronger in the region where cantonal HHAPs were implemented. This study provides important information for planning targeted and effective measures to reduce heat-related health risks in Switzerland. It demonstrates that HHAPs contribute to reducing heat-related mortality, although they may not reach the high-risk population of individuals with low socioeconomic position. Future prevention efforts should also target the less privileged population, including people younger than 75 years.

The impact of education as a proxy for lifestyle habits on reducing the association with dementia prevalence in the Southern Region of Brazil.

This study aimed to investigate the prevalence of dementia among older adults from Florianópolis, in the Southern Region of Brazil. Data were originally drawn from the Epifloripa Aging Cohort Study, a representative and community-based survey designed to evaluate older people's health. This cross-sectional study was conducted in two phases: the community-screening phase, in which the Mini-Mental State Examination and a multifunctional scale were administered to older subjects and close informants, respectively; and the hospital-diagnosis phase, when the Cambridge Examination and the National Institute on Aging criteria were used. Adjustment for screening accuracy was made in order to estimate dementia prevalence. Of 1184 subjects evaluated in the community, 243 were screened for the diagnosis phase, in which 47 were identified with dementia, resulting in a crude prevalence of 4.5% (95% CI: 3.241-5.758) and an estimated prevalence of 9.2% (95% CI: 7.446-10.954). Dementia was associated with older ages, lower education levels, and the presence of stroke. Mild alcohol use (in comparison with no alcohol use), community-group practice, internet use and a higher level of physical activity, rather than education, decreased the odds ratio for dementia. Education was directly associated with these lifestyle habits. Prevalence was lower than that in previous studies in the country, and multivariate analysis reinforced the importance of lifestyle in preventing cognitive disorders in the older population.

Status and influencing factors of knowledge, attitudes and practices relating to screening for breast and cervical cancer among rural women aged 40–65 years in China: a cross-sectional study

ObjectivesThe objectives are to investigate the status of knowledge, attitudes and practices (KAP) and to identify factors related to KAP towards breast and cervical cancer screening among rural Chinese women...

Racial Disparities in Foot Examination among People with Diabetes in Brazil: A Nationwide Survey, 2019.

To assess the absence of diabetic foot examination in Brazil and how ethnicity affected this outcome. This is an analysis of a nationwide survey held in Brazil in 2019. Participants with diabetes and that were 15 years of age or older were eligible for inclusion in the analysis. Adjusted Poisson regression with robust variance was used to calculate prevalence ratios (PRs) and 95% confidence intervals (95% CIs) of never having had the foot examined, with separate models according to ethnicity. Stata 14.2 was used for all calculations. We included 6216 individuals with diabetes; 52.1% (95%CI: 50.0%-54.2%) reported never having had their feet examined by a health care professional and 61% self-declared as Black (Black and Brown [Brazilian mixed race]). A higher frequency of negligence was observed among Black individuals (55.3%; 52.5%-58.1%) than among White individuals (48.2%; 45.0%-51.5%). Negligence was higher between 15- to 39-year-old participants (PR = 1.34, 1.14-1.57), lower educational level (PR = 1.37, 1.13-1.65), higher alcohol consumption (PR = 1.18, 1.06-1.31), fair health status (PR = 1.11, 1.01-1.21), and diabetes diagnosis of up to 10 years (PR = 1.42, 1.28-1.57). Among Blacks, tobacco use and other factors increased the frequency of the outcome, whereas participation in the Brazilian Unified Health System primary care program was a protection factor (P<.05). Black Brazilians with diabetes had higher negligence of foot examination by health care professionals. Strengthening primary care would help mitigate systemic racism in Brazil.

Related Factors of Syphilis Positive Rate in Blood Donors During the COVID-19 Epidemic.

In Shenzhen of China, the continuous increase of syphilis infections threatens the safety of blood transfusion. In 2020, COVID-19 was discovered and spread rapidly around the world, and affected the prevalence of syphilis among blood donors. From 2013 to 2020, there were 839,161 blood samples collected in the Shenzhen Blood Center. Blood samples were screened by ELISA tests and confirmed by the TPPA (Treponema pallidum particle agglutination) tests and the TRUST (toluidine red unheated serum tests). All data was analyzed by the chi-square test. From 2013 to 2020, the positive rate of syphilis among blood donors varied significantly among individuals in different ages, educational backgrounds, regions, and blood donation histories (P<0.001). In 2020, It was the first time that there were more repeat blood donors than first-time blood donors and more blood donors with a higher education level than those with a lower education level, and the lowest reactive and positive rate of syphilis among blood donors was observed. Compared to 2019, the prevalence of syphilis among female and repeat blood donors decreased significantly in 2020 (P<0.01). The prevalence of syphilis in blood donors is related to the characteristics of blood donors (in addition to gender) and the COVID-19 epidemic. COVID-19 can affect the prevalence of syphilis among blood donors by influencing the composition of blood donors and the number of syphile-positive donors in certain blood donors, including female and repeat blood donors.

National trends in thyroid disease and COVID-19 pandemic-related factors, 1998–2021: A nationwide representative study in South Korea

ObjectiveAlthough thyroid disease is a common condition, there is limited research examining the prevalence of thyroid disease over a long period of time, including both before and during the COVID-19 pandemic. Therefore, we aimed to investigate sociodemographic aspects that might be associated with thyroid disease and how its prevalence has varied during the pandemic. MethodsWe assessed the prevalence of thyroid disease among Korean adults by using data from the Korea National Health and Nutrition Examination Survey from 1998 to 2021. We evaluated weighted prevalence and β-coefficients with 95 % CI for factors such as age, sex, residential area, education level, household income, perceived stress level, weight change, occupation category, and body mass index groups. ResultsFrom 1998 to 2021, the prevalence of thyroid disease among 159,896 Korean adults (88,120 females [55.1 %]) aged 20 years and older exhibited an overall increasing trend. The weighted prevalence in the general population rose from 1.52 % (95 % CI, 1.41–1.64) in 1998–2005 to 3.84 % (3.30–4.39) in 2021, with a higher likelihood of thyroid disease exposure as age increased. In addition, females, individuals with lower education levels, those with high levels of perceived stress, those who gained weight, and those classified as overweight or obese emerged as vulnerable groups for thyroid disease. For the majority of subgroups, the change amid the effect of the pandemic on prevalence was minimal. However, the aged ≥60 years group showed a greater increase in prevalence during the pandemic than before the pandemic (βdiff: 0.52 [95 % CI, 0.37–0.68]). ConclusionsA nationwide representative study in South Korea revealed an increasing trend in the prevalence of thyroid disease over 24 years, particularly among the older population. Despite the minimal variation during the pandemic, our findings emphasize the need for targeted thyroid disease policies and further research, especially for specific subgroups such as the older population.

The association between arterial stiffness and socioeconomic status: a cross-sectional study using estimated pulse wave velocity

BackgroundThe impact of socioeconomic status (SES) on arterial stiffness remains unclear. This study aimed to explore the association between both personal and household income, as well as education level, and estimated pulse wave velocity (ePWV).MethodsA total of 13,539 participants (mean age 52.9 ± 16.7 years; 57.1% women) from the Korean National Health and Nutrition Survey database were analyzed. For SES variables, information on personal and household income and education level was collected using standardized questionnaires.ResultsThe ePWV did not show significant differences across groups categorized by individual income levels (P = 0.183). However, there was a noticeable trend of decreasing ePWV with increasing household income levels (P < 0.001). Additionally, ePWV demonstrated a significant negative correlation with higher education levels, indicating that ePWV decreased in groups with higher educational attainment (P < 0.001). In multiple linear regression analyses, both household income (β = -0.055; P < 0.001) and education level (β = -0.076; P < 0.001) were negatively associated with ePWV, even after adjusting for potential confounders.ConclusionsLower household income and lower education levels were associated with higher ePWV, providing further evidence of the influence of SES on arterial stiffness.Graphical abstract

Influence of Obesity and Sociodemographic Features on the Physical Fitness of Breast Cancer Survivors.

Obesity is a chronic, relapsing, and progressive disease. The issue of obesity affects 50 to 80% of patients who have been diagnosed with breast cancer. The aim of this study is to assess the scale of the problem of obesity among breast cancer survivors (BCS) older than 60 years, evaluate their physical fitness, and study the relationship between the occurrence of obesity and levels of fitness among breast cancer survivors. The relationship between fitness and sociodemographic factors has also been analyzed. This original epidemiological clinical study included a cohort of 88 female breast cancer survivors treated in 2022 in Holycross Cancer Center, Kielce, Poland. A questionnaire involving demographic information and medical data was utilized. The Senior Fitness Test (SFT) battery has been used to assess the physical fitness of the patients. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were also analyzed. More than 70% of the studied breast cancer survivors were classified as overweight or obese, according to BMI and WC indices. Depending on the SFT trial, the regression coefficients indicated worse results in participants who were older, lived in urban areas, were professionally active, less educated, and had higher obesity indices. The analysis of the relationship between obesity indices and fitness components revealed that all obesity indices were significantly associated with lower body flexibility (BMI p = 0.0118, WC p = 0.0092, WHR p = 0.0364, WHtR p = 0.0095). Upper body flexibility was significantly correlated with BMI indices (p = 0.0091, p = 0.0193) and WHtR (p = 0.0095). Agility and balance were significantly associated with WC (p = 0.0193), WHR (p = 0.098), and WHtR (p = 0.0095). Lower body strength was significantly correlated with the WHR index (p = 0.0487). Significant differences were found in upper body strength depending on the WHtR category. In the studied group of breast cancer survivors, there is a high prevalence of overweight and obesity. With increasing obesity rates, older age, and lower education levels, physical activity measured by the SFT decreases. Living in urban areas and being professionally active also predispose to lower physical activity levels. As obesity indices increase, physical fitness decreases in trials assessing upper and lower body strength, upper and lower body flexibility, as well as agility and dynamic balance.

Exploring psychotic symptoms among substance-naïve individuals and recent abstainers without a psychosis diagnosis: A cross-country study across Kenya, Uganda, Ethiopia, and South Africa

Psychotic symptoms are of increasing interest in mental health due to their predictive value for future psychotic disorders. While these symptoms are prevalent in the general population, their occurrence varies globally. This study aimed to explore the prevalence and factors associated with psychotic symptoms among individuals identified as substance-naïve and recent abstainers without a history of psychosis. A cross-sectional analysis was conducted on 11,686 participants who reported no lifetime substance use, no substance use in the previous three months, and did not have a diagnosis of psychosis. The study utilized the Psychosis Screening Questionnaire to estimate the one-year prevalence of psychotic symptoms and their associations with demographic and clinical attributes. Results revealed a 3.5 % overall prevalence of psychotic symptoms with 2.9 % prevalence among substance naïve and 4.3 % among recent abstainers. Factors associated with psychotic symptoms were age, being female, having chronic medical conditions, encountering traumatic life events being divorced or separated and lower education levels which positively correlated with symptom scores. There is a need for future investigations and longitudinal studies to uncover the underlying mechanisms and impacts of psychotic symptoms.

Do healthy people migrate more? A 21-year follow-up of a rural cohort in Bangladesh

Demographers have long suspected that health influences whether a person migrates―a “healthy migrant effect” ―but this has rarely been tested for a longer period with high-quality, longitudinal data. This study aimed to assess which measures of health are associated with subsequent migrations among young adults from a rural community in Bangladesh, adjusted for socio-demographic characteristics, and how long these associations persist. The 1996 Matlab Health and Socioeconomic Survey (MHSS) characterized health (by self-reported chronic, and acute morbidity symptoms in the past 12 months and one month, respectively, and self-rated health status) of adults within the Matlab Health and Demographic Surveillance System (HDSS) cohort. Analyses included 3756 (M = 1,496, F = 2260) adults aged 18–34 years (the age when migration peaks) to study the effect of health on migration. Cox Proportional Hazards models were estimated to describe associations between health status and subsequent out-migration in 1996–2017, controlling for age, sex, education, religious affiliation, and household asset quintiles. Discrete-time logistic models were estimated to assess the sustained effects of health status measures on out-migrations. Results reveal that self-reported chronic morbidity, neither acute morbidity nor self-rated health status, inhibited subsequent migration. More reported chronic morbidity symptoms were associated with a lower migration (hazard ratio, HR = 0.82, CI = 0.74–0.92 for one symptom and HR = 0.73, CI = 0.63–0.84 for ≥2 symptoms relative to no symptoms). The differences diminished but persisted over time. Socio-demographic variables inhibiting migration were female sex, older age, and lower-level education. In conclusion, healthy young rural adults were more likely to migrate than their counterparts with symptoms of chronic morbidity, and the effect of chronic morbidity on subsequent migrations waned but not eliminated over time.