Multistage Sampling Method Research Articles

Predictors of the Intention to Perform Preventive Behaviors Against the Occurrence of Breast Cancer

Background: Breast cancer is the most common cancer in women. The purpose of study was to determine the predictors of the intention to perform preventive behaviors against the occurrence of breast cancer (BC) based on the protection motivation theory (PMT). Methods: This research was a cross-sectional study that was conducted on 400 women aged 18 to 70 living in Babol city with a multi-stage sampling method. The data collection tool was a researcher-made questionnaire containing demographic information, questions on BC risk factors based on the constructs of PMT. data was entered into SPSS V20 and analyzed with chi-square, independent t-test, ANOVA, Pearson correlation-test and linear regression at a significance level of 0.05. Results: More than of the participants were single. 66% of participants had no risk factors, 12.5% had one risk factor, 7.5% had three risk factors, and 1.5% had more than four risk factors. The strongest predictors of the intention to perform preventive behaviors against BC were perceived severity (β = 0.280), number of risk factors (β = 0.206), death of a relative due to BC (β = 0.147), and self-efficacy (β = 0.141). Among PMT constructs, perceived severity and self-efficacy constructs were the strongest predictors of preventive behaviors against BC. Conclusion: The PMT plays an important predictive role in the intention to perform cancer prevention behaviors. In this context, it is necessary to design and implement training programs based on these constructs of this model, especially the perceived intensity, self-efficacy and response efficiency.

Prevalence and Risk Factors of Child Abuse: A Descriptive-Analytical Study in Ilam Province, Iran, in 2020

Background and aims: Child abuse is one of the major health and social problems in all countries, which is affected by a set of cultural, social, and family factors and some characteristics of children. The present study was performed to determine factors related to child abuse in Ilam province. Methods: This descriptive-analytical study was designed in 2020 in Ilam province, Iran. Ninety-nine children who had a document of child abuse in social emergency centers were included in the study by the census method. In addition, one hundred and thirty-three children of similar age were selected from the community level by the multi-stage sampling method. The required data were collected using a researcher-made questionnaire whose validity and reliability were confirmed, and a significant level of less than 5% was considered statistically significant. Results: Overall, 53.5% of participants were in the non-abused group, and 46.5% were in the abused children group. Neglect and emotional abuse were the most common types among the abused children. A significant difference was reported between all kinds of child abuse in the abused and non-abused groups (P<0.001). There was a significant relationship between the number of family members with both sexual and nutritional child abuse (P<0.001). Conclusion: Overall, family, economic, and social factors are related to child abuse. Social service counselors recommend the introduction of these factors during the consultation with parents.

Are Tobacco Companies in Nigeria Complying With Health Warning Label Regulations on Cigarettes and Other Tobacco Products?

BACKGROUND: Nigeria has approved 50% coverage of text and images of pictorial health warning labels (PHWLs) on packages of cigarettes and other tobacco products such as cigars, smokeless tobacco, and loose tobacco. While there is knowledge on the extent to which LMICs like Nigeria adopt the WHO Framework Convention of Tobacco Control (FCTC), there is need to examine the compliance with adopted packaging and labeling policies to generate knowledge for strengthening existing policies and efforts at enforcement. We assessed agreement with FCTC regulations as well as compliance with Nigerian requirements which are not adequate and do not effectively capture all FCTC requirements to identify the gaps being explored by these companies in an environment of poor regulation in Lagos, Nigeria. METHODS: This descriptive study was conducted in Lagos State, Nigeria, from October 2022 to January 2023. A multistage random sampling method was utilized. Four local government areas (LGAs) with a combined population of 16 million, accounting for 70% of the population in Lagos, Nigeria were selected while three points‑of‑sale were randomly picked from two selected wards in each LGA. Empty discarded packs of cigarette and other tobacco products were collected from these outlets. The pack dimensions were measured and assessed for PHWLs, health warning manipulations and cessation assistance. Findings were assessed for compliance with the FCTC and national legislation. For each compliance feature, we calculated the frequencies and percentages of the packs that were compliant. RESULTS: 704 packs: 434 packs of 22 cigarette brands and 270 packs of 17 different tobacco products including cigars, snuff and loose tobacco were included in the study. Of 434 cigarette packs assessed, 50.3% were compliant with 9 indicators measured. These ranged from 48.8% to 55.5% for individual brands. For cessation assistance, image variability and image manipulation, compliance was 0% across all cigarette packs. Out of 270 tobacco product packs assessed, 10.6% were compliant with the 9 indicators assessed. Of the 12 multinational parent companies and product distributors assessed, the overall level of compliance among them was 24.9%. Level of compliance was noted to very low for companies involved in marketing other tobacco products, ranging from 0% to 20% but moderate for those marketing cigarettes, ranging from 37% to 55.5%. Companies that had no presence or subsidiaries in Nigeria but only export their products were highly non-compliant. CONCLUSIONS: Tobacco companies had low compliance with PHWL on cigarettes and negligible compliance on other tobacco products like cigars, loose and smokeless tobacco. The government should expand and strictly enforce all regulations applying to health warnings, especially on non-cigarette tobacco products and closely monitor companies that merely export their products to the country.

Free-energy calculations in condensed matter: from early challenges to the advent of umbrella sampling

The investigation of condensed matter transformations hinges on the precision of free-energy calculations. This article charts the evolution of molecular simulations, tracing their development from the techniques of the early 1960s, through the emergence of free-energy calculations toward the end of the decade, and leading to the advent of umbrella sampling in 1977. The discussion explores the inherent challenges and limitations of early simulational endeavors, such as the struggle with accurate phase-space sampling and the need for innovative solutions like importance sampling and multistage sampling methods. Taken together, the initial hurdles and subsequent adoption of advanced techniques exemplify the leap from analytical methods to effective computational strategies that enabled more reliable simulations. Further analysis of this narrative reveals the methodological breakthroughs as well as the setbacks that transformed the theoretical and practical understanding of condensed matter phenomena. A follow-up study will examine the shifts in free-energy calculations from the late 1970s into the 1980s.

Factors associated with fruit and vegetable consumption among people in the highest risk area for Cholangiocarcinoma in Thailand

Background: Over the past 30 years, the incidence of cholangiocarcinoma (CCA) in the Northeast of Thailand has been high and has tended to increase. Fruits and vegetables (FV) were accepted as protective factors against CCA. The prevalence of FV consumption among Northeast people is lower than recommended, which is a significant health problem that must be urgently solved. Objectives: This study investigated the factors associated with FV consumption among people in Ubon Ratchathani, one of the high-risk areas of Thailand. Methods: A multi-stage sampling method was used to select the population aged 40 years and over. Data were analyzed using descriptive and inferential statistics. A logistic regression analysis was performed to identify the factors associated with FV consumption. Results: Out of the total 744 respondents, only 11.83% consumed FV according to the standard of <400 grams/day. The bio-social factor regarding an average family income of more than 15,000 Baht had a 10.54 times greater effect on FV consumption (AOR=10.54, 95% CI: 7.59-20.57). Purchasing FVs from mobile sales trucks (AOR=4.11, 95% CI: 1.69-9.97) and receiving information from radio (AOR=1.97, 95% CI: 1.14-3.39) were associated with standard FV consumption. However, a good level of attitude had decreased the risk of FV consumption (AOR=0.30, 95% CI: 0.18-0.49). Conclusion: The prevalence of FV consumption among the study population is considerably low. Family income, purchasing from mobile sales trucks, receiving information from radio, and having a positive attitude were associated with standard FV consumption among people in Thailand's highest-risk area for CCA. Relevant organizations should organize activities to provide people of every economic status with knowledge and attitude on FV consumption via radio or social media and support access to quality and safe mobile sales trucks to meet consumption standards and prevent as well as reduce the risk of CCA.

Interactive effects of Composite Dietary Antioxidant Index with Body Mass Index for the risk of stroke among U.S. adults: insight from NHANES 2001-2018.

This cross-sectional study aims to explore the interactive effects of the Composite Dietary Antioxidant Index (CDAI) and Body Mass Index (BMI) on stroke risk among U.S. adults, utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018. The analysis involved 42,042 participants from a representative sample of non-institutionalized U.S. civilians, selected through a stratified, multistage probability sampling method. Dietary intake data were collected over two 24-h periods using the Automated Multiple-Pass Method. The study calculated a modified CDAI to assess dietary antioxidant intake, excluding supplements and water sources. Statistical methods included multivariable logistic regression and Generalized Additive Models (GAM) to evaluate the interaction between CDAI scores and BMI in relation to stroke risk, adjusting for a wide range of demographic, lifestyle, and health covariates. The research identified a significant interaction between CDAI scores and BMI categories in stroke risk assessment. While a negative correlation was observed between CDAI scores and stroke risk across the total population (OR 0.97, 95% CI 0.96-0.99), this relationship varied notably across different BMI groups. In participants with a BMI ≥25, a statistically significant negative association persisted, displaying a non-linear pattern. The study also revealed an inflection point in the CDAI score, indicating a shift in the relationship between dietary antioxidants and stroke risk. This study underscores the complex interaction between dietary antioxidant intake and BMI in determining stroke risk among U.S. adults. The findings suggest that individuals with higher BMI may experience more pronounced benefits from dietary antioxidants in stroke prevention. These insights could inform targeted dietary recommendations and public health strategies aimed at reducing stroke risk, particularly in populations with higher BMI. Further research is needed to fully understand these interactions and their implications for stroke prevention guidelines.

Identification of the health education targeted susceptible population of tuberculosis in Ningxia, Northwest China

Knowledge, Attitude, and Practice (KAP) survey, as an effective measure tool, is of practical significance for identifying the susceptible population in high-incidence regions of tuberculosis (TB). We aim to identify the health education targeted susceptible population of TB and discuss the acting pathway of KAP in Ningxia. A multistage random sampling method was used to conduct a face-to-face questionnaire survey for residents. The latent class analysis (LCA) model was used to classify susceptible populations of TB, and the structural equation modeling (SEM) model was also employed to investigate the interaction mechanisms of KAP (mediation analysis). We further applied the ordered logistic regression model to explore the associated factors. A total of 973 residents were enrolled, 70.6% were male, aged from 16 to 89. The LCA analysis demonstrated that 3 categories of susceptible populations of TB ("overall good", "positive attitude" and "overall poor") have optimal goodness of fit (BIC = 7889.5, Entropy = 0.923). SEM model indicated that the attitude plays a significant mediation effect from knowledge to practice toward TB (an indirect effect of 0.038, and a direct effect of 0.138). The ordered logistic regression results found that age, sex, marital status, education level, occupation, family income, self-perceived health status, having a family member or friend with TB, and knowing the DOTS strategy were significantly associated with classifications of KAP level towards TB. Based on the LCA model, we accurately classified the susceptible population of TB into 3 groups with different degrees of KAP. We found that TB attitude plays a mediating role between knowledge and practice. Therefore, we should pay more attention and carry out targeted health education in the community to these populations with overall poor KAP towards TB, and develop effective strategies and measures to realize the End TB Plan.

Association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40-89 in selected areas of China

Objective: To investigate the association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40 to 89 years in selected areas of China. Methods: The research was based on the survey of the impact of soil quality of agricultural land on human health in typical areas conducted in 2019-2020. A total of 5 600 middle-aged and older adults aged 40 to 89 years were included by using a multi-stage stratified random sampling method. Baseline characteristics of the subjects were collected and physical examinations were performed. Random midstream urine was collected to measure urinary cadmium and urinary creatinine and fasting venous blood was collected to measure the leukocyte count, neutrophil count, lymphocyte count, monocyte count and eosinophil count. The linear mixed effect model was used to analyse the association of urinary cadmium levels with leukocyte classification counts, and the dose-response relationship between them was analyzed by using the restricted cubic spline (RCS) function. Results: The age of the subjects was (63.17±12.02) years; 2 851 (50.91%) were males; and the M (Q1, Q3) of urinary creatinine-corrected urinary cadmium levels was 2.69 (1.52, 4.69) μg/g·creatinine. After adjusting for confounding factors, the results of linear mixed effects model analysis showed that for each 1-unit increase in urinary creatinine-corrected urinary cadmium level, the percentage change [% (95%CI)] of leukocyte count and lymphocyte count was -1.70% (-2.61%, -0.79%) and -1.57% (-2.86%, -0.26%), respectively. RCS function showed a negative linear relationship between urinary creatinine-corrected urinary cadmium levels and leukocyte counts and lymphocyte counts, respectively (all Pnon-linear>0.05). Conclusion: Urinary cadmium levels are negatively associated with leukocyte count and lymphocyte count among middle-aged and older adults aged 40 to 89 years in selected areas of China.

Evaluating serum electrolyte and trace element variations between Babesia ovis-infected and uninfected Lohi sheep

Babesiosis caused by Babesia ovis is a major threat to the livestock industry worldwide. In Pakistan, the Lohi sheep breed is an important economic resource, but limited information is available on the impact of B. ovis infection on this breed. This study aimed to investigate the serum electrolyte and trace element variations between B. ovis-infected and uninfected Lohi sheep from Pakistan. A total of 97 Lohi sheep was stratified based on the geographical distribution of Multan district, employing a multistage cluster sampling method. Blood and serum samples were collected from randomly selected sheep, and DNA extraction and PCR amplification were performed to detect B. ovis infection. Serum electrolyte and trace element levels were analyzed in infected (n=67) and uninfected (n=30) groups, stratified by age and gender. The study revealed a 69.07% overall infection rate of B. ovis in Lohi sheep. Infected sheep showed significantly elevated serum copper levels (p<0.0001), with no substantial differences observed in serum iron, sodium, potassium, and chloride levels. However, age-wise variance analysis revealed statistically significant variations in sodium and potassium levels (p<0.0001 and p<0.05, respectively). Notably, serum chloride levels differed between infected and uninfected females in individuals younger than two years (p<0.05). Serum iron levels remained consistent across different age groups. Comparative analysis indicated a higher prevalence of electrolyte imbalances, such as hyponatremia, hyperkalemia, hyperchloremia, and hypoferremia, in infected sheep compared to normal reference ranges, while instances of hypernatremia, hypokalemia, hypochloremia, and hyperferremia were less frequent. In conclusion, our study suggests that B. ovis infections could lead to alterations in serum electrolyte and trace element levels in Lohi sheep, emphasizing the importance of further research into the specific mechanisms driving these alterations to enhance disease management strategies tailored to this breed.

Study on the evaluation and influencing factors of contracted residents on the coordination of primary medical institutions.

The implementation of family doctor contract service is a pivotal measure to enhance primary medical services and execute the hierarchical diagnosis and treatment system. Achieving service coordination among various institutions is both a fundamental objective and a central element of contract services. The study aims to assess residents' evaluations and determining factors related to the coordination of health services within primary medical institutions across different regions of Shandong Province. The findings intend to serve as a reference for enhancing the coordination services offered by these institutions. The study employed a multi-stage stratified random sampling method to select three prefecture-level cities in Shandong Province with different economic levels. Within each city, three counties (districts) were randomly sampled using the same method. Within each county (district), three community health service centers and township health centers implementing family doctor contract services were selected randomly. Face-to-face questionnaire surveys were conducted with contracted residents using the coordination dimension of the revised Primary Care Assessment Tools Scale (PCAT) developed by the research team. Data analysis was conducted using such methods as one-way analysis of variance and multiple linear regression. The sample included 3,859 contracted residents. The coordination dimension score of primary medical institutions averaged 3.41 ± 0.18, with the referral service sub-dimension scoring 3.60 ± 0.58 and the information system sub-dimension scoring 3.34 ± 0.65. The overall score of the referral service sub-dimension surpassed that of the information system sub-dimension. Regression results indicated that the city's economic status, the type of contracted institutions, gender, education, marital status, income, occupation, health status, and endowment insurance payment status significantly influenced the coordinated service score of primary medical institutions (p < 0.05). The coordination of primary medical institutions in Shandong Province warrants further optimization. Continued efforts should focus on refining the referral system, expediting information infrastructure development, enhancing the service standards of primary medical institutions, and fostering resident trust. These measures aim to advance the implementation of the hierarchical diagnosis and treatment and two-way referral system.

Socio-economic burden of sickle cell disease on families attending sickle cell clinic in Kano state, northwestern Nigeria

This study aimed to assess the socio-economic impact of sickle cell disease (SCD) on families of patients receiving care at the SCD clinic of Aminu Kano Teaching Hospital (AKTH) in Kano, Northwest Nigeria. The research adopted a descriptive cross-sectional approach, involving the participation of 273 individuals selected through a multi-stage sampling method. Data was gathered using semi-structured interviews and subjected to analysis using SPSS software. The study achieved a 100 % response rate, with 84 % of the participants being females. The average age of the participants was 35.1 ± 8.6 years, and a significant proportion (79.9 %) reported a monthly income of thirty thousand naira or less. The findings of the study revealed that SCD had a notable social impact, affecting 93.5 % of participants occasionally and 5.8 % most of the time. Furthermore, a substantial financial burden was experienced by 54.2 % of respondents most of the time and 45.1 % occasionally. The research also highlighted the significant influence of SCD on guardians' employment status, income levels, time spent in hospitals, medical expenditures, and overall quality of life. These findings underscore the considerable social and financial challenges faced by guardians of SCD patients. Study results supports prioritizing affordable healthcare access for families affected by SCD to alleviate the burdens they face.

Current situation of family doctor contracting program: A survey of the perspective of general practitioners

BackgroundResearch on family doctor contract services has predominantly focused on residents, with limited attention to the general practitioners (GPs) regarding the current situation of family doctor team contracting. ObjectiveThis study aims to assess the current status of family doctor contract services in primary health care facilities in Guangdong Province from the GPs' perspective and to identify factors influencing the number of people contracting with family doctor teams. MethodsA multi-stage stratified cluster sampling method was used to select GPs from primary health care facilities in Guangdong Province from July 5 to July 31, 2021. A self-developed survey questionnaire was used to collect data. The number of people contracted with family doctor teams under different characteristics of GPs and their teams was compared, and a two-level Logistic regression model was developed using R 4.2.2 software to determine the factors that influence whether enrollment numbers in family doctor teams exceed 2,000. ResultsA total of 3,252 valid responses were collected from family doctor teams with a contracting count above 100. In 2020, the median number of contracts per family doctor team, as reported by GPs, was 1,400(IQR = 2,499). Comparisons of the number of people contracted with family doctor teams among GPs of different genders, ages, educational levels, managerial positions, employment forms, years of professional experience, working facilities, practicing regions, training received, and annual income showed statistically significant differences (P < 0.05). Variables including the number of team members, the population under jurisdiction, the intention for specialist doctors within the health group to join the team, the availability of hospital beds, and guidance from higher-level hospitals also exhibited significant variations (P < 0.05). Zero model fitting results highlighted that the distribution of contracted individuals was regionally clustered among the practicing regions of GPs (P < 0.05). The comprehensive analysis using a two-level Logistic regression model revealed several key findings: GPs holding a college diploma [OR (95 %CI) = 2.79 (1.84, 3.74)] or a vocational school/high school certificate [OR (95 %CI) = 2.83 (1.80, 3.86)] were more likely to manage teams with over 2,000 contracted individuals, compared to those with a master's degree or higher. GPs in managerial positions were less likely [OR (95 %CI) = 0.66 (0.33, 0.99)] to oversee teams exceeding 2,000 contracted individuals, in contrast to those without any managerial role. Formal employment status was associated with a higher likelihood [OR (95 %CI) = 2.02 (1.53, 2.51)] of managing larger numbers of contracted individuals compared to temporary employment. Team size showed a positive correlation with contracting capacity; teams with 4–6 members [OR (95 %CI) = 1.31 (1.05, 1.57)], 7–10 members [OR (95 %CI) = 2.06 (1.75, 2.37)], 11–19 members [OR (95 %CI) = 3.67 (3.31, 4.03)], and ≥20 members [OR (95 %CI) = 3.46 (2.74, 4.18)] were increasingly likely to surpass 2,000 contracted individuals. Teams managing larger populations—2,001–9,999 [OR (95 %CI) = 2.37 (2.12, 2.62)], 10,000–29,999 [OR (95 %CI) = 2.92 (2.65, 3.19)], and ≥30,000 [OR (95 %CI) = 2.86 (2.55, 3.17)]—were more likely to exceed 2,000 contracts compared to those managing ≤2,000 people. The absence of hospital bed resources within a team was positively associated [OR (95 %CI) = 1.38 (1.14, 1.62)] with surpassing the 2,000 contracted individuals threshold. ConclusionThe study findings suggest that a larger family doctor team size and larger population size of jurisdiction positively impact the capacity for contracting with family doctor teams. GPs with higher educational levels, managerial roles, and access to hospital bed resources possess a more profound understanding and control over family doctor contract service policies, leading to optimized management of contracted individuals. Compared to their temporarily employed counterparts, formally employed GPs within family doctor teams are more likely to engage in contracting activities.

Diagnostic Accuracy of Mid-Upper Arm Circumference for the Detection of Acute Malnutrition Among Children Aged 6-60 Months: A Diagnostic Accuracy Study.

Timely and accurate screening of malnutrition at the community level is essential to identifying malnourished children. The World Health Organization (WHO) guidelines classify non-oedematous acute malnutrition among children using mid-upper arm circumference (MUAC) or weight-for-height Z-score (WHZ). Study Design: A cross-sectional study. This study was conducted among children aged 6‒60 months. After necessary exclusions, 433 participants were selected using a multi-stage simple random sampling method. Using WHO guidelines for global acute malnutrition (GAM) [WHZ<-2, MUAC<12.5 cm], the sensitivity (Se), specificity (Sp), predictive values, likelihood ratios, Youden index, and receiver operating characteristic (ROC) curve were calculated for MUAC using WHZ as the criterion. Out of 433 participants, 30% were diagnosed with GAM using WHZ, while 17.6% were found malnourished using MUAC measurements. As per WHO cut-offs, the Se, Sp, positive predictive value (PPV), negative predictive value (NPV), Youden index, positive likelihood ratio (LR+), and negative likelihood ratio (LR-) of MUAC were 48%, 96%, 83%, 81%, 0.44, 12, and 0.54, respectively. The ROC curve displayed an area under the curve of 0.86 (95% confidence interval=0.83, 0.90) for MUAC<12.5 cm. Bivariate Pearson correlation also demonstrated a positive linear relationship (R2=0.302) between the WHZ and MUAC variables. Based on the findings, 48% of the children were correctly identified by the MUAC with an 83% probability of GAM (PPV=0.83). Moreover, there was 96% Sp in non-malnourished children, with only 4% false positives. Therefore, personnel at the grassroots level can use MUAC for timely and accurate screening of children in Anganwadi centers (AWCs) due to its ease of use and simplicity.

Profit Efficiency of Milk Producers in Ethiopia: Empirical Evidence from Western Shewa Milk Shade, Walmara District

The study assessed the profit efficiency and the responsible factors for the inefficiency of dairy farmers in West Shewa milkshed, central Ethiopia. A multistage random sampling method was employed to select sample households. The primary data were collected using structured questionnaires with computer-assisted personal interviews (CAPI). Descriptive and econometric data analysis were performed, and the stochastic frontier model was the model used. The result disclosed that the dairy business is profitable, and the mean efficiency score is 71%, indicating the existence of 29% inefficiency in dairy farming. This result indicates that enhancement of all the efficiencies will enable households to attain a potential profit of 88428.25 birrs. Sex, the price of milk, and the number of cows owned were the main factors that affected the profit inefficiency of the dairy farmers. This study suggests that the profit efficiency of dairy farmers will be enhanced if they choose their dairy farm sizes based on the production resources they have, and if the milk collection centers are availed in all villages.

Exploring Students’ and Teachers’ Insights on School-Based Disaster Risk Reduction and Safety: A Case Study of Western Morava Basin, Serbia

Integrated disaster risk reduction in schools represents a key component of safety strategies within the educational sector of every country. The aim of this study is to comprehensively explore the impact of various demographic and socio-economic factors on the perceptions of students and teachers regarding disaster risk reduction and safety in schools. This study is distinguished by its extensive empirical approach, employing a multistage random sampling method to conduct 850 face-to-face interviews (650 with students and 200 with teachers) throughout 2023 in 10 out of the total 18 municipalities in the Western Morava Basin of the Republic of Serbia. Two structured survey instruments were developed, incorporating a mix of qualitative (closed-ended) multiple-choice questions and five-point Likert scales. The research proposes two central hypotheses regarding school-based disaster risk reduction. Firstly, it suggests that gender, age, parent’s employment, academic achievement, living situation, parental education levels, and engagement with social media collectively influence students’ perspectives on this matter (H1–H8). Secondly, it posits that gender, age, marital status, parenthood, and educational background significantly impact teachers’ viewpoints on school-based disaster risk reduction (H1–H5). Multivariate linear regression was used to explore predictors of students’ and teachers’ insights on school-based disaster risk reduction. Various statistical tests, including Chi-square, t-tests, one-way ANOVA, and Pearson’s correlation, were employed to investigate the influence of demographic and socioeconomic factors on these insights. The results of multivariate regression analyses indicate that age, gender, and marital status emerge as the primary predictors across various facets of students’ and teachers’ insights on school-based disaster risk reduction, including awareness of disasters, disaster education activities, attitudes toward disaster risk reduction education, and enhancement of disaster information accessibility. The findings of this study provide comprehensive insights into the key factors influencing students’ and teachers’ perceptions of disaster risk reduction in schools. This research not only contributes to the academic discourse on disaster education but also serves as a foundational basis for improving educational programs, developing policies and strategies, refining normative educational frameworks, guiding teacher training, and informing further research in disaster education.

The influence of customer experience on loyalty through satisfaction as an intervening variable for users of maxim online transportation services in the city of semarang

The high level of online transportation users in Indonesia creates intense competition and to be able to survive in the midst of competition, companies must improve their performance in various aspects to be able to create a good experience for their users so that there is high satisfaction so that user loyalty to the company continues to survive and increase. This research aims to determine the influence of customer experience on user loyalty through satisfaction with users of Maxim online transportation services in Semarang City. This type of research is explanatory research with a sample size of 96 respondents who are Maxim users in Semarang City. with a sampling technique using non-probability sampling with a multistage purposive sampling method. The population in this research is the people of Semarang City who have used Maxim. The data analysis method uses SmartPLS 3.2.9 software. The research results prove that the mediating relationship between customer experience and loyalty through satisfaction as an intervening variable is partial mediation. The suggestion in this research is that Maxim is expected to pay more attention to aspects that can influence user experience so that users feel maximum satisfaction when using Maxim.

Hypertension in the Polish elderly: Insights into prevalence, awareness, treatment, and control from the NOMED-AF study.

Hypertension is a significant global health issue, disproportionately affecting the elderly population. In Poland, the rapid aging of the population underscores the need for updating data on the epidemiology of hypertension in the elderly. This study aimed to investigate the prevalence, awareness, treatment, and control of hypertension among individuals aged 65 and older in Poland. The NOMED-AF study, a cross-sectional survey conducted from March 2017 to March 2018, enrolled a representative sample of 3014 participants aged 65 and over, using a multistage, stratified, and clustered sampling method. Data collection included standardized questionnaires and physical measurements carried out by trained nurses. Hypertension was diagnosed per the 2018 European Society of Hypertension/European Society of Cardiology guidelines. The study showed a hypertension prevalence of 82.5% in females and 78.3% in males aged 65 and older. Awareness of hypertension was high across all age and sex groups, with 86.2% of women and 83.4% of men being aware of their condition. Treatment rates were 84.8% in women and 80.5% in men. Optimal control of blood pressure among those treated was achieved in 40.3% of women and 45.6% of men. Women over 80 achieved optimal blood pressure control less frequently than men. The results highlight the high prevalence and suboptimal control of hypertension in Poland's elderly population, pointing to a significant public health challenge. Despite high rates of treatment, management of hypertension remains inadequate, which emphasizes the need for enhanced strategies in hypertension care, particularly for elderly women.

The effect of socioeconomic status, depression, and diabetes symptoms severity on diabetes patient’s life satisfaction in India

Evidence suggests that diabetes is on the rise in India, affecting many people’s life satisfaction. Comprehensive estimation of life satisfaction among diabetes patients does not exist in the country. This study examined the effects of socioeconomic status, depression, and diabetes symptoms severity on the life satisfaction of diabetes patients by controlling various demographic variables. It was a cross-sectional study comprising 583 diabetes patients from Punjab, India. Patients were interviewed using a multi-stage purposeful random sampling method. Descriptive analysis and partial least squares structural equation modelling were used in the study to test the hypotheses. Results revealed that socioeconomic status, depression and diabetes symptoms severity significantly influence the life satisfaction of diabetes patients. A 1% drop in diabetes symptoms severity corresponds to a 0.849% increase in life satisfaction, whereas a 1% decrease in depression results in a 0.898% increase in life satisfaction. Patients with higher diabetes symptoms severity were coping with common mental disorders. Women reported higher diabetes symptoms severity and depression than men, resulting in lower life satisfaction. An experimental evaluation of the effects of socioeconomic status, depression and diabetes symptoms severity, and numerous demographic factors on life satisfaction was reported. The findings will help policymakers understand the problem associated with life satisfaction among diabetes patients in the country.

Triple burden of malnutrition among Vietnamese 0·5-11-year-old children in 2020-2021: results of SEANUTS II Vietnam.

SEANUTS II Vietnam aims to obtain an in-depth understanding of the nutritional status and nutrient intake of children between 0.5-11.9 years old. Cross-sectional survey. A multistage cluster systematic random sampling method was implemented in different regions in Vietnam: North Mountainous, Central Highlands, Red River Delta, North Central and Coastal Area, Southeast and Mekong River Delta. 4001 children between 6 months and 11.9 years of age. Prevalence of stunting and underweight was higher in rural than in urban children, whereas overweight and obese rates were higher in urban areas. 12.0% of the children had anemia and especially children 0.5-1-year-old were affected (38.6%). Low serum retinol was found in 6.2% of children ≥ 4 years old. Prevalence of vitamin D insufficiency was 31.1% while 60.8% had low serum zinc. For nutrient intake, overall, 80.1% of the children did not meet the estimated energy requirements. For calcium intake, ∼60% of the younger children did not meet the RNI while it was 92.6% in children >7 years old. For vitamin D intake, 95.0% of the children did not meet RNI. SEANUTS II Vietnam indicated that overnutrition was more prevalent than undernutrition in urban areas, while undernutrition was found more in rural areas. The high prevalence of low serum zinc, vitamin D insufficiency and the inadequate intakes of calcium and vitamin D are of concern. Nutrition strategies for Vietnamese children should consider three sides of malnutrition and focus on approaches for the prevention malnutrition.

ANALYSIS OF ACTIVE SCHOOL COMMUTING INFRASTRUCTURE IN OTA, OGUN STATE, NIGERIA

Active commuting can be enhanced through infrastructure development to promote well-being. Lack of awareness and little or no knowledge of the importance and health benefits reduces the rate at which school children and policymakers value active commuting in Nigeria. The study analysed the activities of active school commuting with cycling in Ota, to provide information on how it would enhance the well-being of young people. Primary (questionnaire) and secondary data were used. A multistage sampling method was adopted. Twenty public schools were identified, and 50% were randomly selected. Random sampling was used to select 20 students up to age from each school selected for the survey, therefore having a total of 200 questionnaires. The data were analysed using descriptive statistics and five-point Likert-scales method. The findings revealed that the road was not constructed to standard, was not in good condition, and lacked some necessary amenities. Active commuting users were not satisfied with the existing conditions of the road. Well-being indicators revealed that derived active factors have the highest mean score of 4.07, and respected active factors have the lowest mean score of 2.74. Active school commuting is a subset of physical activity which promotes wellness and quality of life. It is recommended that the government should rehabilitate the road up to standard and provide necessary amenities for the safety of active commuting users. Local governments also can organize active commuting sports competitions for school children and young ones in their jurisdiction.