Significant Determinants Research Articles

Trust in sources of information about digital health technologies: The User’s Perspective

Abstract Background Trust is key to healthcare, including all types of health information. This applies not only to the process of healthcare delivery, but also to health-related behaviors and the utilization of healthcare services. Trust in health information sources has been shown to vary by social and health characteristics. Therefore, the research question is: Are there social and health-related differences in perceptions of trust in sources of information (government agencies or physicians) about digital health technologies? Methods The analysis is based on a cross-sectional online survey (STELLAR) conducted in 2022 (N = 1,200), Participants were asked whether they perceive trust (1= fully agree- 4= not at all) in information about digital health technologies provided by government agencies (institutional trust) or physicians (interpersonal trust). For the analysis, binary logistic regressions (references: traditionalists, low education level, poor self-perceived health) were used. Results Institutional Trust. Overall, 43.9% of the participants perceived trust in this information source. Baby Boomers (OR 2.022), Generation Y (OR 2.544), and Generation Z (OR 2.566), as well as medium (OR 2.526) and high (OR 3.823) educational level, increased the odds of perceived trust; the same was found for better self-perceived health (OR 1.569). Interpersonal Trust. In general, 94.8 % of the participants expressed trust physicians. Belonging to Generation Z decreased the chance (OR 0.097) and a better subjective health status increased the chance (OR 4.250) of perceiving trust. Education did not emerge as a significant determinant. Conclusions The study confirmed that interpersonal and institutional trust varies by social and health characteristics. There seems to be a need to strengthen efforts to explain the process of trust building in different population groups., e.g. to find explanations for why educational level was only relevant for institutional trust but not for interpersonal trust. Key messages • Trust in sources of information about digital health technologies differ by generation, educational level, and subjective health status. • Given the existing differences in perceptions of trust, it is worthwhile to explore the unknown mechanisms of the trust-building process among different population groups.

Examining the Relationship Between Socio-Demographic Variables and Eco-Anxiety A Systematic Review

Abstract Background Eco-anxiety is a rising concern among young people, characterized by persistent feelings of fear, helplessness, and despair stemming from the looming and uncertain threats of climate change. Understanding how socioeconomic status and demographic factors influence the development of eco-anxiety is crucial in addressing this issue. This study aimed to analyze the literature to elucidate this relationship and its public health implications. Methods We conducted a systematic literature review using PubMed, Scopus, Web of Science, and APA PsycInfo databases. A total of 1,170 articles were initially retrieved, with 10 meeting the inclusion criteria. Quality assessment was performed using the AXIS Tool modification for cross-sectional studies. Data extraction was systematically carried out to analyze the relationship between socioeconomic and demographic determinants and young people’s emotional responses to climate change. Results Preliminary findings indicated that various socioeconomic and demographic factors influence young people’s emotional responses to climate change. Family stressors, economic instability, cultural beliefs, and social influences were identified as significant determinants, contributing to eco-anxiety, ecological distress, and climate change grief among youth. Conclusions The study underscores the importance of considering socioeconomic and demographic factors in addressing eco-anxiety among young people. By recognizing these influences, policymakers, educators, and mental health professionals can develop tailored interventions to mitigate the adverse effects of eco-anxiety. Public health actions may include enhancing mental health services, implementing educational programs, and addressing social determinants of health to alleviate eco-anxiety and promote resilience among youth facing climate-related challenges. This review is produced as part of the PRIN P2022JJ3LB project, funded by the Italian Ministry of University and Research. Key messages • Socioeconomic and demographic factors significantly influence young people’s emotional responses to climate change, including the development of eco-anxiety and ecological distress. • Understanding family stressors, economic instability, and social influences is crucial for tailored interventions for youth.

Civic participation and self-reported health: An intersectional comparative study in Europe

Abstract Background Civic participation has been associated with better self-reported health (SRH). However, how does the association between civic participation and SRH vary by sex and migration status? This study aims to examine the association between social and political determinants of health and SRH in an intersectional perspective. Methods We use data from 26 countries in the 2022 EU Statistics on Income and Living Conditions (EU-SILC) (n = 425,178, 18-80 y.o.), following an intercategorical approach. Eight intersectional groups are created based on sex, migration status and being socially/politically active (participation in activities related to active citizenship or in formal/informal voluntary activities). Multilevel (ML) logistic regression models are employed to assess the association between these groups and SRH, controlling for age and educational level. Results 24.6% of the sample indicate to be socially or politically active, with significant differences between sexes and migration status. A higher proportion of non-migrant active men report good SRH compared to the other intersectional groups (95.2%). Preliminary results from the ML logistic models show that being active increases the likelihood of good SRH (OR = 1.77, 95% CI 1.72-1.83). Migrant active women report better SRH than their non-active counterparts (OR = 1.27, 95% CI 1.12-1.44). Conclusions Findings suggest that being socially/politically active has a positive impact on SRH, especially among foreign women living in European countries. The study highlights the importance of considering civic (both political and social) participation as health determinant and the need of investing in social capital as a way of health promotion, tackling health inequalities and the marginalisation of at-risk groups. Key messages • Civic participation might strengthen individuals’ health, including among migrant women. • Public health policies should consider civic participation as significant determinant of individuals’ health, as well as a way of tackling health inequalities.

KardioNet Digital - a structured care model involving digital tools for intersectoral communication and a patient-focused strategy for treatment of heart failure

Abstract Introduction Inefficiencies and discontinuities in care at the interfaces within Germany's healthcare system, especially between acute and outpatient care, present significant challenges in managing patients with heart failure (HF). The management complexity of HF has increased with the advent of new digital tools, though patient acceptance of these tools remains contentious. The prevention of loss of diagnostic and therapeutic information for this complex disease is crucial for cross-sectoral communication (hospital - office-based cardiologist - general practitioner) and quality of care. Purpose Our goal was to examine the impact of digital app-supported coordination of HF management across different healthcare providers from hospital discharge to the ambulatory sector and to assess patients' acceptance of a structured care program. A patient-focused digital strategy, supported by a Heart Failure Nurse (HFN), aimed to facilitate structured follow-up and patient empowerment, focusing on patient-reported outcomes and experiences (refer to Table 1). Results Out of 401 patients screened during their hospital stay for HF, only 57 (14.9% male, 12.6% female) participated in the KardioNet Digital (KND) program. NYHA classifications were I (3.5%), II (49.1%), III (40.4%), and IV (7.1%); Diagnoses included CMP (26, 45.6%), CAD (19, 33.3%), valvular HF (8, 14.0%), and others (4, 7.0%). The mean age was 55.03 years, with a notable difference in participation based on age (≥70 years: 9.5% male, 33.3% female; <70 years: 90.5% male, 66.7% female). Age was a significant determinant of program participation. Patients who regularly used the app benefited from several features: A total of 35 alerts (17 patients) were triggered for reasons such as bodyweight increase (2kg or more) and device-induced alerts (i.e. false shock delivery, 3x slow-VT, Syncope), leading the HFN to contact the patients. This early intervention prevented rehospitalization due to decompensation of heart failure in 11 patients (64.7%) and addressed device-related alarms for organizing an emergency hospital visit by HFN. Despite substantial incentives, such as support from an HFN and expedited appointments with specialists for follow-up therapy, refusal rates were high (refer to Table 2). Conclusion A structured, digitally supported cross-sectoral care model for heart failure patients can potentially improve care coordination and outcomes. However, the success of such programs critically depends on patient willingness and the seamless integration into existing healthcare structures. Despite valuable incentives, we observed low acceptance of the program. Even among motivated participants (14.1%), there is a significant need for substantial support and education on digital literacy for the widespread implementation of digital tools in real-world settings for the treatment of heart failure.Workflow of structured digital supportReasons for Declining Participation

Introduction to the digital health divide

Abstract This presentation will introduce the concept of digital health divide. It refers to inequalities in accessing and using digital technologies, leading to digital exclusion. Digital inclusion is defined by the United Nations as “equitable, meaningful, and safe access to use, lead, and design of digital technologies, services, and associated opportunities for everyone, everywhere”. Indeed, digitalisation is a worldwide phenomenon that permeates all levels of determinants of health inequities, leading to several populations being more adversely affected. Age, gender, education, and economic status are significant determinants amplifying the digital divide’s impact, with older individuals, women, less educated individuals, and economically disadvantaged populations bearing disproportionate effects. The relationship between the digital divide and health leading to the digital health divide can be direct and indirect. Here, access to the latest advancements in health technologies used along the health span (eHealth, mHealth) - from health prevention to patient care - can directly influence the user’s health. However, the lack of access to or use of existing technologies can also indirectly affect their well-being. A globally informative example of this indirect association is the lack of internet access in rural areas during the hard COVID-19 lockdowns, leading to the loss of a school year for many pupils. Indeed, school attendance and attainment are associated with better physical and mental health. Currently, there is a lack of operationalisation of the digital health divide, making it difficult to measure it accurately. The absence of a standardised evaluation and therefore evidence-based information hinders governments and organizations’ efforts to effectively address digital health divide.

How does perceived security influence mobile wallet users' behavior? A SEM investigation

PurposeThe digital disruptions have provided alternative methods of monetary transactions. Despite the digital wave, cash as a payment option has regained its position. The purpose of this research is to investigate behavioral intentions of mobile wallet (m-wallet) users. The paper explores the dynamics of perception, behavioral intention motivation and satisfaction of m-wallet users.Design/methodology/approachThe authors have used a self-administered questionnaire for data collection. A total of 506 responses were analysed using confirmatory factor analysis in conjunction with Structural Equation Modeling, ensuring the validity and reliability of the insights into the behavioral dynamics of m-wallet users.FindingsThe research highlights the direct impact of perceived security on m-wallet users' perceptions, which subsequently influence both direct and indirect behavioral intentions. Moreover, satisfaction emerged as a significant determinant directly shaping behavioral intentions.Originality/valueThis study contributes significantly to the existing literature by offering a comprehensive understanding of the factors driving m-wallet adoption and usage intentions, thereby equipping stakeholders and policymakers with the necessary tools to devise effective strategies to promote mobile payment technologies in North India. The study employs a multifaceted model that incorporates six key elements, providing a comprehensive understanding of the complex interrelationships among these variables.

Correlates of Continued Church Membership Intention: An Empirical Study of Religion in Ghana

AbstractThis study examines the factors influencing continued church membership intention in Ghana, focusing on the key correlates of this behavior. Using structural equation modeling (SEM) the survey data collected were analyzed. The findings highlight charismatic leadership, religious experience, corporate social responsibility, personal needs fulfillment, tangibles, and message credibility as significant determinants of continued church membership intention. Furthermore, the study identifies a willingness to donate as a consequential outcome. The proposed integrative model not only offers scholars essential constructs for future theoretical exploration but also provides church managers with a comprehensive framework to enhance membership retention strategies. This research serves as a critical foundation for both academic and practical advancements in understanding the dynamics of church membership.

The relationship between sleep quality, depression, and smartphone addiction in pregnant women: a mediation analysis

ABSTRACT In recent years, the prevalence of smartphone addiction has significantly increased. This situation has raised concerns about its potential impact on health aspects, such as sleep quality and mental health, particularly among vulnerable populations like pregnant women. This study aimed to identify the factors that determine sleep quality in pregnant women and examine the relationship between smartphone addiction, depression, and sleep quality. This descriptive correlational study included 257 pregnant women in their second and third trimesters who were registered at six family health centers between September 2022 and March 2023. Data were collected using a sociodemographic questionnaire, the Smartphone Addiction Scale Short Form, Edinburgh Postnatal Depression Scale, and Pittsburgh Sleep Quality Index. Regression and mediation analyses were performed for the data. Of the participants, 44.4 percent had poor sleep quality. Depression and third trimester were significant determinants of sleep quality. The bootstrapping results revealed that smartphone addiction led to an increase in the level of depression (β = 0.145; p < .001). Depression worsened sleep quality (β = 0.262; p < .001). The smartphone addiction did not significantly affect sleep quality (β = 0.020; p = .279). Depression mediates the relationship between sleep quality and smartphone addiction (β = 0.038; 95 percent CI [0.018: 0.062]). The study highlights that while smartphone addiction does not directly impact sleep quality in pregnant women, it is associated with increased depression levels, which subsequently worsen sleep quality. It is recommended that healthcare providers monitor smartphone usage and mental health in pregnant women to mitigate the risk of sleep disturbances and improve overall well-being.

Trends and predictors of full immunization coverage in Nigeria

BackgroundImmunization plays a significant role in global health, yet many children in Nigeria do not receive full immunization due to several influencing factors. Therefore, this study examined the trends in Nigeria’s full immunization coverage and identified key predictors that influence full coverage.MethodsThe data for children aged one to five years, across the six geopolitical zones of Nigeria was retrieved from the 2007, 2011, 2016/17, and 2021 national Multiple Indicator Cluster surveys We analyzed the data using univariate logistic regression. Results were presented as adjusted odds ratios (aORs), and statistical significance was set at 0.05.ResultsThe results showed that 12,229 children (74.2%) had been fully immunized. The trend of immunization coverage was 63.6%, 82%, 63.7%, and 76.4% in 2007, 2011, 2016/17, and 2021 respectively. Children of educated mothers (aOR: 2.6; 95% CI 1.45, 4.76) and from the richest families (aOR: 2.1; 95% CI 1.41, 3.11), were more likely to be fully immunized. Conversely, children in rural areas (aOR: 0.6; 95% CI 0.42, 0.81) and from families of more than five (aOR: 0.6; 95% CI 0.46, 0.81) were less likely to be fully immunized.ConclusionAs of 2021, the rate of full immunization coverage in Nigeria was 76.4%, an improvement from the low 2003 rate (12.3%). Maternal education and wealth index are significant sociodemographic determinants for full immunization coverage. Adopting policies that improve access to education for females nationally and access to healthcare, especially in rural areas may significantly increase full immunization coverage.

Determinants of symptom presentation and resolution following concussions in high school sports

ABSTRACT Sport-related concussions (SRCs) are prevalent in high school (HS) sports, though the determinants of, and relationships between concussion symptoms in this population remain relatively unknown. We analysed SRC data captured within the HS RIO injury surveillance system during 2014/15-2018/19. We used Generalized Estimating Equations to simultaneously assess covariate predictors of symptom presentations and identify pairwise symptom associations and employed multivariable ordinal logistic regressions to determine symptom resolution time (SRT) predictors. Among the 8,969 concussions assessed, headaches (94.3%) and dizziness (73.3%) were the most prevalently reported symptoms. In 5,953 boys’ concussion assessed, class year, event type and injury mechanism emerged as determinants of various concussion symptoms, while in 3,016 girls’ concussions assessed, class year, event type, injury mechanism, and sport type emerged as significant symptom determinants. In both groups, difficulty concentrating, sensitivity to light, sensitivity to noise, and disorientation were symptoms with the strongest associations with other symptoms. Odds of longer SRT were higher with greater endorsement (i.e. counts) of the subset of symptoms with strongest cross-domain associations (ORadj. = 1.35; 95% CI = [1.30, 1.40]). Our findings provide valuable information for informing sideline and follow-up clinical concussion assessment algorithms in high school athletes.

Determinants of Healthcare Expenditure: A Cross-Sectional Analysis at the Country Level

This study examines the determinants of healthcare expenditure through a cross-sectional analysis of 153 countries using 2018 data. The research employs a classical linear regression model to identify key socioeconomic and demographic factors influencing healthcare spending per capita, expressed in PPP (Purchasing Power Parity). The results show that GDP per capita, public health expenditure as a percentage of GDP, physician availability, and out-of-pocket healthcare costs are statistically significant determinants of healthcare spending. Specifically, the analysis highlights the non-linear relationship between GDP and healthcare expenditure, where wealthier nations tend to spend disproportionately more on healthcare. Public investment in healthcare and the availability of medical professionals also play crucial roles in shaping national healthcare expenditures. Out-of-pocket expenses by households further increase overall healthcare costs, especially in countries with lower public funding. The proposed model explains 96.5% of the variation in healthcare expenditure, suggesting that the selected variables are strong predictors of healthcare spending. These findings provide valuable insights for policymakers, particularly in the context of balancing public healthcare financing and improving access to medical services while managing overall costs.

Association of psychological distress with health-related quality of life in Asian adolescents seeking obesity treatment.

There is limited research on the psychosocial health of Asian adolescents undergoing obesity treatment. Our study examined the predictors of psychological distress, disordered eating and poor health-related quality of life (HRQoL) in these adolescents and the associations between them. A total of 82 adolescents aged 11-17 years were recruited from the Weight Management Clinic in KK Women's and Children's Hospital between June 2022 and January 2023. Participants completed the following questionnaires: (a) Young Person's Clinical Outcomes in Routine Evaluation (YP-Core) assessing for psychological distress, (b) Children's Eating Attitude Test (ChEAT) evaluating for disordered eating behaviours, and (c) Pediatric Quality of Life Inventory (PedsQL) measuring HRQoL. Participating adolescents had a mean body mass index of 31.9 ± 5.1 kg/m2. Of the participants, 40% reported significantly symptomatic psychological distress (YP-Core score ≥14) and 16% were at risk of eating disorders (ChEAT score ≥20). A higher YP-Core score was the only significant determinant of poorer HRQoL, after controlling for demographic variables and ChEAT scores. Malay (regression coefficient: 6.6, 95% confidence interval [CI]: 0.6-12.6, P = 0.031) and Indian (regression coefficient: 8.9, 95% CI: 3.8-14.0, P = 0.001) adolescents were more likely to report disordered eating and psychological distress, respectively, as compared to Chinese adolescents. Adolescents whose parent(s) had obesity (regression coefficient: 3.4, 95% CI: 0.1-6.7, P = 0.043) were also more likely to experience greater psychological distress. Understanding the determinants of psychological distress, disordered eating and HRQoL will facilitate targeted screening and management of the psychosocial complications of adolescent obesity.

Interest and Academic Achievement of Students in Senior Secondary School Mathematics as Determined by Teachers' Self-Efficacy

This study examined the degree to which Teacher’s Self-efficacy determined students’ interest and academic achievement in Mathematics. The study adopted correlational research design. The study was guided by two (2) research question and two (2) hypotheses. The population of the study consist of 8 Mathematics Teachers and 5125 Senior Secondary II (SS2) students. A sample of 29 mathematics teachers and 400 students was used for the study. Four instruments were employed for data collection in this study. They are Teachers’ Self-efficacy scale (TSS), Students Mathematics Interest Scale (SMIS) which was developed by researcher and students’ Mathematics Achievement Pro-forma (SMAP). Face validity as well as construct validity were used to the instruments. The reliability indices of the Students Mathematics Interest Scale (SMIS) and Teachers Self-efficacy scale (TSS) were computed using Cronbach's Alpha (α). Regression analysis was performed to analyse the data, and regression ANOVA was utilised to test the hypotheses at the significance level of 0.05. The study's results, among other things, demonstrated that students’ interest in mathematics is determined by teachers self-efficacy (11.1%), found significant (p&gt; 0. 05) determinant of students Interest in Mathematics, it also showed that students’ achievement in Mathematics is determined by teachers self-efficacy (11.2%), found to be significant determinants of students achievement in mathematics. Conclusion were drawn and implications of the findings of the study was highlighted. It was recommended that Teachers should strive to develop high self-efficacy, positive aversion and low anxiety towards the teaching of Mathematics in schools as to boost students’ interest and achievement in mathematics; Government agencies and school administrators should train in-service and pre- service teachers for self-efficacy to enhance students’ interest and academic achievement.

Application of social cognitive theory to determine shaping factors of environmental intention and behaviors of ecotourist in forest areas

BackgroundEcotourism as a responsible travel to natural areas is proposed as a strategy for forest conservation by enhancing the livelihoods of local communities. However, engaging in environmentally friendly behaviors during forest visit is a crucial factor in achieving this conservation. This study aimed to examine the determinants of intention and actual environmental behavior among ecotourists during their visits to forests.MethodsUtilizing social cognitive theory as the theoretical framework, the data from 409 visitors of recreational forest were analyzed. After confirming the validity and reliability of the data, structural equation modeling was employed for analysis.ResultsThe results indicated that the model could explain 59% of the behavioral intention and 27% of the actual environmentally friendly behaviors of ecotourists during their forest visits. Additionally, social influence and the behaviors of other ecotourists were identified as two significant determinants of individuals’ behavioral intention. Self-efficacy and behavioral intention also emerged as significant factors which shape the actual environmental behaviors of tourists, positively.DiscussionThe findings suggest that social expectations, learning from fellow tourists, and enhancing individuals’ abilities while addressing barriers to exhibiting environmentally friendly behaviors should be prioritized in promotional planning for ecotourism.

Trajectories and drivers signalling the end of agricultural abandonment in Trás-os-Montes, Portugal

Agricultural abandonment has given rise to novel landscape dynamics worldwide. This paper investigates abandonment and post-abandonment dynamics in continental Portugal as a hotspot of landscape change. We mapped the spatial patterns and drivers of recent (1995–2018) land use changes in a remote mountainous region as post-abandonment trajectories, based on detailed land use/land cover data made available by the Portuguese government. We showed that ‘Revegetation’ trajectories, indicative of agricultural abandonment, were still widespread between 1995 and 2007. However, between 2007 and 2018, the landscape was much more stable with ‘Return to agriculture’ as the dominant change trajectory. To understand what drives landscape changes after abandonment, we explored the influence of a wide range of potential biogeophysical and socio-economic drivers on the observed trajectories. We contrasted different landscape outcomes in binary logistic regression models with the potential underlying drivers as independent variables. The regressions revealed that the most significant determinants of these alternating dynamics are existing land use, climate, slope, protection regime and accessibility. The results of the regressions are at times counterintuitive and give important indications of the changing spatio-temporal scales at which these variables exert influence on the landscape outcomes. However, the regression models’ limited accuracies highlight the need for deeper investigation of the socio-economic and historic context of the observed changes. Improved understanding of the (drivers of) alternative dynamics following agricultural abandonment can help inform policy decisions regarding agriculture and cultural landscape preservation.

An Integrated Approach for Development of a Decision Support System for Early Surveillance of Japanese Encephalitis: a Remote Sensing-based study in Conjunction with Epidemiological Scenario in Assam, India

Abstract. Japanese Encephalitis (JE) is one of the serious mosquito borne viral diseases mostly prevalent in India and many of the South Asian countries. A comprehensive study was conducted in Dibrugarh, a JE endemic district of Assam taking into the account of the environmental and social factors that determine the outbreak of the disease. Effect of environmental and climatic factors on mosquito vector densities was investigated using geospatial tools and techniques. Wetlands were found to be the most preferred habitat type for most of the JE-transmitting mosquitoes followed by paddy-growing areas and ponds. The villages abundant with these habitats or located nearby were found to be more vulnerable to JE risk. Based on the spatial distribution of habitat types, villages in the district were divided into three categories of vector abundance and hence the risk of JE. It is found that rainfall (intensity as well as duration) is the most significant determinant in the modulation of mosquito density followed by temperature. It is also observed that the derived models could explain about 61% to 73% variation in mosquito density due to change in weather variables as indicated by R2 values of the Models. Among socio-economic determinants, pig rearing habit of the villagers was found to be most significant. JE risk map was prepared by integrating vector abundance map with the map of host abundance in GIS domain. Attempts were also made to forecast the intensity of JE cases based on a time series analysis of historical morbidity pattern, whereas forecast for onset of the disease was based on the modulation of weather variables in the study area. A web-based decision support system (DSS) developed by integrating the forecasts of JE onset, intensity and JE prone villages has been provided to the concerned health authorities to take timely intervention measures. The JE early warning system developed for Dibrugarh district was extended to two more JE prone districts viz, Sibsagar and Tinsukia as validation sites and observed that the accuracy of forecast was within the range of 69% to 77%. DSS on JE has opened up new opportunities to study similar vector-borne diseases of the JE serogroup viz., West Nile.

Analysis of Determinants of Envitonmrntal Awareness Among Beef Consumers

Objective: The objective of this study is to analyze the determinants of environmental awareness among beef consumers in Brazil, focusing on the acceptance of the Carbon Neutral Beef label. Theoretical Framework: The literature review covers the growing consumer concern for sustainability and animal welfare. The concept of Carbon Neutral Beef, developed by EMBRAPA, is discussed as a strategy to mitigate methane emissions in livestock production. Previous studies indicate that factors such as education, income, and environmental awareness influence consumers' willingness to pay more for sustainable beef. Method: The research employed a quantitative approach, applying a survey to beef consumers in Brazil. A total of 256 completed questionnaires were analyzed, and the data were processed using Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). The Tobit econometric model was employed to identify the determinants of consumers' environmental awareness. Results and Discussion: The results show that most consumers prefer beef with sustainability attributes, influenced by income, education, and concern for the environment. The Tobit model indicated that variables such as educational level and household income are significant determinants of environmental awareness. These consumers are willing to pay more for beef that respects the environment and animal welfare. Research Implications: The study provides insights for the beef industry on the importance of adopting sustainable production practices. Originality/Value: The study provides insights for the beef industry on the importance of adopting sustainable production practices.

Efficacy and determinants of response to inhaled treprostinil in pulmonary hypertension - interstitial lung disease

Inhaled treprostinil has shown to improve exercise capacity in patients with pulmonary hypertension-interstitial lung disease (PH-ILD). We evaluated the efficacy and determinants of favorable response to inhaled treprostinil at six months. MethodsOf the 106 patients screened, 42 were eligible for this retrospective single-center study. Assessments included rate of patients who achieved ≥30m improvement on 6-min walk test (6MWT), and death or transplantation rates at 6 months of treatment initiation. ResultsPatients were predominantly female (n = 26, 62 %) with autoimmune PH-ILD (n = 23, 55 %), and a median age of 68 (61, 75) years. Ten (38.5 %) patients achieved a distance increase ≥30 m in 6MWT. No statistically significant determinants of walking ≥30 m were noted on univariate analysis; however, responders had a lower right ventricular (RV) tissue Doppler S' velocity (9.2 [7.0, 11.0] vs. 11.9 [10.0, 14.4], p = 0.018) cm/s and evidence of pericardial effusion on baseline echocardiogram (82 % vs. 26 %, p = 0.003). PH-ILD patients who died or underwent transplantation were more likely to have progressive pulmonary fibrosis (PPF) (95 % vs 50 %, p < 0.001) ConclusionsIn real-world setting, treatment with inhaled treprostinil for six months increased the 6MWT by ≥ 30 m in about a third of PH-ILD patients. Lower RV tissue Doppler S' velocity and presence of pericardial effusion at baseline were associated with favorable response to inhaled treprostinil. PPF portends a poor survival in PH-ILD.

Determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia: Unmatched case control study.

Stunting is a height-for-age (Z-score) less than minus two standard deviations below the mean of reference standard. It is the most important sign of long-term chronic undernutrition and public health problem in Ethiopia. However, little information was known regarding determinants of stunting among adolescents since it had mostly been investigated in late infancy, especially among children under the age of five. Therefore, identifying determinants of stunting among adolescent girl is still crucial. To identify determinants of stunting among adolescent girls in schools of Digo Tsion Town, Northwest Ethiopia, 2022. Case-control study was conducted among 417 adolescent girls (104 cases and 313 controls) in schools of Digo Tsion Town with computer generated simple random sampling technique. World Health Organization Anthroplus 2007 software was used for analyzing anthropometrics data. Data was collected by epicollect5 mobile application through interview by using structured questionnaire. The data was entered in epi data 4.6 and exported into Statistical Package for Social Science version 26. Variables with p- value ≤ 0.25 in bivariable analysis were candidate for multivariable analysis. Model fitness was checked by Hosmer and Lemon Show fitness of test. Variables having a P-value < 0.05 in multivariable analysis were declared as statistically significant at 95% Cl. The result was presented by statement, figures, and tables. A total of 409 (100 cases and 309 controls) adolescent girls participated, with a response rate of 96% for cases and 98.72% for controls. Food insecurity (AOR = 2.13, CI [1.15, 3.93]), low dietary diversity score (AOR = 1.99, CI [1.06, 3.73]), drinking coffee/tea immediately while eating meals (AOR = 2.19, CI [1.22, 3.95]), not getting nutritional counsel (AOR = 2.07, CI [1.17, 3.66]), chronic illness (AOR = 3.78, CI [1.16, 12.3]), and not visited by health extension workers at home (AOR = 1.85, CI [1.03, 3.31]) were statistically significant determinants of stunting. Stunting among adolescents is influenced by a low dietary diversity score, a food-insecure household, drinking coffee or tea immediately while eating a meal, not receiving nutritional counseling, having a chronic illness, and not being visited by health extension workers at home. Future researchers would do better to undertake prospective studies. Health extension workers are better able to provide nutritional counsel for adolescent.

Implications of Traditional Cooking on Air Quality and Female Health: An In-Depth Analysis of Particulate Matter, Carbon Monoxide, and Carbon Dioxide Exposure in a Rural Community

Indoor air pollution, particularly in rural communities, is a significant health determinant, primarily due to the prevalence of traditional cooking practices. The WHO estimates 4.3 million annual deaths related to household air pollution. This study quantifies indoor pollutants and assesses health impacts and perceptions regarding traditional cooking. Using Extech air quality monitoring equipment, the study measured particulate matter (PM), carbon monoxide (CO), and carbon dioxide (CO2) in 48 rural homes. A survey of 39 women gathered insights on their use of wood for cooking and perceptions of air quality. This dual approach analyzed both environmental and social dimensions. Findings showed fine particulate matter (0.3, 0.5, 1.0, and 2.5 μm) exceeded safety limits by threefold, while coarser particulates (5.0 and 10 µm) were concerning but less immediate. CO levels were mostly acceptable, but high concentrations posed risks. CO2 levels indicated good ventilation. Survey responses highlighted reliance on wood and poor air quality perceptions demonstrating little awareness of health risks. Common symptoms included eye discomfort, respiratory issues, and headaches. The study emphasizes the need for interventions to reduce exposure to indoor pollutants and increase awareness of health risks to encourage cleaner cooking practices in rural communities.