Socio-behavioral Factors Research Articles

The health belief model and colorectal cancer screening in the general population: A systematic review.

Colorectal cancer screening saves lives and is cost-effective. It allows early detection of the pathology, and enables earlier medical intervention. Despite clinical practice guidelines promoting screening for average risk individuals, uptake remains suboptimal in many populations. Few studies have examined how sociobehavioural factors influence screening uptake in the context of behaviour change theories such as the health belief model. This systematic review therefore examines how the health belief model’s constructs are associated with colorectal cancer screening.Four databases were systematically searched from inception to September 2019. Quantitative observational studies that used the health belief model to examine colorectal screening history, intention or behaviour were included.A total of 30 studies met the criteria for review; all were of cross-sectional design. Perceived susceptibility, benefits and cues to action were directly associated with screening history or intention. Perceived barriers inversely associated with screening history or intention. The studies included also found other modifying factors including sociodemographic and cultural norms. Self-report of screening history, intention or behaviour, convenience sampling and lack of temporality among factors were common limitations across studies.The health belief model’s associations with colorectal cancer screening uptake was consistent with preventive health behaviours in general. Future studies should examine how theory-based behavioural interventions can be tailored to account for the influence of socioecological factors.

Infeção Genital por Chlamydia Trachomatis nos Adolescentes Portugueses

Os adolescentes (entre os 10 e os 19 anos) são um grupo etário com elevada prevalência de infeções sexualmente transmissíveis (IST), devido aos seus fatores biológicos e socio-comportamentais. Em Portugal, os adolescentes revelam fraca adesão ao preservativo, têm múltiplos parceiros sexuais, deficiente educação sexual e altas taxas de reinfeção. Nesta faixa etária, a infeção genital por Chlamydia trachomatis é a IST mais prevalente, cujo curso assintomático dificulta o diagnóstico e controlo epidemiológico. Pretendeu-se rever os dados publicados de prevalência da infeção genital por Chlamydia trachomatis no grupo dos adolescentes portugueses. Nos estudos populacionais encontrados em Portugal, bastante heterogéneos entre si, verificou-se uma prevalência entre 2,23% e 18,2%. As taxas de notificação portuguesas são inferiores às dos restantes países europeus e os dados oficiais nacionais não discriminam a faixa etária dos adolescentes. Entre os 15-24 anos, foram notificados 41 casos em 2015 e 56 casos em 2016. Segundo o relatório do European Centre for Disease Control, foram notificados 116 e 167 casos na mesma faixa etária, em Portugal, em 2017 e 2018, respetivamente. A compreensão da epidemiologia da infeção genital por CT nos adolescentes portugueses é impossibilitada devido ao subdiagnóstico, à subnotificação e ao não isolamento dos adolescentes nos grupos de estudo. É assim necessário um esforço conjunto a nível clínico e político para que seja possível delinear uma estratégia eficaz no combate a esta infeção nos adolescentes.

Predictors of Patient Portal Use Among Community-Dwelling Older Adults.

Older adults lag behind their younger counterparts in the use of patient portals, which may limit their ability to engage in health care. A better understanding of the factors associated with portal use among older adults is needed. We examined the proportion of 100 community-dwelling older adults who reported using a portal, the associations between sociobehavioral factors and portal use, and modeled predictors of portal use. Of the 52% who reported using a portal, 28% used the portal on their own, and 24% received assistance from others or had others access the portal on their behalf. After controlling for confounders, only marital status was significantly associated with any portal use. Marital status and patient activation were significantly associated with independent portal use. Further exploration is warranted to identify additional factors and the possible mechanisms underlying portal use by older adults. [Research in Gerontological Nursing, 14(1), 33-42.].

The Role of Intranasal Oxytocin on Social Cognition: An Integrative Human Lifespan Approach.

This narrative review synthesizes research from the last two decades on the modulatory role of intranasal OT administration (IN-OT) on social cognition in early life, young/middle adulthood, and older adulthood. Advances and knowledge gaps are identified, and future research directions are discussed within an integrative human lifespan framework to guide novel research on IN-OT and social cognition. Current evidence regarding IN-OT modulation of social-cognitive processes, behavior, and related neurocircuitry is mixed, with some studies suggesting benefits (e.g., improved social perception/interactions, emotion processing) depending on contextual (e.g., social stimuli) and interindividual factors (e.g., age, sex, clinical status). Current research, however, is limited by a focus on isolated life phases, males, and select clinical populations as well as a lack of standardized protocols. This literature-based reflection proposes that greater generalizability of findings and scientific advancement on social-cognitive modulation via IN-OT require standardized, multi-method, longitudinal, and cross-sequential assessments in well-powered, well-controlled, and representative samples in line with an integrative lifespan approach, which considers development as a lifelong dynamic process involving both change and stability characterized by the interplay between genetic, neurobiological, and socio-behavioral factors.

Cannabis use is associated with a lower risk of diabetes in chronic hepatitis C-infected patients (ANRS CO22 Hepather cohort).

Chronic hepatitis C virus (HCV) infection is a risk factor of insulin resistance, and HCV-infected patients are at a high risk of developing diabetes. In the general population, research has shown the potential benefit of cannabis use for the prevention of diabetes and related metabolic disorders. We aimed to test whether cannabis use is associated with a lower risk of diabetes in chronic HCV-infected patients. Chronic HCV-infected patients (n=10445) were selected from the French national, multicenter, observational ANRS CO22 Hepather cohort. Cross-sectional data collected at cohort enrollment were used to assess the association between patients' clinical and behavioural characteristics and the risk of diabetes. Logistic regression model was performed with cannabis use as the main independent variable and a significance level set at 5%. A similar model stratified by the presence of advanced liver fibrosis (FIB-4>3.25) was also run. After multivariable adjustment, current (AOR [95%CI]: 0.49 [0.38-0.63]) and former (0.81 [0.67-0.98], P<.001) cannabis use were both associated with a reduced odds of diabetes. Conversely, male gender, tobacco use, elevated BMI, poverty, being a migrant and advanced fibrosis were associated with increased odds of diabetes. The association between cannabis use and diabetes was maintained in the stratified analysis. In this large cross-sectional study of chronic HCV-infected patients, cannabis use was associated with a lower risk of diabetes independently of clinical and socio-behavioural factors. Further studies are needed to elucidate a potential causal link and shed light on cannabis compounds and mechanisms involved in this relationship.

Social, Behavioral, and Cultural factors of HIV in Malawi: Semi-Automated Systematic Review.

BackgroundDemographic and sociobehavioral factors are strong drivers of HIV infection rates in sub-Saharan Africa. These factors are often studied in qualitative research but ignored in quantitative analyses. However, they provide in-depth insight into the local behavior and may help to improve HIV prevention.ObjectiveTo obtain a comprehensive overview of the sociobehavioral factors influencing HIV prevalence and incidence in Malawi, we systematically reviewed the literature using a newly programmed tool for automatizing part of the systematic review process.MethodsDue to the choice of broad search terms (“HIV AND Malawi”), our preliminary search revealed many thousands of articles. We, therefore, developed a Python tool to automatically extract, process, and categorize open-access articles published from January 1, 1987 to October 1, 2019 in the PubMed, PubMed Central, JSTOR, Paperity, and arXiV databases. We then used a topic modelling algorithm to classify and identify publications of interest.ResultsOur tool extracted 22,709 unique articles; 16,942 could be further processed. After topic modelling, 519 of these were clustered into relevant topics, of which 20 were kept after manual screening. We retrieved 7 more publications after examining the references so that 27 publications were finally included in the review. Reducing the 16,942 articles to 519 potentially relevant articles using the software took 5 days. Several factors contributing to the risk of HIV infection were identified, including religion, gender and relationship dynamics, beliefs, and sociobehavioral attitudes.ConclusionsOur software does not replace traditional systematic reviews, but it returns useful results to broad queries of open-access literature in under a week, without a priori knowledge. This produces a “seed dataset” of relevance that could be further developed. It identified known factors and factors that may be specific to Malawi. In the future, we aim to expand the tool by adding more social science databases and applying it to other sub-Saharan African countries.

COVID-19: a gendered disease? Possible interpretations and knowledge limitations

Several important gender differences in susceptibility, clinical manifestation and response to treatments for a number of diseases are known since a long time, although they continue to be underestimated by a multiplicity of operators, especially men. The recent COVID-19 pandemic has provided a further evidence of the importance of gender medicine. The epidemiological analysis of COVID-19 data has highlighted the presence of multiple and important gender differences, with more unfavourable scenarios for the male gender. The mechanisms underlying these gender differences are varied (including socio-behavioral, immune and viral factors) and not yet fully clarified. A gender-based approach to clinical practice also in the context of this pandemic seems to be mandatory, as it could significantly contribute to health promotion by improving the effectiveness of diagnostic and/or therapeutic approaches and, therefore, leading to important benefits primarily for the patients but also for the sustainability of the National Health System.

Adherence to HIV antiretroviral therapy among pregnant and postpartum women during the Option B+ era: 12‐month cohort study in urban South Africa and rural Uganda

IntroductionWe conducted a cohort study to understand patterns of anti‐retroviral therapy (ART) adherence during pregnancy, postpartum and non‐pregnancy follow‐up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa.MethodsWe collected survey data, continuously monitored ART adherence (Wisepill), HIV‐RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow‐up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non‐pregnancy‐related (neither pregnant nor postpartum). Fractional regression models included demographics and socio‐behavioural factors informed by the Behavioral Model for Vulnerable Populations. We evaluated HIV‐RNA at 12 months by ever‐ versus never‐pregnant status.ResultsIn Uganda, 247 women contributed 676, 900 and 1274 months of pregnancy, postpartum and non‐pregnancy‐related follow‐up. Median ART adherence was consistently ≥90%: pregnancy, 94% (interquartile range [IQR] 78,98); postpartum, 90% (IQR 70,97) and non‐pregnancy, 90% (IQR 80,98). Poorer adherence was associated with younger age (0.98% [95% CI 0.33%, 1.62%] average increase per year of age) and higher CD4 cell count (1.01% [0.08%, 1.94%] average decrease per 50 cells/mm3). HIV‐RNA was suppressed among 91% (N = 135) ever‐pregnant and 86% (N = 85) never‐pregnant women. In South Africa, 190 women contributed 259, 624 and 1247 months of pregnancy, postpartum and non‐pregnancy‐related follow‐up. Median adherence was low during pregnancy, 74% (IQR 31,96); postpartum, 40% (IQR 4,65) and non‐pregnancy, 77% (IQR 47,92). Poorer adherence was associated with postpartum status (22.3% [95%CI 8.6%, 35.4%] average decrease compared to non‐pregnancy‐related follow‐up) and less emotional support (1.4% [0.22%, 2.58%] average increase per unit increase). HIV‐RNA was suppressed among 57% (N = 47) ever‐pregnant and 86% (N = 93) never‐pregnant women.ConclusionsWomen in rural Uganda maintained high adherence with 91% of ever‐pregnant and 86% of never‐pregnant women suppressing HIV‐RNA at 12 months. Women in urban South Africa struggled with adherence, particularly during postpartum follow‐up with median adherence of 40% and 57% of women with HIV‐RNA suppression at one year, suggesting a crisis for postpartum women with HIV in South Africa. Findings suggest that effective interventions should promote emotional support.

Outcomes of ST-elevation myocardial infarction by age and sex in a low-income urban community: The Montefiore STEMI Registry.

ObjectivesTo compare outcomes by age and sex in race/ethnic minorities presenting with ST‐elevation myocardial infarction (STEMI), as studies are limited.MethodsWe studied sociodemographics, management, and outcomes in 1208 STEMI patients evaluated for primary percutaneous coronary intervention between 2008 and 2014 at Montefiore Health System (Bronx, NY). A majority of patients self‐identified as nonwhite, and nearly two‐thirds were young (<45 years) or middle‐aged (45‐64 years).ResultsRisk factors varied significantly across age groups; with more women and non‐Hispanic whites, hypertension, diabetes, dyslipidemia, prior cardiovascular disease, non‐sinus rhythm, and collagen vascular disease in the older age group (≥65 years); and higher body mass index, smoking, cocaine use, human immunodeficiency virus (HIV) infection and family history of heart disease in the young. Younger women had lower summary socioeconomic scores than younger men. Middle‐aged women had more obesity and dysmetabolism, while men had more heavy alcohol use. There was greater disease severity with increasing age; with higher cardiac biomarkers, 3‐vessel disease, cardiogenic shock, and coronary artery bypass grafting. Older patients had higher rates of death and death or readmission over 4.3 (interquartile range 2.4, 6.0) years of follow‐up. Middle‐aged women had higher rates of death or any readmission than men, but these differences were not significant after adjustment.ConclusionsThese findings indicate a high burden of risk factors in younger adults with STEMI from an inner‐city community. Programs to target sociobehavioral factors in disadvantaged settings, including substance abuse, obesity, and risk of HIV, are necessary to more effectively address health disparities in STEMI and its adverse consequences.

Factors associated with non-adherence to antiretroviral therapy among female sex workers living with HIV in Hyderabad, India.

We determined factors associated with non-adherence (consuming <90% of monthly antiretroviral therapy) among female sex workers (FSWs). An interviewer-administered questionnaire was used in a sample of 100 South Indian FSWs living with HIV. We examined demographics, food insecurity, side effects, stigma, alcohol/substance use and self-efficacy. Non-adherence was assessed by self-report, pill-count and combined measures. Prevalence ratios and 95% confidence intervals (CIs) were calculated at p-value <0.1. Thirty-seven percent (33/90) of FSWs were non-adherent by pill-count, 29% (28/95) by self-report and 52% (51/99) by the combined measure. Seventy-six percent (76/100) of FSWs reported experience of at least one form of food insecurity in the past six months. In the regression analysis, arrest in the past year was independently associated with the combined measure of non-adherence (crude prevalence ratios 1.7, 95% CI 1.0-2.8). A successful combination adherence intervention should consider several of the socio-behavioral factors identified in this study including arrest and food insecurity.

FORECASTING THE MORPHOLOGICAL COMPOSITION OF MUNICIPAL WASTE IN THE DESIGN THE CITY SANITARY SCHEME

The article substantiates the importance of predicting the morphological composition of solid waste. For the forecasting study, initial data were collected by surveying the residents of Vinnytsia. This study made it possible to predict the impact on the morphological composition of MSW of a number of factors: seasonality factors, external influences, socio-behavioral factors, consumer behavior and personal preferences, living conditions, organizational factors. A correlation was found between the factors and the target variables of forecasting allows to predict the change in the morphological composition of municipal solid waste depending on the socio-domestic changes in the lives of urban citizens.A model for predicting the morphological composition of municipal solid waste was proposed. This prediction model is based on the artificial neural network method. It makes it possible to analyze the ratio of fractions of municipal solid waste produced in a particular household. The choice of an artificial neural network is due to its ability to predict several indicators. The fractions that were predicted are glass, paper and cardboard, plastic of various markings, the fraction of combined packaging, metal and the fraction of non-recyclable waste.The practical implementation of forecasting the morphological composition of solid waste is performed on the example of Vinnytsia. Based on the information obtained by predicting the morphological composition of solid waste, the prospects for the formation of different fractions of solid waste in the city are practically calculated.Developed forecasting can be an effective tool for management decisions on the location of sanitation facilities, by estimating data on the volumes of different fractions produced in different areas.

Human Immunodeficiency Virus Infection Is Associated With Increased Meningococcal Carriage Acquisition Among First-year Students in 2 South African Universities.

BackgroundInvasive meningococcal disease clusters occur among university students and may reflect higher carriage prevalence among this population. We aimed to measure meningococcal carriage prevalence, acquisition, and risk factors among first-year university students in South Africa.MethodsIn summer–autumn 2017, after consenting to participate, we collected oropharyngeal swabs and questionnaires on carriage risk factors and tested students for HIV at 2 universities, during registration week (survey 1) and 6–8 weeks later (survey 2). Meningococci were detected by culture and polymerase chain reaction.ResultsWe enrolled 2120 students at registration. Mean age was 18.5 years, 59% (1252/2120) were female and 0.8% (16/1984) had HIV. Seventy-eight percent of students returned for survey 2 (1655/2120). Among the cohort, carriage prevalence was 4.7% (77/1655) at registration, increasing to 7.9% (130/1655) at survey 2: 5.0% (83) acquired new carriage, 2.8% (47) had persistent carriage, 1.8% (30) cleared the initial carriage, and 90.3% (1495) remained carriage free. At both surveys, nongenogroupable meningococci predominated, followed by genogroups Y, B, W, and C. On multinomial analysis, risk factors for carriage acquisition included attending nightclubs (adjusted relative risk ratio [aRRR], 2.1; 95% CI, 1.1–4.0), having intimate kissing partners (aRRR, 1.8; 95% CI, 1.1–2.9) and HIV (aRRR, 5.0; 95% CI, 1.1–24.4).ConclusionsMeningococcal carriage among first-year university students increased after 2 months. Sociobehavioral risk factors were associated with increased carriage for all analyses. HIV was associated with carriage acquisition. Until vaccination programs become mandatory in South African universities, data suggest that students with HIV could benefit most from meningococcal vaccination.

Mental morbidity and its associations with socio-behavioural factors and chronic conditions in rural middle- and older-aged adults in South Africa

This study investigated mental morbidity and its association with socio-behavioural health and chronic health conditions among rural middle-older persons in South African (N = 5 059 adults; females = 53.6%; mean age = 62.4 years, SD = 13.1 years). We analysed baseline data from the Health and Aging in Africa Longitudinal Study (HAALSI), which included questions on socio-demographic, clinical, health, depression, and posttraumatic stress disorder (PTSD). Seventeen percent of the participants screened positive for depression and 4.8% for PTSD. The percentage of depression and/or PTSD was significantly higher in individuals with anaemia, angina, cataract, diabetes, dyslipidaemia, chronic bronchitis, heart failure, stroke, kidney disease, and tuberculosis. In multivariable logistic regression, being female, older age, being underweight, and having multi-morbidity portended higher risk for depression. Multi-morbidity and being physically inactive but not obese increased the odds for PTSD. Multi-layered interventions are needed to investigate the mental health burden of this aging rural population.

Influence of some socio-behavioral and medical factors on probability of developing gonococcal infection

Aim. To analyze and assess the influence of some socio-behavioral and medical factors on probability of developing gonococcal infection&#x0D; Materials and methods. The study was carried out among the patients of State Budgetary Institution of Healthcare of Perm Krai Regional Clinical Dermatovenerologic Dispensary. It involved 292 persons. To evaluate the influence of socio-behavioral and medical factors on gonococcal infection sickness rate, the ratio of odds to 95% confidence interval was calculated. Multinominal logit and multi-factor correlation regression analysis were used. Nonparametric criteria were applied to compare quantitative signs.&#x0D; Results. The factors, influencing the development of gonococcal infection were determined. Socio-behavioral factors absence of work, early onset of sexual life, use of psychoactive substances elevate the risk of gonococcal infection development by 2.44.8 times. The most significant medical factors untimely visit to a doctor, full elimination of causative agent after treatment the first dispensary examination, on the day 14th after full elimination of causative agent the second dispensary examination that increases risk for development of gonococcal infection by 1.157.65 times. Significance of the following factors was stated: age and family status; the younger is respondent, the higher is morbidity risk; the same situation is observed when there is no a constant sexual partner. When comparing persons with a single episode of disease and those who were ill twice and more frequently, the most essential factors were registration at detmatovenerologic dispensary, elimination of causative agent, deregistration on the day 42nd after elimination of causative agent, indication of source of disease, examination of sexual partners, treatment of sexual partners, examination and treatment of partners.&#x0D; Conclusions. The priority risk factors were the following: socio-behavioral nonworking persons, who started their sexual life early (under 16) and use psychoactive substances. Medical risk factors: full elimination of causative agent after antibiotic therapy (Clinical Recommendations of Russian Society of Dermatovenerologists and Cosmetologists) the first dispensary examination, and the day 14th after confirmed full elimination of causative agent the second dispensary examination.

Investigating associated factors with glomerular filtration rate: structural equation modeling

BackgroundGlomerular filtration rate (GFR) is a valid indicator of kidney function. Different factors can affect GFR. The purpose of this study is to assess the direct and indirect effects of GFR-related factors using structural equation modeling.Patients and methodsWe analyzed data from the baseline phase of the Ravansar Non-Communicable Disease cohort study. Data on socio-behavioral, nutritional, cardiovascular, and metabolic risk factors were analyzed using a conceptual model in order to test direct and indirect effects of factors related to GFR, separately in male and female, using the structural equation modeling.ResultsOf 8927 individuals who participated in this study, 4212 subjects were male (47.20%). The mean and standard deviation of GFR was 76.05 (±14.31) per 1.73 m2. GFR for 0.2, 11.3, 73.0 and 15.5% of people were < 30, 30 − 59, 60 − 90 and >90, respectively. Hypertension and aging in both sexes and atherogenic factor in males directly, and in females, directly and indirectly, had decreasing effects on GFR. Blood urea nitrogen and smoking in male and female, directly or indirectly through other variables, were associated with a lower GFR. In females, diabetes had a direct and indirect decreasing effect on GFR. Obesity in females was directly associated with upper and indirectly associated with lower GFR.ConclusionAccording to our results, aging, hypertension, diabetes, obesity, high lipid profile, and BUN had a decreasing direct and indirect effect on GFR. Although low GFR might have different reasons, our findings, are in line with other reports and provide more detailed information about important risk factors of low GFR. Public awareness of such factors can improve practice of positive health behaviors.

Factors Associated with Frailty Syndrome in Older Adults.

Frailty is a common geriatric syndrome, characterized by a decrease in energy reserve and stress resistance, resulting in an accumulated decline of multiple physiological systems and greater vulnerability. Frailty syndrome has a multifactorial etiology involving a biological basis associated with sociobehavioral factors. We verify the association of frailty syndrome with family functionality level, nutritional status and medication adherence in older adults. Observational and analytical study. Conducted at ambulatory the university hospital, with patients aged 60 years or older. Cognitive function was measured using the Mini-Mental State Examination (MMSE); nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and Body Mass Index, BMI; the 5-item FRAIL scale was used for frailty screening; family functioning was assessed using the Family APGAR Index, which evaluates Adaptability, Partnership, Growth, Affection, and Resolve; Self-reported medication adherence was measured by the eight-item Morisky Medication Adherence Scale (MMAS-8). The study involved 308 older adults, with a mean age of 70.40 years, There was an association between frailty and highly dysfunctional family with an OR of 5.9 (95% CI 1.9-18.5)(p<0.05), nutritional risk assessed by BMI, where low weight presented an OR of 2.5 (95% CI 1.1-5.8) and obesity an OR of 2.8 (95% CI 1.1-7.0)(P <0.05) and a nutritional risk assessed by MNA with an OR 6.3(95% CI 1.9-20.4) and low medication adherence with an OR of 8.9 (95% CI, 3.6-21.6)(P = 0.01). Frailty syndrome is associated with high levels of family dysfunction, nutritional risk and poor medication adherence amongst older people.

Marked increase in community-associated methicillin-resistant Staphylococcus aureus infections, Western Australia, 2004-2018.

This study presents enhanced surveillance data from 2004 to 2018 for all community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) specimens collected in Western Australia (WA), and describes the changing epidemiology over this period. A total of 57 557 cases were reviewed. Annual incidence rates increased from 86.2 cases per 100 000 population to 245.6 per 100 000 population (IRR = 2.9, CI95 2.7-3.0). The proportion of isolates carrying Panton-Valentine leucocidin (PVL)-associated genes increased from 3.4% to 59.8% (χ2 test for trend 7021.9, P < 0.001). The emergence of PVL-positive, 'Queensland CA-MRSA' (ST93-IV) and 'WA 121' (ST5-IV) accounted for the majority of increases in CA-MRSA across the study period. It is unclear why some clones are more prolific in certain regions. In WA, CA-MRSA rates increase as indices of temperature and humidity increase after controlling for socioeconomic disadvantage. We suggest climatic conditions may contribute to transmission, along with other socio-behavioural factors. A better understanding of the ability for certain clones to form ecological niches and cause outbreaks is required.

Characterization of Sedentary Behavior in Heart Failure Patients With Arthritis.

BackgroundArthritis is one of the most common comorbidities in heart failure (HF) patients, and is associated with decreased activity levels. Few studies have examined sedentary behavior (SB) in HF patients with arthritis, and little is known about the factors that may influence SB in this population.MethodsThis is a retrospective, secondary analysis using data collected from a randomized control trial. SB was measured by the daily sedentary time collected by accelerometers. Structural equation modeling was performed to examine relationships between key concepts based on social cognitive theory, and elucidate the potential pathways by which demographic, clinical and sociobehavioral factors that influence SB.ResultsA total of 101 participants’ data were used for this analysis. Participants were mainly female (n = 64, 63%) with a mean age of 70 years (standard deviation (SD) = 12.2) and an average of 13 years of education (SD = 2.3). SB was highly prevalent at baseline (mean value: 21.0 h/day), 3 months (mean value: 20.6 h/day) and 6 months (mean value: 20.8 h/day) in study participants. Factors with statistically significant positive association with sedentary time include age and retirement, while significant negative association was found with current employment. HF self-care efficacy and behavior were also significantly associated with SB.ConclusionsMost HF patients with arthritis in this study lived a sedentary lifestyle. Additional studies are needed to identify feasible and effective exercise programs for HF participants with arthritis.

Disparities in Caries Experience and Socio-Behavioural Risk Indicators Among Private School Children in Lagos, Nigeria

Objective: To determine the prevalence and socio-behavioural risk factors for dental caries among children at selected LGAs in Lagos State. Material and Methods: This was a descriptive study of 592 school children in four Local Government Areas of Lagos, Nigeria. The presence of caries was recorded using the World Health Organization criteria. Descriptive statistics were reported for analysis of comparative DMFT and SiC scores in relation to age, gender, and other socio-demographic variables. Logistic regression analysis was used to analyze the differential impact of the variables on the probability of being in the high caries prevalence group . Results: The prevalence of dental caries was 16.0% with mean dmft for age 6 being 1.3 ± 1.57 while the mean DMFT for age 12 was 0.15 ± 0.67. The mean Sic for age 6 was 1.5 ± 0.53 while the mean SiC for age 12 was 1.09 ± 0.29. The mean SiC values was significantly higher in the primary and permanent dentition among those who had never visited the dentist, female students, those who don’t use fluoridated toothpaste and those who eat sweets and candy several times a day. After logistic regression analysis, those with no previous dental visit (OR=3.05; CI: 1.72-4.67) and females (OR=1.55; CI: 1.16-1.62) still had significantly higher SiC Values . Conclusion: The prevalence of caries was low in the study population. Being female, non-use of fluoride-containing toothpaste and not visiting the dentist were significant predictors of dental caries among children attending private schools.

High Prevalence of Prehypertension and its Association with Modifiable Risk Factors: Findings of Household STEPS Survey from Urban Puducherry, South India.

Background:Prehypertension increases the likelihood of hypertension, cardiovascular diseases, and renal failure, and it is amenable to control if it is detected early. The burden of prehypertension prevalent in the community is not much explored. This study aimed to estimate the prevalence and to identify the socio-behavioral and dietary factors related to prehypertension in South India.Methods:A community-based cross-sectional study was carried out where data related to socio-demographic status, substance use, dietary patterns, physical activity, and associated comorbidities were assessed using the WHO STEPwise survey tool. Adults aged >=18 years who were not previously diagnosed and treated for hypertension were assessed for prehypertension. Prevalence of prehypertension is reported as percentage with 95% CI. Association was reported as adjusted prevalence ratio obtained through multivariable log binomial regression adjusted for potential confounders.Results:Among 2399 participants, 2213 underwent screening. Among 2213 adults, 810 (36.6%, 95% CI: 34.6–38.6%) were in the prehypertension range. The adjusted prevalence for prehypertension was 36.2% among males and 37.2% among females, respectively. Being in the age group of 45–54 years aPR-1.36, body mass index (BMI) >23 Kg/m2 aPR-1.25, consumption of more than 6 grams of salt per day aPR-1.15 times were more likely to be associated with prehypertension. The comorbid conditions such as diabetes are less likely to be associated with prehypertension aPR-0.54 (0.41–0.72).Conclusions:This community-based surveillance showed 36% of prehypertension among adults which would have been missed if we were to follow the routine cares such as opportunistic and high-risk-based screening. Since prehypertension increases the risk for various end organ failures, there is an impending need to focus on screening and promote healthy lifestyles.