Socio-demographic Related Factors Research Articles

Dog, cat, bird, fish, and other pet ownership and mortality: Evidence from the HILDA cohort.

This study used the nationally representative prospective study of the Household, Income and Labour Dynamics in Australia (HILDA) survey cohort to examine the association of pet ownership (dog, cat, bird, fish, and others) with the risk of all-cause mortality using propensity score matching based on a wide range of factors. The study sample included 15,735 participants who completed the questionnaire on pet ownership in 2018. The HILDA survey sample was matched to the National Death Index through 2022 to assess death during the follow-up period. Statistical analysis was weighted by the inverse of the propensity score in the generalized estimating equation. During the 4-year follow-up period, 377 of 15,735 (2.4%) participants died. The odds ratios (ORs) for all-cause mortality were 0.77 (95%CI: 0.59-0.99) for dog owners compared to non-pet owners after controlling for related socio-demographic, physical, psychological, and social factors. The Sobel test showed a partial mediating effect of physical activity level on the relationship between dog ownership and all-cause mortality. Ownership of cats, birds, fish, and others showed no clear association with mortality, despite owners having similar socio-demographics characteristics to dog owners. Companionship and exercise of a pet dog may be recommended as a component of health promotion policy, and may have an important role to play in promoting health aging.

Comprehensive Clustering Analysis and Profiling of COVID-19 Vaccine Hesitancy and Related Factors across U.S. Counties: Insights for Future Pandemic Responses.

This study employs comprehensive clustering analysis to examine COVID-19 vaccine hesitancy and related socio-demographic factors across U.S. counties, using the collected and curated data from Johns Hopkins University. Utilizing K-Means and hierarchical clustering, we identify five distinct clusters characterized by varying levels of vaccine hesitancy, MMR vaccination coverage, population demographics, and political affiliations. Principal Component Analysis (PCA) was conducted to reduce dimensionality, and key variables were selected based on their contribution to cumulative explained variance. Our analysis reveals significant geographic and demographic patterns in vaccine hesitancy, providing valuable insights for public health strategies and future pandemic responses. Geospatial analysis highlights the distribution of clusters across the United States, indicating areas with high and low vaccine hesitancy. In addition, multiple regression analyses within each cluster identify key predictors of vaccine hesitancy in corresponding U.S. county clusters, emphasizing the importance of socio-economic and demographic factors. The findings underscore the need for targeted public health interventions and tailored communication strategies to address vaccine hesitancy across the United States and, potentially, across the globe.

Core competencies among nurses engaged in pallative care: A scoping review.

To synthesize available evidence about core competencies for nurses engaged in palliative care. A scoping review conducted according to the framework from Joanna Briggs Institute. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist was adopted to report this scoping review. The PubMed, Web of Science, Embase, ScienceDriect, CNKI, WangFang, VIP and Sinomed databases were used to systematically search for published studies from their inception to December 2023. Two researchers independently screened and selected relevant studies and performed the data charting. Twenty-six studies were included in this scoping review. Among these, 14 studies identified core competency assessment instruments among nurses engaged in palliative care, with the Palliative Care Core Competence Questionnaire was used most frequently; 13 studies investigated the status of core competencies of nurses engaged in palliative care, the majority of included studies indicated that nurse's core competencies were at moderate levels; 11 studies explored the factors influencing the core competencies of the nurses engaged in palliative care, which were classified as sociodemographic-related factors, palliative care education-related factors, death attitude, palliative care practice-related experience and others. This scoping review offers a comprehensive overview of the current landscape of core competencies among nurses in palliative care. Findings suggested that the clinical nursing leaders need to develop tailored strategies and interventions to address specific factors and promote the continuous development of nurses' competencies in palliative care. Core competency assessment instruments equip nurses and healthcare organizations with a range of validated tools for evaluating their proficiency in palliative care. Targeted core competency enhancement programmes need to be developed to foster a nursing workforce better equipped to improve the quality of life of end-of-life patients and their families. No patient or public contribution.

Abstract 768: Awareness and use of genetic testing among cancer survivors in the United States: A HINTS-SEER study

Abstract Background: Germline genetic testing is a valuable tool for cancer treatment and family cancer risk assessment, but its uptake among cancer survivors remains low. Understanding the factors that influence awareness and use of genetic testing among survivors is crucial for improving access to this important tool. Methods: We analyzed HINTS-SEER data, a pilot project conducted by the National Cancer Institute (NCI) in 2021, that oversampled cancer survivors diagnosed prior to 2018 using three registries from the Surveillance, Epidemiology, and End Results (SEER) Program (Iowa, New Mexico, Greater Bay Area). We examined sociodemographic factors in relation to awareness and use of genetic testing using survey-weighted multivariable logistic regression models. We also examined associations among breast and prostate cancer survivors, separately, as these cancer types have guidelines for genetic testing and had sufficient observations (>100) for stratified analyses. Results: Of 1232 survivors included in the analysis, 277 (23%) had a history of breast cancer, 285 (23%) had prostate cancer, 82 (6.7%) had colorectal cancer, 25 (2%) had ovarian cancer, and 563 (45.7%) had other cancers. Overall, 76.5% of survivors were aware of genetic testing and 23.5% had used it. Among breast and prostate cancer survivors: 40.0% of breast and 20.6% of prostate cancer survivors were aware of genetic testing, and 21.0% and 2.4% had used it, respectively. In multivariable models, female gender (vs. male; OR=3.1, 95% CI: 2.3, 4.2), higher education (high school or less education vs. greater than high school; OR=2.4, 95% CI: 1.4, 3.9), higher income ($100,000 or more vs. <$20,000; OR=3.2, 95% CI: 1.8,5.7), and family history (OR=2.0, 95% CI: 1.4,3.0) were significantly associated with higher odds of awareness of genetic testing. Older age (≥65 vs. <40 years; OR=0.4, 95% CI: 0.2,0.6), Asian American race (vs. non-Hispanic white; OR= 0.3, 95% CI: 0.3-0.9), and Hispanic ethnicity (vs. non-Hispanic white; OR= 0.5, 95% CI: 0.3-0.9) were associated with lower odds of awareness of genetic testing. Female gender (vs. male; OR=5.3, 95% CI: 3.3,8.5) was significantly associated with higher odds of use of genetic testing. Older age (>65 years vs. <40 years; OR=0.4, 95% CI: 0.2,0.7) and unemployed status (OR=0.4, 95% CI: 0.3-0.6) were significantly associated with lower odds of use of genetic testing. In stratified analyses, only older age among breast cancer survivors (≥65 vs. <40 years; OR=0.2, 95% CI: 0.0,0.9) was associated with lower odds of use of genetic testing. Conclusion: Our study provides valuable insights into genetic testing awareness and utilization among a large sample of cancer survivors in the United States. The identified factors associated with awareness and utilization can be used by healthcare providers to target interventions aimed at improving genetic testing awareness and utilization among cancer survivors. Citation Format: Kirithiga Ramalingam, Aaron Scheffler, Erin Van Blarigan, Stephen Li, Robin C. Vanderpool, Sarah H. Nash, Salma Shariff-Marco, Scarlett Gomez, Mindy Hebert-DeRouen. Awareness and use of genetic testing among cancer survivors in the United States: A HINTS-SEER study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 768.

Local perceptions of anthropogenic and climate factors affecting the use and the conservation of Detarium microcarpum and Detarium senegalense in Burkina Faso (West Africa)

AbstractUnderstanding local perceptions and the different uses of multipurpose plant species is essential for their sustainable management. Despite this, anthropogenic factors such as deforestation, overexploitation of natural resources, extension of agricultural lands, overgrazing, and bushfires, coupled with the adverse effects of climate change, are contributing to the loss of these species. This study analyses the perceptions of local communities in Burkina Faso regarding the threats to Detarium microcarpum and Detarium senegalense and their implications, aiming to contribute to the effective management and conservation of such species. Through individual semi‐structured and focus group interviews with 465 local people, data were collected on sociodemographic characteristics, plant parts used, use categories, threats and their effects, proposed solutions, and perceived conservation strategies. Descriptive statistics (consensus for plant part and relative frequency of citation), component analysis, and non‐parametric analyses were used for data analysis. Results indicated that ethnicity, age, education level, and occupation were the most influential sociodemographic factors in relation to the use of these species. Six plant parts from both Detarium species are used across seven use categories, with fruits (0.40), trunks (0.16), and bark (0.27) being the most exploited. There was consensus among local populations regarding areas of abundance. Threat factors, their effects, and conservation solutions varied significantly according to site status. This study highlights the multipurpose uses of Detarium species throughout Burkina Faso and reveals that threats to these species are linked to the occupation and the status of each site. Sustainable use, effective conservation, and domestication of Detarium species should be considered to promote and sustain the exploitation of non‐timber forest products.

Socio-economic status and autism spectrum disorder: A case-control study in Bangladesh

There are unexpectedly a few statistics about the socio-economic status (SES) and related socio-demographic factors (SDFs) of parents having child with ASD in Bangladesh. The prevalence of ASD might correlate with SES and related SDFs. A case-control study was conducted in 24 locations across 21 districts, encompassing all divisions, to assess the association between SES and the risk of developing ASD in Bangladesh. The structured questionnaire was administered through face-to-face interviews with 620 parents of the subject (310 ASD and 310 healthy controls) from January 2020 to June 2021. For univariate, bivariate and multivariate analyses, IBM SPSS version 23 was employed. The significance level was set at P ≤ 0.05, and the Odds Ratio (OR) within a 95 % CI was used to determine whether the variable poses a higher odd or not. After adjusting all significant covariates of binary logistic regression (including some dummy variables) in forward logistic regression model analysis, the higher level of SES, advanced level of father’s education (≥master), 22–35 years old age group of the father, and nuclear family were strongly associated with decreased odds of ASD compared to healthy controls. Only the male gender was strongly associated with an increased odds of ASD compared to the control. The results will aid policymakers in developing plans considering the SES and related SDFs that influence the risk of developing ASD in Bangladesh. Further research using population-based cohorts or nested case-control designs with matched control is necessary to observe and generalize the association.

Seroprevalence of hepatitis B infection among blood donors in Western zone of Tanzania

BackgroundThere is limited information on burden of hepatitis B infection in the Western zone of Tanzania. In this study, we analyzed a dataset from blood donors to determine Hepatitis B virus (HBV) seroprevalence and related socio-demographic factors among blood donors in the Western regions of Tanzania. Material and methodsThis was a cross-sectional retrospective hospital-based study, in which data were retrieved from the blood donor dataset at the Zonal Blood Transfusion Center. The analyzed information from the dataset included reported Transfusion Transmissible Infections (TTIs), which included Hepatitis B, donor demographics, donor status, donor type, donation place, and the year of donation. The analyzed data was retrieved within five years from January 2018 to December 2022. Rates of hepatitis B surface antigen (HBsAg) were determined and univariate and multivariate analyses were conducted to determine the association between infection and demographic risk factors. ResultsA total of 9604 retrospective blood donors were screened. Majority 8963 (93.3 %) were men, and most of them were under 45 years (89.6 %). Overall, HBsAg seroprevalence was 6.9 % (661), with Katavi (7.8 %) being relatively higher in the studied three regions. The highest HBsAg seroprevalence of 8.2 % (199) was found in the age group ranging from 35 to 44 years. Moreover, 2 (9.5 %) polygamists and 15 (17.1 %) car drivers had relatively high seroprevalence. Results from the multivariate analysis indicated that, car drivers (OR 5.44, 95 % CI; 2.43–12.20, p < 0.001), and first-time donors (OR 5.19, 95 % CI 2.56 = 10.52, P < 0.001), were highly associated with increased chance of getting hepatitis B infection. ConclusionThe findings from this study indicated that, there was high seroprevalence of HBV infection in the Western regions of Tanzania during the studied time period. These findings call for more advocacy on HBV immunization for all groups of persons found at high risk for HBV infection.

Work-related musculoskeletal disorders among dental staff in south Malaysia

The dental industry poses ergonomic health concerns, leading to work-related musculoskeletal disorders (MSD) among staff. This study aims to assess MSD incidence and related sociodemographic and occupational hazard factors among dental practitioners in Johor, Malaysia. A cross-sectional investigation in December 2022 included 382 dental officers from government and commercial sectors. Participants comprised 79.2% females, 72.3% Malays, 97.4% non-smokers, and 92.4% working in dental clinics. MSD was most prevalent in the neck, shoulder, and lower back regions. Logistic regression revealed higher neck pain probability among smokers and a positive association between back pain and standing while working. Poisson regression indicated an inverse relationship between exercise frequency and MSD pain occurrence. Regular physical activity correlated with lower body mass index (BMI) and reduced MSD pain. The study underscores the importance of ergonomic interventions and promoting exercise to prevent MSD and enhance the well-being of dental staff in Johor, Malaysia. Understanding the factors contributing to MSD among dental practitioners is crucial for implementing effective preventive measures and improving overall occupational health in the dental industry.

CTNI-16. USE OF PREDICTIVE SCORE-BASED HISTORICAL CONTROL DATA IN SINGLE-ARM TRIALS

Abstract Even though the randomized controlled trials (RCTs) are still the preferred approach to evaluate the effects of treatments, single-arm study designs have been traditionally used in Phase II oncology clinical trials. The single-arm studies using historical control or external control might be inevitable and even fatal when concurrent controls are impractical or unethical in rare and high-risk diseases. Due to recruiting difficulty, ethical and economic reasons, the single-arm trials can be a good option to test the experimental efficacy with the external control data of historical control rates for early efficacy phase 2 trials in glioblastoma. The FDA guidelines on external control data focus on the use of patient-level data from other clinical trials or real-world data (RWD), and so there is no guidance for summary-level historical control. Furthermore, there exist methodological issues to use historical data like identification of relevant data, amount of discounting (time difference and dissimilarity), prior robustness or operating characteristics. In this study, we propose a synthetic data based predictive scoring method optimally to match the historical control data with the characteristic conditions of the experimental studies. We consider both a binary (PFS on six months) and survival (median PFS) endpoints as surrogates for Phase 2 single-arm trials in newly diagnosed and recurrent glioblastoma patients. We perform meta-analysis to summarize the endpoints and the related socio-demographic, treatment and genetic factors from the summary-level historical data. Then we generate the synthetic patients based on the meta-summarized data. The generalized boosted regression models will be used to identify significant characteristics affecting the survival of GBM patients using the synthetic data. Finally the predictive score-based historical data model will be developed to provide the optimal matching with the characteristics of the experimental studies. This study will be validated using existing patient-level data as well as cross-validation methods.

Trends of mental health care utilization among US adults from 1999 to 2018

BackgroundMental health disorders affect millions of US adults, however, the trends and related factors for mental health care utilization in the US remain unknown.AimsOur study aimed to assess the trend of mental health utilization and related socio-demographic factors in the US.MethodsThe study included 55,052 individuals from the National Health and Nutrition Examination Survey (NHANES) in 1999–2018. Temporal trends in the percentages of mental health care utilizers were estimated across survey cycles. Trends and linked factors of mental health care utilization were assessed by a logistic regression model, while the non-linearity was estimated by restricted cubic splines.ResultsFrom 1999 to 2018, the percentage of mental health care utilizers in the US adult population increased from 7.0 to 11.3% (P < 0.001); meanwhile, the trends in males and females were consistent. The percentage increased positively with age in individuals aged 20–39 (P < 0.001) or aged 60 and over (P = 0.003). The trends were consistent in three race/ethnicity groups (P < 0.05). The logistic regression analysis revealed that several disparities existed in the subpopulations. Older age, female, lower family poverty-income ratio (PIR), chronic diseases, higher educational level, and smoking were estimated to be associated with a higher percentage of mental health care.ConclusionsThe percentage of mental health care utilizers took on an increasing trend in the US adult population from 1999 to 2018. These trends were also observed in the subpopulations, but with disparities. Future research for exploring factors associated with mental health care utilizations is necessary.

Adherence to levothyroxine treatment among patients with hypothyroidism in Oman: a national cross-sectional study

Objective Hormone replacement therapy with levothyroxine is considered the treatment of choice for hypothyroidism; however, non-adherence is a major contributor to poor treatment outcomes. This study aimed to evaluate levels of drug adherence (DA) to levothyroxine therapy among Omani adults with hypothyroidism and to explore related sociodemographic and clinical factors. Methods A national, multi-center, cross-sectional survey was carried out from August to December 2021 at 18 primary healthcare centers across all governorates of Oman. A total of 415 Omani adults were recruited. Data were collected using a pre-tested, Arabic-language questionnaire completed by trained researchers during face-to-face interviews with the participants. Level of DA was determined using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results A total of 400 Omani adults participated in the study (response rate: 96.4%). The mean age was 41.9 ± 12.4 years old (range: 18–78 years) and 90.3% were female. According to their MMAS-8 scores, 157 (39.2%), 139 (34.8%), and 104 (26.0%) participants demonstrated low, medium, and high DA, respectively. No significant correlations were observed between level of DA and any sociodemographic or clinical characteristics, including age, gender, education, duration of treatment, and family history of thyroid disease (p > 0.050). Conclusions Only a quarter of Omani patients with hypothyroidism reported high levels of adherence to levothyroxine treatment, likely as a result of lack of awareness of the disease and the importance of maintaining an euthyroid state. Further studies using more objective measures of DA are recommended to determine correlates of non-compliance to levothyroxine therapy among Omani patients.

IUD-Related knowledge and practice among women in Afghanistan: A cross-sectional survey study

Background: Intrauterine Devices (IUDs) are T-shaped devices that can be inserted into the uterus to provide contraception. IUDs are a form of long-term contraception that are effective birth control methods with few adverse effects. The purpose of this study is to reveal the current baseline for the knowledge and practice of Afghan women toward intrauterine devices and identify the related sociodemographic factors. Methods: This cross-sectional survey was conducted from October 2022 to December 2022 among married women aged at least 18 years old living in Herat province of Afghanistan. A total of 1000 females in Herat were asked, and 411 agreed to participate in this study (response rate=41.1%). Results: Only one-fourth of the participants responded that health care workers are their primary source of information on health issues (25.3%). More than nine-tenths of the participants had poor knowledge level of IUD (91.5%) while only one-twentieth of participants were using IUD (5.8%). Number of children, education level, occupation, and economic status were found to be significantly associated with participants’ knowledge on IUD. Conclusion: Government and health organizations should provide trainings focused on increase of knowledge on IUD and its related issues. The programs should also persuade women to use IUD and its safety. Training should be targeted not only to women, but to family practice physicians, nurse and midwifery practitioners and other providers who offer family planning counseling and services.

Treatment fidelity and satisfaction with an intervention based on case management for older people with falls history: Randomized clinical trial

PurposeTo verify the treatment fidelity and satisfaction with a multifactorial intervention based on case management in community-dwelling older people with falls history and related sociodemographic and clinical factors. MethodsThis is a single-center, randomized, parallel-group controlled clinical trial. 62 community-dwelling older people with falls history were distributed into two groups. The Intervention Group (IG) underwent a case management involving multidimensional evaluation, explanation of the risk factors for falls identified, implementation of an intervention proposal based on the identified risks, elaboration of an individualized falls intervention plan, implementation, monitoring and review of the intervention plan. The Control Group (CG) was accompanied by a monthly phone call. After 16 weeks, the volunteers answered two closed questionnaires about treatment fidelity or non-fidelity to intervention (IG) and satisfaction with intervention (both groups). In addition, the frequency of intervention, adherence to each recommendation of the case management and satisfaction with general care were evaluated. ResultsThere was good treatment fidelity based on case management, as well as good adherence to recommendations. In addition, the satisfaction of both groups was positive, although the IG had a better score (p<0.05). There was a significant influence of monthly income and general health on treatment fidelity (IG). Also, age, years of schooling, general health and physical mobility significantly influenced satisfaction with the IG. There was a significant influence of number of falls on satisfaction with monitoring conducted in the CG. ConclusionsClinical and sociodemographic factors can influence treatment fidelity and satisfaction of older people with falls history to a falls prevention program.

The prevalence of diabetes distress among patients with type 2 diabetes in Jordan

ObjectivesDiabetes distress (DD) is a state of emotional distress that evolves from living with chronic disease and the burden of daily adjustments of medications and lifestyle. This study investigated the prevalence of DD in patients with type 2 diabetes mellitus (T2DM) in Jordan and the related sociodemographic and medical factors. MethodsWe conducted a cross-sectional study in 608 patients with T2DM in Jordan, ranging from ages 15 to 80 years. The participants filled out a questionnaire where they were asked to self-assess their DD using the Diabetes Distress Scale. In all, 32 participants were excluded according to the exclusion criteria, which resulted in 576 people being included in this study. ResultsThe overall prevalence of DD was 53% (25% had moderate distress and 28% had high distress). Emotional distress had the highest prevalence among the DD subscales, with a total prevalence of 58.8%. The data showed a significant association of DD with different factors including age, the presence of diabetic complications, the type of medication used, and medication adherence. ConclusionThis study showed a high prevalence of DD (53%). This finding should raise awareness to healthcare providers about the importance of screening for DD as part of the treatment guidelines, especially in patients who are on multiple medication regimens for DM; patients who have previous medical complications related to DM; and those who exhibit poor adherence to medications, which was found to be a risk factor of DD in this study.

Triggers for Acceptance of COVID-19 Vaccination: A Community- Based Study.

COVID- 19 vaccines have been released, giving a major hope of getting rid of the dark pandemic crisis. The availability of vaccines does not necessarily mean that the mass vaccination program is a success. We aimed to investigate COVID-19 vaccination knowledge level, acceptance rate, and perception state among Egyptians. An analytical cross-sectional online survey was carried out utilizing a selfadministered adult questionnaire that assesses vaccination acceptance with related sociodemographic factors and perceptions based on health belief model perspectives. Predictors of vaccination acceptance were based on logistic regression analysis. We analyzed data for 957 participants, aged 18-78 years, 55.7% were females, and 66.9% were healthcare workers (HCWs). About one-fourth had a history of confirmed COVID-19 infection and 56.5% would accept to have one of the COVID-19 vaccines, where "Pfizer" was the preferable one (37.8%), while "AstraZeneca" was the most rejected vaccine (26.8%). The 1st vaccine dose was received by 273 (28.5%) of which 260 were intended to receive the 2nd dose. Vaccine efficacy, side effects, protection time, and administration route were essentially among the factors that may influence their decision to accept COVID-19 vaccines. About 83.1% had good knowledge about vaccination which was significantly higher with increased age, among graduates/professionals, governmental workers, HCWs in addition to those able to save/invest money, had a history of confirmed COVID-19 infection and intending to have COVID-19 vaccine. Perceptions that vaccination decreases the chance of getting COVID-19 or its complications (OR = 9.28; CI: 5.03-17.12), vaccination makes less worry about catching COVID-19 (OR = 6.76; CI: 3.88-11.76), and being afraid of getting COVID-19 (OR = 2.04; CI: 1.26-3.31) were strong significant predictors for vaccine acceptance. Vaccine campaigns should emphasize vaccine benefits and highlight the severity of infection while addressing barriers to vaccination in order to improve vaccine coverage among populations.

Abstract P255: Risk Factors for Incident Depressive Symptoms During the COVID-19 Pandemic Among Multi-Ethnic Older Adults: The Multi-Ethnic Study of Atherosclerosis (MESA)

Objectives: The COVID-19 pandemic has been associated with an increase in the prevalence of depression symptoms among young adults in the US. We examined the impact of the pandemic on the prevalence and incidence of depression symptoms, and related sociodemographic and cardiovascular risk factors, among older adults in a US general population-based sample. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) is a longitudinal cohort study that recruited participants who were 45-84 years old and without cardiovascular disease in 2000-02. Depression symptoms were assessed using the Center for Epidemiologic Studies depression scale (CES-D-10), during the pandemic (2021-2022) and pre- pandemic (2010-2011). We examined depressive symptoms in individuals with scores in both time periods. Incident depressive symptoms were defined as a CES-D-10 score ≥10 among participants with a CES-D-10 score &lt;10 on pre-pandemic assessment. Risk factors for increases in CES-D-10 score and incident depressive symptoms, were examined by linear and logistic regression, respectively, adjusting for socio-demographic factors, health behaviors, and clinical characteristics. Results: Pre-pandemic and pandemic era CES-D-10 measures were available in 1602 MESA participants with mean age 75 years including 895 (55 %) women, who self-reported race/ethnicity as Non-Hispanic White (42%), Chinese (15%), Black (22%), or Hispanic (21%). The prevalence of depressive symptoms was 13.6% during the pre-pandemic period and 15.8% during the pandemic, and there were 180 incident cases of depressive symptoms (13%). After adjustment, significant increases in CES-D-10 scores were observed in women (+1.2, P&lt;.001) and participants with lower education (less than high school versus college, +1.1, P=.03). Incident depressive symptoms were associated with female sex (aOR=2.16, p&lt;0.001) and current smoking (aOR=2.04, p=0.03). Incident depressive symptoms were modestly yet not significantly associated with moderate to severe COVID-19 infection (aOR=1.88, p=.06). We did not find hypertension or diabetes to be significantly associated with worsening or incident depression symptoms. Conclusions: The prevalence of depressive symptoms increased modestly during the COVID-19 pandemic, compared to assessments one decade earlier, in a sample of multi-ethnic older adults. Greater risk of incident or worsening depressive symptoms was observed in women and current smokers. Additional research is needed on how pandemic-era depressive symptoms could affect future cardiovascular health.

Pelvic floor disorder and relevant factors in Iranian women of reproductive age: a cross-sectional study

BackgroundWith high severity and prevalence, pelvic floor disorder is a health issue that women face worldwide. Different demographic-obstetric factors are involved in the emergence of this dysfunction that can have many adverse effects on a woman’s quality of life. Hence, this study aimed to determine the prevalence of pelvic floor disorder and its related socio-demographic and obstetric factors among Iranian women of reproductive age.MethodsThe statistical population of this cross-sectional study included 400 woman of reproductive age (15–49 years) covered by the health centers of Tabriz, Iran in 2022. The cluster sampling method was employed to select the participants. The data collection tools were a socio-demographic and obstetric characteristics questionnaire and the PDFI-20 (Pelvic Floor Distress Inventory-20). The chi-squared test was conducted to determine the association between socio-demographic and obstetric characteristics and prevalence of pelvic floor disorder in a bivariate analysis, whereas the multivariate logistic regression test was used in a multivariate analysis.ResultsThe general prevalence of pelvic floor disorder was 76%. The prevalence rates of pelvic organ prolapse distress 6 (POPDI-6), colorectal-anal distress 8 (CRAD-8), and urinary distress (UDI-6) were 54.3%, 61.8%, and 49.3%, respectively. The results of the multivariate logistic regression test indicated that constipation (odds ratio = 5.62; 95% CI 1.97 to 16.03; P = 0.001) increased the risk of pelvic floor disorder.ConclusionsAccording to the findings, the prevalence of pelvic floor disorder is high among Iranian women of reproductive age. This condition is correlated with constipation. Therefore, screening is recommended through valid tools in addition to offering preventive measures such as preventing and curing constipation to reduce the risk of pelvic floor disorder.

Factors Associated with Telehealth Utilization among Older African Americans in South Los Angeles during the COVID-19 Pandemic.

The COVID-19 pandemic transformed healthcare delivery with the expansive use of telemedicine. However, health disparities may result from lower adoption of telehealth among African Americans. This study examined how under-resourced, older African Americans with chronic illnesses use telehealth, including related sociodemographic and COVID-19 factors. Using a cross-sectional design, 150 middle-aged and older African Americans were recruited from faith-based centers from March 2021 to August 2022. Data collected included sociodemographics, comorbidities, technological device ownership, internet usage, and attitudes toward COVID-19 disease and vaccination. Descriptive statistics and multivariable regression models were conducted to identify factors associated with telehealth use. Of the 150 participants, 32% had not used telehealth since the COVID-19 pandemic, with 75% reporting no home internet access and 38% having no cellular/internet network on their mobile device. Age, access to a cellular network on a mobile device, and wireless internet at home were significantly associated with the utilization of telehealth care. Higher anxiety and stress with an increased perceived threat of COVID-19 and positive attitudes toward COVID-19 vaccination were associated with telehealth utilization. Access and integration of telehealth services were highlighted as challenges for this population of African Americans. To reduce disparities, expansion of subsidized wireless internet access in marginalized communities is necessitated. Education outreach and training by healthcare systems and community health workers to improve uptake of telehealth currently and post-COVID-19 should be considered.

Prevalence of Psychiatric Morbidity and their Clinical Correlates in Patients Post COVID-19: A Cross-sectional Study from Rural Northern India

Introduction: Myriad of complications were observed in post Coronavirus Disease (COVID-19) survivors, psychiatric morbidities among one of them. Recent body of research has shown that significant number of patients developed psychological symptoms following COVID-19. Most of the Indian studies have assessed psychological morbidity among COVID-19 patients during admission. However, very few Indian studies have assessed the psychological impact of COVID-19 during the follow-up period, especially in rural India. Aim: The study aimed to determine the prevalence of depression and anxiety and evaluate related socio-demographic (age, gender, education, occupation and marital status) and clinical factors (severity of COVID-19, presence of medical co-morbidity, Oxygen requirement, Intensive Care Unit (ICU) referral, duration of admission) in patients post-COVID-19. Materials and Methods: This was a cross-sectional study conducted at Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India. among 96 patients post-COVID -19 after their discharge from the hospital. Data collection was done between July 2021 to September 2021, using a semi-structured proforma and a psychiatric diagnosis was made (based on International Classification of Diseases- 10th Edition Diagnostic Criteria for Research criteria and clinically approved by two qualified psychiatrists). Rating scales such as Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used for severity assessment. Data was analysed using Microsoft Statistical Package for Social Sciences (SPSS) version 20.0. A p-value of &lt;0.05 was considered significant. Results: In 96 patients, 70 (72.91%) were males. 38 patients (39.58%) were of the age group 45-60 years. 36 (37.50%) patients had Depression. Anxiety was seen in 40 (41.66%) participants. Among the clinical variables, the severity of the COVID-19 infection (p-value&lt;0.01), presence of co-morbidity (p-value&lt;0.01), and ICU referral (p-value&lt;0.01), were found to be associated significantly with the presence of depression in the participants. Among 36 depressive patients, mild depression was present in 17 (47%), moderate depression in 12 (33%), severe depression in 5 (14%) and very severe in 2 (6%) of the participants. Anxiety was associated significantly with the gender (p-value=0.02), co-morbidity (p-value&lt;0.01), severity of illness (p-value&lt;0.01), oxygen requirement (p-value=0.04) and ICU admission (p-value&lt;0.01). Mild anxiety was observed in 18 (45%), moderate anxiety in 16 (40%) and severe anxiety in 6 (15%). Conclusion: The prevalence of depression and anxiety is high in patients post COVID-19. The severity of these disorders is significantly associated with presence of medical co-morbidity and severity of COVID-19. Hence, thorough evaluation and management of these disorders in post-COVID-19 patients can help in improving the overall outcome.

Caregiver knowledge of obstructive sleep apnoea in Down syndrome.

Down syndrome (DS) population has a very high prevalence of obstructive sleep apnoea (OSA), but this remains underdiagnosed. Hence, we aimed to evaluate caregiver's knowledge of OSA and related sociodemographic factors that could contribute to OSA screening patterns in this population. An online survey though the LuMind IDSC Foundation focused on OSA diagnosis, treatments and the number of sleep studies performed. Data were compared between subjects born before and after the American Academy of Pediatrics (AAP) recommendations for OSA screening. Of the caregivers, 724 (parents 96.3%), responded to the survey. The median [interquartile (IQR)] age of the subjects with DS was 12 [20;7] years. The majority (84.3%) had sleep apnoea diagnosis, and half of them were initially referred for a sleep study due to disturbed sleep symptoms. Only 58.7% of the responders were aware of the AAP recommendations. This was linked to higher socioeconomic and/or educational level and to an earlier OSA diagnosis. The median (IQR) age of OSA diagnosis was lowered after the AAP guidelines publication compared with before its publication (3 [4;2] years vs. 10 [18;5] years, P<0.000). Adenotonsillectomy (81.9%) and continuous positive airway pressure (61.5%) were the most commonly prescribed treatments. Few had discussed other new therapies such as hypoglossal nerve stimulation (16.0%). Only 16.0% of the subjects repeated the sleep study to monitor OSA with ageing, and 30.2% had to wait more than 4years between studies. This study reinforces the need to improve OSA knowledge of caregivers and clinicians of individuals with DS to promote an earlier diagnosis and optimal treatment of OSA in this population.