Population Sample Research Articles

IMMU-56. THE TIGIT/CD155 AXIS PLAYS A CRITICAL ROLE IN EXTRACELLULAR VESICLE-MEDIATED PROGRAMMING OF THE GLIOBLASTOMA MICROENVIRONMENT

Abstract Glioblastoma (GBM), the most common and deadly primary brain tumor, exerts profound local and systemic immunosuppressive effects through a variety of mechanisms. Tumor-derived extracellular vesicles (EVs) are increasingly appreciated as critical mediators of these effects. In surveying the tumor-immune microenvironment in samples of ultrasonic aspirate collected during surgical resection of GBM (n=13), we identified several key immunomodulatory markers expressed across a range of myeloid cell populations. Particularly, we found TIGIT, classically understood as a T cell inhibitory protein, expressed across a range of myeloid cell populations in patient samples, including in myeloid-derived suppressor cells (MDSCs, 46.84±16.78% of total monocytic MDSCs). Using EVs collected from patient-derived cell lines, we were able to recapitulate these effects upon co-culture with monocytes derived from the peripheral blood of healthy donors (n=7). Furthermore, Induced MDSCs significantly inhibit T cells proliferation (70.97±8.454%, compared to control 19.4±5.71; p<0.03), concomitant with a surge in Th2 immune responses via TIGIT/CD155 axis. This effect was reversed after TIGIT silencing, indicating a TIGIT-dependent immune suppression in the GBM microenvironment. Our study indicates EV-induced TIGIT upregulation in myeloid cells as a crucial immunosuppressive mechanism in glioblastoma, with potential therapeutic applications.

Screening for Atrial Fibrillation During Routine Automated Blood Pressure Measurement in General Population Aged 65 Years and Above: EMENO National Epidemiological Survey in Greece.

Atrial fibrillation (AF) is common with advanced aging and is often asymptomatic and undiagnosed. A blood pressure (BP) monitor with embedded algorithm for detecting AF with high diagnostic accuracy during routine automated BP measurement was used to screen individuals aged ≥ 65 years. The EMENO health survey (2013-2016) applied a multi-stage stratified random sampling method to select a random general adult population sample in Greece. Participants aged ≥ 65 years were screened for AF using an automated oscillometric device with AF detecting algorithm (Microlife BPA100 Plus AFIB) with triplicate measurements on a single occasion. A total of 975 individuals with AF data on at least one BP measurement were analysed [(mean (SD) age 73.2 (6.6) years, men 45%, hypertensives 79.3%). AF was detected in all 3 BP readings in 65 individuals (6.3%, AF group), in none of 3 readings in 661 (73.6%, non-AF group), and in 1-2 readings of 3 or less readings in 249 (20.1%, uncertain AF group). AF group individuals were older (p < 0.001), had lower systolic BP (p < 0.05) and more frequent cardiovascular disease (p < 0.01) compared to the non-AF and uncertain AF group. Moreover, 44.6% were unaware of their AF and all required anticoagulant therapy (CHA2DS2-VASc ≥ 1/≥2, men/women). About 6% of individuals aged ≥ 65 years in Greece appeared to have AF, and 44.6% of them were unaware and requiring anticoagulant treatment. AF screening during routine automated BP measurement appears to be a useful tool for early detection of asymptomatic AF in individuals aged ≥ 65 years.

2001-2021 Comparative Persistence of Oral Antipsychotics in Patients Initiating Treatment: Superiority of Clozapine in Time-to-Treatment Discontinuation.

Continuous antipsychotic (AP) therapy is crucial for managing psychotic disorders, and its early interruption reflects the drug's failure. Real-world epidemiological research is essential for confirming experimental data and generating new research hypotheses. The persistence of oral APs in a large population sample from 2000 to 2021 was analyzed by comparing AP prescriptions over this period across four Italian provinces, using dispensing data linked via a record-linkage procedure among regional healthcare utilization databases. We calculated personalized daily dosages and assessed time-to-treatment discontinuation over a 3-month period for patients initiating AP treatment. Treatment persistence was evaluated using Kaplan-Meier curves and Cox regression, with adjustments for age and sex. Second-generation antipsychotics (SGAs) were favored over first-generation antipsychotics (FGAs), with olanzapine as the most prescribed. Within the study time frame, 42,434 individuals were prescribed a new continuous AP regimen. The analysis revealed 24 significant differences within 28 comparisons. As a class, SGAs demonstrated better treatment persistence than FGAs (HR: 0.76; 95%CI: 0.73, 0.79). Clozapine stood out for its superior persistence, surpassing all other SGAs, notably olanzapine (HR: 0.85; 95%CI: 0.79-0.91) and risperidone (HR: 0.80; 95%CI: 0.74-0.87). Olanzapine and aripiprazole showed better results than both risperidone and quetiapine. Quetiapine showed inferior 3-month persistence in all pairwise comparisons. The study results provide insight into the performance dynamics among SGAs: clozapine, despite being one of the less frequently dispensed APs in our sample, emerged as a significant prescription choice. The significance of pharmacoepidemiological studies in complementing experimental findings is also underscored.

Personal and Clinical Predictors of Voice Therapy Outcomes: A Machine Learning Analysis Using the Voice Handicap Index

In this study, we examine the predictive factors influencing the outcomes of voice treatment in patients with voice-related disorders, using the voice handicap index (VHI) as a key assessment tool. By analyzing various personal habits and clinical variables, we identify the primary factors associated with changes when comparing VHI scores before and after voice treatment. For this research, we employed binomial logistic regression, random forest (RF), and a multilayer perceptron (MLP) model to evaluate the effectiveness of voice treatment. The findings reveal that gender (with female patients showing greater improvements in VHI scores compared to male patients), surgical history, voice use status, and voice training status are significant predictors of therapy outcomes. The MLP model demonstrated high accuracy, sensitivity, and specificity, with an area under the curve (AUC) value of 0.87 indicating its potential as a valuable clinical predictive tool; however, the model’s relatively low specificity suggests the need for further refinement to enhance its predictive accuracy. The results of this study provide valuable insights for clinicians and speech–language pathologists in developing personalized treatment strategies to optimize the effectiveness of voice therapy. Future research should prioritize the validation of these findings in larger and more diverse population samples. Furthermore, it is essential to explore additional predictive variables in order to enhance the model’s accuracy across different types of voice disorders.

Motivations in transition: destination choices of inter-provincial migration among Chinese older adults

AbstractDespite the growing interest in the migration of older adults in China, the intricacies linking migration motivations with destination choices remain insufficiently explored. Drawing from China’s unique context, we categorize inter-provincial older migrants into three types: employment-led, dependent, and lifestyle. Using microdata from the Sixth Population Census of 2010 and the 1% Population Sampling Survey of 2015, we examine their evolving motivations and corresponding shifts in destination preferences. The analysis shows an increase in lifestyle-oriented migration and a decrease in dependent migration, while employment-led migration has remained stable relative to the total. Older migrants seeking employment tend to favor destinations further south, prioritizing regional economic conditions. In contrast, those motivated by lifestyle factors exhibit a broader range of destination choices, largely due to their preference for amenities. Dependent older adult migrants consider both job-related and amenity-related factors and demonstrate a stronger tendency to relocate to the east. Amenity-related factors have increasingly influenced the destination choices across all three types of migration over time. Our findings provide deeper insights into the intricacies of migration in old adulthood and highlight the need for tailored policymaking.

Health Risk Assessment Using Machine Learning: Systematic Review

According to the World Health Organization, chronic illnesses account for over 70% of deaths globally, underscoring the need for effective health risk assessment (HRA). While machine learning (ML) has shown potential in enhancing HRA, no systematic review has explored its application in general health risk assessments. Existing reviews typically focus on specific conditions. This paper reviews published articles that utilize ML for HRA, and it aims to identify the model development methods. A systematic review following Tranfield et al.’s three-stage approach was conducted, and it adhered to the PRISMA protocol. The literature was sourced from five databases, including PubMed. Of the included articles, 42% (11/26) addressed general health risks. Secondary data sources were most common (14/26, 53.85%), while primary data were used in eleven studies, with nine (81.81%) using data from a specific population. Random forest was the most popular algorithm, which was used in nine studies (34.62%). Notably, twelve studies implemented multiple algorithms, while seven studies incorporated model interpretability techniques. Although these studies have shown promise in addressing digital health inequities, more research is needed to include diverse sample populations, particularly from underserved communities, to enhance the generalizability of existing models. Furthermore, model interpretability should be prioritized to ensure transparent, trustworthy, and broadly applicable healthcare solutions.

Geometric morphometric approach to dental health in an 18th‐ to 19th‐century English infirmary

AbstractThis study evaluated correlations between poor dental health and craniomandibular morphology for the Radcliffe Infirmary population buried between 1770 and 1855. The Radcliffe Infirmary is situated in Oxford, 90 km northwest of London, in what used to be a rural area. The original report for this population observed high prevalence rates of dental caries, antemortem tooth loss (AMTL), and periodontal disease. Industrial societies are acknowledged to have highly processed foods that not only are detrimental to dental health but also require less mastication. This softening of diet is suggested to be the leading influence on the modern morphology of the skull. By using two‐dimensional geometric morphometrics (GM) and linear measurements of the skull, the Radcliffe population was evaluated for the effects of poor dental health and decreased wear on the masticatory structures. High frequencies of AMTL, periodontal disease, and caries and low amounts of dental wear were observed in this sample population. Caries and AMTL showed weak correlations with skull shape and craniomandibular dimensions according to the results of the morphometric analysis and Kendall's tau. Dental wear correlated with a wide bizygomatic breadth and a long narrow skull shape for the males only. Periodontal disease was the only dental health variable not correlated with shape or size. This study confirmed that the Radcliffe population ate a cariogenic diet and suggests that dental wear and pathology weakly correlates with craniomandibular shape and size. This unpredicted finding may be due to the limitations of two‐dimensional shape analysis, a small sample size, and the sampling strategy. Future research is highly encouraged to better understand the consequences of poor dental health for skull morphology.

Choice between DNA primer sets (A or B) of the ForenSeq kit: forensic evaluation in a Mexican admixed population sample.

Massively parallel sequencing (MPS) overcomes many PCR-CE limitations to analyze STRs and allow simultaneous inclusion of SNPs in forensic cases. By MPS, the ForenSeq™ DNA Signature Prep kit analyzes 27 aSTRs, 7 X-STRs, 24Y-STRs, and 94 identity-informative SNPs (iiSNPs) with the DNA Primer Set-A (DPS-A). Optionally, the DNA Primer Set-B (DPS-B) adds to the analysis 56 ancestry-informative SNPs (aiSNPs) and 24 phenotype-informative SNPs (piSNPs), but diminishes from 96 to 32 the number of samples per sequencing run. We assessed the forensic informativity provided by the loci analyzed by these two DPS in admixed individuals from Mexico City (Center, Mexico). For STRs, we report length-based (LB) and sequence-based (SB) allele frequencies and forensic parameters of the 152 identity informative markers (DPS-A). For aSTRs, the combined PD of SB genotypes (PD ~ 100%) was ~ 2949 times larger than that from LB. Conversely, the observed phenotype distribution offered low PD levels (PD = 6.6% and 10.4%), whereas piSNPs predicted accurately only the modal brown eye and dark hair colors, respectively. Similarly, aiSNPs detected a large prevalence of admixed individuals (97.3%; PD = 5.4%). Although few individuals were inferred as Europeans and Native Americans (1.37% each), they were self-declared as admixed, which result confusing for HID purposes. In brief, SB genotypes increased significantly the informativity of STRs to solve complex cases (DPS-A), whereas aiSNPs and piSNPs added mostly irrelevant information (DPS-B). We provide useful cost-benefit criteria in one Latin American population to choose DPS-A (96 samples) instead of DPS-B (32 samples) of the Forenseq kit.

Associations of schizophrenia with arrhythmic disorders and electrocardiogram traits: genetic exploration of population samples.

An important contributor to the decreased life expectancy of individuals with schizophrenia is sudden cardiac death. Arrhythmic disorders may play an important role herein, but the nature of the relationship between schizophrenia and arrhythmia is unclear. To assess shared genetic liability and potential causal effects between schizophrenia and arrhythmic disorders and electrocardiogram (ECG) traits. We leveraged summary-level data of large-scale genome-wide association studies of schizophrenia (53 386 cases, 77 258 controls), arrhythmic disorders (atrial fibrillation, 55 114 cases, 482 295 controls; Brugada syndrome, 2820 cases, 10 001 controls) and ECG traits (heart rate (variability), PR interval, QT interval, JT interval and QRS duration, n = 46 952-293 051). We examined shared genetic liability by assessing global and local genetic correlations and conducting functional annotation. Bidirectional causal relations between schizophrenia and arrhythmic disorders and ECG traits were explored using Mendelian randomisation. There was no evidence for global genetic correlation, except between schizophrenia and Brugada syndrome (rg = 0.14, 95% CIs = 0.06-0.22, P = 4.0E-04). In contrast, strong positive and negative local correlations between schizophrenia and all cardiac traits were found across the genome. In the most strongly associated regions, genes related to immune and viral response mechanisms were overrepresented. Mendelian randomisation indicated that liability to schizophrenia causally increases Brugada syndrome risk (beta = 0.14, CIs = 0.03-0.25, P = 0.009) and heart rate during activity (beta = 0.25, CIs = 0.05-0.45, P = 0.015). Despite little evidence for global genetic correlation, specific genomic regions and biological pathways emerged that are important for both schizophrenia and arrhythmia. The putative causal effect of liability to schizophrenia on Brugada syndrome warrants increased cardiac monitoring and early medical intervention in people with schizophrenia.

Employee Dedication and Performance of Deposit-Taking SACCOs in Nairobi, Kenya

Employees well-being and satisfaction need to be the precedence of any successful organization that is aimed at achieving its objectives and customer satisfaction. Thus, the paper sought to scrutinize the connections among staff dedication and performance of deposit-taking Sacco’s in Nairobi, Kenya. The study adopted a cross-sectional census survey of forty-six (46) deposit -taking Sacco’s in Nairobi. Research data was gathered through a questionnaire in a descriptive design. The study utilized purposive sampling technique for the sample population. Reliability and validity of the variables was tested in a pilot study of three (3) deposit-taking Saccos in western part of Kenya. The data analysis was done by means of descriptive and inferential statistics as reinforced by Statistical Package for Social Sciences (SPSS). The research hypothesis was tested by means of regression analysis. The findings (R2 - 0.394; p-value=0.000) indicate that employee dedication has a significant impact on the performance of DT-Saccos in Nairobi, Kenya. The research has shown that staff dedication could pose a positive consequence on organizational performance. The study recommends that the senior managers of DT - Saccos should focus more on promoting labour dedication through effective communication, information sharing, employee participation in decision-making, transparent and accountable management and recognition of sterling personal achievement as they have been identified to affect organizational performance.

Psychometric validation of the French version of two scales measuring general (HLS19-Q12) and navigational (HLS19-NAV) health literacy using the Rasch model

BackgroundTo examine the psychometrics properties of the French version of two scales measuring general (HLS19-Q12) and navigational (HLS19-NAV) health literacy (HL) using validation methods based on modern psychometric test theories: a Rasch model analysis.MethodsThe data on representative samples of the French adult population came from the Health Literacy Survey (N = 2 003), conducted in France in two waves (2020 and 2021), and from the third wave of SLAVACO study (N = 2 022), conducted in December 2021. A Rasch analysis was performed using a partial credit model with marginal maximum likelihood estimation adapted to polytomous data. Category probability curves were used to examine whether participants found it consistently difficult to distinguish between response options. Differential item functioning (DIF) was also examined for each item in the two scales as a function of age, gender, and economic status. A Person Separation Index (PSI) of 0.7 has conventionally been considered to be the minimum acceptable PSI level. Chi-square fit statistics, expressed as infit and outfit mean square statistics, were calculated for each item in the two scales. An acceptable fit corresponded to average values between 0.7 and 1.3. The dimensionality of the scales was assessed using Principal Components Analysis (PCA) on the residual correlation matrix to identify whether items are locally independent. Additionally, Smith’s method was employed to detect potential multidimensionality.ResultsThe PSI values for both scales were greater than 0.90. No disordered categories were observed. No evidence of significant DIF was found when associated with gender and economic status. However, two items for both scales had a DIF which was dependent on age but did not have a significant impact on scale scores between younger and older people. Minor local dependence was noted on the HLS19-NAV scale. However, a PCA and Smith’s method demonstrated the unidimensionality of the French version of the scales measuring general and navigational HL.ConclusionsOur results, based on a rigorous statistical analysis, verified the psychometric parameters of the French version of the HLS19-Q12 and HLS19-NAV scales. Despite strong correlation between both scales, each measured a different latent trait. Moreover, despite the fact that presence of DIF was weak, attention must nonetheless be paid when comparing scale response scores between young and older respondents.

A DEVICE-BASED (GAITON) SAGITTAL PLANE KINEMATICS ANALYSIS OF LOWER EXTREMITY JOINTS AMONG PATIENTS WITH KNEE OSTEOARTHRITIS – A METHODOLOGICAL APPROACH.

Background: Gait assessment is an effective method for identifying functional limitations associated with knee Osteoarthritis and understanding the relationship between disease symptoms and gait quality. Objective: To evaluate the mean difference in the kinematics of lower extremity joints among patients with knee osteoarthritis. Methods: A total of 20 people living with Knee OA were recruited as of 25th September 2024 in this prospective cross-sectional design study. The eligible participants were conveniently recruited from the SRM physiotherapy OPD based on voluntary participation after signing the informed consent. Adult participants aged 18 years and above, both sexes and able to walk independently without mobility aids were recruited and the joint kinematics were measured using the GaitOn Software, 2-dimensional analysis, and sagittal kinematic parameters of stance phase. Results: The mean age of the patients was 53.6 ± 7.3, and the mean BMI was 29.1±4.6. The one sample t-test demonstrated a statistically significant difference between kinematic angles of the lower extremity joint in sagittal plane of population mean (reference value) and sample mean (measured by GaitOn); Initial contact phase (hip: mean diff -4.06, p&lt;0.01, ankle: mean diff 34.1, p &lt; 0.0001), Loading response (hip: mean diff -5.8. p &lt;0.001, knee: mean diff 9.6, p &lt; 0.001, ankle: mean diff 32.4, p &lt; 0.001). Midstance (hip: mean diff 11.06, p &lt;0.001, ankle: 31.4, p&lt; 0.001). Terminal stance (hip: mean diff 28.3, p&lt; 0.004, ankle: mean diff 31.4, p&lt; 0.001) and Pre-swing (hip: mean diff 16.5, p&lt; 0.001, ankle: mean diff 31.4, p&lt; 0.001). Conclusions: The hip and ankle joints equally share knee kinematic compensations. By acknowledging the complex interactions between the hip, ankle, and knee joints, healthcare providers can develop more comprehensive and effective treatment plans for individuals with knee OA.

Psychometric properties of the German version of the Traumatic Grief Inventory-Self Report Plus (TGI-SR+)

ABSTRACT Background: Prolonged Grief Disorder (PGD) has been recognized as a mental health disorder and was added to the ICD-11 and DSM-5-TR. Despite the same name, both versions of PGD differ in symptom count, content, and diagnostic algorithm. A single instrument to screen for both PGD diagnoses is critical for bereavement research and care. The study aimed to evaluate the psychometric properties of the German version of the Traumatic Grief Inventory Self-Report Plus (TGI-SR+), a self-report measure to assess PGDICD-11 and PGDDSM-5-TR symptoms. Methods: Out of a representative sample of the German general population (N = 2509), 1062 reported a significant loss and completed questions about sociodemographic and loss-related variables, the TGI-SR+, and a measure of health-related quality of life. Results: Item analyses demonstrated good item characteristics. Confirmatory factor analyses showed a good fit for two-factor models for PGDICD-11 and PGDDSM-5-TR. Omega values demonstrated good internal consistency. In support of concurrent validity, symptoms of PGDICD-11 and PGDDSM-5-TR were associated with worse health-related quality of life. In support of known-groups validity, symptoms of PGDICD-11 and PGDDSM-5-TR were significantly higher among women, people with a lower educational level, more recently bereaved, those who lost a spouse or child (vs. other person), and those who lost someone due to unnatural causes (vs. natural causes). ROC analyses showed optimal cut-off scores of ≥60 and ≥65 to screen for probable caseness for PGDICD-11 and PGDDSM-5-TR, respectively. Limitations: The analyses were based on a cross-sectional design, and data on retest-reliability and predictive validity is missing. Conclusion: Results support the reliability and validity of the German TGI-SR+ as a screening instrument for PGD in research.

How Chinese adolescents present themselves online regarding physical activity

Digital tools with social networking features are often utilised to promote physical activity among adolescents. However, the need to improve users’ experiences, motivation and engagement with these tools pointed out the need to explore experiences from adolescents’ perspectives. This study is a qualitative study exploring adolescents’ online culture, norms, self-presentation, and self-exposure regarding their physical activity, taking Chinese adolescents as the target population in a collectivist culture context. Inspired by Goffman’s dramaturgical model and Boyd’s concept of self-representation in digital media, we aim to explore how Chinese adolescents construct their online physical activity self-presentation, as well as what and how socio-cultural norms play a role in this process. After drawing a population sample from Chinese adolescents (aged 14–19 years, 50% female) and conducting 13 focus group discussions, our results suggested that Chinese adolescents are willing to construct an active, encouraging, modest and safe physical activity self-presentation on social media, but they also perceived body dissatisfaction, online comparison and privacy intrusion as potential dangers in physical activity self-presentation at the same time. The results demonstrated that Chinese adolescents’ physical activity self-presentation is the result of the interplay and negotiation between personal norms and sociocultural norms.

Relationship between moderate alcohol consumption, genetic polymorphisms and body weight in a population sample of Puerto Madryn, Argentina

Introduction. The relationship between obesity and alcohol consumption is a topic of significant interest to public health. Alcoholic beverages contribute additional calories to the diet, which could be a relevant factor to the overweight risk. However, its association with weight gain is controversial and influenced by multiple factors. Objective. To analyze the relationship between moderate alcohol intake and body mass index, considering the variables that may influence this relationship. Materials and methods. The sample consisted of 155 individuals from Puerto Madryn (Argentina). Each participant completed a questionnaire about health, lifestyle, demographic, and socioeconomic factors. Anthropometric measurements were taken, and polymorphisms of 18 genes related to alcohol metabolism were genotyped. Results. We found that moderate alcohol consumption is associated with a lower body mass index, particularly in females. An increase of 14 grams of alcohol was associated with a risk of 0.68 for obesity and 0.71 for overweight. The T variant of the marker rs4646543 (ALDH1A1), a gene involved in alcohol metabolism and adipogenesis, was associated with a higher frequency of alcohol consumption. Conclusion. The findings of this study suggest that moderate alcohol consumption does not significantly contribute to body weight in the sample studied. Furthermore, the association with genetic variants, such as those of the ALDH1A1 gene, may provide a biological explanation for the inverse relationship observed between weight and alcohol consumption.

Prevalence of Orthosomnia in a General Population Sample: A Cross-Sectional Study

Background/Objectives: Orthosomnia has become a concern in the field of sleep medicine. The purpose of this cross-sectional study was to estimate the prevalence of orthosomnia in the general population. Methods: We collected data from 523 participants via the Generalized Anxiety Disorder Scale, Anxiety and Preoccupation about Sleep Questionnaire, and Athens Insomnia Scale. Additionally, we gathered information about participants’ use of commercial sleep-tracking wearable devices. Results: We developed a four-criteria algorithm to identify cases of orthosomnia: ownership of a wearable sleep-tracking device, AIS score ≥ 6, GAD-7 score ≤ 14, and APSQ score ≥ 40 or APSQ score ≥ 35 or APSQ score ≥ 30, for conservative, moderate, and lenient prevalence estimates, respectively. One hundred seventy-six (35.8%) (95% CI 34.6–40.1%) participants regularly used sleep-tracking devices. The prevalence rates of algorithm-identified orthosomnia in the study sample were: 16 participants (3.0%, 95% CI 1.6–4.5%), 45 participants (8.6%, 95% CI 6.2–11.0%), 73 participants (14.0%, 95% CI 10.9–16.9%) for the for conservative, moderate, and lenient prevalence estimates, respectively. Individuals with orthosomnia were not significantly different in terms of age and sex. The cases consistently had higher AIS scores than non-cases across all APSQ cutoffs, indicating more severe insomnia symptoms, with significant differences observed at each cutoff point. Conclusions: This study offers initial insights into the prevalence of orthosomnia within our sample at a specific time. The findings reveal notable rates of orthosomnia among individuals using sleep-tracking devices; however, we must acknowledge the limitations inherent in a cross-sectional design.

Sociodemographic and health disparities in self-care difficulties among older individuals: Evidence from South Africa

BackgroundAs South Africa’s population rapidly ages, the burden of non-communicable diseases and the challenges of performing daily care activities among older individuals are increasing. This study investigates trends in self-reported difficulties with daily care activities among older adults in South Africa and examines the association between these difficulties, sociodemographic factors, and chronic conditions.MethodsThe study used cross-sectional data from ten rounds of South Africa General Household Survey (2012–2021). Sample population included 26,362 men and 42,400 women aged 60 years and above. The outcome measure was assessed by self-reported difficulty in performing basic care activities such as washing or dressing.ResultsBetween 2012 and 2021, the percentage of participants reporting “A lot of difficulty” increased by 79.75%, “Some difficulty” increased by 112.11%, while “Unable to do” decreased by 8.97%. The risk of self-care difficulties was higher for men (RR = 1.11, 95% CI = 1.02, 1.20) and increased with age: RR = 1.24 (95% CI = 1.08, 1.42) for ages 65–69; RR = 2.27 (95% CI = 2.00, 2.58) for ages 70–74; and RR = 5.65 (95% CI = 5.08, 6.28) for ages 75+. Not being currently married (RR = 1.65, 95% CI = 1.51, 1.79), being of African/Black (RR = 1.21, 95% CI = 1.06, 1.38) or Coloured race (RR = 1.41, 95% CI = 1.21, 1.65), and having diabetes (RR = 1.44, 95% CI = 1.34, 1.55), hypertension (RR = 1.35, 95% CI = 1.26, 1.45), or asthma (RR = 1.30, 95% CI = 1.14, 1.48) were also associated with a higher risk of self-care difficulties.ConclusionThere was a notable increase in the proportion of participants reporting significant difficulty and some difficulty in performing self-care tasks, while a decrease was observed in the category of participants unable to do such tasks. Health policies should prioritize the specific needs of vulnerable sociodemographic and health groups, considering their increased risk of self-care difficulties.

A National Study on the Association of Abdominal Ultrasound with CT Utilization and Disposition in the Emergency Department

Background Ultrasound and CT imaging have distinct and overlapping roles in the assessment of undifferentiated abdominal pain in the emergency department (ED). CT imaging is the gold standard for many pathologies, ranging from bowel obstruction to aortic pathology whereas ultrasound benefits from less radiation exposure and the ability to employ at bedside. In this pilot study, we utilize nationally representative data to identify associations between ultrasound use in ED patients with a primary complaint of abdominal pain with abdominal CT imaging use and disposition. Methods We analyzed retrospective, cross-sectional data on ED patient visits obtained from the National Hospital Ambulatory Medical Care Survey from 2016-2020. This dataset utilizes a weighed multistage, probability sample of ED patient visits involving a four-stage sampling design, including data at county-level geographic regions, hospitals within these regions, emergency service areas in these hospitals, and patient visit records. The study population includes adult patient ED visits with an age of 18 and up presenting with a primary complaint of atraumatic abdominal pain. Descriptive statistics was utilized to describe the sample population. Survey-weighted multivariate logistic regression analysis with calculated odds ratios evaluated for differences between the binary dependent variable of abdominal pain visits with versus without ultrasound use with independent variables of disposition and abdominal CT imaging use while controlling for visit acuity and adjusting for demographic information. Results A total of 7563 patient visits met inclusion criteria, representing approximately 60 million patient visits from 2016-2020. In this study population, 18.5% of visits involved ultrasound, whereas 39.8% of visits involved CT imaging use. 14.6% of visits resulted in hospital admission. On weight-adjusted regression analysis, visits involving ultrasound were less likely to require CT imaging and more likely to be admitted, with ORs of 0.49 (95% CI: 0.37, 0.64) and 1.97 (95% CI: 1.44, 2.68), respectively. Visits involving ultrasound were more likely to be associated with an emergency medicine residency program and an emergent acuity level, with ORs of 1.40 (95% CI: 1.01, 1.94) and 1.53 (95% CI: 1.01, 2.31), respectively. Conclusion In this national pilot study, abdominal pain visits involving ultrasound were associated with a lower likelihood of CT imaging use and a highly likelihood admission and an emergent acuity level.

Uninsured Motorists’ Risk Attitudes and Pedestrian Road Safety: Evidence from Metropolitan Lagos, Nigeria

With the increasing prevalence of uninsured vehicles in urban areas, motorists’ behaviours on pedestrian safety are crucial for developing effective road safety strategies. This study investigated the happenings around uninsured motorists’ risk attitudes and pedestrian road safety in metropolitan Lagos, Nigeria. Using the survey approach cum the two-way sampling techniques comprised of purposive and convenience, data were gathered to analyse the behavioural dispositions of uninsured motorists and their implications on pedestrian road safety. The study adopted a structured questionnaire as a research instrument for data collection from a sample population of 209. The data analytical employed was descriptive statistics comprised of simple frequency percentages presented in tabular form and bar chart description. Findings revealed, based on pedestrian opinions, that uninsured motorists display riskier driving behaviours, such speeding and reckless driving pattern; which was found prevalent among commercial uninsured motorists. In addition, insufficient implementation of insurance regulation and socio-economic factors contributed to the proliferation of uninsured vehicles. The study also showcased the descriptive analysis of uninsured motorists’ risk attitudes towards pedestrian road safety. Further finding presented a descriptive analysis of pedestrians’ road safety metrics on Lagos roads. Then, the study accentuates the urgent need for comprehensive policy intervention targeting uninsured motorists, including stricter application of insurance laws, public awareness campaigns, enhanced infrastructure to improve pedestrian safety in urban environment, like metropolitan, Lagos, Nigeria and in similar contexts in other African cities and beyond. Thus, insurance practitioners, especially motor insurance providers, should synergise their efforts to improve the accessibility and affordability of insurance for motorists, particularly, the low-income individuals; by creating flexible payment options, and subsidising insurance premiums. Lastly, local communities should engage with other stakeholders in the transport industry to ensure road safety culture, promoting responsible driving behaviour and encouraging compliance with insurance regulation

Validity and reliability of the TechPH scale in assessing Iranian older adults’ attitudes toward technology

Background and aimGiven the rapid technological advancements and increased usage of digital tools, understanding older people's attitudes toward technology is vital. Assessing their views can help identify barriers and facilitators to adoption. This understanding is essential for developing effective educational strategies and user-friendly technologies that enhance seniors' quality of life. Therefore, the present study aimed to psychometrically evaluate the scale for measuring attitudes—both willingness and anxiety—toward technology (TechPH) in Iranian older adults.MethodsThis methodological study was conducted on 420 older individuals (aged 60 and above) in Tehran in 2024 to perform a psychometric test of the attitudes toward technology scale (TechPH). Validation was carried out using translation validity methods, including translation-back translation with bilingual experts (n = 2), face validity with a sample of the older population (n = 10), content validity with a panel of 11 experts, and construct validity through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) (n = 420). Instrument reliability was determined through test–retest and internal consistency (Cronbach's alpha) methods with a sample of older individuals (n = 30). Data analysis was performed using SPSS version 16 and EQS 6.4 software.ResultsA comparison of Persian and English translations revealed acceptable translation validity and cultural adaptability for the scale. Each item's Content Validity Index (CVI) and Content Validity Ratio (CVR) were determined, with a total average CVI of 0.95. The results of EFA indicated that the sample size was adequate, as shown by the KMO value of 0.754. Additionally, Bartlett's sphericity test demonstrated a significant correlation between the items (χ2 = 221.819, df = 15, P < 0.0001). EFA revealed that two extracted factors explained 41.002% and 18.111% of the total variance. Furthermore, CFA yielded suitable estimates based on the general fit indices of the model (RMSEA = 0.061, IFI = 0.979, GFI = 0.983, CFI = 0.978, CMIN/DF = 1.769, MFI = 0.989, AGFI = 0.942). In evaluating test–retest stability and internal consistency, the values of the Intra-class Correlation Coefficient (ICC) and Cronbach's α were 0.85 and 0.77, respectively, indicating appropriate reliability for the scale.ConclusionP.TechPH, the first Persian version of the scale for measuring technophilia and technophobia among Iranian older people, has favorable psychometric properties. It can serve as a standard tool for assessing older people’s attitudes toward technology in various studies.