Significant Protective Factor Research Articles

Prevalence, Risk Factors, and Perinatal Outcomes of Velamentous Umbilical Cord Insertion in Twin Pregnancies: A Single-Center Retrospective Study.

The effect of velamentous cord insertion (VCI) on perinatal outcomes in twin pregnancies is unclear due to conflicting findings. This retrospective study aimed to examine VCI prevalence and related risk factors in twin pregnancies and its association with adverse perinatal outcomes. Women with twin pregnancies who delivered between January 2012 and December 2021 in a single tertiary hospital were included. The participants were divided into dichorionic (DC) and monochorionic diamniotic (MCDA) groups, and their maternal and fetal characteristics and VCI rates were compared. Logistic regression models were used to identify risk factors for VCI and VCI-related perinatal outcomes. Among the 694 twin pregnancies included in this study, the VCI rate was significantly higher in MCDA than in DC twins. Body mass index and MCDA twins were significant risk factors for VCI, whereas assisted reproductive technology pregnancy was a significant protective factor against VCI. In DC twins, VCI did not affect perinatal outcomes. In MCDA twins, VCI was a significant risk factor for fetal growth restriction, twin-to-twin transfusion syndrome, and preterm birth at <36 weeks. VCI was a prominent risk factor for adverse perinatal outcomes only in MCDA twins. Antenatal sonographic assessment of the umbilical cord insertion site would be beneficial.

마약중독자의 부도덕적 성관념과 약물심각도 관계에서 성인애착의 매개효과

The purpose of this study was to verify whether adult attachment variables could serve as a significant protective factor in the impact of drug addicts' perceived immoral sexual attitudes on drug severity. This study conducted a survey on 169 people recovering from drug addiction using a purposeful non-probability sampling method, and analyzed 164 questionnaires, excluding 5 questionnaires that were answered insincerely. The main results of the study are as follows: First, the influence of immoral sexual ideas on adult attachment, which is a mediating variable, was statistically significant. Second, the influence of immoral sexual notions on the dependent variable, drug severity, was also statistically significant. Third, adult attachment was found to have a partial mediating effect on immoral sexual attitudes and drug severity. This shows that immoral sexual attitudes have a direct effect on drug severity, and at the same time, they affect drug severity through adult attachment. It can be seen that drug addicts' immoral sexual attitudes increase attachment avoidance and attachment anxiety in adults, which in turn affects drug severity. Based on the results of this study, in order to reduce the drug severity of drug addicts, factors such as adult attachment were considered and social welfare intervention efforts were suggested to reduce immoral sexual attitudes.

Effectiveness of adjuvant traditional Chinese medicine on macrovascular invasion in patients with hepatocellular carcinoma: a real-world propensity score-matched study.

The study aimed to investigate the potential of traditional Chinese medicine (TCM) in reducing the risk of macrovascular invasion (MVI) in Chinese patients with hepatocellular carcinoma (HCC). This retrospective analysis involved 2,267 HCC patients treated at our hospital. Propensity score (PS) matching was used to compare TCM users (n = 485) with non-users (n = 485) in terms of age, Barcelona Clinic Liver Cancer (BCLC) staging, type of treatment, and AFP. The impact of TCM on the hazard ratio (HR) of MVI was evaluated using a Cox multivariate regression model. The efficacy of TCM therapy on MVI was further examined using the log-rank test. The analysis revealed that TCM medication was a significant protective factor for MVI in HCC patients, as evidenced by the Cox analysis (adjusted HR = 0.496, 95% CI: 0.387-0.635, p < 0.001). After PS matching, the Kaplan-Meier curve demonstrated a lower occurrence rate of MVI in TCM users compared to non-users. The study findings suggest that TCM treatment has the potential to decrease the incidence of MVI in HCC patients, irrespective of etiology, BCLC staging, liver function, or treatment type. Notably, as the use of TCM increased, the percentage of MVI in patients showed a gradual decrease, indicating the potential of TCM therapy as a successful strategy for preventing MVI.

Efficacy of surgical intervention over conservative management in intertrochanteric fractures among nonagenarians and centenarians: a prospective cohort study.

Optimal treatment strategy for nonagenarians and centenarians with hip fractures (NCHF) remained unknown. The authors aimed to compare the outcomes of surgical and conservative management in NCHF. A prospective cohort study was conducted based on CPMHF database with NCHF patients hospitalized during 2014-2020. Comorbidities were evaluated by mECM score and restricted cubic spline was utilized to visually assess the dose-effect relationship between the mECM and outcomes. Propensity score matching was performed to balance baseline characteristics between nonsurgical and surgical groups. Multivariate logistic regression, Cox proportional hazard analysis, and survival analysis were employed for unfavorable outcomes (UFO) evaluation. Competing risk of death were analyzed based on Fine and Gray's hazard model and then constructed nomogram models for predicting survival rates. Subgroup analyses were used to determine potential population heterogeneity and sensitivity analyses were performed to test robustness of the results. The authors found increasing trends for UFO with the increase in the mECM score, and that high mECM score (HMS, ≥3) was independently associated with a 2.42-fold (95% CI: 2.07-3.54; P =0.024) increased risk of UFO, which remained significant after considering the competing role of death and were more pronounced in nonsurgical treatment, women, no insurance, and patients with spouse (all P for interaction <0.05). Surgical intervention was identified to be significant protective factors for UFO (RR, 0.59; 95% CI: 0.46-0.75; P <0.001) and severe complications (RR, 0.63; 95% CI: 0.41-0.96; P =0.033) after propensity score matching, as well as survival (HR, 0.40, 95% CI: 0.28-0.58; P <0.001), which remained significant after considering the competing role of death and in all sensitivity analyses and were more pronounced in HMS participants ( P for interaction=0.006). Subgroup analyses revealed surgical patients with HMS had a significantly higher UFO rate (excluding death, P <0.001) while nonsurgical patients with HMS had higher mortality rate as compared to the others ( P =0.005). Surgical treatment for NCHF yields better outcomes compared to conservative treatment.

Association Between Belly Fat and Cardiovascular Disease: A Survey-Based Study

Background: The escalating prevalence of obesity worldwide is intricately linked with numerous health complications, notably diabetes, cardiovascular diseases (CVD), respiratory issues, and mental health disorders. Abdominal obesity, in particular, stands out as a significant predictor of cardiovascular risk, underpinning the need for detailed investigations to facilitate targeted interventions. Objective: This research aimed to elucidate the relationship between abdominal obesity and the risk of cardiovascular disease, focusing on the roles played by waist circumference, socioeconomic factors, exercise habits, and biochemical markers in determining cardiovascular health. Methods: This cross-sectional study, executed by the Cardiology Department at GKMC Swabi, analyzed data from a representative sample of 400 individuals recruited between January 5 and December 31, 2023. Participants were stratified by gender and waist size, undergoing evaluations for waist circumference, fasting blood glucose, lipid profiles, and physical fitness. Socioeconomic status was classified into low to middle, middle to high, and high. Data analysis was conducted using SPSS version 25.0, with chi-square tests and odds ratios computed to ascertain statistical significances at a threshold of p&lt;0.05. Results: The investigation revealed that males with waist sizes ≥85 cm (n=20) had a mean waist circumference of 90.1±43.1 cm and BMI of 23.3±0.80 kg/m², whereas females in the same waist size category (n=30) reported mean values of 88.1±2.7 cm and 23.8±0.7 kg/m², respectively, indicating significant associations with increased cardiovascular risk (p&lt;0.001 for all comparisons). Age analysis showed that individuals with central obesity were significantly older, with mean ages of 63.3±12.64 years for men and 63.9±4.5 years for women in the higher waist size groups, compared to their counterparts with smaller waist sizes (p&lt;0.001). Socioeconomic analysis highlighted an inverse relationship between education level and obesity prevalence, particularly among women. Regular physical activity emerged as a significant protective factor, with individuals engaging in exercise 0-3 days per week showing a lower incidence of elevated waist sizes (p&lt;0.001 for both genders). Adjusted odds ratios for age and BMI pointed to a complex interplay between abdominal obesity and CVD risk, influenced by gender and socioeconomic background. Conclusion: Our findings highlight the multifaceted relationship between abdominal obesity and cardiovascular disease risk, advocating for personalized treatment approaches that consider the intricate influences of socioeconomic status, lifestyle behaviors, and biological markers. The study underscores the importance of holistic strategies that promote lifestyle modification, socioeconomic improvement, and targeted clinical interventions to combat the cardiovascular sequelae of obesity.

Risk and protective factors of suicidal tendencies among freshmen in China revealed by a hierarchical regression model.

This study aimed to identify risk and protective factors for suicidal tendencies among college students by exploring current mental health, personal experiences, family environment, and school adaptation. A total of 11,504 freshmen in China were recruited. Suicidal tendencies were assessed using the Adolescents Suicidal Tendencies Scale (ASTS), while explored risk and protective factors included mental health assessed by the Symptom Checklist-90 (SCL-90), campus adaptation using the College Student School Adaptation Scale, and Personal Situation Survey. Single-factor Logistic regression analysis, correlation analysis, and hierarchical regression analysis were used to analyze the risk and protective factors affecting suicidal tendencies. The results showed that in terms of personal experience, self-injury behavior (OR = 3.522, 95% CI [3.256, 3.811]), sexual assault experience (OR = 2.603, 95% CI [2.374, 2.855]) and lack of friendship relationship (OR = 2.249, 95% CI [2.076, 2.436]) were the most significant risk factors. Regarding family environment, parenting style (OR = 2.455, 95% CI [2.272, 2.652]), parent-child relationship (OR = 2.255, 95% CI [2.092, 2.429]) and violent conflict (OR = 2.164, 95% CI [2.015, 2.324]) were the most prominent risk factors. For protective factors, life satisfaction (OR = 0.330, 95% CI [0.304, 0.359]) and rest quality (OR = 0.415, 95% CI [0.386, 0.447]) were the most significant protective factors. In addition, Symptom Checklist-90 was positively correlated with suicidal tendencies (r = 0.541, 95% CI [0.522, 0.560], p < 0.001), while school adaptation was negatively correlated with suicidal tendencies (r = - 0.590, 95% CI [- 0.579, - 0.601], p < 0.001). After considering demographic variables, psychological symptoms, school adaptation and other risk and protective factors, the hierarchical regression model could explain 48.9% of the variance of suicidal tendencies. The study emphasizes a range of multidimensional risk and protective factors for suicidal tendencies. This enhanced understanding is crucial in aiding the design of future intervention studies targeted at improving the mental health of college students.

A comparison of the substance use related risk and protective factor profiles for American Indian and White American youth: a mixed studies review.

American Indian youth are disproportionately impacted by substance use compared to White American youth in the United States. This mixed studies review focused on gathering data to examine the similarities and differences between the risk and protective factor profiles for substance use among American Indian and White American youth aged 10-21. A scan of the existing literature was needed to review substance use related risk and protective factors for American Indian and White American youth. Search phrases were created to ensure maximum relevant results from existing literature through 2021. After deduplication, an appraisal tool was utilized to review 343 records. A total of 19 articles were deemed relevant. Data from relevant articles was recorded and categorized into the levels of the Social Ecological Model. Significant and salient risk and protective factors of substance use for both American Indian and White American youth presented at the individual, interpersonal (family/non-family), and community levels of the Social Ecological Model. A total of 84 factors were found from relevant articles, 55 risk factors and 29 protective factors. When comparing the American Indian and White American youth profiles, a total of 29 unique differences between American Indian (n = 21) and White American youth (n = 8) were identified. Results from this review can be utilized to inform Tribal leaders, stakeholders, and policymakers, which will ultimately influence health intervention strategies and prioritizations. Given the limited evidence though, researchers should be responsive to Tribal communities' call to action for utilizing a culturally rooted approach.

Risk and protective factors for substance use and media addictive behaviors in adolescents during the COVID-19 pandemic.

This study examined the long-term effects of the COVID-19 pandemic on adolescents' substance use, digital media use, and symptoms of internet, gaming, and social media addiction. A nationally representative longitudinal cohort of 1665 Israeli teens and preteens, aged 9-16, completed questionnaires assessing substance use prevalence, daily screen time, symptoms of media addiction, and potential risk and protective factors. Data were collected before the pandemic (October 2019), after the second wave lockdown (November 2020), and after the fifth wave (April 2022) in Israel. The analysis documented significant increases in substance use, daily screen time, and social media addiction indices over time. Gratitude, life satisfaction, positive emotions, future orientation, grit, and secure attachment emerged as significant protective factors. Sensation-seeking, negative emotions, and mental health symptoms were identified as risk factors. These findings highlight the importance of educational and public mental health services in addressing the pandemic's long-term impact on the mental health and addictive behaviors of adolescents. They also emphasize the significance of enhancing protective factors and reducing risk factors to effectively mitigate substance and digital media abuse among adolescents.

Severe disability and self-reported depression and anxiety among persons living with Type 2 diabetes in Canada

BackgroundThis study aims to estimate the national prevalence of self-reported depression and anxiety disorders among persons living with Type 2 diabetes in Canada, as well as to investigate the potential link between disability severity and these conditions. MethodsWe conducted a cross-sectional analysis of a subsample (N=8,321) of participants living with Type 2 diabetes in the 2017-2018 Canadian Community Health Survey-Annual Component. Modified Poisson regression models were used to examine the association between disability severity and depression and anxiety disorders. Descriptive statistics, prevalence estimates, adjusted relative risk, and 95% confidence intervals are reported. All statistical analyses were conducted using STATA version 18. ResultsThe prevalence of depression and anxiety were 12.4% and 10.1% respectively. Our study found disability severity as a strong risk factor for both psychiatric disorders. We also found (1) dissatisfaction with life, (2) extremely stressful life events, (3) being female (4) single or never married, (5) poor self-rated health, (6) obesity, and (7) current smoker as significant risk factors for both psychiatric disorders. Conversely, increasing age and higher annual personal income status were significant protective factors. LimitationsThe study's limitations include the inability to establish temporal connections between risk factors and psychiatric disorders due to the cross-sectional design and the exclusion of those living in remote parts of the country and others from participation in the survey, which may underestimate the prevalence of Type 2 diabetes and severe disability. ConclusionsThis study's findings point toward a growing demand for tertiary prevention to increase the probability for those living with Type 2 diabetes in Canada of maintaining functional health, improving mental health, and having a better quality of life. Public health prevention efforts targeted at decreasing the prevalence of diabetes and its complications and disability severity are recommended.

Real-world Nationwide Outcomes of Minimally Invasive Surgery for Advanced Gastric Cancer Based on Korean Gastric Cancer Association-Led Survey.

The study aimed to investigate real-world surgical outcomes of minimally invasive surgery (MIS) for advanced gastric cancer using Korean Gastric Cancer Association (KGCA)-led nationwide data. A nationwide survey of patients who underwent surgical treatment for gastric cancer in 2019 was conducted by the KGCA. A total of 14,076 patients from 68 institutions underwent surgery, and 4,953 patients diagnosed with pathological stages IB-III gastric cancer were included. Among them, 1,689 patients who underwent MIS (MIS group) and 1,689 who underwent the open approach (open group) were matched using propensity score in a 1:1 ratio. Surgical outcomes were compared, and multivariate analysis was performed to identify the independent factors for overall morbidity. The MIS group had a lower proportion of D2 lymphadenectomy, total omentectomy, and combined resection. However, the number of harvested lymph nodes was higher in the MIS group. Better surgical outcomes, including less blood loss and shorter hospital stay, were observed in the MIS group, and the overall morbidity rate was significantly lower in the MIS group (17.5% vs. 21.9%, P=0.001). The mortality rates did not differ significantly between the 2 groups. In the multivariate analysis, the minimally invasive approach was a significant protective factor against overall morbidity (odds ratio, 0.799; P=0.006). Based on the Korean nationwide data, MIS for stage IB-III gastric cancer had better short-term outcomes than the open approach, including lower rates of wound complications, intra-abdominal abscesses, and cardiac problems.

Prevalence of and risk factors for surgical site infections after pancreaticoduodenectomy: a systematic review and meta-analysis.

Surgical site infections (SSIs) are one of the most common complications after pancreaticoduodenectomy (PD); however, the global prevalence and risk factors for SSIs after PD remain unknown. To investigate the prevalence of and risk factors for SSIs after PD. The PubMed, Embase, Cochrane Library, Web of Science, and Science Direct databases were systematically searched from inception to 1 December 2022. Observational studies reporting adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of risk factors for SSIs in patients undergoing PD were included. Two independent reviewers in teams performed data extraction, risk of bias assessment, and level of evidence analysis. The pooled results were estimated using a random-effects model. The I 2 statistic and Q χ 2 statistic were used to assess heterogeneity. Funnel plots, Egger's regression test, and the trim-and-fill method were used to determine publication bias. The primary outcomes were identifying risk factors for SSIs after PD. The secondary outcomes were the pooled prevalence rates of SSIs. A total of 98704 patients from 45 studies were included, and 80% of the studies were considered high quality. The estimated pooled prevalence of SSIs was 23% (0.19-0.27, I 2=97%). The prevalence of SSIs was found to be higher in Japan and lower in USA. Preoperative biliary stenting, higher body mass index (BMI), longer operation time, postoperative pancreatic fistula, soft pancreatic texture, perioperative blood transfusion, and cardiac disease were identified as significant risk factors for the development of SSIs after PD. Additionally, broad-spectrum antibiotics were a significant protective factor against SSIs. Subgroup analysis and sensitivity analysis showed that the results were robust. The prevalence of SSIs remains high and varies widely among regions. It is necessary to take effective preventive measures and carry out more prospective studies to further verify these results.

Factors associated with mortality among laboratory-diagnosed drug-resistant tuberculosis patients on treatment, KwaZulu-Natal Province, 2017-2019.

tuberculosis (TB) remains a leading cause of death in South Africa. KwaZulu-Natal (KZN) is one of the provinces with a high burden of TB/drug-resistant TB cases and deaths. We determined predictors for mortality among drug-resistant TB patients on treatment in KZN province. we conducted a retrospective cohort study using secondary data from the Electronic Drug-Resistant Tuberculosis Register. We used a modified Poisson regression model with robust standard errors to determine predictors for drug-resistant TB mortality. of the 7,692 eligible patients, 1,234 (16.0%) died. Males predominated (707, 57.3%) and the median age was 36 years (Interquartlile Range: 29-45 years). The majority (978, 79.2%) were HIV-TB co-infected with 911 (93%) on antiretroviral treatment (ART). The predictors included HIV-TB co-infection without ART (aIRR 3.4; 95% CI: 2.3-5.1), unknown ART status (aIRR: 1.8; 95% CI: 1.4-2.3), aged ≥60 years (aIRR: 2.1; 95% CI: 1.6-2.7), previous drug-resistant TB (aIRR: 1.5; 95% CI: 1.2-1.8) and exposure to second-line drugs (aIRR: 1.7; 95% CI: 1.4-2.0). Other predictors were hospitalization during treatment initiation (aIRR 2.5; 95% CI 2.0-3.1), initiation in other treatment facilities (aIRR: 2.2; 95% CI: 1.6-2.9) and rifampicin-resistant (aIRR: 1.2; 95% CI: 1.1-1.4). Bedaquiline fumarate was a significant protective factor against death (aIRR: 0.5; 95% CI: 0.4-0.5). older age, HIV co-infection without ART, hospitalization for treatment initiation, exposure to second-line drugs and a previous episode of drug-resistant TB were predictors for DR-TB mortality. Early treatment initiation and provision of antiretroviral treatment for all co-infected patients may reduce DR-TB mortality in the Province.

Effect of different treatment modalities on ovarian cancer patients with liver metastases: A retrospective cohort study based on SEER.

To examine the trends in morbidity and mortality among ovarian cancer patients with liver metastases, and investigate the impact of different treatments on both overall survival (OS) and cancer-specific survival (CSS). 2,925 ovarian cancer patients with liver metastases from Surveillance, Epidemiology, and End Results 2010-2019 were included. The primary endpoint was considered as OS and CSS. We conducted trend analysis of the incidence, OS and CSS rates of liver metastases in ovarian cancer. Univariate and multivariate COX proportional risk models were used to investigate the association between different treatment methods and OS, and univariate and multivariate competing risk models were employed to evaluate the impact of treatment methods on CSS. At the end of follow-up, 689 patients remained alive. The OS and CSS rates were 76.44% and 72.99% for all patients, respectively. There was a significant decreasing trend in the incidence [average annual percent change (AAPC) = -2.3, 95% confidence interval (CI): -3.9, -0.7], all-cause mortality (AAPC = -12.8, 95% CI: -15.6, -9.9) and specific mortality (AAPC = -13.0, 95% CI: -16.1, -9.8) rate of liver metastases in ovarian cancer. After adjusting all confounding factor, only receiving surgery was associated with OS [hazard ratio (HR) = 0.39, 95%CI: 0.31-0.48]/CSS (HR = 0.37, 95%CI: 0.30-0.47). Chemotherapy was found to be protective factor for OS (HR = 0.33, 95%CI: 0.30-0.37)/CSS (HR = 0.44, 95%CI: 0.39-0.50) of ovarian cancer patients, while not receiving surgery remained a risk factor. Additionally, the result of subgroup analyses also showed that only receiving surgery and chemotherapy still were significant protective factor of OS and CSS for patients without other distant metastases, with distant metastases to the bone, lung, brain or other organs, with bone metastasis, and with lung metastasis. Our research has elucidated a downward trend in morbidity and mortality rates among patients with liver metastases originating from ovarian cancer. Only receiving surgery and chemotherapy as therapies methods confer survival benefits to patients.

Overall Survival of Primary Single Intracranial Atypical Meningioma with Different Surgical and Postoperative Treatment Options: Evidence from the SEER Database.

The aim of this study is to evaluate the impact of different surgical and postoperative treatment options on the long-term overall survival (OS) in patients with primary single intracranial atypical meningioma. In this retrospective study, participants were drawn from the Surveillance, Epidemiology, and End Results (SEER) database. Inclusion criteria comprised patients who underwent either gross total resection (GTR) or subtotal resection (STR). The inverse probability weighting (IPW) method using generalized boosted models was used to achieve balance in variables across various treatment groups. Subsequent to IPW, multivariate Cox analysis and Kaplan-Meier analysis were conducted, with OS as the endpoint. GTR was conducted on 1650 patients, while STR was conducted on 1109 patients. Among these, 432 patients who underwent GTR and 401 patients who underwent STR received postoperative radiotherapy (PORT). In the case of patients who were under 60 years old, PORT emerged as a significant protective factor for OS in those who underwent STR (HR 0.44; 95% CI 0.23-0.84; p = 0.013). Survival curves demonstrated that patients who underwent STR with PORT exhibited comparable OS to those who underwent GTR without PORT (p = 0.546). Conversely, for patients aged 60 years or older, PORT emerged as an independent risk factor for both GTR (HR 1.42; 95% CI 1.00-2.00; p = 0.048) and STR (HR 1.81; 95% CI 1.26-2.60; p = 0.001). PORT may contribute to improving OS in primary single atypical meningioma patients under 60 years old who receive STR. However, in older patients who underwent either GTR or STR, the administration of PORT may be associated with a potential risk of OS. Therefore, age should be taken into account in applying PORT therapy, and the optimal treatment strategy for PORT in patients with atypical meningiomas needs to be further explored and validated.

FAITH AND HEALTH: THE INTRICATE INTERPLAY OF MARITAL QUALITY, RELIGIOSITY, AND DIABETES

Abstract Although chronic illness in later life can negatively affect marital quality and life satisfaction through increased stress and burden, religiosity and spirituality are known robust protective factors in relational and psychological outcomes. Stress theory suggests that religious behaviors can help moderate this negative relationship by providing patients with a sense of meaning in illness, external social support, and healthy coping mechanisms. Using data from the Life and Family Legacies Study, we analyzed cross-sectional data from 1,210 married participants around age 70 in 2016. Using an OLS linear regression model, we found main effects which showed that type 2 diabetes among older adults was predictive of lower positive marital quality and lower life satisfaction. When religious behaviors were included in the model as a moderator, religious behaviors interacted significantly with diabetes such that individuals with type 2 diabetes who reported high religiosity had high positive marital quality, while those with low religiosity reported significantly lower positive marital quality. Findings suggest that when persons with type 2 diabetes participate regularly in church services, prayer, and scripture study they experience more positive marital quality. This indicates that religiosity may be a significant protective factor and coping tool for marital quality when chronic illness is present.

Outpatient screening for anxiety and depression symptoms in adolescents with type 1 diabetes - a cross-sectional survey

BackgroundThe daily demands of type 1 diabetes management may jeopardize adolescents’ mental health. We aimed to assess anxiety and depression symptoms by broad-scale, tablet-based outpatient screening in adolescents with type 1 diabetes in Germany.MethodsAdolescent patients with type 1 diabetes mellitus (n = 2,394; mean age 15.4 y [SD 2.0]; 50.7% male) were screened for anxiety (GAD-7) and depression symptoms (PHQ-9) by self-report questionnaires and linked to clinical data from the DPV patient registry. Logistic regression was used to estimate the contribution of clinical parameters to positive screening results.ResultsAltogether, 30.2% showed a positive screening (score ≥ 7 in either test), and 11.3% reported suicidal ideations or self-harm. Patients with anxiety and depression symptoms were older (15.7 y [CI 15.5–15.8] vs. 15.3 y [CI 15.2–15.4]; p < 0.0001), had higher HbA1c levels (7.9% [CI 7.8-8.0] (63 mmol/mol) vs. 7.5% [CI 7.4–7.5] (58 mmol/mol); p < 0.0001), and had higher hospitalization rates. Females (adjusted odds ratio (aOR) 2.66 [CI 2.21–3.19]; p < 0.0001), patients > 15 years (aOR 1.40 [1.16–1.68]; p < 0.001), who were overweight (aOR 1.40 [CI 1.14–1.71]; p = 0.001), with HbA1c > 9% (> 75 mmol/mol; aOR 2.58 [1.83–3.64]; each p < 0.0001), with a migration background (aOR 1.46 [CI 1.17–1.81]; p < 0.001), or smoking (aOR 2.72 [CI 1.41–5.23]; p = 0.003) had a higher risk. Regular exercise was a significant protective factor (aOR 0.65 [CI 0.51–0.82]; p < 0.001). Advanced diabetes technologies did not influence screening outcomes.ConclusionsElectronic mental health screening was implemented in 42 centers in parallel, and outcomes showed an association with clinical parameters from sociodemographic, lifestyle, and diabetes-related data. It should be integrated into holistic patient counseling, enabling early recognition of mild mental health symptoms for preventive measures. Females were disproportionally adversely affected. The use of advanced diabetes technologies did not yet reduce the odds of anxiety and depression symptoms in this cross-sectional assessment.

Psychometric Validation of the PROMIS Social Support Scale in a Sample of Individuals With Chronic Health Conditions and Disabilities: A Factor Analytic Study

Social support is a significant protective factor for health and well-being of people with chronic health conditions and disabilities. It is important to include a psychometrically sound measure of social support in their clinical assessment practices, especially during the COVID-19 pandemic. The purpose of this study was to validate the Patient-Reported Outcomes Measurement Information System (PROMIS) Social Support Scale in a sample of people with chronic health conditions and disabilities. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to examine and validate the three-factor measurement structure of the PROMIS Social Support Scale. Exploratory factor analysis and CFA results confirmed that a three-factor measurement structure (instrumental, informational, and emotional support) accounted for 82.75% of the total variance. All items loaded highly onto their respective factors (ranging from .73 to .99). Reliability coefficients of the three subscales ranged from .95 to .97. The three social support factors were positively associated with community participation and subjective well-being in the theoretically expected directions. Findings of this study provide strong empirical support for the psychometric properties of the PROMIS Social Support Scale and its use with people with chronic health conditions and disabilities in clinical practice and research.

Landscape, Socioeconomic, and Meteorological Risk Factors for Canine Leptospirosis in Urban Sydney (2017-2023): A Spatial and Temporal Study.

Leptospirosis is a potentially fatal zoonotic disease caused by infection with pathogenic Leptospira spp. We described reported clinical cases of canine leptospirosis in the council areas of the Inner West and the City of Sydney, Australia, from December 2017 to January 2023 and tested the association with urban spatial (landscape and socioeconomic factors, community seroprevalence, and urban heat island effect) and temporal (precipitation and minimum and maximum temperature) factors and the cases using log-transformed Poisson models, spatially stratified population-adjusted conditional logistic models, General Additive Models (GAMs), and Autoregressive Integrated Moving Average (ARIMA) models. The results suggested that canine leptospirosis is now endemic in the study area. A longer distance to the nearest veterinary hospital (RR 0.118, 95% CI -4.205--0.065, p < 0.05) and a mildly compromised Index of Economic Resources (IER) (RR 0.202, 95% CI -3.124--0.079, p < 0.05) were significant protective factors against leptospirosis. In areas proximal to the clinical cases and seropositive samples, the presence of tree cover was a strong risk factor for higher odds of canine leptospirosis (OR 5.80, 95% CI 1.12-30.11, p < 0.05). As the first study exploring risk factors associated with canine leptospirosis in urban Sydney, our findings indicate a potential transmission from urban green spaces and the possibility of higher exposure to Leptospira-or increased case detection and reporting-in areas adjacent to veterinary hospitals.

Predicting Factors of Pre-coital and Sexual Behaviors among Thai Muslim Adolescents: A Cross-sectional Study

Pre-coital and sexual behaviors are precarious and may lead adolescents to face higher rates of unwanted pregnancies and sexually transmitted infections. This cross-sectional study aimed to determine the factors predicting pre-coital and sexual behaviors amongMuslim adolescents in southernmost Thailand. Seven hundred adolescents were recruited from a vocational college and four schools. Sexual risk behaviors and its related factors questionnaires were employed for data collection. Descriptive statistics were used todescribe the demographic characteristics of the participants; binary and ordinal logistic regression was used to examine the factors explaining sexual risk behaviors. The results indicated that increased age was a predicting factor for higher pre-coital and sexual behaviors. For interpersonal factors, knowledge of sexual risk behaviors was a protective factor, while perceived parent and peer approval of sex and perceived peer norms predicted higher pre-coital and sexual behaviors. More parental monitoring was a protective factor for lower pre-coital behaviors. For environmental factors, cultural norms were a significant protective factor, while neighborhood disorganization predicted higher pre-coital behaviors. In conclusion, age, parental approval of sex, and perceived peer norms were predictors of sexual and pre-coital behaviors. These findings provide useful information for healthcare providers, especially nurses, to develop the intervention with the protective factors and predictors of sexual and pre-coital behaviors. We recommend action research that includes all community stakeholders to develop an intervention to prevent sexual risk behaviors among Muslim adolescents.

When Will This End? Exploring the Relationship between Depression Symptoms, Perceptions of the Future Self, and Anticipated Length of the COVID-19 Pandemic in College Seniors

Introduction: The COVID-19 pandemic changed lives overnight. With the pandemic's abrupt spread, graduating college students encountered widespread setbacks and challenges and were left with considerable uncertainty about how long the pandemic would last. This research explored the relationship between anticipation of the pandemic's length and longitudinal mental health, and the role of perception of the future self (i.e., future self-identification) as a potential protective and promotive factor for mental health during the pandemic. Methods: Graduating college seniors completed a two-part longitudinal study starting as the pandemic initially spread in the United States (March 26—April 10, 2020) and ending over half a year into the pandemic's course (October 20-January 27, 2021). Results: Findings suggested that higher initial symptoms of depression did not predict anticipating a longer pandemic, but anticipating a longer pandemic significantly predicted higher downstream depression symptoms over and above the initial symptoms. Additionally, greater future self-identification did not moderate the relationship between anticipated pandemic length and downstream depression (i.e., it was not a significant protective factor). However, having a positive view of the future self significantly predicted better downstream mental health over and above perceptions of pandemic length and initial depression symptoms. Positivity toward the future self may be an important promotive factor for mental health during the pandemic. Discussion: These results indicate that students who anticipate an extended crisis may need extra support, and perception of the future self as positive may be a valuable psychological resource.