National Cross-sectional Survey Research Articles

Social transition, socioeconomic status and self-rated health in China: evidence from a national cross-sectional survey (CGSS).

Social transition is one of the multi-level mechanisms that influence health disparities. However, it has received less attention as one of the non-traditional social determinants of health. A few studies have examined China's social transition and its impact on health inequality in self-rated health (SRH). Therefore, this study explores the impact of China's market-oriented reforms-social transition and socioeconomic status (SES)-on residents' SRH. Using the cross-sectional data from the Chinese General Social Survey (CGSS) in 2017, we analyzed the effects of social transition and SES on the SRH of Chinese residents using the RIF (Recentered influence function) method. The RIF decomposition method investigated health differences among different populations and their determinants. Social transition and SES have significant positive effects on the SRH of Chinese residents. The correlation between SES and the SRH of Chinese residents is moderated by social transition, implying that social transition can weaken the correlation between SES and the SRH of Chinese residents. The impacts of SES and social transition on SRH vary across populations. Promoting social transition and favoring disadvantaged groups with more resources are urgently needed to promote equitable health outcomes.

National Trends in Emergency Department Visits for Suicide Attempts and Intentional Self-Harm.

This study estimated national annual trends and characteristics of emergency department visits for suicide attempts and intentional self-harm in the United States from 2011 to 2020. Data were from the National Hospital Ambulatory Medical Care Survey, an annual cross-sectional national sample survey of emergency departments. Visits for suicide attempts and intentional self-harm were identified using discharge diagnosis codes (ICD-9-CM for 2011-2015; ICD-10-CM for 2016-2020) or reason-for-visit codes. The annual proportion of emergency department visits for suicide attempts and intentional self-harm was estimated. The weighted number of emergency department visits for suicide attempts and intentional self-harm increased from 1.43 million, or 0.6% of total emergency department visits, in 2011-2012 to 5.37 million, or 2.1% of total emergency department visits in 2019-2020 (average annual percent change, 19.5%, 95% CI=16.9, 22.2). Visits per capita increased from 261 to 871 visits per 100,000 persons (average annual percent change, 18.8%, 95% CI=17.6, 20.0). The increase in visits was widely distributed across sociodemographic groups. While suicide attempt and intentional self-harm visits were most common among adolescents, adults age 65 or older demonstrated the largest increase (average annual percent change, 30.2%, 95% CI=28.5, 32.0). Drug-related diagnoses were the most common co-occurring diagnosis among suicide attempt and intentional self-harm visits. Despite the rise in emergency department visits for suicide attempts and intentional self-harm, less than 16% included an evaluation by a mental health professional. A significant national increase in emergency department visits for suicide attempts and intentional self-harm occurred from 2011 to 2020, as a proportion of total emergency department visits and as visits per capita. These trends underscore an urgent need to improve the continuum of mental health care for individuals with suicidal symptoms.

Should general anesthesiologists be certified to perform anesthesia for patients with morbid obesity undergoing bariatric surgery: A national web-based cross-sectional survey.

Bariatric surgery in Saudi Arabia has become one of the most performed surgical procedures for weight loss surgery (WLS). The aim of this survey is to highlight the importance of education and training in bariatric anesthesia (BA). An Internet-based cross-sectional survey was conducted to examine the percentages of general anesthesiologists among respondents who supported the need for formal structured training in BA as the primary outcome. A 41 items questionnaire on different aspects of BA included in this survey. All anesthesiologists in KSA participated in this survey. 42% responded giving anesthesia for bariatric surgery/year between 25 and 50% of cases/year. 22% responded performing 25-50 cases/month, 21% from 10-25 cases, and 14% from 50-100 cases. Compared with how many elective bariatric surgical procedures performed in your center/month revealed significant differences (P < 0.05), 39% responded with no dedicated team in their center, 14% for <10 cases a month, 9% between 25 and 50 cases a month. Compared to the number of cases performed by non-bariatric anesthetists revealed non-significant differences (P > 0.05), upon asking on how many trained/skilled anesthesiologists in bariatric anesthesia in your center, 24% reported none, 4% only one, 21% 2-5 anesthesiologists, 12% 5-10 anesthesiologists, and 19% of the respondents reported more than 10 anesthesiologists specialized in BA. We believe in education and training in bariatric anesthesia. Residents' rotation in BA should be included in their curriculum. A dedicated fellowship program to be developed at a national level as well as courses and workshops.

Assessing attitudes towards violence against women and girls, their determinants and health-seeking behaviour among women and men in South Sudan: a cross-sectional national survey

ObjectiveInvestigating attitudes accepting two categories of violence against women and girls (VAWG) (intimate partner violence—IPV—and other expressions of VAWG) and their association with seven demographic/social determinants and health-seeking behaviours in...

Cancer clinical trial participation in socioeconomically vulnerable patients: A risk model to aid in targeted interventions.

1529 Background: In patients with cancer, those with lower income are 30% less likely to participate in clinical trials. Lower income individuals face direct and indirect costs that can make participation in a clinical trial prohibitive. However, a broader evaluation of specific behavioral, information, insurance, and area-level variables that could contribute to this disparity has not been conducted. We aimed to develop and validate a model to identify socioeconomically vulnerable patients at high risk of non-participation in clinical trials. Methods: We used data from the Health Information National Trends Survey (HINTS), a national cross-sectional survey about knowledge of, attitudes toward, and use of health-related information. We analyzed HINTS survey databases that included questions about whether patients with cancer participated in a clinical trial (survey years 2014, 2017, and 2020). We examined 21 different demographic, socioeconomic, behavioral, geographic, and health information questions. We derived a risk model to predict clinical trial participation in a random set of 60% of participants using best subset selection with k-fold cross validation. The derived model was validated in the remaining 40% of participants. Logistic regression was used. Results: We examined N=1,023 participants with household income &lt;$75,000, the current median in the U.S. In the training dataset of n=614 participants, a model with 5 variables was identified. Non-Hispanic White patients and patients without a college education, with high levels of distrust, with high levels of anxiety or depression, and from non-urban areas were all at lower risk of trial participation. We summed the adverse risk factors for all individuals; a risk score with 4 levels was constructed based on distribution quartiles. In the independent validation cohort (n=409), each increase in level of adverse risk factors was associated with a 42% reduction in the odds of trial participation (OR=0.58, 95%-CI, 0.40-0.84, p=.004), indicating successful model validation. Among all individuals, trial participation rates decreased from 18.6% to 7.5% to 4.6% to 2.8%, respectively, as the number of adverse risk factors increased (in quartiles) from 0-1 to 2 to 3 to 4-5. Individuals with 4 or 5 risk factors (vs. those with 0-1 factors) were 87% less likely to participate (OR=0.13, 95% CI, 0.05-0.31, p&lt;.0001). Conclusions: We developed and validated a 5-variable risk model that identified a large set of lower income individuals at lower risk of trial participation. In a first-time observation, psychosocial variables were shown to be meaningful predictors of lower trial participation. These findings could aide in the early identification of patients who may benefit from additional support to navigate the treatment trial decision making process, in the name of more equitable participation in trials for all patients.

Body Weight Perceptions Among Youth From 6 Countries and Associations With Social Media Use: Findings From the International Food Policy Study

BackgroundBody dissatisfaction is associated with poor psychological and physical health, particularly among young people. However, limited data exist on body size perceptions across countries and factors associated with dissatisfaction. ObjectiveThis study examined dissatisfaction prevalence and associations with sociodemographics and social media use among youth in 6 countries. DesignRepeat cross-sectional national online surveys were conducted as part of the 2019 and 2020 International Food Policy Study Youth Survey. ParticipantsThe sample included 21 277 youth aged 10 to 17 years from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Youth were recruited to complete the online survey through parents/guardians enrolled in the Nielsen Consumer Insights Global Panel and their partners’ panels. Main outcome measuresFigural drawing scales assessed self-perceived and ideal body images, with differences between scales representing body dissatisfaction. Statistical analyses performedMultinomial logistic regression models examined differences in body dissatisfaction by country, and associations with sociodemographics and either social media screen time or platforms used, including 2-way interactions with country. ResultsOverall, approximately 45% of youth reported the same perceived and ideal body sizes, whereas 35% were “larger than ideal” (from 33% in Canada and Australia to 42% in Chile) and 20% were “thinner than ideal” (from 15% in Chile to 22% in Mexico). Greater social media screen time was associated with a higher likelihood of moderate-severe dissatisfaction for being “thinner than ideal” and at least mild dissatisfaction for being “larger than ideal” (P < .003 for all contrasts), with greater dissatisfaction among users of YouTube and Snapchat than nonusers (P ≤ .005 for both contrasts). Modest differences in body dissatisfaction between countries were observed for age, ethnicity, body mass index, and weight-based teasing. ConclusionsBody dissatisfaction is prevalent among youth across diverse countries. These findings highlight the need to promote healthy body image in youth, particularly among social media users.

Dietary fibre intake and its association with ultraprocessed food consumption in the general population of Switzerland: analysis of a population-based, cross-sectional national nutrition survey

ObjectivesThe objective of this study was to describe the compliance to dietary fibre recommendations of the Swiss population and to investigate the association between dietary fibre intake and ultraprocessed food...

High-resolution mapping of essential maternal and child health service coverage in Nigeria: a machine learning approach

BackgroundNational-level coverage estimates of maternal and child health (MCH) services mask district-level and community-level geographical inequities. The purpose of this study is to estimate grid-level coverage of essential MCH services...

Sustainability challenges concerning the effects of high-priced drugs on the day-to-day operations of community pharmacies in Finland

BackgroundHigh-priced drugs pose a challenge for health budgets, policies, and patient safety. One of the key roles of community pharmacies is to ensure availability to prescription drugs regardless of their price. This has been identified as challenging in certain situations concerning high-priced drugs. ObjectivesThe aim is to investigate the views of proprietary pharmacists regarding the effects of high-priced drugs on the day-to-day operations of pharmacies. MethodsThe data collection of the study was performed as a national cross-sectional online survey. The inclusion criteria were being a proprietary pharmacist and a member of the Association of Finnish Pharmacies. The survey contained questions yielding both quantitative and qualitative answers. The study focused on the qualitative data which was analysed by deductive thematic analysis. ResultsIn total 604 proprietary pharmacists were sent the survey, and 174 eligible answers were included in the study, giving a response rate of 29%. The result describes the relationships between the economic, social, and environmental dimensions of sustainable development based on a framework by Wanamaker, with respect to high-priced drugs and community pharmacy operations as viewed by proprietary pharmacists. The main findings of the study show that proprietary pharmacists find the implementation of real-time reimbursement payments, a further reform of the pharmacy tax, and the abolishment of return bans to the wholesaler as risk mitigations and means to attain sustainability with respect to high-priced drugs and pharmacy practice. They experience that these changes would diminish high-priced drugs unnecessarily ending up as medical waste and improve the working conditions of the pharmacy staff by alleviating stress. ConclusionsAccording to the respondents, high-priced drugs pose challenges for community pharmacies and the legislation and reimbursement system need to adapt to these challenges. If not, community pharmacies in Finland continue to face severe financial declines based on the study results.

An Australian survey of health professionals' perceptions of use and usefulness of electronic medical records in hospitalised children's pain care.

Pain in hospitalised children is common, yet inadequately treated. Electronic medical records (EMRs) can improve care quality and outcomes during hospitalisation. Little is known about how clinicians use EMRs in caring for children with pain. This national cross-sectional survey examined the perceptions of clinician-EMR users about current and potential use of EMRs in children's pain care. One hundred and ninety-four clinicians responded (n = 81, 74% nurses; n = 21, 19% doctors; n = 7, 6% other); most used Epic (n = 53/109, 49%) or Cerner (n = 42/109, 38%). Most (n = 84/113, 74%) agreed EMRs supported their initiation of pharmacological pain interventions. Fewer agreed EMRs supported initiation of physical (n = 49/113, 43%) or psychological interventions (n = 41/111, 37%). Forty-four percent reported their EMR had prompt reminders for pain care. Prompts were perceived as useful (n = 40/51, 78%). Most agreed EMRs supported pain care provision (n = 94/110, 85%) and documentation (n = 99/111, 89%). Only 39% (n = 40/102) agreed EMRs improved pain treatment, and 31% (n = 32/103) agreed EMRs improved how they involve children and families in pain care. Findings provide recommendations for EMR designs that support clinicians' understanding of the multidimensionality of children's pain and drive comprehensive assessments and treatments. This contribution will inform future translational research on harnessing technology to support child and family partnerships in care.

Evaluating the sources and types of dietary and nutritional advice for patients with alopecia areata.

Although there are now two Food and Drug Administration (FDA)-approved treatments for severe alopecia areata (AA), many patients still resort to non-medical therapies and lifestyle modifications such as diet and nutrition. The goal of this study was to evaluate the sources and types of dietary and nutritional advice for patients with AA. We distributed a cross-sectional national survey using the National Alopecia Areata Foundation's email list-serv between August 2022 and January 2023. Most respondents were White (76.3%), employed (58.3%) females (84.4%) with a mean age of 52 years. 163 (19.1%) respondents reported receiving diet and/or nutritional advice and 418 (49.5%) respondents reported searching for diet and/or nutritional advice to help with their AA; the most common source of advice was online. The most common dietary changes were the use of vitamins or supplements (30.6%), adherence to diets (23.2%), and the addition of specific foods (21.4%). 209 (50.2%) respondents reported no change in their disease and 197 (47.4%) respondents reported no change in how they felt about their disease compared to before they tried the change. Many AA patients search for or receive unsolicited dietary and nutritional advice and subsequently modify their behavior to manage their disease. However, the efficacy of these changes is unclear. Providers should be mindful of the sources through which patients obtain treatment information as well as the lifestyle changes patients make to counsel patients with evidence-based information. Further investigation is needed to better characterize the direct and indirect costs of dietary and nutritional modification in the treatment of AA.

Findings From a National Survey of Older US Adults on Patient Willingness to Use Telehealth Services: Cross-Sectional Survey.

Telehealth (telemedicine and telepharmacy) services increase access to patient services and ensure continuity of care. However, few studies have assessed factors that influence patients' willingness to use telehealth services, and we sought to investigate this. This study aims to examine respondents' (aged between 45 and 75 years) willingness to use telehealth services (telepharmacy and telemedicine) and the correlates of the willingness to use telehealth services. We administered a cross-sectional national survey of 1045 noninstitutionalized US adults aged between 45 and 75 years in March and April 2021. Multiple logistic regression analyses were used to identify demographic and health service use correlates of self-reported willingness to use telehealth services. Overall willingness to use telemedicine was high (674/1045, 64.5%). Adults aged 55 years and older were less willing to use telemedicine (aged between 55 and 64 years: odds ratio [OR] 0.61, 95% CI 0.42-0.86; aged 65 years or older: OR 0.33, 95% CI 0.22-0.49) than those younger than 55 years. Those with a regular provider (OR 1.01, 95% CI 1-1.02) and long travel times (OR 1.75, 95% CI 1.03-2.98) were more willing to use telemedicine compared to those without a regular provider and had shorter travel times, respectively. Willingness to use telemedicine services increased from 64.5% (674/1045) to 83% (867/1045) if the service was low-cost or insurance-covered, was with their existing health care provider, or was easy-to-use. Overall willingness to use telepharmacy was 76.7% (801/1045). Adults aged older than 55 years were less willing to use telepharmacy (aged between 55 and 64 years: OR 0.57, 95% CI 0.38-0.86; aged 65 years or older: OR 0.24, 95% CI 0.15-0.37) than those younger than 55 years. Those who rated pharmacy service quality higher were more willing to use telepharmacy (OR 1.06, 95% CI 1.03-1.09) than those who did not. Respondents were generally willing to use telehealth (telemedicine and telepharmacy) services, but the likelihood of their being willing to use telehealth decreased as they were older. For those initially unwilling (aged 55 years or older) to use telemedicine services, inexpensive or insurance-covered services were acceptable.

Midwives' Belief in Normal Birth: The Canadian Survey of Maternity Care Providers’ Attitudes Toward Labour and Birth

Background: Midwifery has been integrated into the health care systems of over half of Canadian provinces and territories. While there are differences in legislation and payment mechanisms, the model of midwifery is fairly similar across the country. This study examined the similarities and differences among midwives' attitudestowardlabourandbirth. Inaddition,wecompareditemswhichrelatedtobeliefsaboutnormal birth between midwives and other care providers.Methods: A national cross-sectional survey was conducted comparing maternity care providers’ beliefs aboutchildbirthandintra-professionalvariationsinmidwives'attitudestowardsbirth. Therewere400 (54%) midwife respondents: 218 from Ontario, 75 from B.C, 53 from Quebec, 48 from the remaining regulated or pre-regulated provinces (six missed information for this field).Results: All midwives were critical of the routine use of interventions such as episiotomy, epidural analgesia andelectronicfetalmonitoring(EFM). Therewasstrongagreementaboutthesafetyofhomebirth,outof hospital birth centres and the importance of women's autonomy and decision-making in pregnancy and birth. However, some regional variations were identified. Quebec midwives were more opposed to epidural analgesia than BC and Ontario (p&lt;.001), and were more likely to believe that cesarean birth is more costly than vaginal birth (p=.005). Ontario midwives were most likely to believe that cesarean birth protects against urinary incontinence (p=.001), and sexual dysfunction (p=.002). Qualitative comments of midwives indicated a strong desire to reduce unnecessary medical intervention and to lower cesarean section rates.Conclusion: Canadian midwives share similar beliefs regarding place of birth, the routine use of episiotomy, EFM, and epidurals, but reported significant attitudinal differences for other issues. Regional differences may be related to midwives' primary practice settings, the historical development of midwifery in their region and the number of new midwives with less than 5 years of clinical experience. A set of core midwifery values was identified that demonstrate a strong belief in normal birth.

Examining determinants of stunting in Urban and Rural Indonesian: a multilevel analysis using the population-based Indonesian family life survey (IFLS).

In Indonesia, chronic malnutrition leading to stunted growth in children represents a significant issue within the public health domain. The prevalence of stunting varies between urban and rural areas, reflecting disparities in access to nutrition, healthcare, and other socioeconomic factors. Understanding these disparities is crucial for developing targeted interventions to address the issue. The study used data from the fifth wave of the Indonesian Family Life Survey (IFLS), which is a national cross-sectional population-based survey conducted across approximately 13 provinces in Indonesia in 2014-2015. Multivariate and Multilevel logistic regression models were utilized in the analysis to determine the factors associated with the prevalence of stunting in Indonesian children. The multivariate logistic regression analysis indicated that among children aged 24-59 months in Indonesia, stunting was associated with the age of the child, birth weight, maternal nutritional status, and residence. Subsequently, the multilevel logistic regression analysis revealed that in rural areas, the age of the child and birth weight exhibited significant associations with stunting. Conversely, in urban areas, stunted children were influenced by 7 factors, including the child's age (months), age of weaning, birth weight (kg), mother and father's age, place of birth, and maternal nutritional status. Variations in childhood stunting between urban and rural regions in Indonesia were observed, indicating a differential prevalence. The study's findings suggests the importance of age-appropriate nutritional support, healthcare interventions, and growth monitoring. Focused interventions are vital, potentially encompassing initiatives such as improving access to maternal and child healthcare services, promoting adequate nutrition during pregnancy and infancy, and facilitate greater parental engagement in childcare responsibilities.

Effects of Racist Microaggressions and Sexual and Gender Minority Stress on Mental Health Among Latinx Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning + Young Adults.

This study examines the effects of racist microaggressions and lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)-related minority stressors (i.e., identity concealment, family rejection, internalized LGBTQ-phobia, victimization, and racialized heterosexism/cisgenderism) on psychological distress among Latinx LGBTQ+ young people, specifically college students. Participants are a Latinx subset (n = 80) from a national online nonprobability cross-sectional survey of LGBTQ+ college students. The study aim was examined using linear/logistic regression. Findings indicated that racist microaggressions and family rejection were associated with psychological distress. In addition, racist microaggressions were the only stressor associated with clinically significant psychological distress that may warrant psychiatric/psychological treatment. Therefore, racist microaggressions and family rejection are unique stressors that may saliently affect mental health among Latinx LGBTQ+ students. There is a great need to integrate minority stress theory with other critically-oriented theories, such as intersectionality, in research and intervention to eliminate mental health inequities faced by Latinx LGBTQ+ young people.

Is food and drink advertising across various settings associated with dietary behaviours and intake among Australian adolescents? Findings from a national cross-sectional survey.

The pervasive promotion of energy-dense, nutrient-poor food and drinks undermines efforts by adolescents and their parent/carers to maintain a nutritious diet during a crucial developmental period. This study examined the association between awareness of food and drink advertisements and adolescents' dietary behaviours and intake. A sample of Australian secondary students aged 12-17 years (N = 8763) self-reported their awareness of food and drink advertisements across seven settings, whether they had tried a new product or asked a parent/carer to purchase a product they had seen advertised, and their consumption of various unhealthy food and drink types. Analyses used multilevel mixed-effects generalised linear models adjusted for school-level clustering, socio-demographic factors and television viewing. Students with higher advertising awareness were more likely to have tried a new product they had seen advertised (adjusted prevalence ratio [APR] = 1.62, 95% CI = 1.51-1.73, p < .001) and asked their parent/carer to buy an advertised product (APR = 1.62, 95% CI = 1.51-1.73, p < .001) at least once in the past month. As advertising awareness increased, so too did students' likelihood of reporting these dietary behaviours. A high unhealthy food intake was more commonly reported among students with higher advertising awareness (APR = 1.45, 95% CI = 1.32-1.58, p < .001), as was a high unhealthy drink intake (APR = 1.29, 95% CI = 1.18-1.42, p < .001). Australian adolescents are vulnerable to the persuasive effects of food and drink marketing. SO WHAT?: Greater restrictions on the way the food and drink industry can market their products to adolescents are needed to better support them in developing and maintaining positive dietary behaviours.

Prevalence of different variations of non-consented care during the childbirth process in Mexico by geographical regions: comparing ENDIREH survey data from 2016 to 2021

IntroductionNon-consented care, a form of obstetric violence involving the lack of informed consent for procedures, is a common but little-understood phenomenon in the global public health arena. The aim of this secondary analysis was to measure the prevalence and assess change over time of non-consented care during childbirth in Mexico in 2016 and 2021, as well as to examine the association of sociodemographic, pregnancy-, and childbirth-factors with this type of violence.MethodsWe measured the prevalence of non-consented care and three of its variations, forced sterilization or contraception, forced cesarean section, and forced consent on paperwork, during childbirth in Mexico for 2016 (N = 24,036) and 2021 (N = 19,322) using data from Mexico’s cross-sectional National Survey on the Dynamics of Household Relationships (ENDIREH). Weighted data were stratified by geographical regions. We performed adjusted logistic regression analyses to explore associations.ResultsThe national prevalence of non-consented care and one of its variations, pressure to get a contraceptive method, increased from 2016 to 2021. A decrease in the prevalence was observed for forced contraception or sterilization without knowledge, forcing women to sign paperwork, and non-consented cesarean sections nationally and in most regions. Women between the ages of 26 and 35 years, married, cohabiting with partner, living in urban settings, who do not identify as Indigenous, and who received prenatal services or gave birth at the Mexican Institute of Social Security (IMSS) facilities experienced a higher prevalence of non-consented care. Being 26 years of age and older, living in a rural setting, experiencing stillbirths in the last five years, having a vaginal delivery, receiving prenatal services at IMSS, or delivering at a private facility were significantly associated with higher odds of reporting non-consented care.ConclusionWhile a decrease in most of the variations of non-consented care was found, the overall prevalence of non-consented care and, in one of its variations, pressure to get contraceptives, increased at a national and regional level. Our findings suggest the need to enforce current laws and strengthen health systems, paying special attention to the geographical regions and populations that have experienced higher reported cases of this structural problem.

Trends of physical activity and recreational screen time among Chinese children and adolescents: a national study from 2017 to 2019

BackgroundThe prevalence of physical inactivity and sedentary behavior among children and adolescents is a growing public health concern. This study aims to examine the trends in Physical Activity (PA) and Recreational Screen Time (RST) amongst children and adolescents in China, considering variations in genders, school levels, areas (urban versus rural), and regions (north versus south). The findings provide a foundation to guide policy and strategy making for future health promotion and development.MethodsAn annual national cross-sectional survey was conducted in China from 2017 to 2019 cumulatively involving 52,503 (48% female) children and adolescents from grades 4 to 12 (aged 12.72 ± 2.12). Data on PA and RST were collected through self-administered questionnaires. Weighted least squares regression was used to analyze the trends and differences in PA and RST among the participants’ profiles.ResultsThere was an annual decreased in PA compliance rate of approximately 3.43% (95% CI: 0.79-6.08%) for primary school students, primarily among males residing in rural areas, and in northern regions. Middle school students experienced a yearly decrease of about 5.23% (95% CI: 2.55-7.92%) in PA compliance across all genders, regions, and urban areas. Similarly, the RST compliance rates for primary school students declined by approximately 3.18% (95% CI: 1.57-4.78%) annually for all genders and areas, but only in the northern regions.ConclusionsThis research highlights a downward trend in PA and RST compliance amongst Chinese children and adolescents, with variations based on school level, gender, area, and region. Urgent policies and interventions are imperative to promote PA while mitigating excessive RST within these populations.

Trends in research grant applications and outcomes among medical students in the United Kingdom: a national self-reported cross-sectional survey.

Background: Research funding disparities contribute to clinical-academic workforce inequalities1-3. Hence, our study explores the association between student demographics and research grant application rates and outcomes among UK medical students. Methods: This is a national multicentre cross-sectional survey of UK medical students in the 2020-21 academic year. Multiple zero-inflated negative binomial regression and generalized linear model (binomial distribution; logit link) were utilized to investigate the association between student demographics, number of grant applications submitted, and successful grant applications (yes or no). P-values less than a Bonferroni-corrected significance level of 0.05/36 = 0.0014 were statistically significant. Results: 1528 students participated from 36 medical schools. 151 respondents (9.9%) had applied for research grants. Black students submitted applications 2.90 times more often than white students [Incident rate ratio (IRR): 2.90, 95% confidence interval (CI): 1.37-6.16], with no ethnic disparity in the odds of successful applications. Gender did not influence application rates significantly (P = .248), but women were 4.61 times more likely to secure a grant than men [odds ratio: 4.61, 95% CI: 2.04-10.4]. Being a PubMed-indexed author was associated with increased grant application submission rates [IRR: 3.61, 95% CI: 2.20- 5.92] while conducting more research was associated with greater odds of securing a grant [odds ratio: 1.42, 95% CI: 1.17- 1.73]. Conclusion: Although black students submitted more applications, ethnicity did not influence success rates. Gender did not influence application rates, but women were more successful. These findings underscore the need for strategies supporting women and underrepresented students for continued academic achievement after graduation. This abstract has been published as a paper4

Prevalence and Disparities in Telehealth Use Among US Adults Following the COVID-19 Pandemic: National Cross-Sectional Survey.

Telemedicine expanded during the COVID-19 pandemic, though use differed by age, sex, race or ethnicity, educational attainment, income, and location. It is unclear if high telehealth use or inequities persisted late into the pandemic. This study aims to evaluate the prevalence of, inequities in, and primary reasons for telehealth visits a year after telemedicine expansion. We used cross-sectional data from the 2022 Health Information National Trends Survey (HINTS 6), the first cycle with data on telemedicine. In total, 4830 English- and Spanish-speaking US adults (aged ≥18 years) were included in this study. The primary outcomes were telehealth visit attendance in the 12 months before March 7, 2022, to November 8, 2022, and the primary reason for the most recent telehealth visit. We evaluated sociodemographic and clinical predictors of telehealth visit attendance and the primary reason for the most recent telehealth visit through Poisson regression. Analyses were weighted according to HINTS 6 standards. We included 4830 participants (mean age 48.3, SD 17.5 years; 50.28% women; 65.21% White). Among US adults, 38.78% reported having a telehealth visit in the previous year. Telehealth visit attendance rates were similar across age, race or ethnicity, income, and urban versus rural location. However, individuals with a telehealth visit were less likely to live in the Midwest (adjusted prevalence ratio [aPR] 0.65, 95% CI 0.54-0.77), and more likely to be women (aPR 1.21, 95% CI 1.06-1.38), college graduates or postgraduates (aPR 1.24, 95% CI 1.05-1.46), covered by health insurance (aPR 1.56, 95% CI 1.08-2.26), and married or cohabitating (aPR 1.17, 95% CI 1.03-1.32), adjusting for sociodemographic characteristics, frequency of health care visits, and comorbidities. Among participants with a telehealth visit in the past year, the primary reasons for their most recent visit were minor or acute illness (32.15%), chronic disease management (21%), mental health or substance abuse (16.94%), and an annual exam (16.22%). Older adults were more likely to report that the primary reason for their most recent telehealth visit was for chronic disease management (aPR 2.08, 95% CI 1.33-3.23), but less likely to report that it was for a mental health or substance abuse issue (aPR 0.19, 95% CI 0.10-0.35), adjusting for sociodemographic characteristics and frequency of health care visits. Among US adults, telehealth visit attendance was high more than a year after telemedicine expansion and did not differ by age, race or ethnicity, income, or urban versus rural location. Telehealth could continue to be leveraged following COVID-19 to improve access to care and health equity.