Poor Economic Conditions Research Articles

Assessment of out-of-pocket (OOP) expenditures on essential medicines for acute and chronic illness: a comparative study across regional and socioeconomic groups in India

BackgroundSubstantial out-of-pocket (OOP) expenditures push a large portion of the population below the poverty line, especially those residing in rural areas having low incomes. Individuals from economically disadvantaged states in India incur higher healthcare costs for hospitalization in public health centers than do those from more developed states. Economically poorer households in states such as Bihar and Odisha face significantly higher OOP expenditures for hospitalization in public health centers than do those in economically developed states such as Tamil Nadu.ObjectiveThis study aims to compare households by using the wealth index and demographic factors concerning OOP expenditures on medicines for acute and chronic illnesses in Odisha, India.MethodologyA cross-sectional household survey was adopted to conduct the research. Access to medicines focused on OOP expenditures in Odisha is being studied by purposively selecting six districts: Rayagada, Kalahandi, Angul, Keonjhar, Khordha, and Kendrapara. A total of 902 households were surveyed. A stratified random sampling procedure was adopted to select the locations and households. The survey took place from October 2021 to February 2022. The sampled respondents were investigated for acute and chronic illnesses. The software SPSS version 25 was used to analyze the data. The details of the expenditures for the past four weeks were compared with those of medicines and healthcare expenses. Households were categorized into wealthy, middle, and poor classes. The prevalence of acute and chronic illnesses was analyzed in light of the share of medicine expenditures to total household expenditures.ResultsOut of 902 surveyed households, 173 (19.2%) spent out-of-pocket (OOP) money on medicines due to acute and chronic illnesses. Among the studied population, 23.7% were affected by acute illness, whereas 10.9% suffered from chronic illness. Wealthy households constituted most of the OOP expenditure (81 wealthy households), whereas 33 poor households also contributed to the OOP expenditure. According to the unadjusted odds ratio (UOR) analysis, wealthy households were 0.25 times less likely to spend more than 50% of their total monthly household budget on medicine than poor households (UOR = 0.25, 95% CI = 0.09—0.65). Similarly, ST households were 0.18 times less likely to spend more than 50% of their money on medicine from their budgets than SC households (UOR = 0.18, 95% CI = 0.04–0.72).ConclusionThe present study again reveals that capital regions (metropolitan regions) are well protected against OOP expenditures on medicines, but tribal areas are still underserved. The odds ratio reveals a critical positive association between high OOP and poor economic status in households in Odisha. That association must be minimized or nullified for equitable economic and social development.

Sociodemographic predictors of flourishing among community older adults in China.

With China becoming a rapidly aging society, the mental health of older adults has become an urgent concern. Past research on mental health assessment has primarily focused on psychopathological aspects such as depression or anxiety. In recent years, however, scholars in positive psychology have suggested that this may ignore the impact of individuals' positive psychological qualities, such as well-being. "Flourishing" is a novel concept in the field of well-being. This adds to psychological well-being based on traditional social and subjective well-being. However, limited research has focused on the flourishing of older Chinese community-dwelling adults from the perspective of positive psychology. Therefore, this study explored the status and factors influencing flourishing among older Chinese community-dwelling adults. A total of 518 community-dwelling older adults living in Chengdu between January 2022 and March 2022 were included in this study through a cross-sectional survey. Participants completed the General Condition Questionnaire and the Flourishing Scale. The data were collected and recorded in a database using a two-person input format. Data analysis was conducted using SPSS Windows software version 26.0. Multivariate linear regression analysis was used to identify the factors influencing flourishing. The mean score of the flourishing scale among Chinese community-dwelling older adults was 40.8 8.8. Univariate analysis showed that economic condition, education level, spousal state, social participation, daily exercise, and chronic disease were significantly associated with flourishing among community-dwelling older adults. In contrast, gender, place of residence, and living state were not. Multivariate linear regression analysis showed that economic condition (β = 0.338, p < 0.001), education level (β = 0.300, p < 0.001), spousal state (β = -0.291, p = 0.008), social participation (β = -0.286, p = 0.013), daily exercise (β = -0.407, p < 0.001), and chronic disease (β = 0.313, p = 0.002) were significant influence factors of flourishing among community-dwelling older adults. This study is one of the first to explore the growth of community-dwelling older adults in China. The findings of this study make essential contributions to existing research on well-being. Interventions targeting older adults with poor economic conditions, lower educational levels, chronic diseases, limited social participation, and widowed or living alone are necessary.

Socio-economic and Demographic Factors Associated with Psychological Distress Among Elderly

Background: Psychological distress is one of the most common mental health disorders in the elderly and can lead to major depression and anxiety disorders. Objectives: The aim of this study was to determine the prevalence, socio-economic and demographic factors associated with psychological distress among elderly in Kermanshah. Methods: The current research was a descriptive study that was conducted among the elderly over 60 years old covered by the pension funds of Kermanshah city in the winter of 2022. Sampling was done by multi-stage cluster sampling method. Data were collected using Kessler Psychological Distress Scale (K6) by interview. Data were analyzed by SPSS version 16 using Pearson correlation, chi-square and independent samples t-test at 95% significant level. Results: Twenty point six percent of the elderly had psychological distress. The correlation between age and psychological distress was positive and significant (r = 0.108 and P = 0.012). Psychological distress was significantly higher among men (P = 0.019), people with primary education (P = 0.001) and poor economic status (P &lt; 0.001). Conclusions: The prevalence of psychological distress among the elderly is noticeable. It is important to teach methods to help the elderly cope with psychological distress. Efforts to prevent and decrease psychological distress among the elderly in Kermanshah should prioritize individuals with low economic status and men.

Investigation of sexual life and perceived spousal support in female recipients after kidney transplantation.

End-stage renal failure has negative effects on sexual life, and solid kidney transplantation helps to recovery in sexuality. However, recovery in sexual life progresses slowly, and female recipients may need spousal support during this process. To examine the perceived spousal support and sexual lives of female kidney recipients in the aim of this study. The study was conducted as a descriptive and cross-sectional research. 158 female kidney recipients were included in the study. In data collection, Personal Information Form, Spousal Support Scale, and Arizona Sexual Experience Scale were used. The study data were analyzed through descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, Dunn-Bonferroni post-hoc test, and Spearman correlation analysis. In this study 47.5% of the female recipients were within the age range of 28-40 years. 43.7% had university education and above. 60.1% had their income equal to their expenses. 38% of the female kidney recipients suffered from diabetes mellitus and endocrine problems. In this study, sexual dysfunction of female kidney recipients was found to be slightly above average. The spouse support perceived by the female recipients was well above average. As a result of this study was determined that as the economic status of the female recipients improved, perceived spousal support increased (p<0.05). It was also determined that the female kidney recipients who were 40 years old and above, had poor economic status, used Tacrolimus and Cyclosporine, and had a comorbid chronic disease were under more risk in terms of poor sexual life, and their perceived spousal support was above moderate level. The sexual life of female kidney recipients is affected by their clinical situation (concomitant diseases, advanced age, medication use). On the other hand, strong spouse support can make significant contributions to improving sexual life. A correlation was found in the study between sexual life and perceived spousal support in the female kidney recipients. The findings of the study point to the importance of spousal support in terms of improving sexual lives in female kidney recipients. Studies should be conducted on these two important concepts in planning care interventions and training programs.

Prevalence and Causes of Neonatal Hearing Loss and Follow-Up Default in a Cohort from Saudi Arabia: A Retrospective Analysis

Background and Aims: The Universal Newborn Hearing Screening (UNHS) program in Saudi Arabia has proven instrumental in curbing the burden of neonatal hearing loss in the country. Recent studies from Saudi Arabia have shown a high rate of neonatal hearing loss and follow up default, along with poor awareness among parents, in the Madina region of the country. The study aimed to investigate the prevalence and causes of neonatal hearing loss and follow-up default, among newborns screened at the Children and Maternity Hospital in Madina, Saudi Arabia. Methods: All 500 neonates who were born at the hospital from January 2021 to January 2022, and underwent UNHS were included. Prevalence and causes were expressed as descriptive statistics. A chi-square test was used to correlate clinical risk factors with the occurrence of neonatal hearing loss. A P value &lt;0.05 was considered statistically significant. Results: The prevalence of neonatal hearing loss was 1.2%, with 17.8% follow-up default. Exposure to ototoxic drugs, low birth weight, craniofacial anomalies, neonatal intensive care unit admission, maternal age &gt;30 years, and hereditary risk showed a statistically significant correlation with neonatal hearing loss. Transportation difficulties (33.7%), lack of education (28.7%) and poor economic condition (21.8%) were the top causes of follow-up default. Conclusions: The study reiterates the dire need to raise awareness among parents of newborns regarding the detrimental effects of neonatal hearing loss, the importance of the UNHS program and the necessity for complete follow-up. A wider and more efficient network of screening and referral centers is needed. Research studies conducted at individual institutions can help identify and address the inadequacies of the UNHS program at a grassroots level.

The Influence of Socioeconomic Factors on Diabetes Management and Its Outcomes

Diabetes is a growing global issue, with socioeconomic status (SES) influencing the incidence and prevalence of the condition. Adults with lower incomes are more likely to develop diabetes and experience higher rates of complications and mortality. In SES assessments, education quality is considered more important than quantity. High-income individuals are less likely to develop diabetes due to their ability to afford balanced diets and medications. Long work hours and illiteracy also contribute to the onset of diabetes. Research conducted in Bahawalpur, Pakistan, found that socioeconomic factors significantly affect diabetes patients, with poor economic status and inadequate diabetic education being more prevalent. Physical inactivity and lack of life insurance further contribute to the condition. In Bahawalpur, a cross-sectional study involving 374 participants from diverse social and economic backgrounds examined the impact of socioeconomic factors on diabetes management and outcomes across different age and gender groups. Among the participants, 60% were male and 39.39% were female, with 66.80% over the age of 50. Out of the 374 participants, 236 (63.10%) were unemployed. Additionally, 41.97% of participants had limited knowledge about diabetes. Due to poor knowledge, economic constraints, and lack of physical activity, participants experienced poor diabetes management, leading to negative outcomes.

The Socioeconomic Conditions and Behavior of Riverside Communities in Disposing of Waste in the Cisadane River Segment of South Tangerang City

The existence of settlements along riverbank, particularly in urban areas, can disrupt both the function of the river and its riverbank. The behavior of riverside communities generally adds to burden the river, primarily through the practice of disposing waste into the river and its riverbank. This behavior can cause detrimental effects on both the environment and society. This research aims to examine the socioeconomic conditions and waste disposal behavior of communities residing along the Cisadane River, South Tangerang City. This research is a quantitative descriptive study. Data collection involved the use of questionnaires, interviews, and observations, which were subsequently analyzed using descriptive statistical techniques. The findings revealed that the majority of riverside communities in South Tangerang City exhibited a high level of understanding (54.55%), a relatively positive perspective (75.76%), and a poor economic condition (57.58%). However, their waste disposal behavior was predominantly inadequate (51.52%). Consequently, the study indicates a discrepancy between the community's level of understanding, perspective, and actual waste disposal practices. With the intervention of communication forums, the creation of mutually agreed norms, and the availability of waste disposal and processing infrastructure, it is hoped that the community awareness and sense of responsibility would be enhanced, that will lead to no rubbish throwing into the river and its borders hence diminishing the burden of the river so that the function of the river and its borders are preserved.

Rightless Migration in India: A Study of Inefficiency and Sufferings Sprouting in the Agricultural Fields of Bihar

The state of Bihar, an agrarian economy, is currently representing a paradoxical situation in India as the development narrative of north and south Bihar displays a unique history of economic advancement. During the Covid-19 pandemic, spurt in migration and even reverse migration created a severe livelihood crisis for the unemployed people in Bihar. United Nations’ Sustainable Development Goals of economic growth, social cohesion, and environmental sustainability can be successful in improving the lives of labourers if the socio-economic protection and workers’ rights are given due importance. The present study aims at explicating the reasons for unemployment, migration and poor economic conditions of labour in Bihar, a state in eastern part of India. Secondary data available from NSSO, Census of India and Economic survey of Bihar have been analysed for this research. The study is based on the qualitative and quantitative analysis and descriptive methods to understand the various socio-economic facets of migration. Absence of uniform labour standards in the unorganised sector related to migrant labourers is the major issue which needs to be immediately and adequately addressed by the Government of India and the state government of Bihar.

Rightless Migration in India: A Study of Inefficiency and Sufferings Sprouting in the Agricultural Fields of Bihar

The state of Bihar, an agrarian economy, is currently representing a paradoxical situation in India as the development narrative of north and south Bihar displays a unique history of economic advancement. During the Covid-19 pandemic, spurt in migration and even reverse migration created a severe livelihood crisis for the unemployed people in Bihar. United Nations’ Sustainable Development Goals of economic growth, social cohesion, and environmental sustainability can be successful in improving the lives of labourers if the socio-economic protection and workers’ rights are given due importance. The present study aims at explicating the reasons for unemployment, migration and poor economic conditions of labour in Bihar, a state in eastern part of India. Secondary data available from NSSO, Census of India and Economic survey of Bihar have been analysed for this research. The study is based on the qualitative and quantitative analysis and descriptive methods to understand the various socio-economic facets of migration. Absence of uniform labour standards in the unorganised sector related to migrant labourers is the major issue which needs to be immediately and adequately addressed by the Government of India and the state government of Bihar.

PEREMPUAN DAN KETIDAKADILAN GENDER (Studi Kasus Bentuk-Bentuk Ketidakadilan Gender di Kota Kendari Tahun 2024)

The purpose of this research is to identify and examine gender inequality as a manifestation of gender differences in Kendari City in 2024. It will examine the forms of gender inequality that women in Kendari City face using the gender concept. The research method used is mixed methods, which combine qualitative and quantitative research methodologies. Data collection techniques using questionnaires distributed via Google form, literature study, and documentation. The three steps of the analysis technique are data reduction, data display, and conclusion drawing. The research indicates that there are five forms of gender inequality in Kendari City, namely: Marginalization, Subordination, Stereotypes, Violence and Workload. Stereotypes, Marginalization, and Subordination are less dominant than the most dominant form of violence that women in Kendari City face. Based on data from the Women’s Empowerment and Child Protection Service, there were 26 cases of violence against women that occurred in the workplace, public spaces, and at home. The workload was found to be 44.4%, especially for women who act as both breadwinners and housewives. In conclusion, workload and violence are the most prevalent forms of gender inequality in Kendari City. Poor economic conditions are the primary factor of this violence and workload.

Analisis Kriminologis Terhadap Tindak Pidana Perdagangan Orang

Human trafficking is a serious crime that continues to evolve at both national and international levels. In Belu Regency, East Nusa Tenggara, human trafficking has become a major issue, particularly concerning the illegal trafficking of Indonesian migrant workers (IMWs). This research employs a juridical-empirical approach, using interviews and document studies as data collection techniques. The findings of this study reveal that: (1) The factors contributing to human trafficking in Belu Regency can be categorized into internal and external factors. Internal factors include the perpetrators' motivation to gain quick financial benefits without considering the consequences and the victims' poor economic conditions and lack of awareness of their rights. External factors encompass poverty, low levels of education, limited job opportunities, and weak law enforcement, which creates opportunities for the perpetrators. (2) The modus operandi of the perpetrators involves deception, such as promising high-paying jobs with good working conditions, which ultimately leads to the exploitation of victims. (3) Efforts to combat human trafficking involve preemptive, preventive, and repressive measures. Preemptive efforts include public awareness campaigns, preventive measures focus on monitoring illegal recruitment activities, and repressive measures involve law enforcement actions against the perpetrators.

Symptoms of acute stress, anxiety, and depression following Türkiye-Syria earthquake among Syrian population: national survey during the acute phase

ABSTRACT Background: On 6 February 2023, an earthquake with a 7.8 magnitude wreaked destruction in northern Syria to add a new emergency status in the country. This study aims to evaluate the mental health status of the Syrian population in the immediate phase of the earthquake. Methods: This nationwide cross-sectional study was conducted in Syria from 17 February to 6 April. Data were collected on socio-demographics, trauma exposure characteristics, and levels of acute stress, depression, and anxiety. The NSESSS Checklist for the APA was used to assess ASD symptoms, PHQ-9 for depression, and GAD-7 for anxiety. Linear mixed-effects models were employed to identify predictive factors while accounting for governorate as a random effect and time elapsed as a fixed factor. Results: The rate of probable ASD symptoms was significant, with 55.3% of participants exhibiting these symptoms, including 10.3% reporting severe-to-extreme levels of severity. Similarly, 71.6% of participants exhibited symptoms of depression and 59.1% showed symptoms of anxiety. Furthermore, 40.4% of participants displayed a co-occurrence of ASD along with anxiety and depression. Linear mixed effects models indicated that symptoms were predicted by female sex, displacement, poor economic status, and a positive mental health history time elapsed, physical trauma, belief in the ongoing risk of earthquakes, feelings of dizziness, recurrent night-time fear arousal, and a continued sensation of seismic activity. Conclusion: This study demonstrated the high rates of symptoms of ASD, anxiety, and depression across the Syrian population during the immediate aftermath of the earthquake. High portions of people may acquire co-occurring symptoms represented by different mental health problems. These findings highlight the need for immediate actions to enhance mental health support in Syria.

Enhancing Agriculture Resilience to Climate Change: Insights from NICRA in Lakhimpur, Assam, India

Aims: This study investigates the adoption of climate-resilient agricultural practices in Lakhimpur, Assam, under the NICRA project. Using a mixed-methods approach involving surveys and interviews, the study identifies key adaptive strategies and their socioeconomic impact. Results highlight increased crop yield and farmer awareness as critical outcomes. These findings underscore the role of sustainable techniques in mitigating climate risks and ensuring agricultural sustainability. Study Design: A multi-stage sampling technique was used to draw samples for the present study. In the first stage, out of nine development blocks of Lakhimpur district, the block where the NICRA project was implemented was selected. In the second stage, all five villages where the NICRA project was implemented in the block were selected purposively. In the third stage, 80 NICRA beneficiary farmers were selected randomly from five villages, which were treated as respondents. Place and Duration of Study: The present study on NICRA project interventions on climate resilient agriculture was taken up in the Lakhimpur district of Assam. As the project was implemented in the district in 2011, the district was selected for the study. The primary data were collected for the year 2021-22. Methodology: An attempt had been made in the study to identify the NICRA interventions, economics of selected interventions and constraints faced by the farmers in the study area. Both primary and secondary data were collected to fulfil the stated objectives. A well-structured pre-tested schedule was developed for the collection of primary data as per the objectives Cost concepts were used to estimate the cost of cultivation (cost of production) and derive the various income measures, viz., farm business income, family labour income, net income, and farm investment income. The cost concepts of Commission for Agricultural Cost and Prices (CACP, New Delhi), viz., Cost A1, Cost A2, Cost B1, Cost B2, Cost C1, Cost C2 and Cost C3 were used in the present study. Identifying the constraints that NICRA beneficiary farmers face, closed-ended questions were asked to determine the most significant challenges they were facing, and recommendations for resolving those issues were also sought. The frequency of respondents was then calculated for each constraint. Finally, ranking was done based on finding out both the frequency and the percentage. Results: The NICRA project includes a "Technology Demonstration" component in which emphasis was given to detecting exact climatic stress and demonstrating site-specific climate resilient solutions in the farmer's field to persuade farmers to adopt locally accessible technology through different interventions. The economics of selected interventions i.e. change in crop variety (rice) &amp; alternative land use system (mushroom) were analysed. Climate resilient agro interventions by NICRA, like real-time contingency planning, preparedness, Climate Risk Management Committee, Custom Hiring 64 Centre, Village Seed Bank, and alternate land use system were identified to be prevailing in the study area. The costs of production of rice per hectare in marginal farmers were found to be Rs. 27484.90 and for small and medium farmers it was found to be Rs. 30055.43 &amp; Rs. 32096.23 respectively. Cost of cultivation per hectare in medium farmers was found to be maximum. The per hectare cost of cultivation as well as return from the rice cultivation varied directly with farm size. The average yield of rice per hectare was found to be 34.21 quintals. The average gross return was found to be Rs. 44477.42. The average costs of mushroom growers were found to be Rs. 1932.60 and gross return was observed to be Rs. 6152.98. The Gross return over cost was found to be 3.18. The results depicted that constraints confronted by respondent farmers were inversely proportional to the size of the farm holding. The constraint faced by the NICRA beneficiary farmers that ranked at the top was identified to be a poor economic condition of the farmers. Conclusion: The study revealed the presence of diverse climate-resilient agro-technological interventions introduced by NICRA, such as real-time contingency strategies, preparedness initiatives, Climate Risk Management Committees, Custom Hiring Centres, Village Seed Banks, and innovative alternate land use systems. As land holding size increased, farmers tended to use more machine labour instead of bullock labour. As indicated by the computed gross return over cost ratio of rice, is profitable in the study area. Hence the “change in crop variety” intervention in the study area was found to be economically feasible. It is found that the per hectare cost of cultivation as well as return from the rice cultivation varied directly with farm size. Mushroom cultivation under the intervention of “alternate enterprise selection” was found to be very profitable for the farmers. Spawn cost shares the highest operational cost percentage for mushroom growers. The constraint faced by the NICRA beneficiary farmers that ranked at the top was identified to be the poor economic condition of the farmers.

A magyar-román-szlovák-ukrán határmenti kapcsolatok az Európai Unió határtérségeinek fényében

The development of border regions has been an integral part of EU regional policy for decades. Border regions, particularly in Central and Eastern Europe, are typically peripheral areas with poor demographic and economic conditions, and one of the ways out of this situation could be to take advantage of cross-border cooperation. One of the first frameworks for this was the creation of Euroregions and, since the 1990s, the Interreg programmes, which offer opportunities for cooperation between border regions at three levels. In addition to the EU framework, Hungarian strategic documents also deal with border regions, and their analysis is also important for the formulation of long-term objectives. Overall, although Interreg projects are trying to respond to the problems of border regions, it may be important in the future to deepen partnerships and better involve partners.

Constraint Analysis and Suggestion of Respondents Regarding Dairy Management Practices in Semi-Urban and Rural Areas

India needs to increase milk production which can be possible by narrowing down the gap between the existing technology and their adoption. Ensuring domestic demand and enduring top most position in the world, India needs to produce 300-400 million tones of milk by 2050 (Vision 2050, 2015). The dairy is a business which provides the continuous source of income to the occupants and in case of landless person who are economically week, livestock farming is a better option. The research was based on a survey done in 2022-23 to analyzing constraint and suggestion of respondents regarding dairy management practices in semi-urban and rural areas of Fatehpur district in Uttar Pradesh. 15 respondents from each selected semi-urban and rural villages were randomly selected to constitute 120 samples (60 semi-urban + 60 rural). The perceived constraints have been studies under different aspects like: personal constraints, economical constraints, technological constraints and marketing constraints. The semi-urban respondents has perceived most serious type constraints viz., lack of poor economic condition of farmers, dysfunctional of animal insurance schemes, A.I. and BAIF centers are away from the village, lack of remunerative milk prices. Whereas rural respondents has perceived most serious type constraints viz., lack of interest of other family members, veterinary medicines are very costly for treatment of sick animals, A.I. and BAIF centers are away from the village, poor transportation also affects adversity in proper disposal of milk products. Suggestions as perceived by semi-urban respondents viz., ‘educational programmes regarding cattle breeds improvement for higher milk production should be initiated’ was ranked first whether in case of rural dairy farmers ‘government must provide marketing facilities at village level for selling the milk and milk products’ was ranked first.

Investigation of prevalence of substance use disorders using direct and indirect methods and factors affecting initiation of substance use

ABSTRACT Background Substance Use Disorders (SUDs) are among some of the major health problems in different societies, especially in Iran, resulting in devastating outcomes. This study was conducted to investigate the prevalence of SUDs using both direct and indirect (network scale-up (NUS) and cross-wise model (CM) methods and to identify the factors affecting initiation of substance use. Methods The study was conducted among people aged 15–69 years in Kermanshah, Iran, with a total of 6127 people selected utilizing a stratified sampling method. Results The prevalence of SUDs was estimated at 3.85% by direct CM, 11.05% by indirect CM and 10.07% by NUS. The results of multivariate logistic regression revealed that the most important factors in increasing the chance of substance use were history of substance use in the family, mental diseases, poor economic status, and age group of 31–45 years. Conclusion Regarding the almost three-fold prevalence of indirect methods for estimating the prevalence of SUDs compared to direct methods on the one hand and the high prevalence of substance use in the province on the other, special prevention health programs are required by considering the groups at risk.

"Behavioural and metabolic risk factors of cardiovascular diseases among post-menopausal women: A cross-sectional study in Itahari sub-metropolitan city of Nepal".

Cardiovascular diseases (CVDs) are main cause of mortality and morbidity among women globally. Menopause, aging and different factors in collaboration leads to increased risk for CVDs among postmenopausal women but study on risk factors of CVDs among postmenopausal women is limited in Nepal. Therefore, we aimed to assess prevalence of behavioural and metabolic risk factors of cardiovascular disease among post-menopausal women. Community based cross-sectional study was carried among 390 post-menopausal women of the Itahari sub-metropolitan city. Multistage simple random sampling technique was used to collect data. Modified semi structured questionnaire STEP I, STEP II and STEP III was used as data collection tool. SPSS version 11.5 used for data analysis. Chi-square test and logistic regressions were performed at 95% confidence interval to find predictors of raised blood pressure and overweight/obesity. The mean age of respondents was 63.37 years. The prevalence of current smokers, current alcohol use, less than 5 servings of fruits and vegetables per day, low level of physical activity, overweight/obesity and raised blood pressure was 9.2%, 18.2%, 86.4%, 52.3%, 56.2% and 44.4% respectively. On multivariate analysis strong predictors of overweight obesity were age ≤59 years (AOR: 3.21, CI 1.49-6.89), poor economic status (AOR: 1.764, CI: 1.120-2.779) and low physical activity (AOR: 2.132, CI: 1.350-3.370). Predictors of raised blood pressure were age ≥75 years (AOR: 2.04, CI: 1.01-4.11), unmarried and widow (AOR: 1.815, CI: 1.108-2.971), higher economic status (AOR: 1.752, CI: 1.119-2.740) and smoking (AOR: 4.109, CI: 1.737-9.718). Prevalence of behavioural and metabolic risk factors among postmenopausal women in Itahari sub-metropolitan city were alarmingly high. This calls for an early need of intervention and policies at local, provincial and institutional level to address risk factors of CVDs.

Study on anxiety, depression, and sleep conditions and their interrelations among vocational college students during the COVID-19 pandemic management normalization.

This study investigates the sleep patterns among vocational college students and examines their association with anxiety and depression amidst the ongoing normalization of COVID-19 management strategies. In the period of January to February 2022, a comprehensive survey was conducted involving a random sample of 3,300 students. By employing face-to-face interviews, data on general demographics, along with levels of anxiety, depression, and sleep quality, were meticulously gathered and analyzed. Out of the 3,049 questionnaires deemed valid for analysis, the prevalence rates for anxiety, depression, and insomnia were found to be 9.7, 14.1, and 81.9%, respectively. Through regression analysis, several factors were identified as significant predictors of insomnia: female gender, a self-perceived average or poor family economic status over the last year, moderate psychological stress due to the pandemic and its associated restrictions, extended daily screen time during the pandemic, absence of a routine physical exercise regime, significant disruption or alteration of daily life routines due to the pandemic, presence of anxiety and depression symptoms during the pandemic, and only partial restoration of normal life routines post-pandemic control measures (p < 0.001, p < 0.005, or p < 0.050). A strong correlation was observed among the symptoms of anxiety, depression, and insomnia (all p < 0.001). The correlation between stress and depression, depression and insomnia, and anxiety and insomnia were 0.824, 0.714, 0.620, respectively, (all p < 0.001). Given the substantial impact of abrupt or prolonged crisis events, it is imperative to develop and implement specific intervention strategies aimed at safeguarding the psychological well-being of college students.

Factors affecting ageism and depression levels in individuals aged 65 and over living in society

Abstract Background The aging process is perceived negatively by some people. This perception prevents/reduces the happiness that can be gained from the aging process. As a result, depressive symptoms may occur. Therefore, this study aimed to examine the factors affecting ageism and depression levels in individuals aged 65 and over living in society. Methods The sample of the research, which was conducted with a cross-sectional, descriptive design, consisted of 287 individuals aged 65 and over living in a neighborhood on the Anatolian side of Istanbul. Data were collected with socio-demographic form, Ageism Questionnaire and Yesavage Geriatric Depression Scale-15. T test, variance analysis and chi-square test were used to analyze the data. Ethical permissions were obtained. Results Moderate depression was found in 27.5% of individuals with a mean age of 70.80±5.42. Individuals scored below the average (18.48±8.14) on the ageism survey. Ageism scores were higher for men, those aged 85 and over, those with poor economic conditions, those with chronic diseases, those hospitalized in the last year, those with severe and moderate depression, and those who needed help with daily tasks (p &amp;lt; 0.05). A statistically significant difference was found between age groups, chronic disease, continuous medication use, hospitalization in the last year, working status, need for help with daily tasks, economic status and depression levels (p &amp;lt; 0.05). Ageism scores of those with severe and moderate depression were found to be high (F = 3.43;p=0.017). Conclusions Variables that are effective in ageism and depression are being aged 85 and over, having a poor economic situation, having a chronic disease, needing help with daily tasks, and receiving inpatient treatment in the last year. The results of this study show that more efforts and resources are needed within the scope of political and social services to reduce ageism in society and the level of depression in older individuals. Key messages • As the level of depression in elderly individuals increases, ageism increases. • Advanced age, economic status, chronic disease, hospitalization and dependence on daily tasks affect depression and ageism.

Cardiovascular and fracture events analysis and intervention strategies in patients undergoing parathyroidectomy with secondary hyperparathyroidism.

Chronic kidney disease (CKD), especially end-stage renal disease (ESRD), is the most common cause of secondary hyperparathyroidism (SHPT), and SHPT is the most severe complication of ESRD. This study aimed to analyze the influencing factors of cardiovascular and fracture events in patients with SHPT which are the leading causes of death in patients with CKD, and provide a reference for selecting patients for whom surgery is more suitable. Patients who underwent parathyroidectomy (PTX) for SHPT at The First Affiliated Hospital, Zhejiang University School of Medicine from September 2021 to April 2024 were selected as the study object, with the inclusion and exclusion criteria as followed. They were divided into rural and urban residents for comparison as a cross-sectional study. The study evaluated the comorbidities, socioeconomic status, and postoperative complications diagnosed by radiography of patients undergoing surgery for SHPT. A total of 119 patients were included, among whom, 71 were from rural areas and 48 were from urban areas. Compared with urban residents, rural residents had poorer economic conditions, a longer interval from disease onset to PTX, and a higher incidence of cardiovascular and fracture events and concurrent nephrolithiasis, all of which were statistically significant. Multivariate analysis indicated that place of residence, age, and duration of uremia were independent risk factors of cardiovascular/fracture events. Medical staff in ESRD outpatient clinics should pay attention to patients with SHPT. ESRD patients should have better surveillance especially for rural, elder and poor phosphorus control patients, and promptly assess surgical intervention measures.