Population-based Survey Research Articles

Association between cadmium exposure and serum neurofilament light chain levels: A nationwide population-based survey

BackgroundAlthough cadmium exposure had been demonstrated to be toxic to the nervous system, little was known about the link between cadmium exposure and axonal injury. Therefore, the present study aimed to reveal whether there was any correlation between blood cadmium and serum neurofilament light chain (NfL) levels in the general population. MethodsThis study included 1040 participants with a median (IQR) age of 47 (35−60) years from the 2013–2014 National Health and Nutrition Examination Survey. Serum NfL levels were measured through immunoassay, and whole blood cadmium concentrations were detected by means of inductively coupled plasma mass spectrometry. Linear regression and restricted cubic spline model was applied to analyze the significance of relationship between blood cadmium and serum NfL levels. ResultsIn the full adjusted model, blood cadmium levels were found to be positively associated with serum NfL levels (Q4 vs Q1, β = 3.35, 95 %CI: 0.41, 6.30, p for trend = 0.014). A potential linear positive dose-effect relationship was discovered between blood cadmium and serum NfL levels (p for non-linearity = 0.15). According to the result of stratified analysis, the significant positive relationship between blood cadmium and serum NfL levels was present only in the population of middle-aged and older adults. ConclusionThe present study suggested a positive association between blood cadmium and serum NfL levels in the general US population.

Contraceptive Use Measured in a National Population-Based Approach: Cross-Sectional Study of Administrative Versus Survey Data.

Prescribed contraception is used worldwide by over 400 million women of reproductive age. Monitoring contraceptive use is a major public health issue that usually relies on population-based surveys. However, these surveys are conducted on average every 6 years and do not allow close follow-up of contraceptive use. Moreover, their sample size is often too limited for the study of specific population subgroups such as people with low income. Health administrative data could be an innovative and less costly source to study contraceptive use. We aimed to explore the potential of health administrative data to study prescribed contraceptive use and compare these data with observations based on survey data. We selected all women aged 15-49 years, covered by French health insurance and living in France, in the health administrative database, which covers 98% of the resident population (n=14,788,124), and in the last French population-based representative survey, the Health Barometer Survey, conducted in 2016 (n=4285). In health administrative data, contraceptive use was recorded with detailed information on the product delivered, whereas in the survey, it was self-declared by the women. In both sources, the prevalence of contraceptive use was estimated globally for all prescribed contraceptives and by type of contraceptive: oral contraceptives, intrauterine devices (IUDs), and implants. Prevalences were analyzed by age. There were more low-income women in health administrative data than in the population-based survey (1,576,066/14,770,256, 11% vs 188/4285, 7%, respectively; P<.001). In health administrative data, 47.6% (7034,710/14,770,256; 95% CI 47.6%-47.7%) of women aged 15-49 years used a prescribed contraceptive versus 50.5% (2297/4285; 95% CI 49.1%-52.0%) in the population-based survey. Considering prevalences by the type of contraceptive in health administrative data versus survey data, they were 26.9% (95% CI 26.9%-26.9%) versus 27.7% (95% CI 26.4%-29.0%) for oral contraceptives, 17.7% (95% CI 17.7%-17.8%) versus 19.6% (95% CI 18.5%-20.8%) for IUDs, and 3% (95% CI 3.0%-3.0%) versus 3.2% (95% CI 2.7%-3.7%) for implants. In both sources, the same overall tendency in prevalence was observed for these 3 contraceptives. Implants remained little used at all ages, oral contraceptives were highly used among young women, whereas IUD use was low among young women. Compared with survey data, health administrative data exhibited the same overall tendencies for oral contraceptives, IUDs, and implants. One of the main strengths of health administrative data is the high quality of information on contraceptive use and the large number of observations, allowing studies of subgroups of population. Health administrative data therefore appear as a promising new source to monitor contraception in a population-based approach. They could open new perspectives for research and be a valuable new asset to guide public policies on reproductive and sexual health.

Alcohol consumption among Iranian population based on the findings of STEPS survey 2021

Alcohol production and consumption have been prohibited in Iran for over four decades, leading to a typical underestimation of its consumption. This study aimed to assess the prevalence of alcohol consumption, its associated factors, and estimate per capita alcohol consumption among Iran’s adult population. In this population-based survey, 27,874 adults from across Iran were selected using systematic proportional-to-size cluster sampling. Alcohol consumption was evaluated through a modified Persian version of the STEPS questionnaires from previous studies, applied over different timespans. Per capita consumption was calculated using the quantity-frequency method, expressed in liters of pure alcohol. Adjusted odds ratios were reported for associates of alcohol consumption concerning metabolic risk factors, sociodemographic elements, and lifestyle variables. The prevalence of lifetime alcohol consumption was 6.9% (95% CI 6.5–7.2) in the adult population, with a notable sex difference (males: 13.7% [95% CI 13–14.4]; females: 1.4% [95% CI 1.1–1.6]). The 12 month prevalence was 3.8% (95% CI 3.6–4.1). For individuals aged 18 and older, the per capita alcohol consumption in Iran was 0.12 L. Factors such as being a lifetime smoker, younger, wealthier, and having 7–12 years of education were significantly linked to higher alcohol consumption. Significant associations were also observed between alcohol consumption and having a history of heart attacks (OR = 2.04, 95% CI 1.44–2.89), and physical injuries (OR = 1.88, 95% CI 1.34–2.64). The estimated lifetime and 12-month prevalence of alcohol use in our study were higher among some of the subpopulations. The findings also revealed a complex relationship between alcohol consumption, behavioral risk factors, and metabolic profiles. Consequently, immediate preventive measures tailored to each factor’s association with alcohol use are recommended.

Determinants of the Utilization of Recognized Traditional and Complementary Medicine Service in Malaysia: A Secondary Analysis of a Cross-Sectional Population-Based Survey

Plain Language SummaryMalaysia is a multiethnic and multicultural country with a long history of the coexistence of various traditional and complementary medicine (T&CM) practices. Currently, seven practice areas are recognized in Malaysia: traditional Malay medicine (TMM), traditional Chinese medicine (TCM), traditional Indian medicine, homeopathy, Islamic medical practice, chiropractic, and osteopathy. Many global studies have investigated the general determinants of T&CM service utilization. However, there has been no comprehensive study reporting specific determinants of recognized T&CM service utilization at a national level. Therefore, this study aimed to examine the prevalence and specific determinants of the utilization of recognized T&CM services in Malaysia. Our study revealed that 19.3% of the Malaysian population had utilized recognized T&CM services in the preceding 12 months, with 15.5% utilizing TMM services, 3.9% utilizing TCM services, and 1.5% utilizing other T&CM services. The specific determinates of service utilization were distinctively different between varied T&CM services, showing strong ethnocultural ownership.

Perception and awareness of the public about presbyopia and its corrective approaches in Saudi Arabia: a population-based survey

BackgroundThis study investigated patients’ awareness of presbyopia and its management approaches and their preferred methods for near vision correction.MethodsIn Saudi Arabia, 785 participants (aged between 35 and 60 years) completed a structured survey online, consisting of hard copies and direct interviews. The survey consisted of twenty-eight items divided into three parts. It was designed to record participants’ awareness of and preferences for presbyopia and its refractive corrections. Nonparametric tests and descriptive analyses were conducted to analyse participants’ responses.ResultApproximately half of the participants had difficulty with near vision activities, such as reading newspapers or using mobile phones. Among all the participants, 76% were not aware of presbyopia. The prevalence of uncorrected presbyopia was 48% of the 785. The majority (82%) felt that spectacles were acceptable for correction of presbyopia. Most reported that they did not experience social stigma when using reading spectacles (87% of participants). When asked if they were aware of management approaches other than spectacles, 72% responded with not at all. Most participants had no earlier knowledge of the use of multifocal contact lenses or eye drops for presbyopia correction (67% and 82%, respectively). In the present study, some tendencies to use corrective approaches to presbyopia other than spectacles were noted. Finally, participants’ age, sex, region, education, and income had a statistically significant impact on essential parts of their responses (p < 0.05).ConclusionPresbyopia is a highly prevalent age-related ocular disorder, and a significant percentage of cases are uncorrected due to a lack of awareness or reluctance to wear spectacles. More efficient health education about presbyopia and its corrective alternatives is urgently needed.

Estimating and Explaining the Differences in Health Care Seeking by Symptom Burden Among Persons With Presumptive Tuberculosis: Findings From a Population-Based Tuberculosis Prevalence Survey in a High-Burden Setting in India.

There is a lack of research evidence on the quantitative relationship between symptom burden and health care seeking among individuals with presumptive tuberculosis (TB). Data were derived from a cross-sectional population-based TB survey conducted between February 2021 and July 2022 in 32 districts of India. Eligible and consented participants (age >15 years) underwent TB symptom screening and history elicitation. Fairlie decomposition analysis was used to estimate the net differences in health care seeking due to varied symptom burden-from 1+ burden (>1 symptom) to 4+ burden (>4 symptoms)-and decomposed by observable covariates based on logit models with 95% CIs. Of the 130 932 individuals surveyed, 9540 (7.3%) reported at least 1 recent TB symptom, of whom 2678 (28.1%; 95% CI, 27.1%-28.9%) reportedly sought health care. The net differences in health care seeking among persons with symptom burden 1+ to 4+ ranged from 6.6 percentage points (95% CI, 4.8-8.4) to 7.7 (95% CI, 5.2-10.2) as compared with persons with less symptom burden. The presence of expectoration, fatigue, and loss of appetite largely explained health care seeking (range, 0.9-3.1 percentage points [42.89%-151.9%]). The presence of fever, cough, past TB care seeking, weight loss, and chest pain moderately explained (range, 5.3%-25.3%) health care seeking. Increased symptom burden and symptoms other than the commonly emphasized cough and fever largely explained health care seeking. Orienting TB awareness and risk communications toward symptom burden and illness perceptions could help address population gaps in health care seeking for TB.

Dealing with the challenges of the pandemic – results of a population-based survey during the second year of the COVID-19 pandemic contrasting benefits and burden

BackgroundThe pandemic and the associated consequences have been ongoing stressors with severe impacts on the population and particularly on families. Research focusing on groups dealing well with the challenges of the pandemic is scarce. Here, we aimed to identify groups being well-adjusted during the pandemic and associated predictors.MethodsA representative sample of the German population (N = 2,515, 51.6% women, 50.09 years), and a subsample of persons with children or adolescents under the age of 18 (N = 453, 60.3% women, 40.08 years) was assessed from July to October 2021. As huge differences in coping with the pandemic are seen, cluster analysis was performed.ResultsPersons in the “well-adjusted cluster” were characterized by higher quality of life, better coping with the pandemic and lower burden of the pandemic. The family subsample well-adjusted cluster was characterized by lower pandemic-associated burden, lower parental stress compared to before the pandemic and a better relationship with the child. Fewer mental health symptoms and less pandemic-associated negative impact on career predicted membership of the well-adjusted cluster in both samples. An interaction between mental health symptoms and the negative impact of COVID-19 on the career was found.ConclusionsOur results underscore the importance of mental health and work-related factors for coping with the pandemic.

Measuring progress on health and well-being in the Eastern Mediterranean Region via voluntary national reviews, 2016-2021: What does the data reveal?

Country submission of Voluntary National Reviews is the formal mechanism to report on progress of the Sustainable Development Goals (SDGs). Despite strong political commitment to strong information systems, large data gaps exist in the Eastern Mediterranean Region. This study aims to review reports submitted by countries in the region to assess the comprehensiveness of reporting on the health-reported SDG targets and indicators. We conducted a content analysis of reports submitted between 2016 and 2021 of 18 countries of the region. The review focused on progress on the SDGs by assessing i) the reporting on the 50 health-related targets and indicators ii) data availability using the WHO reporting framework, and iii) data availability based on source of information. Spreadsheets were developed and used to extract data and facilitate content analysis. All reports confirmed that SDG monitoring and reporting mechanisms have been established, however, only 11 reported on all 17 SDGs and 8 explicitly mentioned country specific 2030 targets. Many reports identified data availability as a key challenge to SDG monitoring; for the health SDG, data availability ranged from 48% to 93% among the five countries reporting this figure. Comprehensiveness of reporting varied by type of indicator (maternal, child and infant mortality were the most common) and by country income level (greater reporting by high income countries). Significant work remains to enhance information systems across the region to monitor progress and guide actions to achieve the health-related SDGs. Strengthening health information systems regulatory frameworks, data collection capacities including strengthening civil registration and vital statistics and population-based surveys are key steps to enhancing access to quality data which in turn can contribute to achieving the health-related SDGs.

Physical, mental, and behavioral health after adverse and benevolent childhood experiences: A comparison of two adversity conceptualizations.

Adverse and benevolent childhood experiences (ACEs and BCEs) impact health across the lifespan. No known study has investigated these associations across different health domains using a representative adult sample. This study examined the associations between adult physical, mental, and behavioral health with ACEs and BCEs based on two ACEs conceptualizations. A cross-sectional population-based survey was conducted in Hong Kong. Thirteen ACEs were measured and conceptualized as cumulative ACE scores and ACE patterns. Self-reports of BCEs; 10 physical health problems; current mental health; posttraumatic stress; history of diagnosed mental illness; suicidal thought and suicide attempt; and engagement in three health risk behaviors (smoking, illicit substance misuse, binge drinking) were also included. A series of regression analyses were conducted to examine the association between childhood experiences and health. In a random sample of 1,070 Hong Kong adults (Mage = 41.78 years; 53.93% female; mean ACEs = 1.64), 649 (60.65%) reported at least one ACE. Four ACE patterns were identified (Low ACEs, Household Instability, Household Violence, and High ACEs). Higher ACE scores associated with poorer health in a dose-response fashion. Two ACE patterns shared similar average ACE scores but differentially linked with outcomes across health domains. High BCEs negatively associated with mental and behavioral health problems. Public health responses to ACEs should consider both the accumulation and co-occurrence of ACE exposure. Schools, neighborhoods, and the wider community should take an active role in helping children and families create more positive experiences as a universal prevention strategy to safeguard population health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Improving Data-Driven Decision Making for Primary Prevention: Providing Data Interpretation Resources to Schools and Communities in Colorado.

Communities are increasingly interested in primary prevention efforts to reduce health inequities. However, few communities can access local data on social determinants of health and many do not have the skills or training to interpret data to inform decision making on appropriate strategies that impact social determinants of health. A population-based youth health survey administered to middle and high school students, such as exists in most states in the United States, can assess health behaviors and risk and protective factors. The schools and school districts that participate are provided with reports of results and data interpretation resources that support their understanding of risk and protective factors to inform local decision making and action. Other states can similarly provide local data and resources on risk and protective factors to help communities collaborate on primary prevention efforts that achieve health equity.

Data-integration with pseudoweights and survey-calibration: application to developing US-representative lung cancer risk models for use in screening

Abstract Accurate cancer risk estimation is crucial to clinical decision-making, such as identifying high-risk people for screening. However, most existing cancer risk models incorporate data from epidemiologic studies, which usually cannot represent the target population. While population-based health surveys are ideal for making inference to the target population, they typically do not collect time-to-cancer incidence data. Instead, time-to-cancer specific mortality is often readily available on surveys via linkage to vital statistics. We develop calibrated pseudoweighting methods that integrate individual-level data from a cohort and a survey, and summary statistics of cancer incidence from national cancer registries. By leveraging individual-level cancer mortality data in the survey, the proposed methods impute time-to-cancer incidence for survey sample individuals and use survey calibration with auxiliary variables of influence functions generated from Cox regression to improve robustness and efficiency of the inverse-propensity pseudoweighting method in estimating pure risks. We develop a lung cancer incidence pure risk model from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial using our proposed methods by integrating data from the National Health Interview Survey and cancer registries.

Care-seeking for difficulties conceiving in sub-Saharan Africa: findings from population-based surveys in eight geographies.

What is the nature of women's care-seeking for difficulties conceiving in sub-Saharan Africa (SSA), including the correlates of seeking biomedical infertility care at a health facility? Care-seeking for difficulties getting pregnant was low, much of which involved traditional or religious sources of care, with evidence of sociodemographic disparities in receipt of biomedical care. Nearly all research on infertility care-seeking patterns in SSA is limited to clinic-based studies among the minority of people in these settings who obtain facility-based services. In the absence of population-based data on infertility care-seeking, we are unable to determine the demand for services and disparities in the use of more effective biomedical sources of care. We used cross-sectional, population-based data from the Performance Monitoring for Action (PMA) female survey in eight geographies in SSA, including nationally representative data from Burkina Faso, Côte d'Ivoire, Kenya, and Uganda and regionally representative data from two provinces in the Democratic Republic of the Congo (DRC) (Kinshasa and Kongo Central) and two states in Nigeria (Kano and Lagos). We employed a multi-stage cluster random sampling design with probability proportional to size selection of clusters within each geography to produce representative samples of women aged 15-49. Samples ranged from 1144 in Kano, Nigeria, to 9489 in Kenya. PMA collected these data between November 2021 and December 2022. We restricted the sample to women who had ever had sex, with analytic samples ranging from 854 in Kano to 8,059 in Kenya, then conducted descriptive and bivariable analyses to examine characteristics of those who sought care for difficulties getting pregnant. Among those who reported seeking care, we conducted bivariable and multivariable logistic regression analyses to determine factors associated with receipt of biomedical services from a health facility. All analyses were conducted separately by geography. Our study found low levels of care-seeking for difficulties getting pregnant among sexually active women in eight geographies in SSA, ranging from 3.7% (Kenya) to 15.3% (Côte d'Ivoire). Of this, 51.8% (Burkina Faso) to 86.7% (Kinshasa) involved receipt of biomedical services in health facilities. While many factors were consistently associated with infertility care-seeking from any source across geographies, factors associated with receipt of biomedical care specifically were less pronounced. This may be a result of the highly limited sources of infertility services in SSA; thus, even privileged groups may struggle to obtain effective treatment for difficulties getting pregnant. However, we did observe disparities in biomedical care-seeking in our bivariable results in several geographies, with the wealthiest women, those with more education, and those residing in urban areas generally more likely to have sought biomedical care for difficulties getting pregnant. Our data lacked details on the nature of the services received and outcomes, and we do not have information on reasons why women chose the sources they did. Small samples of women who sought care limited our power to detect significant differences in care-seeking by women's characteristics in several geographies. Infertility and access to appropriate treatment are issues of reproductive health and human rights. While our results do not indicate to what extent use of non-biomedical sources of care is driven by preferences, cost, or lack of accessible services, it is clear from our results and existing literature that more needs to be done to ensure access to affordable, quality, cost-effective infertility services in SSA. This study was supported by grants from the Bill & Melinda Gates Foundation (INV009639) and the National Institute of Child Health and Human Development (K01HD107172). The funders were not involved in the study design, analyses, manuscript writing, or the decision to publish. The authors have no conflicts of interest to declare. N/A.

Impact of Maternal Pre-Pregnancy Underweight on Cord Blood Metabolome: An Analysis of the Population-Based Survey of Neonates in Pomerania (SNiP).

Intrauterine growth restriction leads to an altered lipid and amino acid profile in the cord blood at the end of pregnancy. Pre-pregnancy underweight is an early risk factor for impaired fetal growth. The aim of this study was to investigate whether a pre-pregnancy body mass index (ppBMI) of <18.5 kg/m2, as early as at the beginning of pregnancy, is associated with changes in the umbilical cord metabolome. In a sample of the Survey of Neonates in Pomerania (SNIP) birth cohort, the cord blood metabolome of n = 240 newborns of mothers with a ppBMI of <18.5 kg/m2 with n = 208 controls (ppBMI of 18.5-24.9 kg/m2) was measured by NMR spectrometry. A maternal ppBMI of <18.5 kg/m2 was associated with increased concentrations of HDL4 cholesterol, HDL4 phospholipids, VLDL5 cholesterol, HDL 2, and HDL4 Apo-A1, as well as decreased VLDL triglycerides and HDL2 free cholesterol. A ppBMI of <18.5 kg/m2 combined with poor intrauterine growth (a gestational weight gain (GWG) < 25th percentile) was associated with decreased concentrations of total cholesterol; cholesterol transporting lipoproteins (LDL4, LDL6, LDL free cholesterol, and HDL2 free cholesterol); LDL4 Apo-B; total Apo-A2; and HDL3 Apo-A2. In conclusion, maternal underweight at the beginning of pregnancy already results in metabolic changes in the lipid profile in the cord blood, but the pattern changes when poor GWG is followed by pre-pregnancy underweight.

Prevalence of hepatitis A virus among migrant workers in Qatar: A national study.

Hepatitis A virus (HAV) is the predominant cause of acute viral hepatitis worldwide; however, data on HAV antibody prevalence (seroprevalence) among migrant populations are limited. This study aimed to investigate HAV seroprevalence among Qatar's migrant craft and manual workers (CMWs), constituting approximately 60% of the country's population. HAV antibody testing was conducted on stored serum specimens obtained from CMWs during a nationwide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) population-based cross-sectional survey between July 26 and September 9, 2020. Associations with HAV infection were investigated through regression analyses. Of the 2,607 specimens with HAV antibody test results, 2,393 were positive, and 214 were negative. The estimated HAV seroprevalence among CMWs was 92.0% (95% CI: 90.9-93.1%). HAV seroprevalence was generally high but exhibited some variation, ranging from 70.9% (95% CI: 62.4-78.2%) among Sri Lankans to 99.8% (95% CI: 98.2-99.9%) among Pakistanis. The multivariable regression analysis identified age, nationality, and educational attainment as statistically significant factors associated with HAV infection. Relative to CMWs aged ≤29 years, the adjusted relative risk (ARR) was 1.06 (95% CI: 1.03-1.10) in CMWs aged 30-39 years and reached 1.15 (95% CI: 1.10-1.19) in those aged ≥50 years. In comparison to Indians, the ARR was lower among Sri Lankans, assessed at 0.81 (95% CI: 0.72-0.91), but higher among Nepalese at 1.07 (95% CI: 1.04-1.11), Bangladeshis at 1.10 (95% CI: 1.07-1.13), Pakistanis at 1.12 (95% CI: 1.09-1.15), and Egyptians at 1.15 (95% CI: 1.08-1.23). No evidence for differences was found by geographic location or occupation. HAV seroprevalence among Qatar's CMW population is very high, with over nine out of every ten individuals having been exposed to this infection, likely during childhood.

Symptom profiles compatible with disorders of gut-brain interaction (DGBI) in organic gastrointestinal diseases: A global population-based study.

Patients with organic gastrointestinal (GI) diseases and diabetes mellitus (DM) can have concomitant disorders of gut-brain interaction (DGBI). This study aimed to compare the global prevalence of DGBI-compatible symptom profiles in adults with and without self-reported organic GI diseases or DM. Data were collected in a population-based internet survey in 26 countries, the Rome Foundation Global Epidemiology Study (n=54,127). Individuals were asked if they had been diagnosed by a doctor with gastroesophageal reflux disease, peptic ulcer, coeliac disease, inflammatory bowel disease (IBD), diverticulitis, GI cancer or DM. Individuals not reporting the organic diagnosis of interest were included in the reference group. DGBI-compatible symptom profiles were based on Rome IV diagnostic questions. Odds ratios (ORs [95% confidence interval]) were calculated using mixed logistic regression models. Having one of the investigated organic GI diseases was linked to having any DGBI-compatible symptom profile ranging from OR 1.64 [1.33, 2.02] in GI cancer to OR 3.22 [2.80, 3.69] in IBD. Those associations were stronger than for DM, OR 1.26 [1.18, 1.35]. Strong links between organic GI diseases and DGBI-compatible symptom profiles were seen for corresponding (e.g., IBD and bowel DGBI) and non-corresponding (e.g., IBD and esophageal DGBI) anatomical regions. The strongest link was seen between fecal incontinence and coeliac disease, OR 6.94 [4.95, 9.73]. After adjusting for confounding factors, associations diminished, but persisted. DGBI-compatible symptom profiles are more common in individuals with self-reported organic GI diseases and DM compared to the general population. The presence of these concomitant DGBIs should be considered in the management of organic (GI) diseases.

Asymmetry in contraceptive information at two sites in Burkina Faso

BackgroundFamily planning programs are foundationally important to public health, but like any medical intervention, contraception has drawbacks in addition to its benefits. Knowledge of these drawbacks in addition to benefits is essential for informed choice. Despite a general consensus among family planning researchers and providers that contraceptive counseling should be unbiased, little quantitative research has assessed the extent of bias in contraceptive counseling, and in people's contraceptive knowledge more broadly. ObjectiveTo understand the extent to which women report being told more about the advantages of contraception than the disadvantages—a concept we call “asymmetry” in contraceptive counseling, at two research sites in Burkina Faso. MethodsWe use data from a cross-sectional population-based survey of 3,929 women residing in the catchment areas of the Ouagadougou (urban) and the Nouna (rural) Health and Demographic Surveillance Systems in Burkina Faso. We use descriptive statistics to explore asymmetry in knowledge of the benefits/advantages and risks/disadvantages of contraceptive use overall, as well as method-specific asymmetry among current method users regarding their counseling experience. FindingsResults show substantial asymmetry in knowledge of advantages/benefits of contraception compared to disadvantages/risks. 86% of respondents said they could name any advantage of family planning, while half of that proportion (43%) could name any disadvantage. We find a similarly stark asymmetry in method-specific results among contraceptive users, especially for hormonal/biomedical methods. We also find substantial variation between research sites, with urban respondents much less likely to self-report complete family planning knowledge than their rural counterparts. ConclusionOur results suggest that family planning messaging in Burkina Faso may place an emphasis on the advantages without a commensurate focus on disadvantages. Family planning programs worldwide must ensure that people can make informed choices based on balanced, accurate information about both the benefits and the disadvantages of contraception.

Association between Physical Activity and Phase Angle Obtained via Bioelectrical Impedance Analysis in South Korean Adults Stratified by Sex.

This cross-sectional study aimed to examine the association of various aspects of physical activity, including intensity, duration, type, and purpose, with the phase angle (PhA), an objective indicator of health, in Korean adults after stratification by sex. Data from the 2022 Korean National Health and Nutrition Examination Survey, a nationwide, representative, population-based survey, were used. In total, 3996 participants were included in the study. Participants self-reported their weekly intensity, frequency, duration of engagement in physical activity. PhA was categorized into two groups on the basis of sex-specific averages. Multiple logistic regression analysis was used to investigate the relationship between physical activity and PhA, and proportional odds logistic regression analysis was performed to determine the association between physical activity and different subclasses of PhA. A positive association was found between sufficiently active aerobic physical activity and PhA compared with inactive physical activity (sufficiently active, male: odds ratio = 1.952, 95% confidence interval = 1.373-2.776; female: odds ratio = 1.333, 95% confidence interval = 1.019-1.745). This association was further strengthened when aerobic physical activity was accompanied by muscle-strengthening activity (sufficiently active with muscle-strengthening activity, male: aOR = 2.318, 95% CI = 1.512-3.554; female: aOR = 1.762, 95% CI = 1.215-2.556) and vigorous-intensity activities (sufficiently active with sufficient vigorous-intensity activity, male: aOR = 2.785, 95% CI = 1.647-4.709; female: aOR = 2.505, 95% CI = 1.441-4.356) and when there was more leisure-time physical activity than occupational physical activity (sufficiently active with more leisure-time physical activity, male: aOR = 2.158, 95% CI = 1.483-3.140; female: aOR = 1.457, 95% CI = 1.078-1.969). Furthermore, the inclusion of muscle-strengthening activity made a significant difference in the values of PhA for males with insufficiently active physical activity (aOR = 2.679, 95% CI = 1.560-4.602). For females with highly active physical activity (aOR = 1.521, 95% CI = 1.068-2.166), the inclusion of muscle-strengthening and vigorous-intensity activities were significantly associated with higher values for PhA. This study can be utilized to provide specific suggestions for better health programs and can change perception that only occupational physical activity is enough. This study also indicated that PhA can be used for personalized health assessments.

Global estimates on the number of people blind or visually impaired by age-related macular degeneration: a meta-analysis from 2000 to 2020

BackgroundWe aimed to update estimates of global vision loss due to age-related macular degeneration (AMD).MethodsWe did a systematic review and meta-analysis of population-based surveys of eye diseases from January, 1980, to October, 2018. We fitted hierarchical models to estimate the prevalence of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness ( < 3/60) caused by AMD, stratified by age, region, and year.ResultsIn 2020, 1.85 million (95%UI: 1.35 to 2.43 million) people were estimated to be blind due to AMD, and another 6.23 million (95%UI: 5.04 to 7.58) with MSVI globally. High-income countries had the highest number of individuals with AMD-related blindness (0.60 million people; 0.46 to 0.77). The crude prevalence of AMD-related blindness in 2020 (among those aged ≥ 50 years) was 0.10% (0.07 to 0.12) globally, and the region with the highest prevalence of AMD-related blindness was North Africa/Middle East (0.22%; 0.16 to 0.30). Age-standardized prevalence (using the GBD 2019 data) of AMD-related MSVI in people aged ≥ 50 years in 2020 was 0.34% (0.27 to 0.41) globally, and the region with the highest prevalence of AMD-related MSVI was also North Africa/Middle East (0.55%; 0.44 to 0.68). From 2000 to 2020, the estimated crude prevalence of AMD-related blindness decreased globally by 19.29%, while the prevalence of MSVI increased by 10.08%.ConclusionsThe estimated increase in the number of individuals with AMD-related blindness and MSVI globally urges the creation of novel treatment modalities and the expansion of rehabilitation services.

The prevalence of misophonia in a representative population-based survey in Germany.

Misophonia is a new disorder, currently defined as significant emotional and physiological distress when exposed to certain sounds. Although there is a growing body of literature on the characteristics of the disorder, the prevalence in the general population is still relatively unknown. This study therefore aims at determining the prevalence and symptom severity of misophonia in a large and representative general population sample in Germany. To examine the prevalence of misophonic sounds, misophonic reactions and misophonia severity, a cross-sectional population representative survey in Germany has been conducted. Participants (N = 2.522) were questioned retrospectively about misophonic symptoms using the Amsterdam Misophonie Scale - Revised (AMISOS-R). Overall 33.3% reported to be sensitive to at least one specific misophonic sound. Within the total sample, subthreshold symptoms were reported by 21.3%, mild symptoms were reported by 9.9%, moderate to severe symptoms were reported by 2.1%, and severe to extreme symptoms were reported in 0.1% of participants. Based on the diverging presentations and prevalence rates of misophonic sounds, reactions and symptoms according to the severity, it seems worthwhile to conceptualize misophonia as a rather continuous spectrum disorder (subthreshold, mild, moderate to severe), still taking into account that an additional categorical diagnostic approach might be necessary to derive a diagnosis in clinical practice.

Frailty Was Associated With Atmospheric NO2 Levels: A Geospatial Approach.

Recent evidence has linked air pollution with frailty, yet little is known about the role of NO2 in this association. Our aim was to assess the association between frailty and NO2 air concentrations in Mexican older adults. We used georeferenced data from the population-based Nutrition and Health Survey in Mexico (NHNS) 2021, representative of national and subnational regions, to measure a frailty index based on 31 health deficits in adults aged 50 and older. Air pollution due to NO2 concentrations was estimated from satellite images validated with data from surface-level stations. Maps were produced using Jensen's Natural break method. The association of frailty and NO2 concentrations was measured using the frailty index (multivariate fractional response logit regression) and a frailty binary variable (frailty index [FI] ≥0.36, multivariate logit regression). There was a positive and significant association of the frailty index with the NO2 concentrations, adjusting for age, sex, urban and rural area, years of education, socioeconomic status, living arrangement, particulate matter smaller than 2.5 microns, and indoor pollution. For each standard deviation increase in NO2 concentrations measured 10 years before the survey, the odds of being frail were 15% higher, and the frailty index was 14.5% higher. The fraction of frailty attributable to NO2 exposure ranged from 1.8% to 23.5% according to different scenarios. Frailty was positively associated with exposure to NO2 concentrations. Mapping frailty and its associated factors like NO2 air concentrations can contribute to the design of targeted pro-healthy aging policies.