Poor Health Research Articles

Arts on prescription intervention for primary healthcare patients with poor mental health or social isolation: a mixed-method study

BackgroundPrimary healthcare providers are increasingly challenged in supporting patients with psychosocial needs. Arts on Prescription (AoP) has been shown to improve primary healthcare patients’ mental health wellbeing. The aim of the current study is to understand the psychosocial effect of participating in an Arts on Prescription programme.MethodsA total of 112 primary healthcare patients from 18 primary healthcare centres in Scania with mental health diagnoses depression and anxiety or social isolation participated in a 10-week group-based arts programme, twice a week for 2 h. A questionnaire with the Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), the Salutogenic Health Indicator Scale (SHIS) (for baseline and follow-up) and 14 sociodemographic and self-rated health covariates were collected as baseline. We also conducted 28 semi-structured interviews. We analysed data using paired t-test and a general linear regression model for change in SWEMWBS and SHIS. Qualitative data was analysed using a thematic approach.ResultsThe paired t-test showed highly significant results (p < 0.001) for increase in both SWEMWBS and SHIS. The general linear regression.models show that women and participants with poorer self-rated health (SRH), more contacts with the healthcare system, other referrals from the primary healthcare centre, and no previous arts and culture engagement displayed significantly stronger associations with increase in SWEMWBS but not SHIS. Qualitative results highlight use of other interventions and difficulties navigating the health system.ConclusionsOur findings support a proportionate universalism (scale and intensity proportionate to the degree of need) approach indicating that AoP programmes could be valuable additions to healthcare pathways enhancing wellbeing for vulnerable populations. Findings should be interpreted with caution due to small sample size.

Relationship Between Oral Health Status and Cachexia in Patient With Dysphagia.

This study aimed to clarify the association between oral health status and cachexia among the patients with dysphagia. The registry data of the Japanese Sarcopenic Dysphagia Database were used. Oral health screening was performed with the Revised Oral Assessment Guide (ROAG) or the Oral Health Assessment Tool (OHAT). ROAG score ≥ 13 or OHAT score ≥ 3 was defined as poor oral health status. Activities of Daily Living (ADL) was evaluated with the Barthel index (BI) and swallowing function was evaluated with the Food Intake Level Scale (FILS). The relationship between oral status and the presence of cachexia and other evaluation criteria was evaluated in univariate and multivariate analyses. The study included 401 older patients with dysphagia (mean age 81 years; 49% women, and 209 cases (52%) had poor oral health. In univariate analysis, poor oral health had significantly more malnutrition and cachexia (p = 0.003 and p = 0.001, respectively) and significantly lower BI and FILS (both p < 0.001). Multivariate analysis showed that oral care status was detected as a factor affecting the presence of cachexia (odds ratio: 1.881, 95% confidence interval, 1.156 to 3.060, p = 0.011). The risk of cachexia is higher in the case of poor oral health status. Rehabilitation, nutritional support and oral health care may contribute to the management of cachexia.

THE EFFECTIVENESS OF 'LUDO GENTING' GAME ON ADOLESCENT HEALTH KNOWLEDGE

Anemia and stunting remain critical public health issues in Indonesia. As of 2023, 32% of adolescent girls were affected by anemia, while stunting impacted 21.6% of children. These conditions are largely driven by poor nutrition and limited health education. Educational games have been shown to be more effective in enhancing knowledge and promoting healthy behaviors compared to traditional lecture-based methods. Game-based learning is increasingly recognized as an innovative and engaging approach to health education, especially among adolescents. This study aimed to assess the effectiveness of the educational game “Ludo Genting” in improving adolescents’ knowledge about anemia, nutrition, and stunting in Bandung. A quantitative pre-experimental study was conducted using a one-group pre-test and post-test design. The study involved 48 adolescents selected through quota sampling. Data were collected using structured questionnaires administered before and after the intervention. The findings revealed a notable increase in adolescents' knowledge following the intervention. In the 10–14 age group, 12 out of 16 participants (75%) demonstrated good knowledge levels. The same percentage (75%) was observed in the 15–19 age group. In the 20–24 age group, 13 out of 16 participants (81.25%) achieved a good knowledge category, indicating a positive impact of the game across all age segments. “Ludo Genting” proved to be an effective educational tool for enhancing adolescent knowledge on anemia, nutrition, and stunting. The results showed a statistically significant improvement with a p-value of &lt;0.001.Keywords: Adolescent, Anemia, Nutrition, Stunting, Game education

LOW 25-HYDROXY-VITAMIN D3 CONCENTRATIONS ARE ASSOCIATED WITH SEXUAL SYMPTOMS IN MIDDLE-AGED AND OLDER MEN

LOW 25-HYDROXY-VITAMIN D3 CONCENTRATIONS ARE ASSOCIATED WITH SEXUAL SYMPTOMS IN MIDDLE-AGED AND OLDER MEN

Distance Learning During the COVID-19 Lockdown and Self-Assessed Competency Development Among Radiology Residents in China: Cross-Sectional Survey.

During the COVID-19 lockdown, it was difficult for residency training programs to conduct on-site, hands-on training. Distance learning, as an alternative to in-person training, could serve as a viable option during this challenging period, but few studies have assessed its role. This study aims to investigate the impact of distance learning during the lockdown on residents' self-assessed competency development and to explore the moderating effect of poor mental health on the associations. It is hypothesized that radiology residents who were trained through distance learning during the lockdown were more likely to report higher self-assessed competency compared to those who did not receive organized, formal training. A cross-sectional survey was conducted in 2021 among all of the radiology residents in 407 radiology residency programs across 31 provinces of China. To estimate the long-term outcomes of radiology residents' training after the initial COVID-19 outbreak, this study measured 6 core competencies developed by the US Accreditation Council for Graduate Medical Education reported by radiology residents. Multiple linear regression and moderating effect analysis were conducted to examine the associations between distance learning, mental health status, and self-assessed competencies. Mental health status moderated the association between distance learning and self-assessed competency of radiology residents. A total of 2381 radiology residents (29.7% of the 8,008 nationwide) met the inclusion criteria and were included in the analysis. Among them, 71.4% (n=1699) received distance learning during the COVID-19 lockdown, and 73.2% (n=1742) reported mental health struggles ranging in severity from slight to extremely severe. Radiology residents who were trained through distance learning (β=0.35, 90% CI 0.24-0.45) were more likely to report higher self-assessed competencies. This was particularly true for the competency of "interpersonal and communication skills" (β=0.55, 90% CI 0.39-0.70). Whereas, the competency of "patient care and technical skills" (β=0.14, 90% CI 0.01-0.26) benefited the least from distance learning. Poor mental health significantly moderated the relationship between distance learning and competency (β=-0.15, 90% CI -0.27 to -0.02). Distance learning, a means of promoting enabling environments during the COVID-19 lockdown, serves its purpose and helps generally improve residents' self-assessed competencies, though different competency domains benefit unequally. The impact of mental health status calls for special attention so that distance learning can fulfill its potential.

Transforming Female Education in Sub-Saharan Africa: Addressing Socio-Cultural, Economic, Institutional and Instructional Barriers to Access and Inclusion

The phrase “educate a girl, you educate a nation” highlights the powerful impact of girls’ education on society. This review explores the ongoing barriers that prevent girls in sub-Saharan Africa from getting an equal education. It draws on peer-reviewed studies and international reports to identify key obstacles, including gender roles, harmful cultural practices, early marriage and pregnancy, poor health, poverty, and child labor. These challenges often overlap and affect girls differently based on their background, location, and social status. Guided by liberal and intersectional feminist theories, the review shows that real progress depends on gender-sensitive policies and targeted programs that address both personal and structural issues. The goal must go beyond increasing enrollment, it must also make schools safe, inclusive, and supportive for all girls, especially those who are most disadvantaged. The review calls on governments, communities, and global partners to take stronger, coordinated action. Investing in girls’ education is not only the right thing to do, it is essential for building fairer, healthier, and more prosperous societies.

Altered brain function and structure in youth-onset type 2 diabetes.

Despite the aggressive clinical trajectory of youth-onset type 2 diabetes (Y-T2D) and consistent evidence of cognitive dysfunction and poor brain health in adults with T2D, the impact of Y-T2D on brain function and structure is understudied. This study aimed to characterize brain function and structure in a cross-sectional sample of young people with Y-T2D and compare these brain attributes to peers with obesity alone (OB) or healthy weight (HW) without T2D. Brain structure and function were measured via magnetic resonance imaging. Functional connectivity was estimated with a seed-to-voxel analysis, and gray matter (GM) volume differences explored between groups. Forty young adult participants were included (Y-T2D: n=12, mean [±SD] age 25.0±7.2 years, diabetes duration 6.5±6.7 years; OB: n=8, age 19±1.6 years; HW: n=20, age 22.9±4.1 years). The Y-T2D group showed stronger functional connectivity between the salience network and default mode network, compared to both the OB and HW groups (p<0.05 for all, respectively). The Y-T2D group had reduced GM volume in regions associated with executive functioning, language, and visual processing relative to the OB and HW groups (p<0.001 for all, respectively). Y-T2D is associated with distinct alterations in brain function and structure, providing evidence of potentially compromised brain health in this clinical population.

Examining the Relationship Between Daily Activity Levels and Elder Abuse and Neglect: Bringing Light on Elder Abuse.

To examine the relationship between sociodemographic characteristics, daily activity levels, and elder abuse among older adults in Turkey. A descriptive, cross-sectional study was conducted across seven provinces. The study was carried out between January and August 2023, involving 448 older adults. Data were collected using the Sociodemographic Form, Mini-Mental State Examination, Barthel Index, and Geriatric Mistreatment Scale. Approximately one in four participants reported experiencing at least one form of non-sexual elder abuse, with psychological abuse being the most common. Sons and male caregivers were frequently identified as perpetrators. While no significant relationship was found between daily activity dependency and abuse, factors such as lower education, poor self-rated health, intrafamily conflict, and regional variation were significantly associated with increased risk. Elder abuse remains a prevalent and underrecognized issue, shaped by both individual vulnerabilities and contextual dynamics. The absence of a direct link between functional dependency and abuse suggests the need to consider broader social and environmental factors. Routine screening for elder abuse, particularly psychological abuse, should be part of geriatric care. Training healthcare professionals to identify risk factors-such as perceived health, family dynamics, and regional differences-and using culturally sensitive, sociodemographic assessments can improve early detection and intervention. Strengthening collaboration and community-based support is key to ensuring older adults' safety and well-being. The study highlights elder abuse in Turkey as a complex, regionally variable issue influenced by health perception and family dynamics. It calls for targeted, community-based interventions and stronger collaboration among healthcare providers, nurses, social workers, and policymakers, emphasising the need for improved social security and culturally sensitive training. This study followed STROBE guidelines. No patient or public contribution.

The body cannot be cheated: sexual practices and modern contraceptive use among street-involved young people in two South West States in Nigeria

Background Young people aged 10–24 years constitute about one-third of the total population of Nigeria. Street-involved young people (SIYP) face a double burden of living condition instability and lack of adequate parental monitoring. This leaves them vulnerable to poor sexual and reproductive health (SRH) choices and behaviour. Risky sexual behaviour with poor access to SRH information and interventions increases their vulnerability to adverse SRH outcomes. This study explored the use of modern contraceptives and sexual practices among male and female SIYP (10–24 years) in Nigeria. Methods This qualitative study used an exploratory research design to guide the development of the focus group discussion (FGD) and in-depth interview (IDI) guides. Participants were asked questions on background information, lived experiences and SRH practices. The FGDs were stratified by sex and age. Both FGD discussions and IDI interviews were recoded; transcripts were transcribed and translated from local dialect into English language. Content analysis was conducted thematically with the aid of NVivo. Results A total of 17 IDIs and 11 FGDs were conducted109 participants. Awareness and use of modern contraceptives varied among sexually active SIYP. Commonly methods included condoms, oral pills, and emergency contraceptives, while knowledge of IUDs, female condoms, and injectables was limited. Inconsistent use stemmed from poor access, financial barriers, and myths. Condoms were underused due to stigma linking them to disease or immorality. Early sexual debut (ages 10–15) was influenced by peer pressure or sexual violence. Sexual activity was often viewed as normal—for fun, affection, or survival—with transactional sex common among young women. Reports of same-sex relationships were rare. Conclusions The study concludes that SIYP are generally aware of modern contraceptives, particularly male condoms, but usage is inconsistent and inadequate. These behaviours were driven by survival struggles, increasing vulnerability to negative SRH outcomes. To address these gaps, actions are recommended to dispel myths, increase contraceptive knowledge and uptake, and promote safe sex practices, improving both health and socio-economic well-being for SIYP.

IOT Based Sanitary Pad Vending Machine

Abstract - Now-a-days a menstruation is the part of the women’s life it is important to take measures for the hygiene during these days. Due to poor hygiene many health problems arise. Usage of cloth during menstruation is also unhygienic. In India women are still shy of purchasing sanitary napkins from medical stores. We can overcome this problem by installing the vending machines in public places, offices, toilets, schools and colleges. The existing vending machine operates on coin which provides a napkin whenever a coin is inserted. But it has a drawback sometimes the vending machine is unable to recognize which coin due to which the napkin is easily provided when a duplicate coin is inserted. Instead of using coin we are coming up with the idea of using QR code. Whenever the QR code is scanned the napkin is dispensed and the owner gets the SMS on the registered mobile number whenever the napkin is dispensed and it also gets the count of the napkins remaining in the vending machine. Key Words: IOT, Sanitary Pad Vending Machine, Accessibility, Hygiene, Menstruation, Remote Monitoring, Automated Dispensing System.

A qualitative study on ASHA workers’ perspective on HPV self-sampling in Sikkim India

Cervical cancer is a major public health concern in India, hampered by limitations in traditional screening methods and healthcare infrastructure. This study aimed to evaluate the feasibility and challenges of implementing Human Papillomavirus self-sampling (HPV) self-sampling, conducted by ASHA workers (Accredited Social-Health Activists) in Sikkim, India, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. In-depth interviews were conducted between February and May 2023 with ASHA workers involved in HPV self-sampling implementation within Sikkim. The data was analysed using qualitative methods and tagged under relevant RE-AIM categories. Twenty ASHA workers participated in the study. Facilitators included participant autonomy, positive community attitudes, and logistical advantages of home-based testing. ASHA workers’ efforts in health education, counselling, and community engagement were crucial. Successful implementation was supported by adequate training, community trust, and mobile technology for result transmission. Barriers included poor health literacy, logistical challenges for ASHA workers, and inadequate incentives. The study highlights the importance of tailored screening procedures, community engagement, and programmatic support in enhancing acceptance of HPV self-sampling. Addressing barriers requires multifaceted interventions at individual, community, and systemic levels.

Association between urinary cadmium levels and increased gallstone disease in US adults

Heavy metal exposure is acknowledged as a risk factor for poor health. However, the effect of heavy metal exposure on the prevalence of gallstones is still unknown. Therefore, we investigated the relationship between heavy metal concentrations and the prevalence of gallstones among US adults. Multivariate logistic regression indicated that only urinary cadmium was an independent risk factor for gallstones. Compared to the low urine cadmium group, the high cadmium group had a elevated increased risk of gallstone formation. Furthermore, the weighted quantile sum model showed that heavy metal mixtures were not associated with gallstone prevalence. Additionally, urinary cadmium levels were associated with an increased risk of gallstone formation in young individuals, males, Mexican Americans, Non-Hispanic Whites, as well as smokers and drinkers. Moreover, nine machine learning methods were utilized to construct an interpretable predictive model for gallstone prevalence. Among these models, the XGBoost model exhibited the highest performance and was selected for further investigation. Subsequently, shapely additive explanations was used for model interpretation. The results also indicated that urinary cadmium concentrations were the most important variable for gallstones. Thus, our results indicated that long-term chronic cadmium exposure is a risk factor for gallstone prevalence.

Contributors to caregiver burden, depression, and anxiety in the partners of professional American-style football players: a cross-sectional study

IntroductionAmerican-style football (ASF) has been linked to chronic adverse health outcomes. The extent to which ASF players' careers impact their spouses' caregiver burden, depression, and anxiety remains unknown. In addition to conventional family stressors, ASF families may have specific concerns such as chronic traumatic encephalopathy (CTE; a condition that can only be established at autopsy), which may additionally contribute to caregiver burden and mood symptoms.MethodsFamily Experiences Managing Football Lives (FEM-FL) is a cross-sectional study developed under the Football Players Health Study at Harvard University. Eligible participants were partners of current and former professional ASF players who completed electronic surveys from 2021 to 2024. Data on age, race, family composition, income, employment status, caregiver help, personal health, marital satisfaction, player position, and number of relocations were collected. Participants were asked whether they believed their partner had “CTE.” Multivariable models measured associations between established and ASF-specific risk factors and caregiver burden (Zarit 4-item Burden Interview), and depression and anxiety symptoms (Patient Health Questionnaire-4).ResultsAmong 153 partners of active and former professional ASF players, mean [SD] age was 48.1 [13.5], and 28.8% self-identified as Black. In models that adjusted for established risk factors and ASF-specific variables, poor health among partners was associated with a 1.6 point increase in depression score (95% CI = 0.90, 2.30; p &amp;lt; 0.001) and 1.87 point increase in anxiety (95% CI = 1.05, 2.69; p &amp;lt; 0.001). Models that controlled for established risk factors identified significant associations between increased marital satisfaction and a 5.87 reduction in caregiver burden score (95% CI= −7.32, −4.43; p &amp;lt; 0.001), 1.26 score reduction in depression score (95% CI = −1.75, −0.77; p &amp;lt; 0.001) and 1.32 reduction in anxiety score (95% CI = −1.89, −0.75; p &amp;lt; 0.001). CTE concerns were associated with a 2.90 increase in caregiver burden score (95% CI = 1.78, 3.99; p &amp;lt; 0.001) and a 0.44 increase in reported anxiety (95% CI = −0.01, 0.88; p = 0.05), but had no association with depression in adjusted models.DiscussionAmong partners of active and former professional ASF players, marital satisfaction, poor health, and concerns about CTE may play a role in caregiver burden and behavioral health. CTE concerns represents a potential novel risk factor for increased caregiver burden among partners of ASF players.

Unpacking the post-Covid association between unexpected births and excess deaths.

Global fertility has halved since its 1960s peak to be little above the replacement rate, and lower in many developed countries. In addition it has been suggested that excess deaths since onset of the Covid pandemic may have influenced fertility. Given the economic and social interest in declining fertility, this study seeks an explanation. We developed a sample for 18 mid-large industrialized countries of 30 variables covering vital statistics and health, social and economic data, and determined excess deaths during 2020-2022 and unexpected births during 2022-2024. Analysis estimated the link between Covid excess deaths and subsequent unexpected births; and estimated links between excess deaths and unexpected births and national parameters. Countries' average birth rate during 2022-2023 was 5-6 percent below that expected from their trend and mean prior to spread of Covid in 2020. Birth rates were higher than expected after 2022 in countries which had high excess deaths during 2020-2022. Regression against national parameters traced reductions in post-Covid births to countries' strong economic measures (low unemployment, high GDP per capita), indicators of women's high economic capacity (years at school, female workforce participation), and weak religiosity. Similar analysis identified higher excess deaths in less wealthy countries, and those with weaker social measures and women's opportunities, and poor pre-existing health outcomes (high infant mortality, low life expectancy, fewer physicians). The association between unexpected births and excess deaths this decade is largely spurious because lower wealth and poor previous health outcomes drove excess deaths, while the opportunity cost of childbearing has accelerated declining births in wealthier countries post-Covid.Better understanding population effects of the pandemic is of broad social and economic interest given declining fertility rates; and change in trajectory of births could prove the pandemic's most serious socio-economic consequences.

Menopausal symptoms among perimenopausal women in rural Turkey: a cross-sectional study

Objective This study aimed to evaluate the prevalence and severity of menopausal symptoms among perimenopausal women in a rural area of southeastern Turkey and their association with sleep quality, depression and sociodemographic and lifestyle-related factors. Methods This cross-sectional study included 122 perimenopausal women aged 40–55 years residing in southeastern rural Turkey. Participants completed the Beck Depression Inventory (BDI), the Menopause Rating Scale (MRS) and the Pittsburgh Sleep Quality Index (PSQI), alongside demographic data collection. Results The median age was 46 years (43–49 years). Higher MRS scores were significantly linked to a sedentary lifestyle, poor self-rated health and concerns about partner infidelity. MRS total scores were moderately correlated with global PSQI scores (r = 0.49, p < 0.001) and strongly correlated with BDI scores (r = 0.71, p < 0.001). Severe menopausal symptoms were significantly associated with poor sleep quality (odds ratio [OR] = 2.62; 95% confidence interval [CI]: 1.16–5.95), mild to severe depression (OR = 4.78; 95% CI: 2.08–10.98) and poor self-rated general health (OR = 2.76; 95% CI: 1.03–7.41), even after adjusting for age, parity and body mass index. Conclusions Perimenopausal women in southeastern rural Turkey experience severe menopausal symptoms that are significantly associated with self-rated general health, sleep quality and depression.

Podcasts in Mental, Physical, or Combined Health Interventions for Adults: Scoping Review.

The increasing prevalence of poor mental and physical health in adults is a global health concern. Given the scope of this problem, scalable and effective treatment interventions are needed. While podcasts (online digital audio files) are becoming more popular, the extent of podcast use in mental, physical, or combined health interventions has not been reviewed. This scoping review primarily aims to summarize the available evidence regarding the use of podcasts in health promotion interventions. A series of 5 research questions was designed to systematically review and accurately represent podcast use in current research interventions. We conducted a search of electronic databases (MEDLINE, PsycINFO, Embase, CINAHL, Scopus, and CENTRAL), gray literature articles, and relevant journals reported in the English language. Eligible studies targeted adults (aged ≥18 y), included a podcast in at least 1 intervention, and measured a mental or physical health outcome. Overall, 51 articles (published studies: n=26, 51% and gray literature articles: n=25, 49%) were deemed eligible. In total, 58% (15/26) of the included peer-reviewed studies were published in the last 5 years, suggesting that the use of podcasts as an intervention approach is increasing. On average, 85.6% (n=2104) of the participants included in these research studies were women. In total, 31% (8/26) of the studies contained a female-only sample. In contrast, no research studies contained a male-only sample. Most peer-reviewed published studies (19/26, 73%) and gray literature sources (22/25, 88%) of the podcasts were used within multicomponent interventions, with most targeting physical health outcomes (peer-reviewed publications: 14/26, 54% and gray literature sources: 13/25, 52%). Results pertaining to podcast design, sources, theoretical principles, and thorough process evaluation indicators were heterogeneous. The versatility that podcasts can offer as a medium for reaching and engaging with participants and end users was evident in this scoping review. While research using podcasts is growing, many (18/26, 69%) studies included in this scoping review were conducted in the United States and sampled female participants, highlighting the need to diversify the field. As expected, there was a high level of variation across the included studies in relation to how podcasts were used and designed within interventions. To address this, a standardized approach would be valuable in guiding researchers and practitioners through both the development and reporting phases of future podcast research, including aspects such as theoretical framework, a description of podcast development (eg, co-design and end-user engagement), objective podcast use, and process evaluation data.

Major Causes of Rabies Outbreak in Pastoral Areas of the Somali Region and Importance of the One Health Approach

ABSTRACTRabies is a fatal disease caused by a virus belonging to the genus Lyssavirus in the family Rhabdoviridae. The virus has the potential to infect all warm‐blooded animals, with primary reservoirs including dogs, wild carnivores (such as foxes, jackals, hyenas, and skunks), and bats. These reservoirs pose a significant public health risk, particularly in regions where human–animal interactions are frequent. The Somali Region in Ethiopia is predominantly home to pastoral and agropastoral communities, which inhabit vast swathes of land with diverse wildlife populations. The coexistence of these communities, domestic animals, and wildlife presents a unique environmental challenge that requires careful management. In times of drought, pastoralists may be compelled to migrate to remote and isolated habitats in search of grazing lands, resulting in heightened interaction between livestock and wildlife. The major causes of rabies outbreaks in the Somali Region include increased interaction between wildlife and livestock in remote pastoral settings without adequate control measures, such as lack of mass vaccination for at‐risk dogs, low dog ownership rates, poor animal health infrastructure, limited diagnostic capacity, and weak surveillance systems. Comprehensive response of one‐health approach is necessary to prevent and control rabies outbreaks in the Somali Region. These include increasing vaccination coverage for at‐risk dogs, improving the animal health infrastructure, enhancing surveillance systems, increasing awareness and education, and strengthening wildlife management. These measures can improve the health and well‐being of animals and humans. This review aims to highlight the major causes of rabies outbreaks and the need to implement a one‐health approach in the Somali Region.

Impact of Poverty Reduction on Oral Health Outcomes among US Adults.

Poor oral health is a public health issue in the United States, disproportionately affecting people in poverty. This cross-sectional study investigates the impact of reducing absolute and relative poverty on the prevalence of periodontitis, caries, and dental pain among US adults. Data from 13,139 adults aged 30 to 70 y who completed dental examinations in the 2011-2018 National Health and Nutrition Examination Surveys were used. Periodontitis and dental caries outcomes were assessed with the 2011-2014 surveys (n = 6,563). Assessment of absolute and relative poverty was based on the poverty income ratio established by the US Census Bureau. Hypothetical counterfactual scenarios were emulated to assess the impact of poverty reductions (10%, 25%, and 50%) on periodontitis, dental caries, and dental pain. A targeted minimum loss-based estimator was used to estimate the outcomes under each scenario adjusted for age, sex, race, comorbidity, and marital status. Reductions in absolute and relative poverty were associated with a lower prevalence of oral disease. A 50% reduction in absolute poverty would avert 1.1 million cases of periodontitis, 0.4 million individuals with dental caries, and 0.6 million dental pain cases. A similar reduction in relative poverty would avert 5.4 million cases of periodontitis, 3.8 million individuals with caries, and 2 million cases of dental pain. The greatest impact was seen with a 50% relative poverty reduction: 12% reduction in periodontitis (prevalence ratio [PR], 0.88; 95% CI, 0.85 to 0.92), 13% reduction in caries (PR, 0.87; 95% CI, 0.81 to 0.92), and 18% reduction in frequent dental pain (PR, 0.82; 95% CI, 0.73 to 0.91). These findings highlight the potential of poverty reduction, especially relative poverty, to significantly lower the US oral disease burden and emphasize policy importance for reducing income inequality to achieve equitable oral health.

Problematic social media use and self-rated health among Swedish adolescents: is the association moderated by family support?

BackgroundRecent studies have documented a range of adverse health outcomes associated with excessive social media use among adolescents. Fewer studies have examined potential protective factors in this context. Our study aims to bridge this gap by exploring the relationship between Problematic Social Media Use (PSMU) and poor Self-Reported Health (SRH) among Swedish adolescents, while also examining the potential buffering role of family support.MethodsThe data was sourced from the 2017/18 cross-sectional Swedish Health Behaviour in School-aged Children (HBSC) study, encompassing 3,135 students aged 11, 13, and 15 years. PSMU was measured using the Social Media Disorder Scale and categorized into three levels: low risk of PSMU, moderate risk of PSMU and having PSMU. Poor SRH was defined as a binary variable, with ‘Less than good health’ as the outcome category. Family support was measured using three items that quantified the level of emotional support received, categorized into an index of low, moderate, and high family support. Logistic regression analyses were performed to examine the association between PSMU and poor SRH, adjusting for age, gender, and family affluence. The potential moderating effect of family support was analyzed by including variables to test for both multiplicative and additive interaction between PSMU and family support on the risk of poor SRH.ResultsAfter adjustment for covariates, the results revealed a graded association between PSMU and poor SRH, with adolescents classified as having PSMU showing the highest odds of poor SRH, followed by those at moderate risk for PSMU. No statistically significant interaction was found on the multiplicative scale. The additive interaction analysis indicated potential trends of a buffering effect of high family support on the risk of poor SRH among adolescents with PSMU, although this was not statistically confirmed [due to small numbers in some of the cells].ConclusionsOur study revealed a significant, graded relationship between PSMU and poor SRH, highlighting the need to limit excessive social media use among adolescents to prevent health issues. The finding, that high family support may serve as a potential protective factor against poor SRH in adolescents with PSMU underscores the role of family engagement in safeguarding adolescent well-being.

Adolescent Refugee Potential Traumatic Experience and Mental Health in Gambella Region in Ethiopia: A Model Examining Mediating Effects of Coping and Resilience

Background: Refugees often experience multiple traumatic events due to persecution, conflict, and displacement, which can result in poor mental health outcomes. Objective: The current study examined whether coping and resilience mediate the relationship between traumatic experience(s) and mental health outcomes and whether these indirect effects were moderated by age, gender, and refugee camp duration. Method: A cross-sectional, correlational study design was employed. Data were collected from 14 July 2019 to 28 August 2019. A sample of 414 adolescent refugees from two refugee camps in the Gambella regional state of Ethiopia were selected using proportional stratified sampling and simple random sampling techniques. Participants completed a self-reported questionnaire. Data were analysed using Structural Equation Modelling for hypotheses testing causal models. Results: Coping and resilience fully mediated the relationship between traumatic experience and mental health among adolescent refugees. Refugee camp duration as a moderator factor weakens the positive relationship between traumatic experiences and mental health outcomes. Conclusions: This study highlights the critical importance of comprehensive intervention strategies that strengthen adolescent refugee personal, family, social, and community level coping and resilience abilities within refugee camps setting. The findings also strongly suggested that early intervention in refugee camps could protect adolescent refugees from possible psychological distress and maintain adolescents’ mental health and well-being within refugee camps.