Proportion Of People Research Articles

How Does the Proportion of Never Treatment Influence the Success of Mass Drug Administration Programs for the Elimination of Lymphatic Filariasis?

Mass drug administration (MDA) is the cornerstone for the elimination of lymphatic filariasis (LF). The proportion of the population that is never treated (NT) is a crucial determinant of whether this goal is achieved within reasonable time frames. Using 2 individual-based stochastic LF transmission models, we assess the maximum permissible level of NT for which the 1% microfilaremia (mf) prevalence threshold can be achieved (with 90% probability) within 10 years under different scenarios of annual MDA coverage, drug combination and transmission setting. For Anopheles-transmission settings, we find that treating 80% of the eligible population annually with ivermectin + albendazole (IA) can achieve the 1% mf prevalence threshold within 10 years of annual treatment when baseline mf prevalence is 10%, as long as NT <10%. Higher proportions of NT are acceptable when more efficacious treatment regimens are used. For Culex-transmission settings with a low (5%) baseline mf prevalence and diethylcarbamazine + albendazole (DA) or ivermectin + diethylcarbamazine + albendazole (IDA) treatment, elimination can be reached if treatment coverage among eligibles is 80% or higher. For 10% baseline mf prevalence, the target can be achieved when the annual coverage is 80% and NT ≤15%. Higher infection prevalence or levels of NT would make achieving the target more difficult. The proportion of people never treated in MDA programmes for LF can strongly influence the achievement of elimination and the impact of NT is greater in high transmission areas. This study provides a starting point for further development of criteria for the evaluation of NT.

P069 Moving more with Axial Spondyloarthritis - a short survey to help design future exercise studies

Abstract Background/Aims Axial Spondyloarthritis (AxSpA) is an inflammatory arthritis affecting 0.5-1.0% of people in the UK. Physical activity guidance for people living with AxSpA from the National Institute for Health and Care Excellence is vague. Individualised, structured aerobic exercise is recommended without any direction towards exercise type, frequency, intensity, or acknowledgement of physical limitations to an individual’s environment which may prevent exercise participation. Consequently, the proportion of people with AxSpA meeting the World Health Organisation physical activity recommendations (&amp;gt;150 minutes of moderate-intensity exercise per week) is significantly lower than the general population. Therefore, a short survey was administered to people with AxSpA to understand types of physical activities they would like to participate in, and any common barriers to exercise participation. Methods The National Axial Spondyloarthritis Society (NASS) invited subscribers to their e-newsletter with lived experience to complete a short online survey. Respondents were asked ‘which of the following activities would you like to include as part of your usual lifestyle?’ ‘What would prevent you from taking part in the activities above?’ and ‘Do you already include any of the physical activities in your usual lifestyle?’ Respondents were allowed to choose multiple options from a range of activities and barriers. Results 266 people living with AxSpA (68% women, 31% men, 1% non-binary, 94% white British/Irish) responded. Walking was most selected for activities respondents would like to be included as part of their lifestyle (83%), followed by stretching/flexibility exercises (61%), swimming (46%), weight training and resistance exercise (41%), and cycling (33%). Only eight respondents (3%) stated hydrotherapy which is traditionally advocated as exercise therapy in AxSpA. Worries about pain and flare ups (57%), fatigue (45%), time (39%), cost (27%), not knowing enough about how much activity to do (22%), and lack of available facilities (20%) were common barriers. Conclusion To maximise reach and benefit, exercise guidance needs to relate to exercise that people with AxSpA would like to or already do; the benefits of exercise can only be realised if people want to participate. The responses emphasise the need for guidance relating to inclusive models of exercise. This includes exercise such as walking that is flexible and adaptable to limitations of time and does not require additional cost, equipment, or facilities. The results also highlight the importance of including outcome assessments of pain, flare frequency, and fatigue. Disclosure M. Roberts: None. S. Qooja: None. A. Moorthy: Consultancies; AM has received speaker fees from Lilly, Novartis, Galapagos, and UCB. L. Bishop: Grants/research support; NCB has received funding from NASS..

Assessment of the blood lipid spectrum of workers under stressful conditions labor

The importance of dyslipidemia for health lies in the potentiation of cardiovascular diseases. We assessed the blood lipid spectrum and types of dyslipidemia in people with intense work (men aged 35.7 ± 0.8 years, n = 58). Body mass index (BMI) and nutritional status were determined. We assessed working conditions according to the degree of harmfulness and danger. A survey was conducted to establish the fact of tobacco and alcohol consumption. Mental work with high psycho-emotional stress and intensity of the work process in conditions of physical inactivity was assessed as harmful — 3.2. The proportion of smokers was 10.3 %, 100.0 % drank alcohol in moderate doses periodically. Body weight 84.6 ± 1.3 kg, BMI — 26.1 ± 0.3 kg/m2. The proportion of people with overweight and obesity was 68.4 %. Elevated triglycerides (TG) were detected in 17.7 %, total cholesterol (TC) in 60.3 %, low-density lipoproteins (LDL) in 74.0 %, reduced high-density lipoproteins (HDL) in 17.0 %. The atherogenic coefficient (AC) was 3.58 ± 0.13; in 51.8 % it exceeded the normal value. An adequate and inadequate response of the body to living conditions was evidenced by high and low levels of HDL: in 30.2 % and 5.4 % of those examined. The leading type of dyslipidemia was hypercholesterolemia (in 44.6 %). The proportion of mixed and atherogenic was 5.4 % and 1.8 %. In 23.2 %, excess levels of TC, LDL and TG in various combinations were recorded against the background of high HDL; their KA was normal. It can be assumed that physical inactivity against the background of intense work are risk factors for the development of dyslipidemia.

Assessment of health consequences of fossil fuel energy use in Osun state, Nigeria: burden and implications

The use of fossil fuel energy persists in all the continents of the world, especially in Africa. This study examined fossil fuel energy usage and its health implications in residents of Osun State, Nigeria. This was a cross-sectional study done across Osun State Nigeria. The study took place between January and June 2020. 1044 participants were recruited by multi-stage random sampling. Structured questionnaires were used to obtain necessary information from the study participants. The study data shows there were 534 females (51.1%). 601 (57.6%) relied solely on fossil fuel energy compared to 443 (42.4%) who use non-traditional energy sources. The proportion of people whose annual income is less than 56.6 USD (fifty thousand Naira based on the current official exchange rate as of Jan 2024) is far higher among those who use fossil fuel energy (88.0%) compared to those who use modern energy (59.1%). Electricity consumption accessibility was also more likely among those who used modern energy (91.9%) compared to 52.4% of those who use fossil fuel energy for daily energy needs. Reports of ill-health were significantly commoner among those who used fossil fuel than modern energy in the population including asthma illness (15.3% vs. 11.3%), cough (21.1% vs. 16.7%), catarrh (19.3% vs. 10.8%) and difficulty in breathing (9.3% vs. 6.3%) respectively. This study showed that fossil fuel energy use is very prevalent among residents of Osun State, Nigeria. And may be linked with many indices of poverty. It is associated with significant health impacts including respiratory diseases and poor quality of life. There is a need to encourage and implement policies toward effective and efficient energy use among residents in Osun State to reduce the associated long-term health impact.

Socioeconomic determinants of COVID-19 vaccine acceptance.

The aim of the paper is to evaluate the relative importance of the set of socioeconomic characteristics of population on collective decision on COVID-19 vaccine acceptance. We apply cross-section OLS methods to the municipal-level non-survey data for 145 municipalities in Serbia, on the COVID-19 vaccination rate and socioeconomic characteristics of the population, to evaluate the determinants of cross-municipal variation in vaccine uptake decision. Using the estimated coefficients from the OLS regressions, we apply the standardized beta method to evaluate the relative importance of each factor. Vaccine acceptance in municipalities rises with the average level of education (especially in the female population), age and employment, while being negatively linked to religiosity of people and the proportion of rural population. We also find some evidence on the positive impact of the overall trust in government. Education level has the single largest impact, shaping around 37% of (explained) variation in the vaccination rate across municipalities, a rise in the proportion of people with higher degree by 1% being associated with increase in vaccination rate by 0.36%. Age of population explains 21%, urban-rural structure 13% and religiosity 11% of variation in vaccine acceptance, while employment status and trust in government each explain around 9% of variation in vaccine uptake across municipalities. Effective vaccination promotion strategy should be focused on younger, less-educated, unemployed cohorts, as well as on rural areas and should involve representatives of mainstream religions. Fostering education and strengthening trust in government are some of the key structural factors that may promote efficient collective behaviour in this respect.

On the issue of assessing the blood lipid spectrum in working men of different ages

Introduction. Harmful working conditions contribute to the development of dyslipidemia&#x0D; Goal – assessment of the blood lipid spectrum in men of different age groups under conditions of occupational stress.&#x0D; Materials and methods. We analyzed the lipid spectrum of the blood in men aged up to 40 years (groups No. 1, 2 with different work experience, n=22 and n=20) and over 40 years of age (group No. 3, n=20). Assessed working conditions. Nutritional status, diet, physical activity, tobacco smoking, and alcohol consumption were determined.&#x0D; Result. Working conditions are harmful in terms of tension of 3.2 degrees. Physical activity is insufficient, 47.3% have three meals a day, 52.7% have two meals a day. In groups under 40 years of age with different years of experience, 68.2% and 63.2% are overweight; in people over 40 years old, 55.0% are overweight, class I obesity. at 20.0%. The proportion of smokers is 4.5%, 10.0% and 20.0%. With increasing age and experience, triglycerides increased (from 1.12±0.95 to 1.53±0.94 (p=0.022), total cholesterol (from 5.04±1.22 to 6.31±1.2, p=0.001), low-density lipoproteins (from 3.8±0.98 to 4.83± 1.11, p=0.01) mmol/l; proportions of people with hypertriglyceridemia (from 9.1 to 43.8%), hypercholesterolemia (from 40.9% to 93.7%), high LDL-C (from 47.6 to 93.75%); &#x0D; in subgroup No. 1, 19.0%, No. 2, 33.4% had HDL-C below normal. Lipid atherogenicity increased from 3.34±0.13 to 3.95±0.27 (p=0.031). &#x0D; Limitations. Men under 40 and over 40 years of age with varying years of experience working in hazardous work conditions. &#x0D; Conclusion. Hard work with poor nutrition and physical inactivity contributes to atherogenic changes in blood lipids. It is proposed to expand the list of studies to assess the atherogenicity of lipids in trained workers; in people with strenuous work, determine at an earlier age for the prevention of cardiovascular diseases.

Patterns And Determinants of Utilizing In-Patient Medical Care in Uttar Pradesh and Kerala Across Public and Private Hospitals

The healthcare institutions in India providing inpatient medical care are broadly classified into public/government hospitals, private hospitals, and NGO/Charitable run hospitals. The state of Kerala predominantly had public hospitals for providing health care facilities right from its formation till the late 1980s. Since the 1990s private hospitals have outpaced public hospitals in terms of the number and availability of beds whereas Uttar Pradesh despite being largest state of the country its performance on health is very poor and always come low in the NITI Aayog index. Using the latest unit-level data from NSSO 75th round on Social Consumption: Health, the study examines the pattern and determinants of availing of inpatient medical care in Kerala and Uttar Pradesh across public and private hospitals and the expenditure differences involved. The study finds out that the proportion of people who are hospitalized in Kerala is much higher compared to the all-India average and 66 percent of those hospitalized are in the private sector. Socioeconomic factors determine the choice of a public or private hospital for inpatient care, with people belonging to the highest socioeconomic category depending more on the private sector but in both states lower income households are seeking treatment in the public hospitals.

Evaluation of a population-wide, systematic screening initiative for tuberculosis on Daru island, Western Province, Papua New Guinea

BackgroundA population-wide, systematic screening initiative for tuberculosis (TB) was implemented on Daru island in the Western Province of Papua New Guinea, where TB is known to be highly prevalent. The initiative used a mobile van equipped with a digital X-ray device, computer-aided detection (CAD) software to identify TB-related abnormalities on chest radiographs, and GeneXpert machines for follow-on diagnostic testing. We describe the results of the TB screening initiative, evaluate its population-level impact and examine risk factors associated with TB detection.MethodsThrough a retrospective review of screening data, we assessed the effectiveness of the screening by examining the enrolment coverage and the proportion of people with TB among screened subjects. A cascade analysis was performed to illustrate the flow of participants in the screening algorithm. We conducted univariate and multivariate analyses to identify factors associated with TB. Furthermore, we estimated the number of additional cases detected by the project by examining the trend of routine TB case notifications during the intervention period, compared to the historical baseline cases and trend-adjusted expected cases.ResultsOf the island’s 18,854 residents, 8,085 (42.9%) were enrolled and 7,970 (98.6%) had chest X-ray interpreted by the CAD4TB software. A total of 1,116 (14.0%) participants were considered to have abnormal CXR. A total of 69 Xpert-positive cases were diagnosed, resulting in a detection rate of 853 per 100 000 population screened. 19.4% of people with TB had resistance to rifampicin. People who were in older age groups (aOR 6.6, 95%CI: 1.5–29.1 for the 45–59 age group), were severely underweight (aOR 2.5, 95%CI:1.0-6.1) or underweight (aOR 2.1, 95%CI: 1.1–3.8), lived in households < 5 people (aOR 3.4, 95%CI:1.8–6.6) and had a past history of TB (aOR 2.1, 95%CI: 1.2–3.6) were more likely to have TB. The number of bacteriologically confirmed TB notified during the intervention period was 79.3% and 90.8% higher than baseline notifications and forecasted notifications, respectively.ConclusionThe screening project demonstrated its effectiveness with the high Xpert-positive TB prevalence among the participants and by successfully yielding additional cases of bacteriologically confirmed TB including rifampicin-resistant TB. The results and lessons learnt from the project should inform future TB screening initiatives in Papua New Guinea.

Contributions to a global understanding of socioenvironmental justice related to urban forest: Trends from Brazilian cities in the southeastern Paraná State

Global studies on urban forests (UFs) have extensively covered both environmental and social aspects, including concerns about public health and green solutions provided by trees and forests in cities. However, this trend has not been widely observed in South America, particularly in cities located outside and distant from capital cities and wealthier regions. So, this study examines disparities in socioenvironmental justice of cities in the poorest region of Paraná State, Brazil, comparing to Curitiba (CWB), the capital and one of the greenest cities of Brazil, and proposes a methodology to surpass the scarcity of adequate dataset. A four-dimensional analysis covers the configuration of UF landscapes, the provision of ecosystem services, accessibility to UF, and their interrelation with socioeconomic indicators. We used high-resolution multispectral images from PlanetScope Dove and employed a machine learning algorithm to accurately map UF. We quantified landscape patterns of UFs using a variety of landscape metrics (LM), including mean patch area (AREA_MN), percentage of the landscape class (PLAND), largest patch index (LPI), mean shape index (SHAPE_MN), and the percentage of similar adjacencies (PLADJ). Additionally, we estimated ecosystem services such as total biomass (TB), carbon stock (TCS), carbon dioxide equivalent (CO2eq), urban heat island (UHI), and available public green areas (PGA). We created accessibility maps to PGA at distances of 300 and 800 m. A Mann-Kendall correlation analysis was employed to explore the relationships between these variables and various socioeconomic indicators, including the percentage of people in households without adequate water supply and sewage (TAEE), the percentage of the population living in urban households without garbage collection service (TPSL), the illiteracy rate of the population aged 15 years or older (TANAL), the proportion of people with per capita household income equal to or less than half minimum wage at year of 2010 (TVULNER), the number of schools (SCHOOLS), and the number of permanent residents (MPERM). The Sen's slope test was performed to determine the magnitude of these correlations. Our four-dimensional analysis revealed significant disparities in the distribution and accessibility of ecosystem services within the cities of southeastern Paraná State when compared to CWB. Correlation analyses revealed significant discrepancies between different socioeconomic conditions and the availability of ecosystem services. Financial vulnerability is positively correlated with ecosystem services, while the lack of sanitation negatively impacts their availability. The results highlight the urgent need for equitable distribution of UF ecosystem services.

Population ageing and national healthcare systems sustainability. A review of world practices

By 2050, the proportion of people over 60 years of age worldwide is expected to be 22 %, and the number of people over 80 is expected to triple by that time, reaching 426 million. Population aging threatens the sustainable functioning of national health care systems, since the increase in the proportion of the elderly population is accompanied by increased costs for the health care system and a decrease in the availability of medical care for other age groups. Based on the analysis and synthesis of data from foreign publications on the impact of population aging on the sustainability of the functioning of national healthcare systems, proposed measures and models of medical care that take into account changes in the age structure of the population are systematized. Analysis of foreign publications made it possible to identify the following challenges for the healthcare system associated with the aging population: rising costs of providing medical care, the need to increase emphasis on preventive measures, increasing prevalence and severity of chronic non-communicable diseases and comorbidity, inequality in access to medical care, expressed in territorial (regional), age and gender aspects, as well as determined by the socio-economic status of a person. Experts suggest that the most obvious and realistic solution to the problem is active prevention of chronic diseases and more intensive monitoring of the health status of the population. Digital solutions that provide disease prevention and remote monitoring of the health status of the elderly population, based on the use of machine learning technologies, artificial intelligence and telemedicine technologies, are identified as promising areas for limiting healthcare costs.

Norm From The Top: A Social Norm Nudge To Promote Low-Practiced Behaviors Without Boomerang Effect

Social norms are an essential determinant of conformity in decision-making, a powerful nudge for helping people adopt prosocial behavior. Informing people that most of their peers behave virtuously encourages them to improve their own behavior. Nevertheless, social norm mechanisms are efficient if the proportion of people who already act prosocially is sufficient, otherwise, the norm can lead to a ”boomerang effect” namely, this induces a person who acts prosocially to abandon her previous choice since she is informed that the majority does not support her prosocial behavior. The purpose of this paper is to develop a new norm that can be efficient even when implemented in behaviors practiced by a minority of people, by contrast to current social norm nudges. In our experiment, we create a new type of feedback that includes descriptive and injunctive norms and then observe whether they are more effective than standard social norm feedback. This new feedback, named ”Norm From The Top”, provides information based on the most altruistic people in the population. The experiment was run online due to the sanitary conditions in 2021. 203 participants were recruited from Cirano (Montreal, Quebec). Cirano is an interuniversity center, multidisciplinary and intersectoral. The sample comprises 120 women and 83 men (Average age = 37.2; SD = 10.5). In the experiment, participants were randomly exposed to a social norm that elicited prosocial behavior from other participants, and we observed whether the group exposed to the Norm From The Top increased their prosocial behavior compared to the other groups. Specifically, participants were asked whether they were willing to complete surveys without compensation. This study found that this norm acted as an effective nudge, increasing the average decision regarding prosocial behavior and addressing the boomerang effect issue. The Norm From The Top sets a high reference point compared to the standard norm and does not induce a reduction of contributions higher than this reference point. In contrast, the standard norm does not have a significant effect due to the boomerang effect and leads to a concentration of the contributions towards the average, resulting in an inefficient nudge in this context. These results show the potential of the Norm From The Top enforcement to promote low-practiced prosocial behaviors, thereby increasing the range of prosocial behaviors that social norm nudges can reinforce. Applying this norm to different types of prosocial behaviors in field experiments would allow for observing its impact on actual behaviors and assessing the external validity of this new instrument before making it available to policymakers.

Prevalence of smoking and consumption of nicotine-containing products among students of medical and technical universities (PROTECT)

BACKGROUND: The article presents data of the study “Prevalence of smoking and consumption of nicotine-containing products among students of medical and technical universities” (PROTEСT), carried out in 2023 at North-Western State Medical University named after I.I. Mechnikov and Saint Petersburg Electrotechnical University (LETI) named after V.I. Ulyanov (Lenin).&#x0D; AIM: To study the prevalence and patterns of consumption of tobacco and nicotine-containing products, attitudes to smoking behaviour.&#x0D; MATERIALS AND METHODS: A cross-sectional study of a random sample of student groups included 1105 respondents.&#x0D; RESULTS: The average age of respondents was 20.7 ± 2.0 years, 44.3% were men. 6.8% of participants smoked cigarettes; more often men than women (9.4 vs. 4.7%, p 0.01). The prevalence of nicotine-containing products consumption was 15.7%. There were no differences by gender (men 15.7% and women 15.8%). The use of a combination of cigarettes and nicotine-containing products was noted by 6.6% of students, which led to increase the tobacco smokers number to 13.4%; and the number of people consuming nicotine-containing products to 22.4%. The main reason for starting smoking/consuming nicotine-containing products was the example of friends (in 35.8 and 34% of cases). The reason for the start of smoking and consuming nicotine-containing products were problems in school and family among 21.1% of women and 6.6% of men (p 0.05), and nicotine-containing products by 16.0% of women and 5.7% of men (p 0.05). The majority of consumers of cigarettes and nicotine-containing products combination (38.4%) use them in a 20/80 ratio. Among the respondents, the proportion of smoking relatives is 40.3%, friends — 66.2%, classmates/dormitory neighbors — 71.9%.&#x0D; CONCLUSIONS: A reduction in tobacco smoking and an increase in the proportion of people using nicotine-containing products and their combination with tobacco, as well as the absence of gender differences in nicotine-containing products consumption, indicates a change in the smoking behavior of students and increases the risk of developing nicotine addiction and harmful health consequences. Differences in the motivation for starting smoking/using nicotine-containing product among men and women requires more detailed study.

AYURVEDIC MANAGEMENT IN PREDIABETES - A CASE REPORT

Prediabetes is a condition where there is an increase in glycemic variables in the blood that are higher than usual, and when not controlled, may end up in Diabetes. Presently, 5-10% of people are entering into diabetes from prediabetes, and the same proportion of people are converting into normoglycemia. The prevalence of prediabetes is increasing in the present era throughout the world and is going to reach about 470 million by the year-end of 2030. Prediabetes, when not able to control, may lead to diabetes along with different neuropathy, chronic kidney disease and cardiovascular diseases. According to Ayurvedic principles, all the vata and kapha dosha are involved in this condition. Various Ayurvedic medicines are mentioned in Ayurvedic classics regarding regularly maintaining glucose levels. Madumehahari Kashaya is the medicine that shows the possibility of alleviating these diseases. The patient was given Madhumehāri Kashaya, about 60 ml, for 90 days in this condition.

Does foreign direct investment promote access to basic services? The case of drinking water in Africa

AbstractAddressing the challenge of limited access to drinking water requires a comprehensive understanding of its underlying causes. This study aims to evaluate the effect of foreign direct investment (FDI) on access to basic services in Africa, focusing specifically on people's access to drinking water. Utilizing data from a panel of 51 countries spanning the period 2000–2020, we employed a two‐step system generalized method of moments to estimate dynamic econometric models. Our analysis reveals a positive correlation between FDI inflows and improved access to drinking water. A one‐percentage point increase in FDI inflows leads to a 0.026 percentage point rise in the proportion of people with access to drinking water. Notably, the effects vary between urban and rural areas, with marginal effects of 0.022 and 0.160, respectively. Furthermore, our findings indicate an inverse U‐shaped relationship between FDI and access to drinking water in Africa, signifying that while access to drinking water improves with increasing FDI, the rate of improvement diminishes. The study recommends the judicious utilization of tax revenues from multinational enterprises to fund basic service infrastructures and advocates for measures aimed at attracting additional FDIs.

Abstract P142: Trends and Racial/Ethnic Differences in Age at Diagnosis of Type 1 and Type 2 Diabetes Among Adults in the United States, 2016-2022

Introduction: Age at diagnosis of diabetes and diabetes type are associated with medical costs, lost productivity, vascular complications, and premature mortality that affect people disproportionately by race/ethnicity. However, age at diagnosis of diabetes by diabetes type and race/ethnicity along with their temporal trends are unclear. Hypothesis: We assessed the hypothesis that different trends and racial/ethnic differences in age at diagnosis of diabetes by diabetes type existed between 2016 and 2022. Methods: Adults aged 18 years or more were included from the National Health Interview Survey, 2016-2022. Type and age at diagnosis of diabetes were self-reported. Trends in age at diagnosis of type 1 diabetes (T1D) and type 2 diabetes (T2D) and in proportions of people with T1D or T2D diagnosed at different ages were assessed by linear and logistic regressions adjusted for sex and race/ethnicity, respectively. Racial/ethnic differences in age at diagnosis of T1D and T2D were estimated using Rao-Scott chi-square test. Results: Of 16,063 participants, 1,551 individuals had T1D with a mean [SE] age of 53.1 [0.6] years; 48.7% were women and 57.9% non-Hispanic White. T2D was found in 14,512 individuals with a mean [SE] age of 62.5 [0.2] years; 48.5% were women and 53.7% non-Hispanic White. The mean [SE] diagnosis age of T1D decreased from 37.5 [1.4] years in 2016 to 35.6 [1.4] years in 2022 ( P for trend = 0.03). During the same period for T2D, the mean [SE] diagnosis age increased from 48.7 [0.4] years to 49.2 [0.3] years ( P for trend &lt;0.001). From 2016 to 2022, the proportion of people with T1D and T2D diagnosed at &lt;45 years increased by 8% and decreased by 3% annually, respectively ( P for trend ≤0.01); the proportion of people with T1D and T2D diagnosed at ≥60 years decreased by 9% and increased by 3% annually, respectively ( P for trend ≤0.03). All results were adjusted for sex and race/ethnicity. Compared with non-Hispanic Whites, the mean diagnosis age of T1D was 7.8, 7.9, and 11.2 years higher whereas of T2D was 5.0, 6.4, and 2.5 years lower, respectively, in non-Hispanic Black, Hispanic, and non-Hispanic Asian people (all P for difference ≤0.002). Conclusions: In US adults, the mean age at diagnosis of T1D significantly decreased, whereas of T2D significantly increased from 2016 to 2022. Substantial differences in diagnosis age of T1D and T2D by race/ethnicity existed.

Intensity of educational expansion: a key factor in explaining educational inequality across regions and cohorts in Spain

Abstract Previous sociological research has indirectly examined the association between educational expansion and inequality by analysing changes in inequality over cohorts during the expansion process. This study tests the impact of educational expansion in Spain by using the proportion of people with a specific level of education in a particular region cohort as a direct measure of expansion. More importantly, this study focuses on the intensity of the expansionary process (of one level of education) as a crucial dimension that influences inequality (in the attainment of the next level). We argue that an intense expansion may strengthen the motivation of advantaged families to increase their investments in their children’s education but limit their capacity to undertake effective educational responses, particularly during the initial stages of the expansionary process. We use the socio-demographic survey conducted in Spain in 1991, which provides representative samples for different cohorts and regions in the country, and employ multilevel modelling to analyse the effect of the phase and intensity of the expansion on inequality. Our findings show a strong positive relationship between the intensity of expansion and the level of inequality that, nonetheless, is less strong at the initial stage of the expansionary process.

The effect of knee replacement on renal function in patients with hypertension and type 2 diabetes mellitus

Objective: to evaluate the effect of knee replacement on kidney function in patients with hypertension and type 2 diabetes mellitus. Materials and methods: at stage 1, 308 people suffering from hypertension (GB), stage III osteoarthritis of the knee joint (OA CS), type 2 diabetes mellitus (DM) were examined. GB occurred in 308 people, DM — in 66 people, and OA CS — in 216 people. Depending on the presence of OA CS, observation and comparison groups were identified. Within each group, subgroups are distinguished by the presence of SD: subgroup 1 (n=170) — OA CS +GB, subgroup 2 (n=46) — OA CS+GB+SD, subgroup 3 (n=72) — GB, subgroup 4 (n=20) — GB+SD. At stage 2, the dynamics of GFR after total knee arthroplasty (TEP CS) in subgroups 1 and 2 and against the background of AGT therapy in subgroups 3 and 4 were evaluated. Results: at the 1st stage, it was found that the proportion of people with GFR 60 ml/min/1.73 m2 was significantly higher in subgroup 1 (OA CS+GB) compared with subgroup 3 of patients with GB without joint pathology (40.6% vs. 12.5%, p0.01). The presence of DM in patients with GB significantly affected renal filtration function, which is reflected in an increase in serum creatinine levels in subgroup 4 (GB+DM) by 20.02% and a decrease in GFR by 15.35%.Against the background of the performed TEP in the group with GB, 64.06% had a stable GFR value or its increase, and in the subgroup of GB+ DM after TEP, 72.41% of patients had an increase or stable state of renal filtration capacity. At the same time, during the same follow-up period in the comparison group (in patients with GB without comorbid conditions), only 39.13% of cases had stable GFR values, and a decrease in GFR was recorded in 60.87%. At the same time, the dynamics of GFR values manifested itself in an increase of 11.19% in patients of subgroup 5 (TEP CS + GB) and by 12.47% in the group of the described knee joint intervention with a combination of GB and DM. In patients with controlled hypertension, GFR decreased by 6.6%. Conclusion: knee replacement in patients with hypertension and type 2 diabetes mellitus can slow down the rate of GFR reduction.

Factors Influencing Utilisation of Family Planning Services at Fort Portal Regional Referral Hospital, Kabarole District in Western Uganda

Family Planning was defined by the World Health Organization as a voluntary and informed decision by an individual or couple on the number of children to have and when to have them. According to the 2013 WHO facts sheet on Family Planning, “it was achieved mainly through the use of various contraceptive methods and treatment of involuntary infertility. The intervention for family planning reveals a contraceptive prevalence of 43. 1% which was way below the national target of 50% by 2020. This leaves 4 in 10 sexually active Ugandan women not using any form of contraception, including 3 in 10 who express a desire to delay childbearing. This study intended to assess factors influencing the utilization of family planning services at Fort Portal Regional Referral Hospital, Western Uganda. A cross-sectional, descriptive and analytical hospital-based study design was used to get 174 men and women of the reproductive age group at Fort Portal Regional Referral Hospital based on the Fischer et al., (1990) formula and the targeted 100% response rate was obtained however due to knowledge gaps, not all questions were answered 100% but a valid percentage was considered for the questions answered. Self-administered questionnaires were used, data was entered and reviewed for faults using Microsoft Excel, and after transferred to STATA version 20 for analysis, presented in frequency and percentage charts and tables with P-values and Odds ratios and their respective Confidence intervals where necessary. According to the findings, the proportion of people who use contraceptives was 44.91%of the participants at Fort Portal Regional Referral Hospital in Western Uganda. In multivariate analysis, socio-demographic factors like the education level of respondents that was to say tertiary had a P-value of 0.004[COR(CI; 95%);1.00 (65-3.09)], place of residence that was to say urban had a P-value of 0.003[COR(CI; 95%); 1.94 (1.35-4.92)], obstetric factors like history of abortion had a P-value of 0.001[COR(CI; 95%); 2.15 (1.04-4.51)], and medical factors like HIV had a P-value of 0.028[COR(CI; 95%); 1.94 (1.35-4.92)], and were significant and considered for the discussion because they had a P-value of less than or equal to 0.05. The utilization of family planning services at Fort Portal Regional Referral Hospital remains low at 44.91% in comparison to the national target which is 50% as per Uganda. Similarly, socio-demographic factors like level of education and place of residency, obstetric factors like history of abortion and medical factors like HIV significantly influence the utilizationof family planning services at Fort Portal Regional Referral Hospital in Western Uganda. Keywords: Family Planning services, Contraceptive methods, Childbearing, Women, HIV.

Efficacy and safety of 3D reconstruction and basket multi-electrode renal denervation (RDN) for refractory hypertensive patients with chronic kidney disease.

Renal Artery Sympathetic Denervation (RDN) can lower blood pressure. Different ablation catheters (single electrode, multi-electrode) have different scopes of ablation (renal artery main stem and branches). Few studies have compared the advantages and disadvantages of different ablation catheters and different procedures in terms of antihypertensive efficacy. To compare the efficacy and safety of 3D reconstruction radiofrequency ablation (3DRA) and basket multi-electrode radiofrequency ablation (BMRA) in Renal Artery Sympathetic Denervation. Fifty-three patients with Refractory hypertension (RHT) were divided into BMRA, (n=28) and 3DRA(n=25). BMRA group used a stereobasket multi-electrode ablation catheter with a controlled ablation temperature of 60°C and an ablation time of 120s per site. 3DRA group used a NavStar pressure-monitored perfusion monopolar ablation catheter with a controlled ablation temperature of 40°C, an ablation time of 40s per site, and an ablation energy of 12W. Baseline and RDN parameters and complications were compared in both groups. Home and 24h ambulatory blood pressure, type of anti-hypertensive medication taken, and serum creatinine were followed up at 1, 3, 6, 12, and 24 months after the RDN. There were no differences in baseline characteristics between the two groups. (23.14±2.00)months of follow-up in the BMRA group resulted in a total of (25.86±8.61) loci ablation. (19.28±7.40)months of follow-up in the 3DRA group resulted in a total of (21.04±6.47)loci ablation. Home SBP was significantly lower in both groups at 1 month after RDN treatment compared to baseline(H-SBP/mmHg: BMRA 149.9±10.59vs. baseline 168.36±12.76; 3DRA 152.6±14.91vs. 164.89±12.96, both p<.05). The proportion of people with 24h ambulatory SBP attainment was significantly higher in both groups and was maintained for 24 months. At each follow-up time point, there were no differences in home and 24-h flow SBP, DBP, or Scr between the two groups. There were two cases of severe renal artery complications from implanted vascular stents and one case of femoral artery pseudoaneurysm in the 3DRA group. At follow-up, 1 (1.9%) patient in the 3DRA group died of unexplained death and 1 (1.9%) patient developed heart failure, and 1 (1.9%) patient in the BMRA group died of unexplained death. Basket multi-electrode radiofrequency ablation and 3D reconstruction radiofrequency ablation of the renal artery applied to RDN have comparable efficacy in reducing systolic blood pressure.

Hygienic assessment of health risks for employees of the Omsk ambulance service due to tobacco smoking

The results of many studies indicate that there is a cause-effect relationship between active tobacco smoking and risks of various diseases, lung and bronchial cancer (C34) and coronary heart disease (I25) being the most common among them. These diseases are one of the main causes of death in working age. The aim of this study was to perform hygienic assessment of risks of lung and bronchial cancer and coronary heart disease due to active tobacco smoking. Healthcare workers employed at the Omsk ambulance station were chosen as the research object. Additional risk levels were calculated for lung and bronchial cancer and coronary heart disease in accordance with the methodical guidelines MR 2.1.10.0033-11 Assessment of Risks Associated with Impacts of Lifestyle Factors on Public Health. Smoking was a health risk factor for 27.5 % of emergency medical services workers, including 42.5 % of men and 21.3 % of women. Sixty-six point seven percent of men aged between 31 and 40 years smoked. Prevalence of smoking among the females in the sample did not depend on age. The risk analysis revealed that smokers, equally men and women (p &gt; 0.1) were the most likely to have lung and bronchial cancer and coronary heart disease. The corresponding median levels of additional risk equaled 1.45E-05 and 9.0E-06. The proportion of people with unacceptable levels of additional risks of the analyzed diseases (&gt; 1.4E-04) equaled 43.3 and 53.3 % respectively among people older than 40 years. Likelihood of lung and bronchial cancer and coronary heart disease statistically significantly depends on the intensity of smoking.