Representative Population Sample Research Articles

Association of the oral microbiome with cognitive function among older adults: NHANES 2011–2012

BackgroundAn association between the gut microbiome and cognitive function has been demonstrated in prior studies. However, whether the oral microbiome, the second largest microbial habitant in humans, has a role in cognition remains unclear. Design, setting, participantsUsing weighted data from the 2011 to 2012 National Health and Nutrition Examination Survey, we examined the association between oral microbial composition and cognitive function in older adults. The oral microbiome was characterized by 16S ribosomal RNA gene sequencing. Cognitive status was assessed using the Consortium to Establish a Registry for Alzheimer’s Disease immediate recall and delayed recall, Animal Fluency Test, and Digit Symbol Substitution Test (DSST). Subjective memory changes over 12 months were also assessed. Linear and logistic regression models were conducted to quantify the association of α-diversity with different cognitive measurements controlling for potential confounding variables. Differences in β-diversity were analyzed using permutational analysis of variance. ResultsA total of 605 participants aged 60–69 years were included in the analysis. Oral microbial α-diversity was significantly and positively correlated with DSST (β, 2.92; 95% CI, 1.01–4.84). Participants with higher oral microbial α-diversity were more likely to have better cognitive performance status based on DSST (adjusted odds ratio, 2.35; 95% CI, 1.28–4.30) and were less likely to experience subjective memory changes (adjusted odds ratio, 0.43; 95% CI, 0.25–0.74). In addition, β-diversity was statistically significant for the cognitive performance status based on DSST (P = 0.031) and subjective memory changes (P = 0.023). ConclusionsOral microbial composition was associated with executive function and subjective memory changes among older adults among older U.S. adults in a nationally representative population sample. Oral dysbiosis is a potential biomarker or therapeutic target for cognitive decline. Further work is needed to elucidate the mechanisms underpinning the association between the oral microbiome and cognitive function.

Health-Related Quality of Life and Return to Work after Surgery for Spinal Schwannoma: A Population-Based Cohort Study.

Spinal schwannomas are the second most common primary intradural spinal tumor. This study aimed to assess health-related quality of life (HRQoL) and the frequency of return to work after the surgical treatment of spinal schwannomas. HRQoL was compared to a sample of the general population. Patients operated for spinal schwannomas between 2006 and 2020 were identified in a previous study and those alive at follow-up (171 of 180) were asked to participate. Ninety-four (56%) responded and were included in this study. Data were compared to the Stockholm Public Health Survey 2006, a cross-sectional survey of a representative sample of the general population. An analysis for any potential non-response bias was performed and showed no significant differences between the groups. HRQoL was equal between the spinal schwannoma sample and the general population sample in all but one dimension; men in the spinal schwannoma sample reported more moderate problems in the usual activities dimension than men in the general population (p = 0.020). In the schwannoma sample, there were no significant differences between men and women in either of the dimensions EQ-5Dindex or EQVAS. Before surgery, a total of 71 (76%) were working full-time and after surgery almost all (94%) returned to work, most of them within 3 months of surgery. Eighty-nine (95%) of the patients responded that they would accept the surgery for their spinal schwannoma if asked again today. To conclude, surgical treatment of spinal schwannomas is associated with good HRQoL and with a high frequency of return to work.

Impact of Atopic Dermatitis on Adult Women's Lives: A Survey of 1,009 French Women.

Atopic dermatitis (AD) is one of the most common inflammatory diseases, and has a higher prevalence among females in adulthood. The aim of this observational, cross-sectional, survey-based study was to evaluate the impact of AD on the daily lives of adult women patients. A scientific committee composed exclusively of women constructed a specific questionnaire in partnership with the French Eczema Association. Severity of AD was evaluated with the Patient-Oriented Eczema Measure (POEM). A sample of 1,009 adult women (mean age ± standard deviation: 41.8 ± 14.2 years) with AD was identified from a representative sample of the French population (82% response rate 1,230 women surveyed). According to the POEM, 50.64% (n = 511) of subjects were identified as having mild AD, 39.35% (n = 397) moderate AD, and 10.01% (n = 101) severe AD. Overall, 67.7% (n = 682) reported that their eczema involved a visible area (face, neck or hands), and 19.6% (n = 198) a sensual area (breasts/chest, genital area or buttocks). Of the 720 women with menstrual cycles, exacerbations of AD were reported to occur mostly before (50.6%) and during (48.3%) menstruation. A small proportion of women, 7.3% (n = 74), reported being afraid of becoming pregnant because of their eczema. If AD involvement was in a visible area it had a greater impact on romantic relationships, sexual relationships and occupation. If AD involvement was in a sensual area it had a greater influence on romantic relationships and sexuality. Particular attention should be given to patients with localization of AD on the face, neck or hands, as they have a higher risk of social exclusion. Moreover, these results should encourage health professionals to ask patients with AD about the possible involvement of sensual areas.

Utilization of Mental Health Provision, Epistemic Stance and Comorbid Psychopathology of Individuals with Complex Post-Traumatic Stress Disorders (CPTSD)-Results from a Representative German Observational Study.

Background: Complex post-traumatic stress disorder (CPTSD) is a severely debilitating recently added symptom cluster in the International Classification of Diseases (ICD-11). So far, only limited information on mental health treatment-uptake and -satisfaction of individuals with CPTSD is available. The aim of this study is to investigate these aspects in a representative sample of the German general population. Methods: Participants completed the International Trauma Questionnaire (ITQ) to identify participants with CPTSD, as well as questionnaires on mental health treatment uptake and satisfaction, adverse childhood experiences, anxiety, depression, working ability, personality functioning, and epistemic trust. Results: Of the included n = 1918 participants, n = 29 (1.5%) fulfilled the criteria for CPTSD. Participants with CPTSD had received mental health treatment significantly more often than participants with PTSD or depression (65.5% vs. 58.8% vs. 31.6%; p = 0.031) but reported significantly less symptom improvement (52.9% vs. 78.0% vs. 80.0%; p = 0.008). Lower levels of epistemic trust were associated with higher CPTSD symptoms (p < 0.001). Conclusions: Our study shows that while the vast majority of individuals with CPTSD had received mental health treatment, subjective symptom improvement rates are not satisfactory. CPTSD was associated with a broad number of comorbidities and impairments in functioning. Lower levels of epistemic trust may partially explain worse treatment outcomes.

The Association Between Cardiometabolic Risk and Cognitive Function Among Older Americans and Chinese.

Cardiometabolic risk (CMR) is associated with cognitive health, but the association can be affected by broader social, economic, and medical contexts. The United States and China have very different developmental and epidemiological histories, and thus CMR among older people could be linked to cognitive function differently in the 2 countries. Cross-sectional and longitudinal ordinary least squares regression models were estimated for each country using nationally representative samples of populations over age 50: 7430/4474 Americans and 6108/3655 Chinese in the cross-sectional/longitudinal samples. In the United States, higher CMR is associated with worse cognitive function (b = -0.08, p < .016). Longitudinally, CMR increase is associated with worse cognitive function at a marginally significant level (b = -0.10, p = .055). No relationship between CMR level or change and cognitive function is observed in China. Higher education levels are linked to better cognitive function and slower cognitive decline in both countries. Unlike older Americans, relative to those with very low education levels, among older Chinese with the highest education level, a higher CMR links to better cognitive function (b = 0.63, p = .013) and slower cognitive decline (b = 0.35, p = .062); Nevertheless, a rapid increase in CMR is additionally harmful (b = -0.54, p = .050) for cognitive function and may lead to faster cognitive decline (b = -0.35, p = .079). The significant relationship between CMR and cognitive function in the United States suggests the importance of monitoring and controlling CMR factors at older ages. The insignificant relationship in China may be explained by the high CMR among those with high education levels, highlighting the need for improving cardiometabolic health through education and promoting healthy lifestyles.

Differential associations between Quantity, content, and context of screen time, and Children's health-related quality of life: A two-wave study

Existing literature suggests that lengthy durations of screen time (ST) are associated with lower levels of health-related quality of life (HRQoL) and other negative outcomes in children. Nonetheless, the current available evidence largely relies on cross-sectional studies. In addition, data on the content and context (parent–child co-use and solitary use) of ST are scarce. We set out to conduct a one-year, two-wave longitudinal study to investigate the association between exposure to different types of ST and HRQoL among primary school children in Hong Kong, from 2021 to 2022. A population representative random sample (N = 1428) participated in the study. Results from pooled ordinary least squares regressions showed children's ST duration was significantly associated with worse HRQoL (β = −1.101, p < 0.0001). However, interactions of ST content and context, including parent–child co-use × TV viewing (β = 1.305, p < 0.0001), parent–child co-use × video gaming (β = 0.280, p < 0.0001), solitary use × video gaming (β = 0.198, p < 0.0001), and solitary use × social media use (β = 0.454, p < 0.0001) were significantly associated with better HRQoL. Our findings suggest that increased overall durations of ST are associated with worse HRQoL in children, but this association is impacted by the types of ST content and context.

A Feasible Estimation of a “Corrected” EQ-5D Social Tariff

ObjectivesTo demonstrate the feasibility of estimating a social tariff free of utility curvature and probability weighting biases and to test transferability between riskless and risky contexts. MethodsValuations for a selection of EQ-5D-3L health states were collected from a large and representative sample (N = 1676) of the Spanish general population through computer-assisted personal interviewing. Two elicitation methods were used: the traditional time trade-off (TTO) and a novel risky-TTO procedure. Both methods are equivalent for better than death states, which allowed us to test transferability of utilities across riskless and risky contexts. Corrective procedures applied are based on rank-dependent utility theory, identifying parameter estimates at the individual level. All corrections are health-state specific, which is a unique feature of our corrective approach. ResultsTwo corrected value sets for the EQ-5D-3L system are estimated, highlighting the feasibility of developing national tariffs under nonexpected utility theories, such as rank-dependent utility. Furthermore, transferability was not supported for at least half of the health states valued by our sample. ConclusionsIt is feasible to estimate a social tariff by using interviewing techniques, sample sizes, and sample representativeness equivalent to prior studies designed to generate national value sets for the EQ-5D. Utilities obtained in distinct contexts may not be interchangeable. Our findings caution against routinely taking transferability of utility for granted.

MISSION 70/26 HAS SUCCESSFULLY STARTED IN CROATIA. DO YOU KNOW YOUR NUMBERS?

Objective: Approximatively 50% of Croatia's adult population suffers from arterial hypertension (AH). One-fifth of patients do not know that they have AH, and control has been achieved in less than 50% of treated patients. It is our aim to achieve controlled values of blood pressure (BP) in 70% of treated patients with AH by 2026. This mission is part of the permanent campaign of the Croatian Hypertension League called “The Hunt for the Silent Killer”. Design and method: The whole mission is devoted to increase health literacy in both health care workers and in general population (including patients with AH). Results: For the general population we will organize: 1) classical public-health activities; BP will be measured and educative materials will be distributed at the public places; 2) using Croatian Hypertensive League educative web platform (Hunting the Silent Killer) and social networks; and 3) via different media (Vecernji list, the biggest daily newspaper in Croatia is partner of the League). For health care workers 1) school for communication in hypertension; 2) monthly newsletters with information about therapeutic inertia, promotion of health literacy, and education on treatment persistence. For this purpose, we have developed special educative sub-portal 70/26. All healthcare workers will be invited to visit our scientific educative web portal Healthmed with plenty of recent information on cardio-kidney-metabolic syndrome where members of the editorial board are key opinion leaders in hypertension, nephrology, cardiology, neurology, diabetology and family physicians. In parallel with hypertension we will analyze success in treatment of dyslipidemia in our sister mission “Do you know your numbers?” Conclusions: At the end of this program, we are going to organize a nationwide study (EHUH 3) where a representative sample of random adult population will be enrolled. In this study we will use the same methodology as in recently ended nationwide EHUH 2 study where we obtained current information on hypertension and dyslipidemia prevalence, awareness, treatment and control. Using the same methods we will be able to make conclusion about our success following evidence-based medicine postulates. Acknowledgement: This program is supported by a grant from Servier.

PREVALENCE, AWARENESS, TREATMENT AND CONTROL OF DYSLIPIDEMIA (LDL-CHOLESTEROL &gt; 3.0 MMOL/L) IN CROATIA – EHUH 2 STUDY PRELIMINARY REPORT

Objective: Cardiovascular mortality is leading cause of death in Croatia. Beside hypertension, high prevalence and poor control of dyslipidemia is the main cause for this shameful medical failure. Our aim was to analyze prevalence, awareness, treatment and control of dyslipidemia (defined here as LDL cholesterol &gt; 3.0 mmol/l) in general adult population. Design and method: EHUH-2 study is nationwide study in which representative random sample of adult population was enrolled. Structured questionnaire was applied, subjects were clinically examined, fasting blood was drawn and urine samples were collected. In this preliminary analyses from the EHUH-2 study we are reporting data collected from 1313 subjects. Results: Prevalence and awareness on high dyslipidemia were non-significantly higher in women than men (65.6% vs 63.4%; 34.6 vs 33.7%). On contrary, treatment and control were higher in men than in women (29.0% vs 24.1%, 88.4% vs 77.7.%; p&lt; 0.05). Dyslipidemia was treated in only 25.2%, 29.9% and 33% patients with diabetes, hypertension and chronic kidney disease, respectively. In treated and controlled hypertensive patients, targets of LDL cholesterol were achieved in only 30.2% pointing on poor adherence to statin therapy. In untreated hypertensive patients dyslipidemia was treated in only 16.3% indicating on common clinical inertia. We observed significant differences in the prevalence, treatment, and control of dyslipidemia between urban and rural areas (58.7% vs. 74.5%, 29% vs. 19.7%, 25.6% vs, 14.4%, respectively, all p&lt;0.001). Conclusions: Dyslipidemia (LDL &gt; 3.0 mmol/l) is highly prevalent in Croatia. Poor control (less than 30% in high risk population) is mostly due to poor adherence and clinical inertia. Rural population has higher prevalence and lower rates of treatment and control. Medical scientific community including public health experts and health care providers have to work harder at first place increasing health literacy which will hopefully improve adherence and diminish clinical inertia. Special focus should be on remote areas where medical care is lacking.

A cross- sectional study to assess medication safety, knowledge, attitude, and practices regarding nutrition and medication among pregnant women

Objective: To assess pregnant women's knowledge, attitude, and practice regarding nutrition and medication usage, analyse the prescribing pattern, and categorize them based on the Food and Drug Administration (FDA) guidelines. Methods: A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023. A knowledge, attitude, and practice (KAP) questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members. The validated questionnaire was then translated into regional languages, Kannada and Malayalam. The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects (10 subjects for each language). The subjects' knowledge, attitude, and practice were evaluated using the validated KAP questionnaire. The safety of the medication was assessed using the FDA drug safety classification for pregnancy. Results: The mean scores for nutritional and medication usage knowledge, attitude, and practice were 4.14±1.15, 4.50±1.09, and 3.00±1.47, respectively. Among 30 prescribed medications, 3 belong to category A (no risk in human studies), 8 belong to category B (no risk in animal studies), 18 belong to category C (risk cannot be ruled out) and 1 drug is not classified. A significant association was observed between medication knowledge and practice (r=0.159, P=0.010). Conclusions: Most of the study population knows the need to maintain good dietary and medication practices during pregnancy. Counselling pregnant women regarding diet and medication usage is crucial in maternal care.

Assessing structural models of neighborhood and family sociodemographic characteristics and their relations with externalizing psychopathology.

Externalizing psychopathology has been found to have small to moderate associations with neighborhood and family sociodemographic characteristics. However, prior studies may have used suboptimal operationalizations of neighborhood sociodemographic characteristics and externalizing psychopathology, potentially misestimating relations between these constructs. To address these limitations, in the current study we test different measurement models of these constructs and assess the structural relations between them. Using a population-representative sample of 2,195 twins and siblings from the Georgia Twin Study and data from the National Neighborhood Data Archive and 2000 U.S. Census, we assessed the fit of competing measurement models for family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics. In structural models, we regressed a general externalizing dimension on different operationalizations of these variables separately and then simultaneously in a final model. Latent variable operationalizations of family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics explained no more variance in broad externalizing psychopathology than other operationalizations. In an omnibus model, family sociodemographic characteristics showed a small association with externalizing psychopathology, while neighborhood sociodemographic and environmental characteristics did not. Family sociodemographic characteristics showed small associations with neighborhood sociodemographic and environmental characteristics, and neighborhood sociodemographic characteristics were moderately associated with neighborhood environment. These findings suggest that family sociodemographic characteristics are more associated with the development of broad externalizing psychopathology in youth than neighborhood sociodemographic characteristics and neighborhood environment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Projections of functional dependence among the late middle-aged and older population from 2018-2048 in China: a dynamic microsimulation

BackgroundThe population of China is aging rapidly. However, the long-term trajectories of functionally dependent late middle-aged and older Chinese people are currently absent. The present study aimed to estimate the population size and proportion of late middle-aged and older adults with difficulties and dependence on activities of daily living (ADL) and instrumental activities of daily living (IADL) in China from 2018 to 2048.MethodsWe constructed a dynamic microsimulation model to project the population size and proportions of late middle-aged and older Chinese people who have difficulty and dependence in ADL and IADL from 2018-2048. The model was populated with a representative sample of the target population and allowed individual-level interaction between risk factors, diseases, and health outcomes. Analyses by socioeconomic subgroups were also conducted.ResultsAlmost 25% and 38% of late middle-aged and older people in China will become ADL- and IADL-dependent by 2048, respectively. Also, 17% of the target population will be severely ADL-disabled by 2048. The inequity in functional status across subgroups by sex, educational level, and urban/rural residency will become substantial.ConclusionsThe numbers and percentages of China's functionally difficult and dependent late middle-aged and older population will increase by magnitudes as of the mid-21st century, the pressure of which is compounded by its disproportionate distribution across subgroups. To alleviate the overwhelming challenge, efforts to improve the functional status of the underserved subpopulation should also be iterated.

Harmonizing Human-AI Synergy in Smart Cities: Exploring Emotion Understanding and Technology Anxiety in an Asian Context

Artificial Superintelligence (ASI) envisions AI surpassing human cognitive abilities, mimicking and developing its own thinking skills. However, this raises ethical and control issues, emphasizing the need for robust regulations in AI development. The prime objective of the study is to align aligning human intelligence with artificial superintelligence in smart cities. Particularly, the study has examined the mediating role of emotion-understanding ability, and the technology anxiety between AI and shared decision-making. This study investigates the relationship between emotional intelligence and decision-making in the Khon Kaen Smart City, Thailand. Data was collected from various financial institutions, including community and commercial banks, and managers working in the city. The largest and most developed province served as the primary focus of the study, and area cluster sampling was employed to obtain a representative sample of the province's varied population. A total of 297 out of the 700 questionnaires that were given to the seven different groups for the survey were filled out. Shared Decision-Making (SDM) and Emotion-Understanding Ability (EUA) were found to have a strong correlation in the study, which highlights the importance of emotional intelligence in decision-making due to the strong correlation between the two. This comprehension is especially helpful when artificial intelligence is used to improve decision-making processes. This highlights the significance of human factors, such as comprehension and emotion, in the process of developing effective decision-making framework.

Associations between short-term exposure to air pollution and thyroid function in a representative sample of the Korean population

BackgroundDisruption of thyroid function can profoundly affect various organ systems. However, studies on the association between air pollution and thyroid function are relatively scarce and most studies have focused on the long-term effects of air pollution among pregnant women. ObjectivesThis study aimed to explore the associations between short-term exposure to air pollution and thyroid function in the general population. MethodsData from the Korea National Health and Nutrition Examination Survey (2013–2015) were analyzed (n = 5,626). Air pollution concentrations in residential addresses were estimated using Community Multiscale Air Quality models. The moving averages of air pollution over 7 days were set as exposure variables through exploratory analyses. Linear regression and quantile g-computation models were constructed to assess the effects of individual air pollutants and air pollution mixture, respectively. ResultsA 10-ppb increase in NO2 (18.8-μg/m3 increase) and CO (11.5-μg/m3 increase) was associated with 2.43% [95% confidence interval (CI): 0.42, 4.48] and 0.19% (95% CI: 0.01, 0.36) higher thyroid-stimulating hormone (TSH) levels, respectively. A 10-μg/m3 increase in PM2.5 and a 10-ppb increase in O3 (19.6-μg/m3 increment) were associated with 0.87% (95% CI: 1.47, −0.27) and 0.59% (95% CI: 1.18, −0.001) lower free thyroxine (fT4) levels, respectively. A simultaneous quartile increase in PM2.5, NO2, O3, and CO levels was associated with lower fT4 but not TSH levels. ConclusionsAs the subtle changes in thyroid function can affect various organ systems, the present results may have substantial public health implications despite the relatively modest effect sizes. Because this was a cross-sectional study, it is necessary to conduct further experimental or repeated-measures studies to consolidate the current results.

The COVID-19 Pandemic: A Catalyst for Increased Consumption in Television and Social Media Usage in Romania

The general perception is that the COVID-19 pandemic led to significant shifts in social media usage patterns, resulting in increased Internet traffic for communication purposes. This study analyses the use of social media and television by the Romanian population before (in 2018), during (in 2020), and after (in 2023) the COVID-19 lockdown. The results indicate that during and after the lockdown, the most frequently used social networking sites and mobile apps in Romania were Facebook and WhatsApp. TikTok experienced a significant increase in user registrations, surpassing Instagram. Despite the presumption that TV lost market share compared to the Internet, television not only remained the most utilised medium, but TV consumption increased during and after the pandemic. The data was collected by the media agency Dentsu Romania, combining information obtained from BRAT (Biroul Român de Audit Transmedia) and Dentsu Romania, based on a collection methodology involving online and face-to-face interviews, on a representative sample of the Romanian population. BRAT and Dentsu Romania media consumption data was cross-referenced with information on consumption behaviour monitored through people meters by ARMA (Asociația Română pentru Măsurarea Audiențelor).

Evolving Altruistic Attitudes towards Vaccination Post COVID-19 Pandemic: A Comparative Analysis across Age Groups.

Altruism plays an essential role in promoting vaccine uptake, an issue that came to the fore during the COVID-19 pandemic through discussions of herd immunity and altruistic motivations. In response, the primary objective of this cross-sectional survey was to explore how altruistic attitudes have evolved in the post-pandemic era and to assess their effectiveness in motivating vaccination behavior in different age groups. The study aimed to elucidate changes in altruistic motivations for vaccination and their implications for public health strategies. Using a representative sample of the adult population of South Tyrol, Italy, including 1388 participants, altruism was assessed in 2023 with the scales of the Elderly Care Research Center (ECRC) and the International Personality Item Pool (IPIP) subscale of the version 5F30F-R1. Its association with demographic variables, vaccination attitudes and personal beliefs in two age groups (18-69 years, 70+ years) was analyzed. The results reveal distinct predictors of altruism across these scales and age groups, suggesting a shift in altruistic attitudes towards vaccination when comparing data from a similar survey conducted in 2021 with the 2023 results. Consequently, the use of altruism scales for different age groups is warranted. This study highlights the need for further research in this field. It concludes that while promoting altruistic behavior to increase vaccine uptake appears to be effective primarily among the younger population, emphasizing personal safety is more appropriate for encouraging vaccination among older individuals.

Psychometric evaluation of the patient health questionnaire stress scale

The “Patient Health Questionnaire (PHQ)” is a screening instrument, designed for time-efficient detection and severity assessment of depression, anxiety, and other syndromes in medical settings. Besides the questions on psychological symptoms, there are items on psychosocial functioning, on stressors and critical life events. However, for the stress items there are no psychometric properties available until now. The present study is thought to investigate item characteristics, internal consistency as well as factorial and construct validity of the stress scale of the PHQ. A representative sample of the general population of Germany was collected by a demography consulting company (USUMA, Berlin). Per random-route procedure, households and members of the households were selected. The sample was representative for the German community regarding age, gender, and education. In this investigation the following questionnaires were administered: PHQ-Stress, Questions on Life Satisfaction Modules (FLZ-M), Type-D Scale-14 (DS14). The sample included N = 2396 participants with mean age of 48.50 (SD = 17.75; range = 14 to 92) and 55.2 % being female. Reliability of the PHQ stress scale was acceptable (ω = 0.776), but some factor loadings were comparatively low. Model fit indices showed mixed results, some indicating unacceptable and some indicating acceptable fit of the 10-item stress scale of the PHQ. Correlations with related constructs demonstrated the scale's convergent validity. The results of this validation study indicate that the PHQ stress scale, which provides a one-dimensional total stress score, is a valid, good practical and reliable self-report instrument for assessing the severity of psychosocial stress.

Assessing health-related quality of life of Chinese population using CQ-11D

PurposeThis study aimed to assess the health-related quality of life (HRQoL) of the Chinese population by using the Chinese medicine quality of life-11 dimensions (CQ-11D) questionnaire and to identify factors associated with HRQoL.MethodsThe data was derived from a survey conducted by the Institute of Pharmacoeconomics Evaluation at Beijing University of Chinese Medicine on the quality of life of the Chinese population. The sex and age of respondents were considered through quota sampling. Demographic, socioeconomic, and health indicators were collected using the structured questionnaire. We performed bivariate analyses first to examine the associations between the above factors and the HRQoL of respondents measured by the CQ-11D. Multivariate linear regression and ordinal logistic regression models were established to analyze the factors (demographic, socioeconomic, and health indicators) differences in HRQoL, as well as the risk of each group reporting problems across the 11 dimensions of CQ-11D.ResultsFrom February 2021 to November 2022, a total of 7,604 respondents were involved and 7,498 respondents were included. The sample approximated the general adult Chinese population in terms of age, sex, and district of residence, and each geographic distribution ranged from 9.71 to 25.54%. Of the respondents, 45.84% were male, and 89.82% were Han ethnicity. The mean utility score ranged from 0.796 to 0.921 as age increased. According to the respondents, most health problems were identified in the PL (fatigue) (70.16%) and SM (quality of sleep) (63.63%) dimensions. The CQ-11D index scores varied with the demographic and socioeconomic characteristics of respondents, except for ethnicity (p > 0.05) and income (p > 0.05). The multivariate analysis revealed significant negative associations between health utility scores and various factors. These factors include sex (female), age over 65, belonging to ethnic minorities, rural household registration, being widowed or divorced, having a primary school education or below, being a student or unemployed, having a low income of 0–1,300, engaging in smoking or drinking, limited participation in physical activities, experiencing changes in self-perceived health status compared to the previous year, and having chronic diseases. The odds of respondents reporting problems in 11 dimensions varied among different socio-demographic groups.ConclusionsThis study reports the first Chinese population norms for the CQ-11D derived using a representative sample of the Chinese general population. Self-reported health status measured by the CQ-11D varies among different socio-economic groups. In addition to participation a physical activity and the presence of chronic disease, smoking and drinking also significantly influence HRQoL.

User Attitudes to Content Moderation in Web Search

Internet users highly rely on and trust web search engines, such as Google, to find relevant information online. However, scholars have documented numerous biases and inaccuracies in search outputs. To improve the quality of search results, search engines employ various content moderation practices such as interface elements informing users about potentially dangerous websites and algorithmic mechanisms for downgrading or removing low-quality search results. While the reliance of the public on web search engines and their use of moderation practices is well-established, user attitudes towards these practices have not yet been explored in detail. To address this gap, we first conducted an overview of content moderation practices used by search engines, and then surveyed a representative sample of the US adult population (N=398) to examine the levels of support for different moderation practices applied to potentially misleading and/or potentially offensive content in web search. We also analyzed the relationship between user characteristics and their support for specific moderation practices. We find that the most supported practice is informing users about potentially misleading or offensive content, and the least supported one is the complete removal of search results. More conservative users and users with lower levels of trust in web search results are more likely to be against content moderation in web search.

Factors associated with high and low mental well-being in Spanish university students

BackgroundPrevious studies conducted in various nationally representative samples of the general population show that positive mental health is related to social prosperity. However, specific studies in university populations are scarce. In this study, we set out to explore factors associated with mental well-being (MWB) in a representative sample of first-year university students in Spain. MethodsMWB was assessed with the short version of the Warwick-Edinburgh Mental Well-Being Scale. Multinomial logistic regressions were performed to explore the association between different blocks of factors, including relational, adversity, stress, lifestyle, spiritual, health, and self-perceived health variables with high and low MWB, controlling for sociodemographic and university-related variables. ResultsData from 2082 students (18.6 ± 1.2 years; 56.6 % females) were analysed. Being male, being born in a foreign country, “high” self-perceived support, and “high” self-perceived mental health increased the odds of high MWB. Growing up in the suburbs, stressful experiences, and anxiety disorders reduced the odds of high MWB. Mood and anxiety disorders increased the odds of low MWB. “Middle” self-perceived support, sleeping ≥8 h per day, and “high” self-perceived mental health reduced the odds of low MWB. LimitationsThe cross-sectional design precludes establishing causal relationships. Data were collected in the 2014–15 academic year using self-reported online surveys. ConclusionThe factors associated with high and low MWB do not always mirror each other, so specific plans are needed to successfully address each of the two poles. Interventions and policies targeting these factors for health promotion and disease prevention would improve the MWB of university students.