Population Subgroups Research Articles

A model-based boosting approach to risk factors for physical intimate partner violence against women and girls in Mexico

The goal of this study was to identify and describe the extent to which a comprehensive set of risk factors from the ecological model are associated with physical intimate partner violence (IPV) victimization in Mexico. To achieve this goal, a structured additive probit model is applied to a dataset of 35,000 observations and 42 theoretical correlates from 10 data sources. Due to the model's high dimensionality, the boosting algorithm is used for estimating and simultaneously performing variable selection and model choice. The findings indicate that age at sexual initiation and marriage, sexual and professional autonomy, social connectedness, household overcrowding, housework division, women's political participation, and geographical space are associated with physical IPV. The findings provide evidence of risk factors that were previously unknown in Mexico or were solely based on theoretical grounds without empirical testing. Specifically, this paper makes three key contributions. First, by examining the individual and relationship levels, it was possible to identify high-risk population subgroups that are often overlooked, such as women who experienced sexual initiation during childhood and women living in overcrowded families. Second, the inclusion of community factors enabled the identification of the importance of promoting women's political participation. Finally, the introduction of several emerging indicators allowed to examine the experiences faced by women in various aspects of life, such as decision-making power, social networks, and the division of housework.

Perceptions of attitudes toward statistics among medical undergraduates: insights from a regional medical college in China.

Among Chinese medical students, medical statistics is often perceived as a formidable subject. While existing research has explored the attitudes of Chinese postgraduate medical students towards statistics and its impact on academic performance, there is a scarcity of studies examining the attitudes of Chinese medical undergraduates on this subject. This study endeavors to scrutinize the attitudes of Chinese medical undergraduates towards statistics, assessing their ramifications on learning achievements, and delving into the influence of demographic factors. 1266 medical undergraduates participated in this study, completing a questionnaire that included SATS-36 and additional queries. Furthermore, an examination was administered at the end of the medical statistics course. The analysis encompassed the SATS score and exam scores, examining both the overall participant population and specific demographic subgroups. Undergraduate medical students generally exhibit a favorable disposition towards statistics concerning Affect, Cognitive Competence, and Value components, yet harbor less favorable sentiments regarding the Difficulty component of SATS-36, aligning with previous research findings. In comparison to their postgraduate counterparts, undergraduates display heightened enthusiasm for medical statistics. However, they demonstrate a lower cognitive capacity in statistics and tend to underestimate both the value and difficulty of learning statistics. Despite these disparities, undergraduate medical students express a genuine interest in statistics and exhibit a strong dedication to mastering the subject. It is noteworthy that students' attitudes toward statistics may be influenced by their major and gender. Additionally, there exists a statistically significant positive correlation between learning achievement and the Affect, Cognitive Competence, Value, Interest, and Effort components of the SATS-36, while a negative correlation is observed with the Difficulty component. Educators should carefully consider the influence of attitudes toward statistics, especially the variations observed among majors and genders when formulating strategies and curricula to enhance medical statistics education.

An examination of urban green spaces usage behaviours and self-perceived mental health benefits: findings from two urban green neighbourhoods in Pakistan

ABSTRACT The present study examined urban green space users’ self-perceived mental health benefits of visiting green spaces in Pakistan – one of South Asia’s rapidly urbanizing countries. By using a quantitative-based cross-sectional survey, 384 participants were surveyed in green urban neighbourhood settings. It was found that most green space users believed that their visits to green spaces have at least some positive effects on the different parameters of their mental health, such as stress or anxiety levels, mood, energy levels, optimism levels, confidence levels, or concentration levels, among others. The study explored that the frequency and duration of green space usage and intensity of activity performed in the green space have an important role in determining the degree of the self-perceived mental health benefits of visiting green spaces, suggesting the importance of green interventions, including physical changes in the environment and social promotion activities to encourage green space usage among urban dwellers. Moreover, the study revealed low green space usage and activity intensity levels among certain sub-population groups compared to others, such as women, young adults, or the elderly, highlighting the need to ensure equity of access to green spaces for all sub-population groups and prioritize them in intervention strategies.

Restricting the content of alcohol advertising and including text health warnings: A between-group online experiment with a non-probability adult sample in the United Kingdom.

Statutory options for restricting alcohol advertising include limiting it to product-orientated information and requiring health warnings. We assess the impact of removing positive contextual factors from alcohol advertising and including a health warning among adults in the United Kingdom (UK). We conducted a 2 × 2 online between-group experiment with adults (18+) (n = 2421) recruited from a non-probability research panel in the United Kingdom. Participants were randomized to see an alcohol (vodka) advertisement (advert) which varied by context (no context vs. imagery depicting positive social interactions around alcohol) and message (multiple text health warning vs. "drink responsibly"). The multiple text health warning, based on recent legislation in Ireland, comprised three separate warnings (liver disease, cancers, drinking during pregnancy) and a web address for alcohol-related information and support. The "drink responsibly" control reflected the self-regulatory messages commonly used by alcohol companies. Participants rated the advert on 7-point scales for advert attractiveness, product appeal, trial intentions, perceived harm, and whether it made drinking alcohol seem enjoyable. Removing the positive social context reduced positive advert and product reactions (difference in estimated marginal means [EMM]: -1.57 [makes drinking alcohol seem enjoyable] to -0.23 [intention to try]). Including the multiple text health warning also reduced positive advert and product reactions (difference in EMM: -0.55 [advert attractiveness] to -0.25 [intention to try]) and increased perceived product harm (difference in EMM: +0.25). There were no interactions between advert context and message for any outcome. Restricting content and including a multiple text health warning (compared to a "drink responsibly" message) may attenuate the persuasive impact of alcohol advertising and increase perceived product harm. Further research is needed to examine different degrees of content restrictions, alternative warning content and design, generalizability to different alcohol products and advert formats, and whether the impact of content controls varies among population subgroups.

#960 Trends in eGFR and ultra-processed food intake in relationship to income among United States adults

Abstract Background and Aims Ultra-processed foods (UPF) are formulations of ingredients that are mostly of exclusive industrial use and may contain additives like artificial colors, flavors, or stabilizers. The sale and consumption of these foods has been increasing despite their associations with increased risk for several non-communicable diseases including chronic kidney disease. Ultra-processed foods are widely accessible, more shelf-stable and convenient while tending to be more affordable and lower in nutritional quality. The aim of this study was to evaluate trends in kidney function and UPF intake and temporal effect of income among United States (US) adults. Method We used dietary intake data collected with 24-hour dietary recalls from 35160 US adults across 8 cycles of the National Health and Nutrition Examination Survey (NHANES) (from 2003-2004 to 2017-2018 cycles) to categorize intake using the Nova processed food classification system. Poisson regression models were used to assess the 15-year trends in populations at risk for kidney function decline (measured by estimated glomerular filtration rate [eGFR]) and higher percentage of calories from UPF (PC-UPF) consumed along with the temporal effect of income in select subpopulations and adjusted for age and gender and non-linear effects of income and age). Results Over the past 15 years eGFR, PC-UPF, and self-reported income continue to increase among US adults. However, the associations between eGFR, PC-UPF and income are quite complex, vary by subpopulation and non-linearly depend on age. Specifically, among Black adults adjusted for age (age2) and gender, eGFR was the lowest (85 mL/min/1.73 m2, 95% CI: 84.9, 85.0 mL/min/1.73 m2) among those with the lowest ($2,500) and highest ($125,000) income (p = 0.0000000579 for a quadratic term of income), respectively. Hispanic and Mexican Americans also have similar pattern eGFR with the lowest and highest income though the eGFR is consistently higher than White and Black Americans. Across cycles, White Americans with the lowest income ($2,500) have the highest PC-UPF (range: 57-62%, p <2e-16; mean: 59.4%, 95% CI: 59.3, 59.6%) while Black Americans with the lowest ($2,500) and highest income ($125,000) have the highest PC-UPF (range: 53-58%, p <2e-16; mean: 54.8%, 95% CI: 54.3, 55.4%). Income levels does not predict PC-UPF among Mexican Americans. Overall, the PC-UPF is steadily increasing in all population subgroups. Conclusion Among Non-White US adults, higher eGFR was associated with higher income until reaching a group-specific threshold when the relationship reversed. We observed a similar threshold pattern in the association between PC-UPF and income among Black and Hispanic Americans. These complex non-linear relationships between eGFR, PC-UPF and income are driven in part by age-related association and warrant further exploration.

Cost-Effectiveness of the Prenatal Detection of Congenital Heart Diseases: A Systematic Literature Review

Background: Congenital heart disease is the most common congenital condition worldwide, with a prevalence of 80 cases per 10 000 live births. In addition to perinatal morbidity and mortality, it entails long-term consequences such as multiple surgeries, prolonged hospitalizations, lifelong cardiac follow-up, reduced quality of life, risk of heart failure, and premature mortality in adulthood. This significant health and economic burden on healthcare systems and families highlights the relevance of evaluating the cost-effectiveness of methods for early detection of this condition. Objective: To conduct a systematic literature review (SLR) to identify and analyze existing economic evaluations on prenatal detection of congenital heart diseases through ultrasound, focusing on the reported cost-effectiveness results and the methodological quality of the evaluated studies according to established criteria. Methods: An SLR of economic evaluations was conducted following PRISMA guidelines. A quantitative synthesis of key methodological components of each economic evaluation was performed. The incremental medical costs, effectiveness measures, and cost-effectiveness ratios reported in each study were compiled and compared. The methodological quality was assessed according to compliance with the 24 CHEERS criteria. Results: We found 785 articles, of which only 7 met all inclusion criteria. Most were cost-effectiveness analyses, with the most common outcome being number of cases detected. Screening with only 4-chamber views interpreted by general practitioners or cardiologists were dominant strategies compared with screening with 4-chamber plus outflow views interpreted by a general practitioner. Fetal echocardiography was most effective but most expensive. Screening with 4-chamber and outflow view, followed by referral to a specialist, were recommended as the least expensive strategy per defect detected. On average, articles met 17 of the 24 CHEERS criteria. Discussion: While recent cost-effectiveness analyses demonstrated improved methodological quality, there was a lack of homogeneity due to differences in comparators and population subgroups analyzed. Despite this heterogeneity, fetal ultrasonography screening was consistently identified as a cost-effective strategy, with its cost-effectiveness heavily influenced by the expertise of the interpreting physician. Conclusion: Most studies recommend implementing obstetric ultrasonography screening, without routine fetal echocardiography, for detecting congenital heart diseases.

Cost-Effectiveness of the Prenatal Detection of Congenital Heart Diseases: A Systematic Literature Review.

Background: Congenital heart disease is the most common congenital condition worldwide, with a prevalence of 80 cases per 10 000 live births. In addition to perinatal morbidity and mortality, it entails long-term consequences such as multiple surgeries, prolonged hospitalizations, lifelong cardiac follow-up, reduced quality of life, risk of heart failure, and premature mortality in adulthood. This significant health and economic burden on healthcare systems and families highlights the relevance of evaluating the cost-effectiveness of methods for early detection of this condition. Objective: To conduct a systematic literature review (SLR) to identify and analyze existing economic evaluations on prenatal detection of congenital heart diseases through ultrasound, focusing on the reported cost-effectiveness results and the methodological quality of the evaluated studies according to established criteria. Methods: An SLR of economic evaluations was conducted following PRISMA guidelines. A quantitative synthesis of key methodological components of each economic evaluation was performed. The incremental medical costs, effectiveness measures, and cost-effectiveness ratios reported in each study were compiled and compared. The methodological quality was assessed according to compliance with the 24 CHEERS criteria. Results: We found 785 articles, of which only 7 met all inclusion criteria. Most were cost-effectiveness analyses, with the most common outcome being number of cases detected. Screening with only 4-chamber views interpreted by general practitioners or cardiologists were dominant strategies compared with screening with 4-chamber plus outflow views interpreted by a general practitioner. Fetal echocardiography was most effective but most expensive. Screening with 4-chamber and outflow view, followed by referral to a specialist, were recommended as the least expensive strategy per defect detected. On average, articles met 17 of the 24 CHEERS criteria. Discussion: While recent cost-effectiveness analyses demonstrated improved methodological quality, there was a lack of homogeneity due to differences in comparators and population subgroups analyzed. Despite this heterogeneity, fetal ultrasonography screening was consistently identified as a cost-effective strategy, with its cost-effectiveness heavily influenced by the expertise of the interpreting physician. Conclusion: Most studies recommend implementing obstetric ultrasonography screening, without routine fetal echocardiography, for detecting congenital heart diseases.

An ecological view on the correlates of sedentary behavior in Brazilian adolescents: a cross-sectional study with network analysis

BackgroundSedentary behavior has been identified as a public health concern. The present study analyzed the correlates of sedentary behavior in Brazilian adolescents through network analysis, in the light of an ecological approach.MethodsThe sample consisted of 126,354 adolescents, participating in the fourth edition of the Brazilian National School Health Survey. The variables were grouped into domains, namely intrapersonal, interpersonal, perceived environment, school variables, food variables, active behavior domains, and leisure sedentary behavior. The data were analyzed using network analysis.ResultsThe results reinforce that sedentary behavior is independent of the assessed active behavior domains, despite being weakly related to physical activity outside physical education classes (− 0.073). The variable with the greatest closeness and one of the variables with the greatest expected influence in the model was having internet at home, which was associated with private schools (− 0.230), having a cell phone (0.378), having a computer or notebook at home (0.409), and a greater weekly frequency of watching television (0.169). Furthermore, having internet at home was strongly associated with an increase in sedentary behavior (− 0.197), which, in turn, was linked to greater consumption of treats (0.067) and sodas (0.052).ConclusionsWe concluded that having internet at home is associated with longer sedentary time, which, in turn, is associated with greater consumption of foods of poorer nutritional quality. Interventions on sedentary behavior should be specific for population subgroups and consider actions in different levels.

Cohabitation and Marriage Formation in Times of Fertility Decline: The Case of Sweden in the Twenty-First Century

Developments over time in the prevalence of marriage and cohabitation formation has long received much interest, but less is known about more recent developments for different population subgroups in European countries. This applies as well to Sweden, a country considered a forerunner in family-demographic change. In contrast, much attention has been paid to the falling birth rates during the 2010s, and explanations that focus on the role of increasing uncertainties. In the Swedish case, the fertility decline has been documented across all main socio-demographic subgroups. The objective of this study is to examine whether the same situation holds for first marriage and cohabitation formation during the 2010s and the exceptional years of the Covid-19 pandemic. Based on Swedish population registers, including with new cohabitation data, we present annual indices of first marriage formation (1991–2022) and cohabitation formation (2012–2022) across a number of socio-demographic strata. We demonstrate a continuous decline in first marriage formation since the early 2010s with an additional sharp dip during the pandemic and a post-pandemic recovery. In contrast, there was a remarkable stability in cohabitation formation during 2012–2022. Although socio-demographic groups differ in their overall levels of marriage and cohabitation formation, the recent trends are strikingly similar across groups. Cohabiting couples, across population subgroups, have become less inclined to transition their union status to a more committed level, as manifested by marriage or parenthood. This occurred in spite of a positive economic climate in the 2010s and stable family policies, indicating that other forces are at play.

On the Timing of Marriage and Childbearing: Family Formation Pathways Among Immigrants in Switzerland.

This paper examines childbearing in and outside of marriage as a manifestation of the Second Demographic Transition among immigrant populations in Switzerland. Based on full-population register data, we simultaneously analyse fertility and partnership changes at different stages of the migration process. Results from a multistate event history model show that most of the differences in family formation patterns between migrant groups and natives are in the sequencing of marriage and first birth among childless unmarried women. Out of wedlock family trajectories prove to be a common experience for European migrants, but a sustainable family pathway only among natives, as well as among immigrants from France, and Sub-Saharan Africa. Among married women, it is the risk of a third birth that marks the differences between groups; first and second birth rates are relatively similar across migrant groups. Distinguishing between the transition patterns of newly arrived immigrants and settled immigrants (characterised by various residence durations) support the disruption hypothesis among EU migrants and the interrelated life events hypothesis among non-EU groups. Family size and the partnership context of fertility highlight which family regime prevails in different population subgroups and the role that immigrants play in the Second Demographic Transition and family transformation in Europe.

Cardiovascular Outcome in Patients with Major Depression: Role of Obstructive Sleep Apnea Syndrome, Insomnia Disorder, and COMISA.

In this study, the 10-year cardiovascular risk associated with comorbid sleep disorders (insomnia disorder, obstructive sleep apnea syndrome, and COMISA [comorbid insomnia and sleep apnea]) was investigated for patients with major depression. To enable our analysis, 607 patients with major depression were selected from the data register of the Sleep Unit. High 10-year cardiovascular risk was considered present when the Framingham Risk Score was ≥10%. The 10-year cardiovascular risk associated with comorbid sleep disorders has been assessed using logistic regression analyzes. High 10-year cardiovascular risk is significant (40.4%) in patients with major depression. After successive introduction of the different confounders, multivariate logistic regressions showed that for patients with major depression high 10-year cardiovascular risk was significantly associated with COMISA but was not significantly associated with insomnia disorder or obstructive sleep apnea syndrome alone. Thus, these results highlight the existence of a negative synergistic action between insomnia disorder and obstructive sleep apnea syndrome on the 10-year cardiovascular risk in patients with major depression, which demonstrates the importance of researching and treating COMISA to improve the prognosis of this specific population subgroup characterized by higher cardiovascular morbidity and mortality.

Travel-Time Disparities in Access to Proton Beam Therapy for Cancer Treatment

Proton beam therapy is an emerging radiotherapy treatment for patients with cancer that may produce similar outcomes as traditional photon-based therapy for many cancers while delivering lower amounts of toxic radiation to surrounding tissue. Geographic proximity to a proton facility is a critical component of ensuring equitable access both for indicated diagnoses and ongoing clinical trials. To characterize the distribution of proton facilities in the US, quantify drive-time access for the population, and investigate the likelihood of long commutes for certain population subgroups. This population-based cross-sectional study analyzed travel times to proton facilities in the US. Census tract variables in the contiguous US were measured between January 1, 2017, and December 31, 2021. Statistical analysis was performed from September to November 2023. Drive time in minutes to nearest proton facility. Population totals and prevalence of specific factors measured from the American Community Survey: age; race and ethnicity; insurance, disability, and income status; vehicle availability; broadband access; and urbanicity. Poor access to proton facilities was defined as having a drive-time commute of at least 4 hours to the nearest location. Median drive time and percentage of population with poor access were calculated for the entire population and by population subgroups. Univariable and multivariable odds of poor access were also calculated for certain population subgroups. Geographic access was considered for 327 536 032 residents of the contiguous US (60 594 624 [18.5%] Hispanic, 17 974 186 [5.5%] non-Hispanic Asian, 40 146 994 [12.3%] non-Hispanic Black, and 195 265 639 [59.6%] non-Hispanic White; 282 031 819 [86.1%] resided in urban counties). The median (IQR) drive time to the nearest proton facility was 96.1 (39.6-195.3) minutes; 119.8 million US residents (36.6%) lived within a 1-hour drive of the nearest proton facility, and 53.6 million (16.4%) required a commute of at least 4 hours. Persons identifying as non-Hispanic White had the longest median (IQR) commute time at 109.8 (48.0-197.6) minutes. Multivariable analysis identified rurality (odds ratio [OR], 2.45 [95% CI, 2.27-2.64]), age 65 years or older (OR, 1.09 [95% CI, 1.06-1.11]), and living below the federal poverty line (OR, 1.22 [1.20-1.25]) as factors associated with commute times of at least 4 hours. This cross-sectional study of drive-time access to proton beam therapy found that disparities in access existed among certain populations in the US. These results suggest that such disparities present a barrier to an emerging technology in cancer treatment and inhibit equitable access to ongoing clinical trials.

National trends in nine key minerals intake (quantity and source) among U.S. adults, 1999 to march 2020

BackgroundChanges in economy and dietary guidelines brought a great shock to diet quality and meal behaviors, but if these transformations have extended to minerals intake and their sources was still poorly understood. It is essential to evaluate time trends in minerals intake and their sources to inform policy makers.ObjectiveTo investigate trends in minerals intake and their sources among U.S. adults.MethodsThis analysis used dietary data collected by 24-h recalls from U.S. adults (≥ 20 years) in NHANES (1999-March 2020). Minerals intake, age-adjusted percentage of participants meeting recommendations, and minerals sources were calculated among all participants and by population subgroups in each NHANES survey cycle. Weighted linear or logistic regression models were used to examine the statistical significance of time trends.ResultsA total of 48223 U.S. adults were included in this analysis. From 1999 to March 2020, intake of calcium (from 0.94 to 1.02 g/day), magnesium (from 308.07 to 321.85 mg/day), phosphorus (from 1.24 to 1.30 g/day), and sodium (from 3.24 to 3.26 mg/day) from food and beverages (FB) and dietary supplements (DSs) significantly increased, and intake of iron (from 19.17 to 16.38 mg/day), zinc (from 16.45 to 14.19 mg/day), copper (from 1.79 to 1.38 mg/day), and potassium (from 2.65 to 2.50 g/day) from FB + DSs decreased (all FDR < 0.05). Additionally, age-adjusted percentage of participants meeting recommendations for calcium, phosphorus, sodium, and selenium significantly increased, that for iron, potassium, zinc, and copper decreased (all FDR < 0.05). Minerals intake and time trends in minerals intake were highly variable depending on age, gender, race/ethnicity, education, and income. For example, white, higher socioeconomic status participants had a higher minerals intake (e.g. iron, zinc, and copper), but had a greater decrease in minerals intake. Furthermore, the percentage of minerals from milks and DSs decreased, and that from beverages increased.ConclusionFrom 1999 to March 2020, both minerals intake and their sources experienced a significant alteration among U.S. adults. Many differences in minerals intake and their food sources across sociodemographic characteristics appeared to narrow over time. Although some improvements were observed, important challenges, such as overconsumption of sodium and underconsumption of potassium, calcium, and magnesium, still remained among U.S. adults.

Insulin resistance, coronary artery lesion complexity and adverse cardiovascular outcomes in patients with acute coronary syndrome

BackgroundInsulin resistance (IR) is linked to both the complexity of coronary artery lesions and the prognosis of acute coronary syndrome (ACS). However, the precise extent of this correlation and its impact on adverse cardiovascular outcomes in ACS patients remain unclear. Therefore, this study aims to investigate the intricate relationship between IR, coronary artery lesion complexity, and the prognosis of ACS through a cohort design analysis.MethodA total of 986 patients with ACS who underwent percutaneous coronary intervention (PCI) were included in this analysis. IR was assessed using the triglyceride-glucose (TyG) index, while coronary artery lesion complexity was evaluated using the SYNTAX score. Pearson’s correlation coefficients were utilized to analyze the correlations between variables. The association of the TyG index and SYNTAX score with major adverse cardiovascular events (MACEs) in ACS was investigated using the Kaplan-Meier method, restricted cubic splines (RCS), and adjusted Cox regression. Additionally, a novel 2-stage regression method for survival data was employed in mediation analysis to explore the mediating impact of the SYNTAX score on the association between the TyG index and adverse cardiovascular outcomes, including MACEs and unplanned revascularization.ResultsDuring a median follow-up of 30.72 months, 167 cases of MACEs were documented, including 66 all-cause deaths (6.69%), 26 nonfatal myocardial infarctions (MIs) (2.64%), and 99 unplanned revascularizations (10.04%). The incidence of MACEs, all-cause death, and unplanned revascularization increased with elevated TyG index and SYNTAX score. Both the TyG index (non-linear, P = 0.119) and SYNTAX score (non-linear, P = 0.004) displayed a positive dose-response relationship with MACEs, as illustrated by the RCS curve. Following adjustment for multiple factors, both the TyG index and SYNTAX score emerged as significant predictors of MACEs across the total population and various subgroups. Mediation analysis indicated that the SYNTAX score mediated 25.03%, 18.00%, 14.93%, and 11.53% of the correlation between the TyG index and MACEs in different adjusted models, respectively. Similar mediating effects were observed when endpoint was defined as unplanned revascularization.ConclusionElevated baseline TyG index and SYNTAX score were associated with a higher risk of MACEs in ACS. Furthermore, the SYNTAX score partially mediated the relationship between the TyG index and adverse cardiovascular outcomes.

Globally Estimated UVB Exposure Times Required to Maintain Sufficiency in Vitamin D Levels.

A paucity of vitamin D is a common deficiency globally, with implications for many aspects of health besides the well-known impact on musculoskeletal health. The two sources of vitamin D are through oral intake, or through endogenous synthesis in the skin when exposed to ultraviolet radiation in sunlight. Assessing nutritional needs, whether by food, food fortification or supplementation, is aided by an understanding of local potential for cutaneous synthesis of the vitamin, dependent on latitude and climate, personal skin type and local culture. To aid these discussions we provide indicative exposure times for the maintenance of vitamin D status as a function of latitude, month and skin type, for the clear-sky case and all-sky conditions, for an ambulatory person wearing modest skirt/shorts and T-shirt. At latitudes greater than ±40 degrees, lack of available sunlight limits vitamin D synthesis in some months for all, while at the equator exposure times range from 3 to 15 min at noontime, for white and black skin, respectively. Rather than a sun exposure prescription, the data are intended to show where nutritional vitamin D intake is necessary, advisable, or can be mitigated by sun exposure, and allows for such advice to be personalized to account for different sub-groups in a multicultural population.

Sociodemographic differences in recreational screen time before and during the COVID-19 pandemic in Canada.

Over the last several years, recreational screen time has been increasing. During the COVID-19 pandemic, recreational screen time rose among Canadian youth and adults, and those who increased screen time had poorer self-reported mental health compared with those who decreased or maintained their recreational screen time levels. Using data from the 2017, 2018, and 2021 Canadian Community Health Survey, the prevalence of meeting the recreational screen time recommendation from the Canadian 24-Hour Movement Guidelines was compared before and during the pandemic across sociodemographic groups. Logistic regression was used to identify sociodemographic groups that were more likely to meet the recreational screen time recommendation before and during the pandemic. The amount of time Canadians spent engaging in daily recreational screen time increased from 2018 to 2021, leading to fewer youth and adults meeting the recreational screen time recommendation during the pandemic compared with before. The prevalence of meeting the recommendation was lower during the pandemic compared with before the pandemic among almost all sociodemographic groups. Among youth, living in a rural area was associated with a greater likelihood of meeting the recommendation before and during the pandemic. Among adults, the following characteristics were all associated with a greater likelihood of meeting the recommendation during the pandemic: being female; living in a rural area or a small population centre; identifying as South Asian; being an immigrant to Canada; living in a two-parent household; being married or in a common-law relationship or widowed, separated, or divorced; working full time; and being a health care worker. The prevalence of meeting the recreational screen time recommendation during the pandemic was lower overall compared with before the pandemic. Several sociodemographic groups were more likely to meet the recommendation during the pandemic. Continued surveillance of recreational screen time is necessary to monitor the indirect effects of the pandemic and to identify population subgroups that would benefit from tailored interventions in the pandemic recovery period.

Unveiling Financial Literacy: Perspectives from Individuals and the Global Stage

In recent years, there has been a developing emphasis on exploring and assessing Financial literacy and its broader ramifications. However, much of this research has tended to focus on vulnerable population sub-groups, often overlooking more affluent segments of society. To establish a sustainable financial system, it's essential to extend financial literacy efforts to all individuals, including those who are educated and capable of disseminating financial information. This paper aims to offer a comprehensive perspective on the importance of financial literacy from a global standpoint and the determinants that influence an individual's level of financial education. Financial literacy is increasingly recognized as a key skill necessary for navigating today's complex financial landscape. It encompasses understanding concepts such as budgeting, saving, investing, and managing debt. Moreover, it involves the ability to critically evaluate financial products and make informed decisions about personal finances. Despite its importance, financial literacy levels vary widely among individuals and across different demographics. Factors such as education, income level, age, and cultural background can significantly influence one's financial literacy. For instance, individuals with higher levels of education generally exhibit greater financial literacy due to their exposure to financial concepts and resources. However, merely possessing a high level of education does not guarantee financial literacy. Other factors, such as personal experiences, family upbringing, and access to financial education resources, also play crucial roles. Furthermore, societal and cultural norms regarding money management can shape an individual's financial attitudes and behaviors. In light of these complexities, efforts to enhance financial education must be inclusive and holistic. This entails providing accessible and relevant financial education to individuals across all demographics, including those who may not traditionally be considered at risk. By empowering people with the knowledge and skills to make sound financial decisions, we can contribute to building a more resilient and equitable financial system for the future. KEY WORDS Financial Literacy, Importance, Determinants, Vulnerable Populations, Affluent Segments, Sustainable System, Education, Dissemination, Global Perspective, Navigating

Fairness-Aware Oversampling Algorithm Based on Distributions of Sensitive Attributes

Given the growing utilization of machine learning algorithms in decision-making processes that impact individuals, it is crucial to ensure that predictions do not exhibit bias towards specific population subgroups, such as race or gender. Bias occurs when the likelihood of a positive outcome varies among different groups defined by these sensitive attributes. Research has demonstrated that this bias often stems from imbalanced datasets, where one class is significantly underrepresented compared to others. Understanding the nature of this imbalance, particularly the distribution of minority classes, is essential. This study introduces FAWOS, a Fairness-Aware oversampling technique designed to mitigate unfair treatment related to imbalances in sensitive attributes. FAWOS classifies data points based on their proximity to specific local neighborhoods defined by sensitive attributes, identifying those that are more challenging for classifiers to learn. To address dataset imbalance, FAWOS synthesizes new data points by oversampling from identified challenging data types. The impact of FAWOS on various classifiers is evaluated, assessing which ones are better equipped to handle imbalances related to sensitive attributes. Empirical findings indicate that FAWOS effectively enhances fairness in classifier outcomes without compromising overall performance. Key Words: Fairness-Aware Oversampling, Bias Mitigation, Imbalanced Datasets, Classifier Performance

Thyroid Cancer Incidence Among Korean Individuals: A Comparison of South Korea and the United States.

To compare thyroid cancer incidence rates and trends between Korean, non-Korean Asian, and non-Hispanic White populations in the United States, and between the US Korean population and the South Korean population. Population-based analysis of cancer incidence data. Cases of thyroid cancer diagnosed during 1999-2014 from the Korean Central Cancer Registry (KCCR) and the Surveillance, Epidemiology, and End Results (SEER) 9 detailed Asian/Pacific Islander subgroup incidence and population dataset were included. Incidence rates were obtained from the datasets, and annual percent change (APC) of the incidence rates was calculated using Joinpoint regression analysis. Thyroid cancer incidence rate for 1999-2014 was significantly higher for South Korea (48.05 [95% CI 47.89-48.22] per 100,000 person-years) than for the US Korean population (11.12 [95% CI 10.49-11.78] per 100,000 person-years), which was slightly higher than the Non-Korean Asian population (10.23 [95% CI 10.02-10.43] per 100,000 person-years), and slightly lower than the Non-Hispanic White population (12.78 [95% CI 12.69-12.87] per 100,000 person-years). Incidence rates in South Korea increased dramatically (average APC 17.9, 95% CI 16.0-19.9), significantly higher than the US Korean population (average APC 5.0, 95% CI 3.1-6.8), which was similar to the non-Korean Asian (average APC 2.5, 95% CI 0.9-4.2) and the non-Hispanic White (average APC 5.1, 95% CI 4.7-5.6) populations. South Korea's high thyroid cancer incidence rates cannot be attributed to genetic factors, but are likely due to health care system factors. 3 Laryngoscope, 134:4156-4160, 2024.

Uptake and factors associated with HIV self-testing among women in South Africa

Background: Human immunodeficiency virus (HIV) self-testing (ST) is a convenient and discreet practice to know HIV status. It is required to reach the underserved population subgroups. We examined the uptake and factors associated with HIVST among reproductive-aged South African women.Methods: A sample of 8182 women from 2016 South African Demographic and Health Survey data were analysed. Percentage and multivariable logistic regression model were conducted. The significance level was set at p 0.05.Results: Approximately 3.1% of women had HIVST uptake. Respondents with primary education had a 75% reduction in the odds of HIVST, compared with women who had no formal education. Women who are employed were 1.44 times as likely to have HIVST uptake compared to those not employed. Women aged 20–24 years, 25–29 years, 30–34 years, and 40–44 years had about two times higher odds of HIVST, when compared with women aged 15–19 years. Women who read newspaper or magazine less than once a week or at least once a week were 1.90 and 2.25 times as likely to have HIVST uptake, respectively, when compared with those who do not read at all.Conclusion: The prevalence of HIVST uptake was low. HIVST was associated with women’s sociodemographic characteristics. The findings highlight the importance of addressing women’s needs to know their HIV status.Contribution: This study adds to the body of literature in understanding the utilisation patterns of HIVST across women in South Africa.